Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
Effect of Modafinil Administration on the Level of Consciousness in Patients with Brain Injuries of Moderate Severity
1
5
EN
Omid
Moradi Moghadam
Anesthesiology and Critical Care Department of Iran University Medical Sciences, Rasool-e-Akram Complex Hospital, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
Nima
Nematollahi
Iran University of Medical Sciences, Tehran, Iran
Ebadallah
Shiri Malek Abad
AJA University of Medical Sciences, Tehran, Iran
Valiolah
Hasani
Iran University of Medical Sciences, Tehran, Iran
Alireza
Tabibkhooei
Iran University of Medical Sciences, Tehran, Iran
alireza.tabibkhooei@gmail.com
Mehrdad
Sheikhvatan
Iran University of Medical Sciences, Tehran, Iran
Mohammad
Niakan Lahiji
Anesthesiology and Critical Care Department of Iran University Medical Sciences, Rasool-e-Akram Complex Hospital, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
m.niakan48@gmail.com
10.5812/traumamon.61505
<strong>Background:</strong> With regards to the importance of traumatic brain injury (TBI) and its high incidence rate in Iran as well as its severe consequences, it is important to determine the safety and efficiency of modafinil to increase the level of consciousness in hospitalized TBI patients.<br /><strong>Methods:</strong> This double-blind randomized controlled trial was done during 2016. Sixty patients with TBI and moderate GCS score between 9 and 13 had the inclusion criteria and entered the study and were divided into two groups. Patients in the treatment group received 200 mg of modafinil once a day and the control group received the placebo. Overall, 24 hours after admission, defined as base day, modafinil was prescribed for 196 hours after admission and GCS scores were recorded: this period was defined as the last day. Level of consciousness in both treatment and control groups was assessed by the GCS score. Data were analyzed by SPSS version 21 software using the independent t-test with intention-to-treat approach.<br /><strong>Results:</strong> Among 60 patients, there were 34 (56.66%) males and 26 (43%) females; 45 (75%) survived. The ITT analysis was employed to assess changes in the level of consciousness (LOC) after prescribing modafinil and placebo. Based on the findings, modafinil prescription was not associated with significant differences in LoC in the first time period (24 hours after) and the last day (196 hours) (P > 0.05).<br /><strong>Conclusions:</strong> Prescribing modafinil was not associated with significant changes in LoC in comparison with the placebo.
Modafinil,Level of Consciousness,Glasgow coma scale,Traumatic Brain Injury
https://www.traumamon.com/article_101969.html
https://www.traumamon.com/article_101969_c78560f815bd9015a9b26a7ecc5e22c8.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
The Impact of Safety Equipment on Traffic Accidents: A Hospital Based Study
1
5
EN
Mohammad
Manouchehrifar
Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Roghaieh
Ghalandari
Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hamidreza
Hatamabadi
0000000283388156
Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
hhatamabadi@yahoo.com
10.5812/traumamon.65580
<strong><span class="fontstyle0">Background: </span></strong><span class="fontstyle2">Traffic accidents are one of the main challenges in community health. Three-fifths of road accident trauma are attributed to behavioral factors such as no use of protective equipment, including seat belts by car riders and crash helmets by motorcyclists. This study was undertaken to evaluate the severity of injuries of motor vehicle accidents.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">The present cross-sectional study was carried out from April 2015 to April 2016 on 600 car accident victims. Statistical analyses were carried out with SPSS 21.0 at a significance level of 95% (P < 0.05). Data were reported using frequencies, percentages, and means. Chi-squared test was used to determine correlation.<br /></span><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">Based on the results, the accidents were most prevalent between 5 p.m. to 12 midnight. Pedestrians and drivers were at highest risk for accidents on highways while motorcyclists exhibited the highest rate of accidents on side streets. There was no significant correlation between the type of injury, the location of accident, and the status of the victims in the emergency ward and use of safety equipment. There was a strong correlation between the injury severity, type of injury, and the anatomic location of injury and use of safety equipment (P < 0.05).<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">Strong correlation was observed between the severity of injury, the type of injury, and the anatomic location of the trauma and no use of safety equipment (P < 0.05).</span>
Injury,safety,Accident Prevention,Protective Devices
https://www.traumamon.com/article_101970.html
https://www.traumamon.com/article_101970_33b46e4f32da50eeadb862232eefab75.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
Quality of Life and Disability in Candidates for Lumbar Spinal Fusion Surgery
1
5
EN
Rahim
Roeintan
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Ahmadreza
