Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
The Effect of Various Types of Surgical Repair of Sciatic Nerve Transection on Number of Dorsal Root Ganglion Neurons
1
6
FA
Mohamamd ali
Atlasi
Mahdi
Mehdizadeh
Gholam Hossein
Farjah
Amrollah
Roozbehi
Background: Considering the need for appropriate maintenance of function and survival of neurons after nerve injury, and inadequacy of information about the number of sensory neurons in dorsal root ganglion after nerve trauma, this study was carried out on mice ganglia after their sciatic nerve cut. Materials and Methods: In this experimental study 12 adult, 200-250 gram weight, Wistar rats were randomly assigned into four groups of axotomy, epineurial suture repair, nerve guidance channel repair, and sham. Left sciatic nerve was transected in mid-thigh level and then in axotomy group, it left without repair in epineurial suture group it was repaired end to end and in nerve guidance channel repair it was repaird by PVDF (Polyvinilidine Flouride) tube containing collagen gel. The right side sciatic nerve spared intact. After 12 weeks, the 5th left and right dorsal root ganglia were excised and flouroscent Hoescht staining of prepared frozen sections performed and their neurons counted. Data were analysed with one way Anova, and Tuki tests. Results: The average number of neurons in axotomy group was 144.2±11.2 (P ≤0. 001), in epineurial repair group 189.8±15.5 (P<0.04), and in nerve guidance channel group 163.9±5.6 (p<0.001). Conclusion: Primary surgical nerve repair decreased sensory neuronal loss after nerve transection, but could not prevent it completely. Further studies on the causes of sensory neuron death after nerve injury and repair is recommended at molecular level.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Evaluation of systemic inflammatory response syndrome (SIRS) score as a predictor of mortalitiy and length of hospital stay in trauma patients
7
11
FA
Mehrdad
Hosseinpour
Background : The aim of this study is evaluation of the relation between Systemic Inflammatory Response Syndrome (SIRS) score and mortality and length of hospital stay in trauma patients. Materials and Methods: Seventy-three trauma patients admitted to Al- Zahra hospital in Isfahan medical university were enrolled to this study. The injury severity score and SIRS of each patient were calculated. In all patients, length of hospital stay, age, sex, trauma mechanism, and vital signs were recorded and blood samples obtained. Patients were followed until their discharge or death. Logistic regression test was used for statistical analysis. Results: Forty three percent of 73 patients had positive SIRS markers. Mean age of patients was 25.09±14.35 years. Trauma mechanism was blunt in 84% of patients. Mean of Injury severity and SIRS were 12.09±10.15 and 1.3±0.07 respectively. Mean length of hospital stay was 5.6±5.2 days. There is a significant correlation between SIRS and length of hospital stay (p= 0.03), and SIR ُ S and death (P=0.01). WBC count has a significant correlation with length of stay (p= 0.04) and mortality (p =0.02). Conclusion: Our findings suggest that admission SIRS score of trauma patients may be used as a predictor of outcome.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Infection Rate in Patients with Compound Depressed Skull Fractures and Primary Bone Fragment Replacement, Kashan-Iran, 1997-2005
12
16
FA
Homayoun
Tabesh
Esmaeil
Fakharian
Malake
Deljo
Akbar
Ali Asgharzade
Hossein
Akbari
Background : Compound depressed skull fracture (CDF) is a complication of trauma to head. In spite of many decades of studies on the management of CDF there is yet disagreements regarding primary repair or discarding the bone fragments and late repair. This study has conducted to evaluate infection rate in primary repair of CDF. Materials and Methods : This study included 60 patients with blunt trauma to head and CDF admitted to Naghavi hospital of Kashan University of Medical Sciences (KAUMS), from 1997 to 2005. Age, sex, the interval between admission and operation, severity of trauma, duration of hospital stay, and infections were recorded and analyzed with descriptive statistics. Results : Male to female ratio was 7.6:1, and mean age 19±12.4 years. It was most common in the age range of 11-20 (19 