Emergency medicine
Marziye Hadian; Alireza Jabbari; Hojjat Sheikhbardsiri
Articles in Press, Accepted Manuscript, Available Online from 20 December 2021
Abstract
Objective: In order to heal burn wounds, many researches have been done, including the use of biological scaffolds due to their ability to achieve the desired properties. Owing to the appropriate biological properties of chitosan such as biocompatibility and antimicrobial properties as well as the promotion ...
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Objective: In order to heal burn wounds, many researches have been done, including the use of biological scaffolds due to their ability to achieve the desired properties. Owing to the appropriate biological properties of chitosan such as biocompatibility and antimicrobial properties as well as the promotion of wound healing in biomedical applications, we aimed to perform a systematic review to investigate the effect of this technology on the treatment of burn hazards victims.Methods: The present research was conducted in 2020 as a systematic review of studies related to the effect of chitosan on burns. In this study, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Critical Appraisal Skills Programme (CASP) guidelines were used to assess the articles. The key words “Chitosan,” “Chitin,” “victim,” “Injury,” “Burn,” “Heal,” “wound” “treat,” “hazard,” and “care” were used in combination with the Boolean operators OR and AND. The ISI web of science, PubMed, Scopus, Science Direct, Ovid, Pro Quest, Wiley and Google Scholar were searched.Results: Recently, chitosan and its derivatives have been proposed as suitable candidates for scaffolding and can be used as temporary scaffolds to modify and stimulate the growth of new tissues. Studies to demonstrate the use of chitosan in the treatment of burns have been limited to research on animal models and have been superior to conventional therapies in terms of time, pain, and efficacy.Conclusion: The effect of chitosan on burns has been positive in animal models and has accelerated wound healing. Since the main ingredient of chit powder is chitosan and due to the limited studies done on humans, it cannot be said with certainty that the use of chitosan and its derivatives to treat burns is better than other ways to treat burns.
Disaster
Simin Salehinejad; Nazanin Jannati; Roghayeh Ershad Sarabi; Kambiz Bahaadinbeigy
Volume 7, Issue 1 , January 2021, , Pages 56-62
Abstract
Objective: Both natural and man-made disasters need near-term and long-term interventions to reduce morbidity and mortality among the affected population. Recently, telemedicine has been effectively used in both man-made and natural disasters and showed its effectiveness in eliminating the adverse consequences ...
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Objective: Both natural and man-made disasters need near-term and long-term interventions to reduce morbidity and mortality among the affected population. Recently, telemedicine has been effectively used in both man-made and natural disasters and showed its effectiveness in eliminating the adverse consequences of disasters. Therefore, the purpose of this study was to identify the application of telehealth in different phases of disaster. Methods: We systematically searched all English papers regarding the use of telemedicine in different phases of disaster indexed in PubMed, Embase, and Web of Science databases until June 2020. A data collection form was designed to extract the required data such as types of systems, telecommunication technologies, and phases of disaster. Results: In this study, 16 out of 4490 retrieved articles were selected as relevant and reviewed by the authors. Findings indicated that the majority of studies highlighted the use of telemedicine in natural disasters (n=12), and only four discussed it in a man-made disaster like war and terrorist attacks. In 6 studies out of 16, telemedicine was used to treat and assess mental disorders among the affected population. And the internet was the most common technology for telemedicine development. Conclusion: Providing health care during a disaster is necessary, and telemedicine is important for such care. This systematic review helps define the components and application of telemedicine in disaster as a new technology in recent days, but we need to consider it and develop this technology in all phases of disaster management, especially during the response phase.
Emergency medicine
Mohit Kumar Arora; Ela Madaan; Sandeep Kumar
Volume 5, Issue 2 , July 2019, , Pages 78-80
Abstract
Simultaneous fracture of lateral condyle and medial epicondyle of humerus along with elbow dislocation is very rare injury in adults. Only a few cases have been reported in literature in pediatric age groups. The authors describe a case report of fracture of lateral condyle and medial epicondyle of humerus ...
