Thoracic Pneumorrhachis in Patient with Lumbar Fractures; a Case Report

Pneumorrhachis as a relatively rare condition may be an indication of substantial intra-spinal column injury. Here we report a 39-year-old man was admitted because of low back pain and dyspenea after locating between motor vehicle and wall three days before admission. On arrival, physical exams and vital signs were normal. Computed tomography (CT) scan showed bilateral pleural effusion, fracture of ribs number 8, 9 and 10 in lower left side of thorax, fracture of vertebra in L2-L4, and air bubbles in upper thoracic spinal canal.

The diagnostic value of RDW in appendicitis

Introduction: Diagnosis of acute appendicitis is based on clinical manifestation .Some patients have atypical clinical symptoms, and diagnosis is difficult. Red blood cell distribution width (RDW) is a measure of heterogeneity in the size of circulating red blood cells. The aim of this study was to evaluate RDW values in diagnosis of appendicitis. Methods: This is a retrospective case-control study, in which 399 patients with pathological diagnosis of appendicitis were divided into two groups of acute appendicitis and complicated appendicitis and compared with 400 healthy controls for appendicitis. RDW, white blood cell (WBC), platelet count (PLT), and hemoglobin changes were compared in three groups of patients. Results: In all three groups, the ratio of men was significantly higher than women (P<0.05). WBC (P=0.00), PLT (P=0.01), and RDW (P=0.01) had a significant difference between the three groups. However, there was no significant difference in the hemoglobin level between the three groups (P=0.3). RDW level was significantly higher in complicated appendicitis compared to acute (P=0.09) and control group (P=0.012). Conclusion: The results of this study showed that RDW value in three groups were significantly different. However, these values are not clinically useful for detecting appendicitis due to the slow progression of RDW value in patients

Epidural Hematoma Following Hemodialysis in a Methanol Poisoned Pa-tient; a Case Report

Brain injury associated with methanol toxicity can be ischemic, necrotic or hemorrhagic in nature. It most commonly affects the putamenal area bilaterally, but can be seen in other locations. This report describes a 22-year-old intoxicated patient who developed an epidural hematoma following hemodialysis. Heparinization during hemodialysis may contribute to cerebral hemorrhagic complications in methanol poisoning. In addition, a history of head trauma may raise the incidence of post-hemodialysis hemorrhagic brain insults. Heparin-free dialysis or peritoneal dialysis can be a good option in these cases

Knowledge and Attitude Regarding Organ Donation among Relatives of Patients Referred to the Emergency Department

Introduction: Organ donation is one of the surviving procedures which can increase the life expectancy of end-stage patients. Inappropriate beliefs and attitude of individuals to organ donation, their poor knowledge, and the socio-economic level are one of the most important barriers for organ donation. Therefore, here knowledge and attitude levels among relatives of trauma patients regarding organ donation were evaluated. Methods: This cross-sectional study was done on relatives of trauma patients referred to the emergency department of Sina Hospital, Tabriz, Iran, through 2013 to 2014. The questionnaire included parts of demographic data and socio-economic situations as well as status of knowledge and attitude regarding organ donation. A score between 0-7 was belonged to each person based on his/her level of knowledge. Attitude level had a score between 0-12. Chi- square, Fisher, and Mann–Whitney U test were performed to assess the relation between demographic variables and the level of knowledge and attitude. P&lt;0.05 was considered as a significant level. Results: 79 persons (57.1% male) with the mean age of 31.3±11.3 years were evaluated. 57 (73.1%) of subjects agreed with organ transplant. The main causes of disagreement among relatives regarding organ donation were dissatisfaction of the donor's relatives (25%) and religious issues (15%). 49 (62.02%) studied people had inappropriate attitude and 27 (34.2%) ones had good knowledge. male gender (OR=5.87; 95%CI: 3.32-8.42; p=0.001) and self-employed job (OR=7.78; 95%CI: 4.64-10.92; p=0.001) are independent factors associated with poor knowledge about organ donation. Self-employed job (OR=3.86; 95%CI: 1.41-6.11; p=0.009) and poor knowledge (OR=15.3; 95%CI: 9.03-21.57; p&lt;0.001) were related to inappropriate attitude toward organ donation. Conclusion: The present study showed that 73.1% of participants agreed with organ donation. The major causes of disagreements were dissatisfaction of other relatives and religious beliefs. 62.0% of the studied people had positive view regarding organ donation and 34.2% of them well-informed about. The most important causative factors for poor knowledge in this context were male gender and self-employed occupation. In addition, poor knowledge and self-employed job were two factors associated with inappropriate attitude toward organ donation

