Brain multi-infarct and decompression sickness
Luis Rafael
Moscote-Salazar
Neurosurgeon-Critical Care, RED LATINO. Latin American Trauma & Intensive Neuro-Care Organization, Bogota, Colombia
author
Guru Dutta
Satyarthee
All India Institute of Medical Sciences, New Delhi, India
author
Nidia Escobar
Hernandez
Department of Radiology, National Autonomous Universitiy of Mexico, Mexico City, Mexico
author
Jorge Aquino
Matus
Department of Radiology Hospital, General Dr. Manuel Gea González, Mexico City, Mexico
author
Willem Guillermo
Calderon-Miranda
Department of Radiology Hospital, General Dr. Manuel Gea González, Mexico City, Mexico
author
Marco Antonio
Blancas-Varas
National Autonomous Universitiy of Mexico, Mexico City, Mexico
author
Johana
Maraby
Universidad de Cartagena, Cartagena de Indias, Colombia
author
Joulen
Mo-Carrascal
Universidad de Cartagena, Cartagena de Indias, Colombia
author
text
article
2018
eng
Scuba diving is associated with an important risk of developing decompression sickness secondary to formation of gas bubbles inside the body. The latter is formed mainly by nitrogen in the body on the diver’s way to the surface (1,2). In some cases, it might injure the central nervous system. Several decompression cases that have been associated with neurologic symptoms are described in the literature; however, brain multi-infarct with lethal outcome has never been described.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
53
54
http://www.jept.ir/article_46326_96cb028adeceea40631d0b5409714922.pdf
dx.doi.org/10.15171/jept.2017.17
The ability of the emergency medical service personnel to take patients’ medical history
Ali
Sadrollahi
Department of Nursing Science, Bandar Gaz Branch, Islamic Azad University, Bandar Gaz, Iran
author
Adeleh
Gharataghani
Department of Clinical Affairs, Golestan University of Medical Sciences, Gorgan, Iran
author
Mehdi
Mahmoudi
Department of Nursing Science, Bandar Gaz Branch, Islamic Azad University, Bandar Gaz, Iran
author
Fardaneh
Gholipour
Department of Nursing, Khalkhal Branch, Islamic Azad University, Khalkhal, Iran
author
text
article
2018
eng
Objective: The key point to detect patients’ need in pre-hospital emergency is to have high ability to take medical history. All research findings show that this ability is low. The objective of this research is to investigate the ability to take medical history of patients among the personnel of pre-hospital emergency medical service (EMS) in Golestan province, Iran.Methods: This research was a descriptive cross-sectional study carried in 2016. The population included non-staff technicians and an operator working in the message center (N = 171). The samples were selected using multi-stage cluster sampling. Data were collected by a researcher-developed questionnaire. The collected data were analyzed by SPSS software version 16 conducting descriptive and inferential statistics. All tests were administered at a significance level of P < 0.05.Results: One hundred sixty-five (96.5%) participants were male. The mean score of the ability to take medical history was 58.4 ± 11.1. Therefore, 95 participants (58.3 %) had poor ability and 64 participants (39.3 %) owned moderate ability. The highest score concerning the ability to take medical history was for the aspect of professional knowledge (mean rank = 5). The most influential aspect in the ability was respectively for ‘professional knowledge’ (P = 0.0001, Beta = 0.509). Pearson correlation coefficient indicated a relationship (r=-0.149, P = 0.05) between the ability to take medical history and age.Conclusion: The results of the current study indicated that the ability to take medical history among the personnel of pre-hospital medical emergency of Golestan province was low. Therefore, a thorough review of trainings promoting personnel’s professional knowledge is urgently required.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
55
61
http://www.jept.ir/article_57896_6de613e30409ced7b3230cbc0a69d47c.pdf
dx.doi.org/10.15171/jept.2017.32
Effect of oral tizanidine on prolongation of intrathecal lidocaine
Arman
Taheri
Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
author
Morteza
Hashemian
Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran
author
Mehrdad
Noroozi
Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran
author
Mohammad
Bakhtiari
