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@#Objective: During the COVID-19, Telehealth attention and use have been increased in all medical fields. We decided to share our experience on the Sabatavan platform in a Psychiatric Hospital. Methods: One patient diagnosed with schizophrenia spectrum disorder and depression participated 4 sessions in the Sabatavan platform and mental status examination, diagnosis, medication dose adjustment, and psychoeducation about conditions and medication performed through the psychiatrist's Sabatavan platform. Results: According to our experience, Telepsychiatry was some benefits, such as the possibility of more communication between the therapists and patient, easy use of both patient and clinicians, more Accessibility of the patients and their families to psycho educational data. Lack of Tele pharmacy to change or renew the drug prescription and the impossibility of comprehensive examination and documentation of the patient's progress and changes, and lack of standard and official guidelines is challenging for Tele psychiatry. Conclusion: Telepsychiatry is an excellent mechanism for providing high-level care to physicians and psychiatrists in Iran.
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@#Background & Objective: This study aimed to find a biomarker to predict the development of multiple sclerosis (MS). Serum levels of vitamin D3, C-reactive protein (CRP) and melatonin and their ratio were evaluated to find the valuable cut-off point. Methods: Serum levels of vitamin D3, CRP and melatonin were evaluated using commercial ELISA kit in newly diagnosed MS patients and compared with healthy controls. Results: Serum CRP level significantly increased and serum melatonin level significantly decreased in MS patients in comparison to controls. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the cut-off point of CRP/melatonin ratio ≥ 78.29087 were 80%. Conclusion: CRP/melatonin ratio ≥ 78.29087 may be used for prediction of MS in an at risk population
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Background: The aim of present study was to clarify the role of the peroxisome proliferator-activated receptor [PPAR] gamma Pro12Ala and C161T polymorphisms in the pathogenesis of polycystic ovary syndrome [PCOS] and their influence on lipid and lipoprotein profiles of patients
Materials and Methods: The present cross-sectional study consisted of 50 women with PCOS, who referred to the Kermanshah University of Medical Sciences Clinic between April and October 2015, and 233 unrelated age-matched healthy women from the same region [West Iran]. The PPAR gamma Pro12Ala and PPAR gamma C161T polymorphisms were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Fasting blood sugar [FBS], serum triglycerides [TG], cholesterol, low density lipoprotein- cholesterol [LDL-C], high density lipoprotein- cholesterol [HDL-C] and estradiol levels were measured
Results: The serum level of estradiol was significantly lower in PCOS patients compared to healthy women. The PPAR gamma Pro12Ala [CG] genotype increased the risk of PCOS 2.96-fold. The frequency of the PPAR gamma T allele [at C161T] was 21% in patients and 17.2% in controls with no significant difference [P=0.52]. In all studied individuals, the PPARgamma CG genotype was associated with significantly higher levels of TG. However, significantly lower levels of total cholesterol and LDL-C were observed in PPAR gamma TT individuals compared with those with the CC genotype. Within the PCOS group, the PPAR gamma CG genotype was significantly associated with lower levels of estradiol compared with the CC genotype. Also, the CG genotype was significantly associated with higher levels of TG when compared with the CC genotype
Conclusion: Our study shows that, unlike PPAR gamma C161T, PPAR gamma Pro12Ala is associated with the risk of PCOS. Also, we found that the lipid and lipoprotein profiles significantly vary based on PPAR gamma Pro12Ala and C161T genotypes
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BACKGROUND: This study aimed to assess the effects of the topical application of tamoxifen on wound healing of burned skin in Wistar rats by evaluating 3 healing characteristics: fibrotic tissue thickness (FTT), scar surface area (SSA), and angiogenesis in the healed scar tissue. METHODS: Eighteen male Wistar rats were used in this study. A third-degree burn wound was made on the shaved animals’ back, measuring 2×2×2 cm. In the first group, a 2% tamoxifen ointment was applied to the wound twice daily for 8 weeks. The second group received a placebo ointment during the same period. The third group did not receive any treatment and served as the control group. RESULTS: The median (interquartile range=[Q1, Q3]) FTT was 1.35 (1.15, 1.62) mm, 1.00 (0.95, 1.02) mm, and 1.25 (0.8, 1.5) mm in the control, tamoxifen, and placebo groups, respectively (P=0.069). However, the FTT in the tamoxifen group was less than in the placebo and control groups. The median angiogenesis was 3.5 (3.00, 6.25), 8.00 (6.75, 9.25), and 7.00 (5.50, 8.25) vessels per high-power field for the control, tamoxifen, and placebo groups, respectively (P=0.067). However, the median angiogenesis was higher in the tamoxifen group than in the control group. No significant difference was observed in the mean SSA between the tamoxifen group and the control group (P=0.990). CONCLUSIONS: Local application of tamoxifen increased angiogenesis and decreased the FTT, with no change in the SSA in burned skin areas. These effects are expected to expedite the wound healing process, reducing contracture and preventing hypertrophic scar and keloid formation.