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Simultaneous fracture of lateral condyle and medial epicondyle of humerus along with elbow dislocation is very rare injury in adults. Only a few cases have been reported in literature in pediatric age groups. The authors describe a case report of fracture of lateral condyle and medial epicondyle of humerus along with elbow dislocation in a young adult. The patient sustained injury in the form of fall from bike. Clinically the patient had swelling and deformity of the elbow joint. There were contusions present in the skin around the elbow joint. There was no distal neuro-vascular deficit. Appropriate radiological investigations were done. The elbow joint was then reduced and found to be unstable. Hence, patient was taken up for surgery in the form of open reduction and internal fixation. The functional outcome of the surgery is presented in the case report. Open reduction and internal fixation are the treatment of choices in these types of cases.
Infectious disease
Sohil Pothiawala
Volume 6, Issue 2 , July 2020, , Pages 102-108
Abstract
Introduction: Emerging viral diseases (EVDs) pose a significant threat to public health. There have been a few viral epidemics in the last two decades. Coronavirus disease 2019 (COVID-19) is now a global pandemic.Objective: To provide emergency physicians an update on severe acute respiratory syndrome ...
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Introduction: Emerging viral diseases (EVDs) pose a significant threat to public health. There have been a few viral epidemics in the last two decades. Coronavirus disease 2019 (COVID-19) is now a global pandemic.Objective: To provide emergency physicians an update on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its dynamic impact on the emergency department (ED) in terms of preparedness and management of patients presenting to ED with suspected COVID-19 disease.Discussion: COVID-19 has a human-to-human transmission through close contact and even from asymptomatic carriers. Symptoms are similar to a viral respiratory illness. The disease is mild and self-limiting in most patients, but some develop severe illness like pneumonia, acute respiratory distress syndrome (ARDS) and multiorgan failure. Emergency physicians should prioritize early identification of these patients at risk, isolate them and after collaborating with relevant hospital and national authorities, develop clinical pathways to safely evaluate, manage and dispose patients with COVID-19. Various strategies for managing these patients in the ED are discussed. Disposition of these patients depends on symptoms and hemodynamic status and potential to self quarantine versus admission to an isolation facility.Conclusion: This review provides an overview of patients presenting to the ED with suspected COVID-19 and its impact on the ED. It reiterates the fact that emergency physicians, in close collaboration with relevant hospital authorities, play a pivotal role during EVDs. It emphasizes the need for pandemic preparedness, enabling us to better manage such events in the future.
Emergency medicine
Shaghayegh Rahmani; Kosar Deldar; Sara Hemati Ali
Volume 7, Issue 2 , July 2021, , Pages 133-134
Abstract
Objective: Nowadays, many countries all over the world are involved with COVID-19 and the number of new cases and deaths are on a rise. The role of emergency medicine and physician-led triage is important in this period. We report some near missed cases in our academic center related to this pandemic.Case ...
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Objective: Nowadays, many countries all over the world are involved with COVID-19 and the number of new cases and deaths are on a rise. The role of emergency medicine and physician-led triage is important in this period. We report some near missed cases in our academic center related to this pandemic.Case Presentation: We report 5 cases that missed triage or received delayed diagnosis because of COVID-19 suspicion. Some cases are life threatening.Conclusion: Although COVID-19 is the main health concern these days, other critical conditions should be considered. Stabilizing patients before transferring them between hospitals should be the essential goal of emergency department whether the patient is Corona virus infected or not. And before any intervention, the safety of healthcare workers must be ensured.
Infectious disease
Mohsen Eshraghi; Enayatollah Noori; Ahmad Kachoie; Moien Zolmafakher
Articles in Press, Corrected Proof, Available Online from 23 April 2021
Abstract
Objective: Bronchopleural fistula (BPF) is a pathological communication between thebronchial tree and pleural space. BPFs are commonly seen after lung surgery, and are lesscommon in trauma, lung abscess, and radiation therapy. In this study, we describe theclinical course and surgery of a case of pulmonary ...
