2024-03-29T04:54:30+03:30 http://journal.gums.ac.ir/browse.php?mag_id=55&slc_lang=fa&sid=1
55-912 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Road Traffic Accidents, Life-threatening Phenomenon in Guilan Province: An Epidemiologic Study F Mohtasham amiri SH Yousefzadeh-Chabok Z Haghdoust Haghdoostzahra@yahoo.com H Hemmati Abstract Introduction: Road traffic accidents (RTAs) are one of the most eminent causes of mortality and health challenges but neglected worldwide so that WHO has considered it as the main subject of more research and studies. Objective: Epidemiologic study of road traffic accidents as a life-threatening phenomenon in guilan province. Materials and Methods: This is a cross-sectional study conducted on 2,315 records of dead individuals due to RTAs since 2009 to 2011 in guilan. data obtained from the iranian forensic medicine organization, provincial transportation and terminals department of guilan, management and Planning organization of guilan including demographic characteristics, accident type, place and time were recorded in a checklist. Data were analyzed using SPSS and descriptive statistics. Results: Out of 2,315 dead, 1,892 were men (81.7%) and 699 (30.2%) in age range of 21-40 years old. Most of them were driver (43.6%) and most leading-to-death accidents were 2-vehicle collisions (53.2%). Most frequent and simultaneous lesion sites were head and face, chest and abdomen, hand and arm and leg trauma (31.8%). Head injury was reported as the mortality cause in most individuals. 1087 (47%) died on site before reaching hospital. June to July were the months with highest accidents and the number of dead individuals in suburban roads (67%) was more than that in other places. Conclusion: The results of this study suggest that road accidents are an important health and social problem in Guilan province. Enough information at local and national level is necessary as an important recourse to plan for the safety of roads, preventive measures and decision-making. Accidents- Traffic Craniocerebral Trauma Guilan Mortality 2015 1 01 1 8 http://journal.gums.ac.ir/article-1-912-en.pdf
55-913 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Epidemiology of Trauma in Children Admitted to Poursina Teaching Hospital P Asadi K Asadi S Rimaz V Monsef-Kasmaie B Zohrevandi Z Mohtasham-Amiri mohtasham@gums.ac.ir Abstract Introduction: Pediatric trauma is considered as a growing public health issue in the world. Trauma is the most common cause of mortality in children and puts a heavy burden on society. Objective: This study aimed to investigate the epidemiology of trauma in children admitted to Poursina Teaching Hospital. Materials and Methods: This descriptive cross-sectional study was conducted on children under 15 years of age admitted to Poursina Hospital in 2011. Sampling was performed using census method on hospital records. Information on demographic characteristics, type of trauma, season of trauma occurrence, length of hospital stay, trauma location, anatomic trauma site, and death due to trauma were collected and analyzed using SPSS (Version 18). To analyze the relationship between mortality and other variables, Chi-square and T-test were used. P<0.05 was considered as significance level. Results: Out of 641 traumatic children enrolled in study, 62.1% were male and 37.9% female. Their mean age was 6.62 ± 4.16 years. Most common locations of trauma occurrence included house (49.6%), followed by urban roads (32.9%). Most common mechanisms of trauma involved falling (40.4%) and accidents (35.1%). The most common anatomic sites of trauma were head (71.2%), followed by organs (15.5%). Most frequent seasons for people to refer were summer (36%) and spring (31%). A statistically significant difference was observed between treatment outcome (death or survival) and age category (P=0.04). The case with 5 deaths was the one with highest mortality on urban and suburban roads Conclusion: Given that most injuries occurred in heads and necks of children, using protective equipment such as child seat for infants and safety belt for adults in the car or using appropriate helmet while riding a motorcycle should be mandated in popular culture. Child Epidemiology Mortality Wounds and Injuvies 2015 1 01 9 15 http://journal.gums.ac.ir/article-1-913-en.pdf
55-914 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Epidemiological Survey of Industrial Hand Trauma in the Guilan Province AR Mirbolook k Asadi SH Yousefzadeh Chabok Sh A Karimi info@gtrc.ir M Soleimanha MS Mousavi S Saghary Abstract Introduction: Hand movements in humans plays a major role in the life of a professional career .Hand injuries are the most common job-related injuries. Understanding the epidemiology of occupational trauma can lead to the prevention and reduction of industrial injuries, according to local conditions. Objective: Epidemiology of trauma industry in Gilan Materials and Methods: This study is a descriptive- cross sectional one performed in 2011 on all patients brought to the Poursina hospital emergency ward with job-related injuries. For all of the patients, questionnaire was completed (valid and reliable) by interns. In the second step, an accurate diagnosis of lesions was performed by orthopedic and emergency medicine specialists. Results: Totally, 200 patients with occupational hand injuries were enrolled in the study. Highest rate of occupational accidents were resulting from agricultural, with 48 cases (24%) and the lowest with 12 cases (6%) working in the mine. Workers’ knowledge about the tools of industrial, was mostly average or low. According to the questionnaire, 117 patients (58,5%) were using the safety devices and 83 patients (41,5%) were not. Fingers with 64.9% of the total injuries (142 cases) was the most affected site. A significant correlation was observed between experience and the use of safety devices(P= 0.0001). Also, the experience was correlated with reduced amputation rate (P=0.007). Conclusion: Given the incidence of industrial injuries resulting from agricultural activities in the province, training for the more mechanized farming in compliance with safety requirements and providing immediate supportive treatment for the respective patients seem essential. Hand Injuries Safety Wounds and Injuries 2015 1 01 16 23 http://journal.gums.ac.ir/article-1-914-en.pdf
