An Algorithmic Approach to Operative Management of Complex Pediatric Dog Bites: 3-year Review of a Level I Regional Referral Pediatric Trauma Hospital

Background: Incidence of dog bites continues to rise among the pediatric population and serves as a public health threat for the well-being of children. Plastic surgeons are at the forefront of initial management and eventual outcome of these devastating injuries. This study set out to determine the nature of dog bite injuries treated over a 3-year period at a large level 1 pediatric trauma center. Methods: A retrospective review of emergency room records of all pediatric patients (age, 0-18 years old) who sustained dog bites between January 2012 and December 2014 were gathered. All details about age of patient, location and severity of dog bites, type of dog breed, antibiotics given, and emergency versus operative treatment were recorded and analyzed. Results: One hundred eight patients aged 5 months to 18 years old were treated in the emergency department after suffering dog bite injuries during the study period. The highest incidence of dog bites occurred in preschool children. The mean age for patients who required operative repair was lower than the mean age for patients who underwent primary closure in the emergency department. The location of injury was most commonly isolated to the head/neck region. Of the 56 cases that had an identified dog breed, pit bulls accounted for 48.2% of the dog bites, and 47.8% of pit bull bites required intervention in the operating room. Conclusion: Children with large dog bite injuries require more immediate care in a level 1 pediatric trauma hospitals in order to optimize their hospitalization course and eventual outcome

The comparison between the attitudes of employees and clients towards organizational intelligence (case study: Isfahan General Directorate of Sports and Youth)

This study was conducted in 2013, aiming tocompare the attitudes of employees and clientstowards organizational intelligence of IsfahanGeneral Directorate of Sport and Youth. The current studyis applied in terms of goal, descriptive in terms of natureand survey in terms of data collection. Based on Krejcie &Morgan table for sample size determination from a givenpopulation, 123 samples of employees were selected.Due to the comparison between the attitudes of employeesand clients, 123 clients were also selected throughsimple random method. The measurement tool in thisresearch was standard questionnaire of organizationalmultiple intelligence (Aghahosseini, 2010). To determinethe validity of it, the experts and professors of physicaleducation and sport sciences as well as management andplanning were consulted. Hereby, the content validity ofquestionnaire was confirmed. The reliability of it was alsocalculated through Cronbach’s alpha coefficient as 0.87.The descriptive and inferential statistical methods wereutilized for data analysis using SPSS software in error levelof 0.05. The results of study indicated no significant differencebetween the attitudes of employees and clientstowards organizational intelligence of Isfahan General Directorateof Sport and Youth (P=0.651). According to theemployees, the components of systematic intelligence,emotional intelligence, cooperative intelligence and educationalintelligence were upper than average level exceptoperational intelligence which was less than mean level(P=4.473). According to clients, all components in IsfahanGeneral Directorate of Sport and Youth were upperthan average level but there was no significant differencebetween the attitudes of employees and clients in any ofcomponents of organizational intelligence (P=0.05)

Quality of the Results Section of Original Dental Articles Published in National Farsi and International English Journals

Objective: Lack of scientific writing skills is one major problem encountered for publication of research results of Iranian scientists in accredited journals. As the result, many research projects or dissertation findings remain unpublished. This study aimed to assess the quality of writing of the “results” section of some original articles published in Iranian Farsi and international English journals.Methods: This analytical, cross-sectional study was conducted on 64 dental articles published in 3 international English and 3 Iranian Farsi journals. Selection of journals was non-random but articles were selected randomly based on specific criteria. A checklist containing 32 criteria regarding general statistics, context of the results, statistical tests, tables, charts and graphs was prepared. Obtained data were analyzed by SPSS 10 using Fisher’s exact and chi square tests.Results: Farsi articles met 64.1% and English articles met 65.8% of the checklist criteria. No significant difference was found in the quality of the results section of Farsi and English papers (p>0.05).Conclusion: Most papers did not provide adequate details in the results section to help readers better comprehend the subject

The comparison of Obsessive-Compulsive Personality Disorder and Traits in mothers of 4 -11 years children having OCD Vs control group

Objectives: Obsessive-compulsive disorder (OCD)   begins in childhood and adolescence and progresses along with aging .This  survy is conducted to compare temperament and character and Obsessive-Compulsive Personality Disorder (OCPD) and OCPD traits in parents of children with OCD and parents of healthy controls.Materials and Methods: In each group, 30 patients were studied. There were 11 boys (%36.7) in the study group (children with obsessive compulsive disorder), and 12 ones in control group (%40.0). In case group, four mothers (%13.3) had obsessive compulsive personality disorder, while the frequency in control group was one (%3.3) and the frequency difference was not considered statistically significant. There was also a case of borderline personality disorder in mothers of children with obsessive-compulsive disorder, but those in control group were not diagnosed with this disorder which showed thta there was still no significant difference between the two groups. No other personality disorders (including mixed personality disorder or NOS)  was detected in two groups.Results:The results indicated that the frequency of preoccupation with details was %46.7 in the case group (children with obsessive-compulsive disorder), and %10.0 in the control group that means no significant difference between the two groups (0.002). The frequency of perfectionism was %43.3 in the treatment group and %20.0 in the control group which again had no significant difference (0.052).Conclusions: The existence of the some symptomsof OCPD according to SCID in parents of children withOCD in comparison to parents of healthy children confirm the necessity of considering the role of personality factors in familial OCD.The results of this study showed that the four dimensions of temperament based on TCI-125 and triple dimensions of attitudes between mothers in the two groups was not statistically different