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Objective: Bronchopleural fistula (BPF) is a pathological communication between thebronchial tree and pleural space. BPFs are commonly seen after lung surgery, and are lesscommon in trauma, lung abscess, and radiation therapy. In this study, we describe theclinical course and surgery of a case of pulmonary necrosis and BPF in a patient infectedwith coronavirus disease 2019 (COVID-19).Case Presentation: The patient was a 54-year-old man with multiple myeloma and endstagerenal disease from the last 8 years. He had a history of coronary artery bypass graftingfrom the last 3 years. He also suffered from progressive shortness of breath and dry coughsince March 2019.Conclusion: The results of this study showed that BPF is one of the most severecomplications after thorax surgery, and there is no effective prevention methodparticularly in this patient who had COVID-19 pneumonia. Therefore, early intervention,especially when diagnosed at an early stage, by strengthening the stump inside the thoraxor thoracotomy in the open window may eventually accelerate the closure of the BPF andimprove the survival.
Trauma
Mohit Kumar Arora; Ela Madaan
Volume 4, Issue 1 , January 2018, , Pages 48-50
Abstract
Patellar fracture is a relatively uncommon fracture especially the vertical sagittal type. In cases of high energy trauma injury, it is usually associated with fracture of ipsilateral distal femur or proximal tibia. However, the combination of vertical sagittal fracture patella and ipsilateral fracture ...
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Patellar fracture is a relatively uncommon fracture especially the vertical sagittal type. In cases of high energy trauma injury, it is usually associated with fracture of ipsilateral distal femur or proximal tibia. However, the combination of vertical sagittal fracture patella and ipsilateral fracture lateral condyle is very rare. This necessitates judicious diagnosis and appropriate management to ensure optimal functional outcome. Open reduction and internal fixation is the treatment of choice in managing these types of injuries. This should be followed by gradual mobilization of the affected knee joint. Weight bearing can be started once the fracture starts showing signs of union on X-rays. Literature search shows only one case report describing this pattern. The aim of this case report is to highlight the rarity of this injury, to understand the injury mechanism and surgical approach used for these injuries. The knowledge of this combination will help us manage these injuries so that good functional outcome is achieved
Emergency medicine
Shyam lal; Vinod Kumar Singh; Suhas Agarwal
Volume 8, Issue 1 , January 2022, , Pages 49-54
Abstract
Objective: Perforation peritonitis is a common surgical emergency which is treated bysurgery and antibiotics. Candida isolation in peritoneal fluid and antifungal treatment isnot a norm. The aim of this study was to determine the incidence of Candida in peritonealfluid and its role in the outcome of ...
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Objective: Perforation peritonitis is a common surgical emergency which is treated bysurgery and antibiotics. Candida isolation in peritoneal fluid and antifungal treatment isnot a norm. The aim of this study was to determine the incidence of Candida in peritonealfluid and its role in the outcome of patients with perforation peritonitis.Methods: This prospective observational study was conducted on 70 patients withperforation peritonitis from October 2016 to February 2018. Intraoperatively, peritonealfluid was taken and sent for microbiological culture and sensitivity. Perforation wasmanaged according to the site of perforation and condition of bowel.Results: The mean age of the patients was 38.74 years with male predominance (58,82.85%). Forty-seven (67.14%) patients had positive peritoneal cultures. Escherichia coliwas the most common bacteria (n=29), while Candida was found to be the most commonfungi and was found in 18 patients. The incidence of Candida was higher in upper gastroduodenal perforation (30, 42.85%). Patients found positive for Candida had APACHE IIseverity score 10 or more which was higher than the rest of the patients. The mortality washigher in patients with positive peritoneal cultures (10/47) as compare to negative ones(2/23, P<0.001). The mortality in mixed bacterial and fungal-positive cultures (7/18) wasalso higher as compared to isolated bacterial culture (3/29, P <0.001). The overall mortalityrate was 17.14%.Conclusion: Patients with Candida positive peritoneal culture had a significant mortalityand morbidity as compared to Candida negative. Peritoneal fluid culture and sensitivity forbacterial and fungal were helpful in the early diagnosis and treatment
Trauma
Ganesh Singh Dharmshaktu
Volume 3, Issue 2 , July 2017, , Pages 64-65
Abstract
Simultaneous combination of fracture of the lateral condyle and postero-medial elbow dislocation is a rare event and limited to few reports or case series in the literature. Rarity of the injury also necessitates judicious diagnosis and appropriate management to ensure optimal functional outcome. Various ...
