Comparison of ropivacaine and bupivacaine as single-shot epidural anaesthesia for orthopaedic surgery

To compare the efficacy and side-effects of 0.5% ropivacaine with that of 0.5% bupivacaine when used for single-shot epidural anaesthesia for orthopaedic surgery. Randomized controlled trial. Department of Anesthesiology, Combined Military Hospital Rawalpindi, over a period of eight months from June 2013 to January 2014. The study was carried out in 60 ASA physical status I, II or III patients undergoing elective lower extremity orthopedic surgery. Two groups of 30 patients each received single-shot epidural anaesthesia either with ropivacaine 0.5% [ropivacaine group] or bupivacaine 0.5% [bupivacaine group]. Onset, time for maximum height and median height of sensory block was assessed as well as time to two segment recession. Modified Bromage scale was used for motor blockade. Total duration of motor block and common side effects were also recorded. The patients in both groups were similar in age, height, weight, gender and ASA status. There was no significant difference in onset of sensory block and time for maximum height of sensory block. The median heighest level of sensory block was T6 [T5-T8] for ropivacaine group and T5 [T4-T7] for bupivacaine group. Time for two segment regression and duration of sensory block were also comparable for both groups. The total duration of motor block was significantly more in bupivacaine group [159 min vs 134.2 min, p< 0.001]. Modified Bromage scale was also significantly higher in bupivacaine group [2.86 vs 1.96 min, p<0.001]. Side effects like hypotension, bradycardia, nausea, vomiting and shivering were similar in both groups. Epidural administration of 0.5% ropivacaine provided effective and good quality anaesthesia. Motor blockade was of less duration as compared to equivalent dose of 0.5% bupivacaine, which may offer potential benefit of early patient mobilization after orthopaedic surgery

Distal radius fracture; functional outcome in patients with distal radius fracture irrespecitive of radiological deformities

The objective of the study is to find out functional outcome in patients with distal radius fractures irrespective of radiographic deformities after close reduction and cast splint age

Design: Case series study

Setting: Department of Orthopedics and Spine Surgery, Hayatabad Medical Complex Peshawar

Period: May 2010 to April 2015

Materials and Methods: 28 consecutive patients of either sex with age above 40 years, having distal radius fracture. Functional outcome was assessed with disability of arm, shoulder and hand [DASH] and Patient Rated Wrist/Hand Evolution [PRWHE] questionnaire

Results: Out of 28 patients male were 12[42.9%] and female were 16[57.1%]. minimum age was 40 maximum 81 and average was 50. Right side was involved in 17 [60.7%] while left side was involved in 11[39.3%]. The DASH Score Record shows that no Disability was seen in 13[46.4%], Minimal Disability in 7[25%], Mild Disability in 5[17.9%], Moderate Disability in 1[3.6%] and Severe Disability in 2[7.1%] patients. While the PRWHE Score Record shows that no Disability was seen in 14[50%], Minimal Disability in 6[21.4%], Mild Disability in 5[17.9%], Moderate Disability in 1[3.6%] and Severe Disability in 2[7.1%] patients

Conclusion: A majority of the distal radius fractures can achieve good results after treatment by closed reduction and cast immobilization, for which conservative treatment should be the first choice. Deformity of the distal radius cannot affect the functional outcome of the wrist and hand

Traditional bone setters; preference and patronage

Objectives: To evaluate the factors for preferring the traditional bone setters by people

Study Design: Observational study

Setting: Department of Orthopedics and Spine Surgery Hayatabad Medical Complex Peshawar

Period: October, 2013 to March, 2014

Materials and Methods: Sixty consecutive patients who presented at orthopedics out-patient clinic after attending Traditional Bone Setting Centers were recruited for the study. Information about the patients' bio data, mechanism of injury, who advised them to contact TBS and what are the factors that compelled them to attend TBS were obtained and filled into prepared proforma. The data obtained was recorded and analyzed on SPSS version 17

