Introduction: Trauma is one of the most common causes of death in the world. E-Fast ultrasound can detect the haemoperitoneum, intravenous pneumothorax, and hemothorax. In this study, we evaluated the accuracy of E-FAST focused ultrasound in blunt trauma patients referred to the Emergency Department. Methods: In this study 167 blunt trauma patients were included. E-FAST is performed from four standard spaces in terms of free fluid, chest in terms of hemothorax, and pneumothorax. Ultrasound is performed on the trauma patient and the obtained results were compared with the result of the standard gold CT scan test. All patient information including age, sex, mechanism of trauma, patient ISS, E-FAST result, and CT scan result were registered. Results: Overall, 174 patients were included that 45 (25.9%) of them were females. The mean age of the patients was 38.39±12.31 years. E-FAST had a sensitivity of 66.7 and a specificity of 100% in the diagnosis of hemothorax. Also, a positive predictive value of 100% and a negative predictive value of 99.4% were detected for 120 people in both normal tests. Conclusion: The results show E-FAST is a suitable alternative to CT scan in the diagnosis of hemothorax, pneumothorax, and free fluid in the abdomen, vulva, and pericardial cavity. Due to portability, safe body, no need for contrast, fast performance, as well as cheapness, and reproducibility, it will be a great help in diagnosing trauma-related lesions and prompt and timely treatment. CT scan should be used only in limited cases and special indications.
Introduction: Investigating and recognizing the epidemiological structure of earthquake damages in earthquake- prone countries is of great importance. The aim of this study was to evaluation of traumatic injuries in1028 patients referred to the Ayatollah Taleghani Hospital from the Sarpul-Zahab earthquake (November 12, 2017). Method: This study is a cross-sectional study that includes 1028 traumatic patients from the Kermanshah earthquake. The patients, including outpatients in the emergency department, admitted in orthopedic, general surgery and neurosurgery, or even patients who needed to be transferred to other treatment centers. Result: Of the 1,028 patients, 488 were men (47.5%). The number of men with high injury severity was 51 (10.4%) and the number of women with high severity of the injury was 58 (10.7%). The average age of the injured was 33.04±15.01 years. The mean ISS measure in this study was 8.9±1.6. A total of 109 (10.6%) had scores above 17. The number of cases with head and neck injury was 328 (24%), 233 cases (17%), chest 114 (8.3%), The abdomen or pelvis is 190 (13.9%), the spine is 200 patients (14.6%). After examining the type of trauma in 1791 injuries, 1074 injuries (59.9%) had penetrating trauma and 717 injuries (40.1%) of blunt trauma were calculated. Of patients with severe trauma, 83 patients suffered severe injuries (7.7%) and in patients with blunt trauma, 68 patients suffered severe injuries (9.4%). The mortality rate was 5 (0.5%). Conclusion: This study established a fracture pattern in the referred patient of the Sarpul-Zahab earthquake to the Ayatollah Taleghani Hospital and is practical for clinicians to increase understanding of this natural disaster and permits superior selection of the triage management and therapeutic process.
The applications of negative-pressure wound therapy (NPWT) have achieved remarkable diversification. Initially used in the therapy of soft tissue wounds related to open fractures, this technique led to the understanding of the complex mechanisms underlying it. This paper aims to analyze the evolutionary scenarios of a group of patients with heterogeneous lesions under negative pressure aspiration treatment. We aimed to identify and analyze various associated pathologies that have the potential to negatively influence the healing process under negative pressure treatment and implicitly analyze the particularities of representative cases for the group whose evolution under treatment proved to be unfavorable. Retrospective, observational study, type series of cases focused on a group of 17 hospitalized patients, who received treatment by negative aspiration, between 2015-2019 in the Surgery Department of the University Emergency Hospital Bucharest. Regarding the obtained results, diabetes mellitus, obliterating arteriopathy, and anemia had a prevalent distribution in the group with unfavorable evolution. The glycemic value can predict 17% of the evolutionary scenario of a patient (favorable/unfavorable) being necessary an integrative therapeutic conduct. Concluding, although an extremely promising therapeutic option, NPWT can prove to be disappointing given its impact in the background of suboptimally managed comorbidities.
