ABSTRACT
This is a descriptive analysis, performed on victims of Iran's December 26, 2003 Bam earthquake that were referred to tertiary referral trauma management centre in Tehran. Two hundred and ten patients were included in this study. Associated musculoskeletal injuries and renal function of the patients were recorded. The mean time under rubble was 1.9 h in our patients with a mean rescue to first medical aid time of 13.5 h. We had 19 cases of compartment syndrome and 6.7% of patients had impaired renal function. The incidence of compartment syndrome had a direct relation to the time under rubble and the incidence of renal failure was directly related to rescue to first medical aid time. Axial skeleton fractures, amongst them the lateral compression type pelvic fractures, were particularly common. Fracture associated neural injuries were also common. Institution of renal protective protocols from the very first hours after injury more conservative approaches to treatment of fractures in these crush trauma patients are strongly recommended.
Subject(s)
Disasters , Musculoskeletal System/injuries , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Adolescent , Adult , Aged , Arm Injuries/epidemiology , Arm Injuries/etiology , Child , Compartment Syndromes/epidemiology , Compartment Syndromes/etiology , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/etiology , Female , Fractures, Bone/epidemiology , Fractures, Bone/etiology , Humans , Incidence , Iran/epidemiology , Leg Injuries/epidemiology , Leg Injuries/etiology , Male , Middle Aged , Pelvis/injuries , Retrospective Studies , Spinal Injuries/epidemiology , Spinal Injuries/etiology , Time FactorsABSTRACT
We report three members of a family with clinical and laboratory features, consistent with dyshormonogenic hypothyroidism, with an autosomal recessive pattern of inheritance. Two had primary hypothyroidism with normal Tc(99m) thyroid scans, presenting with growth delay at ages of 7.5 and 2, and one had hypoplasia of the right lobe of the thyroid with left lobe hemiagenesis and low thyroid uptake in iodide thyroid scan, diagnosed at 14 months. They had slender facies with nasal retrognathic mandible and a prominent bridge. They had reasonably normal intellectual development despite delayed onset of treatment. Despite advancement of bone age with treatment the patients remained significantly short. Possible differential diagnoses are dyshormonogenic hypothyroidism, especially hyporesponsiveness to thyrotropin and short stature that may be due to an abnormal gene in this family.
