Earthquake Related Injuries: Assessment of 854 Victims of the 2003 Bam Disaster Transported to Tertiary Referral Hospitals

2008 ◽  
Vol 23 (6) ◽  
pp. 510-515 ◽  
Author(s):  
Hassan Ali Mohebbi ◽  
Shaban Mehrvarz ◽  
Masoud Saghafinia ◽  
Yadollah Rezaei ◽  
Seyed Mohsen Towliat Kashani ◽  
...  
Keyword(s):  
Medical Care ◽  
Injury Severity ◽  
Demographic Data ◽  
Mean Value ◽  
Outcome Data ◽  
Tertiary Referral ◽  
Disaster Victims ◽  
Richter Scale ◽  
Referral Hospitals ◽  
The Mean

AbstractBackground:In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed >90% of the city. After the assessment and initial treatment of injuries at national and international field hospitals, a considerable number of victims (approximately 12,000) were transferred to tertiary referral hospitals around the country. Objective: This report evaluated the injuries of 854 victims transferred to 12 referral hospitals in Tehran.Methods:The demographic data, injury patterns, injury severity score (ISS), diagnosis, treatment, and outcome data of 854 Bam earthquake victims were assessed.Results:There were 467 (54.7%) males and 387 (45.3%) females. The mean age of the patients was 29.0 years. Transportation by aircraft was the most common method used for evacuation, which was used to evacuate 555 patients (65%). Fifty-four percent of the victims required initial medical aid at field hospitals before transportation to Tehran. There were 1,322 patients with injuries, of which, fractures of the lower extremities were the most common (331; 25%). Limb fixation was the most commonly performed primary procedure in emergency wards (389 cases, 39.9%). The mean value ±SD for ISS was 6.7 ±5.2. Orthopedic operations were the most frequent surgical procedures performed (195/260 operations, 75%) and the overall mortality rate was 1.6% (n = 14).Conclusions:Along with the crucial importance of aid provided by national and international field hospitals in disasters, suitable triage of casualties and preparedness of tertiary referral centers in unaffected regions also play an important role in providing medical care to disaster victims. During these situations, the number of victims cannot be predicted accurately, and sufficient medical care, particularly for orthopedic problems, can be provided by referral centers.

scholarly journals AB0189 LIPOPROTEIN ABNORMALITIES IN RHEUMATOID ARTHRITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1119.1-1119
Author(s):  
L. Nacef ◽  
Y. Besbes ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Demographic Data ◽  
Calcium Score ◽  
Healthy Person ◽  
Mean Value ◽  
Immunological Parameters ◽  
American College Of Rheumatology ◽  
Patient Consent ◽  
The Mean ◽  
High Level

Background:The lipid paradox is termed the decreased cholesterol level in rheumatoid arthritis (RA). Nevertheless, the apolipoprotein levels are usually higher than a healthy person and are predictors of cardiovascular events.Objectives:We aimed to describe lipid abnormalities in RA patients and to look for predictor factors of these changes.Methods:The prospective study was carried out on patients with RA who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria. These patients were followed in the rheumatology department of the Kassab Institute.We collected the socio-demographic data, biological and immunological parameters.The lipid assessment included: a measurement of total cholesterol (TC), HDL, LDL, and triglycerides (TG). Lipoproteins APOA1 and APOB were measured. All data were collected after patient consent.Results:Of the 47 patients recruited, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The average RA progressed from 86.25 ±63 months [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. Eight patients had a previous CV history.Mean TC was 4.42 ±1.3 [1.2-7.58], mean HDL was 1.38 ±0.73 [0.18-4.10], mean LDL was 2.55 ±1.16 [0.24-5.54]. The mean TG value was 1.28 ±0.6 [0.24-5.54]. TC elevation was found in 9.1% of cases, HDL in 21.3% of cases, LDL in 5.5% of cases, and TG in 16.4% of cases. Mean APOB/APOA1 ratio was 0.67 ±0.18 [0,46-1,11]. LDL elevation was associated to a high DAS28 (p=0.06, r=0.512). APOA1 was associated to a low DAS28 (p=0.04, r=-0.642).The mean value of APO A1 was 1.36 ±0.21 [0.84-1.81], that of APOB was 0.90 ±0.22 [0.58-1.40]. APOA1 values were lower in patients with high-level LDL (p=0.767). The APOB value was associated with lipid disturbance without significant correlation (p=0.291).Conclusion:Lipid test abnormalities can be found in RA patients outside of any known CV risk factors. APOA1 seems to have a protective effect. Screening and treatment of these abnormalities can prevent CV risk.References:[1]Miguel Bernardes and al. Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers. Int J Rheum Dis. 2019;00:1–16.[2]Anna So dergren and al. Biomarkers associated with cardiovascular disease in patients with early rheumatoid arthritis. PLOS ONE. August 5, 2019.Disclosure of Interests:None declared

