فهرست مطالب

Journal of Surgery and Trauma
Volume:4 Issue: 1, Spring 2016

  • تاریخ انتشار: 1395/03/13
  • تعداد عناوین: 8
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  • Mohammad Reza Raeisoon Page 1
  • Zahra Amouzeshi, Narges Soltani, Narjes Khatoon Taheri, Majid Zare Bidaki, Seyed Ali Reza Mousavi, Manizhe Nasirizade, Farzaneh Safajou Pages 2-6
    Introduction
    The use of e-learning and computer-aided methods is rapidly on the rise in medical and nursing education. Therefore, given the conflicting findings and lack of systematic clinical trials on comparison of the effects of e-learning and traditional methods in nursing education, this study aimed to assess the effects of offline e-Learning on cognitive learning (levels of knowledge, comprehension, and application) in the Fluid and Electrolyte Imbalances course among nursing students.
    Methods
    This is a quasi-experimental study with a two-group, post-test-only design. A total of 52 third-semester nursing students were selected by convenience sampling method. Course contents were presented during 6 weeks by lecture and question and answer (Q & A) in the traditional learning group and by offline e-Learning in the second group. Afterwards, the students’ cognitive learning (knowledge, comprehension, and application) was assessed using a 23-item questionnaire on Fluid and Electrolyte Imbalances course. The obtained data were analyzed in SPSS (version 16) using Mann-Whitney, t-test, Chi-square, Fisher''s Exact Test, and analysis of two-way variance. The significant level was considered as P
    Results
    The mean score of cognitive learning was significantly higher in the traditional learning group (14.1±1.9) than in the e-learning group (12.4±2.2) (P=0.006). The difference was also significant in the domain of knowledge (P
    Conclusions
    According to the results, the method of teaching e-learning, alongside traditional teaching method is recommended.
    Keywords: Cognitive learning, Nursing Students, e, Learning, Traditional learning
  • Reza Abdi, Moein Aboobakri Pages 7-10
    Introduction
    Intramedullary nailing (IMN) of high tibia fracture has some mechanical and biological advantages over the other form of fixation. However, valgus, apex anterior malalignment and anterior displacement of proximal fragment commonly occur after isolated IMN fixation of proximal high tibia fracture. The purpose of this study is to determine the effectiveness of using 3.5-mm locking compression plate (LCP) with unicortical screws combined with IMN fixation to maintain the difficult reduction and prevent any displacement after classic nail insertion.
    Methods
    This cross-sectional study was performed between 2010 and 2012, thirty-three open or closed tibia fractures involving the high proximal tibia metaphysis were operated using combined 3.5 mm LCP unicortical plate with the classic reamed intramedullary nailing technique. The clinical and radiological results of the study were collected on the basis of the time to :::union:::, non:::union:::, mal:::union:::, degree of angulations at the fracture site, and infection. Follow-up ranged from 24 to 36 months (mean 28 months).
    Results
    The :::union::: rate was 100% on radiographs at 3.38 months postoperatively. No complications such as mal:::union:::, delayed :::union:::, implant failure, prominent valgus, anterior angulation malalignment, or postoperative deep infection occurred.
    Conclusions
    Although prominent malalignment occurs after IM nailing of proximal one-third tibia fractures, we can avoid it by using the medially inserted 3.5 LCP unicortical plate. The results are good even in open fracture type one or two.
    Keywords: Nail, Tibia, Intramedullary, Proximal, Fracture, Fixation
  • Seyed Amirkazem Vejdan, Ghodratollah Naseh, Narjes Masoodi, Malihe Khosravi Pages 11-16
    Introduction
    With a prevalence rate of 7-8 percent, acute appendicitis is one of the most common public surgical emergencies worldwide. Given the complications of this disease because of lack of medical diagnosis and not on-time arrival of patients, this study evaluated the diagnostic performance of physicians (general or specialist) in patients with suspected appendicitis admitted in Imam Reza Hospital of Birjand in 2015’s second half.
    Methods
    In this cross-sectional study, diagnostic and treatment process from the onset of symptoms to hospitalization and surgery of 147 patients with a diagnosis of acute appendicitis undergoing surgery in the second half of 2015 in Imam Reza (AS) hospital in Birjand were evaluated using questionnaires and checklist. After examining the results of the histopathology, confirmed appendicitis cases were analyzed. The data were analyzed using statistical software SPSS 15 and statistical tests of chi-square, Fisher exact test, and Mann-Whitney U test.
    Results
    In the study, the mean age of the 147 patients was 24.45±13.32 years and all the patients were complaining of abdominal pain. The initial pain in 52% of the cases was in the periumbilical area. Moreover, 105 (71.42%) of the patients presented typical symptoms and 42 (28.57%) had untypical symptoms. Appendicitis in 74.8 percent of patients had led to no complications and 21.1% of them were admitted with generalized peritonitis in surgery. Distribution of the people in cases of complicated appendicitis evaluated by clinical examination (N=22) was significantly lower than uncomplicated cases (99 patients) (P
    Conclusions
    Based on these results, it is necessary to raise awareness about quick lookup. It is also recommended to physicians to observe early signs and symptoms of appendicitis to accurately refer the patients to specialized diagnostic procedures in order to take quick actions and appropriate treatment.
