The decision rule developed by the authors appears to be 100% sensitive and 46% specific for positive findings on brain CT and will, in developing countries, help clarify the decision to obtain scans.

Oral sweet almond oil, if especially used immediately after poisoning with ALP, improves the survival rate.

Introduction:Among imaging techniques, computed tomography (CT) is a reliable method for detecting intracranial hematomas in patients with head trauma, but it is not generally available in special circumstances like prehospital situations and harsh conditions such as those following an earthquake.Objective:The objective of this study is to determine if near-infrared spectroscopy (NIRS) is useful for performing CT scans on patients with closed head trauma that present to medical centers that do not have the ability to perform a CT scan or in prehospital or harsh situations. Near-infrared spectroscopy and CT scan were compared according to sensitivity and specificity.Methods:This was an observational, prospective study. One hundred forty-eight patients admitted to Rasool Akram General Hospital in Tehran, Iran with head injuries during a one-month period were studied using NIRS and CT. The observational, prospective study was conducted and sensitivity, specificity, positive and negative predictive values of NIRS were calculated. Chi-square and Kappa analysis was performed, and a p-value <0.05 was considered significant.Results:According to the CT scan findings, 54 (36.5%) of the patients developed intracranial hematoma. The NIRS examination showed that 69 patients (46.6%) might have intracranial hematoma. The number of true negatives was 73 and the number of false negatives was six patients. The sensitivity and specificity of NIRS examination was 88.9% and 77.7%, respectively.Conclusions:This study speculates that NIRS may be a useful screening tool to detect intracranial hematoma. This capability could be useful in special situations like in a deprived area, medical centers without CT scan capabilities, prehospital situations, and in harsh conditions like those after an earthquake or other disasters that causes increased numbers of victims with closed head trauma.

Naloxone can be considered in the management of postseizure complaints of tramadol toxicity, but further rigorous studies are needed to provide sufficient evidence to support its routine use.

Kawasaki disease is generally known as a systemic vasculitis that often concerns doctors due to its serious cardiac complications; however, other visceral organs may get involved as well. Surgical manifestations of the intestinal tract in Kawasaki disease are rare. In this report, we describe the case of a 2.5-year-old boy with typical Kawasaki disease who presented with GI bleeding and surgical abdomen. The diagnosis of duodenal perforation was confirmed.

No abstract

RÉSUMÉ la présente étude descriptive a évalué la fréquence de certains facteurs de risque pour la grossesse à haut risque chez les femmes de la région de Sousse. Elle a été menée du 15 février au 15 août 2005 auprès de l'ensemble des femmes ayant accouché au-delà de 28 semaines d'aménorrhée dans quatre maternités publiques et présentant au moins un facteur de risque. La collecte des données a été effectuée dans les 24 heures qui ont suivi l'accouchement à partir des dossiers obstétricaux et fiches de consultation prénatale et par entretien. Sur 4660 femmes, 1194 (25,6 %) avaient au moins un facteur de risque et étaient considérées comme des grossesses à risque. Les femmes à risque avaient un âge moyen de 31,3 ans (ET 5,4) ; 73 % étaient d'origine urbaine, 38 % avaient un niveau d'étude secondaire ou supérieure et 75 % étaient des femmes au foyer. La moyenne des facteurs de risque est de 1,5 par femme. La majorité des femmes (59,3 %) avaient un facteur de risque et 30,4 % en avaient deux. La moyenne des visites prénatales était de 4 ; 68,6 % ont été assurées par un obstétricien et 43 % des femmes ont recouru au secteur privé. Certains facteurs ont été insuffisamment dépistés : âge > 35 ans, parité > 4, antécédent de faible poids de naissance et de décès néonatal, hauteur utérine excessive et anémie. This descriptive study assessed the frequency of selected risk factors for high risk pregnancy (HRP) among women in Sousse region. All pregnant women (beyond 28 weeks gestation) giving birth in 4 public maternity hospitals between 15 February 2005 and 15 August 2005 and who had at least 1 risk factor were enrolled. Data were collected within 24 hours of birth from obstetric and antenatal records and by interview. Of 4660 pregnant women, 1194 (25.6%) had at least 1 risk factor and were considered at-risk pregnancies. Mean age of the at-risk women was 31.3 (SD 5.4) years, 73% were urban residents, 38% had secondary education or higher and 75% were housewives. The mean number of risk factors was 1.5 per woman. The majority of women (59.3%) had 1 risk factor and 30.4% had 2. The mean number of prenatal visits was 4, 68.6% were seen by an obstetrician and 43% used the private sector. Certain factors were inadequately screened: age > 35 years, parity > 4, previous low birth weight and neonatal death, excessive fundal height and anaemia.

The rule-based process is the most common CDM process used by emergency doctors, perhaps because of the minimisation of human error in this process. CDM choice may be influenced by triage level, treatment room and doctors' educational levels. Revealing and studying these factors may help shift decisions to the best possible decision making levels, defining a model in future research.