Khoshroo
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Alireza
Khoshnevisan
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
akhoshnevisan@tums.ac.ir
Alireza
Arefidoust
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Hamid Reza
Rasouli
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
10.5812/traumamon.67090
<span class="fontstyle0"><strong>Background:</strong> </span><span class="fontstyle2">As life expectancy in the society increases, the rate of degenerative diseases of the spine surge dramatically. Therefore, the number of patients undergoing spinal fusion surgery rises; however, the effectiveness of this operation is still controversial.<br /></span><strong><span class="fontstyle0">Objectives: </span></strong><span class="fontstyle2">The aim of this study was to investigate disability and quality of life in patients undergoing spinal fusion and compare the results with a matched general population sample.<br /></span><strong><span class="fontstyle0">Methods: </span></strong><span class="fontstyle2">In this prospective study, which was conducted during 2015 - 2016 in Iran, data were collected from 100 patients undergoing spinal fusion surgery at Baqiyatallah and Shariati Hospitals. We also recruited 100 people from the general population in the hospital matched with the patients with regard to sex, age, and smoking status. The participants filled out the 36-item short form (SF-36) and Oswestry disability index (ODI) questionnaires. The collected data on the quality of life and disability of patients, before and three and six months after the surgery were compared.<br /></span><span class="fontstyle0"><strong>Results:</strong> </span><span class="fontstyle2">The patient and general population groups were matched in terms of sex, age, educational level, body mass index (BMI), employment status, and smoking status (P > 0.05). Preoperative ODI score in the patients was 54.8 (SD 15.7), and six months after the surgery, it diminished to 24.8 (SD 9.25). ODI score in the general population sample was 17.5 (SD 8.3). Although disability improved significantly six months after surgery, it did not reach the level of the general population sample (P < 0.001). All aspects of the SF-36 improved six months after surgery (P < 0.05) and the patients reached the general population sample in emotional, mental health, and vitality subscales of SF-36 (P > 0.05). They did not reach the general population sample in other subscales of SF-36 (P < 0.05).<br /></span><span class="fontstyle0"><strong>Conclusions:</strong> </span><span class="fontstyle2">Despite the significant improvement in disability and all subscales of quality of life in the patients, they did not reach the general population sample in disability index, physical function, general health, physical role, social function, and pain subscales of the SF-36. However, they reached general population sample level in emotional, mental health, and vitality subscales of the SF-36.</span>
life expectancy,Quality of Life,Spinal Fusion
https://www.traumamon.com/article_101971.html
https://www.traumamon.com/article_101971_8325623061e5371901c177bcc2e07494.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
Comparison of Hematoma Block and Wrist Block in the Treatment of Fracture of Neck of Fifth Metacarpus
1
5
EN
Mohsen
Mardani-Kivi
Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
Mohammad
Haghighi
Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran
Farkhonde Hasannejad
Farkhonde Hasannejad
93it.hasannejad@gmail.com
10.5812/traumamon.67616.
<strong><span class="fontstyle0">Background: </span></strong><span class="fontstyle2">Fracture of neck of fifth metacarpal bone or boxer fracture is one of the most common types of hand fracture. Nowadays, two analgesic methods, hematoma block and wrist block, are used at the emergency unit for relocating the fracture. The aim of this study was to compare the advantages and disadvantages of these two methods.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">In this randomized clinical trial, all male patients between age of 18 and 60 years were evaluated regarding the inclusion criteria and divided into two groups. In the first group (wrist block), after finding the landmarks and using nerve locator, the radial, median, and ulnar nerves were blocked using 2% lidocaine. In the second group (hematoma block), 2% lidocaine was injected at the site of fracture hematoma. Patients’ pain in both groups was assessed using the visual analogue scale (VAS) before, during, and five minutes after reduction. Correction of angle of fracture and hand grip power were evaluated at two months, post-treatment.<br /></span><strong><span class="fontstyle0">Results: </span></strong><span class="fontstyle2">Forty-eight patients in the wrist block and 50 patients in the hematoma block were enrolled. In both groups, pain level based on VAS score was decreased during and at five minutes after reduction, which was significant in the wrist block group at both times. No significant associations were detected between correction of angle of fracture and recovery of hand grip power at two months post-treatment with type of analgesia. Also, grip power showed a significant negative association with age, only in the wrist block group.<br /></span><span class="fontstyle0"><strong>Conclusions:</strong> </span><span class="fontstyle2">This study demonstrated that wrist block is more effective than hematoma block during and at five minutes after reduction. However, two months after treatment, it was found that grip power was inversely proportional to the age in the wrist block group.</span>
