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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  [10 journals]
  • Deep Brain Stimulation in Patients with Traumatic Brain Injury; Facts and

    • Authors: Fariborz Ghaffarpasand, Ali Razmkon, Hosseinali Khalili
      Pages: 101 - 102
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Perihepatic Packing versus Primary Surgical Repair in Patients with Blunt
           Liver Trauma; an 8-year Experience

    • Authors: Shahram Paydar, Mojtaba Mahmoodi, Mohammad Jamshidi, Hadi Niakan, Mohammad Keshavarz, Nader Moeenvaziri, Mohammad Esmaeil Ghorbaninejad, Farnaz Farrokhnia, Forough Izadi Fard, Zahra Jaafari, Yalda Golshan, Hamidreza Abbasi, Shahram Bolandparvaz, Behnam Honarvar
      Pages: 103 - 109
      Abstract: Objective: To explore the pros and cons of early versus delayed intervention when dealing with severe blunt liver injury with significant hemoperitoneum and hemodynamic instability.Methods: This retrospective cross-sectional study was performed at the Nemazi hospital, Shiraz, Southern Iran, level I trauma Center affiliated with Shiraz University of Medical Sciences. The study population comprised of all patients who were operated with the impression of blunt abdominal trauma and confirmed diagnosis of liver trauma during an 8-year period. All data were extracted from patients’ hospital medical records during the study period. The patients’ outcome was compared between those who underwent perihepatic packing or primary surgical repair.Results: Medical records of 76 patients with blunt abdominal liver trauma who underwent surgical intervention were evaluated. Perihepatic packing was performed more in patients who have been transferred to operation room  due to unstable hemodynamics (p<0.001) as well as in patients with more than 1000 milliliters of hemoperitoneum based on pre-operative imaging studies (e.g. CT/US) (p=0.002).Conclusion: We recommend that trauma surgeons should approach perihepatic packing earlier in patients who have been developed at least two of these three criteria; unstable hemodynamics, more  than  1000 milliliters hemoperitoneum  and  more  than  1600 milliliters of intra-operative  estimated blood  loss. We believe that considering these criteria will help trauma surgeons to diagnose and treat high risk patients in time so significant hemorrhage (e.g. caused by dilatational coagulopathy, hypothermia and acidosis, etc.) can ultimately be prevented and more lives can be saved.
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Executive Functions among Traumatic Injury Patients: Comparison of Normal
           Individuals and those with Attention Deficit Hyperactivity Disorder

    • Authors: Arash Mani, Rohallah Rostami, Ali Alavi Shoushtari, Shahram Paydar
      Pages: 110 - 114
      Abstract: Objectives: To describe the executive function of patients with traumatic injury admitted to Rajaei hospital, Shiraz, Iran and to compare the executive function between normal individuals and those with Attention Deficit Hyperactivity Disorder (ADHD).
      Methods: This was a case control study being performed during a 6-month period during spring and summer of 2013 in Shiraz level I trauma center. We included all patients admitted during the study period with impression of traumatic injury with or without adult ADHD. The patients’ demographic factors were assessed through
      self-report questionnaire and executive functions by Wisconsin Card Sort Test (WCST) and Tower of London (TOL) Results were compared between normal individuals and those with ADHD.Results: Among 60 patients evaluated during the study period, with impression of traumatic injury, 29 fulfilled adult ADHD criteria and 31 were normal. The mean age of ADHD patients was 27.16±5.6 years and that of normal individuals was 26±3.4 years (p=0.330). There were no significant differences between two study groups regarding IQ (p=0.191) and education (p=0.396). Patients with ADHD had significantly poorer mean in executive functions in different parts of the test scoring system when compared to normal individuals.Conclusion: ADHD patients with traumatic injury had poor executive function compared to normal individuals. This might lead to poor inhibition, shifting and problem solving in this population.
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Determinants of Behavior of Students as Pedestrian and Car Occupants in
           Relation to Traffic Laws in 2013, Gorgan, Iran; An Application of Health
           Belief Model

    • Authors: Hashem Heshmati, Nasser Behnampour, Golnaz Binaei, Samane Khajavai
      Pages: 115 - 120
      Abstract: Objectives: To determine the behavioral pattern of Golestan University of Medical Science (GUMS) students as pedestrian and car occupants in relation to traffic law based on Health Belief Model.
      Methods: This cross-sectional study was performed during 2012 in GUMS. A total of 370 students of GUMS were selected using multi-stage sampling method including stratified and random sampling. Data were collected by using a reliable and valid questionnaire. All the participants filled the questionnaire and the data was extracted according to previously described method. Data were analyzed by using SPSS 18 Software. Descriptive statistic and Spearman correlation was used for
      analyzing the data.
      Results: Mean age of the participants was 20.92±1.98 (range 17-32) years. Mean score of perceived susceptibility was 81.87±17.18, being in desirable level. Mean score of perceived severity was 73.39±18.4, being also in desirable level. Mean score of perceived benefits was 77.22 ±16.13, which was also assumed to be in desirable level. Mean score of perceived barriers was 53.46±16.27, assumed as moderate level. In the same way the mean score of practice was 66.17±17.51, so practice in students was in moderate level. Television was the most important cues to action.Conclusion: Perceived susceptibility, perceived severity, perceived benefits regarding safety behaviors was in good level but perceived barriers and behavior was in moderate level and according to the importance of Television, we recommended appropriate intervention such as health education and advocacy, especially through national Television.
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Subciliary Approach for Inferior Orbital Rim Fractures; Case Series and
           Literature Review

