Pub Date : 2020-07-21DOI: 10.30491/TM.2020.224696.1087
A. Manafi, Mohamad Qoreishi, Ali Maleky, R. Zandi, M. Elahi, Farshid Dehkhoda
Introduction: The pelvic ring and sacral fractures and sacroiliac dislocations are managed with different methods. The upper sacral segment dysplasia increases the risk of perforation of the osseous cortex during Iliosacral fixation with a screw. Dysmorphic sacra have narrow and angular osseous corridor. An understanding of the anatomy of the pelvis is key to the management and treatment of pelvic injuries to prevent iatrogenic injuries, and to provide the best results.To date no study has been done about sacral dysmorphism and quantitative and qualitative criteria for fixation with iliosacral screw in sacral dysmorphism in the Iranian population.Method and Material: We analyzed 100 CT scan and Outlet CT reformation forms of traumatic patients without pelvic trauma to determine 5 qualitative criteria of sacral dysmorphism (i.e., Mammillary bodies, Misshapen sacral foramen, Upper sacral segment not recessed in the pelvis, Residual disc between S1 and S2 vertebra and Acute alar slope) and sixth characteristic (tongue-in-groove) from the axial pelvic CT section were obtained by an orthopedic surgeon.Upper sacral surface area and angulation were determined from CT scan reformatted. Coronal reconstruction was used to divide the patients into dysmorphic and non-dysmorphic groups by drawing a line along the axis of the osseous corridor from one side of iliosacral to its other side. Results: The results showed that 37% of the patients were in the dysmorphic group and 63% in non-dysmorphic. The obtained mean angle in the dysmorphic and non-dysmorphic group was 84° and 72°, respectively. Sacral dysmorphism score was calculated in all patients. As the score increased, the safety of osseous corridor decreased.Conclusion: Axial angulation and coronal angulation were the most important quantitative criteria for determining the sacral dysmorphism. Detecting sacral dysmorphism can be useful for preoperative planning of iliosacral screw placement.
{"title":"Determination of anatomical sacral dysmorphism criteria based on CT scan findings for iliosacral screw fixation in a sample of Iranian population without pelvic ring fracture","authors":"A. Manafi, Mohamad Qoreishi, Ali Maleky, R. Zandi, M. Elahi, Farshid Dehkhoda","doi":"10.30491/TM.2020.224696.1087","DOIUrl":"https://doi.org/10.30491/TM.2020.224696.1087","url":null,"abstract":"Introduction: The pelvic ring and sacral fractures and sacroiliac dislocations are managed with different methods. The upper sacral segment dysplasia increases the risk of perforation of the osseous cortex during Iliosacral fixation with a screw. Dysmorphic sacra have narrow and angular osseous corridor. An understanding of the anatomy of the pelvis is key to the management and treatment of pelvic injuries to prevent iatrogenic injuries, and to provide the best results.To date no study has been done about sacral dysmorphism and quantitative and qualitative criteria for fixation with iliosacral screw in sacral dysmorphism in the Iranian population.Method and Material: We analyzed 100 CT scan and Outlet CT reformation forms of traumatic patients without pelvic trauma to determine 5 qualitative criteria of sacral dysmorphism (i.e., Mammillary bodies, Misshapen sacral foramen, Upper sacral segment not recessed in the pelvis, Residual disc between S1 and S2 vertebra and Acute alar slope) and sixth characteristic (tongue-in-groove) from the axial pelvic CT section were obtained by an orthopedic surgeon.Upper sacral surface area and angulation were determined from CT scan reformatted. Coronal reconstruction was used to divide the patients into dysmorphic and non-dysmorphic groups by drawing a line along the axis of the osseous corridor from one side of iliosacral to its other side. Results: The results showed that 37% of the patients were in the dysmorphic group and 63% in non-dysmorphic. The obtained mean angle in the dysmorphic and non-dysmorphic group was 84° and 72°, respectively. Sacral dysmorphism score was calculated in all patients. As the score increased, the safety of osseous corridor decreased.Conclusion: Axial angulation and coronal angulation were the most important quantitative criteria for determining the sacral dysmorphism. Detecting sacral dysmorphism can be useful for preoperative planning of iliosacral screw placement.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88504144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.224033.1083
H. Jafarimanesh, K. Abdi, M. Kia, S. Moayedi, A. Sahebi, Mohamad Golitaleb
