Comparing the Severity of Injury and Trauma Pattern between Scooter and Street Motorcycle Riders; a Prospective Cohort Study

Introduction: The popularity of motorcycle riding in Iran is increasing. However, there is a lack of information about the safety of different motorcycle types. This study aimed to compare the severity of injury and trauma pattern between scooter (vespa) and street (standard) motorcycle riders. Method: In a prospective cohort study, a comparison of demographics, injury severity, trauma pattern, and clinical characteristics between 324 riders (162 Vespa and 162 standard motorcycles) admitted to emergency departments was undertaken. The risk factors associated with severe injuries in the two groups were also determined. An emergency medicine specialist determined the severity of trauma based on the abbreviated injury scale (AIS). Results: The Odds Ratio (OR) of severe injuries was significantly higher in the standard motorcycle riders’ group (OR: 3.09; 95% CI: 1.9-4.21; p: 0.013). The frequency of lower extremity fractures was significantly lower in the Vespa group (OR: 4.11; 95% CI: 2.01-6.25; p = 0.012). The frequency of admission to the intensive care unit was significantly higher in the standard motorbike riders’ group (OR: 1.64; 95% CI: 1.11-2.51; p = 0.033). The multivariate analysis indicated that motorcycle type, the speed at the time of the accident, use of helmet, and age of riders are the most important predictors of trauma severity in riders (p<0.05). Conclusion: The pattern of injury varies between standard and Vespa motorcycles. The standard motorcycle riders were prone to a higher risk of adverse outcomes such as severe injuries. Due to the particular structure of scooters, the rate of lower limb injuries was significantly lower than standard motorcycles

Evaluation of health-related quality of life after total hip arthroplasty: a case-control study in the Iranian population

Abstract Background As the total hip arthroplasty (THA) mainly aims to improve the quality of life of the patients, study of health-related quality of life (HRQoL) after THA has attracted much attention. Yet, the results considerably vary between studies. Here, we evaluate the HRQoL of the patient after THA, for the first time in the Iranian population. Methods In a case-control study, HRQoL was assessed in 217 patients after THA and compared with a matched reference population. The 36-item short-form health survey (SF-36) was used for the evaluation of HRQoL. A multiple linear regression model was used to investigate the influence of sociodemographic and clinical characteristics of the patients on the HRQOL. Results The mean follow-up of the patients was 27 ± 18 months. The mean total SF-36 score was 41.4 ± 22.2 in the case and 67.3 ± 26.6 in the control group (p = 0.001). The mean physical component score, but not the mental component score, was significantly lower in the patient group (p = 0.001). Except for the vitality and emotional role, all other SF-36 subscales were significantly lower in the case group. Male sex (B = 4.52, p = 0.023), number of comorbidities (B = − 4.82, p = 0.011), body mass index (B = − 1.18, p = 0.044), number of post-operative complications (B = − 6.57, p = 0.001), and adherence to physiotherapy protocol (B = 2.09, p = 0.014) were associated with HRQoL after THA. Conclusion Although THA is considered as one of the most successful orthopedic practices, it is associated with remarkable reduced HRQoL in Iranian population when compared with the reference population. A variety of patients-associated factors influence the HRQoL after THA

Preoperative predictors of implant size in patients undergoing total knee arthroplasty: a retrospective cohort study

Abstract Background Traditionally, the size of total knee arthroplasty (TKA) components is predicted by preoperative radiographic templating, which is of limited accuracy. This study aimed to evaluate the role of demographic data and ankle volume in predicting implant size in TKA candidates. Methods In a retrospective study, 415 patients who underwent TKA at a single institution were included. The mean age of the patients was 67.5 ± 7.1 years. The mean BMI of the patients was 31.1 ± 4.7 kg/m2. TKA implants were Zimmer Biomet NexGen LPS-Flex Knee in all cases. The demographic data included age, sex, height, weight, BMI, ethnicity, and ankle volume. Ankle volume was assessed with the figure-of-eight method. Multivariate linear regression analysis was used for predicting factors of implant size. Results Multivariate linear regression analysis showed that the Sex (β:1.41, P < 0.001), height (β:0.058, P < 0.001), ankle volume (β:0.11, P < 0.001), and Age (β:0.017, P = 0.004) were significant predictors of tibial component size. Sex (β:0.89, P < 0.001), height (β:0.035, P < 0.001), and ankle volume(β:0.091, P < 0.001) were significant predictors of femoral component size in the multivariate analysis. Conclusion Demographic data, adjunct with the ankle volume, could provide a promising model for preoperative prediction of the size of tibial and femoral components in TKA candidates

The use of metformin, sulfonylurea compounds and insulin and the risk of hip fractures in diabetic patients: a systematic review and meta-analysis of observational studies

