scholarly journals Assessment and Clinical Outcomes of Fall Related Injuries at Emergency

2021 ◽  
Vol 4 (1) ◽  
pp. 50-59
Author(s):  
Shawbo Osman ◽  
◽  
Vian Naqshbandi ◽  

Background and objectives: Falls are significant cause of mortality and morbidity with a considerable burden on societies, families and victims. The study aims to determine the interventions and outcomes of fall-related injuries, and the association between injury se-verity and fall height. Methods: A descriptive cross-sectional study was conducted among 322 fall-related in-jured persons in West and East emergency hospitals in Erbil City from September 2020 to February 2021. Study sample demography, location of injury, place of affected body re-gions, outcome, and hospital stay were analyzed. Results: Of the 322 patients studied, 68.9% were males, and 31.1% were female. Less than half of the samples (48.8%) were between the ages 18 to 36 years old. The most common location for fall-related injuries was residential facilities (44.1%) followed by the place of work (35.1%). According to the type of fall, fall from ground was 38.4%, and fall from a fall height of 1-3 meters was 48.8%. Finally, according to the injury classification, more than half (56.5%) of the study sample had a significant degree of severity. The discharged status of disposition at the emergency room had the highest percentage (64.9%) of the study sample. There was a significant difference between the scores of the items of fall conse-quences and outcomes regarding to type of ground (soft or hard). There was a significant relationship between injury severity and fall height (p-value = 0.00). Conclusion: Fall-related injuries are the most common cases at emergency departments in Erbil city. Among ages 18 to 36, men are more frequently exposed to falls than women. The highest risk of fall is occupation with construction laborers at the greatest risk. Fall-related injury is a burden on the health care system, particularly on emergency services in developing countries like Iraq in relations cost of care and resources.

2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.


Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Javad vatani ◽  
Zahra Khanikosarkhizi ◽  
Mohammad Ali Shahabi Rabori ◽  
mohammad khandan ◽  
Mohsen aminizadeh ◽  
...  

BACKGROUND: Safety climate is a common insight of staff that indicates individuals’ attitudes toward safety and priority of safety at work. OBJECTIVES: Nursing is a risky job where paying attention to safety is crucial. The assessment of the safety climate is one of the methods to measure the safety conditions in this occupation. The aim of this study was to assess the safety climate of rehabilitation nurses working in hospitals in Tehran. METHODS: This is a cross-sectional study which was carried out on 140 rehabilitation nurses selected from all hospitals and clinics in Tehran in 2019. To collect the required data, a two-section questionnaire was used. The first section was related to demographic factors and the second part (22 statements) was to measure the safety climate using nurses’ safety climate assessment questionnaire. The collected data were analyzed by SPSS V16 using independent t-test, ANOVA, Kruskal-Wallis and Mann-Whitney U test at the 5% level. RESULTS: Findings showed that the total mean of safety climate was 3.06±0.56. According to the results, a significant difference was found between the positive and negative satisfaction of nurses with safety climates (P-value = 0.03), communication with nurses (P-value = 0.01) and supervisors’ attitude (P-value = 0.02). Furthermore, a significant difference in safety climate between the individual with the second job and the individual without second could be observed (P-value = 0.01). CONCLUSIONS: The results indicated that the safety climate was not at an acceptable level. Thus, it is essential to introduce safety training courses (e.g. safety, work-rest balance, and so on) and to improve the safety performance at work.


2021 ◽  
Vol 11 (02) ◽  
pp. 65-69
Author(s):  
Maria Shakoor Abbasi ◽  
Naseer Ahmed ◽  
Azad Ali Azad ◽  
Fatima Fouad ◽  
Humza Daudpota ◽  
...  

Objectives: To assess the concepts of complete denture occlusion among dental fraternity. Study Design And Setting: Cross-sectional study conducted at various dental hospitals and institutes of Karachi, for a period of six months, from 1st June’2019 to 30th November’2019 Methodology: Total 849 dental practitioners who are currently practising were included. A well-structured and validated questionnaire was used for data collection. SPSS version 25 was used. Results: Bilateral balanced occlusion was an ideal occlusion by majority subjects i.e, 530(62.4%) in patients with wellformed ridges, followed by 464(54.7%) candidates with skeletal class 1, total 376(44.3%) chose it with uncontrolled diabetes mellitus, 365(43%) in single complete denture cases, 339(39.9%) with increased inter-arch space, 298(35.1%) with parafunction habits, 296(34.9%) in patients with history of neuromuscular disorder and 271(31.9%) where a complete denture opposes a removable partial denture. Furthermore, Lingualized occlusion was preferred by 341(40.25%) participants for patients with skeletal class 3. Total 316(37.2%) candidates chose it for patients with displaceable supporting tissue followed by 264(31.1%) who chose it for skeletal 2 and 260(30.6%) for cases of highly resorbed ridges. Lastly, 311(36.6%) chose canine guided occlusion with highly resorbed ridges accompanied by high aesthetic demand A significant difference between education level and knowledge of occlusal schemes was also found. Chi-square (73.87), df 6, p-value =0.000. Conclusion: Dental practitioners lack adequate knowledge of occlusal schemes in terms of prescription in complete denture patients. A significant difference between the education level and knowledge of occlusal schemes was found. Therefore, awareness of various occlusal schemes should be increased at undergraduate level.


