Seyed Mohammad Tahami; Seyed Ali Hashemi; Armin Akbarzadeh; Mohammad hadi Gerami; Amir Aminian; Seyed Amirreza Mesbahi; Amin Zarrabi; Rasool Safari
Abstract
Background: The novel COVID-19 disease was presented at first in Wuhan, China, in December 2019. During COVID-19 pandemic, elective surgeries were postponed, and health care facilities and resources were reorganized to provide efficient service for the large number of infected patients with COVID-19. ...
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Background: The novel COVID-19 disease was presented at first in Wuhan, China, in December 2019. During COVID-19 pandemic, elective surgeries were postponed, and health care facilities and resources were reorganized to provide efficient service for the large number of infected patients with COVID-19. Therefore, approaching trauma patients, who could have had COVID-19, was a challenging issue requiring special considerations and healthcare set up.Methods: This retrospective cohort study was conducted at Rajaei hospital, the main trauma center of the south of Iran, between March 2020 and August 2020 from the beginning of the COVID-19 pandemic. The COVID-19 infection was considered positive by either positive lung CT scan or PCR test. Trauma-related data such as the mechanism and pattern of trauma and injury, and surgical intervention procedures on the suspicious patients were recorded. Baseline characteristics including age, sex, cigarette smoking, and comorbidities were also collected. Need for ICU admission and mortality rates for the Covid and non-Covid cases were investigated and compared together as outcome variables.Results: During a six-month period of the pandemic Covid-19, 9248 patients referred to our trauma center. While 222 patients were suspected to have Corona infection, Sixty-four cases were confirmed to be positive that had mean age of 44 years. Among the 64 COVID-19 -positive patients, 33 cases with mean age of 36.4 had orthopaedic injuries. 23 patients underwent surgical treatment due to the orthopaedic injuries. 24 patients were victims of motor vehicle accidents which included 7 cases of pelvic and acetabulum fractures.The mortality rate of COVID-19 -positive cases were 15.6 % (10 patients out of the 64 cases and COVID-19 negative ones was 10.1 % (16 patients out of 158). The difference was not statistically significant (p.value:0.25). Multivariate analysis of the effect of the baseline and trauma related factors on mortality rate, showed that older age (p. value: 0.001), COVID-19 infection (p. value: 0.033), and surgical procedure (p.value:0.038) were the poor prognostic factors associated with mortality rate.Conclusion: The mortality rate of trauma patients with COVID-19 positive infection was 15.6 % (10 patients). Older age, COVID-19 infection, and surgical procedure were associated with higher mortality rate.
Saeed Solooki; Amir Rahmani Rasa; Narges Ghamari; Mohammad Mehdi Kamravan
Abstract
Background: Ewing's sarcoma is a primitive and malignant bone tumor that is a serious medical challenge in preserving the patient's life and choosing the appropriate treatment. The aim of this study was to consider the metastasis and survival rate after preoperative chemotherapy, surgery and postoperative ...
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Background: Ewing's sarcoma is a primitive and malignant bone tumor that is a serious medical challenge in preserving the patient's life and choosing the appropriate treatment. The aim of this study was to consider the metastasis and survival rate after preoperative chemotherapy, surgery and postoperative chemotherapy as a treatment protocol.Methods: In this study, 42 patients with Ewing's Sarcoma admitted to Chamran and Namazi Hospitals during 2005 to 2016 were enrolled. After considering inclusion and exclusion criteria, 27 patients were finally entered the study. Neo adjuvant chemotherapy and again restaging with MRI and chest CT scan was done. After restaging, treatment was selected. Treatments included amputation; only wide resection; wide resection and allograft; wide resection and prosthesis and only chemotherapy. After surgical treatments, patient had adjuvant chemotherapy.Results: In this study, 42 patients were investigated of whom 29 (%69) were male and 13 (%31) female respectively. The age mean and standard deviation were 21.45± 7.69 and 16.23± 4.9 in the male and female in respect. Femur (%30) and tibia (%23.8), respectively, were the more commonly involved sites. The treatments of 27 cases in the study group were amputation (5 subjects), only wide resection (6 subjects), wide resection and allograft (8 subjects) and wide resection and prosthesis (3 subjects). Patients with pelvis involvement received only chemotherapy (5 subjects). %46.2 of subjects had a 5-year survival period.Conclusion: Early diagnosis of Ewing's sarcoma and appropriate treatment using preoperative chemotherapy followed by, surgery through proper margin removal and then postoperative chemotherapy is highly recommended for this condition. Our study confirmed the above-mentioned points on preoperative chemotherapy followed by surgery and post operative chemotherapy.
