Aim:To determine and compare the patterns of spinal injury in car occupants.Materials and Methods:Retrospective cross-sectional study enrolling all patients with spinal fracture after car accidents, who were admitted to hospital more than 24 h during 2004–2009.Results:The lumbosacral spine was the most commonly involved region (64.8). Six patients had spinal cord injury (6.6%). The majority of the victims were drivers of the vehicle (86.8%) and remaining were passengers. There was a significant difference in lumbar anatomic region (P = 0.05) and place of accident (P = 0.05) in car occupants’ position (P = 0.05). Car rollover was the most common mechanism of spinal fractures. There was a significant difference in lumbar anatomic region (P = 0.05), and two or more associated organ injuries (P ≤ 0.05) in car accident mechanism (P = 0.05).Conclusion:The chance of sustaining serious spine and associated multiple injuries in car accidents is quite high in our today's society. This may be due to the low level of standards for car manufacturing, absence or inadequacy of appropriate safety measures in cars, and poorly designed roads and problems in quality of driving to mention some reasons. Therefore, these victims are prone to significant morbidity and even mortality and need more specific prehospital supportive interventions.

BackgroundTranscutaneous electrical nerve stimulation (TENS) is a non-pharmacological analgesic method used to control different types of pain.ObjectivesThe aim of this study was to evaluate the effects of preoperative TENS on post inguinal hernia repair pain.Patients and MethodsThis randomized, double-blind, placebo-controlled clinical trial was performed on 66 male patients with unilateral inguinal hernias who were admitted to the Shahid Beheshti hospital in Kashan, Iran, from April to October 2014. Participants were selected using a convenience sampling method and were assigned to intervention (n = 33) and control (n = 33) groups using permuted-block randomization. Patients in the intervention group were treated with TENS 1 hour before surgery, while the placebo was administered to patients in the control group. All of the patients underwent inguinal hernia repair by the Lichtenstein method, and pain intensity was evaluated at 2, 4, 6, and 12 hours after surgery using a visual analogue scale. Additionally, the amounts of analgesic administered by pump were calculated and compared between the two groups.ResultsThe mean estimated postoperative pain intensity was 6.21 ± 1.63 in the intervention group and 5.45 ± 1.82 in the control group (P = 0.08). In the intervention group pain intensity at 2 and 4 hours after surgery were 3.54 ± 1.48 and 5.12 ± 1.41 (P < 0.001), respectively. In the control group these values were 4.0±1.5 and 4.76 ± 1.39 (P = 0.04), respectively. No significant differences were observed in mean pain intensities at 6 and 12 hours.ConclusionsTENS can reduce postoperative pain in the early hours after inguinal hernia repair surgery.

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Nonmelanoma skin cancer (NMSC) is the most common malignancy in the United States representing a considerable public health burden. Pharmacological suppression of skin photo-carcinogenesis has shown promise in preclinical and clinical studies, but more efficacious photochemopreventive agents are needed. Here, we tested feasibility of harnessing pharmacological disruption of intracellular zinc-homeostasis for photochemoprevention in vitro and in vivo. Employing the zinc-ionophore and FDA-approved microbicidal agent zinc pyrithione (ZnPT), used worldwide in over-the-counter (OTC) topical consumer products, we first demonstrated feasibility of achieving ZnPT-based intracellular Zn2+-overload in cultured malignant keratinocytes (HaCaT-ras II-4; SCC-25) employing membrane-permeable fluorescent probes. Zinc-overload was accompanied by induction of intracellular oxidative stress, associated with mitochondrial superoxide-release as substantiated by MitoSOX-Red™ fluorescence microscopy. ZnPT-induced cell death observable in malignant keratinocytes was preceded by induction of metal (MT2A), proteotoxic (HSPA6, HSPA1A, DDIT3, HMOX1), and genotoxic stress response (GADD45A, XRCC2) gene expression at the mRNA and protein levels. Comet analysis revealed introduction of formamidopyrimidine-DNA-glycosylase (Fpg)-sensitive oxidative DNA lesions. In a photocarcinogenesis model (UV-exposed SKH-1 high-risk mouse skin), topical ZnPT-administration post-UV caused epidermal zinc-overload and stress response gene expression with pronounced blockade of tumorigenesis. Taken together, these data suggest feasibility of repurposing a topical OTC-drug for zinc-directed photochemoprevention of solar UV-induced NMSC.

Study design Descriptive study. Objectives The aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR). Setting SCI community in Iran. Methods The NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry. Results The final version of the data set was composed of 376 data elements including sociodemographic, hospital admission, injury incidence, prehospital procedures, emergency department visit, medical history, vertebral injury, spinal cord injury details, interventions, complications, and discharge data. It also includes 163 components of the International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) and 65 data elements related to quality of life, pressure ulcers, pain, and spasticity. Conclusion The NSCIR-IR data set was developed in order to meet the quality improvement objectives of the registry. The process was centered around choosing the data elements assessing care provided to individuals in the acute and chronic phases of SCI in hospital settings. The International Spinal Cord Injury Data Set was selected as a basic framework, helped by comparison with data from other countries. Expert panel modifications facilitated the implementation of the registry process with the current clinical workflow in hospitals.