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Animais , Humanos , Masculino , Ratos , Queimaduras , Cicatriz , Cicatriz Hipertrófica , Contratura , Queloide , Ratos Wistar , Pele , Tamoxifeno , Cicatrização , Ferimentos e LesõesRESUMO
BACKGROUND: This study aimed to assess the effects of the topical application of tamoxifen on wound healing of burned skin in Wistar rats by evaluating 3 healing characteristics: fibrotic tissue thickness (FTT), scar surface area (SSA), and angiogenesis in the healed scar tissue. METHODS: Eighteen male Wistar rats were used in this study. A third-degree burn wound was made on the shaved animals’ back, measuring 2×2×2 cm. In the first group, a 2% tamoxifen ointment was applied to the wound twice daily for 8 weeks. The second group received a placebo ointment during the same period. The third group did not receive any treatment and served as the control group. RESULTS: The median (interquartile range=[Q1, Q3]) FTT was 1.35 (1.15, 1.62) mm, 1.00 (0.95, 1.02) mm, and 1.25 (0.8, 1.5) mm in the control, tamoxifen, and placebo groups, respectively (P=0.069). However, the FTT in the tamoxifen group was less than in the placebo and control groups. The median angiogenesis was 3.5 (3.00, 6.25), 8.00 (6.75, 9.25), and 7.00 (5.50, 8.25) vessels per high-power field for the control, tamoxifen, and placebo groups, respectively (P=0.067). However, the median angiogenesis was higher in the tamoxifen group than in the control group. No significant difference was observed in the mean SSA between the tamoxifen group and the control group (P=0.990). CONCLUSIONS: Local application of tamoxifen increased angiogenesis and decreased the FTT, with no change in the SSA in burned skin areas. These effects are expected to expedite the wound healing process, reducing contracture and preventing hypertrophic scar and keloid formation.