ASSOCIATED DISEASES IN ROTAVIRUS GASTROENTERITIS IN CHILDREN HOSPITALIZED IN CLINICAL INFECTIOUS DISEASES HOSPITAL OF CONSTANTA

2017 ◽  
Vol 20 (3) ◽  
pp. 130-134
Author(s):  
Simona Diaconu ◽  
◽  
Simona Claudia Cambrea ◽  
Lucian Cristian Petcu ◽  
Sorin Rugina ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Respiratory Disease ◽  
Medical Records ◽  
Digestive Disease ◽  
Demographic Data ◽  
Mean Value ◽  
Maximum Temperature ◽  
Rotavirus Gastroenteritis ◽  
Associated Diseases ◽  
The Mean

Our study included 505 children hospitalized in the Clinical Hospital of Infectious Diseases Constanta in 2011-2012 with gastroenteritis with rotavirus. We analyzed the medical records of the patients and extracted demographic data, temperature, and frequency of vomiting and diarrheic stools. We divided the group of cases into 4 groups associated with: respiratory disease (RD) – 160 cases, digestive disease (DD) – 52 cases, eruptive disease (ED) – 11 cases, and a group without other associated diseases (simple) – 282 cases. We found significant differences between the four groups regarding the number of stools, the number of vomiting per day, the mean value of maximum temperature, the mean value of hospitalization.

scholarly journals Epidural Hematoma Treated Conservatively: When to Expect the Worst

2015 ◽  
Vol 43 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Mohammed Basamh ◽  
Antony Robert ◽  
Julie Lamoureux ◽  
Rajeet Singh Saluja ◽  
Judith Marcoux
Keyword(s):  
Conservative Management ◽  
Epidural Hematoma ◽  
Injury Severity ◽  
Demographic Data ◽  
Neurological Status ◽  
Younger Age ◽  
Bivariate Association ◽  
The Mean ◽  
Surgical Guidelines ◽  
The Brain

ABSTRACTBackground: The Brain Trauma Foundation’s 2006 surgical guidelines have objectively defined the epidural hematoma (EDH) patients who can be treated conservatively. Since then, the literature has not provided adequate clues to identify patients who are at higher risk for EDH progression (EDHP) and conversion to surgical therapy. The goal of our study was to identify those patients. Methods: We carried a retrospective review over a 5-year period of all EDH who were initially triaged for conservative management. Demographic data, injury severity and history, neurological status, use of anticoagulants or anti-platelets, radiological parameters, conversion to surgery and its timing, and Glasgow Outcome Scale were analyzed. Bivariate association and further logistic regression were used to point out the significant predictors of EDHP and conversion to surgery. Results: 125 patients (75% of all EDH) were included. The mean age was 39.1 years. The brain injury was mild in 62.4% of our sample and severe in 14.4%. Only 11.2% of the patients required surgery. Statistical comparison showed that younger age (p< 0.0001) and coagulopathy (p=0.009) were the only significant factors for conversion to surgery. There was no difference in outcomes between patients who had EDHP and those who did not. Conclusions: Most traumatic EDH are not surgical at presentation. The rate of conversion to surgery is low. Significant predictors of EDHP are coagulopathy and younger age. These patients need closer observation because of a higher risk of EDHP. Outcome of surgical conversion was similar to successful conservative management.

scholarly journals Clinical Outcomes of Total Laparoscopic Hysterectomy (TLH): Seven Years’ Experience in a Public Hospital

2019 ◽  
Vol 34 (1) ◽  
pp. 28-35
Author(s):  
Jobaida Sultana ◽  
Md Manir Hossain Khan ◽  
Professor Fatema Ashraf ◽  
Mahmuda Sultana ◽  
Mariha Alam Chowdhury
Keyword(s):  
Demographic Data ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Outcome Data ◽  
Total Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Bladder Injury ◽  
Ureterovaginal Fistula ◽  
Urological Complications ◽  
The Mean

