Acta medica Iranica
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Acta medica Iranica · Jan 2014
Randomized Controlled TrialVertical infraclavicular block with local anesthetic injections at different currents.
Injecting local anesthetic at the seeking current would be appealing. It would save time and avoid potentially dangerous manipulations of the needle. This study aimed to test the hypotheses that in vertical infraclavicular block, injecting local anesthetic at a seeking current of 0.8 mA would produce the same quality of block as injecting at ≤0.5mA. ⋯ We had patients in both groups who developed complete anesthesia of the hand within 25 minutes. We conclude that the injection at 0.8 mA would result in a similar quality of block to one injected at ≤0.5 mA. The difference between two groups was not statistically significant.
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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.