Results: The mean age was 25.57 years with minimum age 5 years and maximum 65 years. Sixteen patients were females and 44 were male. Two [3.3%] patients first attended Modern orthopedic service [MOS] and 58[96.7%] patients attended TBS.47[78.3%] patients were taken by their own immediate family members to TBS, 20% were referred by friends and 1.7% were self-referral. Thirty seven [61.7%] opted for TBS because of their belief, 11[18.3%] considered this service cheap, 7[11.7%] attended it because it is quick service and 5 [8.3%] reverted to TBS because of attitude of hospital personals

Conclusion: A considerable of people still have great trust on TBS regarding management of musculoskeletal problems. Belief is the most leading cause of consulting traditional bonesetters, other causes include low cast, quick service and attitude of hospital personnel

Sliver nanoparticles accelerate skin wound healing in mice [Mus musculus] through suppression of innate immune system

This study aimed to find the effects of silver nanoparticles [Ag-NPs] [40 nm] on skin wound healing in mice Mus musculus when innate immune system has been suppressed. A group of 50 BALB/c mice of about 8 weeks [weighting 24.2 +/- 3.0 g] were randomly divided into two groups: Ag-NPs and control group, each with 25 mice. Once a day at the same time, a volume of 50 microliters from the nanosilver solution [10ppm] was applied to the wound bed in the Ag-NPs group while in the untreated [control] group no nanosilver solution was used but the wound area was washed by a physiological solution. The experiment lasted for 14. Transforming growth factor beta [TGF-beta], complement component C3, and two other immune system factors involving in inflammation, namely C-reactive protein [CRP] and rheumatoid factor [RF] in sera of both groups were assessed and then confirmed by complement CH50 level of the blood. The results show that wound healing is a complex process involving coordinated interactions between diverse immunological and biological systems and that Ag-NPs significantly accelerated wound healing and reduce scar appearance through suppression of immune system as indicated by decreasing levels of all inflammatory factors measured in this study. Exposure of mice to Ag-NPs can result in significant changes in innate immune function at the molecular levels. The study improves our understanding of nanoparticle interaction with components of the immune system and suggests that Ag-NPs have strong anti-inflammatory effects on skin wound healing and reduce scarring

Histopathological effects of nanosilver [Ag-NPs] in liver after dermal exposure during wound healing

With the advent of nanotechnology, significant progress has been made in the area of nanoscale materials such as nanosilver [Ag-Nps]. These nanoparticles have a wide range of applications and been used for antimicrobial purposes for more than a century. However, little attention has been paid to the toxicity of nanosilver wound dressing. This study was designed to investigate the possible histopathological toxicity of Ag-NPs in liver of mice during wound healing. A group of 50 female BALB/c mice of about 8 weeks were randomly divided into two groups: Ag-NPs and control groups [n=25]. After creating similar wound on the backs of all animals, the wound bed was treated in Ag-NPs group, with a volume of 50 microliters of the nanosilver solution [10ppm] ,and in control group, with the same amount of distilled water. The experiment lasted for 14 days. Histopathaological samplings of liver were conducted on days 2, 7 and 14 of the experiment. Histopathological studies demonstrated time-dependent changes in mice liver treated with Ag-NPs compared to control group. Some changes include dilation in central venous, hyperemia, cell swelling, increase of Kupffer and inflammatory cells. This study suggests that use of nanosilver for wound healing may cause a mild toxicity, as indicated by time-dependent toxic responses in liver tissue. However, this issue will have to be considered more extensively in further studies