Objective: The aim of the study was to explore the surgical outcomes of total laparoscopic hysterectomy. Materials and methods: This was a prospective analysis of total Laparoscopic Hysterectomy (TLH) done between January, 2012 to December, 2018 in Shaheed Suhrawardy Medical College and Hospital. Demographic data, clinical criteria, intra operative and postoperative outcome data were recorded. Data were collected in a predesigned Data collection sheet. Follow up records done during discharge from the hospital, one week and four weeks postoperatively. Results: Total 298, laparoscopic hysterectomy were performed during the period. Among them 96 % (n=286) for benign and 4 %( n=12) for malignant condition were included in the study population. Mean age of the patients was 45.4 ± 5.6 years, mean parity was 1.9 ± 0.64 and the mean body mass index was 27.48 ± 0.57. The most common benign disease was leiomyoma, 51.7 %. Among the study cases 21.8% (n=65) had history of at least one previous abdomino-pelvic surgery. Maximum size of uterus removed was 28 weeks and maximum patients, 48% (n=143) had uterine size of 10-14 weeks. The operating time was variable between 50 min to 180 min and in the course of time, the mean operating time dropped from 130 min to 60 min. The mean length of hospital stay was 2 days and the return to normal activities was within 2 weeks. Major complications observed among 3.7 % of cases among them 2(0.67%) bladder injury, 2(0.67%) vesico-vaginal fistula (VVF), 3(1.0%) ureterovaginal fistula (UVF) and 4(1.3%) peroperative hemorrhage requiring blood transfusion. Among the 7 cases of urological complications, one patient with VVF and one patient with UVF needed relaparotomy. Ultimately all cases were managed without any residual problem. Conversion to laparotomy was 0.3 % (n=1) of case. Conclusion: TLH offers the benefit of minimally invasive surgery to the patient and is a safe and acceptable alternative to standard hysterectomy for various gynaecological indications. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 28-35

Patient Satisfaction with Absorbable Anchoring Facial Threads

2021 ◽  
Author(s):  
Georges Ziade ◽  
Dayane Daou ◽  
Desiree Karam
Keyword(s):  
Quality Of Life ◽  
Adverse Effects ◽  
Demographic Data ◽  
Descriptive Analysis ◽  
Mean Value ◽  
Facial Appearance ◽  
Mean Values ◽  
The Mean ◽  
Nasolabial Folds

AbstractThis study aimed to evaluate satisfaction in terms of facial appearance, quality of life, and adverse effects in patients undergoing the facial thread lifting procedure using the absorbable facial threads anchored on the superficial and deep temporal fascias. The charts of patients for whom facial anchored thread lifting was performed using absorbable threads between February 2017 and September 2019 were reviewed. Demographic data including age and gender as well as data from the Face-Q scales were collected. Descriptive analysis was made for the adverse effects 1 week after the procedure. The mean value of adverse effects scales was compared 1 and 2 weeks after the procedure and also the mean values of facial appearance and quality-of-life scales were compared at baseline, 6 months, and 12 months after the procedure. All recruited subjects were females with a mean age of 43.42 years. There was a statistically significant decrease in the rate of adverse effects following the procedure between the first and second week. The mean difference in patients' perceived age 6 and 12 months after the procedure was statistically significant when compared with baseline. The psychological distress significantly decreased and the psychological function improved 6 and 12 months after the procedure. The overall satisfaction with facial appearance increased significantly after 6 months with a mean of 20.08. This was maintained at 12 months. The satisfaction in skin appearance, cheeks, nasolabial folds, marionettes, lower face, and jawline appearances improved significantly 6 months after the procedure. This was also maintained at 12 months. Face lifting using the polycaprolactone threads anchored on the temporalis fascia showed a significant improvement in the quality of life and facial appearance. The adverse effects are tolerable starting 2 weeks after the procedure.

scholarly journals Temporal delays in trauma craniotomies

2016 ◽  
Vol 125 (3) ◽  
pp. 642-647 ◽  
Author(s):  
Judith Marcoux ◽  
David Bracco ◽  
Rajeet S. Saluja
Keyword(s):  
Injury Severity ◽  
Demographic Data ◽  
Ct Scanning ◽  
Skin Incision ◽  
Outcome Data ◽  
Ct Imaging ◽  
Median Delay ◽  
Brain Trauma Foundation ◽  
Significant Difference ◽  
Life Threatening