Fifth Metacarpal Bone,Hematoma Block,Wrist Block
https://www.traumamon.com/article_101972.html
https://www.traumamon.com/article_101972_97ea1b422464380e86d326197105324f.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2018
09
17
The Short-Term and Long-Term Effects of Kinesio Taping on Pain,Range of Motion and Disability of Neck in Patients with Myofascial Pain Syndrome: A Randomized Clinical Trial
1
6
EN
Zabih Allah
Rasti
Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
Alireza
Shamsoddini
Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
10.5812/traumamon.69226
<span class="fontstyle0"><strong>Background:</strong> </span><span class="fontstyle2">Myofascial pain syndrome (MPS) is a musculoskeletal disorder characterized by tenderness, the presence of trigger points, localized or referral pain, muscle weakness, and limitation in range of motion, which leads to limitations in physical, vocational and social activities, and ultimately the reduced work efficiency and quality of life.<br /></span><span class="fontstyle0"><strong>Objectives:</strong> </span><span class="fontstyle2">The aim of this study is to investigate the short-term and long-term effects of Kinesio Taping on pain, range of motion, and disability of neck in patients with MPS.<br /></span><strong><span class="fontstyle0">Methods: </span></strong><span class="fontstyle2">In a single-blind randomized clinical trial, 30 patientswith MPSwere randomly divided into two groups, treatment group (n = 15) and control group (n = 15). The treatment group was given Kinesio Taping with proper tension and the control group was given Kinesio Taping without any tension. Pain intensity, range of motion, and neck disability was measured by NPRS, Goniometry, and NDI, respectively. Evaluationswere performed before the intervention, three days later, and finally 14 days after the intervention.<br /></span><strong><span class="fontstyle0">Results: </span></strong><span class="fontstyle2">A comparison of the patients’ mean pain, range of motion of flexion, lateral flexion, and neck rotation in the short and long term indicated a significant difference between the two groups (P < 0.05); although no significant difference was observed between the mean range of motion of neck extension between the two groups (P = 0.33 and P = 0.16 respectively for short term and long term). Neck disability showed a significant difference in both short/long term in pre-post evaluation of treatment group and comparison between groups with P < 0.05.<br /></span><span class="fontstyle0"><strong>Conclusions:</strong> </span><span class="fontstyle2">According to the results of this study, Kinesio Taping can reduce neck pain, increase the neck’s range of motion, and ultimately reduce the disability caused by myofascial pain syndrome both in the short term and in the long term. However, the duration of use of Kinesio Taping can increase its influence.</span>
myofascial pain syndrome,Neck pain,Triggers Points,Neck Disability,Kinesio Taping
https://www.traumamon.com/article_101973.html
https://www.traumamon.com/article_101973_a30673d5971e904b6b040b1417514864.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
Effect of Frontal Lobe Traumatic Brain Injury on Sentence Comprehension and Working Memory
1
7
EN
Ehsan
Hemmati
Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
Zahra
Ghayoumi-Anaraki
Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Reza
Ehsaei
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad , Iran
Leila
Ghasisin
Communication Disorder Research Center, Rehabilitation Sciences Institute, Isfahan University of Medical Sciences, Isfahan, Iran
ghasisin@rehab.mui.ac.ir
10.5812/traumamon.74353
<span class="fontstyle0"><strong>Background:</strong> </span><span class="fontstyle2">This study was conducted to examine the sentence comprehension and working memory in individuals with mild and moderate frontal lobe traumatic brain injury (TBI) and determine the relationship between them.<br /></span><strong><span class="fontstyle0">Methods: </span></strong><span class="fontstyle2">Participants included 18 patients with mild TBI, 17 patients with moderate TBI and 18 non-TBI individuals. The digit span subtest of the Wechsler intelligence scale-IV (WISC-IV) and a N-back test were used to evaluate working memory. Moreover, the syntactic comprehension subtest of Bilingual Aphasia Test (BAT) was used for sentence comprehension assessment.<br /></span><strong><span class="fontstyle0">Results: </span></strong><span class="fontstyle2">The results showed that patients withmild and moderate TBI had a lower performance in comprehension of non-canonical sentences and working memory compared to the non-TBI group. There was also a significant correlation between sentence comprehension and working memory in the TBI groups.<br /></span><span class="fontstyle0"><strong>Conclusions:</strong> </span><span class="fontstyle2">Sentence comprehension and working memory in TBI patients with frontal lobe damage are significantly lower than that of the non-TBI group, which may lead to some daily communication problems in these individuals.</span>