patients, 31.7%). Motorcycle was the most common cause of the problem (45 patients, 75%). Tirty nine patients (65%) had dural laceration. The most common site of fracture was frontal bone (37 and 61.7%). Twenty eight cases (46.6%) had mild, 13 (21.7%) moderate, and 19 (31.7%) severe head injury. Fifty four patients (90%) underwent operation in less than 24 hours of their arrival to hospital and had primary bone replacement. In 6 months follow up there was no infection in either the wound or bone. Conclusion : In the absence of heavy contamination, and by carrying debridment as soon as possible there will be excellent outcome with primary replacement of bone fragments in CDF patients, excluding the need for another operation and the apprehension about infection.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Epidemiology of Chest Trauma in Kashan Trauma Centers
17
22
FA
Abdolhossein
Davoodabadi
Esmaeil
Abdoulrahimkashi
Mohsen
Fattahi
Gholam Abbas
Moosavi
Mohammad
Afshar
Ahmad
Talebian
Background: Trauma is the most common cause of death between the ages of 1 and 44. Chest trauma as a potentially life threatening injury is increasing with increased number of high-speed accidents in Iran. Materials and Methods: 282 patients were treated for chest trauma in our center between March 2003 and September 2007. Data including the patients' age and gender, blood pressure, respiratory rate on admission, Glasgow Coma Scale (GCS) scores, Revised Trauma Score, types of trauma, the extent of intra thoracic injury, types of associated injuries, length of hospital and ICU stay, morbid conditions, and deaths were recorded and analyzed. Results: 237 patients were male (84%), and 45 female (16%). Mean age was 37.67±19.14 with the age range of 6 months to 84 years. 222 patients (78.7%) had blunt and 60 (21.3%) penetrating chest trauma. Motorcycles and car accidents were the most common etiologic causes in 167 (59.3%). Rib fracture was the most common thoracic injury with 178 (63%) and pelvic and limb injuries the most frequent extra-thoracic injury with 93 (33%). Seventy percent of patients were treated with either closed thoracostomy drainage or clinical observation while 71 (25%) needed surgical intervention during the first 24 hours. The most common operation was laparotomy. Mean duration of hospital stay was 7± 9.6 (range: 1-70) and ICU stay 1.9days. Out of 282 patients overall mortality was 33 (11.7%) and pulmonary infection 12 (4.2%). Conclusion: Chest trauma is a major preventable cause of mortality and morbidity in our country. Systolic blood pressure ≤90, pulse rate ≥120, respiratory rate >29, GCS <8 at the time of admission, and blunt type of trauma were found as the predictors of mortality and morbidity.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
An Epidemiologic Study on Diaphragmatic Traumatic Injuries in Al-Zahra Medical Center, Isfahan, 2003-2007
23
27
FA
Ali Akbar
Beigi
Hassan
Masoud-Pour
Mehrdad
Hossein-Pour
Background: Diaphragmatic hernias are relatively common after blunt and penetrating trauma. The difficulties in diagnosing traumatic diaphragmatic rupture (TDR) due to coexisting problems and the silent nature of these injuries at the time of first admission are the common causes of morbidity and mortality. Materials and Methods: Medical records of 34 patients treated for post traumatic diaphragmatic hernias between August 2003 and June 2007 in Al-Zahra Hospital, were studied and data including age, sex, kind and site of trauma, timing and accompanying injuries were recorded and analyzed retrospectively. Results: There were 28 (82.4 %) men and 6 (17.6 %) women, with age range of 1 to 68 years and mean of 32.2±9.1. Rupture of diaphragm was left-sided in 22 (64.7%) and right-sided in 11 (32.4%) and both in 1 (2.9%). Blunt trauma accounted for 22 (64.7%) of patients. Elective operation was done in 7 (20.6%) cases. Diagnosis was established preoperatively in 15 patients (44.1%), and intraoperatively in 13 (38.2 %). The diagnosis was missed in 6 (17.7 %) patients in first operation. Strangulation of viscera was found in four patients. The longest interval between trauma and diagnosis was about 3 years in one case. Mean duration of hospital stay was 12.3 days. Multiple associated injuries were observed in 22 patients (66.7 %). Postoperative complications were encountered in 9 (26.5 %) patients, and the overall mortality was 14.7 %. Conclusion: Diaphragmatic hernia should be suspected in all kinds of trauma to thorax and abdomen, and the presence of such an injury should be excluded before terminating the exploratory procedures.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Epidemiological Study on Injuries in Kashan form 1383 to 1385