Epidemiology of Alcohol Poisoning and Its Outcome in the North-West of Iran

Introduction: Alcohol poisoning is one of the main preventable causes of death, disability, and injury in many societies. Ethanol and methanol are the most prevalent kinds of alcohol used. There is no any exact reports of alcohol poisoning and its outcome in Iranian society. Therefore, the present study was assessed the status of alcohol poisoning and its outcome in referees to the emergency department. Methods: This is a cross-sectional study which was done from July 2013 to 2014 in Sina Trauma Center, Tabriz, Iran. The studied population included all alcohol poisoning cases referred to this center. Demographic variables, clinical evaluation, laboratory tests, and patient's outcome were evaluated. To assess the relation between evaluated factors and outcome of alcohol poisoning. After univariate analysis a multivariate logistic regression was applied to evaluate independent risk factors for death. P&lt;0.05 was considered as a significant level. Results: Lastly 81 patients with alcohol poisoning were entered to the study (91.4% male) with the mean age of 27.9±10.4 years. Ten (12.3%) subjects were dialyzed and 34 (42%) cases hospitalized that 3 (3.7%) of them died. The multivariate logistic regression test displayed that plasma creatinine level (OR=2.2 95%Cl: 1.8-2.5; p=0.015) and need for dialysis (OR=6.4; 95%Cl: 5.3-7.5; p&lt;0.001) were the only risk factors of death among these patients. Conclusion: The findings of the present study revealed that total mortality rate of referees to the emergency with alcohol poisoning was 3.7% all of whom related to methanol poisoning. Based on this result, the mortality rate of methanol poisoning was estimated 20%. Need for dialysis and increasing the creatinine level were accounted as independent risk factors of death

Epidemiological study of trauma patients referred from Imam Reza trauma center to Shohada orthopedic center in Tabriz, Iran, during 2015

Introduction: Traumas are one of the most common causes of morbidity and mortality all over the world, especially in developing countries. The economic and social burdens of the disease vastly affect both developed and developing countries in different ways. Although the importance of this issue is obvious, there are few documentations about the characteristics of trauma patients in Iran. This study aimed to evaluate the characteristics of trauma patients referred to orthopedic center in Tabriz, Iran, during 2015. Methods: Eight hundred twenty-one patients with trauma that needed orthopedic interventions were studied in this cross-sectional study during 2015 in Tabriz. Age, sex, trauma type and date were collected and analyzed by SPSS. Results: From 821 patients, 70.9% were male. Most of the patients were referred in summer (33.6%) in June (11.6%). The mean age was 40.67 ± 20.4 with a tendency toward young ages (skewness = 0.28). The most common trauma types were car accidents (54.8%) and falling traumas (33.5%). Falling trauma was higher among females (42.31% vs 31.91%). Car accidents increased in cold seasons of the year. Most falling traumas were in spring and summer. Falling increased with increase in age while bicycle and motorcycle accidents decreased. Conclusion: According to high incidence of traffic injuries, an integrated multidisciplinary intervention to reduce the rate of traumas and their burden is essential

Red blood cell distribution width: a determinant of hospital mortality in pancreatitis