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Simultaneous combination of fracture of the lateral condyle and postero-medial elbow dislocation is a rare event and limited to few reports or case series in the literature. Rarity of the injury also necessitates judicious diagnosis and appropriate management to ensure optimal functional outcome. Various authors have reported about the condition including the management which mostly includes surgical intervention. A report of one such injury pattern in an 8 years old male child with operative management and satisfactory outcome is presented to highlight the presence of this rare combination and adherence to standard treatment protocols to address them. The report is an addition to the limited resources available on similar fractures and highlights the importance of ruling out possible associated injuries in cases of elbow dislocations. A good fixation of lateral condyle fracture is instrumental to avoid late complications leading to poor functional outcome. The early and supervised rehabilitation also plays a role in ensuring successful return to activities of daily living.
Emergency medicine
Seyed Reza Habibzadeh; Ehsan Bolvardi; Esmail Rayat Dost; Mahdi Foroughian
Volume 6, Issue 2 , July 2020, , Pages 109-111
Abstract
Introduction: Child abuse has been defined as allowing others to cause physical, emotional, and sexual harm, and also physical and emotional pain to a child. The present study was a report on a case of physical and sexual child abuse accompanied by traumatic brain injury (TBI) referred to an emergency ...
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Introduction: Child abuse has been defined as allowing others to cause physical, emotional, and sexual harm, and also physical and emotional pain to a child. The present study was a report on a case of physical and sexual child abuse accompanied by traumatic brain injury (TBI) referred to an emergency department.Case Presentation: A 4-year-old child was rushed into an emergency department by her mother. At the time of hospital admission, the child was feeling confused and drowsy and had symptoms of hemorrhage in the right preperitoneal space as well as bleeding from the mouth. According to the pattern of the child’s admission to the emergency department, contradictory descriptions by parents, clinical examinations, and TBI pattern; the probability of a case of child abuse was raised. Thus; neurosurgery, legal medicine, gynecology, and surgery consultations were requested. With regard to the brain injury and epidural hematoma, immediate measures (i.e. head lifting, taking Dilantin, blood glucose control, blood pressure control, and maintaining adequate oxygen saturation in the arterial blood) were taken to put a stop to secondary brain injury, and the patient was then transferred to the intensive care unit (ICU) for further treatments.Conclusion: In the present case study, the child was seriously examined and followed up. In conclusion; 20 days later, the case was discharged from the pediatric ward with good medical conditions, and received counseling and psychiatric services for one year.
Emergency medicine
Maryam Adimolmasali; Ali Teimouri; Hamid Reza Mokhtar; Mahdi Foroughian; Parvin Zohoorian Sadr; Mohammad Hossien Kamaloddini
Volume 7, Issue 2 , July 2021, , Pages 135-136
Abstract
Systemic toxemia with topical anesthetics could be fatal due to the use of anesthetics in various ways (oral, intravenous, intramuscular, or subcutaneous). Nowadays, topical anesthetics are used in inpatient and outpatient treatments. Despite its widespread usage, many physicians are not fully aware ...
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Systemic toxemia with topical anesthetics could be fatal due to the use of anesthetics in various ways (oral, intravenous, intramuscular, or subcutaneous). Nowadays, topical anesthetics are used in inpatient and outpatient treatments. Despite its widespread usage, many physicians are not fully aware of the deadly side effects of lidocaine poisoning and its treatment. The objective of this case report is to highlight the diagnosis and treatment of lidocaine toxicity. A 21-year-old woman with a history of multiple suicide attempts ingested approximately three 10% w/w lidocaine sprays. The patient was brought to the emergency department of Imam Reza hospital of Mashhad University of Medical Science with cardiac arrest and respiratory failure. After successful cardiopulmonary resuscitation (CPR), she was admitted to the intensive care unit (ICU). She stayed in ICU for 2 days and we administered dobutamine drip and intravenous lipid emulsion for her then she was transferred to the general ward. We discharged her after 8 days.
