ABSTRACT
BACKGROUND: Mandibular fracture is considered the second most common facial fracture worldwide. We aimed to evaluate the epidemiology of mandibular fractures in traumatic patients hospitalized at Velayat Teaching Hospital in Rasht, Iran for 6-year. METHODS: In this retrospective study, all traumatic patients with mandibular fractures admitted to Velayat Teaching Hospital, Rasht, northern Iran for 6-year (2013-18) were enrolled. The data collection tool was a checklist consisting of two parts: demographic information, and injury data. All data were collected through the Hospital Information System (HIS), and analyzed using SPSS software and descriptive and analytical statistics tests. RESULTS: Overall, 463 hospitalized patients were reviewed. Males had higher frequency than females. The most common accident place was rural roads. The most frequent mechanism of fractures was road accidents. The most common injuries occurred in motorcyclists, followed by car passengers, pedestrians, and cyclists. The highest and lowest frequency of injury occurred in September, and February, respectively. The most common site of fracture was condyle, followed by trunk. In concurrent fractures, the most frequently affected site was maxillary bone, followed by zygomatic bones, orbital, nasal, and frontal bones. CONCLUSION: The majority of patients with mandibular fractures were young men of working age following motor vehicle accidents. Consequently, the most effective strategy for reducing accidents leading to mandibular fractures is considering all three components of human, environment, and vehicle.
ABSTRACT
BACKGROUND: Although electrical burns are less prevalent than other types, they put socioeconomic burden on communities, yielding higher mortalities. Therefore, the frequency and causes of electrical burns in the largest burn center in northern Iran were studied. METHODS: All patients with electrical burn injuries admitted to Velayat Hospital, Rasht, Iran participated in this descriptive cross-sectional study. The data collection tool was a checklist including demographic data, damage mechanism, voltage classification (high or low), injured organ, ICU need, length of stay (LOC), electrical burn severity (degree and area of burns based on TBSA), surgical interventions, and return to work. All data were gathered through HIS system and analyzed. RESULTS: Most electrical burns occurred in men (99.4%) and most of whom had electricity-related jobs (26%). The majority of victims had third-degree burns (63%), and electrical current-induced burns in entry points occurred in the upper and lower extremities, head and other organs ranked the first to fourth, respectively. Most burns happened due to abrupt contact with electrical current (83.33%) in routine home activities (52.78%). The mean LOC was 8.73 days, suggesting that LOC increased significantly, if the electrical current entered the body through lower extremities, while it decreased significantly, if the electrical current exited through lower extremities. CONCLUSION: The majority of electrical burn victims were men. Most burns occurred in urban communities in summer. Most people were affected by high voltage electricity.
ABSTRACT
BACKGROUND: Burn pain is recognized as being maximal during therapeutic procedures, and wound debridement can be more painful than the burn injury itself. Uncontrolled acute burn pain increases the stress response and the incidence of chronic pain and associated depression. Although opiates are excellent analgesics, they do not effectively prevent central sensitization to pain. The anticonvulsant gabapentin has been proven effective for treating neuropathic pain in large placebo-controlled clinical trials. Experimental and clinical studies have demonstrated antihyperalgesic effects in models with central neuronal sensitization. It has been suggested that central neuronal sensitization may play an important role in postoperative pain. OBJECTIVES: The aim of this study was to investigate the effect of gabapentin on morphine consumption and postoperative pain in burn patients undergoing resection of burn wounds. PATIENTS AND METHODS: In a randomized, double-blind, placebo-controlled study, 50 burn patients received a single oral dose of gabapentin (1200mg) or placebo 2h before surgery. Anesthesia was induced with propofol and fentanyl and maintained by infusingpropofol, remifentanil, and 50% N2O in O2. All patients received patient-controlled analgesia with morphine at doses of 2.5 mg bolus and a lock-out time of 10 min for 24h before the operation. Pain was assessed on a visual analog scale (VAS) at rest and during movement at 1,4,8,12,16,20, and 24 h before the operation. Heart rate, oxygen saturation, mean arterial blood pressure, respiratory rate, sedation score, and morphine consumption were studied. RESULTS: All the enrolled patients were able to complete the study; therefore, data from 50 patients wereanalyzed. The VAS scores at rest andduring movement at 1,4,8,12,16,20, and 24 h after the operation were significantly lower in the gabapentin group than in the placebo group (P < 0.05). Morphine consumption was significantly lessr in the gabapentin group than in the placebo group (P < 0.05). Sedation scores were similar in the 2 groups at all measured times. There were no differences in adverse effects between the groups. CONCLUSIONS: A single oral dose of 1200mg gabapentin resulted in a substantial reduction in postoperative morphine consumption and pain scores after surgical debridement in burn patients.
