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Journal Cover   Bulletin of Emergency And Trauma
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2322-2522 - ISSN (Online) 2322-3960
   Published by Shiraz University Homepage  [11 journals]
  • Role of Motorcycle Running Lights in Reducing Motorcycle Crashes during
           Daytime; A Review of the Current Literature

    • Authors: Seyed Rasoul Davoodi, Seyed Mohamad Hossayni
      First page: 73
      Abstract: In comparison to other transportation modes, riding motorcycle is prone to accidents.  Motorcyclists are more exposed to physical injury than the car drivers. Many multi-vehicle motorcycles crashes occur, there is right-of-way violation takes place in which another vehicle turns in fronts of a motorcycle, or a sudden cross of path of an on-coming motorcycle. One main factor which leads to high rate of motorcycle crashes is lack of conspicuity of motorcycles by other road users especially during day time traffic. This paper highlights previous studies on the implementation of motorcycle DRLs, focusing on the efficacy of the DRLs to improve motorcycle conspicuity. This paper reviews the impacts of DRL by motorcyclists on multi-vehicle motorcycle crash. The three categories of effects of motorcycle DRLs were reviewed. All literature, supporting that operating headlights during daytime appears to be an influential and effective approach to reduce rate of collision by improving motorcycle’s conspicuity in traffic. The motorcycle DRLs managed to reduce about 4 to 20% of motorcycle crash risk. This paper also recommends that motorcycle DRLs must be used globally, especially in countries with high motorcycle accidents to improve the safety of the riders as well as their pillion riders.
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
  • Effects of Human Erythropoietin on Functional Outcome of Patients with
           Traumatic Cervical Cord Injury; A Pilot Randomized Clinical Trial

    • Authors: EhsanAli Alibai, Fahim Baghban, Majid Reza Farrokhi, Navideh Mohebali, Mohammad Hossein Ashraf
      First page: 79
      Abstract: Objective: To determine the effects of recombinant human erythropoietin (rhEPO) on functional outcome and disability of patients with traumatic cervical spinal cord injury (SCI). Methods: This was a randomized, double blind, placebo controlled clinical trial being performed in Nemazee and Shahid Rajaei hospitals of Shiraz during a 3-year period from 2011 to 2014. A total number of 20 patients with acute traumatic cervical SCI less than 8 hours after injury were included. We excluded those with anatomic cord dissection, penetrating cord injury and significant concomitant injury. Patients were randomly assigned to receive rhEPO in 500IU/mL dosage immediately and 24-hour later (n=11) or placebo (n=9). All the patient received standard regimen of methylprednisolone. Neurological function was assessed on admission, 1, 6 and 12 months after the injury according to the American Spinal Cord Injury Association (ASIA).Results: Overall we include a total number of 20 patients. The mean age of the patients was found to be 40.1 ± 9.5 (ranging from 19 to 59) years. There were 18 (90.0%) men and 2 (10.0%) women among the patients. There was no significant difference between two study groups regarding the baseline characteristics. The baseline ASIA score was comparable between two study groups. The motor and sensory ASIA scores were comparable between two study groups after 1, 6 and 12 months follow-ups. We also found that there was no significant difference between two study groups regarding the motor and sensory outcome in complete cord injury and incomplete cord injury subgroups. Conclusion: Administration of rhEPO does not improve the functional outcome of patients with traumatic cervical SCI.Clinical trial registration: The study has been registered with Iranian Registry for Clinical Trials (; IRCT2014122920471N1)
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
  • Effects of Intravenous and Catheter Directed Thrombolytic Therapy with
           Recombinant Tissue Plasminogen Activator (Alteplase) in Non-Traumatic
           Acute Limb Ischemia; A Randomized Double-Blind Clinical Trial