Background: Adherence of emergency medical technicians (EMTs) to a professional code of ethics is one of the most important aspects of their occupation. Objectives: The purpose of this study was to determine the degree of adherence to the professional code of ethics from the perspective of EMTs and their patients. Methods: This was a cross-sectional study. The inclusion criteria for patients were age between 18-65 years, willingness to participate in the study, normal mental status, being medically stable and absence of any chronic mental or psychiatric disorder. The inclusion criteria for EMTs were willingness to participate in the study, having an associate or bachelor’s degree in the medical emergency, working at medical emergency departments and management centers. The exclusion criteria were refusal to continue the study and the necessity of therapeutic intervention while completing the questionnaire. The patients were recruited by cluster sampling. For this reason, first, two hospitals were randomly selected among six hospitals in Arak, Markazi province (Arak, Iran). Then, the list of missions at each shift was extracted by referring to the emergency departments of these hospitals. Afterward, one of the missions in each shift was randomly selected. In this study, a two-part questionnaire was used for data gathering. In this first part, the demographic information of the participants was collected. In the second part, a professional code of ethics for EMTs' questionnaire, including 26 statements in 5 dimensions was used. Finally, the questionnaires were given and completed by the pre-hospital emergency personnel and the transferred patients. Results: A total of 105 EMTs and 109 patients were randomly selected as they transported patients to the studied hospitals. From the viewpoint of patients, adherence to the professional code of ethics was rated 2% as highly desirable, 39% as desirable, 58% as moderate, and 1% as undesirable. On the other hand, the EMTs rated themselves as 59.8% highly desirable, 37.1% as desirable, and 3.1% as moderate. There was a statistically significant difference between the average score of adherence to a professional code of ethics from the viewpoint of patients versus that of the EMTs (p <0.001). Conclusion: There was a statistically significant difference between the degrees of adherence to the professional code of ethics by EMTs from their own viewpoint versus that of the patients.
{"title":"Adherence to Professional Code of Ethics from Emergency Medical Technicians and Their Patient's Perspective: A Cross-Sectional Study","authors":"H. Jafarimanesh, K. Abdi, M. Kia, S. Moayedi, A. Sahebi, Mohamad Golitaleb","doi":"10.30491/TM.2020.224033.1083","DOIUrl":"https://doi.org/10.30491/TM.2020.224033.1083","url":null,"abstract":"Background: Adherence of emergency medical technicians (EMTs) to a professional code of ethics is one of the most important aspects of their occupation. Objectives: The purpose of this study was to determine the degree of adherence to the professional code of ethics from the perspective of EMTs and their patients. Methods: This was a cross-sectional study. The inclusion criteria for patients were age between 18-65 years, willingness to participate in the study, normal mental status, being medically stable and absence of any chronic mental or psychiatric disorder. The inclusion criteria for EMTs were willingness to participate in the study, having an associate or bachelor’s degree in the medical emergency, working at medical emergency departments and management centers. The exclusion criteria were refusal to continue the study and the necessity of therapeutic intervention while completing the questionnaire. The patients were recruited by cluster sampling. For this reason, first, two hospitals were randomly selected among six hospitals in Arak, Markazi province (Arak, Iran). Then, the list of missions at each shift was extracted by referring to the emergency departments of these hospitals. Afterward, one of the missions in each shift was randomly selected. In this study, a two-part questionnaire was used for data gathering. In this first part, the demographic information of the participants was collected. In the second part, a professional code of ethics for EMTs' questionnaire, including 26 statements in 5 dimensions was used. Finally, the questionnaires were given and completed by the pre-hospital emergency personnel and the transferred patients. Results: A total of 105 EMTs and 109 patients were randomly selected as they transported patients to the studied hospitals. From the viewpoint of patients, adherence to the professional code of ethics was rated 2% as highly desirable, 39% as desirable, 58% as moderate, and 1% as undesirable. On the other hand, the EMTs rated themselves as 59.8% highly desirable, 37.1% as desirable, and 3.1% as moderate. There was a statistically significant difference between the average score of adherence to a professional code of ethics from the viewpoint of patients versus that of the EMTs (p <0.001). Conclusion: There was a statistically significant difference between the degrees of adherence to the professional code of ethics by EMTs from their own viewpoint versus that of the patients.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"24 1","pages":"160-166"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82163086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.217352.1061
Mohammad Kazem Emami Meybodi, H. Hesarikia, Z. Hasanzadeh, A. Rahimnia