    Keywords: Appendicitis, Typical, untypical symptoms, Complications, Clinical treatment
  • Mohammad Reza Mofatteh, Marziye Asli, Masoome Shaghab, Ali Mofatteh Pages 17-32
    Introduction
    Laryngeal and hypopharyngeal lesions areamong common head-and-neck diseases. Evaluating them with direct laryngoscope provides information about the kinds and regions of the lesions, whichalong with the clinical signs helps to diagnose and determine the treatment plans. The aim of this study is to evaluatethe frequency distribution of different types of laryngeal and hypopharyngeal lesions viadirect laryngoscopyofthe patients referred to the medical centers of Birjand city.
    Methods
    This cross-sectionalstudy wasperformed on 165 patients referred to all ENT specialized medical centers of Birjand city who,according to the primary clinical diagnosis, were in need of direct laryngoscopy. Patients with bronchial or lower lesions were omitted from the study. The necessary information including age, sex, residence, primary complaint, risk factors,type and region of the lesion was collected with the patient’s consent. Data were analyzed in SPSS 18 software usingKruskal-Wallis and Chi-Square tests. The significance level was set at P
    Results
    The mean age of the participants was 43.76±23.66 years, and 53.3% were male. The most frequent primary complaint was dysphonia,the most frequent types of lesion were foreign object and neoplasm, the most involved regions were glottis and hypopharynx, and the most frequent risk factors were opium and smoking.The results showed a significant correlation between the type of lesions and the variables of age, residence, risk factors and region of legions.
    Conclusions
    The results showed that dysphonia was the most frequent primary complaint. The majority of neoplastic lesions,which had a significant correlation with smoking, opium consumption and bad nutritional habits, were seen in men,indicating the necessity to inform people about the primary signsof these lesions in order to diagnose timely and decrease tobacco use.
    Keywords: Laryngoscopy, Laryngeal Neoplasms, Hypopharyngeal Neoplasms
  • Nahid Azdaki, Hamidreza Mashreghimoghaddam, Marjan Farzad, Toba Kazemi Pages 24-26
    Torsades de pointes is a rare but potentially lethal arrhythmia which mainly occurs in the setting of a prolonged QT interval. ECG is a reliable tool to detect such abnormalities, routinely taken from all patients over 40 who undergo surgery.
    We describe the case of a 35-year-old woman with torsades de points arrhythmia after hysterectomy surgery. Most likely, our patients had long QT syndrome which has not already been detected.
    Surgery can elicit both acquired and unknown congenital long QT syndrome. Preoperative ECG is recommended even for people under 40 years to detect unknown congenital long QT syndrome.
    Keywords: Torsades de pointes, Long QT syndrome, Surgery, EKG
  • Samaneh Kouzegaran, Amir Sabertanha Pages 27-29
    A hydatid cyst is a zoonotic infection caused by the larval forms of mostly the Echinococcus granulosus. In humans, the most common site of cyst development is the liver (60%), followed by the lungs (20%), and much less commonly in other organs such as kidney, spleen, brain, and other soft tissues. The localization of cysts in muscles and subcutaneous is very rare. We report a case of 38-year-old female patient with a cystic shoulder mass turning out to be hydatid cyst on surgical exploration.
    However, especially in non-endemic regions, the most diagnostic tool for an unusual presentation is the awareness of the physician. Surgical excision is the main modality of treatment. Also, complementary investigation to rule out other organs’ involvement is necessary. During surgical interventions, all precautions antiscolicidal solutions along with meticulous surgical techniques go a long way in the prevention of recurrence of this disease.
    Keywords: Echinococcosis, Hydatid disease, shoulder hydatid
  • Nasir Hematin, M. Hosseinzadeh-Maleki, R. Shabanian, Ma Navbi, Forod Salehi Pages 30-32
    Thrombotic events are very unusual in neonatal period. This congenital anomaly may be caused by certain risk factors such as polycythemia, perinatal asphyxia, septicemia, maternal diabetes, dehydration, and low cardiac output, or it may occur upon catheterization of central lines. A 20-day-old neonate was referred to our ward with primary signs of hypertrophic cardiomyopathy (HCMP). Echocardiography and CT-angiography were performed to find stenosis or no stenosis of aortic valve, which showed a great mass into the ascending aorta. This mass was resected and removed successfully and thereafter the aortic arch was repaired. There was no prothrombic disorder in his family history.
    Keywords: Neonatal, Hypertrophic cardiomyopathy (HCMP), Echocardiography, Aortic thrombosis