Department of Anesthesiology, Sirjan School of Medicine, Sirjan, Iran
author
Mohammad Reza
Doroodian
Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran
author
Shirin
Salajegheh
Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran
author
text
article
2018
eng
Objective: In order to prolong the duration of intrathecal lidocaine, various drugs are used along with it. Due to the promising effects of tizanidine on central nervous system, it can be assumed that tizanidine can have a positive effect on increasing the anesthesia duration too. Thus, we aimed to investigate the effect of oral tizanidine on the duration of lidocaine spinal anesthesia.Methods: This double blind clinical trial was conducted on 40 male patients waiting for elective leg surgery with the age range of 20-60 years in one of the educational hospitals of Kerman University of Medical Sciences, Iran. We used simple random sampling and our participants were assigned into 2 groups (placebo and oral tizanidine receivers). Spinal anesthesia with 1 mg/kg of hyperbaric lidocaine 5% was performed in both groups. In tizanidine group, patients received 4 mg of oral tizanidine one hour before spinal anesthesia. Sensory block was examined by pin prick test and all anesthetic duration including start block until reduction of sensory level was calculated at 2 lower dermatomes.Results: Findings showed that oral tizanidine compared to placebo can cause a 10-15 minute increase in patients’ lidocaine spinal anesthesia. Therefore, the average anesthesia time for tizanidine group increased meaningfully (P = 0.03). In addition, tizanidine can sedate patients during surgery (P = 0.00) or in recovery (P = 0.003).Conclusion: Based on the results, tizanidine increased the duration of lidocaine so oral tizanidine can be used to prolong the duration of lidocaine spinal anesthesia.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
62
66
http://www.jept.ir/article_62695_708190832c7b629c52f022f7e24b36b5.pdf
dx.doi.org/10.15171/jept.2018.06
Abdominal trauma in a semi-urban tertiary health institution
Julius Gbenga
Olaogun
Department of Surgery, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
author
Olusoga Olusola
Akute
Department of Surgery, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
author
Amarachuku Chiduziem
Etonyeaku
Department of Surgery, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
author
Joshua Taye
Ige
Department of Surgery, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
author
David Brown
Ajibola
Department of Surgery, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
author
Jide Michael
Afolayan
Department of Anaesthesia, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
author
Eyitayo Ebenezer
Emmanuel
Department of Epidemiology and Community Health, Ekiti State University, Ado-Ekiti, Nigeria
author
text
article
2018
eng
Objective: There has been a global increase in the incidence of abdominal trauma in surgical patients. We conducted this study to evaluate the pattern of abdominal injuries, patient characteristics and the management outcome in our setting.Methods: It was a descriptive (combined retrospective and prospective) study of all patients with abdominal trauma admitted and managed at Ekiti State University Teaching Hospital, Ado-Ekiti between January 2013 and December 2016. Data on socio-demographics, clinical profile, investigations, treatments and outcome were entered into a spread sheet and analyzed using SPSS version 20.0.Results: A total of 2728 trauma patients presented during the study period. Of these, 68 (2.5%) suffered from abdominal injuries. Their ages ranged from 6 to 72 years (mean 30.3±13.2). Fifty-nine (86.8%) were males while 9 (13.2%) were females (M: F ratio = 6.6:1). Forty-nine (72.1%) sustained blunt trauma while 19 (27.9%) had penetrating injuries. Road traffic incident (RTI) (n=41; 60.3%) was the most common source of trauma, followed by assault: gunshot (n=9; 13.2%), and stab (n=7; 10.3%). Spleen (n=23; 33.8%) was the most common solid organ injured followed by the liver (n=7; 10.3%) while small bowel (n=8; 11.8%) was the most common hollow viscous injured. Forty-seven (69.1%) required operative intervention. Post-operative complication rate was 17% with wound infection (12.5%) predominating. The mortality rate was 4 (5.9%).Conclusion: RTI and assault are major causes of abdominal injury. Measures to reduce RTI, youth restiveness and criminal activities will stem the tide.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