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Animais , Humanos , Masculino , Ratos , Queimaduras , Cicatriz , Cicatriz Hipertrófica , Contratura , Queloide , Ratos Wistar , Pele , Tamoxifeno , Cicatrização , Ferimentos e LesõesRESUMO
Background: In recent decades neoadjuvant therapies such as combined chemotherapy and radiotherapy have been introduced for cancer management. Compared with monotherapy modalities, neoadjuvant therapy is associated with greater effectiveness while having minor side effects. Docetaxel is a chemotherapy agent for breast cancer treatment which can blocks the cell cycle at the G2/M phase which has shown special sensitivity to the ionizing radiation and hence causes cell death. To the best of our knowledge, there are currently no reports that explore the synergistic effects of Docetaxel and ionizing radiation on MCF-7 cancer cell death. Methods: We divided cells into four different groups; control, cells which got in touch with Docetaxel, cells that with exposure to radiotherapy and cells which were influenced with combination of Docetaxel and radiotherapy. In vitro cell viability tests were done at different concentration of Docetaxel and different dose of radiation for 24, 48 and 72 h after the experiment. Results: Results showed that the cytotoxicity was depending on the doses of radiation and Docetaxel. Radiation at 2 Gy dose was unable to produce significant effects neither in the radiation-only nor in the neoadjuvant therapy groups. However, the synergistic effects of neoadjuvant therapy were apparent at 4 and 6 Gy doses of radiation which could exert more significant cytotoxic effects on MCF-7 cells. Conclusions: Study findings suggest that neoadjuvant therapy by using Docetaxel and 4 and 6 Gy ionizing radiation has synergistic effects on MCF-7 cell death and produces more significant results compared with monotherapy modalities (AU)
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Humanos , Neoplasias da Mama/tratamento farmacológico , Terapia Neoadjuvante , Citotoxicidade Imunológica , Quimiorradioterapia , Radiação IonizanteRESUMO
Encouraging an active lifestyle is an essential part of successful rehabilitation programs, and the link between physical activity and quality of life [QOL] is well established among patients with mobility disorders. Biomechanical aspects of wheelchair design play an important role in physical activity and social participation of disabled individuals. This review focuses on key biomechanical features of wheeled mobility devices including propulsion methods, overuse injuries, assistive technologies, prevention of pressure ulcers, and tire and frame design. We briefly review the role of design modifications in increasing the physical activity and improvement of QOL among wheelchair-bound adults
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Objectives: Interleukin [IL]-33 is a cytokine with both pro- and anti-inflammatory effects involved in the pathogenesis of some inflammatory diseases. The purpose of this investigation was to evaluate the serum and cerebrospinal fluid [CSF] IL-33 concentrations in patients with multiple sclerosis [MS]
Methods: Blood specimens were obtained from 140 patients with MS [46 males and 94 females] with various disease patterns and treatment plans and 140 healthy subjects [47 males and 93 females], who acted as a control group. CSF samples were collected from 20 MS group and 20 sex- and agematched patients with other neurological diseases of nonautoimmune etiology. The serum and CSF concentrations of IL-33 were measured by the enzyme-linked immunosorbent assay
Results: The serum and CSF IL-33 levels were significantly higher in the MS group compared to the control group [p<0.001 and p<0.050, respectively]. The serum IL-33 concentrations were also significantly higher in newly diagnosed [untreated] patients and patients treated with methylprednisolone or with interferon-beta and methylprednisolone compared to the healthy patient group [p<0.007, p<0.002, and p<0.010, respectively]. Moreover, the serum IL-33 concentrations in patients with relapsing-remitting [RRMS], primary progressive [PPMS], and secondary progressive [SPMS] forms of the disease were significantly higher than in the healthy control group [p<0.006, p<0.001, and p<0.020, respectively]
Conclusions: Our results showed increased concentrations of IL-33 in patients with MS including both untreated and treated MS patients and patients with the RRMS, SPMS, and PPMS forms. This suggests that IL-33 may be involved in the pathogenesis of all MS forms and treatment with methylprednisolone or both interferon-beta plus methylprednisolone has no influence on IL-33 concentrations