Uterine atony; association of low serum vitamin D

Uterine atony is one of the causes of postpartum hemorrhage, resulting in increased maternal morbidity and mortality. To determine the association of low serum vitamin D level with uterine atony, among women delivering in a tertiary care hospital. Case control Study. Gynae and Obstetrics department of Sheikh Zayed Medical College, Rahim Yar Khan. 1st January to 31st December, 2013. A total of 130 patients were recruited and grouped as A [Cases] including patients with uterine atony [100 patients] and group B [Controls] patients having no uterine atony [30 patients] after cesearean section or vaginal delivery and fulfilling the inclusion or exclusion criteria. The test for 25 OH vitamin D was performed on Elecsys 2010 Roche by using electrochemiluminescence technique. Oral informed consent was taken from all subjects and approval from institutional ethical committee was obtained. Chi square test was applied to compare atony and non atony groups in terms of presence or absence of vitamin D deficiency. The data was entered and analysed on SPSS version 17. It was noted that those who have uterine atony 87% were having vitamin D deficiency or insufficiency as compared to 68% in group with no uterine atony. This difference was statistically significant. [p=0.02] so uterine atony was significantly associated with vitamin D deficiency or insufficiency. In atony group mean age was 25+/-4 years, gravida 2.64+/-1.2, gestational age, 37+/-1.2, blood loss 1032+/-400, and serum vitamin D level 15.9+/-6, ng/ml. In non atony group, group mean age was 26+/-3 years, gravida 2.7+/-1, gestational age, 38+/-.8, blood loss 309+/-92, and serum vitamin D level 23+/-9 ng/ ml. The mean level of serum vitamin D level was significantly low [15.9+/-6 ng/ml] in atony group as compared to non atony group[23+/-9 ng/ml]. Mean blood loss was significantly high [1032ml] in atony group as compared to non atony group [309ml]. Our results revealed that low vitamin D level is strongly associated with uterine atony and hence is a risk factor for uterine atony

Reduction Versus non-reduction technique in low grade spondylolisthesis ; functional outcome

Spondylolisthesis is a condition in which a vertebra slips anteriorly in relation to the vertebra below as a results of pars defect or degenerative disease.The slipped segment produces abnormal positioning of the vertebrae in relation to each other along the spinal column that causing back pain and neurologic deficit.There are debates about surgical maneuvers low grade spondylolisthesis [grade 1 and 2 according to meyerding classification] whether to reduce the slipped segment or not, the aim of this study is to determine the short and long term difference in the functional iutcome between these methods. This randomized prospective study consist of 32 patients aged between 42-63 years old [11 males and 21 females] treated for sypmtomatic low grade spondylolisthesis between october 2009 to november 2011 and followed up for 24 months.All patients were randomly divided into two groups: group 1 [15 patients] underwent surgical reduction of the slipped segment, and group 2 [17 patients] who underwent in-situ fusion without reduction.both groups had the same pre and postoperative managment.Early postoperative minor complications uncluding one case in each group had superficial wound infections [6.6% and 5.8% in group 1 and 2 respectively] had dural tear intraoperatively that was repaired during the operation; none of patients has CSF leak postoperatively there were two cases in group 1 [13.3%] and one in group 2 [5.8%] had postoperative transient sciatic pain due to nerve irritaton.Depending on the Oswestry disability index [ODI] there was a significant statistical difference between both groups in the shirt term [p-value=0.004] but there was no significant statstical difference in the long term follow up between them [p-value=0.33] regarding the functional outcome.Surgical treatment of low grade symptomatic spondylolisthesis usualy include neural decompression fixation and fusion; however reduction of the slipped segment is not necessary for these patients as the ultimate outcome is similar to those who underwent in-situ fusion only

Frequency of hepatic encephalopathy in HCV cirrhotic patients with and without diabetes mellitus

Objective: to compare the frequency of hepatic encephalopathy [HE] in HCV cirrhotic patients with and without Diabetes Mellitus