Abstract Background Hip fracture is a major health problem that occurs more often in the elderly, especially in diabetic patients. Some studies have been conducted regarding the effect of anti- diabetic drugs on fractures. But so far, no meta-analysis study has been conducted to investigate the effect of diabetic drugs on hip fractures. Therefore, this study investigated the relationship between anti-diabetic drugs (Metformin, Sulfonylurea, and insulin) with hip fractures. Methods In this systematic review and meta analysis study, PubMed, Scopus, Google Scholar, and Web of Science databases were searched with specific keywords to find relevant studies. Two researchers included related studies after screening based on the title and full text. Cochran’s Q and I2 tests were used to assess heterogeneity between studies. Publication bias between studies was evaluated for each drug using Egger’s test. A 95% confidence interval was used for effect size significance. Overall, 49 studies, including 6,631,297 participants, were reviewed. Results The results showed that metformin significantly reduced the risk of hip fracture (HR: 0.833, 95% CI: 0.759, 0.914, P:0.001). Consumption of sulfonylurea compounds was significantly associated with an increased risk of hip fracture. (HR: 1.175, 95% CI:1.068,1.293, P:0.001), The risk of hip fracture in patients receiving insulin was significantly higher than in diabetic patients who did not receive insulin. (HR:1.366, 95% CI:1.226,1.522, P:0.001). Conclusion The results of this study showed that taking metformin reduces the risk of hip fracture, and insulin and Sulfonylurea increase the risk of hip fracture

Comparison of hepatitis C virus risk factors in genotypes 1a and 3a

Background: One of the most important causes of chronic liver disease is hepatitis C virus (HCV), which causes liver cirrhosis and hepatocellular carcinoma. To control the prevalence of the disease, knowledge and information in risk factor of HCV are required. The aim of this study was to compare the risk factors of infection between HCV patients with genotypes 1a and 3a. Methods: This is an observational analytical study. HCV patients who referred to the clinic of hepatology, Rasoul-e-Akram University Hospital from July 2015 to July 2017, were assigned to the genotype 1a and 3a. Demographic (age, sex, family history), clinical (cirrhosis, hepatocellular carcinoma) and laboratory data, history of intravenous drug and alcohol usage, and history of imprisonment were gathered and compared between two groups. All the patients completed the informed consent form. Data analysis was performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). P value less than 0.05 was considered statistically significant. Results: Overall, 97 HCV patients were included in this study. Mean age was 45&plusmn;12 years and 78 (80%) of patients were male. Among them, 58 (60%) and 39 (40%) had genotype 1a and 3a. respectively. History of injection drug usage was recorded in 34/39 (87%) of patients with genotype 3a, and significantly higher in genotype 3a as compared to genotype 1a [OR adj: 3.1, CI (1.3-6.2)]. Also, in this study, genotype 3a was significantly recorded in younger patients [OR adj: 1.7, CI (1.2-4.1)]. However, cirrhosis and hepatocellular carcinoma was more common in patients with genotype 1a as compared to genotype 3a [OR adj: 2.05, CI (1.6-5.4) and OR adj: 2.8, CI (1.3-5.7)] respectively. Conclusion: According to the results of this study, hepatitis C virus transmission risk factors differed in genotypes 3a and 1a. Genotype 3a is found among young patients with a history of intravenous drug usage and genotype 1a in patients with cirrhosis and hepatocellular carcinoma

The effect of Trolox on the rabbit anal sphincterotomy repair

Abstract Introduction Fecal incontinence (FI) is caused by external anal sphincter injury. Vitamin E is a potential strategy for anal sphincter muscle repair via its antioxidant, anti-inflammatory, anti-fibrotic, and protective properties against myocyte loss. Thus, we aimed to evaluate the water-soluble form of vitamin E efficacy in repairing anal sphincter muscle defects in rabbits. Methods Twenty-one male rabbits were equally assigned to the intact (without any intervention), control (sphincterotomy), and Trolox (sphincterotomy + Trolox administration) groups. Ninety days after sphincterotomy, the resting and squeeze pressures were evaluated by manometry, and the number of motor units in the sphincterotomy site was calculated by electromyography. Also, the amount of muscle and collagen in the injury site was investigated by Mallory’s trichrome staining. Results Ninety days after the intervention, the resting and squeeze pressures in the intact and Trolox groups were significantly higher than in the control group (P = 0.001). Moreover, the total collagen percentage of the sphincterotomy site was significantly lower in the Trolox group than in the control group (P = 0.002), and the total muscle percentage was significantly higher in the Trolox group compared to the control group (P = 0.001). Also, the motor unit number was higher in the Trolox group than in the control group (P = 0.001). Conclusion Trolox administration in the rabbit sphincterotomy model can decrease the amount of collagen and increase muscle, leading to improved anal sphincter electromyography and manometry results. Therefore, Trolox is a potential treatment strategy for FI