Khosro Ayazi; Parham Nikraftar; Hamidreza Hatamabadi; Fatemeh Shojaeian; Shervan Family
Articles in Press, Corrected Proof, Available Online from 03 December 2021
Abstract
Objective: One of the most prevalent surgical emergencies is appendicitis, caused by different factors. However, its relation to trauma has not been well-known yet. Here we have described three cases with blunt abdominal trauma and a secondary diagnosis of appendicitis that were transferred to the operation ...
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Objective: One of the most prevalent surgical emergencies is appendicitis, caused by different factors. However, its relation to trauma has not been well-known yet. Here we have described three cases with blunt abdominal trauma and a secondary diagnosis of appendicitis that were transferred to the operation room.Case Presentation: Three patients suffering from blunt trauma and abdominal pain were referred to the emergency department (ED). Of these patients, one of them was transferred to the operation room (OR) with a peritonitis diagnosis and the other two patients had appendicitis signs and symptoms. The abdominal pain and related signs and symptoms of these three patients were due to appendicitis. All three patients were discharged from the hospital with normal vital signs.Conclusion: Traumatic appendicitis might be regarded as one of the differential diagnoses of the patients referred to the ED with blunt abdominal trauma and abdominal pain; hence, appendicitis and blunt abdominal trauma have some unknown relations.
Emergency medicine
Rosanna Varutti; Alessandro Mosca; Nicola Latronico
Volume 6, Issue 1 , January 2020, , Pages 50-52
Abstract
Objective: One of the most frequent causes of death and acquired disability in the pediatric population is the Traumatic Brain Injury (TBI). TBI is secondary to falls, road traffic and vehicle collisions, child abuse and assaults. Penetrating brain injury is a severe form of traumatic brain injury. Blunt ...
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Objective: One of the most frequent causes of death and acquired disability in the pediatric population is the Traumatic Brain Injury (TBI). TBI is secondary to falls, road traffic and vehicle collisions, child abuse and assaults. Penetrating brain injury is a severe form of traumatic brain injury. Blunt head injury is more frequent than TBI in children, but the second one carries a poor prognosis and a worse outcomes.Case Presentation: We report a pediatric case of penetrating craniofacial trauma, caused by a pencil in to the eye, and the successful of multidisciplinary management.Conclusion: Traumatic head injuries in children are frequently seen in the emergency ward, but the penetrating head injuries are unusual in young children. This case shows the importance of the ‘first golden hour’ after head trauma. The collaboration between team members, added to a promptly and invasive strategy, allowed to reduce neurological sequelae.
Emergency medicine
Seyed Reza Habibzadeh; Hamid Zamani Moghadam; Neema John Mehramiz; Mahdi Foroughian
Volume 7, Issue 1 , January 2021, , Pages 63-65
Abstract
Objective: Anterior teeth are of utmost importance with regard to chewing, speaking, and beauty. Therefore, any traumatic dental injury has psychologically undesirable effects on children and their parents. The present study reported a case of a traumatic dental injury induced by falling ...
