فهرست مطالب

Bulletin of Emergency And Trauma
Volume:8 Issue: 1, Jan 2020

  • تاریخ انتشار: 1398/12/21
  • تعداد عناوین: 10
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  • Mukesh Meena, Karmbeer Singh, Sanjay Meena *, Chetan Kumbhare, Dushyant Chouhan Pages 4-9
    Objective
    To find out which surgical approach, optimize the functional outcomes and reduce the risk of complications.
    Methods
    Medline, EMBASE, Cochrane Library, and Google Scholar were searched to identify relevant studies, which were included if they were retrospective or prospective in design, involved participants who had terrible triad of elbow (TTIE) that compared lateral approach (LA) with combined lateral and anteromedial approach (CML), and were published in English. Outcomes of interest were functional outcomes, complications, and operative time.
    Results
    Four studies, involving 470 patients were included in the systematic review. Mean follow up after surgery was typically 24 to 30 months. We found significant more range of motion (ROM) of elbow in CML as compared to LA group (MD: -14.21, 95% CI: -21.13 to-7.29, p<0.00001). There was significant more forearm rotation in CML as compared to LA group (MD: -18.88, 95% CI: -32.35 to -5.40, p<0.00001). Mayo elbow performance score (MEPS) was significantly more in CML (MD: -3.31, 95% CI: -7.23 to 0.62, p=0.00001). Blood loss, operative time, VAS and complications were more in CML group; however, the difference was not significant. The heterogeneity of the study and synthesizing retrospective data were the primary limitations.
    Conclusion
    Our analysis demonstrated that combined lateral and medial approach had significantly more elbow ROM and forearm rotation. The combined approach also had significantly more MEPS. However, using combined approach significantly increased the operative time.
    Keywords: Terrible triad of the elbow, Postoperative complications, Operative approaches
  • Darab Faraji, Mohsen Ebrahimi *, Babak Paknezhad, Zahra Hami, Alireza Jahandideh Pages 10-18
    Objective

    To assess regenerative capacities of chitosan-nanoselenium conduit on transected sciatic nerve in diabetic rats.

    Methods

    A 10-mm sciatic nerve defect was bridged using a chitosan-nanoselenium conduit filled with phosphate buffered saline. In chitosan group, the chitosan conduit was filled with phosphate buffered saline solution. In sham-operated group, sciatic nerve was exposed and closed. In transected group, right sciatic nerve was transected and nerve cut ends were fixed in the adjacent muscle. The regenerated fibers were studied within 12 weeks after surgery.

    Results

    The behavioral and functional and electrophysiological tests confirmed faster recovery of the regenerated axons in chitosan-nanoselenium conduit group compared to chitosan group (p=0.001). The mean ratios of gastrocnemius muscles weight were measured. There was statistically significant difference between the muscle weight ratios of chitosan-nanoselenium conduit and chitosan groups (p=0.001). Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers were significantly higher in chitosan-nanoselenium conduit group than in chitosan group.

    Conclusion

    chitosan-nanoselenium conduit resulted in acceleration of functional recovery and quantitative morphometric indices of sciatic nerve.