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<p><b>OBJECTIVE</b>To examine the relaxant effects of hydro-ethanolic, macerated aqueous (MA) and lipidfree macerated aqueous (LFMA) extract of Tymus vulgaris on tracheal chains of guinea pigs.</p><p><b>METHODS</b>The relaxant effects of five cumulative concentrations of each extract (0.4, 0.8, 1.2, 1.6 and 2.0 g/100 mL) were compared with saline as negative control and five cumulative concentrations of theophylline (0.1, 0.2, 0.4, 0.6 and 0.8 mmol/L) on precontracted tracheal smooth muscle of guinea pig with 60 mmol/L KCl (group 1) and 10 µmol/L methacholine (group 2, n=6 for each group).</p><p><b>RESULTS</b>In group 1 all concentrations of theophylline, three higher concentrations of hydro-ethanolic, two concentrations of LFMA and last concentration of MA extracts showed significant relaxant effects compared with that of saline (P<0.05 or P<0.01). Two lower concentrations of LFMA and all concentrations of MA except higher one caused contraction compared with saline (P<0.05 or 0.01). In group 2 experiments, all concentrations of theophylline, hydro-ethanolic, MA and LFMA extracts showed significant relaxant effects compared to that of saline (P<0.05 or P<0.01). In both groups, the relaxant effect of all concentrations of hydro-ethanolic extract were significantly higher than most concentrations of others (P<0.05 or P<0.01). The relaxant effect of different concentrations of three extracts were significantly greater in group 2 compared with group 1 experiments (all P<0.01). There were significantly positive correlations between the relaxant effects and concentrations for theophylline and all extracts in both groups (P<0.05 or P<0.01).</p><p><b>CONCLUSION</b>Hydro-ethanolic extract has a potent weaker relaxant effect for other extracts from Tymus vulgaris on tracheal chains of guinea pigs.</p>
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Animais , Broncodilatadores , Farmacologia , Cobaias , Técnicas In Vitro , Lamiaceae , Química , Lipídeos , Química , Relaxamento Muscular , Músculo Liso , Fisiologia , Extratos Vegetais , Farmacologia , Solubilidade , Soluções , Teofilina , Traqueia , Fisiologia , Água , QuímicaRESUMO
Statement of the Problem: Tonsilloliths are relatively common clusters of dystrophic calcified material that form in the tonsillar crypts, mostly the palatine tonsils. Although they may be asymptomatic, some cause halitosis, cough, dysphagia, and foreign body sensation, as well as otalgia. Since tonsilloliths can be detected on panoramic views as radiopaque lesions, and misdiagnosis may lead to wasting time and cost, dentist should be familiar with radiographic characteristics of this type of calcification.
Purpose: This study was conducted to determine the prevalence and the pattern of distribution of tonsilloliths on panoramic radiographs.
Materials and Method: This cross-sectional study was based on 2000 panoramic radiographs from 1030 female and 970 male aged 6-75 years old evaluated for the presence and pattern of tonsillolithiasis, between 2011 and 2013 in Shiraz, Iran. Chi- square test and odds ratio were used to evaluate the relationship between tonsillolithiasis and gender. p< 0.05 was considered as statistically significant
Results: Out of the 2000 individuals, 101 cases [5.05%] had tonsilloliths on panoramic radiographs out of which 61 were male [60.4%] and 40 were female [39.6%], with age range of 18 to 65. Forty patients [39.6%] had both left and right sides involved, 25 of tonsilloliths [24.75%] were located on the right and 36 on the left side [35.65%]. Men were more likely to develop tonsilloliths [p= 0.014]
Conclusion: Tonsilloliths are not very common finding and can be detected on nearly 5.05% of panoramic radiographs. Most of the cases are unilateral with a diameter less than 2mm
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Background: CCL22 is a chemokine that induces the migration of Th2- and regulatory T cells to the inflammatory sites. The aim of this study was to investigate the association of a single nucleotide polymorphism [SNP], rs4359426, in CCL22 gene, with multiple sclerosis [MS] in patients from southeast of Iran
Materials and Methods: the blood samples collected from 150 patients with MS and 150 healthy subjects as a control group. The serum levels of CCL20 measured by ELISA and the DNA analyzed for CCL22 polymorphism using PCR-RFLP method
Results: there were no significant differences in the frequencies of genotypes and alleles at SNP rs4359426 in CCL22 gene between MS patients and controls. No significant differences also observed between controls and patients with RRMS, SPMS, PPMS and PRMS patterns regarding the genetic variation of rs4359426. In both MS and control groups, no significant differences were observed between subjects with CC, CA and AA genotypes or between subjects with C and A alleles concerning rs4359426 with respect to the serum levels of CCL22
