Case Report: geographic information system for timely search and rescue operation: a case study in Rigan earthquake

Background: Short golden time is important to save the injured in earthquake and to start search and rescue [SAR] operation as soon as possible in affected regions. This study evaluated application of geographic information system [GIS] for SAR operation in Rigan Town, Kerman Province, which was hit by an earthquake of 6.3 Richter scale on December 12, 2010 at 22:12

Materials and Methods: A GIS-based decision-making system with 99 information layers was used to manage the operations in this earthquake. Decisions were made by using available information layers and a proportional scenario. The scenario was designed based on depth and intensity of the earthquake. All residential areas within the radius of 20 km from the epicenter were defined in emergency operation center [EOC] to be considered by SAR teams. Accordingly, SAR teams were called and dispatched to the affected area quickly. They were guiding using radio navigation

Results: The subsequent assessment on 25, 30, and 40 km buffers showed that there was no need to increase the field of search and rescue. Field managers were supported with provided information about affected people and villages, structural context of buildings, distribution of operational equipments, manpower, resources, and access roads. All of this updated information was provided by designed GIS

Conclusion: Although the earthquake happened at 22:12 in a rural region with scattered population and 250 km far from decision-making center, the search and rescue operation was completed in the shortest possible time at 2:30 morning, next day

influence of lateral and supine position on bacterial colonization of endotracheal tube in neonates admitted to neonatal intensive care unit

Recent data suggest that during mechanical ventilation, lateral patient position [in which the endotracheal tube is horizontal] decreases the incidence of bacterial colonization of ventilated neonates. The objective of this study was to evaluate the influence of lateral and supine position on bacterial colonization of endotracheal tube in neonates. We conducted a prospective, randomized, clinical trial with 31 intubated neonates [intubated within 48 hours after birth]; sixteen neonates were positioned supine [supine group], and fifteen were maintained in the lateral position [lateral group].Tracheal aspirates were cultured in second and fifth days of mechanical ventilation. Data were analyzed with SPSS version 16. In the second day of ventilation, positive cultures were recognized in 6.2% of supine group and 6.7% of lateral group. After 5 days, tracheal cultures were positive in 25% [4 neonates] of supine group and 13.3% [2 neonates] of lateral group that wasn't statistically significant [P=0.9 in second day and P=0.9 in the fifth day]. The most common organisms isolated from tracheal aspirates were Gram-negative rods [Klebsiella]. Since respiratory contamination is very common among ventilated neonates and the effect of lateral position on bacterial colonization of endotracheal tubes of intubated neonates wasn't established in our study, further studies are required to suggest ways to decrease bacterial colonization of intubated neonates

The prevalence of polycystic ovary syndrome [PCOS] in high school students in Rasht in 2009 according to NIH criteria

Polycystic ovary syndrome [PCOS] is the most common endocrine disorder in women associated with many reproductive, endocrine, metabolic and cardiovascular dysfunctions. This study aimed to determine the prevalence of PCOS among high school students in Rasht. In a cross-sectional study, 1850 students were selected by a multi-stage cluster sampling from all high schools in Rasht. The inclusion criteria were: age 17-18 years, menarche from 10-16 years, normal prolactin and thyroid stimulating hormone [TSH] values, no history of anatomical malformation, no use of medication or hair-removal techniques, and a history of oligo- or amenorrhea. PCOS was diagnosed if both menstrual dysfunction and clinical hyperandrogenism were detected. Mean age of subjects was 17.2 +/- 0.7 years and the age of menarche was 12.8 +/- 0.9 years. Of all students, 378 [20.4%] had oligomenorrhea and PCOS was diagnosed in 210 [11.34%] according to the National Institute of Health [NIH] definition. PCOS subjects, mean body mass index [BMI], waist circumference, and waist/hip [W/H] ratio were 21.1 +/- 3.6, 73.4 +/- 8.0 cm and 0.77 +/- 0.05, respectively. A family history of diabetes mellitus type 2 was reported in 24.7% of subjects. The prevalence of PCOS in this study was similar to the international estimates of 10-20% in Caucasians. A long-term follow-up is needed to compare the accuracy of clinical determination of the disease versus diagnosis based on hormonal and/or sonographic assessments

Reconstructive metroplastic myomectomy of an infertile woman

While myoma is the most common pelvic mass of women, most women do not seek screening tests for uterine myoma and if they have any fibroid they are not volunteer for its surgical removal. Case: We present here a novel technique of vascular skeletonization to preserve uterus, making pregnancy possible for an infertile woman with a large uterine myoma, situated in the uterine lower segment. Vascular skeletonization to preserve vessels for a case of myomectomy helped preserve the patient's ability to conceive

Cord compression due to extramedullary hematopoiesis in two patients of beta -thalassemia intermedia

Thalassemia is the most important hemoglobinopathy in Khuzestan province. Thalassemia intermedia [TI] is a genetically heterogenous disease and can result from many different genetic lesions. We report two cases of TI-EMH caused by two separate mechanism and their successful management. Magnetic Resonance Imaging [MRI] is the best diagnostic method in these cases. Management can be done via: Transfusion therapy, Radiotherapy, Hydroxyurea [HU], and Surgery. A 17 years old girl with beta-TI previously asymptomatic presented with back pain and leg weakness which started one month ago. The other patient was 25 years old man referred to hospital with back pain, paresthesia, urine frequency and impairment of gait. In the first case the cause of cord compression was the osseous expansion while in the second patient it was related to soft tissue EMH. First patient was successfully treated with low dose radiotherapy and HU. Radiotherapy was initiated with 200cGY fractions to a total dose of 1600cGY and HU 10mg/kg/day. At the end of radiotherapy, the patient was ambulatory with mild residual weakness. She was regularly followed for two years; at present she is active and asymptomatic. The second patient was successfully treated with low-dose radiotherapy and HU. Radiotherapy was started in 200cGY fractions to a total dose of 1600cGY and HU was given at 10mg/kg/day. At the end of radiotherapy the patient was ambulatory with mild residual weakness. He was regularly followed for six months. At his last visit, he was able to walk and climb stair without any assistance. His neurological examination was much better than before. The most common site of spinal epidural extramedullary hematopoiesis is the posterior aspect in the thoracic spine. EMH can be prevented by regular transfusion therapy which corrects anemia and thereby abolishes the stimulus for EMH. Surgical decompression is the method of choice for the management of EMH because histological diagnosis can be established and immediate decompression of the mass can be achieved. This is especially important to decompress the spinal cord quickly in patients with epidural mass caused by EMH. The disadvantages of surgical intervention include risk of excessive bleeding due to high vascularity of the mass and higher incidence of recurrence. In areas where thalassemia is prevalent, EMH should be considered in the differential diagnosis of patients who have chronic anemia with an intrathoracic mediastinal mass