The increasing incidence of obesity, a significant health problem worldwide, represents a major socio-economic burden with a high impact on the quality of life. It is considered a risk factor for multiple medical conditions. More than half of women from developed countries are overweight or obese, this comorbidity can affect them from puberty through the reproductive period and then in the menopausal period, involving multiple medical and surgical specialties. It has a significant impact on the onset of puberty, the menstrual cycle, ovulation, fertility rate, and pregnancy outcome. In postmenopausal women, obesity represents an important risk factor for breast cancer, endometrial cancers or polyps, fibroids, pelvic organ prolapse, or stress urinary incontinence in addition to a higher risk of post-operative complications and also to some types of fragility fractures, especially if diabetes mellitus is associated. Pelvic floor disorders include pelvic organ prolapse, urinary or fecal incontinence. Obese patients seem more affected compare with normal-weighted females. We introduce a single-center, retrospective study on 74 patients (admitted between 2016 and 2019) with pelvic organ prolapses that were referred for surgical correction, and further on they were evaluated after one month, respective after 6 months since procedure. On admission, the subjects, aged between 41-82 years (median of 57 years) showed a strong correlation between the symptomatology caused by the prolapse degree and obesity (40.54% of them), as it appears that the discomfort and symptoms are significantly higher in the women with higher body mass index. In the reevaluation form, the patients with obesity complaint more frequently compared to the non-obese females about urinary and colorectal distress and low sexual desire and interest. The use of surgical treatment for pelvic organ dysfunctions is a contributor to improved quality of life in adult obese females.
The SARS-CoV-2 pandemic challenged the authorities into taking measures that limit the spread of the virus in the community. TAMEC project (Advanced Community Approaches to Epidemic Management) developed a system that detects the contacts of patients infected with the SARS-CoV-2 virus and alerts them using mobile applications. It allows real-time analysis of confirmed patients and identified contacts, early detection of new outbreaks, and provides decision- making information to prevent viral transmission. The system uses its patent for homomorphic encryption, a method that allows to process and manipulate data in an encrypted format, without having access to the original data. Thus, the solution proposed in the TAMEC project fully respects the privacy rules of citizens imposed by the EU, using the concept of privacy preservation. Our solution offers the possibility to identify and validate a risk score that could become an extremely helpful tool in the stratification of COVID-19 patients. The TAMEC system is innovative in its simplicity and ability to facilitate the prevention of the spread of the SARS-CoV-2 virus in the community
Social Marketing offers new insight into the design of health care programs that focus on the comprehensive vision of understanding the target audience. As there have been several confusions between the Health Care Social Marketing and education or preventive health care programs, the characteristics refer to the social good and behavior change on voluntary grounds. This paper aimed to elaborate some guidelines for Health Care Social Marketing campaigns to increase the chances of success and trigger the expected behavioral change in the target audience. To ensure the successful implementation of a Social Marketing campaign in health care, a plan that describes the necessary steps to respond in terms of efficiency and effectiveness to the public health campaign outcomes needs to be elaborated. The proposed model has three levels of intervention, as found in the scientific literature: Diagnosis of social problems, Benefits, and social change, and Social Marketing Mix.
Carpal tunnel syndrome is currently the most common peripheral nerve compression neuropathy that affects approximately 1% of the population [7,8,9]. The incidence of CTS seems to be increasing. The diagnosis is based on clinical symptoms and electrodiagnostic studies.