Unilateral eyelid edema and mucosal involvement as the first presentations of Wegener granulomatosis

Background: Wegener granulomatosis or granulomatosis with polyangiitis is a pauci-immune small vessel vasculitis which is usually associated with anti-neutrophil cytoplasmic antibodies (ANCA) mainly in old men. This small vessel vasculitis is usually characterized by necrotizing granulomatous inflammation with multiorgan involvement. Kidneys could be involved as the main and life-threatening condition in Wegener granulomatosis.  Oral or ocular lesions may occur as the first and uncommon presentations before internal organ involvement in these patients and could be misdiagnosed with other diseases. Case presentation: We present a 24-year-old man with erosions and ulcerations on palatal mucosa and a strawberry-like gingival hypertrophy associated with nasal congestion and epistaxis which two stated months ago. Also he had an episode of unilateral blepharitis and upper eyelid edema five months ago. Mucosal biopsy showed perivascular infiltrations of mainly neutrophils, some eosinophils and rare giant cells. He had elevated level of proteinase 3–ANCA or C-ANCA with microscopic hematuria without significant kidney involvement in kidney biopsy. Mucosal lesions and hematuria improved after two months of treatment with oral prednisolone. Conclusion: Unilateral eyelid edema and mucosal erosions in a young man could be the uncommon presentations of Wegener granulomatosis

Inflammatory myopathies in a patient with Darier disease, a possible association

Background: Darier disease (DD) is an autosomal dominant genetic disorder which develops from a mutation in the ATP2A2 gene. Inflammatory myopathies (IM) are the largest group of potentially treatable myopathies. In this case, we report development of IM in a patient with DD for the second time in the literature. Case presentation: The patient is a 59-year-old female, a known case of DD, who developed proximal muscle weakness 2 weeks prior to admission. Elevated muscle-enzymes, as well as typical electromyographic and radiologic confirmed the diagnosis of IM. Conclusions: Abnormalities in intracellular calcium homeostasis may explain the association between DM and DD, therefore it is noteworthy to keep this association in mind and conduct more research regarding this issue

Nail involvements as an indicator of skin severity in psoriatic patients

Psoriasis is a recurrent chronic inflammatory skin disease with various mild to severe clinical manifestations. The relationship between severity of the skin lesions and nail involvement has always been underestimated.Aim of the study was to evaluate the severity of skin involvement in psoriatic patients with and without nail manifestations.In this analytic cross-sectional study, patients with psoriasis referred to Razi University Hospital of Rasht from November 2015 to March 2016 were enrolled. Demographical features (i.e. age, gender) were obtained. Psoriasis severity and nail involvement criteria were assessed by Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI), respectively. All the gathered data were analyzed by SPSS software.In this study, 71 psoriatic patients with a mean age of 39.23±17.9 years (mean ± Standard Deviation; range: 4 to 77 years old) were studied. 22 patients (31%) had nail involvements. PASI scores were 11.7±5.7 and 5.7±4.5 in the two groups with and without nail involvements, respectively (P&lt;0.001). There were no significant differences between age, age of onset, and duration of the disease between the two groups (P&gt;0.05).The correlation coefficient between PASI and NAPSI was 0.367, which was statistically significant (P&lt;0.001).Based on the findings of our study, nail involvement is an important criterion in determining the severity of skin manifestations in psoriatic patients. Additionally, a high percentage of such patients probably manifest both skin and nail manifestations. Therefore it is highly recommended to consider nail involvement when evaluating psoriasis. </p

Evaluation of dermoscopic findings of longitudinal melanonychia in referred patients to dermatology clinics in Guilan, Iran

Introduction: Longitudinal melanonychia (LM) is a common clinical condition that is mostly identified by the presence of longitudinal, demarcated, and pigmented bands on the nail. Different benign or malignant pathologies can present with longitudinal melanonychia. Therefore, we aimed to investigate the frequency of dermoscopic features of LM in patients with LM referred to dermatology clinics in Guilan, Iran. Materials and Methods: This case-series study was conducted on 30 patients with LM who were referred to Besat clinic and Razi hospital, Rasht, Iran, from March 2022 to August 2022 with a complaint of LM. Demographical data and dermoscopic findings of patients were collected and analyzed using SPSS version 21. The LM and dermoscopic features were investigated using a dermatoscope (HEINE IC1, HEINE Optotechnik, Germany). Results: Out of 30 patients, 24 patients were female and 6 patients were male with a mean age of 30.08 ± 14.31 years old. Among these patients, five patients had a family history of LM, one patient with melanoma had Hutchinson’s sign, and three patients had pseudo-Hutchinson’s sign. The mean width of lesions of the nail was 2.42±2.12 mm with a mean time of onset of 7.42 ± 7.12 months. Also, the majority of the involved site of LM was hand (26.6%). Conclusion: According to our study, LM was more frequent in females and the trauma-related lesions of the nail were the most common dermatological findings among the patients