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EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)                     

Showing 1 - 124 of 124 Journals sorted alphabetically
AACN Advanced Critical Care     Full-text available via subscription   (Followers: 35)
Academic Emergency Medicine     Hybrid Journal   (Followers: 90)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 8)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 8)
Advances in Emergency Medicine     Open Access   (Followers: 17)
Advances in Neonatal Care     Hybrid Journal   (Followers: 43)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 6)
African Journal of Emergency Medicine     Open Access   (Followers: 7)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 5)
American Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Annals of Emergency Medicine     Hybrid Journal   (Followers: 122)
Annals of Intensive Care     Open Access   (Followers: 37)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 15)
Archives of Academic Emergency Medicine     Open Access   (Followers: 6)
Archives of Trauma Research     Open Access   (Followers: 4)
ASAIO Journal     Hybrid Journal   (Followers: 2)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Critical Care     Full-text available via subscription   (Followers: 21)
Bangladesh Critical Care Journal     Open Access   (Followers: 1)
BMC Emergency Medicine     Open Access   (Followers: 25)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65)
Burns Open     Open Access  
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 2)
Case Reports in Acute Medicine     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 12)
Case Reports in Emergency Medicine     Open Access   (Followers: 19)
Chronic Wound Care Management and Research     Open Access   (Followers: 7)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32)
Clinical Intensive Care     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 3)
Clinical Risk     Hybrid Journal   (Followers: 5)
Crisis: The Journal of Crisis Intervention and Suicide Prevention     Hybrid Journal   (Followers: 15)
Critical Care     Open Access   (Followers: 74)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 29)
Critical Care Clinics     Full-text available via subscription   (Followers: 34)
Critical Care Explorations     Open Access   (Followers: 3)
Critical Care Medicine     Hybrid Journal   (Followers: 268)
Critical Care Research and Practice     Open Access   (Followers: 13)
Current Emergency and Hospital Medicine Reports     Hybrid Journal   (Followers: 5)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 73)
Disaster and Emergency Medicine Journal     Open Access   (Followers: 12)
Egyptian Journal of Critical Care Medicine     Open Access   (Followers: 2)
EMC - Urgenze     Full-text available via subscription  
Emergency Care Journal     Open Access   (Followers: 7)
Emergency Medicine (Medicina neotložnyh sostoânij)     Open Access  
Emergency Medicine Australasia     Hybrid Journal   (Followers: 17)
Emergency Medicine Clinics of North America     Full-text available via subscription   (Followers: 19)
Emergency Medicine International     Open Access   (Followers: 8)
Emergency Medicine Journal     Hybrid Journal   (Followers: 53)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Emergency Nurse     Full-text available via subscription   (Followers: 17)
Enfermería Intensiva (English ed.)     Full-text available via subscription  
European Burn Journal     Open Access   (Followers: 5)
European Journal of Emergency Medicine     Hybrid Journal   (Followers: 24)
Frontiers in Emergency Medicine     Open Access   (Followers: 8)
Global Journal of Transfusion Medicine     Open Access   (Followers: 1)
Hong Kong Journal of Emergency Medicine     Full-text available via subscription   (Followers: 5)
Indian Journal of Burns     Open Access   (Followers: 2)
Injury     Hybrid Journal   (Followers: 20)
Intensive Care Medicine     Hybrid Journal   (Followers: 82)
Intensive Care Medicine Experimental     Open Access   (Followers: 2)
Intensivmedizin up2date     Hybrid Journal   (Followers: 4)