2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 


2015 ◽  
Vol 3 (3) ◽  
Author(s):  
I Gusti Bagus Magitojaya ◽  
Jehosua S. V. Sinolungan ◽  
Lydia David

Abstract: Nowadays, phenomeneon of juvenile delinquency has been spreading widely. Particularly to students, they usually perform juvenile delinquency that would harm themselves and finally trouble their minds due to consquences they are going to face. This study aimed to investigate the comparison of anxiety levels among students who performed juvenile delinquency. This was an analytical observational study with a cross sectional design. Subjects were 86 students of Swadharma Mopugad High School and Swadharma Werdhi Agung Senior High School obtained by using simple random sampling. Data were analyzed by using T independent test with α=0.005. The T independent test showed a t value of 0.457 and a p value of 0.649 (> 0.005) which indicated that there was no significant difference of anxiety levels among students who performed juvenile delinquency in both high schools. Conclusion: There was no significant difference between anxiety levels of students who performed juvenile delinquency in Swadharma Mopugad Senior High School and Swadharma Werdhi Agung Senior High School.Keywords: juvenile delinquency, anxietyAbstrak: Fenomena kenakalan remaja makin meluas dewasa ini. Hal ini tentunya dapat menimbulkan kecemasan pada siswa yang melakukannya mengingat sanksi yang bisa diperoleh akibat perbuatannya. Penelitian ini bertujuan untuk mengetahui perbandingan kecemasan siswa yang melakukan perilaku kenakalan remaja. Penelitian ini menggunakan metode analitik observasional dengan pendekatan potong lintang. Teknik pengambilan sampel yang digunakan yaitu simple random sampling. Subyek penelitian ialah siswa kelas XI SMA Swadharma Mopugad dan siswa kelas XI SMA Swadharma Werdhi Agung dengan jumlah total 86 siswa. Data dianalisis dengan uji T Independent (α = 0,005). Hasil uji T Independent mendapatkan nilai t sebesar 0,457, p = 0,649, yang menunjukkan tidak terdapat perbedaan tingkat kecemasan pada siswa yang melakukan kenakalan remaja di SMA Swadharma Mopugad dan SMA Swadharma Werdhi Agung. Simpulan: Tidak terdapat perbedaan tingkat kecemasan yang bermakna pada siswa yang melakukan kenakalan remaja di SMA Swadharma Mopugad dan SMA Swadharma Werdhi Agung.Kata kunci: kenakalan remaja, kecemasan


e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Marianne C. Jacobus ◽  
Max F.J Mantik ◽  
Adrian . Umboh

Abstract: Haemoglobin is the main component of red blood cells that serves as a transporter of oxygen and carbon dioxide in the blood. The normal range of haemoglobin values can be used to determine the degree of anemia according to age and gender. Geographical condition such as altitude influences the haemoglobin value. This study aimed to obtain the difference of haemoglobin levels between teenagers with good nutrition status who live at the highland and those at the seaside. This was an observational analytical study with a cross sectional design. Samples were students with good nutrition status of SMPN 3 Tomohon (living at the highland) and those of SMP Kristen Nazaret Tuminting (living at the seaside). There were 60 students who met the inclusion criteria as follows: adolescent, good nutrition status, healthy, aged 13-15 years, lived at the highland or at the seaside ≥ 6 month, and willing to be performed blood examinations, and had been approved by their parents. The Mann-Whitney test for the difference between haemoglobin levels of the two groups showed a p value < 0,001. Conclusion: There was a very significant difference between haemoglobin levels of good nutrition teenagers who lived at the highland and at the seaside. Keywords: haemoglobin levels, good nutrition, teenagers, highland, seaside  Abstrak: Hemoglobin merupakan komponen utama sel darah merah dan berfungsi sebagai transporter oksigen dan karbon dioksida dalam darah. Batas normal nilai hemoglobin dapat digunakan untuk menetapkan derajat anemia, dengan distribusi usia dan jenis kelamin spesifik didasarkan pada sampel referensi sehat. Kondisi geografis, seperti ketinggian tempat dari permukaan laut menjadi faktor pertimbangan dalam distribusi nilai normal hemoglobin. Penelitian ini bertujuan untuk mendapatkan perbedaan kadar hemoglobin antara remaja gizi baik yang tinggal di pegunungan dengan yang tinggal di tepi pantai. Jenis penelitian ini analitik-observasional dengan desain potong lintang. Sampel penelitian yaitu remaja gizi baik yang tinggal di pegunungan yaitu siswa SMPN 3 Tomohon dan yang di tepi pantai yaitu siswa SMP Kristen Nazaret Tuminting. Subjek penelitian berjumlah 60 remaja yang memenuhi kriteria inklusi yaitu gizi baik, sehat, berumur 13-15 tahun, berdomisili di pegunungan atau tepi pantai ≥6 bulan, bersedia dilakukan pemeriksaan darah, dan telah disetujui oleh orang tua. Data yang diperoleh dianalisis menggunakan uji Mann-Whitney dengan bantuan program SPSS. Hasil uji Mann-Whitney mengenai perbedaan kadar hemoglobin antara kedua kelompok menunjukkan nila p <0,001. Simpulan: Terdapat perbedaan yang sangat bermakna kadar hemoglobin remaja gizi baik yang tinggal di pegunungan dengan di tepi pantai.Kata kunci: kadar hemoglobin, remaja gizi baik, pegunungan, tepi pantai