55-915 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Evaluation of Burnout Among Nurses Working in a First Level Trauma Center A Davoudi-Kiakalayeh F Farahbod M Goudarzvand Chegini S Rimaz L Kouchakinejad-Eramsadati info@gtrc.ir M Akbari Abstract Introduction: Burnout can affect the quality of personal, family and professional life of people and is considered as a serious problem. Different working wards is one of the effective factors of burnout in nurses. Objective: To investigate burnout among nurses working in different wards of a first level trauma center. Materials and Methods: This is a cross-sectional study in 2012. The sample size included 214 nurses working in different wards of the first level Poursina Hospital in Rasht city. Two questionnaires of demographic information and Maslach were distributed among nurses which contain 3 dimensions of emotional exhaustion (9 items), depersonalization (5 items) and reduced personal accomplishment (8 items).All three dimensions were measured based on frequency and intensity. Data were analyzed using SPSS 18 and non-parametrical Kruskal–Walli test with significance level of P=0.05. Results: This is a cross-sectional study performed in 2012. The sample included 214 nurses working in different wards of the first level Poursina Hospital in Rasht city. Two questionnaires of demographic information and Maslach were distributed among nurses, consisting of 3 dimensions of emotional exhaustion (9 items), depersonalization (5 items) and reduced personal accomplishment (8 items). All three dimensions were measured based on frequency and intensity. Conclusion: This study showed that nurses have high burnout in reduced personal accomplishment, compared to other dimensions based on frequency and intensity, and managers can reduce burnout in nurses by effective interventions and promoting motivation Burnout-Professional Nursing Staff Hospital 2015 1 01 24 30 http://journal.gums.ac.ir/article-1-915-en.pdf
55-917 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Evaluation of Frequency of Cervical Spine Injuries in Patients with Blunt Trauma P Asadi K Asadi V Monsef-Kasmaei vmonsef@yahoo.com B Zohrevandi B E Kazemnejad-leili L Kouchakinejad Eramsadati K khayyami SH Majdi Abstract Introduction: Trauma is one of the most important causes of mortality and morbidity in first four decades of life. Damage to cervical vertebrae due to high rate of mortality and morbidity is of high importance. These injuries can cause many psycho-mental, social and financial problems for respective patients and their families. Objective: This study aimed at evaluating the spine vertebrae in traumatic patients. Materials and Methods: This cross-sectional study was conducted on records of patients with cervical trauma admitted to Emergency Ward of Poursina Hospital from October 2009 to September 2012. The diagnostic criteria included cervical spine fracture, radiography and CT scan approved by a specialist in emergency medicine. Demographic data, site of injury, mechanism of injury, and fracture type according to the file contents were extracted. The data were analyzed by statistical software SPSS 16. Results: After a review on 6235 patients with cervical spine trauma, 374 cases with blunt cervical spine trauma complaint were enrolled in the study. 83.7% were men (Mean age= 39.64 ± 17.46 years). The most involved age was 30-59 years. Most causes of injuries were vehicle accidents (69%) and fallings (14.2%). Most fractures of cervical spine were in vertebrae C6 (19.1%) and the highest rate of cervical dislocation belonged to C6-C7 (22.9%). In 16% of the cases, incomplete spinal cord injury and in 7.8% of cases complete spinal cord injury had occurred. In 56.7% of cases, accompanying lesions were seen, most of which included extremity injuries (61.3%), followed by head trauma with reduced GCS (21.7%). A significant relationship was observed between gender and cause of injury (P<0.0001), vertebral fractures (P=0.002), presence of accompanying lesions (P=0.003), and types of accompanying lesions (P=0.009). There was a significant association between age and cause of injury (P<0.0001). Conclusion: Given that most of vertebral spinal injuries occurred in men and involved young group (20-39), and most mechanisms of injury belonged to car accidents, more care and attention can help prevent these injuries to a great extent Neck Injuries Spinal Injuries 2015 1 01 31 36 http://journal.gums.ac.ir/article-1-917-en.pdf