OBJECTIVE The Brain Trauma Foundation recommendation regarding the timing of surgical evacuation of epidural hematomas and subdural hematomas is to perform the procedure as soon as possible. Indeed, faster evacuation is associated with better outcome. However, to the authors' knowledge, no study has looked at where delays in intrahospital care occurred for patients suffering from traumatic intracranial mass lesions. The goals of this study were as follows: 1) to characterize the performance of a Level 1 trauma center in terms of delays for emergency trauma craniotomies, 2) to review step by step where delays occurred in patient care, and 3) to propose ways to improve performance. METHODS A retrospective review was conducted covering a 5-year period of all emergency trauma craniotomies. Demographic data, injury severity, neurological status, and functional outcome data were collected. The time elapsed between emergency department (ED) arrival and CT imaging, between CT imaging and arrival at the operating room (OR), between ED arrival and OR arrival, between OR arrival and skin incision, and between ED arrival and skin incision were calculated. Patients were also subcategorized as either having immediate life-threatening emergencies (E0) or life-threatening emergencies (E1). The operative technique was also reviewed (standard craniotomy opening vs immediate bur hole decompression followed by craniotomy). RESULTS The study included 166 patients. Of these, 58 (35%) were classified into the E0 group and 108 (64.2%) into the E1 group. The median ED-to-CT delay was 54 minutes with no significant difference between the E0 and the E1 groups. The median CT-to-OR time delay was 57 minutes. The median delay for the E0 group was 39 minutes and that for the E1 group was 70 minutes (p = 0.002). The median delay from ED to OR arrival for patients with a CT scanning done at an outside hospital was 75 minutes. The median delay from ED to OR arrival was 85 minutes for the E0 group and 127 minutes for the E1 group (p < 0.0001). The median delay from OR arrival to skin incision was 35 minutes (E0: median 27 minutes; E1: median 39 minutes; p < 0.0001). The median total time elapsed between ED arrival and skin incision was 150 minutes (E0: median 131 minutes; E1: median 180 minutes). Overall, only 17% of patients underwent immediate bur hole decompression, but the proportion climbed to 41% in the E0 group. A lower Glasgow Coma Scale score was associated with a shorter delay (p = 0.0004). CONCLUSIONS A long delay until surgery still exists for patients requiring urgent mass lesion evacuation. Many factors contribute to this delay, including performing imaging and transfer to and preparation in the OR. Strategies can be implemented to reduce delays and improve the delivery of care.

scholarly journals Study on electrolyte disturbances in dengue fever in a tertiary care centre

2019 ◽  
Vol 6 (6) ◽  
pp. 2504
Author(s):  
Poornima Shankar ◽  
Nithya E. ◽  
Kavya C.
Keyword(s):  
Dengue Fever ◽  
Serum Sodium ◽  
Demographic Data ◽  
Tertiary Care ◽  
Clinical History ◽  
Mean Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Electrolyte Disturbances ◽  
The Mean

Background: Dengue is a mosquito borne disease of significant morbidity and mortality. Dengue viral infection has been shown to be associated with electrolyte abnormalities and renal dysfunction. It is necessary to have a thorough understanding about electrolyte disturbances in Dengue, so as to predict, diagnose and treat them accordingly. The aim and objective of this study is to study electrolyte disturbances in dengue fever and its correlation with severity of dengue fever.Methods: This study was performed in a tertiary care centre in Bangalore , India. The study was a prosspective observational study. 200 Patients diagnosed with Dengue were enrolled for the study. Patients demographic data, clinical history, electrolyte values were recorded and analysed.Results: In our study majority of patients belonged to 5-12 years age group ie 47%. Fever was found to be the most common presentation in 196 patients (98%) followed by myalgia in 142 patients (71%), headache in 102 patients (51%), skin rash in 43 patients (21.5%). The mean value of serum sodium observed was 133.69 mEq/L and of serum potassium was 3.58 mEq/L and there was positive and significant correlation between difference in serum sodium and potassium levels with severity of dengue fever.Conclusions: Dyselectrolytemia is more common in dengue fever. Serum electrolytes testing early is very important in dengue patients during management so that if abnormalities are found, they can be appropriately managed as some of these abnormalities may lead to increased severity as well as mortality.

scholarly journals Long-term Clinical Course of Benign Fibro-osseous Lesions in the Paranasal Sinuses

2020 ◽  
Author(s):  
Jung Joo Lee ◽  
Gwanghui Ryu ◽  
Kyung Eun Lee ◽  
Sang Duk Hong ◽  
Yong Gi Jung ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Clinical Course ◽  
Demographic Data ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Image Study ◽  
The Mean ◽  
Clinical Conditions ◽  
Radiologic Features

