علی ارجمند

The Glasgow coma scale (GCS) score is a commonly used in the initial evaluation of patients with traumatic brain injury (TBI). The GCS has some limitations to evaluate the unconscious patients. This study aims to reliability and predictive validity of outcome at discharge of GCS in an intensive care unit population.
This study is a cross-sectional method in 84 patients with acute brain injury in Shahid beheshti hospital in Qom (Iran). The inter-rater agreement for the GCS scores was evaluated by the weighted kappa. Outcome prediction power of the scales was assessed by the area under the curve (AUC) in the ROC curve.
In total, 168 ratings were performed for 84 patients by the GCS score. Inter-rater reliability for GCSC score was excellent. Cronbach’s showed a high degree of internal consistency for the GCS (α=0.82). The inter-rater agreement for each pair of raters was excellent (kw 0.838, 95% CI 0.889 - 0.987). The results show that scale is able to predict in-hospital mortality and poor outcome. The cut of point was 6.
The researchers conclude that the reliability and predictive validity of Persian version of the GCS score is a valid scale. The present study shows that the Persian version of the GCS score is a reliable tool for the measurement of consciousness changes in TBI patients

In order to study the effect of time incorporation to the soil and green manure crop on chemical soil properties and the primary growth of wheat a field experiment was conducted in experimental farm of Agricultural Faculty of ShahidChamran University of Ahvaz at 2013-2014 growing season. Experimental design was randomized complete block as a split-plot with three replications. The main plots was three time incorporation to the soil of green manures includes 40,50 and 60 days after planting and sub-plots was different green manure crops including Sorghum, Barley, mungbean, Intercropping of barley and mung bean and fallow (without green manure application). The results showed that the green manure treatments had significant effects on soil chemical properties. The mungbean treatment had the highest nitrogen content (0.085%). Barley-mungbean intercropping had the highest soil organic matter (1.33). The highest electrical conductivity (EC= 2.7 ds/m) was related to sorghumgreen manure treatment. Also the result revealed that the highest effects of green manure on wheat seedling dry matter and LAI for all three time incorporation were obtained at mungbean and barley-mungbean intercropping treatment. It is concluded that green manure type and decomposition duration are two main factors affecting soil properties and subsequent crop growth in crop rotation.

Due to the importance of taking care of patients admitted to the treatment centers, especially ICU, the provided care should be commensurate with the severity of disease. Using APACHE II (Acute Physiology and Chronic Health Evaluation II) standard scoring for determining severity of the disease and comparing it with other therapeutic centers is necessary. The aim of this study was to determine the mortality rate of patients admitted to trauma ICU with different APACHE II scores. Methods and This descriptive and retrospective study was performed in 6 month period from March to Sep 2011 in trauma ICU ward of Shahid Beheshti Hospital of Qom. Overall admitted patients were 140 and data was obtained from 110 patients with complete data and special data sheet of APACHE II Scoring system was performed for them. Data sheet were prepared for all patient and at the end of sheet, total scoring was recorded. Out of 110 patients, 80 (73%) were male and 25(27%) were female. Mortality and viability in these two group was 25(22.7%) and 85(77.3%) respectively. Eight percent of 75 (68.2%) patients with scoring below 15 died and in 20(18.2%) patients with scoring 20-30, 12(60%) died and 8 patients survived. Of the patients with scoring number 16-19, mortality rate was 6(42.9%) and survival was 8 (57.1%). In comparison with standard scoring system, in our study mortality rate in scores below 19 was lower than standard, but with scores above 20, mortality rate was 25% higher than the standard system. APACHE II scoring system can be useful in trauma ICU and in greater scoring numbers, severe intensive care must be considered for ICU patient.

Extramedulary hematopoiesis i common sequelae in thalassemic patients but extramedullary hematopoiesis in the spinal epidural space that lead to paraparesis in pregnancy in very rare. We managed a thalassemic patient with extramedullary hematopoiesis and spinal cord compression during pregnancy. The diagnosis was made on clinical features and magnetic resonance imaging (MRI)showing a paravertebral mass infiltrating the epidural space. She was treated with repeated blood transfusion but her symptom worsened and paraparesis progressed to paraplegic state. Surgical decompression of the spine and the removal of the culprit lesion compressing the spine were performed. Improving of the symptoms and control of the lesion could be obtained