A seven-year study on head injuries in infants, Iran---the changing pattern / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Head injury (HI) is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this study was to survey infant HI patients admitted to Shahid Behest Hospital in Kashan, Iran from 2004 to 2010, and to identify the causes of HIs in this age group.</p><p><b>METHODS</b>In this retrospective study, all HI patients under the age of two who were hospitalized for more than 24 hours between January 2004 and January 2010 were enrolled in the study. Demographic, etiologic, and injury data were collected and a descriptive analysis was performed.</p><p><b>RESULTS</b>Infants comprised 20.8% of all children (under 15 years old) with HIs and 65.1% of the injuries occurred in the home. Falls were the most common cause of injury (63.4%). In hospital mortality was 6.6 per 100 000 infants. A decreasing trend was seen in home events, but HIs caused by traffic accidents were increasing during the study period. The amount of HI infants resulting from car accidents has tripled from the years 2004 to 2010.</p><p><b>CONCLUSION</b>Although home events and falling are the main causes of infant HIs and need attention, our study showed an increase of HIs caused by road traffic accidents, especially by car accidents, thus legislation for the implementation of protective equipment such as child safety seats and programs is urgently needed.</p>

Ischiorectal Block with Bupivacaine for Post Hemorrhoidectomy Pain

BACKGROUND: Hemorrhoid is one of the most common surgical diseases occurring in the anorectal region. In this study, we evaluated the effect of ischiorectal fossa block on alleviating post hemorrhoidectomy pain. METHODS: In this study, 90 patients suffering from hemorrhoids were evaluated. They were randomly divided into 3 groups. The first group had no block, the second group an ischiorectal block with placebo (normal saline), and the third group a preemptive ischiorectal block with bupivacaine. Postoperative variables such as pain intensity, pethidine consumption, nausea, and vomiting were compared between the groups. RESULTS: The postoperative pain score in group 1 was 8.5 +/- 1.3 and 8.1 +/- 0.9 (P = NS) in group 2. The post operative analgesic demand was 3.1 +/- 1.5 and 3.3 +/- 1.8 hours in groups 1 and 2, respectively (P = NS). The post operative pain score and analgesic demand were 4.2 +/- 2.1 and 9.3 +/- 2.7 hours, respectively, in group 3 (P < 0.0001). CONCLUSIONS: Preemptive ischiorectal block reduces the posthemorrhoidectomy pain and opioid demand.