    • Authors: Seyed Mohammad Motamed al Shariati, Mostafa Dahmardehei, Hasan Ravari
      Pages: 121 - 124
      Abstract: Objective: To report the outcome of subciliary approach for inferior orbital rim fractures in a series of Iranian patients.Methods: This was prospective cross-sectional, being performed during a 12-month period during 2013 in plastic surgery department of Emamreza Hospital of Mashhad. We included 12 patients with traumatic inferior orbital rim fractures who underwent surgical repair through subciliary approach. All the patients were followed for 12 months and were evaluated regarding paresthesia and function as well as presence of a visible scar and lower-eyelid malposition.Results: There were 9 (75.0%) men and 3 (25.0%) women among the patients with mean age of 26.3±10.6 (range 16-48) years. Of the 12 patients treated with the subciliary approach, 4 (33.3%) experienced complications. One (8.3%) patient showed 1.5 mm sclera at the end of one year follow-up. No ectropion or entropion was reported in our series. In contrast to 3 (25.0%) cases of lower lid visible scar, there was no occurrence of hypertrophic scar.Conclusion: It would be expected that the transorbital approach as it offers good visualization of anterior fractures would result in good outcomes in cases of orbital rim and floor fracture.
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Determinants of Successful Non-Operative Management of Intra-Peritoneal
           Bleeding Following Blunt Abdominal Trauma

    • Authors: Ammar Heidar, Parsa Ravanfar, Golnaz Namazi, Taha Nikseresht, Hadi Niakan
      Pages: 125 - 129
      Abstract: Objectives: To identify the predictive factors of successful non-operative management of patients with intraperitoneal bleeding following blunt abdominal trauma.Methods: This was cross-sectional study being performed in our Level I trauma center in southern Iran between 2010 and 2011. We included adult (>14 years) patients with blunt abdominal trauma and intraperitoneal hemorrhage detected by CT-Scan who were hemodynamically stable and did not require any surgical intervention. Patients were managed conservatively in ICU. Those who required laparotomy during the study period were named as non-operative management failure (NOM-F) while the other were nonoperative management success (NOM-S). The baseline, clinical and laboratory characteristics were compared between two study groups in order to detect the predictors of successful NOM of intra-peritoneal bleeding.Results: Overall we included 80 eligible patients among whom there were 55 (68.7%) men and 25 (31.3%) women with mean age of 30.63.6± years. Finally, 43 (53.8%) were successfully managed conservatively (NOM-S) while 37 (46.2%) required laparotomy (NOM-F). We found that those who underwent emergency laparotomy had significantly higher ĘHb (p=0.016) and lower base deficit (p=0.005) when compared to those who were successfully managed conservatively. Those who required surgical intervention had significantly lower baseline systolic blood pressure (p<0.001) and higher shock index (p=0.002). The other parameters such as pulse rate and respiratory rate were comparable between two study groups.Conclusion: In patients with intra-peritoneal bleeding following blunt abdominal trauma, the most reliable predictive clinical and para-clinical factor of successful non-operative management are shock index and systolic blood pressure on arrival, base deficit and hemoglobin drop within first 12 hours of admission. 
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Bilateral Traumatic Basal Ganglia Hemorrhage Associated With Epidural
           Hematoma: Case Report and Literature Review

    • Authors: Willem Guillermo Calderon-Miranda, Hernando Raphael Alvis-Miranda, Gabriel Alcala-Cerra, Andres M Rubiano, Luis Rafael Moscote-Salazar
      Pages: 130 - 132
      Abstract: Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. Bilateral basal ganglia hematoma are among the devastating and rare condition. We herein report a 28-year old man, a victim of car-car accident
      who was brought to our surgical emergency room by immediate loss of consciousness and was diagnosed to have hyperdense lesion in the basal ganglia bilaterally, with the presence of right parietal epidural hematoma. Craniotomy and epidural hematoma drainage were considered, associated to conservative management of gangliobasal traumatic contusions. On day 7 the patient had sudden neurologic deterioration, cardiac arrest unresponsive to resuscitation. Management of these lesions is similar to any other injury in moderate to severe traumatic injury. The use of intracranial pressure monitoring must be guaranteed.
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Chemotherapy-Induced Perforation of Gastric Burkitt Lymphoma; A Case
           Report and Review of the Literature

    • Authors: Shahram Bolandparvaz, Sina Jelodar, Mina Heidari Esfahani, Sam Moslemi
      Pages: 133 - 135
      Abstract: Burkitt lymphoma of stomach is among the most rapidly growing gastric cancersassociated with several gasterointestinal  symptoms  including  hematemesis,  anorexia,  vomiting  and  etc. Gastric perforation  in patients with Burkitt lymphoma of stomach is a very rare condition especially after chemotherapy. We herein present a 21-year old man who was kwon case of gastric Burkitt lymphoma who had undergone chemotherapy and presented with acute onset gastric pain and tenderness. He was diagnosed to suffer from perforated gastric lymphoma for which laparotomy and total gastrectomy was performed. Treatment was continued by chemotherapy. Closed observation is thus recommended for those patients with gastric Burkitt lymphoma undergoing chemotherapy.
      PubDate: 2014-07-01
      Issue No: Vol. 2, No. 3 JUL (2014)
  • Perfect Timing of Tracheostomy in Patients with Traumatic Brain Injury

    • Authors: Shahram Paydar, Hosseinali Khalili, Seyed Mohsen Mousavi
      Pages: 136 - 137
      PubDate: 2014-07-10
      Issue No: Vol. 2, No. 3 JUL (2014)
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