67
72
http://www.jept.ir/article_63117_7887ff254b7313357ec3a6e3a3f9ed64.pdf
dx.doi.org/10.15171/jept.2018.07
Prevalence and pattern of hypertension and effect of body mass index on blood pressure in six communities of Biase LGA In Cross River, Nigeria
Lawson
Ekpe
Department of Chemical Pathology, College of Medical Sciences, University of Calabar, Nigeria
author
Kingsley
Osuji
Department of Chemical Pathology, Irrua Specialist Hospital, Irrua, Nigeria
author
text
article
2018
eng
Objective: Hypertension is a major risk factor for stroke, renal failure, and heart failure globally. This trend of complications has been seen even among our rural and urban dwellers in the tropics. This study aims at determining the prevalence and pattern of hypertension and body mass index (BMI) in six rural communities in Southern Nigeria.Methods: Adult participants, aged 18-80 years of age from six rural Biase communities who presented for a health screening were recruited. This was a rural community-based cross-sectional study involving 419 adults. Information was obtained from questionnaires which were administered to assess and obtain demographic data. Blood pressure and anthropometric indices were measured from participants to assess the BMI and risk factors associated with hypertension, and pattern of blood pressure.Results: A total of 419 enrolled for the study, but 137 had hypertension (systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥90 mm Hg) and this was made up of 86 females (62.8%) and 51 males (37.2%). Only 29 of the hypertensives (21.1%) were aware of their condition. The prevalence of hypertension was 32.7%. Moderate hypertension was the commonest presentation. High blood pressure, obesity and overweight was common among the women folk compared to the men that had isolated systolic hypertension (P < 0.05).Conclusion: In recent times, hypertension is seen to be high even in rural settings; hence strict screening should be enhanced to allow for quicker diagnosis and early intervention.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
73
76
http://www.jept.ir/article_62717_f3ee4f56bafc46b488b6f091e734e860.pdf
dx.doi.org/10.15171/jept.2018.04
Patients’ satisfaction towards medical services at the emergency department of European Gaza Hospital- Gaza Strip
Hammoda
Abu-Odah
Department of Emergency, European Gaza Hospital, Gaza Strip, occupied Palestinian Territory
author
Akram
Abu Salah
Palestine College of Nursing, El-Fukhari, Gaza Strip, occupied Palestinian Territory
author
Ali
El-Khateeb
Nursing and Health Sciences Department, University Collage of Applied Sciences, Gaza Strip, occupied Palestinian Territory
author
Khawla
El-Nems
Medical Military Rafah Clinic, Medical Services Directorate, Gaza Strip, occupied Palestinian Tterritory
author
text
article
2018
eng
Objective: Patients’ satisfaction (PS) is recognized as an important emergency department service design and it has received a high interest and attention in the health management where many studies have focused on determining factors affecting PS in health-related circumstances. In this study, we aimed to examine PS in emergency department (ED) of the European Gaza Hospital (EGH) in the Gaza Strip (GS).Methods: A descriptive-analytical cross sectional study was performed at ED-EGH between March, 15 and June 20, 2015. Press Ganey questionnaire was used as a tool for data collection. For each patient, a self-administered questionnaire including 22 questions was filled based on a Likert scale. Results were analyzed using SPSS version 22.Results: Overall, 200 respondents were included in the study. About 73% of respondents were satisfied with overall medical services. The term of nurses’ concern provided to patients elicited the highest score (83.1%), followed by physicians’ concern with patients (72.0%) and communication skills with patients (71.4%), while the lowest score was reported in waiting time and security staff. Furthermore, our findings show an association between PS and level of education, gender differences, living area, and work shifts.Conclusion: The study results conclude that areas of medical and nursing care, respects of staff, physical comfort and waiting time ED-EGH is highly acceptable and offer in appropriate manners.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