Material and Methods: this cross sectional survey of 100 patients was conducted in all medical units of Mayo Hospital Lahore after meeting the inclusion criteria. Patients were classified as diabetic if they were on oral hypoglycemic agents or insulin or have BSF>126mg/dl and non-diabetic if they had BSF<126 mg/di. The assessment for presence or absence of hepatic encephalopathy was determined using criteria defined in operational definition. HCV LIVER CIRRHOSIS is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scare tissue and regenerative nodules. Cirrhosis was confirmed by Ultrasonography abdomen and hepatitis C was confirmed with ELISA test

Results: mean age of patient was 44.43+/-10.16 years with minimum and maximum ages 18 and 60 years respectively. Frequency of DM was determined as 34% among HCV cirrhosis patients while in 66% patients the diabetes was not seen. Hepatic encephalopathy was seen in 31 [91.2%] of diabetics and in 48[72. 7%] of non-diabetic patients. HE was not seen in 21 % of patients in which 3 were diabetics and 18 were non diabetic. In this study frequency of HE was higher in diabetic group as compared to non-diabetic group i.e. P- value=0.032

Conclusion: according to this study, frequency of Hepatic encephalopathy [HE] is significantly higher in diabetic patients as compared to non-diabetic patients i.e. P value 0.032. Frequency of HE was seen in 91.2% of the diabetic patients and in 72. 7% of non-diabetic patients

Production of cloned mice by nuclear transfer of cumulus cells

Over the past several years, mammals have been successfully cloned by either the splitting of an early stage embryo or nuclear transfer of adult somatic cells [NT] into oocytes. Although it has been 15 years since the generation of the first cloned mammals from somatic cells by NT, the success rate for producing live offspring by this technique is low regardless of the cell type and animal species used. However, these techniques have the potential to be important tools for future research in basic biology. In the present study, we described our experiences in producing successfully cloned mouse using NT method and piezo-actuated micromanipulator. B6D2F1 mice, 8-12 weeks old, were superovulated with injections of 5 IU of pregnant mare serum gonadotropin and 5 IU of human chorionic gonadotropin administered 48 hr apart. Enucleation and donor nuclei cumulus cell injection were performed with a piezo-actuated micromanipulator after which activation and trichostatin A treatment were used for reconstructed oocytes. Two-cell stage cloned embryos that developed in the mWM medium were transferred into the oviducts of pseudopregnant NMRI mice. Of 367 oocytes collected, 131 [69%] developed into 2-cell stage embryos. Of these, 5 [1%] live pups were successfully delivered. We used NMRI foster mother to raise the pups by lactation. One adult cloned mouse was mated, after which she delivered and raised normal offspring. For mouse cloning, the present study also successfully tested the capability of somatic cell nuclear transfer SCNT using a piezo unit

[ sealing ability of different thicknesses of orthograde apical plugs of mineral trioxide aggregate in comparison with gutta-percha and sealer AH26]

The purpose of this study was to evaluate the sealing ability of different thicknesses of orthograde MTA plugs in comparison with 5 mm gutta-percha. Fifty extracted single rooted human teeth were collected. After root canal preparation, the samples were randomly divided into 4 experimental [n=10] and two control groups [n=5]. In group 1, the apical 5 mm of the canals were obturated using laterally condensed gutta-percha and sealer AH26. Groups 2, 3 and 4 received 2, 3 and 4-mm thick orthograde MTA plug, respectively. Thereafter, the coronal portion of specimens was exposed to the microbial solution containing streptococcus sanguis and the root tips were placed in phenol red lactose broth. The color changes were observed within 60 days. The data were analyzed with Fisher exact test. The leakage was found in all samples [100%] in group 1 and 72.7%, 30.8% and 50% of the samples in groups 2, 3 and 4, respectively. Significant difference was found between 3 mm thickness of MTA plug and gutta percha and sealer [P=0.02]. According to the findings, it seems that 3 mm thickness of orthograde MTA plug had better sealing ability than the other thicknesses of MTA plug as well as the 5 mm of gutta-percha

Oswestry disability index for the assessment of postoperative disability in spinal trauma

