Acta medica Iranica
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Acta medica Iranica · Aug 2016
Effect of Air Pollution in Frequency of Hospitalizations in Asthmatic Children.
Asthma is one of the most common diseases in childhood, which has been increased during last decade because of epidemiological pattern changes with climate and industrialization of the communities. There are some controversies on the relationship between air pollution and asthma. Tehran, as the capital of Iran, is one of the densest populations and is one of the most polluted cities in the world. ⋯ Two thousand two hundred nineteen cases enrolled in the study and asthma admission to total admission ratio compared with air pollutants data in admission day (725 days), using nonlinear regression method. Analysis of the data revealed that there is a significant relationship between NONGOOD nitrogen dioxide (P=0.01), ozone (P=0.01), and sulfur dioxide (P=0.04), levels and admission due to asthma in children, but There was no significant relationship between carbon monoxide levels and asthma admission in children. A significant relationship between nitrogen dioxide, ozone and sulfur dioxide concentration in air and admission due to asthma at levels other than GOOD, reveals air pollutants levels can be significantly harmful to children before AQI reaches to hazardous levels.
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Acta medica Iranica · Jun 2016
Evaluation of the Significance of Vital Signs in the Up-Triage of Patients Visiting Emergency Department from Emergency Severity Index Level 3 to 2.
The Emergency Severity Index (ESI) is a five-level triage system that has shown promising reliability and validity. According to ESI algorithm, in the presence of danger zone respiratory rate (RR), heart rate (HR) or Oxygen (O2) saturation, patients should be up-triaged from ESI level 3 to 2 Hence, the current study aimed to investigate the value of the measurement of vital signs in predicting the up-triage of patients from ESI level 3 to 2. Patients who visited the emergency department at Imam Khomeini Hospital Complex, Tehran, Iran, and were categorized into ESI level 3 were investigated. ⋯ Only 12 cases (2.2%) had normal RR and HR, who were up-triaged only due to abnormal O2 saturation. Out of these 12 cases, 10 had O2 saturations <92% at common health status, 1 had acutely altered mental status and should have been triaged into ESI level 2 in the first place and 1 could not be located for further investigations. In conclusion, compared to O2 saturation, the abnormal findings during the assessment of RR and HR seem to much more commonly result in the up-triage of patients from ESI level 3 to 2.
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Acta medica Iranica · May 2016
Case ReportsIdiopathic Lumbar Epidural Lipomatosis Mimicking Disc Herniation: A Case Report.
Spinal epidural lipomatosis is a rare condition which is described as the accumulation of fat in the extradural territory and often causes dural impingement. Spinal epidural lipomatosis has been implicated in causing a variety of neurologic impairments ranging from back pain, radiculopathy, claudication, myelopathy or even cauda equina syndrome. We report a 46-year-old female with obesity and a history of chronic back pain and radiculopathy who developed idiopathic Spinal epidural lipomatosis diagnosed by magnetic resonance imaging. The purpose of this report is to present a case of spinal epidural lipomatosis presenting with symptomatic cord compression and also remind this rare condition as a the differential diagnosis of epidural lesions in patients with risk factors.
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Acta medica Iranica · Mar 2016
Randomized Controlled TrialAdding Sufentanil to TAP Block Hyperbaric Bupivacaine Decreases Post-Cesarean Delivery Morphine Consumption.
Pain management is crucially important in the postoperative period as it increases patient comfort and satisfaction. The primary outcome of present study was to evaluate the effect of sufentanil added to hyperbaric bupivacaine solution 0.25% in transversus abdominis plane (TAP) block, on postoperative analgesic consumption. Fifty ASA physical status I-II term primiparous single-tone pregnant women aged 20-40 years scheduled for elective cesarean delivery with Pfannenstiel incision under general anaesthesia were enrolled in this randomized, double-blind, placebo-controlled trial. ⋯ The morphine consumption was significantly less in the study group (37.2 ± 16.1 mg) than the control group (52.8 ± 16.7 mg, P =0.002). The VAS for pain both in rest and coughing were same in groups. Sufentanil added to 0.25% hyperbaric bupivacaine in TAP block decreases post cesarean delivery morphine consumption.
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Acta medica Iranica · Jan 2016
Case ReportsA Rare Case of Splenic Torsion with Sigmoid Volvulus in a 14-Year-Old Girl.
Wandering spleen is an uncommon entity in adults and has been described only rarely with sigmoid volvulus, that rarely affects children and adolescents. It is usually described in adults. Wandering spleen characterized by the abnormal location of the spleen, caused by incomplete fusion of the four primary splenic ligaments, allowing the spleen to be mobile within the abdomen. ⋯ We present a rare clinical case of acute abdomen due to torsion of wandering spleen and volvulus of sigmoid in a 14-year-old girl presented with painful periumbilical mass. Detorsion of sigmoid occurred while undergoing exploratory laparotomy and splenectomy was performed. The possibility of torsion and its complication like gastric, pancreas tail and colon volvulus should be kept in mind in the differential diagnosis of the acute abdomen to avoid serious complications.