International Journal of Critical Illness and Injury Science     Open Access   (Followers: 1)
International Journal of Emergency Medicine     Open Access   (Followers: 9)
International Journal of Emergency Mental Health and Human Resilience     Open Access   (Followers: 2)
International Paramedic Practice     Full-text available via subscription   (Followers: 14)
Iranian Journal of Emergency Medicine     Open Access  
Irish Journal of Paramedicine     Open Access   (Followers: 2)
Journal Européen des Urgences et de Réanimation     Hybrid Journal   (Followers: 1)
Journal of Acute Care Physical Therapy     Hybrid Journal   (Followers: 3)
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal Of Cardiovascular Emergencies     Open Access  
Journal of Concussion     Open Access  
Journal of Critical Care     Hybrid Journal   (Followers: 47)
Journal of Critical Care Medicine     Open Access   (Followers: 17)
Journal of Education and Teaching in Emergency Medicine     Open Access   (Followers: 1)
Journal of Emergencies, Trauma and Shock     Open Access   (Followers: 13)
Journal of Emergency Medical Services     Full-text available via subscription   (Followers: 12)
Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Journal of Emergency Medicine, Trauma and Acute Care     Open Access   (Followers: 26)
Journal of Emergency Practice and Trauma     Open Access   (Followers: 6)
Journal of Intensive Care     Open Access   (Followers: 9)
Journal of Intensive Care Medicine     Hybrid Journal   (Followers: 22)
Journal of Intensive Medicine     Open Access  
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Stroke Medicine     Hybrid Journal  
Journal of the American College of Emergency Physicians Open     Open Access   (Followers: 1)
Journal of the Intensive Care Society     Hybrid Journal   (Followers: 4)
Journal of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6)
Journal of Thrombosis and Haemostasis     Hybrid Journal   (Followers: 81)
Journal of Translational Critical Care Medicine     Open Access   (Followers: 5)
Journal of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 34)
La Presse Médicale Open     Open Access  
Médecine de Catastrophe - Urgences Collectives     Hybrid Journal  
Medicina Intensiva     Open Access   (Followers: 3)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Mediterranean Journal of Emergency Medicine & Acute Care : MedJEM     Open Access  
Notfall + Rettungsmedizin     Hybrid Journal   (Followers: 3)
OA Critical Care     Open Access   (Followers: 3)
OA Emergency Medicine     Open Access   (Followers: 2)
Open Access Emergency Medicine     Open Access   (Followers: 7)
Open Journal of Emergency Medicine     Open Access   (Followers: 2)
Palliative Care : Research and Treatment     Open Access   (Followers: 19)
Palliative Medicine     Hybrid Journal   (Followers: 51)
Prehospital Emergency Care     Hybrid Journal   (Followers: 19)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 41)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Resuscitation     Hybrid Journal   (Followers: 54)
Resuscitation Plus     Open Access   (Followers: 2)
Saudi Critical Care Journal     Open Access   (Followers: 2)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine     Open Access   (Followers: 11)
Seminars in Thrombosis and Hemostasis     Hybrid Journal   (Followers: 47)
Shock : Injury, Inflammation, and Sepsis : Laboratory and Clinical Approaches     Hybrid Journal   (Followers: 10)
Sklifosovsky Journal Emergency Medical Care     Open Access  
The Journal of Trauma Injury Infection and Critical Care     Full-text available via subscription   (Followers: 24)
Therapeutics and Clinical Risk Management     Open Access   (Followers: 2)
Transplant Research and Risk Management     Open Access  
Trauma Case Reports     Open Access   (Followers: 1)
Trauma Monthly     Open Access   (Followers: 3)
Visual Journal of Emergency Medicine     Full-text available via subscription   (Followers: 1)
Western Journal of Emergency Medicine     Open Access   (Followers: 11)
 AEM Education and Training : A Global Journal of Emergency Care     Open Access   (Followers: 1)

