Diagnostic accuracy of ultrasonography in blunt abdominal trauma

Patients in unstable clinical conditions with blunt abdominal trauma require rapid evaluation of the abdominal organ injury to assess the need for laparatomy. This prospective study was conducted to determine the use of emergency sonography for evaluating patients with blunt abdominal trauma and to compare the accuracy of sonography with the results of diagnostic peritoneal lavage [DPL], exploratory laparatomy and CTscan. Emergency sonography was performed prior to any of the diagnostic methods, peritoneal lavage, exploratory laparatomy and CT, on 204 patients with blunt abdominal trauma. Sonography was performed with the "focused abdominal sonography for trauma" [FAST] technique and six areas of the abdomen were examined to detect free peritoneal fluid. Sonography showed a sensitivity of 95.4%, specificity of 78.4% and an overall accuracy of 89% in the diagnosis of free peritoneal fluid. The positive and negative predictive values of sonography were 89.2% and 90.6%, respectively. Sonography is a reliable and accurate method for the emergency evaluation of blunt abdominal trauma

Consultation-liaison psychiatry in a general hospital

At least one half of all patients who admitted to general hospitals, suffer from psychiatric comorbidities. Management of mental disorders in these patients, significantly, improves the course and outcome of medical diseases. The aim of this survey was to answer the following questions: 1] what is the rate of diagnosable psychiatric symptoms among medical and surgical inpatients? and 2] what proportion of them undergo psychiatric consultation? Three hundred and ninety two patients admitted to medical and surgical wards of Alzahra hospital [Isfahan] from January 2005 until March 2005 were evaluated by the revised form of psychiatric symptoms checklist [SCL-90- R]. The total referral records were also maintained and compared with the data of morbidity. One hundred and fifty six [42.7%] of the evaluated subjects had psychiatric co-morbidities. The most prevalent psychiatric symptoms determined in this group were depression, somatization and anxiety. Only 84 [3%] of these patients had undergone psychiatric consultation. This study demonstrates that many of the patients, who are admitted to general hospitals, may have psychiatric co-morbidities but only a very small percentage of them receive appropriate mental cares