Background:On 26 December 2003, an earthquake measuring 6.5 on the Richter scale occurred in the city of Bam in southeastern Iran. Bam was destroyed completely, >43,000 people were killed, and 30,000 were injured. The national and international responses were quick and considerable. Many field hospitals werecreated and large numbers of patients were evacuated from their homes and transported to hospitals throughoutIran. Nearly 700 patients were transferred to Chamran hospital in Shiraz within the first 48 hours after the earthquake.Methods:This is a retrospective study based on the medical records of earthquake casualties dispatched to Chamran Hospital. A screening tunnel composed of multiple stations was prepared before patients entered to facilitate the large influx of patients. Each of the victims was passed through this screening tunnel and assigned into one of three groups: (1) those needing emergency surgical intervention; (2) those needing less urgent surgery; and (3) those needing elective operations, supportive care, observation, and/or rehabilitation.Results:Among the 708 patients, 392 were male (male/female ratio: 1.24) with a mean value of their ages of 30.5 years. (range: 1.5 months–70 years). Extremity fractures (136, 19%) were more common than were axial skeleton fractures (28, 4%). Out of the total 708 patients, 152 (21.5%) patients needed emergency operations, 26 (4%) needed less urgent surgery, and 530 (74.5%) required wound care or antibiotic therapy and other forms of supportive care. Some complications occurred, such as two patients with compartment syndromes of theleg, three required below-the-knee amputation, eight suffered acute renal failure, two developed fat emboli syndrome, and one had a brain injury that resulted in death.Conclusion:A comprehensive disaster plan is required to ensure a prompt disaster response and coordinated management of a multi-casualty incident. This can influence the outcomes of patients directly. A patient screening tunnel has advantages in rapid and effective evaluation and management of victims in any multi-casualty incident.
BackgroundsShigellosis remains an important public health problem in developing countries with S. sonnei and S. flexneri in US, Europe and in Asian countries being of importance.ObjectivesThis study evaluates the protective effect of Lactobacillus casei cell-free culture supernatants (CFCS) against multiple drug resistance (MDR) clinical samples of Shigella sonnei and Shigella flexneri in vitro.Materials and MethodsS. sonnei and S .flexneri was identified by common microbiological and serological methods. Antibiogram with 18 antibiotics were tested for 34 positive cultures by disc diffusion method. The Samples showed considerable resistance to antibiotics. Antimicrobial effects of CFCS were tested against S. sonnei and S. flexneri by agar-well assay and broth micro dilution methods. In addition, the antimicrobial activity remained active treatment after adjust pH 7, adding Proteinase K and heating for L. casei.ResultsThe results implicate that L. casei strongly inhibits the development of pathogen samples. In contrast, via the disc diffusion method 4 out of 18 antibiogram have shown complete resistance against the pathogen samples. In addition, the natures of antimicrobial properties have been tested in different conditions such as various pH, temperature and presence of proteinase K. The MIC50 (minimum inhibitory concentration) and MIC90 of CFCS of L. casei were determined, for S. sonnei were 2.25 and 10.5, for S .flexneri were 5.25 and 5.25 respectively. The results have shown a significant resistance pattern by these four antibiotics in this case.ConclusionsThe data indicates that. L. casei highly resistant against to antibiotics, heat, Proteinase K and so many activities against MDR Shigella pathogenic strains . L. casei is the best probiotics candidate.
BackgroundSeveral reports have suggested low bone mineral density (BMD) in patients with adolescent idiopathic scoliosis (AIS). We determined bone mineral status in patients with AIS to evaluate the effect of brace treatment on BMD.MethodsBMD was measured in 46 patients (mean age, 17.8 ± 4.9 years) with AIS (17 with brace and 29 without brace) by dual-energy X-ray absorptiometry scan and compared the results to an age-matched (mean age, 16.6 ± 3.9 years) control group (n = 54).ResultsThe AIS group had significantly lower bone mass at the lumbar spine (Z-score, -1.500 vs. -0.832) and hip (Z-score, -1.221 vs. -0.754) except at the femoral neck. No difference in BMD was found between patients with AIS who used a brace and those who did not.ConclusionsThe results confirmed that BMD was low in AIS patients and it was not affected by brace treatment.
Background: Among the most common infectious diseases, second ranking after respiratory (tract) system infection is urinary tract infection which involve (infects) about 250 million people in developing countries annually. Objectives: The purpose of this study is to investigate the pattern of antibiotic resistance in common pathogens that cause urinary tract infection. This study is the first to evaluate the incidence of antibiotic resistance is the large number of samples in Iran. Patients and Methods:The susceptibility of samples obtained from 14,332 patients with urinary tract infections admitted to different medical diagnostic laboratories of Tehran, was measured using disk diffusion method for 18 common antibiotics. Results: Most of the identified bacteria were Escherichia coli (64.56%) and Klebsiella pneumoniae (13.78%). The most resistant antibiotics were respectively identified as trimethoprim/ sulfamethoxazole (61.35%) for E-coli and (49.6%) for Klebsiella sp. Also intermediate resistance to Nitrofurantion and Chlor tetracycline was observed. Conclusions: The findings of this study indicate that E. coli is the predominant pathogen of this infection. There are also bacteria with high resistance that Interfere with prescription of drugs in order to treat urinary tract system infection. Also increasing of resistance to antibiotics among bacterial pathogens is evolving and requires an inspectoral and research procedure which could provide more information for doctors to treat the infection more efficiently.Keywords: Drug Resistance; Microbial; Urinary Tract Infections; E. coli Implication for health policy/practice/research/medical education: According to the results of this study, we showed that Sulfamethoxazole/trimetoprime is not recommended as the first line of empirical treatment for urinary tract infections in Tehran but Nitrofurantoin and Fleuroquinolone could be used as the first and the second empirical treatment lines. Also this study is the first to evaluate the incidence of antibiotic resistance is the large number of samples in Iran
Aneurysmal bone cyst (ABC), a locally benign aggressive lytic lesion of either primary or secondary origin, seldom involves the talus. Herein, we present a 25-year-old man with recurrent ABC of the talus after curettage and bone grafting, which was managed by total resection followed by filling the defect using fibular graft and finally tibiotalocalcaneal arthrodesis due to articular surface involvement. At 18 mo postoperatively, no recurrence was detected. Arthrodesis might be a good option in cases with recurrent ABC of the talus especially with articular surface involvement.
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