Acta medica Iranica
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Hoffa fracture is a rare injury consisting of unicondylar tangential posterior fracture of the distal femur and only very few cases have been reported in the literature. These fractures are due to high energy trauma and conservative treatment generally yields poor results, but rigid internal fixation allows early functional rehabilitation and decreases the incidence of complications. The purpose of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment. ⋯ Complications were stiffness and pain in one patient, collateral laxity in one patient and progression of arthritis in one patient. The results were excellent in 90.90% and good in 9.09% patients. Finally, we conclude that the early anatomical reduction and rigid fixation with screws provide best results and minimal complications.
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Acta medica Iranica · Jan 2014
Evaluation of emergency medicine residents competencies in electrocardiogram interpretation.
An electrocardiogram (ECG) leads physicians to diagnose many potentially life-threatening cardiac, metabolic, electrolyte, and toxicological conditions. This study was designed to evaluate the competency of emergency medicine residents (EMRs) in comparison with cardiologists in the interpretation of ECG when an interpretation checklist is used. This clinical trial was done in the emergency wards of the first grand general hospital of Iran. ⋯ In second-year EMRs, both ECG interpretation and ECG diagnosis scores improved significantly (P<0.05 and P<0.01, respectively). In third year EMRs, ECG interpretation was not improved but ECG diagnosis based on two methods improved significantly (P<0.05). The significant increase in accuracy of ECG interpretation and final diagnosis can be attributed to the utilization of a checklist by EMRs especially in the first year and second residents.
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Acta medica Iranica · Jan 2014
Investigating the effect of clinical governess approach on patients' length of stay in emergency department: an action research study.
Over the past decade, clinical governance approach with aims to improve the quality of health services has been proposed in Iran. Considering the obvious problems especially patients' length of stay (LOS) in the emergency departments (EDs); the present study has been carried out with the purpose of Investigating the effect of clinical governess approach on patients' LOS in the one of the largest medical centers in the country. After the problem was specified by the 17 interviews with employees and managers of the ED; the emergency clinical governance committee was formed by two academic researchers and seven ED staff (key participants) that had the most involvement with the subject of study. ⋯ Make regular patients visits by medical groups especially orthopedists and neurologists; Decision making about patients situation by emergency physicians and transferring patients to the relevant units by bed managers; Refusing to admit elective patients during overcrowding times; to regulate the list of patients requiring ICU by anesthesiologists. Prolonged LOS can be due to various causes and a team approach, which is one of the requirements of clinical governance approach, is needed to manage it. The results showed that the multidisciplinary team could make positive changes and reduce LOS in emergency setting.