Conclusion: these results do not show any association between the investigated genotypes and alleles at rs4359426 in CCL22 gene with MS or its patterns in MS patients. The serum levels of chemokine did not also influence by genetic variation of SNP rs4359426
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Multiple sclerosis [MS] is a chronic disease of the nervous system, the cause of which remains unknown. Its prevalence rate has been estimated at 2.5 million individuals across the globe, and 31.5 individuals per 100,000 in Kerman province, Iran. Although different studies have reported disparate results, there are many authentic reports claiming that seasonal changes affect MS prevalence in certain months. The present study investigated the rate of MS seizures in terms of different seasons. Patients referring to the Neurology Ward of Shafa medical center, affiliated to Kerman University of Medical Sciences, Iran, were examined in a 5 year period from 2007 to 2011. A specially developed form, containing demographic and background information, and results of examinations, was filled out for each and every patient. A neurology faculty member approved MS seizures or otherwise rejected irrelevant observations. Findings were analyzed through SPSS20 software. In the present study, 802 attacks of MS were detected; 187 cases in men [23.32%] and 615 cases in women [76.68%]. The mean age of the participants was 32.69 years. The highest rate of hospitalization occurred in winter and spring. This finding is mostly related to MS attacks in women, but in men the rate of attacks are equal in different seasons. During the past 5 years, 802 acute cases of multiple were registered [187 cases [23.3%] in men and 615 cases [76.68%] in women]. Most cases occurred in winter and spring, which may be due to seasonal infections or other factors triggered by certain climatic conditions specific to these periods
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<p><b>OBJECTIVES</b>To elucidate the possible ways by which hydroxyurea molecules affect globin chain (α or β-like) synthesis.</p><p><b>METHODS</b>A total of 23 thalassemia intermedia patients (13 male and 10 female) aged between 5 and 26 years were treated for five months with 15 mg/(kg·day) of hydroxyurea. Hemoglobins electrophoresis and globin chain electrophoresis was performed on each sample at different time points before and during the treatment.</p><p><b>RESULTS</b>Fetal hemoglobin increased significantly in most patients and average episodes of transfusion decreased. Both Gγ and Aγ-globin chains increased significantly and α-globin:Nonα-globin chain as well as Gγ-globin:Aγ globin chains ratios decreased.</p><p><b>CONCLUSIONS</b>Improvement in α:non-α ratio and consequent decrease of free α-globin chain might be the cause of beneficial effects of hydroxyurea therapy. Two patients who felt better didn't show significant increase in their fetal hemoglobin level, and this is in contradiction with the hypothesis claiming that the HbF level increase is the cause of such therapeutic effect. In spite of the unclear mechanism of action of this drug, hydroxyurea therapy had noticeable impacts on thalassemia intermedia and also sickle cell disease and even patients suffering from thalassemia major.</p>
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STUDY DESIGN: Prospective study. PURPOSE: We compared the effects of two methods of epidural steroid injection in patients with recurrent disc herniation. OVERVIEW OF LITERATURE: To our knowledge, there is no previous report of such a comparison in these patients. METHODS: The study was performed with 30 patients with relapsed lumbar disc herniation whose pain was not relieved by conservative remedies. The patients were divided into two groups, each of 15 patients, and entered the study for caudal or transforaminal injections. The degree of pain, ability to stand and walk, and the Prolo function score were evaluated in both groups before the injection and 2 months and 6 months after the injection. RESULTS: The degrees of pain reduction in the caudal injection group in the second and sixth months were 0.6 and 1.63, respectively, and in the transforaminal injection group were 1.33 and 1.56, respectively. The difference between the two methods was not statistically significant. Similarly, no other evaluated criterion showed a significant difference between the methods. CONCLUSIONS: In the current study, the caudal and transforaminal steroid injection methods showed similar outcomes in the treatment of relapsed lumbar disc herniation. However, more detailed patient categorizing may help in finding possible subgroups with differences.