           

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Journal Cover
Trauma Monthly
Journal Prestige (SJR): 0.313
Citation Impact (citeScore): 1
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2251-7464 - ISSN (Online) 2251-7472
Published by Kowsar Publishing Co Homepage  [19 journals]
  • Multidisciplinary Team Experiences of Challenges to Early Rehabilitation
           Care in Multiple Trauma Patients in Iran: A Qualitative Study

    • Abstract: Background: Trauma is one of the major non-communicable diseases of this century and one of the main problems threatening public health. Trauma injuries are the leading cause of disability and mortality in all countries. This study aimed to explore and understand the challenges of early rehabilitation care in multiple trauma patients from the experience of a multidisciplinary care team using a qualitative research method. Methods: This study was conducted with the qualitative research approach using qualitative content analysis. Participants were seven nurses, two doctors, three physiotherapies, and two occupational therapists in inpatient wards and outpatient trauma were interviewed. Data were collected through semi-structured interviews with a purposive sampling continued until data saturation. Analysis of data collected concurrently with data for comparison was done.Results: First, for depth descriptions of the participant statements, 800 codes were extracted and finally, for the analysis, and constant comparison, two main themes of the lack of holistic care and support structure were extracted.Conclusion: The results showed that comprehensive and rehabilitation-based care was essential to achieve important care goals in this group of patients. Understanding the challenges of early rehabilitation care in multiple trauma patients will help health policymakers that solve these problems and help improve the health of this group.
       
  • External Iliac Artery Injury Occurring After Pelvic Ring and Acetabulum
           Fracture: A Rare Case Report

    • Abstract: After head trauma, pelvic fractures are the most common cause of death in patients with multiple trauma. The primary cause of death in patients with a pelvic fracture is uncontrollable bleeding, and in cases of delayed intervention, hemorrhagic shock is the principal cause of death. Bleeding from the external iliac artery following a Pelvic Ring and acetabulum fractures is an uncommon injury and an orthopedic emergency. A 48-year-old man who experienced an accident trauma was referred to the hospital, and an APC‎ II of the Pelvic Ring‏ ‏and Acetabulum fractures were diagnosed. The patient developed thrombosis in the external iliac artery 48 hours after admission with a diagnosis of a lack of femoral pulse. CT angiography was performed for further examination. Then, in surgery, the anterior column of the acetabulum on the left side and symphysis disruption, an open reduction, and internal fixation with a reconstruction of 3.5 plates via a modified Stoppa approach was used. Sacroiliac disruption on the right side was repaired by percutaneous sacroiliac screw fixation. In the same session, the vascular repair was conducted via interposition graft of PTFE. After the treatment interventions, the patient's general condition was satisfactory, and he was discharged without any particular complication. Due to the possibility of arterial injury in this trauma, the appropriate treatment can be done at the right time by checking pulses. While artery injuries are rare, they could be life-threatening.
       
  • Minimally Invasive Plate Osteosynthesis (MIPO) Technique for Treatment of
           Delayed or Nonunion of the Humerus Shaft Fracture: A New Technique

    • Abstract: Background: The humerus shaft fracture (HSF) is a typical long bone fracture. Following non-surgical therapy, some patients experience delayed or non-union of the HSF. The most common treatment is open reduction and internal fixation (ORIF) with plate and bone graft. However, substantial tissue dissection increases radial nerve damage and delays union. Because of its minimally invasive nature, the minimally invasive plate osteosynthesis (MIPO) method may be a suitable replacement technique. MIPO helps in the protection of soft tissue and nerves in the area of the fracture. A better and faster union achieve with less tissue dissection and vascular disturbance.Methods: All patients were treated with the MIPO method using bone graft implantation. A specific six-hole locking plate was used during surgeries. Physical examinations and radiological studies were used to monitor the patients' progress. UCLA and the MEPS scoring system assessed shoulder and elbow function. The average follow-up period was six months.Result: The mean age of patients was 39.8 years (19-73 years). The mean fracture site distance from the elbow joint was 12.1 cm. The mean maximal final rotation was 3.3 degrees. The last rotation alignment was within normal limits. No shortening was detected. Average scores were 35 for UCLA and 100 for MEPS. Radial nerve damage was not reported. Malunion delayed union, or nonunion did not occur. Mean union time was 2.8 months.Conclusion: MIPO technique combined with bone transplant causes micromotion at the fracture site, resulting in a better and faster union. Its minimally invasive nature also helps prevent iatrogenic injury to nerves and soft tissue. Less tissue manipulation and dissection help shoulder and elbow function progress more quickly and reduce the rate of malunion. We recommend using this method in delayed union and nonunion of the HSF patients to reach better outcomes and lesser complications.
       
