Study of maxillofacial fractures in patients referred to Ayatollah - Mousavi Hospital in Zanjan (2013-15)

Background: After cerebrovascular and coronary diseases, trauma due to road accident is the leading cause of death in our country. Maxillofacial fractures have economic and psychological consequences in addition to effects on the aesthetic and function of a person. Because of high frequency of car accidents in Zanjan province roadways, evaluation of maxillofacial fractures is important. Objective: The aim of study was to evaluate the epidemiologic characteristics of maxillofacial fractures in patients referred to Ayatollah - Mousavi Hospital in Zanjan in 2013-15. Methods: In this descriptive retrospective study, personal’s profile (age, sex), and fracture pattern (etiology and location) of 303 patients were selected by archive review and recorded in the informative form. Data were analyzed with descriptive statistics. Findings: From 277 evaluated maxillofacial fractures patients who met the inclusion criteria in this study such as completeness and legibility of registered data, 229 patients (82%) were male and 48 patients (18%) female. The peak incidence of maxillofacial injury was observed in the age group of 21-31 years. Most and least frequent site for fracture were mandible (26.7%) and condyle (6.9%) respectively. The most common cause for maxillofacial fracture in sequence were: car accident (79.4%), falling (8.3%), violence and assaults (5.8%). Conclusion: The most common cause for maxillofacial fracture was car accident especially in young adult males. So, emergency relief for victims, vehicle safety, and increase public awareness about seat belt usage is suggested

Alarming carcinogenic and non-carcinogenic risk of heavy metals in Sabalan dam reservoir, Northwest of Iran

Abstract This research aims to assess contamination status of water and sediment in Sabalan dam reservoir (SDR) and evaluate the impact of water withdrawal depths on the carcinogenic and non-carcinogenic risks of metals for exposed people. Results of metal pollution indices revealed some degree of pollution in water and sediment of the reservoir, especially associated with arsenic. Risk assessment of metals in water of the SDR for non-carcinogenic materials through different scenarios of water withdrawal depth revealed that consuming water from the depth of 10 m can be somewhat troublesome to human health. The carcinogenic risk of arsenic from depth of 10 m of the reservoir was about four times greater than that from water surface. Minimum carcinogenic risk of consuming water in the reservoir was found to be 1.69 × 10E-4, which is higher than the maximum limit proposed by the U.S. EPA, indicating the water consumption from the SDR can result in harmful effects on human health

Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting

This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting (PONV) in both adult and pediatric populations. The guidelines are established by an international panel of experts under the auspices of the American Society of Enhanced Recovery and Society for Ambulatory Anesthesia based on a comprehensive search and review of literature up to September 2019. The guidelines provide recommendation on identifying high-risk patients, managing baseline PONV risks, choices for prophylaxis, and rescue treatment of PONV as well as recommendations for the institutional implementation of a PONV protocol. In addition, the current guidelines focus on the evidence for newer drugs (eg, second-generation 5-hydroxytryptamine 3 [5-HT3] receptor antagonists, neurokinin 1 (NK1) receptor antagonists, and dopamine antagonists), discussion regarding the use of general multimodal PONV prophylaxis, and PONV management as part of enhanced recovery pathways. This set of guidelines have been endorsed by 23 professional societies and organizations from different disciplines (Appendix 1).Guidelines currently available include the 3 iterations of the consensus guideline we previously published, which was last updated 6 years ago; a guideline published by American Society of Health System Pharmacists in 1999; a brief discussion on PONV management as part of a comprehensive postoperative care guidelines; focused guidelines published by the Society of Obstetricians and Gynecologists of Canada, the Association of Paediatric Anaesthetists of Great Britain & Ireland and the Association of Perianesthesia Nursing; and several guidelines published in other languages.The current guideline was developed to provide perioperative practitioners with a comprehensive and up-to-date, evidence-based guidance on the risk stratification, prevention, and treatment of PONV in both adults and children. The guideline also provides guidance on the management of PONV within enhanced recovery pathways.The previous consensus guideline was published 6 years ago with a literature search updated to October 2011. Several guidelines, which have been published since, are either limited to a specific populations or do not address all aspects of PONV management. The current guideline was developed based on a systematic review of the literature published up through September 2019. This includes recent studies of newer pharmacological agents such as the second-generation 5-hydroxytryptamine 3 (5-HT3) receptor antagonists, a dopamine antagonist, neurokinin 1 (NK1) receptor antagonists as well as several novel combination therapies. In addition, it also contains an evidence-based discussion on the management of PONV in enhanced recovery pathways. We have also discussed the implementation of a general multimodal PONV prophylaxis in all at-risk surgical patients based on the consensus of the expert panel