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Objective: Anterior teeth are of utmost importance with regard to chewing, speaking, and beauty. Therefore, any traumatic dental injury has psychologically undesirable effects on children and their parents. The present study reported a case of a traumatic dental injury induced by falling off a bike and referral to an emergency department as well as measures taken for dental reconstruction and patient’s improvement.Case Presentation: An 8-year-old child was taken to an emergency department due to falling off a bike following imbalance, while suffering from dental pain in his upper jaw due to dental subluxation. Afterwards, dental retaining paste along with a fixer wire was used to maintain the position of the teeth. The patient also received oral non-steroidal analgesia (acetaminophen) for proper control of the pain and was subsequently referred to a dentist to repair the teeth. The initial examinations revealed that the child was fully conscious. Considering the patient’s severe pain and intrusion of the superior left primary first tooth and the subluxation of the superior right primary first tooth. Local anesthesia was performed using 1% lidocaine in the location of the given teeth using infiltration technique. Then they were brought into an alignment by extracting the plunged tooth and the child was referred to a dentist for advanced dental trauma care.Conclusion: Dentists are not always present in hospital emergency departments; therefore, an emergency medicine specialist should be able to diagnose common traumatic dental injuries in order to manage them appropriately at the early stages, and if necessary, refer patients to dentists for further complementary treatments. This important fact will bedone after full examination and ruling out critical causes of trauma in the emergency department.
Critical Care
Haleh Mousavi; Samad Shams Vahdati; Roshan Fahimi
Volume 3, Issue 2 , July 2017, , Pages 66-67
Abstract
Invagination is a kind of intestine disease in children and it is occurred between 2 upto 14 years old. This is a report of 17 months infant with intussusception due to trauma. The patient had admitted to emergency department because of motor vehicle accident and because of abdominal pain, abdominal ...
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Invagination is a kind of intestine disease in children and it is occurred between 2 upto 14 years old. This is a report of 17 months infant with intussusception due to trauma. The patient had admitted to emergency department because of motor vehicle accident and because of abdominal pain, abdominal computed tomography (CT) scan was done.
Emergency medicine
Manoel Francisco de Campos Neto; Vidal Haddad Junior
Volume 5, Issue 2 , July 2019, , Pages 81-84
Abstract
This communication describes two attacks by domestic and wild carnivores in Caceres County, localized in the Pantanal area, an extensive flooded plain in Mato Grosso State, Midwest region of Brazil. The first attack took place in an urban area and was caused by a Rottweiler dog (Canis lupus familiaris) ...
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This communication describes two attacks by domestic and wild carnivores in Caceres County, localized in the Pantanal area, an extensive flooded plain in Mato Grosso State, Midwest region of Brazil. The first attack took place in an urban area and was caused by a Rottweiler dog (Canis lupus familiaris) created by the family of the victim. Another attack occurred in a rural area, caused by a jaguar (Panthera onca), which was disturbed while feeding, characterizing an unprovoked attack. Both the patients were wounded in the forearm, with different severity of the wounds. The lesions restricted to the forearm were the consequence of the victims using their arms as a shield, featuring the “defense” injuries, but the severity of the wounds were proportional to the strength of the attacking carnivore. Health staffs and emergency centers should be alert for soft tissue and bone injuries in the observed body regions after domestic and wild animal attacks.
Emergency medicine
Lalit Kumar Bansal; Raja Bhanukiran; Poras Chaudhary; Arun Kumar Gupta
Volume 7, Issue 2 , July 2021, , Pages 137-139
Abstract
Objective: objectives: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the developed world. Most of such kind of trans abdominal penetrating bamboo stick injury is associated with multiple solid and hollow viscus injuries. In developing countries like India, where nearly ...
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Objective: objectives: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the developed world. Most of such kind of trans abdominal penetrating bamboo stick injury is associated with multiple solid and hollow viscus injuries. In developing countries like India, where nearly 70% of the population reside in rural areas, it is not that uncommon. Aim of this report is to recognition of risk factors and explain optimum surgical management in trans-abdominal bamboo stick injury.Case Presentation: Here we describe a case of penetrating trans abdominal bamboo stick injury resulting due to fallover a branch of bamboo stick with multiorgan damage, which was successfully managedby early surgical exploration in our institute.Conclusion: There are many factorswhich can prognosticate the penetrating trauma cases. The most important factors includea long interval between injury and surgical exploration, presence or absence of shock, andother associated organ injuries at the time of admission. Early recognition of the severity ofinjury with surgical management is utmost necessary. These patients have high morbidityand mortality rates due to multiorgan damage and post-operative infection
Infectious disease
Ovais Nazir; Rana Pratap Singh; Amit Kumar
Articles in Press, Accepted Manuscript, Available Online from 28 May 2022
Abstract
Objective: Since April 2021, there has been significant increase in number of COVID-19 cases in India. As the caseload increased, so did the complications like pneumomediastinum (PM) and subcutaneous emphysema (SE).Case Presentation: We present clinical course of 4 patients as case series of COVID-19 ...