  • Transverse Clival Fracture with Vertical Displacement: A Case Report

    • Abstract: Clival fracture is a rare traumatic injury that usually occurs in patients with high-energy trauma to the head and neck. Here, we present and discuss our experience with a patient with a transverse clival fracture associated with a significant vertical displacement. A 52 years-old comatose patient was admitted to our emergency department after a high-energy motor vehicle accident. The physical examination demonstrated a Glasgow coma scale (GCS) of 6 (with the motor scale of 4) associated with a left-sided six cranial nerve palsy, a left-sided fixed and dilated pupil; and quadriparesis that was more severe on the right side. The imaging tests revealed the brain contusions, pneumocephalus, and generalized brain edema without local mass effect and midline shift. Also, it showed TCF with a significant vertical displacement and a signal change within the medulla oblongata. The clival fracture was managed in a mild head flexion position without bracing, a routine ICU exchange body positioning program, and the minimum time of supine positioning. The follow-up imaging three months later showed complete bone fusion without any displacement. After 18 months of follow-up, he ambulated, and cranial nerve deficits improved except for mild diplopia due to a remnant of 6 nerve paresis. Transverse clival fracture, as most of the authors reported, does not need surgical treatment. Bracing can be used in conscious ambulated patients. A mild head-on-neck flexion position associated with suppurative care for bedsores can be a good option for unconscious patients.
       
  • Treatment of Acute Type I Proximal Fifth Metatarsal Fracture; Casting vs
           Bracing: Randomized Clinical Trial

    • Abstract: After head trauma, pelvic fractures are the most common cause of death in patients with multiple trauma. The primary cause of death in patients with a pelvic fracture is uncontrollable bleeding, and in cases of delayed intervention, hemorrhagic shock is the principal cause of death. Bleeding from the external iliac artery following a Pelvic Ring and acetabulum fractures is an uncommon injury and an orthopedic emergency. A 48-year-old man who experienced an accident trauma was referred to the hospital, and an APC‎ II of the Pelvic Ring‏ ‏and Acetabulum fractures were diagnosed. The patient developed thrombosis in the external iliac artery 48 hours after admission with a diagnosis of a lack of femoral pulse. CT angiography was performed for further examination. Then, in surgery, the anterior column of the acetabulum on the left side and symphysis disruption, an open reduction, and internal fixation with a reconstruction of 3.5 plates via a modified Stoppa approach was used. Sacroiliac disruption on the right side was repaired by percutaneous sacroiliac screw fixation. In the same session, the vascular repair was conducted via interposition graft of PTFE. After the treatment interventions, the patient's general condition was satisfactory, and he was discharged without any particular complication. Due to the possibility of arterial injury in this trauma, the appropriate treatment can be done at the right time by checking pulses. While artery injuries are rare, they could be life-threatening.
       
  • Comparison of Effect of Dressing with Bilva Herbal Ointment and Silver
           Sulfadiazine on Healing Process, Pain and Itching of Burn Wounds: A
           Randomized Clinical Trial

    • Abstract: Background: The most common method for the dressing of burn wounds is silver sulfadiazine (SSD); however, its side effects on wound healing, along with the need for repeated use for healing, are often painful.This study aimed to compare two different dressings, namely Bilva and SSD ointments, on healing, pain, itching, and scarring of theburn wounds. Methods: This clinical trial study was performed on 35 patients with superficial second-degree burns hospitalized in Burn Ward of Sina Hospital in Tabriz, Iran, from 2019 to 20. After irrigation of the wound, Bilva ointment was applied randomly on one side and SSD ointment on the other side to repair patients' burns. Patients were followed up on days 1, 7, 14, 21, as well as the first, second, and third months after burns; data related to the wound healing process along with pain, itching, and scar status of patients were collected with a checklist.   Results: There was no statistically significant difference between the two groups of variables related to the wound healing process on all days of the study. The amount of burn wound scar did not differ between the two groups on day 21 as well as on the first, second, and third months. Patients' pain and itching were significantly better in the Bilva group on the 7th (p<0.01), 14th (p<0.01), 21st day (p<0.01), and the first month (p<0.01) after burns relative to the SSD group. Conclusion: Bilva ointment had a similar effect in healing the burn wounds of patients compared to SSD, and it was more effective in controlling pain and itching of burn wounds than SSD. Further studies are needed to evaluate the cost-effectiveness of this dressing method on superficial burn wounds.
       