Background: In surgeries, when making a window in the bone cortex is necessary, a circular window is usually recommended. A review of the literature did not yield any positive evidence indicating the preference for the circular shape under bending and compression loading. Objectives: In this study, we examined this issue using two methods, including software analysis and performing load tests in laboratory. Methods: Windows of different shapes with the same area were made in 40 femoral bones of the same-weight New Zealand rabbits, and then they were put under bending and compression force by a hydraulic device in the laboratory to measure the force required to fracture the bone by a computer. Simultaneously, ANSYS® software was used to simulate the test by the Biomechanics Research Team of the University of Technology. Results: According to the results obtained from software analysis and simulation, under compression and bending loading conditions, the mean fracture force in a trapezoidal shape was more than that in circular, square, and triangular shapes. These results were also confirmed in the experiments. Conclusion: Based on the results, no significant difference was observed between these shapes under the bending force. Moreover, under compression loading, no significant difference was found between trapezoidal and circular shapes.
{"title":"Biomechanical Analysis of Window Configuration of Femur under Different Loading Conditions","authors":"Mohammad Kazem Emami Meybodi, H. Hesarikia, Z. Hasanzadeh, A. Rahimnia","doi":"10.30491/TM.2020.217352.1061","DOIUrl":"https://doi.org/10.30491/TM.2020.217352.1061","url":null,"abstract":"Background: In surgeries, when making a window in the bone cortex is necessary, a circular window is usually recommended. A review of the literature did not yield any positive evidence indicating the preference for the circular shape under bending and compression loading. Objectives: In this study, we examined this issue using two methods, including software analysis and performing load tests in laboratory. Methods: Windows of different shapes with the same area were made in 40 femoral bones of the same-weight New Zealand rabbits, and then they were put under bending and compression force by a hydraulic device in the laboratory to measure the force required to fracture the bone by a computer. Simultaneously, ANSYS® software was used to simulate the test by the Biomechanics Research Team of the University of Technology. Results: According to the results obtained from software analysis and simulation, under compression and bending loading conditions, the mean fracture force in a trapezoidal shape was more than that in circular, square, and triangular shapes. These results were also confirmed in the experiments. Conclusion: Based on the results, no significant difference was observed between these shapes under the bending force. Moreover, under compression loading, no significant difference was found between trapezoidal and circular shapes.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"3 1","pages":"167-172"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90413065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.244639.1165
A. Farahani, K. Hassanpour, T. Badri, J. Swann, H. Shirzad
{"title":"Salient points to observe in mass ceremonies during the COVID-19 pandemic","authors":"A. Farahani, K. Hassanpour, T. Badri, J. Swann, H. Shirzad","doi":"10.30491/TM.2020.244639.1165","DOIUrl":"https://doi.org/10.30491/TM.2020.244639.1165","url":null,"abstract":"","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"83 9 1","pages":"143-144"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87656367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.213791.1032
M. Raadabadi, A. Darvishi, B. Ahmadi, F. Soleymani
Background: Antibiotics contribute to a lot of patients’ treatment. However, improper prescription and wasteful use of antibiotics may lead to various side effects or complications such as medicinal resistance and lack of treatment, resulting in an excessive financial burden. Objectives: The present study aimed to compare antibiotics prescription pattern and their financial burden before and after intervention based on prophylactic antibiotics guidelines in traumatic surgical sections. Methods: This analytical and cross-sectional study was conducted in 2018 on patients undergoing surgery in 4 general, urology, neurosurgery, and orthopedics surgery sections. The sample consisted of 464 patients with traumatic injuries. A researcher-made questionnaire was used as a principal instrument for gathering data. The data was analysed using SPSS (version 21). Results: The accordance of dose, method and kind of prescribed antibiotics with the instructions and guidelines after intervention increased to 29, 5.1 and 28.8%, respectively. There was a significant relationship between dose, method, and kind of prescribed antibiotic before and after the intervention (p <0.05). The financial burden of prescribed antibiotics before and after the intervention was 56400480 and 52789290 IRR, respectively. Conclusion: Based on the results, the intervention was effective in accordance with dose, method and kind of prescribed antibiotics. Also, financial burden reduced by 6.4% after the intervention. Continuous monitoring of antibiotic prescription based on instructions, training instructions of prophylaxis antibiotics to physicians, and infectious monitoring committee meetings can prevent irrational prescriptions and reduce the excessive financial burden on society, government and insurance organizations.