28
31
FA
Mohammad Reza
Fazel
Esmaeil
Homayoun
Tabesh
Davood
Firouz
Azordegan
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Epidemiology of Occupational Injuries in Kashan during 2005-2006
32
37
FA
Hamid Reza
Saberi
Masoud
Motalebi
Mitra
Hanani
Hossein
Akbari
Background: According to International Labor Organization (ILO), annually, an estimated 15 million people suffer occupational accidents and one million die from their accidents, throughout the world. Occupational injuries and accidents can result in personal disability and impairment. The purpose of this study was to identify and describe the work related injuries in Kashan during 2005-2006. Materials and Methods: This descriptive study was carried on 1517 workers injured in their workplaces including factories, farms, and different kinds of office works, in Kashan. A specifically designed questionnaire was completed for all cases of occupational injuries referred to the emergency departments during 2005 to 2006 by a trained nurse. Data was analyzed by x2 test. Results: Out of 1517 work related injury cases 1476 (97.3%) were male, with age between 12 and 75 years (29.7± 10.2). Most of the patients were in the age range of 20 to 29 (41.3%) and most of them had less than 4 years history of work (42.7%). Eyes (53.6%) and hands (26.6%) were the most common sites of injury. Almost half of injuries happened in office works (50.2%) and then in industrial and mining workplaces (48.3%) followed by 1.5% in agricultural activities. In this study the most important mechanisms of injury were blunt objects trauma (39.3%) and then working with machines (14.3%). There is a significant relation between location of injury in body and workplace, and also between the injured organ and kind of injury (PV<0.001). Conclusions: Paying further attention to safety standards, as well as proper training for working with machines and in specific situations may reduce the magnitude and severity of occupational injuries.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
A Study on Traumatic Injuries of Female Genital Tract, Kashan-Iran, 2005-2006
38
42
FA
Elahe
Mesdaghinia
Azam
Mesdaghinia
Azade
Zolfagharpour
Background: Considering special physical, psychological and social importance of traumatic injuries to female genital tract, this study was carried out to determine the causes and characteristics of injuries of this system. Materials and Methods: This descriptive study was conducted on 21 patients operated upon for non-obstetrical injuries between March 2005 and March 2008 in Shabihkhani University Hospital, Kashan, Iran. The patients' data including age, mechanism, location, and kind of injury, and type of operation was extracted, recorded and analyzed. Results: Of 12825 surgeries, 21 cases (0.16%) had traumatic complications. M ean age of the patient population was 19.2 ± 12.8, and most of the cases were seen in the age group 19 to 35 years. In 33.3% of cases more than one part were damaged. Labia major, labia minor, fourchette and clitoris had been injured equally, each in 14.3%. Fall and intercourse were the most frequent causes of trauma (28.6%). Conclusion: Although it seems that the incidence of genital trauma in women is low, these kinds of injuries may result in many physical and psychological problems particularly in young girls while they are often preventable.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Assessment of Chest Trauma in Patients Admitted to Academic Medical Centers of Isfahan
43
46
FA
Akbar
Behdad
Mehrdad
Hosseinpour
Morteza
Rezaei Adaryani