Introduction: Intensive care facilities may play an important role in reducing corona mortality. This study aimed to assess the epidemiological features, treatments, and prognosis of corona patients that admitted to the Intensive Care Unit (ICU) of Baqiyatallah Hospital. Methods: All patients with a corona that admitted to the ICU of Baqiyatallah Hospital from March 5 to May 20, 2020, were included. The epidemiological characteristics, pharmacological, non-pharmacological, and supportive therapies and prognosis were assessed. Underlying diseases, smoking, and severity of lung involvement based on CT scan findings (mild, moderate, severe) and length of hospital stay in the ICU were recorded in a questionnaire. Non-invasive ventilation (NIV) or tracheal intubation, ventilator ventilation, and duration of endotracheal intubation, if needed, were recorded in the questionnaire. Meanwhile, whether tracheostomy was performed, the time of the procedure, and its duration were also recorded. Results: Overall, 82 patients were included in the study that 68 (82.9%) of them were males. The mean age was 57.96±14.08 years. The mortality rate was 53 cases (64.6%). There were 57 subjects (73.1%) at a severe lung involvement and 21 subjects (26.9%) at a moderate lung involvement. There was a significant relationship between severity of lung involvement and mortality (Odds ratio= 14.3, P<0.001). There was a significant relationship between mortality and Armadile use (Odds ratio= 2.9, P=0.04). There was a significant relationship between mortality and tracheal intubation (Odds ratio= 27.2, P<0.001). There was no significant difference between mortality and discharge of patients regarding the intubation period (P=0.26). There was not a significant relationship between tracheostomy, NIV, and mortality status in the patients (P=0.14 and 0.33 respectively). Also, there was no significant difference between mortality and discharge of patients regarding tracheostomy and NIV period (P=0.51 and 0.17). There was no significant difference in age between severe and moderate lung involvement cases (P=0.63). There was a significant difference in the duration of ICU hospitalization between severe and moderate lung involvement cases (P=0.004). Conclusion: The results showed none of the factors of age, sex, underlying diseases other than hypertension, pharmacological methods other than Armadile, and non-pharmacological methods such as hemoperfusion, plasmapheresis, IVIG, hyperimmune plasma injection, and stem cell as well as Ozone therapy does not affect corona patient’s mortality. Only the severity of lung involvement leading to endotracheal intubation and mechanical ventilation is related to patients’ mortality
Introduction: It was reported that snake venom contains a wide mixture of proteins and peptides with various toxicological and pharmacological effects. In recent years, the isolation of effective molecules from snake venom as a drug to treatment of some incurable diseases is considered by many biological research centers. This investigation aimed to determine electrophoretic and chromatographic patterns of Pseudocerastes persicus snake venom and in-vitro study of bactericidal and anti-cancer properties of its fractions in a human hepatocellular liver carcinoma cell line (HepG2). Materials and methods: The fractions of venom were isolated and collected using preparative RP-HPLC. The Bactericidal activity of fractions in 20 μg/ml of protein concentration was investigated toward Gram-negative and Gram-positive bacteria. Antibacterial susceptibility tests were done using MTT and MIC assays. Furthermore, cell viability was measured by MTT reduction assay and confirmed with Neutral red uptake assay following exposure of HepG2 cancer cells to 20 and 40 μg/ml of protein concentrations of fractions having more antibacterial properties. Apoptotic effects were investigated using the comet assay. Results: SDS-PAGE pattern of the crude venom revealed 10 major bands with molecular weight ranging from 13.2 to 99.25 kDa and the single-step separation of different fractions from the venom by HPLC resulted in isolation and collection of 11 fractions. The results of this study showed that two fractions of snake venom have significant antibacterial activity against Gram-positive as compared to Gram-negative bacteria. On the other hand, our findings indicated that one of them is not toxic to the HepG2 cells. Discussion: We for the first time reported bactericidal and anticancer effects of isolated fractions of Persian horned viper venom. These properties make components of these fractions a favorable source for isolation of molecule(s) with antibacterial and antitumor activities.
Background and aim: Preoperative anxiety and fear of separation from parents are some of the most important preoperative problems for children with deaf muteness. Here, the effect of intravenous administration of ketamine and midazolam was compared on sedation in children who candidates for choral cochlear implantation at the time of separation from parents. Patients and methods: This double-blind, prospective clinical study was performed on 74 children with deaf-muteness before cochlear implantation. Patients were randomly divided into two groups, midazolam (0.1 mg /kg) and ketamine (1 mg/kg). The sedation anxiety score scale (SASS) form was filled in to assess the anxiety and sedation status for each child. The children's relaxation score from recovery was assessed by the PACU sedation score scale (PACUSSS). Results: The average of the children's anxiety score after the injection of both drugs during the separation from their parents was 3, and there was no significant difference in the mean of SASS between the two groups (p>0.05). The mean PACU sedation score scale in both ketamine and midazolam groups was 1.08 ± 0.89 and 1.32 ± 1.01, respectively (p = 0.27). The mean of extubation and recovery times in the ketamine group were 10.44 ± 4.47 and 30.27 ± 6.87, respectively, while the mean extubation and recovery times in the midazolam group were 11.83 ± 3.33 and 29.81 ± 6.31 minutes, respectively. Conclusion: Both ketamine and midazolam caused equal sedation scores in children with deaf muteness at the time of separating from their parents.