{"title":"Antibiotics Prescription Pattern and their Financial Burden before and after Intervention in Traumatic Injuries","authors":"M. Raadabadi, A. Darvishi, B. Ahmadi, F. Soleymani","doi":"10.30491/TM.2020.213791.1032","DOIUrl":"https://doi.org/10.30491/TM.2020.213791.1032","url":null,"abstract":"Background: Antibiotics contribute to a lot of patients’ treatment. However, improper prescription and wasteful use of antibiotics may lead to various side effects or complications such as medicinal resistance and lack of treatment, resulting in an excessive financial burden. Objectives: The present study aimed to compare antibiotics prescription pattern and their financial burden before and after intervention based on prophylactic antibiotics guidelines in traumatic surgical sections. Methods: This analytical and cross-sectional study was conducted in 2018 on patients undergoing surgery in 4 general, urology, neurosurgery, and orthopedics surgery sections. The sample consisted of 464 patients with traumatic injuries. A researcher-made questionnaire was used as a principal instrument for gathering data. The data was analysed using SPSS (version 21). Results: The accordance of dose, method and kind of prescribed antibiotics with the instructions and guidelines after intervention increased to 29, 5.1 and 28.8%, respectively. There was a significant relationship between dose, method, and kind of prescribed antibiotic before and after the intervention (p <0.05). The financial burden of prescribed antibiotics before and after the intervention was 56400480 and 52789290 IRR, respectively. Conclusion: Based on the results, the intervention was effective in accordance with dose, method and kind of prescribed antibiotics. Also, financial burden reduced by 6.4% after the intervention. Continuous monitoring of antibiotic prescription based on instructions, training instructions of prophylaxis antibiotics to physicians, and infectious monitoring committee meetings can prevent irrational prescriptions and reduce the excessive financial burden on society, government and insurance organizations.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"56 1","pages":"173-179"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85224898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.232351.1122
Vahid Shojaeimotlagh, Hero Khorshid Hassan, S. Dalvand, A. Dehkordi, Reza Ghanei Gheshlagh
Background: Mechanically ventilated patients are at risk of developing the iatrogenic infection ventilator-associated pneumonia (VAP). Inadequate knowledge of nurses is one of the obstacles to adherence to evidence-based guidelines to prevent VAP. Objectives: This study aimed to estimate the knowledge of nurses about VAP prevention. Methods: In this systematic review and meta-analysis, national and international databases, including MagIran, Scientific Information Database (SID), Web of Sciences, PubMed, and Scopus were searched using the following keywords: “Ventilator-associated pneumonia”, “VAP”, “Nosocomial pneumonia”, “Knowledge”, and their possible combinations. The VAP prevention score was calculated according to the questionnaire introduced and validated by Labeau et al. The analyses were performed using Stata (version 12). Results: In the initial search, 1193 articles were found of which a total of 8 articles were included in the analysis. The nurses achieved 48.31% of the VAP prevention total score (Confidence Interval [CI]: 95%: 44.63-52). The lowest and highest VAP prevention scores were attributed to frequency of humidifier changes (15.13%, CI: 95%: 11.35-18.92) and patient positioning (81.03%, CI: 95%: 75.43-86.64), respectively. The percentage of nurses’ knowledge about VAP prevention in Asian studies was higher than that in the European studies (54.71% versus 44.92%). Conclusion: The nurses obtained less than half of the VAP prevention total score. Regular training courses and reviewing VAP prevention guidelines can keep nurses' knowledge up to date.