Objectives. Fibro-osseous lesions of the paranasal sinuses can present various clinical conditions. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features. Methods. Radiologically confirmed BFOLs except osteoma cases were reviewed retrospectively between 1994 and 2016. We compared demographic data between the surgery and observation groups. Reason for image study, radiographic features, histopathology, and clinical course with serial image scans were analyzed.Results. A total of 183 subjects were selected from a thorough review of head and neck radiologic tests (n= 606,068) in a tertiary referral hospital over 22 years. The mean age was 28.6

scholarly journals DESCRIPTIVE STUDY OF HAND INJURY ATTENDED AT TERTIARY CARE HOSPITAL WITH SPECIAL REFERENCE TO ASSESS SEVERITY OF HAND INJURY WITH HISS SCORE

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Nikhil Bansal ◽  
Sanjay Yadav ◽  
R L Dayma ◽  
Aditya Singh Rathore
Keyword(s):  
Injury Severity ◽  
Recovery Period ◽  
Tertiary Care ◽  
Mean Value ◽  
Hand Injury ◽  
Hand Strength ◽  
Care Hospital ◽  
Dominant Hand ◽  
The Mean ◽  
Traumatic Hand Injury

Background: We conducted this study to establish the predictability of HISS system to hand strength in patients with traumatic hand injury. Methods: This retrospective study was conducted on 30 hospitalized patients for surgery in in Jaipur due to traumatic hand injury. All of them received rehabilitation occupational therapy in the same trauma center with established protocols and were supervised by the same group of therapists within one month after surgery. Passive/active range of motion exercise, hand grip strength training, proprioception/functional training were included in this standardized protocol. Results: The mean age of patients was 41.36±13.69 Yrs. Among them, 23 patients were male and 7 patients were female.  63.33% were dominant hand injured. The mean value of total HISS score is 53.21 ± 36.35. A positive correlation exists between the differences of the strength of two hands, and the severity shown by HISS system. Conclusion: In conclusion, initial anatomical injury severity assessed by HISS system may predict hand strength in traumatic hand injured patients after an adequate recovery period. Poor hand strength could be expected with initial high total HISS score. Keywords: HISS, Hand injury, Palmer pinch.

scholarly journals Evaluation of Changes in the Number of Eosinophils Before and After Phototherapy in Neonatal Hyperbilirubinemia

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Razieh Sangsari ◽  
Maryam Saeedi ◽  
Maliheh Kadivar ◽  
Sara Khalighi
Keyword(s):  
Total Bilirubin ◽  
Medical Center ◽  
Demographic Data ◽  
Laboratory Data ◽  
Significant Negative Correlation ◽  
Mean Value ◽  
Serum Total Bilirubin ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean

Background: The prevalence of asthma is higher in icteric babies. It is thought that eosinophilia and asthma are complications of phototherapy rather than hyperbilirubinemia. Objectives: Since there is little data in this regard, we evaluated the relationship between phototherapy and the level of eosinophils in this study. Methods: In this cross-sectional prospective study, we assessed icteric neonates admitted to the neonatal and intensive care unit of Children’s Medical Center of Tehran during 2017 - 2018. Laboratory data including serum bilirubin and count of blood cell differentiation for eosinophils, before, during, and after phototherapy besides demographic data like age, gender, gestational age, and duration of phototherapy were collected. Results: Totally, 163 neonates (52.1% male and 47.9% female) with a mean age of 5.49 ± 4.01 days, enrolled in the study. The prevalence of term neonates was 81% and 19% were preterm. The mean of serum total bilirubin was 17.91 ± 3.37 mg/dL. Compared to the mean value of eosinophils before phototherapy, this value in the first (P = 0.001) and second (P < 0.001) days were significantly higher. In female neonates, there was a significant increase in eosinophils in the first (P = 0.001) and second (P < 0.001) day of the post-treatment period. However, in male subjects, this increase was significant only in the second day after phototherapy (P = 0.001). In neonates less than one week of age, this count was significantly increased on the first (P = 0.003) and second (P < 0.001) day after phototherapy. In cases with hemolytic hyperbilirubinemia, eosinophils count before phototherapy and the second day was significant (P = 0.006). The mean of eosinophils in first and second days after phototherapy was not correlated with the severity of hyperbilirubinemia but there is a significant negative correlation between the mean total bilirubin of patients with mean eosinophils before phototherapy. Conclusions: Our findings showed that there was a significant relationship between hyperbilirubinemia and its therapeutic phototherapy with an increasing level of peripheral eosinophils count in neonates.

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