Traumatic Brain Injury,Sentence Comprehension,working memory,Frontal lobe
https://www.traumamon.com/article_101974.html
https://www.traumamon.com/article_101974_729a0c7896bb112c213c5dbcda92719f.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
Monitoring of Serum Total Cortisol Level in Burned Traumatic Patients
1
6
EN
Mohammad
Niakan Lahiji
Anesthesiology and Critical Care Department, Trauma and Injury Research Center, Rasool-e-Akram Complex Hospital, Iran University of Medical Sciences, Tehran, Iran
Ali Reza
Khalesi
Trauma and Injury Research Center, Critical Care Department, Iran University of Medical Sciences, Tehran, Iran
Abbas
Gholami
Trauma and Injury Research Center, Critical Care Department, Iran University of Medical Sciences, Tehran, Iran
Omid Moradi Moghadam
Omid Moradi Moghadam
moradimoghadam@yahoo.com
10.5812/traumamon.82362
<strong><span class="fontstyle0">Background: </span></strong><span class="fontstyle2">Systematic inflammatory syndrome causes death in many conditions. Inflammation and anti-inflammation parameters variation monitoring were done by different clinical and lab methods, however, determining the progression of inflammation is very important for on time interference, gaining best results, and cost controlling. In this condition, adrenal insufficiency’s variation causes water and electrolyte disorders, circulatory failure, and uncontrolled progression of inflammatory response, which is very important. Routine serum total cortisol level monitoring for SIRS is not advised as yet, and corticosteroid was used blindly according to hemodynamic condition and physician diagnosis.<br /></span><strong><span class="fontstyle0">Objectives: </span></strong><span class="fontstyle2">In this pilot study, the ability of first three days monitoring serum total cortisol level in SIRS of burned ICU traumatic patients was studied for outcoming improvement.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">A total of 60 patients, 15 - 70 years old, < 80% burn, with systemic inflammatory response syndrome, during first three days of admission in the ICU, that weren’t included in the exclusion criteria (patients with history of clinical adrenal insufficiency or corton usage, or recent drug history of etomidate or ketoconazole), were divided randomly between two groups with 30 patients. The first group considered under the routine clinical treatment and in the second group, besides the routine methods cortisol daily measurement at 8 o’clock, was done during three days to find the cortisol level under 15 ug/dL, and replacement therapy with 50 mg hydrocortisone IV, four times a day.<br /></span><span class="fontstyle0"><strong>Results:</strong> </span><span class="fontstyle2">None of the patients had a cortisol drop during their first three days. Among patients with cortisol more than normal, 20% (6 patients) died.<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">Despite the fact that total serum cortisol drop during systemic inflammatory response syndrome may happen, it is not prevalent, however, it is wise to consider it as an effective parameter on monitoring of treatment measures.</span>
SIRS,cortisol,Adrenal insufficiency
https://www.traumamon.com/article_101975.html
https://www.traumamon.com/article_101975_6973df9518588bad214c19905928c210.pdf
Official Publication of the National Center for Trauma Research
Trauma Monthly
2251-7464
2251-7472
24
1
2019
01
01
Management of Metacarpal Nonunion in a Two-Year-Old Child
1
3
EN
Seyed Ramin
Haj Zargarbashi
Department of Pediatric Orthopedic Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Behnam
Panjavi
Department of Pediatric Orthopedic Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Hamid Reza Arti
Hamid Reza Arti
hamidrezaarti@gmail.com
10.5812/traumamon.82449
<strong><span class="fontstyle0">Introduction: </span></strong><span class="fontstyle2">Metacarpal fractures are common in childhood and adolescence and bone healing is the rule.<br /></span><strong><span class="fontstyle0">Case Presentation: </span></strong><span class="fontstyle2">We present a two-year-old boy with an established nonunion of the fourth and fifth metacarpal fractures, treated successfully without any complications. Both fractures resulted from a high-energy trauma; although initial treatment seemed appropriate, nonunion occurred. The child was referred to our center for nonunion and humpback deformity. The patient was treated with open reduction/internal fixation and bone graft. All metacarpal fractures healed radiographically and clinically without any problem. The final functional and cosmetic result was excellent.<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">Although the occurrence of metacarpal nonunion is rare in children, careful follow-up must be done to achieve osseous union.</span>
Metacarp,nonunion,Pediatric
https://www.traumamon.com/article_101976.html
https://www.traumamon.com/article_101976_0da57b43d29be0008a3ac4b555beb8d5.pdf