  • Surgery First vs. Orthodontic First Orthognathic Surgery Approaches in
           Management of Skeletal Class III Malocclusion: A Systematic Review

    • Abstract: Background: This study aimed to review the articles comparing orthodontic first (OFA) and surgery first approaches (SFA) orthognathic approaches from various treatment aspects of patients with class III skeletal malocclusion. Methods: Electronic databases were systematically searched, including PubMed, Scopus, and Web of Science. We included experimental cohort and retrospective studies that compared the orthodontics first (conventional method) and surgery first approaches in the management of patients with skeletal class III malocclusion in various aspects. Results: Overall, 294 records were found through database searching and after removing duplicates, 131 papers were investigated. Finally, 17 studies were included in this study. The included studies have evaluated vast spectroum of outcome measures ranging from quality of life and duration of treatment to cephalometric measures. The amount of surgical movement, post-surgical change, and the relapse rate was the most prevalent assessed outcome measure in 10 out of 17 included studies, followed by total treatment time, which was evaluated in 8 studies. Other less common outcome measures were temporomandibular joint (TMJ) disorders and the oral health-related quality of life (OQLQ) questionnaire. Conclusion: Two OFA and SFA orthognathic surgery approaches are not different in terms of the final amounts of surgical change in the mandible and maxilla. Also, these two approaches can remarkably improve the quality of life with no intergroup differences. It was realized that there are no united agreements on the effects of two OF and SF approaches on the outcomes the patients with class III skeletal malocclusions.
       
  • A True Finger Artery Aneurysm Without Trauma Relationship: A Case Report

    • Abstract: An aneurysm is defined as a permanent dilation of an artery diameter more than 50% of its typical diameter. The aneurysm of the finger artery is a sporadic disease that divides into true and false types. A Pseudo-aneurysm of the finger artery is more prevalent than a true aneurysm; caused by penetrating trauma. A patient with a true aneurysm of the finger's artery without trauma history is reported. It was removed after proximal and distal control and heparin IV injection. The finger artery was micro-surgically repaired to maintain distal blood flow and prevent finger ischemia and adverse consequences in future trauma.
       
  • Fracture of the Humeral Trochlea: A Rare Case

    • Abstract: The isolated trochlea fracture is a rare condition that has been previously reported in different settings and times. However, there is still a lack of data regarding the diagnosis and treatment of this condition. Hence, we sought to clarify various aspects of isolated trochlea fracture. The case presented was a young man referred to our hospital following a high-energy motor-car accident. The diagnosis was made via anteroposterior and lateral X-ray and   with 3-dimensional computed tomography. Following diagnosis, open reduction and internal fixation with medial approach were selected for the patient. Finally, the patient’s follow-up revealed that the range of motion of the affected elbow reached its normal range six months after the operation.
       
  • Aspiration in Tube Feeding Method of Intermittent Drip Bag in the
           Intensive Care Unit and Trauma Patients

