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Hojat Hossein PourFeizy , Airag Lotfiniya ,
Volume 5, Issue 1 (spring 2005)
Background & Objectives: Fat embolism syndrome (FES) is mainly due to the obstruction of blood vessels with fat globules, reached to circulation. FES is associated with traumatic and non traumatic diseases. The prevalence is 2-5% in long-bone fractures. The purpose of this study is to evaluate manifestations, laboratory findings and the diagnosed cases of fat embolism.
Methods: In this retrospective study all the patient records associated with injury were evaluated and those diagnosed with the traumatic fat embolism were selected. The data including sex, age, type of fracture, clinical and laboratory findings and symptom onset time were collected using a questionnaire. These data were then statistically analyzed.
Results: 17 out of 1660 patients were found to have fat embolism most of which belonged to middle-aged men. The most common clinical features consisted of: respiratory failure, tachycardia and consciousness level alterations. Fat embolism was mainly associated with tibial and femoral shaft fractures. Low level of Pao2 (Pao2<60) is the most reliable laboratory test in this study.
Conclusion: Fat embolism should be regarded as a threarening factor in patients (especially middle-aged ones) with fractures in long bons of lower limbs. Pao2 Level of can also be used as a reliable laboratory finding.
Farhad Salehzadeh , Dina Emami , Aliasghar Zolfeghari , Abbas Yazdanbod , Shahram Habibzadeh , Bahman Bashardoost , Manoochehr Barak , Eiraj Feizy , Hormoz Azimi , Marina Jastan , Jafar Khalafi ,
Volume 6, Issue 3 (Autumn 2006)
Background and Objectives: Familial Mediterranean fever which is the prototype of the hereditary periodic fever syndromes is common in the countries around the Mediterranean Sea. Regarding the geographical position of the northwest of Iran, having Turkish originality and its vicinity to the Mediterranean Sea , the incidence of this disease is significant in Ardabil. The goal of this study was to introduce Familial Mediterranean Fever as a disease with significant outbreak in this area.
Methods: This research is a descriptive study which has been done during one year from October 2004 to October 2005. According to the Tel-Hashomer criteria, the patients suffering from Familial Mediterranean Fever were collected from private clinics and pediatric rheumatology clinics records. Then from 112 patients only 74 ones were studied. All of the patients were interviewed and filled out a questionnaire.
Results: Familial Mediterranean fever is common among children under 18 (76%) and more common in male than female. Abdominal pain has been the most common complaint (74%) and abdominal pain and fever (95% and 84% respectively) were the main clinical symptoms. The most common period of pain was 12-72 hours and the common recovery (attack free) period was from 1 week to 1 month (63/5%). Majority of the patients had hospital admission for diagnostic work up (85%) and some of them (32%) had been under surgical operation mistakenly. On the whole 92% of the patients had taken medications as a result of wrong diagnosis and 20% had positive familial history. 50% of the patients' parents were first degree relatives and in 59.5% delay in diagnosis was more than 3 years.
Conclusion: Results of this study and introduction of this group of patients in a one-year research indicate that: Familial Mediterranean Fever is more common in the Northwest of Iran although physicians are not familiar with that. The common age for manifestation of this disease is under 18 and its presentation after the age of 40 is very rare.
Vadood Norouzi , Eiraj Feizy , Firooz Amani , Pouneh Zamani ,
Volume 6, Issue 4 (Winter 2006)
Background & Objectives: Pain acts as a defensive mechanism of body, which occurs following tissue damage. It is expected in surgical wounds. With regard to negative clinical outcomes resulting from surgery pain, this study was conducted to investigate the quality of pain control after appendectomy.
Methods: In this descriptive, cross- sectional and prospective study, 200 patients undergoing appendectomy were randomly selected. Pain control in all of the patients was managed for 8 hours using narcotics injected intramuscularly. The patients were studied during 12 hours after surgery. The rating scale of 0-10 grade was used to estimate pain severity. The collected data were analysed by SPSS.
Results: From 200 patients experiencing appendectomy, 101 (50.5%) were female and 99 (49.5%) were male. Pain was controlled with pethidine, methadon and pentazocin in 123 (61.5%), 51 (25.5%) and 26 (13%) patients, respectively. In 98 (49%) patients there was severe pain following the surgery. The most severe pain belonged to 21 (80.7%) patients who received pentazocin.
Conclusions: With regard to multiple complications and problems resulting from pain after appendectomy, careful control of pain and more attention is necessary.