77
81
http://www.jept.ir/article_63821_21d7dfef75e391413a76126efa1dc69d.pdf
dx.doi.org/10.15171/jept.2018.08
Tramadol abuse and shoulder dislocation
Behnam
Behnush
Department of Forensic Medicine and Toxicology, Tehran University of Medical Sciences, Tehran, Iran
author
Roya
Kordrostami
Department of Forensic Medicine and Toxicology, Iran University of Medical Science, Tehran, Iran
author
Nahid
Dadashzadeh
Department of Forensic Medicine and Toxicology, Iran University of Medical Science, Tehran, Iran
author
Maryam
Ameri
Department of Forensic Medicine and Toxicology, Iran University of Medical Science, Tehran, Iran
author
text
article
2018
eng
This study aimed to evaluate the shoulder dislocation following tramadol-induced seizure and its potential difference with other shoulder dislocations. We evaluated six cases that used tramadol tablets and some of them had a history of seizure. All of the cases had shoulder dislocation. According to the findings, tramadol use and tramadol-induced seizure may increase the risk of shoulder dislocation.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
82
85
http://www.jept.ir/article_45958_264c85f7035c9aaaf03ab0ea9b72d5ac.pdf
dx.doi.org/10.15171/jept.2017.15
Munchausen syndrome as scorpion biting:a misdiagnosis
Reza
Bidaki
Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Mehrdad
Roozbeh
Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Mohamad Amin
Sharifi
Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Seyed Nader
Mostafavi
Department of Forensic Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Mohammad Ali
Abdolkarimi Davarani
Department of Internal Medicine , Rafsanjan University of Medical Sciences, Rafsanjan, Iran
author
text
article
2018
eng
Factitious disorder as Munchausen syndrome is a time and money consuming condition that is presented with different signs and symptoms. In emergent situations, it is not a differential diagnosis with high priority, but when it becomes recurrent with atypical symptoms, factitious disorder and malingering should be considered as well. In this survey, we report an odd and interesting presentation of a factitious disease as a scorpion sting which misled some professional healthcare providers until the patient finally confessed that she used turmeric to mimic the signs of a scorpion sting. She exaggerated her symptoms when asked about the details of the mechanism of the scorpion bite. When encountering an emergent condition, after ruling out the critical conditions especially when the symptom is recurrent, factitious disorders should be considered. Consultation with a psychiatrist help the team manage the patient properly.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
86
88
http://www.jept.ir/article_48213_d851582b2823d3cba756c13dfbd36ee6.pdf
dx.doi.org/10.15171/jept.2016.15
Traumatic spinal epidural hematoma: an alarming and diagnostic challenge in the ED
Krishna
Prasad
Department of Emergency Medicine, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, India
author
Susan
Tharian
Department of Emergency Medicine, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, India
author
Jebu
A Thomas
Department of Emergency Medicine, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, India
author
text
article
2018
eng
Traumatic spinal epidural hematoma (TSEH) is a neurosurgical emergency which is considered as one of the rare causes of back pain. The onset of symptoms presentation can vary especially following a trauma. Here, we report a case where a young girl had a trivial fall and presented symptoms of back pain three days later. She developed abrupt onset of lower limb weakness during her stay in the emergency department (ED). X-ray and computed tomography (CT) imaging of the spine did not show any obvious abnormality whereas, Magnetic resonance imaging (MRI) imaging revealed hyper-intense lesions in the thoracic spinal segment which led to the diagnosis of TSEH. Our case highlights the importance of the atypical and varied nature of presentation and the choice of investigation which would help in the early diagnosis of this entity.
Journal of Emergency Practice and Trauma
Kerman University of Medical Sciences
2383-4544
4
v.
2
no.
2018
89
91
http://www.jept.ir/article_62691_d33d9c3cba13e1c93d0148ff698b2127.pdf
dx.doi.org/10.15171/jept.2018.02