    • Abstract: Introduction: Aspiration-induced pneumonia is responsible for 15-20% of hospital infections and a 39% increase in   costs. Besides, it is one of the ten leading causes of death in   the USA. It can be prevented by choosing the feeding method. This study aimed to assess the incidence of respiratory aspiration using the tube feeding method of intermittent drip bag.Methods: This one group only post-test study was conducted on 36 ICU   trauma patients. The patients were fed using the tube feeding method of intermittent drip bag for three days, each time with 150 to 300 cc liquid nourishing solution for 30 to 60 minutes with three-hour intervals. To detect respiratory aspiration, 0.5 cc of methylene blue 1% was added to 500 cc of the liquid. In case the patients needed suction, whenever the blue color of methylene blue was observed in the lung secretions during suction of the respiratory tube, incidence of respiratory aspiration was ascertained. The data were collected using Demographic information registration form and Clinical Information Registration Questionnaire. Then, the data were analyzed using SPSS V19 and descriptive and analytic statistics.Results: The results revealed no incidence of respiratory aspiration via the tube feeding method of intermittent drip bag during   three consecutive days.Conclusion: The present study indicated no respiratory aspiration   observed using the tube feeding method of intermittent drip bag, this method can be utilized in the centers that are not equipped with feeding pump. Moreover, using feeding bags instead of feeding pumps plays a key role in reducing related costs.
       
  • Diagnostic Accuracy of Jaw Bone Particles Adjacent to Metallic Foreign
           Bodies in The Maxillofacial Region: An Animal Model

    • Abstract: Introduction: Knowledge of effective imaging methods to determine the metallic foreign bodies is essential to better manage patients with trauma injuries. The study aimed to evaluate of visibility of jaw bone particles adjacent to metallic foreign bodies related to the explosion in the maxillofacial region by panoramic imaging, Computed Tomography (CT), Cone-Beam Computed Tomography (CBCT), and Ultrasonography (US). Methods: Ten fresh sheep’s head was used in this in vitro study. Metal foreign objects with dimensions of 1×10×10 mm, 1×5×5 mm, and 1×3×3 mm were placed in the infraorbital area on the right were used. In each imaging, just one of the iron bodies is applied at the center. Then nine parts of the mandibular bone with dimensions of 1×10×10 mm, 1×5×5 mm, and 1×3×3 mm (3 sets, containing all sizes) were placed 5, 10, 20 mm upper (cephalic), inferior (caudal), and posterior to a metallic foreign body, respectively. The same procedure was repeated for all three sizes of metals. Panoramic imaging, computed tomography, cone-beam computed tomography, and Ultrasonography were obtained by were observed by an oral and maxillofacial radiologist and a general radiologist.  Results: CBCT and CT had good visibility in detections of bone particles adjacent to metallic foreign bodies. There were no significant differences between CBCT and CT regarding detections of bone particles adjacent to metallic foreign bodies (8.56±1.54 and 8.46±2.15 and P=0.56). Panoramic view and US poor visibility in detections of bone particles adjacent to metallic foreign bodies. The mean of number bone detection in the panoramic view was 3.47±1.41 and in the US was 4.06±1.74 (P=0.23). There were significant differences between panoramic view and the US with CBCT and CT regarding detections of bone particles adjacent to metallic foreign bodies (P<0.001). The results were the same regarding distances of bones to metallic foreign bodies. Conclusion: The results showed that CBCT and CT are effective methods as the first option in detecting bone particles adjacent to metallic foreign bodies in the infraorbital area of the Maxillofacial Region.
       
  • An Analysis of Daily Emergency Department Surge and its Relevance to
           Disaster Preparedness

    • Abstract: Introduction: Daily emergency department surges can cause crowding in facilities that do not have adequate physical and personnel resources to meet peak demands. The mismatch between surge and surge capacity results in ED crowding, thus indicating compromised daily ED capacity. This study aimed to analyze the daily ED visits and the relevance of this data in disaster preparedness at the Qassim hospital in Saudi Arabia. Methods: This retrospective analytic study was conducted in the central hospitals of Buraidah City, including King Fahad Specialist Hospital (KFSH), Buraidah Central Hospital (BCH), and Maternity and Children’s Hospital (MCH) in Saudi Arabia. Data were collected from January 2017 to December 2018 using a specially designed data collection form. ED visit information such as visits per month, and per day, were collected. Results: During the study period, 311805 patients visited the King Fahad Specialist Hospital ED, 131071 patients visited the Maternity and Children’s Hospital ED, and 284693 patients visited the Buraida Central Hospital ED. The highest number of visits per month in 2017 was recorded at KFSH with 18,849 patients, while in 2018, it was at BCH with 11,983 patients. The mean number of ED visits per day and month was significantly different between the three hospitals in 2017 and 2018 (P <.001). A significant association was noted between visits per time of day and hospitals in 2018 (P <.0001). Conclusion: This study suggests that overcrowding investigated during the selected period occurred less in 2018 compared to 2017 in KFSH due to a strict triage initiative. However, the problem of patient overcrowding in MCH and BCH still needs to be addressed.
       