    • Authors: Abbas Saroukhani, Hasan Ravari, Masoud Pezashki Rad
      First page: 86
      Abstract: Objective: To evaluate the efficacy and safety of intravenous and catheter directed thrombolysis by recombinant tissue plasminogen activator (Alteplase) in the patients with non-traumatic acute limb ischemia (ALI).Methods: This was a randomized clinical trial being performed between 2009 and 2011 in Mashhad University of Medical Sciences. We included those patients who were<75 years, with symptoms of less than 14 days duration, ALI of grade IIa and IIb (according to Rutherford classification) and absence of distal run off. Baseline assessment of peripheral circulation performed in all the patients. Patients were randomly assigned to undergo intravenous (n=18) or catheter directed thrombolysis (n=20) with Alteplase. The primary endpoint of the study was improvement of clinical status measured by Rutherford classification, ankle brachial index (ABI), visual analogue scale (VAS) score measured at 1, 3 and 6 months. The secondary endpoint of the study was complete or near complete recanalization of the occluded artery.Results: A total number of 38 patients with mean age of 54.13±13.5 years were included in the study. There were 23 (60.5%) men and 15 (39.5%) women among the patients. Overall 3 (7.9%) patients had upper and 35 (92.1%) lower extremity ischemia. There was no significant difference between two study groups. None of the patients experienced major therapeutic side effects. Both ABI and VAS score improved in patients who have received first dose of t-PA within 24-hourof ALI. There was no significant difference between two study groups regarding the 6-month clinical grade (p=0.088), VAS score (p=0.316) and ABI (p=0.360). The angiographic improvement was significantly higher in CDT group (p<0.001).Conclusion: Intravenous and catheter directed thrombolysis with t-PA is a safe and effective method in treatment of acute arteriolar ischemia of extremities. However there both intravenous thrombolysis and CDT are comparable regarding the clinical outcome.Clinical Trial Registry: The current study is registered with Iranian Registry for Clinical Trials (; ''')
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
  • Sleep Quality among Patients with Mild Traumatic Brain Injury: A
           Cross-Sectional Study

    • Authors: Arash Mani, Seyed Ali Dastgheib, Atie Chanoor, Hosseinali Khalili, Laaya Ahmadzadeh, Jamshid Ahmadi
      First page: 93
      Abstract: Objective: To evaluate and describe the sleep quality in seven subscales among the patients with mild traumatic brain injury (TBI) and compare it with normal patterns.Methods: This cross-sectional study was conducted within a 6-month period from February to August 2014 in Shahid Rajaei trauma center of Shiraz. Participants were selected randomly from all adult (18-60 years of age) patients admitted during the study period with impression of mild TBI (GCS of more than 13). The patients’ sleep quality and demographic characteristics were evaluated by Pittsburgh sleep quality index (PSQI) and self-report questionnaire, respectively. Results were compared with normal data, which extracted from the normative data of PSQI manual.Results: Overall we included 60 patients with mild TBI with mean age of 36.2 ± 13.4 years. All the patients had sleep disturbance. Among them there were 46 (76.7%) men and 14 (23.3%) women. The subjective sleep quality (p=0.01), sleep latency (p=0.01), habitual sleep efficiency (p=0.01), sleep disturbance (p=0.01), use of sleep medication (p=0.01) and day time dysfunction (p=0.01) were significantly lower in patients with mild TBI when compared to those with mild TBI when compared to normal values. There were no difference between men and women regarding the sleep quality. The sleep duration was comparable between the subjects and the normal values.Conclusion: Patients with mild TBI have poor sleep quality which should be considered as one of the main factors in interventions after the injury and it might lead to better quality of life.
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
  • Administration of Intravenous Infliximab for Prevention of Peritoneal
           Adhesions Formation in Rats