55-918 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 In-Hospital Airway Management of Trauma Patients Before Transfer to Reference Trauma Center: A Prospective Study S Rimaz S Emir Alavi A Sedighinejad A_sedighinejad@yahoo.com M Mohseni Abstract Introduction: Definitive airway control by endotracheal intubation (ETI) is standard of care in pre-hospital airway management and inadequate airway management is a major contributor to pre-hospital and in-hospital morbidity and mortality. Objective: The purpose of this study was to evaluate the success rate of airway management interventions in the multiple trauma patients, befor inter hospital transfer. Materials and Methods: In a descriptive, cross sectional study, conducted over six months, we evaluated airway interventions (Endotracheal Intubation) and cervical spine immobilization performed by emergency physician providers in multiple trauma and isolated severe traumatic brain injury patients who were transferred to Poursina trauma hospital. Results: we analyzed 163 consecutive trauma patients transferred after early care in level lll&lV trauma centers to Poursina trauma hospital. Mean age in years was 37.81.Sex distribution (male to female) was 141:22. The average study GCS score for trauma patients undergoing emergency tracheal intubation was 6/06±2/27 however, the GCS score varied across its spectrum. Airway was not secure in 41/8% of the cases, while more than 42/6% of the patients did not have their cervical spine immobilization. Conclusions: A.T.L.S(Advanced Trauma Life Support) emphasizes the ABCs mnemonic, early and adequate airway management and ventilation are lifesaving interventions and major contributors to reduce morbidity and mortality in trauma patients. Results of this study suggest that those emergency clinicians whose duties include in-hospital airway management should regularly attend courses on airway management Airway Management Intubation- Intracheal Multiple Trauma 2015 1 01 37 43 http://journal.gums.ac.ir/article-1-918-en.pdf
55-919 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Evaluation of Correlation Between Optic Nerve Sheath Diameter and Intracranial Pressure in Patients with Head Trauma A Dehnadi Moghadam A Alizadeh SH Yousefzadeh Chabok B Naderi-Nabi H Hemmati info@gtrc.ir AR Kord SM Pourabbas Abstract Introduction: Today, trauma is one of the major causes of mortality and the most common cause of death in first three decades of life. Head trauma is the most common one among all types of trauma. One of the non-invasive methods that meets monitoring of intracranial pressure is measurement of the optic nerve sheath diameter (ONSD) by ultrasonography device. Objectives: The aim of this study is evaluation of the correlation between intracranial pressure and optic nerve sheet diameter by ultrasonography. Materials and Methods: In this analytic cross-sectional study, 29 adult patients with traumatic brain injury (TBI) of both sexes with GCS≤8 were evaluated. In first 48 hours of brain injury, ICP was measured by both methods of gold standard and noninvasive method of determining ONSD using ultrasonography device with a linear probe of 6.5 - 7.5 MHz by an experienced person. Then, the results of two methods were compared using the Pearson correlation test. Results: A positive strong relationship was observed between ICP (R=0.77, p<0.000.( A statistical significant difference was seen between ICP means in first and second days and ONSD. ROC curve was indicative of the ability of ONSD in diagnosis of high ICP (above 15mmHg) and cut-off point for ONSD was 7.25 mm (100% sensitivity, 95% specificity). Conclusion: This study revealed that evaluating ONSD by ultrasonography can be a good indicator of increased ICP in patients with severe traumatic brain injury. Craniocerebral Trauma Intracranial Pressure Optic Nerve Sheath Diameter 2015 1 01 44 49 http://journal.gums.ac.ir/article-1-919-en.pdf
55-920 2024-03-29 10.1002
Journal of Guilan University of Medical Sciences JGUMS 2383-4307 2423-4818 10.32598 2015 23 92 Quality Survey of Pre-hospital Emergency Services in Guilan Province E Kazamneghad M Pourshaikhian pourshaikhian_m@yahoo.com S Vatankhah Abstract Introduction: Pre-hospital emergency is a part of health systems and equipped ambulances is necessary to provide appropriate services in this sector. Despite the high prevalence of road traffic injuries in Iran and importance of the quality of intervention, few studies have been conducted in this field. This study aimed to compare the ambulances medical equipments of emergency ambulances in Guilan province with national standards. Objective: To assess the quality of pre-hospital emergency providing services in Guilan based on national standards. Materials and Methods: This study is a descriptive-analytical and functional study that was performed in Guilan in 2013. The samples consisted of 71 active ambulance of emergency medical services. Data collection tools included the standard medical examination card checklist of B type ambulances of Ministry of Health and Checklist of 4374 of rescue vehicles and equipment of the National Iranian Standard Organization. The checklists have been completed by observation of the medical equipment existing in all emergency medical services ambulances by researchers. Also, response time (for an emergency vehicle to arrive on scene) was recorded. Data were analyzed using descriptive and inferential statistics Results: Overall, average medical equipment, according to standards of health ministry and Iran’s Standard National organization, were 55 and 53%, respectively, indicating a significant difference with standards (p<0.05). Also, the average equipment rates according to the two standards were as follows: equipment of respiration/ventilation, 94.6 and 93.7%, injection/drugs: 74.2 and 59.4%, equipment of treatment-critical management 31 and 30%, respectively, showing a significant difference with Iran’s defined standards in all cases (p<0.05). Also, response time in cities and roads was in compliance with standard of Ministry of health Conclusion: Since the deficiency of medical equipment of ambulances will reduce the efficiency of emergency medical services, it seems that more effective measures should be taken to meet the established national standards. Delivery of Health care Emergencies Health service 2015 1 01 50 58 http://journal.gums.ac.ir/article-1-920-en.pdf