[Prevalence of intra abdominal injuries due to penetrating trauma in Gorgan, Iran [2002-07]]

Trauma is the most common cause of death in all individuals between 1 and 44 years and the third most common cause of death regardless of age. The abdomen is the third most commonly injured region of the body. Some intra abdominal organ injured more than others, related to mechanism of injury, size and location of organ in abdominal cavity. This study was carried out to determine the prevalence of intra abdominal injuries due to penetrating trauma. This retrospective descriptive study was done on 114 patients admitted to 5 Azar hospital in Gorgan, Iran due to penetrating abdominal trauma during 2002-07. Gender, age, type of injury causes of trauma and hospitlalization period were obtained form patients files. 92.1% of patients were male. The mean age of subjects was 24.8 years [9-70 years] with highest frequency between 20-24 years. Two [1.8%] deaths directly related to abdominal stab wounds related to hemorrhagic shock. The most common cause of penetrating abdominal injury was knife wound [78.9%]. The mean time spent in hospital was 4.6 +/- 2.8 days. In 53 patients, cause of trauma were either related to pentration into peritoneum or passing through in. Small intestine injuries [14%], rupture of diaphragm and concurrent lung injuries [7%] were the common damage organs. This study showed that the knife was the main cause of abdominal penetrate trauma and peritoneum was the most common damage tissue

Antipyretic efficacy of acetaminophen and ibuprofen in children aged 6 months to 10 years

Fever and consequent convulsion are among major concerns for parents of febrile children. Many antipyretic drugs are applied excessively to decrease ever in children. Many antipyretic drugs are applied excessively to decrease fever in children. This research is designed to study the efficacy and stability effects of cetaminophen and Ibuprofen in febrile children aged 6 months to 10 years old. This single-blind clinical trial study was performed on 390 children [aged 6 months to 10 years] referring to pediatric emergency department. The cases were divided equally and randomly into two groups, allocated to receive either 15 mg/kg Acetaminophen or 10mg/kg Ibuprofen. Including criteria was oral temperature of 38-40 degrees centigrade or rectal temperature of 38.5-40.5 degrees centigrade. Temperatures were recorded at the time of admission, 2, 4 and 6 hours after receiving antipyretic drug. Data was analyzed by SPSS software. T-tests and chi-square test were used for statistical comparisons. Findings revealed that mean temperatures on admission were 39.01 +/- 0.7 degrees centigrade and 39.03 +/- 0.69 degrees centigrade in the Acetaminophen and Ibuprofen groups, respectively, showing no significant difference. Mean temperatures at 2 hours after initiation of treatment in Acetaminophen and Ibruprofen groups were 38.78 +/- 0.92 degrees centigrade and 37.25 +/- 0.78 degrees centigrade, respectively [P<0.0001]. After 6 hours, the temperatures were 37.36 +/- 0.92 degrees centigrade and 36.99 +/- 0.05 degrees centigrade [P<0.002]. Overall, stability of antipyretic effect of Ibuprofen was more than Acetaminophen. Results indicate that Ibruporfen is more effective than Acetaminophen in maximum decline in temperature and its stability in lowering temperature is better than Acetaminophen. It is suggested that Ibruprofen be used as an antipyretic in children older than 6 months when Acetaminophen cannot control fever or more stable antipyretic is expected

Flowcytometric evaluation of antibodies against histocompatibility antigens and platelet-specific antigens in patients with hematological disorders following the transfusion of platelets concentrates

Blood transfusion may lead to the manifestation of anti-HLA and platelet-specific antibodies that may in turn bring about different problems like platelet refractoriness. It appears that the study of antibodies against HLA-Class I and platelet-specific antigens are useful for the selection and success of the appropriate treatment protocol. The aim of this study was to detect anti-HLA and anti-platelet-specific antibodies by flowcytometry in patients with hematologic disorders [including Acute Leukemia, Aplastic Anemia] and patients with ITP. In this descriptive study, anti-HLA and platelet-specific antibodies were detected by flowcytometric technique, using 62 sera drawn from patients with different hematological disorders who showed a poor response to platelet transfusion and 20 from patients with ITP. The results of anti-HLA antibodies were then compared by Panel Reactive Antibodies [PRA]. Our results showed 44 [53.7%] out of 82 patients had anti-HLA Class-I antibodies in their sera. The frequency of each antibody isotype was found to be as follows: IgM [51.2%], IgG [32.9%] and IgA [1.2%]. 36 [43.9%] out of 82 patients had platelet specific antibodies and the frequency of each antibody isotype was found to be as follows: IgM [40.2%], IgG [30.5%] and IgA [12.2%]. 27 [31.7%] out of 82 patients had both antibodies. No difference was found between the two groups in platelet specific antibodies. Despite significant correlation between flowcytometry and PRA methods, PRA can only detect antibodies which react with complement. With increase in the number of platelet transfusion, immunization to HLA antigens occures; moreover, immunization against platelet specific antigens may also occure during autoimmunity. The presence of these antibodies may be one of the reasons of poor response to platelet transfusion and platelet refractoriness in patients under study. Conducting similar studies with higher number of samples, platelet cross-match, and the use of HLA- matched platelets for these patients are recommended