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Humanos , Estudos ProspectivosRESUMO
Primary culture takes place following the cell isolation from tissues. Isolation and culture of melanocytes based on their roll in the protection of body against hazardous sun rays, production of skin, cornea and hair color is really important. This study was done to set isolation, culture and proliferation of melanocytes from children foreskin and adult eyelashes, and also comparison of two types of melanocyte culture medium. Human foreskin and eyelash samples were used for melanocyte isolation and culture. After isolation of epidermis from dermis, epidermis cell suspensions were prepared by enzymatic digestion. The isolated cells were cultured in two melanocyte selective culture media. Immunocytochemistary and reverse transcription-polymerase chain reaction [RT-PCR] assays were used for confirmation of isolated and cultured melanocytes. Our results indicated that isolated melanocyte cultured in the selective medium without phorbol esters is better than the melanocytes cultured in selective medium containing phorbol esters not only morphologically but also physiologically and from the aspect of cell adhesion. In addition, the results showed that isolated melanocyte from adult eyelashes are more dendritic than melanocytes isolated from children foreskin. Conversely, our results indicated that the number of cell passages in melanocyte isolated from foreskin is more than melanocytes isolated from adult eyelashes. Melanocytes cultured in selective medium containing convenient growth factors in absence of phorbol esters show more native physiological and adhesive properties. In addition, melanocyte isolated from younger tissues such as foreskin have better proliferative and sub-culturing properties so we suggest isolation and culture of younger tissues.
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Humanos , Técnicas de Cultura , Pele , Ésteres de Forbol , Prepúcio do Pênis , Epiderme , Peptídeos e Proteínas de Sinalização IntercelularRESUMO
Histoid leprosy is one of the rare kinds of lepromatous leprosy with specific clinical pathologic manifestations. It is most commonly observed in patients who have been under long-term single drug therapy with dapsone. Clinical manifestations mostly consist of red papules and nodules and pathologic examination there are spindle like histiocytes. Following acid-fast staining, abundant bacilli can be seen. Significance of these patients is due to their rarity, atypicality of dermal lesions, failure in early diagnosis, and high bacillus load which can be a barrier in the eradication of the disease and act as a potential source of infection in areas where the disease has been eradicated. Our case showed up with plentiful dermal papules and nodules from two years ago which caused no discomfort. He had a history of leprosy 25 years ago and had been treated only with dapsone for 3 years. Therefore, the diagnosis of histoid type lepromatous leprosy was made and confirmed based on clinical and histopathological findings.
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Humanos , Masculino , Histiócitos , Diagnóstico Precoce , Hanseníase Virchowiana/patologia , Mycobacterium leprae/patogenicidade , Dapsona/efeitos adversosRESUMO
Objective: In this study we investigated the epidemiology of MS and some related environmental factors in Kerman province, southeastern Iran. Methods: The MS diagnosis was based on the revised Mc-Donald criteria. The patients were those registered at the Iran MS society, Kerman branch; those in the MS registration centers of Kerman and Rafsanjan University of Medical Sciences, and the Department of Neurology at Shafa Medical Center were studied. Results: The prevalence of MS was 31.5 per 100,000 population in Kerman province, and 57.3 per 100,000 population in Kerman city. The male to female ratio was 1:3. Average age at onset was 28.35 years, and 3.9% of cases were early onset at ≤16 years of age. A linear relationship was observed between prevalence and average environmental temperature as prevalence tended to be lower in areas where the annual average temperature was higher. However, in the town of Shahrbabak which has cold weather, prevalence was low, which might be related to the presence of copper in this area. Average disability was 4.5± 1.9 (4.83 ± 1.9 in men and 4.26 ± 1.8 in women, p=0.0035) on the Kurtzke Disability Status Scale. The mean duration of illness was 8.2 ± 1 year. Almost all patients in this study used beta-interferon for a period of at least 4 years. Conclusion: The prevalence of MS in Kerman province was 31.5 per 100,000 people. A linear relationship between an increase in prevalence and low average temperature was observed. Copper may have a preventive effect.