Objectives: The objective of this study was to assess functional disability measured with the Oswestry Disability Index in patients with thoracolumbar spine instrumentation

Study Design: A descriptive study

Place And Duration: Department of Orthopedics and Spine Surgery, Hayatabad Medical Complex Peshawar from July 2007 to June 2012

Methodology: This descriptive study was performed in Department of Orthopedics and Spine Surgery, Hayatabad Medical Complex Peshawar from July 2007 to June 2012 on 52 consecutive patients of either sex with age above 17 years, have unstable fracture of thoracolumbar spine with intact neurology that has been treated by posterior spinal fixation with pedicular screws and rods. Using Oswestry Disability Index questionnaire which assess the functional disability the data was collected by a proforma and analyzed with SPSS version 10

Results: There were total 52 patients. Male patients were 35 [67.3%] while female were 17 [32.7%]. Minimum age was 18 years, maximum 75 while average age was 35.90. The Oswestry disability index was grade D in 24[46.2%] patients and grade E in 28[53.8%] patients preoperatively. Postoperatively at six months the index was grade A in 33[63.5%]patients, grade B in 15[28.8%] and grade C in 4[7.7%] patients while minimum Oswestry disability index was 10%, maximum 56% and average was 22.76

Conclusion: Our study shows improved results based on Oswestry Disability Index, in patients with fracture of thoracolumber spine undergoing posterior spinal fixation with pedicular screws and rod. Our findings also document the effectiveness of surgical techniques that has been done, suggesting that a bed bound or crippled patient was enabled almost to live independently

Catecholamine contents of different region of adult rat brain are altered following short and long-term exposures to Pb[+2]

Catecholamine is a group of neurotransmitters that is believed to be responsible for the normal function of animal brain. Physiological and behavioral changes of human body have been reported due to the damage of the brain function following lead exposure. Due to the assumption of lead disposal in brain tissue with two year for its half-life, which results in alteration of brain function, we investigated the ability of lead to change the brain catecholamines during short and long-term studies. Rats were exposed daily with varying amounts of lead and catecholamine contents of cerebellum, mid-brain and brain cortex were determined. Acute peritoneal administration of single dose of lead as lead acetate [260 micro mol/Kg] after 2 h reduced [p < 0.05] the catecholamine levels of cerebellum, mid-brain and cortex part by 34.9%, 35.44% and 23.8%, respectively. The extension of experiment time to 5 h, significant [p < 0.05] reductions in catecholamine levels of mentioned regions of brain by 32.35%, 12.35% and 19.3% were seen respectively. Daily intraperitoneal administration of 10 micro mol/Kg lead for 30 and 60 days reduced catecholamines levels of cerebellum [22.22% and 30.44%], midbrain [12.48% and 26.27%] and brain cortex [11.58% and 26.7%] respectively. It might be concluded that brain dysfunction in lead intoxicated rat occurred through the reduction in the catecholamine levels of different parts of brain. Lead might be therefore considered as a probable factor in causing neurological disease in lead exposed man

Spine surgery; complication of iliac crest bone graft harvesting

The objective of this study is to find out the complication directly related to iliac bone graft harvest in spine surgery. Observational prospective study. Department of Orthopedic and Spine surgery, Hayatabad Medical Complex Peshawar. January 2007 to April 2012 on 139 patients. Only those cases were included in whom bone grafting was done for fusion as part of their spine surgery and were successfully followed for at least 6 months. Out of 139 patients 59[42.4%] were female patients while 80[57.6%] were male. Minimum age of the patients was 4 years while maximum was 70 years. In 119[85.6%] patients cortico-cancellous bone graft was taken. While in 20[14.4%] patients, tri-cortical graft was taken. In majority 106[76.3%] cases graft was obtained from the posterior iliac crest while in 33[23.7%] it was obtained from the anterior iliac crest. 45[32.4%] had some pain at the bone graft site. 8[5.8%] had early deep infection while 6[4.3%] had early superficial infection. Nine [6.4%] of our patients had nerve injury evident by parasthesia in the zone of distribution. Iliac crest is an excellent source and best available material for autogenous bone grafting. However it is not free of complications. The most common complications are persistent chronic donor site pain, infection and heamatoma