背景:机械通气患者存在发生医源性感染呼吸机相关性肺炎(VAP)的风险。护士知识不足是阻碍遵守以证据为基础的预防VAP指南的障碍之一。目的:了解护士对VAP预防知识的了解情况。方法:在本系统综述和meta分析中，使用以下关键词:“呼吸机相关性肺炎”、“VAP”、“医院性肺炎”、“Knowledge”及其可能的组合，对MagIran、科学信息数据库(SID)、Web of Sciences、PubMed和Scopus等国内外数据库进行检索。VAP预防评分依据Labeau等引入并验证的问卷计算。使用Stata(版本12)进行分析。结果:初检索共检索到1193篇文献，其中8篇文献被纳入分析。护士VAP预防总得分达到48.31%(置信区间[CI]: 95%: 44.63-52)。最低和最高的VAP预防评分分别归因于加湿器更换频率(15.13%，CI: 95%: 11.35-18.92)和患者体位(81.03%，CI: 95%: 75.43-86.64)。亚洲研究中护士对VAP预防的知晓率高于欧洲研究(54.71%对44.92%)。结论:护士获得的VAP预防总分不到一半。定期培训课程和审查VAP预防指南可以使护士的知识保持最新。
{"title":"Nurses’ Knowledge on Ventilator-Associated Pneumonia: A Systematic Review and Meta-Analysis","authors":"Vahid Shojaeimotlagh, Hero Khorshid Hassan, S. Dalvand, A. Dehkordi, Reza Ghanei Gheshlagh","doi":"10.30491/TM.2020.232351.1122","DOIUrl":"https://doi.org/10.30491/TM.2020.232351.1122","url":null,"abstract":"Background: Mechanically ventilated patients are at risk of developing the iatrogenic infection ventilator-associated pneumonia (VAP). Inadequate knowledge of nurses is one of the obstacles to adherence to evidence-based guidelines to prevent VAP. Objectives: This study aimed to estimate the knowledge of nurses about VAP prevention. Methods: In this systematic review and meta-analysis, national and international databases, including MagIran, Scientific Information Database (SID), Web of Sciences, PubMed, and Scopus were searched using the following keywords: “Ventilator-associated pneumonia”, “VAP”, “Nosocomial pneumonia”, “Knowledge”, and their possible combinations. The VAP prevention score was calculated according to the questionnaire introduced and validated by Labeau et al. The analyses were performed using Stata (version 12). Results: In the initial search, 1193 articles were found of which a total of 8 articles were included in the analysis. The nurses achieved 48.31% of the VAP prevention total score (Confidence Interval [CI]: 95%: 44.63-52). The lowest and highest VAP prevention scores were attributed to frequency of humidifier changes (15.13%, CI: 95%: 11.35-18.92) and patient positioning (81.03%, CI: 95%: 75.43-86.64), respectively. The percentage of nurses’ knowledge about VAP prevention in Asian studies was higher than that in the European studies (54.71% versus 44.92%). Conclusion: The nurses obtained less than half of the VAP prevention total score. Regular training courses and reviewing VAP prevention guidelines can keep nurses' knowledge up to date.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"19 1","pages":"180-187"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85936976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.218542.1069
S. Oraee-Yazdani, M. Golmohammadi, M. Akhlaghpasand, Voorya Nooranipour, Maryam Oraee-Yazdani, Esmaeil Fakharian, A. Zali
Background: Many signs in relation to vascular events and consequent loss of consciousness could be easily incorrectly explained (unclear) in a setting of trauma, especially when these events are a result of the car accident. Third cranial nerve palsy widely occurs due to internal carotid and posterior communicating artery aneurysm. An anterior communicating(ACOM) aneurysm is a rare reason that could lead to oculomotor dysfunction. ACOM ruptured aneurysm may present with sub arachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH) but isolated IVH is a rare finding for ACOM ruptured aneurysm. Case Description: A 56-year-old male presented to the hospital emergency department because of trauma after a car accident. He was unconscious with left-sided dilated pupil and ptosis with a brain CT indicating IVH. Brain CT angiography that performed two weeks after the accident revealed ACOM aneurysm. The patient underwent craniotomy and clipping the aneurysm. He was discharged, after completing the period of the following treatmentA combination of neuropathic agents and opioids helped to control pain. These analgesic included amitriptyline, gabapentin, pregabalin, tramadol and morphine in various regimens. Paracetamol and ibuprofen were also used. Conclusion: This report is a unique case of synchronization of third cranial nerve palsy and isolated IVH without SAH due to ACOM aneurysm. In addition, it could be interesting to re-emphasize the need for a comprehensive assessment of traumatic patients for finding some primary pathologies, which could result in an accident.