Objective: In recent years, there has been a great attention concerning red blood cell distribution width (RDW) in clinical decisions as well as determining the severity of diseases. This study was conducted to evaluate the primary level of RDW to predict hospital mortality in pancreatitis. Methods: This was a descriptive analytical study performed on 100 patients with acute pancreatitis in the emergency department of Imam Reza hospital of Tabriz University of Medical Sciences. In this study, the primary level of RDW in patients with acute pancreatitis presenting to the emergency ward was collected and after patients’ admission we followed them. Also, the admission outcome (mortality or discharge) of patients was registered, and finally we evaluated the predictive value of RDW in determining the patient’s outcome in hospital. Results: In our study, 47 patients were male, and 53 patients were female. Mean RDW in patients was 13.82 ± 1.69. Five patients died during the study. Mean RDW in dead patients and other patients was 16.44 ± 4.22 and 13.68 ± 1.37, respectively (P < 0.001). The cut-off point of 14.55 for RDW with 80% sensitivity and 85% specificity was determined for predicting mortality in patients. Conclusion: Based on our study results, the initial RDW level is an independent factor for predicting in-hospital mortality in pancreatitis but not for determining the need for surgery or admission to the intensive care unit (ICU)

The Effect of Start Triage Education on Knowledge and Practice of Emergency Medical Technicians in Disasters

Introduction: Pre-hospital triage is one of the most fundamental concepts in emergency management. Limited human resource changes triage to an inevitable solution in the management of disasters. The aim of this study was to evaluate the role of education of simple triage and rapid treatment (START) in the knowledge and practice of Emergency Medical Service (EMS) employees of Eastern Azerbaijan. Methods: This is a pre-and post-intervention study conducted on two hundred and five (205) of employees of EMS sector, in the disaster and emergency management center of Eastern Azerbaijan Province, 2015. The utilized tool is a questionnaire of the knowledge and practice of individuals regarding START triage. The questionnaire was filled by the participants pre- and post-education; thereafter the data were analyzed using SPSS 13 software. Results: The total score of the participants increased from 22.02 (4.49) to 28.54 (3.47). Moreover, the score of sections related to knowledge of the triage was a necessity and the mean score of the section related to the practice increased from 11.47 (2.15) to 13.63 (1.38), and 10.73 (3.57) to 14.93 (2.78), respectively, which were statistically significant. Conclusion: In this study, it was found that holding the educational classes of pre-hospital triage before the disasters is effective in improving the knowledge and practice of employees such as EMS technicians and this resulted to decreased error in performing this process as well as reduced overload in hospitals

Reliability of Platelet Indices for Diagnosing Pulmonary Embolism; a Brief Report

Introduction: Early diagnosis of pulmonary thromboembolism (PTE) is crucial in clinical medicine. Many para-clinical measurements are used to diagnose PTE. Objective: The present study was conducted to evaluate platelet indices in terms of diagnosing PTE. Methods: The present case-control study was conducted between September 2015 and September 2016 with 173 patients suspected of PTE in the emergency wards of Shahid Madani Hospital and Imam Reza Hospital affiliated to Tabriz University of Medical Sciences, Iran. The patients’ platelet indices were checked upon admission and they were evaluated in terms of diagnosing PTE. Platelet indices included mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PL-CR). PTE was diagnosed in 125 out of the 173 patients. Platelet indices were also compared between two groups. Results: No statistically significant differences were observed between the two groups in term of demographic variables (P>0.05). MPV was found to be 10.38±8.59 in the case group and 9.46±1.11 in the controls (P˃0.05). PDW was also found to be 12.86±5.57 in the case group and 12.32±2.48 in the controls (P>0.05). Moreover, PL-CR was found to be 22.59±7.32 in the case group and 21.97±8.16 in the controls (P>0.05). Conclusion: According to the obtained results, platelet indices do not increase in PTE. They cannot be therefore used to diagnose PTE in suspected patients