[Relationship between student's spiritual intelligence and general health in Fasa University of medical sciences - 2013]

Background and Aims: mental health is a character that affect on different component of life and Spiritual intelligence as the foundation of one's beliefs assists him in solving problems in the level of value. The purpose of this study was to examine the relationship between SI and general health in students of Fasa University of Medical Sciences [FUMS]

Materials and Methods: In this cross-sectional study in 2013, 370 students of FUMS were studied by a convenience sampling method. Demographic data, Goldberg general health questionnaire- 28 and spiritual intelligence questionnaire in four domains: Doctrinal, Deal with problems, Moral character, Consciousness and love were used. Data were analyzed via SPSS version 18 and analysis of variance ANOVA, t-test and Pearson correlation was done

Results: General health was correlated with spiritual intelligence [r=-0.52, p<0.001]. 69.7% of students had good general health. The mean of Spiritual Intelligence scores was 151.6 +/- 17.3. Doctorinal domain was higher for women in comparison to men; 50.8 +/- 7.4 vs. 48.2 +/- 7.3 [P<0.01] and points of consciousness and love in married and single groups were 26.2 +/- 3.8 and 24.3 +/- 5.0, respectively [P<0.05]. Scores of dealing with problems was significantly different in the students of emergency medicine from the other groups

Conclusion:According to this study and association between general health and spiritual intelligence, is recommended that with planning to upgrade the spiritual intelligence of students help them to solve psychological and value problems

Haematological parameters and recurrent aphthous stomatitis

To find out the relationship between recurrent aphthous stomatitis [RAS] with deficiencies of haemoglobin, haematocrit, serum vitamin B12, serum Ferritin and red blood cells [RBC] Folate level. An analytical cross-sectional study. Department of Oral Health Sciences, Shaikh Zayed Federal Postgraduate Medical Complex, Lahore, from February to July 2008. Sixty consecutive subjects with active RAS were taken as the aphthous group; 60 age and gender matched subjects without RAS were as the Non-Aphthous group. Five milliliter blood was taken from both groups to evaluate the levels of serum B12, and RBC Folate through radio immuno assay and serum ferritin with enzyme linked immuno-sorbent assay tests. Complete blood count was carried out to determine the level of haemoglobin and haematocrit in both groups. Proportion of subjects with lower values was compared using 2 text of proportions with significance at p < 0.05. Serum Ferritin [p = 0.001], haematocrit [p < 0.001], RBC Folate [p < 0.001] and serum B12 [p < 0.001] were significantly lower in the RAS group. Combined deficiency state [haemoglobin, serum Ferritin, haematocrit, RBC Folate and serum B12] was identified in 13% [n = 8] RAS patients. Frequency of haematinic deficiencies was high in RAS patients. Serum B12 and RBC Folate were significantly low in aphthous group

Clinical features and long term prognosis of childhood brucellosis in northeast Iran