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Objective: Since April 2021, there has been significant increase in number of COVID-19 cases in India. As the caseload increased, so did the complications like pneumomediastinum (PM) and subcutaneous emphysema (SE).Case Presentation: We present clinical course of 4 patients as case series of COVID-19 pneumonia who developed PM and SE during their management. Two cases with the need of non-invasive ventilation (NIV) recovered and two cases that needed invasive mechanical ventilation (IMV) ultimately expired.Conclusion: This case series highlights the importance of positive pressure ventilation via NIV and IMV as a predisposing factor for PM and SE as well as the need of strict vigilance by clinicians managing COVID-19 patients in IMV.
Clinical Toxicology
Mustafa Bolatkale; Muhittin İşsever; Ulaş Karaoğlu; Ahmet Cagdas Acara; Mehtap Bulut
Volume 4, Issue 1 , January 2018, , Pages 51-52
Abstract
Statins are commonly used drugs in the treatment of hyperlipidemia (HL), despite some undesirable side effects. These range from mild symptoms such as myopathy, muscle weakness and myalgia to severe muscle weakness associated with chronic myopathy and acute renal failure (ARF) as a result of rhabdomyolysis. ...
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Statins are commonly used drugs in the treatment of hyperlipidemia (HL), despite some undesirable side effects. These range from mild symptoms such as myopathy, muscle weakness and myalgia to severe muscle weakness associated with chronic myopathy and acute renal failure (ARF) as a result of rhabdomyolysis. The most serious and deadly side effect of statins is rhabdomyolysis. The case presented here is of a patient with rhabdomyolysis due to treatment with the antihyperlipidemic drug, atorvastatin.
Infectious disease
Manas Sharma; Rajendra B Nerli; Shridhar C Ghagane
Volume 8, Issue 1 , January 2022, , Pages 55-59
Abstract
The COVID-19 pandemic will have numerous consequences in the management of patientswith genitourinary cancers. As we are struggling to best exploit our limited health-careresources in managing COVID-19 infected patients, we need to rethink our approach toprovide the best medical care for cancer patients ...
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The COVID-19 pandemic will have numerous consequences in the management of patientswith genitourinary cancers. As we are struggling to best exploit our limited health-careresources in managing COVID-19 infected patients, we need to rethink our approach toprovide the best medical care for cancer patients in the time of this global crisis. Thereis a need for a decision-making algorithm which takes into account the age, presentingsymptoms, comorbid illnesses, access to health-care services, and availability of qualifiedhealth-care personnel. We must provide support, a clear and comprehensible informationalong with essential care to the patients seeking medical opinion during a time of thisunforeseen global health crisis. In this mini review we have made an attempt to prioritizethe necessity of intervention in urological oncology patients as per various national andinternational guidelines. This approach should be tailored as per locally available healthcare resources and the burden of COVID-19 infected cases in that region.
Clinical Toxicology
Mohammad Hossein Kamaloddini; Hamid Reza Kheradmand
Volume 7, Issue 1 , January 2021, , Pages 66-68
Abstract
Objective: Clostridium botulinum is one of the most common life-threatening agents all around the world which produces botulinum neurotoxin (BoNT). It may lead to morbidities such as paralysis and mortality after consuming canned tuna fish, local dairy products and home-preserved or commercial food. ...