{"title":"Unilateral Oculomotor Nerve Dysfunction Induced by Ruptured Anterior Communicating Artery Aneurysm along with Isolated Intraventricular Hemorrhage in a Trauma Patient","authors":"S. Oraee-Yazdani, M. Golmohammadi, M. Akhlaghpasand, Voorya Nooranipour, Maryam Oraee-Yazdani, Esmaeil Fakharian, A. Zali","doi":"10.30491/TM.2020.218542.1069","DOIUrl":"https://doi.org/10.30491/TM.2020.218542.1069","url":null,"abstract":"Background: Many signs in relation to vascular events and consequent loss of consciousness could be easily incorrectly explained (unclear) in a setting of trauma, especially when these events are a result of the car accident. Third cranial nerve palsy widely occurs due to internal carotid and posterior communicating artery aneurysm. An anterior communicating(ACOM) aneurysm is a rare reason that could lead to oculomotor dysfunction. ACOM ruptured aneurysm may present with sub arachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH) but isolated IVH is a rare finding for ACOM ruptured aneurysm. Case Description: A 56-year-old male presented to the hospital emergency department because of trauma after a car accident. He was unconscious with left-sided dilated pupil and ptosis with a brain CT indicating IVH. Brain CT angiography that performed two weeks after the accident revealed ACOM aneurysm. The patient underwent craniotomy and clipping the aneurysm. He was discharged, after completing the period of the following treatmentA combination of neuropathic agents and opioids helped to control pain. These analgesic included amitriptyline, gabapentin, pregabalin, tramadol and morphine in various regimens. Paracetamol and ibuprofen were also used. Conclusion: This report is a unique case of synchronization of third cranial nerve palsy and isolated IVH without SAH due to ACOM aneurysm. In addition, it could be interesting to re-emphasize the need for a comprehensive assessment of traumatic patients for finding some primary pathologies, which could result in an accident.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"17 1","pages":"188-190"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88047532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.30491/TM.2020.233968.1133
Ehsan Naeini, Farzin Sarkarat, Adbolreza Jamilian, M. Motamedi
Background: The finite element method is a used computational technique in obtaining detailed displacement of the fractured mandible with a fixation system. Objectives: The aim of the study was the evaluation of the biomechanical performance of different rigid fixation methods in mandibular angle fractures. Methods: Computed Tomography (CT) scans applied to prepare a model of the mandible with a mandibular fracture angle. The fracture line was fixed with 7 different fixation plates. The CT scans were transferred and converted to the finite element model. The commercial ANSYS software was applied to analyze the Von Mises stresses and the amount of displacement on bones, plates, and screws. 150-newton vertical force was applied to central incisors in order to simulate the most critical loading. Results: The maximum Von Mises stress values were found in the Champy technique with 474 Mpa in bones and 579 Mpa in screws, whereas the lowest Von Mises stress values observed in the square plate which was 180 Mpa. The minimum displacement observed in the Reconstructive plate & mini-plate which was 0.25 millimeters. Conclusion: The application of Reconstructive Plate & Mini-Plate, Dual straight mini-plates, Square Mini-Plate led to lower stress and displacement than other techniques in the bone, Plate, and screw. Reconstructive Plate & Mini-Plate, Dual straight mini-plates, Square mini-plate offers more resistance and stability at the fracture site than other techniques used in the current study. This study was done based on the analysis of computer data. Clinical evidence showed that other procedures were used for many years with success. There are many other factors in the clinical application that have a critical role in stability.