Brucellosis is a prevalent disorder in children of developing countries. The aim of this study is to describe the epidemiology and long term prognosis of Brucellosis in Khorasan, Iran. This is a descriptive cross sectional study [from November 2003 up to February 2006], the subjects of which are composed of 82 patients [from Imam Reza hospital, Mashhad, and Health Center of Kashmar]. In this study the diagnosis of Brucellosis is based on serology accompanied with clinical signs and symptoms. Our strategy for duration of treatment was to treat all patients for at least 6 weeks. We followed the patients by phone and if necessary by visiting. During 38 months we had 82 children with Brucellosis. The mean age was 8.02 y, and 40% of them were girls [M/F=1.21]. Summer with 45.9% of the cases was the peak season. History of consuming raw dairy products, close contact with farm animals, living in village and Brucellosis in family was found in 91.6%, 76%, 70.24% and 41.1% of the cases respectively. The presenting symptom in 79.7% of the cases was joint pain, 72.9% had history of fever during the course of the disease. Arthritis, splenomegaly and lymphadenopathy were found in 60.97%, 16.9%, 7.5%, of patients respectively. The therapeutic regimen of 48.7% of our patients was Co-trimoxazole and rifampin. We followed 74% of the patients for at least 3 years which showed the relapse rate of 6.5%. There was a case of reinfection, a patient with residual sequel and one death related to Brucellosis in our case series. Brucellosis is still a common disease in our children and at least a risk factor for it can be found in the history of almost all cases of pediatric Brucellosis. With at least six weeks treatment with two antibiotics and with close follow up, we can decrease the relapse rate in pediatric Brucellosis to zero, even without repeating the serology during or after treatment

Olecranon fracture

The objective of the study is to assess the clinical and radiological outcome after tension band wiring of olecranon fractures. Descriptive study. Department of Orthopedics and Spine Surgery, Hayatabad Medical Complex Peshawar. July 2007 to June 2010. 29 consecutive patients of either sex with age above 20 years, having olecranon fracture. Fracture osteosynthesis was achieved with the insertion of two parallel 1.8 mm Kirschner wires from the tip of the olecranon and an 18 gauge wire in a figure of eight fashion. Then functional outcome is evaluated with Mayo Elbow Performance scores [MEPS] while radiological outcomes is evaluated with standard radiographs. Out of 20 patients, male were 19[65.5%] while female were 10[34.5%]. Minimum age was 20, maximum 80 and average age was 47.5 years. There were 7[24.1%] patients with type A, 6[20.7%] type B, 9[31%] type C, 6[20.7%] type E and 1[3.4%] with Schatzker type F fracture. Mayo Elbow Performance Score was Excellent in 13 [44.8%], Good in 10[34.5%], Fair in 4[13.6%] and Poor in 2[6.9%] patients. There were 10[34.5%] complications including prominent wire in 3[10.3%], osteoarthritis in 1[3.4%], broken skin in 3[10.3%], irritation of skin in 1[3.4%], erythema in 1[3.4%] and serous discharge in 1[3.4%] patient. There was no non union recorded in this study. Olecranon fractures heal well in most instances achieving recovery of normal function in more than 95% of patients. Functional outcome is dependent on fracture severity, length of immobilization, and patient factors

[Epidemiology of injuries in toddlers and infants [6-24 months]]

Injury is a leading cause for morbidity and mortality in otherwise healthy children. There are few data [especially in Iran] about epidemiology and incidence of injury in the first two years of life. This research was a cross sectional descriptive study on a group of 1000 infants [6-24 months old], from all the health care centers in Mashhad, who were evaluated about the history of any kind of injury since birth. The study was performed in autumn of 2004. The mean age of the study group was 13.8 +/- 7.8 months. During this time 55.7% of the infants had experienced some kind of injury. The occurred injuries in order of frequency were Falls [13.4%], Chocking due to foreign body aspiration [12.8%], Cuts and lacerations [11.9%], Burning [10.9%], Poisoning [3.9%] Traffic accidents [1.5%] Drowning [0.7%] and electrical injuries [0.6%]. Overall fifty infants [5%] in our group were visited [for accident] in an office by a doctor, which burning [with 16 outpatient visits] was the most common injury in this group. There was history of 80 hospital admission in the study group but only seven of them were due to accidents, and poisoning in three cases was the most common causes of injury related admission. The periodic prevalence of injuries in our study group was 55.7%. Falls, Chocking [due to foreign body aspiration], Cuts and burns were [in order of frequency] the most common types of the injuries in infants of Mashhad. Injury was not a significant cause for hospital admission in this age group