Hossein Akbari Agdam; Mohammadreza gholamrezaei; Paria Rouhi; Amirhosein Farrokhzad
Abstract
Background: There is increasing trend of orthopaedic surgeons for closed pinning of type II supracondylar fractures. In this study, the result of treatment of closed reduction and casting in comparison with pinning is evaluated.Method: In a retrospective cross-sectional study, 39 children aged 3-11 years ...
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Background: There is increasing trend of orthopaedic surgeons for closed pinning of type II supracondylar fractures. In this study, the result of treatment of closed reduction and casting in comparison with pinning is evaluated.Method: In a retrospective cross-sectional study, 39 children aged 3-11 years with Gartland type II supracondylar fracture who were treated with closed reduction and pinning were compared with closed reduction and casting by using demographic information and measurement of Baumann’s angle, and in hospital stay, by easy non-random sampling method and in 4 weeks follow-up.Result: By using the independent sample T-Test, there was a significant difference between the time duration of hospital stay and type of treatment and it was significantly lower in the group who had undergone treatment with closed reduction and casting [p value < 0.005, Mean, SD: 37.43 +- 6.42]. There was no significant difference between the Baumann’s Angle in the two groups.Conclusion: No significant difference in the radiographic outcome of the two types of treatment was observed after four weeks of follow-up.
Hamid Hesarikia; Alireza Rahimnia; Gholamreza Farzanegan; Musa Reza Anbarloui; Amin Hamidzadeh Khiyavi
Abstract
Background: The application of Tranexamic Acid (TA) is one of the methods to control and reduce bleeding in spinal surgery. The aim is to compare systemic (TA) with local (TA) administration for reduction of blood loss during spinal surgery in order to promote health economics.Method: The research schema ...
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Background: The application of Tranexamic Acid (TA) is one of the methods to control and reduce bleeding in spinal surgery. The aim is to compare systemic (TA) with local (TA) administration for reduction of blood loss during spinal surgery in order to promote health economics.Method: The research schema was cross-sectional and retrospective in the community of patients undergoing spinal surgery in the Baqiyatallah Hospital. The inclusion criteria were elective spinal surgeries of three levels or more. The exclusion criteria were bleeding disorder. The required analyses are performed using SPSS software. Moreover, the significance level of the statistical test is 0.05 The intravenous dose is selected to be 10 mg/kg. The maintenance is also 1 mg/kg/h. The topical dosage is one gram in300 ml at the beginning and 500 mg in 50 ml at the end. The amount of calculated bleeding is the volume of blood in the drain.Results: In this research, 22 patients (44.9% of 49 patients) received TA intravenously and 27 patients (55.1% of 49 patients) received local TA. There was no remarkable relationship between the amount of bleeding in different groups with the surgery type (p: 0.48), surgery level number (p: 0.48), and the amount of total bleeding (p: 0.14). The local TA group’s intra-operative and post-operative bleeding amounts were 563.89 ± 367.48ml and 116.30 ± 71.37ml, respectively. These intra-operative and post-operative bleeding amounts were 496.64 ± 296.84ml and 75.84 ± 120ml for the case of the intravenous (TA) group.Conclusion: The results do not confirm the effectiveness of the local administration compared with the intravenous administration. However, the average amount of bleeding in the local application of tranexamic acid is similar to the systemic one.
Zahra Rahimi
Abstract
Background: The forward head tilt and round holding of shoulder are the two postural problems, being observed not infrequently in young and middle age people. The present study is aimed at investigating such postural abnormalities in two-age groups of women.Methods: In a relatively randomized ...
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Background: The forward head tilt and round holding of shoulder are the two postural problems, being observed not infrequently in young and middle age people. The present study is aimed at investigating such postural abnormalities in two-age groups of women.Methods: In a relatively randomized sampling, 500 women in two age groups were tested to investigate the incidence of "Forward head" and "Round shoulder" abnormalities. 400 women between the ages of 19-25 (mean 19) years and 100 between 35-50 (mean 40) years were examined for mild, moderate and severe abnormalities. Evaluation of posture was carried out by plumb line. The kyphosis was also documented by a kyphosis goniometer. The subjects were also asked about their back pain, and then correlated with the postures and jobs and sporting activities.Results: There was significant difference between variables of "age" and "round shoulder" (p<0.05), but the relationship between "age" and "forward head" was not significant. (P < 0.05) .Also, a significant correlation was noticed between jobs that are position -dependent and abnormalities and severity of pain with job (p<0.05). The kyphosis angle was higher in older age group. There was also a correlation between the kyphosis angle and pain in inter-scapular region". (r=0.4, p=0.0001)Conclusion: The postural abnormalities of “head tilt” and “round shoulder” are seen in both young and middle -age women. The individuals who do regular exercises have less complaint of pain relative to their postural anomalies. Age and Job are effective elements on incidence of most mentioned postural abnormalities in older subjects.