Background : Chest trauma is the cause of one fourth of deaths in accidents, so its early diagnosis and proper management is important. The aim of this study was evaluation of various aspects of chest trauma in patients admitted to trauma centers in Isfahan. Materials and Methods : One hundred patients with chest trauma referred to hospitals affiliated to Isfahan Medical University were enrolled to this cross sectional study. Data including age, sex, accident time, trauma mechanism, organ injury, hospitalization length, complications, and outcomes were all recorded and analyzed with Chi square and t- tests . Results: Eighty percent of patients were male. The most common time of injury was between 12 PM and 1 AM (62%). Blunt trauma was the common type of injury. The most common age range was 21-30 years. The main complication of trauma was hemothorax (41%) and it was more common in penetrating injuries (45%). Hospitalization length was below 10 days in 47%, ten days in 12% and more than 10 days in 41% of patients. Associated head and abdominal injuries were found in 25% and 4% of patients, respectively. Death rate was 5%. Conclusion : consideration on chest injury is recommended in any case of trauma especially in blunt injuries. Epidemiologic studies in other parts of Iran can help in establishing appropriate criteria for chest trauma diagnosis and management in our country.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Epidemiology of Severe Ocular Injuries in Kashan, 1383
47
50
FA
Davood
Aghadoost
Mohammad
Zare
Mohammad Reza
Fazel
Abbas
Dalirian
Background: This study was carried out to determine the frequency of severe ocular injuries and identify their nature. Material and Methods: 221 consecutive patients with severe eye injuries referred to emergency room of Matini hospital of Kashan University of Medical Sciences (KAUMS) during a twelve month period were enrolled to this cross -sectional study . All patients were visited by trained general physicians and after consultation with ophthalmologists were treated appropriately. Data were recorded and analyzed by means of descriptive statistics. Results: Out of 221 patients 186 (84.2%) were male. Male to female ratio was 5:1 and the average age 22±14 years (range 1-85 years). Most ocular traumas occurred at age 11-30 years (57%). The most common types of eye injury were eyelid laceration (39.8%), corneal laceration (18.6%), conjunctival laceration (13.1%) and hyphema (11.3%). Ninety percent of patients were referred to emergency room within 24 hours after trauma. Workplace and home-related ocular injuries accounted for 63.4% of cases. Fifty two percent of eye traumas were penetrating, 44% blunt and 4% of missile type. None of them used protective glasses. Conclusion: Our study showed that young males and children composed the majority of eye injury victims, so it is recommended to use safe measures in theses groups.
Kashan University of Medical Sciences
Feyz Medical Sciences Journal
1029-7855
11
5
2008
1
1
Determining the Fequency of Sport Trauma in Boys’ School Sport Competetions, Kashan, 2006-2007
51
55
FA
Mansour
Sayyah
Esmaeil
Fakharian
Manzardokht
Bigdeli
Rasoul
Hamayat-Talab
Background : Sport injuries are inevitable events associated with school sports. They can be prevented if they are well scrutinized. This research was conducted to determine the frequency rate of trauma in student competitions in Kashan institutional sport contest during 2005-2006. Materials and methods : In this descriptive cross-sectional study on 80 sport events including 2256 student athletes, at the elementary, intermediate, and high school levels injuries were recorded by direct observation of the sport arenas at the city of Kashan during the educational year 2006-2007 championship events. All injuries due to any cause during the competitions were recorded. Results : A total of 50 injuries were recorded during the competitions. The highest frequency of injuries was observed in high school competitions with 21(42%) cases followed by elementary school competitions and intermediate school with 17(34%) and 12(24%) cases respectively. The highest frequency of trauma was observed in Basketball competetions with 16 (32%) cases and 4.7 per 100 athletes, followed by Football and Handball by 13 (26%) and 3.6 per 100 athletes, and 7 (14% ) cases and 3 per 100 athlete injuries, repectively. Conclusion: The pattern of sport injuries in this research was similar to those found in the literature. It is suggested that special care be taken in all sport competetions , particularly care be devoted to Basketball competetions at high school levels.