2019 ◽  
Vol 31 (2) ◽  
pp. 105-110

Metabolic syndrome is a cluster of risk factors for type 2 diabetes and cardiovascular disease, with insulin resistance proposed as a linking factor. It is common and is increasing in prevalence worldwide, largely attributed to increasing obesity and sedentary lifestyles, and now is both a public health and clinical problem. This community-based, cross-sectional descriptive study was conducted during 2015 to identify metabolic risk factors and associated morbidities among adult urban people in Pyin Oo Lwin Township. A total of 355 participants, 94 men (26.5%) and 261 women (73.5%) were enrolled. Age distribution was from 18 to 85 years with mean of 49.98 (SD:15.22) years. Metabolic risk factors were identified according to National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) guideline. In this study, central obesity was the highest component with 145 subjects (40.8%) followed by elevated triglycerides 129(36. 3%), elevated blood pressure 104(29.3%), low HDL-cholesterols 85(23.9%), and elevated fasting glucose in only 48 individuals (13.5%). The total prevalence of metabolic syndrome was 35.2% with 26.6% in men and 38.3% in women, respectively. There were statistically significant associations above all five metabolic risk factors with metabolic syndrome (p value <0.001). Regarding its associated morbidities, ECG examinations showed normal 296 cases (83.4%) and abnormal in 59 cases (16.6%) but there was no significant difference between metabolic syndrome and abnormal ECG findings. In conclusion, this study recognizes the high prevalence rate of metabolic syndrome and can be depicted about the metabolic risks as the baseline data for implementation of further activities to reduce the incidence of non-communicable diseases.


2020 ◽  
Vol 19 (2) ◽  
pp. 1-5
Author(s):  
Aso Sabir Saeed ◽  
◽  
Osama MohammadAmin Shukr

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache


2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Humaira Fayyaz ◽  
Shazadi Ambreen ◽  
Hammad Raziq ◽  
Azmat Hayyat

Objectives: To compare the levels of cortisol in patients of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS). Methods: A cross-sectional analytical study was conducted at Islamic International Medical College, Rawalpindi and Electrophysiology Department at (AFIC). This study included 80 subjects, comprising of 35 patients in each group of vasovagal syncope and postural tachycardia syndrome and 10 healthy subjects. Patients with complaint of syncope was evaluated for vasovagal syncope and postural tachycardia syndrome using Head Up Tilt Test (HUTT). Blood samples of all the participants were taken and serum cortisol was analyzed using ELISA method. Results were analyzed on SPSS Statistics 21 using ANOVA with a p-value of ≤0.05 regarded as significant. Results: Hormonal analysis shows that cortisol levels in the vasovagal, postural tachycardia syndrome and in control group was 153±16.7pg/ml, 160.17±pg/ml, and 69.65±5.8pg/ml respectively. Cortisol levels were significantly higher in both vasovagal and POTS groups as compared to controls with a p-value of 0.04 and 0.023 respectively. However, there was no significant difference between vasovagal and POTS patients with p value 0.570. Conclusion: It is concluded from the study that cortisol responses of VVS and POTS were positive. doi: https://doi.org/10.12669/pjms.38.1.4122 How to cite this:Khan HF, Ambreen S, Raziq H, Hayat A. Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4122 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saleh Alshaibi ◽  
Tala AlBassri ◽  
Suliman AlQeuflie ◽  
Winnie Philip ◽  
Nesrin Alharthy

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.


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