    Keywords: Peripheral nerve repair, Sciatic, Chitosan-nanoselenium conduit, Local
  • Siyamak Tahmasebi, Seyyed Mohammad Hosein Javadi *, Tahereh Azari Arghun, Forough Edrisi, Alireza Tajlili Pages 19-26
    Objective
    To identify the human factors contributing to traffic accidents with a special focus on psychosocial factors amongst young girls of Tehran, Iran.
    Methods
    In a descriptive study conducted in Tehran, Iran in 2013, 108 girls aged 18-24 were enrolled by using a stratified cluster sampling method. Participants filled a wide range of validated questionnaires about traffic psychology.
    Results
    The developed psychological model about behaviors of drivers’ factors as well as agreeable and aggressive personality trait with B coefficient of 0.25% and 0.37% were able to predict violation, driving style, perception of police laws, and off hook scheme and the mistrust with B coefficient of 0.33%, 0.23% and 0.28% in the level of 0.1 were able to predict violations and lapses of sample group, respectively. Extroversion with B coefficient of 0.27% also predicted unintentional violations of girls. B coefficient for perception of police laws was 0.22%. This was 0.25% for openness to experiences. Concerning driving accidents, the perception ofpolice rules has the highest predictability.
    Conclusion
    According to the results of the current research amongst girls in Tehran, a gender-sensitive interventional model can be designed for reduction of traffic accidents for this population group.
    Keywords: Psychosocial factors, Traffic accidents, Automobile driving, Young girls
  • Mahnaz Yadollahi *, Ali Kashkooe, Reza Rezaiee, Kazem Jamali, Mohammad Hadi Niakan Pages 27-33
    Objective
    To compare the injury severity scales as predictors of mortality in trauma patients to search for the best scale.
    Methods
    In a prospective cohort study and systematical random sampling conducted from March to September 2017, trauma patients over the age of 13 years were enrolled. The investigated variables were age, gender, systolic blood pressure, heart rate, respiratory rate, injured body region, Glasgow Coma Scale (GCS), injury severity score (ISS), revised trauma score (RTS), trauma injury severity score (TRISS) and the outcome.
    Results
    Totally, 1410 trauma patients were followed up, out of which 68.5% were male. The participants’ mean age was 43.5±20.88 years. After adjusting the confounding effects, age over 60 years (OR=7.38, CI [3.91-13.93]), GCSthan 5.5.
    Conclusion
    Our results showed that TRISS, RTS, GCS, and ISS were all very effective approaches for evaluating prognosis, mortality and probable complications in trauma patients; thus, these systems of injury evaluation and scoring are recommended to facilitate treatment. TRISS, RTS, and ISS had almost the same sensitivity that was higher than GCS, but GCS had the most specificity. Finally, TRISS was selected as the most efficient scale for predicting mortality.
    Keywords: Trauma injury severity score, Revised trauma score, Injury severity score, Mortality, Injury
  • Pankaj Kumar Mishra *, Rishi Dwivedi, Charanjit Singh Dhillon Pages 34-40
    Objective
    To evaluate the functional and radiological outcome of balloon kyphoplasty and to endorse the unilateral single balloon extrapedicular kyphoplasty as practically more feasible and safer method in comparison to the conventional methods.
    Methods
    Totally, 81 patients were presented to our center with osteoporotic vertebral compression fracture. Among these, 59 patients (61 vertebrae) were enrolled with stable wedge osteoporotic compression fracture. Pre-operatively percentage of vertebral height loss and kyphotic angle were calculated and single balloon extrapedicular kyphoplasty was performed in all cases.
    Results
    Postoperatively, anterior vertebral height improved to 79.61% of normal subjects. In our study, the mean segmental kyphosis correction following balloon kyphoplasty was 14.27°. Overall incidence of cement leak in our study was 15.25%.
    Conclusion
    Although we encountered the few difficulties, but this technique holds the safety and feasibility measures. Furthermore, it is effective in restoring anterior vertebral height, alignment and angle of kyphosis.
    Keywords: Uni-extrapedicular, Balloon kyphoplasty, Percutaneous, Compression fracture
  • Richard Amini *, Luis Camacho, Josie Acuña, Elaine Situ Lacasse, Srikar Adhikari Pages 41-46

    Pyogenic tenosynovitis is caused by hematogenous spread of infection or trauma with direct inoculation of a tendon sheath. Symptoms and clinical examination findings associated with pyogenic tenosynovitis may be confused with superficial soft tissue infections, however management plans between pyogenic tenosynovitis and superficial soft tissue infection vary significantly. In patients with pyogenic tenosynovitis, operative intervention and subsequent irrigation and debridement offer a definitive therapy. Bedside ultrasound helps clinicians inspect the involved tendon sheath and may help assisting diagnosis of pyogenic tenosynovitis. In this case report, we described three cases, where point of care ultrasound was used to assist the diagnosis of pyogenic tenosynovitis, to accelerate consultation, and to expedite operative intervention.

    Keywords: Tenosynovitis, Pyogenic tenosynovitis, Septic tenosynovitis, Point of care, Bedside ultrasound
  • Daniel Quesada *, Larissa Morsky, Phillip Aguìñiga Navarrete, Laura Castro, Luke Kim Pages 47-48
  • Mehrdad Amir Behghadami *, Masoumeh Gholizadeh, Ali Janati Pages 49-50

    Dear editor, Recently, we read with great interest the article authored by Jadidi et al. [1] that was entitled“Is emergency medical services (EMS) in Islamic Republic of Iran practical and efficient in facingEbola?” and published in Bull Emerg Trauma in 2019, in 7th volume and 3rd issue. First of all, wewould like to extend our gratitude to the authors of this article. Although the mentioned study wasappropriate and valuable, there was a fundamental flaw in the method, which has led to an ambiguous interpretation of the findings. Therefore, the purpose of this letter is to raise concerns about the data collection instrument and emphasize the importance of reporting its validity and reliability in crosssectional studies.

    Keywords: cross-sectional study, Methodological Issues, Instrument
  • Masoumeh Gholizadeh, Mehrdad Amir Behghadami *, Ali Janati Pages 51-52

    Dear editor, Recently, Ayalew et al. have published an article, titled, “Drug related hospital admissions; Asystematic review of the recent literatures” in Bull Emerg Trauma in 2019, 7th volume and 4th issue that has been caught our attention [1]. Even though the results of the study are interesting, there are flaws due to the authors’ negligence in the method, which leads to ambiguity in the interpretation of the findings. Therefore, the points expressed in this letter indicate what are needed to be perused in reporting systematic reviews.

    Keywords: Systematic reviews, Methodology, PRISMA Guidelines