Penetrating apex cardiac trauma

Penetrating cardiac trauma is a medical emergency and should be managed as soon as possible. There are some different causes of cardiothoracic injury, which gun and stab wounds are the most important direct cause of penetrating cardiac trauma. Depending on the wound size, penetrating cardiac trauma causes different clinical manifestations. Small stab wounds lead to cardiac tamponade, meanwhile severe hemorrhage and shock are reported for gun wounds. A 45 years old man was admitted with complaints of dyspnea, weakness and severe hemorrhage during a dispute. There were two wounds on the thorax the first wound was in 5th intercostal space at left mid clavicle and the second was in 10th intercostal space at left mid axillary. Breath sounds were going to diminish in the left base. After performing CPR in emergency room, the patient was sent to operation room immediately. In operation room a left thoracotomy was performed. There was a bleeding area on apex. Apex rupture and pericardial rupture were repaired and bleeding was controlled. After 48 hours echocardiography and chest x-rays were normal and the patient was discharged in good conditions after 7 days

[Correlation between blood glucose measured using glucometers and standard laboratory methods]

Diabetes Mellitus [DM] is the most common chronic and non-communicable disease, with many complications including renal failure, blindness and non traumatic amputation. Prevention of DM is possible through monitoring and control of blood glucose levels. Considering how easy home blood glucose monitoring is, we decided to evaluate the performance of two available glucometers for detection of blood glucose compared with standard laboratory methods. In this study, we compared of capillary blood glucose levels of 402 patients as determined by test strips [Glucometer] with venous blood glucose levels measurements by the enzymatic method [the standard laboratory kit]. Of the 402 patients studied, there were 230 [57.2%] males and 172 [42.8%] females; 65 [16.2%] had past history of DM. Their mean age was 40.2 +/- 14.9 years [range 3-70], mean BMI was 24.4 +/- 3.2 Kg/m2 and mean HOT was 45.4 +/- 4.1 percent. The mean blood glucose measurements reported using the Glucomen glucometer, the Prestic glucometer and the standard laboratory method were 128.0 +/- 45.2mg/dl, 127.4+45.9 mg/dL and 125.3 +/- 43.2 mg/dL, respectively with increase of HCT [polycytemia]; sensivity of devices for detection of hyperglycemia [BS >/= 126 mg/dl] was increased but specificity was decreased [64.7%]. Results obtained using the 2 devices had no differences with the standard method levels. Good correlation was observed between the glucometer and the standard enzymatic method of blood glucose measurements, advocating usage of glucometers at home environments

[ case report of late hemorrhagic disease of newborn]

Late hemorrhagic disease of Newborn [LADN] is a bleeding problem that occurs in the newborn between 2-8 weeks but can occur at anytime in the first year. In this report we introduce a 4.5 months girl with right lower extremity swelling and hematoma with limited motion and persistent crying. The patient was admitted to Imam Hossein hospital. In clinical examination, she had a 4x6cm tender mass in right lower extremity, without erythema or inflammation. Laboratory findings were Pt > 60", PTT > 180", PLT - 221000 and Hb - 10.8 mg/dl at the time of admission. In ultrasonography of mass, there was 20cc fluid without any solid material. She was treated with 2 g vitamin k injection and after surgical consultation the mass was drained. She discharged after 2 days of observation with the diagnosis of idiopathic type of LHDN