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Objective: Clostridium botulinum is one of the most common life-threatening agents all around the world which produces botulinum neurotoxin (BoNT). It may lead to morbidities such as paralysis and mortality after consuming canned tuna fish, local dairy products and home-preserved or commercial food. People use a good deal of local dairy products such as cheese and it exposes a variety of population to botulinum intoxication.Case Presentation: A 48-year-old woman referred to the ED complaining about acute dysphonia accompanied with symmetric hypotonia and bilateral ptosis. She had a history of consuming local dairy cheese.Conclusion: It is indispensable for the physician to identify major features of foodborne botulism in order to differentiate it from other illnesses and early initiation of intensive care for intoxicated patients. To prevent the incidence of dairy product derived botulinum, it is firmly suggested to have quality control on local dairy products
Trauma
Gholamreza Faridaalaee; Bahman Naghipour; Sajjad Ahmadi; Seyed Hesam Rahmani
Volume 3, Issue 2 , July 2017, , Pages 68-70
Abstract
Carotid artery thrombosis and concomitant brain infarction after blunt trauma are rare conditions. We report a 34-year-old woman with multiple traumas due to pedestrian car accident. At the time of initial visiting, she was somnolent and her Glasgow coma scale (GCS) score was 14. Initial vital signs ...
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Carotid artery thrombosis and concomitant brain infarction after blunt trauma are rare conditions. We report a 34-year-old woman with multiple traumas due to pedestrian car accident. At the time of initial visiting, she was somnolent and her Glasgow coma scale (GCS) score was 14. Initial vital signs (V/S) and brain computed tomography (CT) scan were normal. One day after admission to the emergency observation unit, GCS improved to 15 but right-sided hemiparesis occurred. Magnetic resonance imaging (MRI) showed brain infarction and Doppler sonography indicated internal carotid artery thrombosis. She was admitted in the Neurosurgery ward and underwent anticoagulant therapy. With appropriate treatment, the patient’s condition improved after 5 days of admission and she was discharged on oral warfarin treatment and close follow up. Although there is no ideal treatment for traumatic internal carotid artery thrombosis, it seems that in most cases anticoagulation therapy is the preferred method of treatment but in some patients surgical or endovascular revascularization is indicated.
Clinical Toxicology
Zahra Ataee; Bita Dadpour
Volume 6, Issue 2 , July 2020, , Pages 112-114
Abstract
Objective: Tramadol is a synthetic analgesic with two mechanisms. The opioid and non-opioid mechanisms are responsible for tramadol side effects. Non-opioid side effects of tramadol are due to the reuptake inhibitions of serotonin and norepinephrine. Some of the side effects include anaphylactoid reactions, ...
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Objective: Tramadol is a synthetic analgesic with two mechanisms. The opioid and non-opioid mechanisms are responsible for tramadol side effects. Non-opioid side effects of tramadol are due to the reuptake inhibitions of serotonin and norepinephrine. Some of the side effects include anaphylactoid reactions, CNS depression, hypoglycemia, hypotension, respiratory depression, seizures, and serotonin syndrome. Seizure may happen in therapeutic doses. If the frequency of tramadol seizures increases, ischemic brain injury and hypoxic-ischemic encephalopathy can be induced.Case Report: We report a young man with a history of tramadol abuse that was admitted with status epilepticus in Imam Reza hospital in Mashhad, Iran. Due to his altered mental status, he was intubated and antiepileptic agents were prescribed. He was transferred to ICU. After regaining consciousness, he was extubated and with the prescription of rehabilitation support he was discharged.Conclusion: Tramadol is a synthetic analgesic agent with less potential for dependence. It is important to mention that the overdose of this drug is common. This drug has two mechanisms. This paper reports a case that developed generalized tonic clonic seizures due to tramadol and hypoxic ischemic encephalopathy. With adequate treatment and supportive care, patient’s mental status improves and he/she can be discharged.
Emergency medicine
Mustafa Mahmood Eid
Volume 7, Issue 2 , July 2021, , Pages 140-142
Abstract
Objective: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient ...
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Objective: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient with a history of seizures was provoked by smoking midwakh, despite having no previous disease history. Conclusion: Although the patient had a negative workup for epilepsy, midwakh should be classified as an epileptogenic drug. More studies need to be conducted on the effects of midwakh on the neurological system
Emergency medicine
Abdolghader Pakniyat
Articles in Press, Corrected Proof, Available Online from 29 May 2022