    • Authors: Saman Nikeghbalian, Homeira Vafaei, Farid Moradian, Kourosh Kazemi, Nader Tanideh, Leila Shayan, Zahra Nikeghbalian
      First page: 97
      Abstract: Objectives: To investigate the effects of intravenous infliximab in preventing the formation of peritoneal adhesions in an animal model of rat.Methods: This was an experimental study being performed in animal laboratory of Shiraz University of Medical Sciences during 2012. Sixty albino rats were randomly assigned in to three groups by Random Design Method. The first group received single infliximab injection (n=20), the second one received double infliximab injection (n=20) and the third received nothing (n=20), after receiving intra-peritoneal injection of talc for induction of peritoneal adhesions. All the animals were sacrificed after 6 weeks and the peritoneal adhesions were evaluated according to Nair classification.Results: We observed that the mean adhesion grade was lower in those who received double dose of infliximib when compared to single dose and controls. However the difference did not reach a significant value (p=0.178). The grade of peritoneal adhesion was also comparable between the three study groups (p=0.103). The mean number of 1st WBC count was also comparable between three study groups (p=0.382). We observed that 2nd WBC count was also comparable between two study groups (p=0.317).Conclusion: Administration of intravenous infliximab after intraabdominal surgicalprocedures would not prevent the formation of peritoneal adhesions in animal model of albino rat.
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
  • Epidemiological and Clinical Characteristics of Fall Injuries in East
           Azerbaijan, Iran; A Cross-Sectional Study

    • Authors: Saber Ghaffari-fam, Ehsan Sarbazi, Amin Daemi, Mohamadreza Sarbazi, Lachin Riyazi, Homayoun Sadeghi-Bazargani, Ali Allahyari
      First page: 104
      Abstract: Objective: To describe the epidemiological and clinical characteristics of fall injuries in East Azerbaijan, Iran.Methods: This cross-sectional study was based on Hospital Information System (HIS) data for patients referred to the Imam Reza Hospital between 2008 and 2013. We recorded the demographic characteristics and epidemiological patterns of patients who were admitted to our center due to fall injuries. To standardize the reports the International Classification of Diseases (ICD), the International Classification of Diseases 9 Clinical Modification (ICD-9-CM)was used. Equally, the hospitalization period and number, admission ward, and the final status of victims after discharge from the hospital were extracted from the HIS.Results: Overall we included a total number of 3397 patients with mean age of 39.2±22.7 years. There were 2501 (73.6%) men among the patients. Long bone fracture (48.1%) and intracranial injury (24.2%) were the most frequent injuries among fall injury victims. Operations on spinal cord and spinal canal structures (12.0%), Operations on nose (11.6%) were the most common operations being performed in these patients. The survival was significantly lower in patients with age more than 60 years when compared to other age groups (p=0.001).The survival rate was significantly lower in age group of >60 years, compared to other age groups (p=0.001).Conclusion: Given the high rate of fall injuries and death among the elderly that increases with age, appropriate measures must be taken to control and prevent injuries while prioritizing the elderly.
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
  • Traumatic Aneurysm of Innominate Artery Resulting in Tracheal Stenosis and
           Rapidly Progressive Respiratory Failure; A Case Report and Literature

    • Authors: Hossein Hodjati, Parviz Mardani, Masoud Mousavi, Ahmad Hoseinzadeh, Sajjad Ahmadi, Sahar Sohrabi, Alireza Golchini
      First page: 111
      Abstract: Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. She had previous motor-vehicle accident a month before presentation for which had undergone chest tube insertion. She was diagnosed to have traumatic aneurysm of innominate artery resulting in tracheal stenosis resulting in acute life threatening respiratory failure. She underwent simultaneous aneurysm resection and tracheal reconstruction. She was uneventfully discharged from hospital. Any post-traumatic respiratory and cardiovascular symptoms may propound an undiagnosed serious injury to the great vessels. Extra and repetitive imaging studies may help us in better evaluation of traumatized patients with high energy mechanisms and sharp injuries to chest and neck.
      PubDate: 2015-07-01
      Issue No: Vol. 3, No. 3 JUL (2015)
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