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To obtain more accurate epidemiological data of non-melanoma skin cancers [NMSC]. This descriptive and analytical study was conducted amongst 133 patients pathologically documented as NMSC at Hajdaie Dermatological Clinic in Kermanshah, Iran, during 2009-10. In addition, specific findings such as type, location and number of the lesions, associated and underlying disorders were recorded. Statistical analysis was performed using SPSS version 16. Chi-square was used to compare the qualitative data. P-value <0.05 was considered statistically significant. A total of 133 patients with 235 lesions, and their age ranging between 25 and 97 years were enrolled in this study. The ratio of basal cell carcinoma [BCC] to squamous cell carcinoma [SCC] was 7.3/1. NMSC are mostly seen as facial solitary lesions in outdoor workers and the people with moderate brown skin. However, no difference was found in its prevalence between males and females or residents of urban and rural areas. Familial and personal history and host susceptibility played no important role in our patients either [P value >0.05]. Solar keratosis was the most common associated skin lesion. NMSC was seen slightly more common in males. BCC was considerably more common than SCC in this study. All obtained indices were practically consistent with previous reports. Besides, ultraviolet light was still the most important factor for NMSC induction in our area
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This article sought to review and compare data of major earthquakes of the past decade and their aftermath in order to compare the magnitude, death toll, type of injuries, management procedures, extent of destruction and effectiveness of relief efforts. A retrospective study of the various aspects of management and / aftermath of 5 major earthquakes of the past decade [2000-2010] was undertaken. This included earthquakes occurring in Bam Iran, Sichuan China, Port-au-Prince Haiti, Kashmir Pakistan and lea Peru. A literature search was done via computer of published articles [indexed in Pubmed]. The issues assessed included: l]Local magnitude,2] Type of building structure 3]Time of the earthquake [day/time/season], 4]Time to rescue, 5] Triage, Transfer, and Treatment 6] Distribution of casualties [dead/ injured], 7]Degree of city damage, 8]Degree of damage to health facilities, 9] Field hospital availability, 10International aid, 11] Air transfer, 12] Telecommunication systems availability, 13] PTSD prevalence, 14] Most common injury and 15] Most common disease outbreak. The Bam earthquake had the lowest [6.6 Richter's] and the Sichuan earthquake had the greatest magnitude [8.0 Richter's]. Mortality in Haiti was 212,000 and it was the deadliest earthquake of the past decade. Collapse of heavy clay roofing structures was a major cause, of death in Iran and Pakistan. Earthquakes occurring at night and nonworking days carried a high death toll. The time to rescue and treat was the lengthiest in Haiti [possibly contributing to the death to injured ratio]. However, the worst dead to injured ratios were in Bam]51%] and in Pakistan [47%]; the best ratio was in China [15%]. Iran and Pakistan suffered the highest percentage of damage to the health facilities [90%]. Field hospital availability, international aid and air transfer were important issues. Telecommunication systems were best in China and worst in Pakistan. PTSD prevalence was highest in Iran. Respiratory infection was the most common infection following all 5 earthquakes. Earthquake damage, death toll, managerial protocols etc. vary in different countries and are influenced by many factors including the hour the earthquake hits and the day of the week. Additionally, social, structural and geographic factors as well as the medical, governmental and NGO respondents are influential. Engineered residential construction remains to be of importance in reducing mortality in developing countries. It is essential that hospitals, fire departments and police stations, water, telephone and electrical facilities be made earthquake proof
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Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debride-ment and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention