اپیدمیولوژی شکستگی های ناحیه سر و گردن ناشی از تصادفات موتور سیکلت

Introduction: Injuries resulting from motor-vehicle accidents are a growing burden to health all over the world. Each year, many people get severely injured or die due to road traffic accidents. Therefore, we aimed to evaluate the demographics of head and neck fractures caused by motorcycle accidents. Methods: In the present retrospective cross-sectional study, all the patients who were referred to emergency department, during the time from March 2013 to March 2014, with head and neck injuries due to motorcycle accidents were included using census sampling. A checklist consisting of demographic data, trauma mechanism, time of trauma, being the driver or the passenger, using safety equipment, head and neck fractures, accompanying injuries, imaging findings, and final outcome was filled for all patients using their medical files, and the data were used for descriptive analysis. Results: 386 patients with the mean age of 28.4 ± 10.79 years were evaluated (84.4% male). Most of the patients were under 30 years old (p = 0.001). Spring, with 152 (39.4%) cases, had the highest rate of accidents among the seasons. 223 (57.8%) accidents happened in the daytime (p = 0.037). Only 191 (49.5%) patients had used helmets. The most frequent fracture was cervical vertebrae fracture with 61 (15.8%) cases. Finally, 207 (53.6%) of the patients were discharged from emergency department after diagnostic and therapeutic measures were taken. 175 (45.4%) cases were hospitalized in other departments for further treatments and were later discharged with good general condition. 4 (1%) cases of mortality were recorded. Conclusion: The results of the present epidemiologic study reveal that the prevalence of head and neck fractures in motorcycle accidents is higher in young people, male sex, and those who do not use safety equipment. The most common site for head and neck fractures are cervical vertebrae, skull, and face bones, respectively. مقدمه: در سراسر جهان آسیب های ناشی از تصادفات وسایل موتوری یک معضل در حال رشد برای سلامت جمعیت عمومی محسوب می شوند. سالانه تعداد افراد زیادی به علت تصادفات جاده ای شدیدا زخمی می شوند و یا جان خود را از دست می دهند. لذا بر آن شدیم تا با طراحی مطالعه حاضر به بررسی دموگرافیک شکستگی های ناحیه سر و گردن ناشی از تصادفات موتورسیکلت بپردازیم. روش کار: در این مطالعه مقطعی گذشته نگر تمامی بیمارانی که در طول سال 1392 به بخش اورژانس ارجاع شدند و دچار آسیب های ناحیه سر و گردن ناشی از تصادف با موتورسیکلت بودند به صورت سرشماری وارد گردیدند. چک لیستی شامل اطلاعات دموگرافیک، مکانیسم تروما، زمان وقوع تروما، راکب یا سرنشین بودن، کاربری وسیله نقلیه، استفاده از تجهیزات ایمنی، شکستگی های ناحیه سر و گردن، آسیب های همراه، یافته های تصویربرداری و پیامد نهایی از طریق مراجعه به پرونده های بالینی برای تمامی بیماران تکمیل و مورد آنالیز توصیفی قرار گرفت. يافته ها: 386 بیمار با میانگین سنی بیماران 79/10 ± 4/28 سال مورد ارزیابی قرار گرفتند (4/84 درصد مرد). اکثر بیماران در محدوده سنی کمتر از 30 سال قرار داشتند (001/0p =). سه ماهه اول سال با 152 (4/39 درصد) مورد بیشترین آمار تصادفات از جهت توزیع فصلی را به خود اختصاص داد. 223 (8/57 درصد) مورد از تصادفات در طی روز افتاده بود (037/0p =). تنها 191 (5/49 درصد) نفر از بیماران از کلاه ایمنی استفاده کرده بودند. شایع ترین شکستگی مربوط به مهره های گردنی با 61 (8/15 درصد) مورد بود. در نهایت 207 (6/53 درصد) مورد بعد از انجام اقدامات تشخیصی و درمانی مقتضی از اورژانس ترخیص شدند. 175 (4/45 درصد) مورد در بخش های مختلف بیمارستان برای اقدامات درمانی بیشتر بستری و بعد از مدتی با حال عمومی خوب ترخیص گردیدند. 4 (1 درصد) مورد هم مرگ و میر ثبت  شد. نتيجه گيری: نتایج این مطالعه اپیدمیولوژیک نشان می دهد، شیوع شکستگی های ناحیه سر و گردن در تصادف با موتورسیکلت  در افراد با سن پایین، جنس مذکر و عدم استفاده از تجهیزات ایمنی بیشتر است. شایعترین محل شکستگی های ناحیه سر و گردن به ترتیب مربوط به شکستگی مهره های گردن، جمجمه و در نهایت استخوان های صورت بود

Carnitine in Alleviation of Complications Caused by Acute Valproic Acid Toxicity; an Exprimental Study on Mice

Introduction: Hyperammonemia and hepatotoxicity are well-known complications of valproic acid (VPA) poisoning. The objective of this study is to evaluate the potential role of carnitine in mitigating the adverse effects of acute VPA toxicity in mice. Methods: 54 male mice (25-30 g) were randomly assigned to one of three categories, including acute, sub-acute, and chronic poisoning. Each category contained 3 groups, each consisting of 6 mice (Group 1: control, Group 2: VPA treated, and Group 3: VPA + carnitine treated). The animals were sacrificed 24 hours after the initial injection, and their blood, liver, and brain samples were compared between groups of each category regarding liver function biomarkers, oxidative stress markers, ammonia level, and liver histopathologic changes using one-way ANOVA followed by Tukey’s multiple comparison test. Results: The administration of VPA increased the serum level of aspartate aminotransferase (AST) (p=0.003) and alanine aminotransferase (ALT) (p=0.001), as well as serum, and brain level of ammonia (p=0.0001 for both) in the intervention group. Elevated levels of lipid peroxidation and oxidative stress (p=0.0001 for both) in the liver tissue, decreased liver glutathione (p=0.0001) and ferric ion-reducing antioxidant power (FRAP) (p=0.0001), and histopathologic changes in the form of moderate to severe inflammation were observed. Administration of VPA + carnitine reduced AST (p=0.05) and ALT (p=0.01), increased the FRAP, reduced free oxygen radicals and liver lipid peroxidation (p=0.0001 for all), and decreased tissue damage in the form of moderate inflammation. The administration of carnitine was ineffective in reducing brain or plasma ammonia levels in acute VPA-treated animals (p = 0.0115). Conclusions: Although the administration of carnitine has been suggested as a protective remedy in cases of VPA toxicity, according to the present study, it did not have an antidotal effect and did not prevent encephalopathy or liver injury in acute VPA toxicity

Epidemiology of Head and Neck Fractures Caused by Motorcycle Accidents

Introduction: Injuries resulting from motor-vehicle accidents are a growing burden to health all over the world. Each year, many people get severely injured or die due to road traffic accidents. Therefore, we aimed to evaluate the demographics of head and neck fractures caused by motorcycle accidents. Methods: In the present retrospective cross-sectional study, all the patients who were referred to emergency department, during the time from March 2013 to March 2014, with head and neck injuries due to motorcycle accidents were included using census sampling. A checklist consisting of demographic data, trauma mechanism, time of trauma, being the driver or the passenger, using safety equipment, head and neck fractures, accompanying injuries, imaging findings, and final outcome was filled for all patients using their medical files, and the data were used for descriptive analysis. Results: 386 patients with the mean age of 28.4 ± 10.79 years were evaluated (84.4% male). Most of the patients were under 30 years old (p = 0.001). Spring, with 152 (39.4%) cases, had the highest rate of accidents among the seasons. 223 (57.8%) accidents happened in the daytime (p = 0.037). Only 191 (49.5%) patients had used helmets. The most frequent fracture was cervical vertebrae fracture with 61 (15.8%) cases. Finally, 207 (53.6%) of the patients were discharged from emergency department after diagnostic and therapeutic measures were taken. 175 (45.4%) cases were hospitalized in other departments for further treatments and were later discharged with good general condition. 4 (1%) cases of mortality were recorded. Conclusion: The results of the present epidemiologic study reveal that the prevalence of head and neck fractures in motorcycle accidents is higher in young people, male sex, and those who do not use safety equipment. The most common site for head and neck fractures are cervical vertebrae, skull, and face bones, respectively

Health Related Quality of Life and Pain Characteristics Among Iranian Patients Suffering Non-malignant Chronic Pain

Abstract&nbsp;Background: Chronic pain is a frequent disability that negatively affects patient’s quality of life. Understanding of the possible relation between sociodemographic and medical variables with Health Related Quality of Life (HRQL) may help identifying the multidimensionality of pain and risk factors that limit physical and psychological adjustment of the patients. The present study was done to find these possible relationships, based on using Medical Outcomes Survey-Short Form (SF-36).&nbsp;Methods: Among the patients who were referred to pain clinic of Iranian Pain Society, 101 consecutive outpatients were select based on the defined inclusion and exclusion criteria. All the participants in this study orally satisfied and were fully informed by a check list and SF-36 questionnaire. The possible impact of demographic variables, characteristics, diagnosis, analgesic use, smoking and opium addiction were collected as the first part of a routine pretreatment evaluation.&nbsp;Results: Our findings showed significant relation between HRQL and gender (P<0.05), the rate of chronic pain in female was higher than male, and same results found for elderly patients compared to younger ones. Our findings also showed significant relation between employment and intensity of pain (p=0.001) as, employed patients showed less physical and psychotic problems than unemployed ones. The mean average of intensity of pain in these patients was 7.5±2.2; few patients used alcohol (4%), opium (1%) and cigarette (10%). Large number of participants used analgesic (%78.2). No significant difference between sociodemographic features with pain duration and quality of life was found. In contrast our data showed significant difference between pain intensity and quality of life (p<0.001).&nbsp;Conclusion: Based on our findings it could be concluded that chronic pain in Iranian patients certainly leads to poor HRQL, the state is more serious in the elderly and female patients. Thus, in order to re-socialize the patients suffering chronic pain and decrease the impact of their pain on their life, these findings should be considered in any kind of pain relief therapy

Multifunctional PEGylated Niosomal Nanoparticle-Loaded Herbal Drugs as a Novel Nano-Radiosensitizer and Stimuli-Sensitive Nanocarrier for Synergistic Cancer Therapy

Nowadays, radiotherapy is one of the most effective treatments for breast cancer. In order to overcome the radioresistance of cancer cells, radio-sensitizing agents can be used combined with irradiation to increase the therapeutic efficiency. Curcumin can enhance the radiosensitivity of cancer cells and decrease their viability by the accumulation of these cells in the G2 phase. The encapsulation of curcumin in a nanoniosomal delivery system increases aqueous solubility and bioavailability, resulting in increased radio sensitivity. The present study aimed to enhance the radio-sensitizing effect of the curcumin-containing nanoniosome (Cur-Nio) when combined with irradiation. Thus, curcumin (0.5 mg ml−1) was loaded on a PEGylated nanoniosome containing Tween 60, cholesterol, DOTAP, and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-poly(ethylene glycol) (DSPE-PEG) (at ratios of 70:30:10:5, respectively) by the thin-film hydration method. The particle size, zeta potential, entrapment efficiency, and drug-release rate of formulated nanoniosomes were determined. In order to assess cytotoxicity and apoptosis, different doses of irradiation along with various concentrations of free curcumin and Cur-Nio (single or in combination with irradiation) were treated with breast cancer cells. The particle size and zeta potential of Cur-Nio were reported to be 117.5 nm and −15.1 mV, respectively. The entrapment efficiency (EE%) and loading capacities were 72.3% and 6.68%, respectively. The drug-release rate during 6 h was 65.9%. Cell survival in the presence of curcumin at doses of 1 and 3 Gy showed a significant reduction compared with cells irradiated at 48 h and 72 h (p < 0.000). Also, the rate of cytotoxicity and apoptosis was significantly higher in cells treated with the combination of curcumin-containing nanoniosomes and irradiation in comparison with those treated with free curcumin. These findings indicate that the efficacy of pre-treatment with Cur-Nio as a radiosensitizer during radiotherapy enhances irradiation-induced breast cancer cell apoptosis and is a useful strategy to increase the effectiveness of breast cancer therapy