  • Functional and Radiological Outcomes in Intra-Articular Fractures of
           Distal Radius with Volar Variable Angle Locking Plates

    • Abstract: Introduction: Intra-articular fractures of the distal radius pose a surgical challenge as there is no consensus in the literature on the treatment for these fractures. Many treatment modalities have been described; however, the use of volar variable angle locking plates is currently being advocated for these fractures. Methods: Overall, 28 patients with intra-articular fractures of the distal radius managed with a volar variable angle locking plate were included in this study. The mean age of the patients in our study was 33.24 ± 11.74 years (range 22-64), and the average follow-up period was 12.18 ±2.64 months (range 6-20). Radiological assessment was done by analyzing volar tilt, radial inclination, radial length, and ulnar variance from the radiographs taken at six weeks and six months’ post-surgery. Functional assessment was done at two weeks, six weeks, three months, and six months. The final functional outcome was calculated at six months   using the Gartland and Werley scoring system.  Results: There was a constant gain in functional parameters, and significant improvements occurred within 12 weeks. Radiological indices were also maintained after six months of final follow-up showed no significant change. According to the Gartland and Werley scoring system, results were   75% excellent, 14.28% good, 7.14% fair, and 3.57% poor.   One patient developed a superficial infection which was managed with oral antibiotics, one patient had screw impingement for which screw removal was done at eight months, and another developed complex regional pain syndrome that was managed conservatively but ultimately had a poor outcome. Conclusion: The use of Volar VALCP in intraarticular distal radius fractures is associated with early rehabilitation and good functional and radiological outcomes.
       
  • Nerve Root Sedimentation Sign: A Potential Diagnosis of Symptomatic Lumbar
           Spinal Stenosis

    • Abstract: Introduction: Nerve root sedimentation sign is natural sedimentation of lumbar nerve roots to the dorsal part of the dural sac seen on transverse MRI scans. This phenomenon can be taken advantage of to distinguish symptomatic lumbar spinal stenosis from nonspecific low back pain. We aimed to evaluate the clinical validity of the nerve root sedimentation sign to diagnose patients with symptomatic lumbar spinal stenosis who need surgical intervention.Methods: In this study, 100 patients were surveyed referring to an Orthopedic Clinic with a chief complaint of chronic low back pain (LBP) for three months or more. Demographic information, physical examination, and lumbar MRI scans were obtained, then the patients were assigned to two groups of 50 patients in each   namely Lumbar spinal stenosis (LSS) and LBP groups. The frequency of a positive sedimentation sign was compared between the two groups.Results: The mean age of patients was 57.95±9.81 years, 61 of them were male, and the rest of the 39 subjects were female. Nerve root sedimentation sign was positive in 48 pts of the LSS group (96% Sensitivity) but none in the LBP group (100% specificity).Conclusion: A positive sedimentation sign exclusively and reliably occurs in patients with lumbar spinal stenosis, suggesting its usefulness in clinical practice. Future   studies are needed to address its sensitivity and specificity. 
       
  • A Review on Total Hip Replacement and Vascular Complications

    • Abstract: Introduction: Total hip arthroplasty (THA) is a typical surgical procedure with uncommon and preventable complications. However, most adverse events following THA are unusual and preventable or easily treated as expected. This study examined the two common complications of the THA procedure namely: orthopedic and vascular complications and their management. Methods: The primary search began with reviewing   citations from PubMed, and Scopus, between 1991 and 2020 using the keywords: (Hip arthroplasty) or (Arthroplasty AND Hip AND vascular Complications). Results: Overall, 117 articles were extracted with the initial search. Then 67 studies were selected and used in the present study according to inclusion criteria. The studies reputed thromboembolic disease as vascular complications. The management of vascular complications includes preoperative management, preoperative clinical investigation, intraoperative, and postoperative management. Conclusion: In general, vascular injuries are rare in hip replacement surgeries. Vascular injuries can appear early in surgery, in the mid-term as postoperative bleeding, and later as pseudo-aneurysms. 
       