{"title":"Comparative Evaluation of 7 Fixation Plates in Mandibular Angle Fractures Using Finite Element Analysis","authors":"Ehsan Naeini, Farzin Sarkarat, Adbolreza Jamilian, M. Motamedi","doi":"10.30491/TM.2020.233968.1133","DOIUrl":"https://doi.org/10.30491/TM.2020.233968.1133","url":null,"abstract":"Background: The finite element method is a used computational technique in obtaining detailed displacement of the fractured mandible with a fixation system. Objectives: The aim of the study was the evaluation of the biomechanical performance of different rigid fixation methods in mandibular angle fractures. Methods: Computed Tomography (CT) scans applied to prepare a model of the mandible with a mandibular fracture angle. The fracture line was fixed with 7 different fixation plates. The CT scans were transferred and converted to the finite element model. The commercial ANSYS software was applied to analyze the Von Mises stresses and the amount of displacement on bones, plates, and screws. 150-newton vertical force was applied to central incisors in order to simulate the most critical loading. Results: The maximum Von Mises stress values were found in the Champy technique with 474 Mpa in bones and 579 Mpa in screws, whereas the lowest Von Mises stress values observed in the square plate which was 180 Mpa. The minimum displacement observed in the Reconstructive plate & mini-plate which was 0.25 millimeters. Conclusion: The application of Reconstructive Plate & Mini-Plate, Dual straight mini-plates, Square Mini-Plate led to lower stress and displacement than other techniques in the bone, Plate, and screw. Reconstructive Plate & Mini-Plate, Dual straight mini-plates, Square mini-plate offers more resistance and stability at the fracture site than other techniques used in the current study. This study was done based on the analysis of computer data. Clinical evidence showed that other procedures were used for many years with success. There are many other factors in the clinical application that have a critical role in stability.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"9 1","pages":"145-152"},"PeriodicalIF":0.5,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91101770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-05DOI: 10.30491/TM.2020.231934.1121
P. Firoozi, S. O. Keyhan, H. Fallahi, Paymon Mehryar, A. Motamedi, Vahid Khoshkam, O. Moghaddas, B. Hooshmand, M. H. Motamedi, Behzad Cheshmi
Following the severe acute respiratory syndrome coronavirus (SARS-CoV-1) and Middle East respiratory syndrome coronavirus (MERS-CoV), another pathogenic coronavirus called SARS-CoV-2 emerged in December 2019 in Wuhan, China. This virus has similarities with SARS-CoV-1 and causes acute pneumonia. The most characteristic symptom of patients with SARS-CoV-2 is respiratory distress, and most of the patients could not breathe spontaneously. Additionally, some patients with SARS-CoV-2 also show neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also influence the central nervous system (1). SARS-CoV-2 transmits via droplets and contact routes, but some doubt about airborne, fecal, or intrauterine transmission should be solved. Its’ fatality rate is about 6.3%, but it varies in different ages and counties, and it could be over 15% (2). Sneezing, coughing, and application of rotary instruments can result in the production of airborne particles (0.001 to 10 000 μm). It has been shown that airborne particles produced during dental procedures decrease to baseline levels within 10 to 30 minutes
{"title":"Reopening of Dental Clinics during SARS-CoV 2 Pandemic: An Evidence Based Recommendations before starting Clinical Interventions","authors":"P. Firoozi, S. O. Keyhan, H. Fallahi, Paymon Mehryar, A. Motamedi, Vahid Khoshkam, O. Moghaddas, B. Hooshmand, M. H. Motamedi, Behzad Cheshmi","doi":"10.30491/TM.2020.231934.1121","DOIUrl":"https://doi.org/10.30491/TM.2020.231934.1121","url":null,"abstract":"Following the severe acute respiratory syndrome coronavirus (SARS-CoV-1) and Middle East respiratory syndrome coronavirus (MERS-CoV), another pathogenic coronavirus called SARS-CoV-2 emerged in December 2019 in Wuhan, China. This virus has similarities with SARS-CoV-1 and causes acute pneumonia. The most characteristic symptom of patients with SARS-CoV-2 is respiratory distress, and most of the patients could not breathe spontaneously. Additionally, some patients with SARS-CoV-2 also show neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also influence the central nervous system (1). SARS-CoV-2 transmits via droplets and contact routes, but some doubt about airborne, fecal, or intrauterine transmission should be solved. Its’ fatality rate is about 6.3%, but it varies in different ages and counties, and it could be over 15% (2). Sneezing, coughing, and application of rotary instruments can result in the production of airborne particles (0.001 to 10 000 μm). It has been shown that airborne particles produced during dental procedures decrease to baseline levels within 10 to 30 minutes","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"50 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73627234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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