Mehdi Teimouri; Mehdi Motififard; Sahar sadat Lalehzar; Mahsa Elyasi
Abstract
Background: Hip hemiarthroplasty is a common method in treating femoral neck fractures in patients older than 70 years old. Depending on the severity of bone destruction, and bone stock, two methods either cemented or non-cement bipolar prosthesis may be used.Methods: In a prospective study, ...
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Background: Hip hemiarthroplasty is a common method in treating femoral neck fractures in patients older than 70 years old. Depending on the severity of bone destruction, and bone stock, two methods either cemented or non-cement bipolar prosthesis may be used.Methods: In a prospective study, 60 patients with femoral neck fractures who were referred to the university hospitals of Isfahan, Iran, were divided into two treatment groups: 30 patients were treated with cemented bipolar method and 30 with non-cement bipolar hip arthroplasty surgery. In a 6-month follow-up, the surgical outcomes were assessed using the VAS pain scale, SF36 general health instrument score, and Harris hip score (HHS). Results: The pain scale (VAS), SF36 and Harris scores showed non- significant differences in the two groups: pain=3.63 out of 10 in 3 months and 2.6 out of 10 in 6 months; SF36= 69 and 86 in 3 and 6 months ,respectively; HHS=78 in both in 3 and 6 month in the cemented group .In non-cemented group the pain scores were 3.91and 3.12 in 3 and 6 months; SF36=67 and 83, and HHS=82 in 3 and 6 months respectively.Conclusion: It seems that the two methods of cemented and non-cemented bipolar hemiarthroplasty, in elderly hip fractures, would have similar pain, quality of life, and hip function in short term follow-ups.
Basic
Vahid Zarghami; Fereshteh Moharramzadeh Jeghanab; Mohammad Ali Shokrgozar
Abstract
Background: One of the issues related to stimulating and accelerating bone regeneration and bone repair is the role of the immune system in fracture healing, known as osteo-immunology.Method: In these review 57 articles of science direct and pumped database is investigated for potential role and mechanism ...
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Background: One of the issues related to stimulating and accelerating bone regeneration and bone repair is the role of the immune system in fracture healing, known as osteo-immunology.Method: In these review 57 articles of science direct and pumped database is investigated for potential role and mechanism of the immune system's response to bone fracture. Results: biological materials such as tumor necrosis factor alpha (TNF-α), lipopolysaccharide (LPS), interleukin-17 (IL-17) protein, lipotic Acid (LTA) could regulate the immune system, which have the ability to improve the ossification process and faster healing.Conclusion: The direction of future research was predicted regarding the emergence of new therapeutic compounds derived from bone-building materials such as bone growth factors and substances that regulate the behaviour of the immune system in order to regenerate bone.
Banafsheh Jafargholizadeh; Nahid Hassanzadeh Nemati
Abstract
Introduction: An increasing population of the elderly has led to increasing demand for orthopedic implants. Excellent biocompatibility of orthodontic wires, drug delivery systems, cardiovascular stents, and orthopedic implants has attracted widespread attention by researchers for use in medical industries. ...
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Introduction: An increasing population of the elderly has led to increasing demand for orthopedic implants. Excellent biocompatibility of orthodontic wires, drug delivery systems, cardiovascular stents, and orthopedic implants has attracted widespread attention by researchers for use in medical industries. In some cases, however, superficial properties such as corrosion resistance and other biological behavior are not sufficient for clinical application. Infection caused by the presence of implants in the body is one of the most common complaints of patients. Since the bacteria play important role in patients ’disability, the development of antibacterial properties has been considered.Methods: Nanotubes, created on the surface of nitinol through anodizing, can be one of the useful solutions in creating antibacterial properties. Also, the ability of these structures to carry drugs such as antibiotics can solve the problems caused by implantation of orthopedic implants in the body.Results: In order to increase the long-term antibacterial ability of orthopedic implants, the researchers have improved the physical properties by modification of nitinol levels by anodizing method and the formation of nanotubes on its surface and drug loading.Conclusion: The effect of different parameters on morphology, nickel ion release, corrosion behavior, biological and drug delivery, applicable in orthopedic implants, is discussed.