  • Dual mobility cups hip arthroplasty as a treatment for displaced fracture
           of the femoral neck in the elderly patients: A prospective, systematic
           study with specific focus on postoperative dislocation using posterior
           approach.

    • Abstract: Introduction: Displaced fractures of the femoral neck in the elderly are best treated with arthroplasty. The type of arthroplasty to be used, either hemi- or total hip arthroplasty, remains controversial as total hip replacements potentially have a higher rate of dislocation.Hypothesis: Dual mobility cups have a low dislocation rate when used to manage fractures of the femoral neck with posterior approach.Patients and methods: In our center prospective study conducted in Amritsar (Punjab) India over an inclusion time of 2 years, all displaced fractures of the femoral neck treated with arthroplasty were operated on with insertion of a dual mobility cup with posterior approach. Patients had clinical and radiological assessment at immediate post op, 3 and 6 months, 1 year and 3 year after surgery.Results: Among these 240 patients, The right hip was operated on 121 (50.4%) patients and left hip on 119 (49.6%) patients. There was a male preponderance seen and 101 (42.1%) out of 240 patients were female. None of the patients was lost to follow-up. All patients were operated through a posterior approach. The mean Harris hip score improved from 16.62 ± 6.34 preoperative to 92.86 ± 2.28 at the time of 1 year follow up and 95.20 ± 1.82 at the time of 3 years follow up We had three dislocation occurred and Open Reduction was performed through posterior approach under regional anesthesia for 2 patients and close reduction done in one patient . There was no recurrence of dislocation.CONCLUSIONS: Our experience with Dual mobility cup is an effective solution for the management of treatment for displaced fracture of the femoral neck in the elderly undergoing total hip replacement to reduce the incidence of postoperative instability even after using posterior approach.
       
  • Assessment of Endoscopic Colonic Stenting outcomes in Patients with Acute
           Malignant Colonic Obstruction

    • Abstract: Background: The traditional method of treating patients with acute malignant colonic obstruction (AMCO) is emergency surgery, which is often accompanied by the development of severe complications and high mortality. Endoscopic colonic stenting with self-expandable metal stents (SEMS) is considered to be a promising way to treat such patients. However, its capabilities are not yet fully explored. This paper presents a cross-sectional study of the results of endoscopic colonic stenting using SEMS in AMCO patients, performed in 2016 - 2020.Objective: to clarify the outcomes of endoscopic stenting with SEMS in AMCO patients and identify the factors that influence its result.Materials and Methods. The study included 218 patients with AMCO in whom surgeons made an attempt to eliminate the acute colonic obstruction using the method of endoscopic stenting. The capabilities of endoscopic stenting were assessed on the basis of calculated technical and clinical efficacy, the incidence of complications and mortality. To identify the factors that can predict the outcome of a stenting attempt, all patients were divided into two groups: a group of clinical success (182 patients) and a group of clinical failure (36 patients). The groups were subjected to comparative analysis.Results. The analysis of the obtained results registered that the technical efficiency of endoscopic stenting of the colon is 91.7% and its clinical efficiency is 83.5%, the incidence of intra-abdominal complications is 8.3%, the incidence of somatic complications is 11.9%, the mortality is 5%. Comparative analysis of the groups revealed differences (with p <0.05) for the oncological process stage, the duration and the severity of intestinal obstruction. Conclusion. Endoscopic stenting of the colon with SEMS is an effective way to treat patients with AMCO. Its success can vary depending on the severity of trophic disorders in the intestinal wall.
       
 
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