فهرست مطالب niaz mohammad jafari chokan

Some clinical decision rules have been developed to identify minor head trauma (MHT) patientsin need of brain computed tomography (CT) scan for detection of possible traumatic brain injuries (TBIs). Thisstudy aimed to evaluate the performance of American College of Emergency Physicians (ACEP) recommenda-tions in this regard.

This study is a cross-sectional study of MHT (GCS: 13-15) cases who referred toemergency department of a level one trauma center, Mashhad, Iran, from October 2017 to March 2018. Thescreening performance characteristics of ACEP recommendations for performing brain CT scan in these pa-tients were calculated.

500 patients with a mean age of 37.97±15.96 years were evaluated. Based onlevel one recommendations, 73 (14.6 %) patients had to be assessed by brain CT scan. 67 (91.8%) were assessedand 6 (8.2%) were not assessed based on decision of their in-charge physician. According to level two recom-mendations, 125 (25.0%) patients did not need brain CT scan, 85 (68%) of whom had been assessed (all normal).Performing brain CT scan according to the level one recommendation of ACEP’s clinical policy showed 29.6%sensitivity (95% CI: 13.75 to 50.18) and 86.3% specificity (95% CI: 82.68 to 89.14). The overall ACEP’s clinical pol-icy for neuroimaging of adults with MTBI showed sensitivity and specificity of 92.59% (95% CI: 75.71 to 99.09)and 26.4% (95% CI: 22.51 to 30.65), respectively.

ACEP’s clinical policy has a high-level sensitivityfor using brain CT scan in detection of probable TBI in patients with MHT.

Quality of cardiopulmonary resuscitation affects its success and survival of patient. Several studies have shown that physicians’ knowledge about resuscitation is very low, but there is no detailed information in our country. Therefore, this study was designed to determine the level of basic knowledge of Mashhad University of Medical Sciences residents in the field of resuscitation.
Subjects & The newly arrived residents of Mashhad University of Medical Sciences participated in a resuscitation training course. Pre-test with 20 questions endorsed by the American Heart Association was performed and a score of 0 to 20 was considered as the level of basic knowledge. After a training course, post-test was performed.
Findings A total of: 136 people participated in the study, with an average age of31.24±4.82 years. Of these, 44.1% were male and 55.9% were female. Pre-test and post-test mean scores were 10.24±3.4 and 13.35±2.9, respectively. The difference was statistically significant (P = 0.000), and training improved the knowledge by 30%. Gender and specialty had no significant effect on pre-test and post-test scores.
This study showed that the level of knowledge of residents about cardiopulmonary resuscitation was not acceptable, and needed appropriate training courses with appropriate intervals to improve their knowledge and skills.

Anterior shoulder dislocation is the most common joint dislocation in human body. Many methods are traditionally described for reduction of shoulder dislocation. Most of these techniques are painful to patients and may be associated with further injury. An ideal method should be easy, effective, and less painful, not associated with iatrogenic complications and should be easy to teach and learn. Among different methods of reduction, external rotation and Milch methods are more popular. Both methods are found to be atraumatic, relatively painless and can be performed without anesthesia. In this article, we aimed to review the literatures regarding these two methods of reduction and comparing their success rate and outcome. We reviewed the literature to find articles related to reduction of anterior shoulder dislocations applying one of two techniques described above. We searched PubMed and Google Scholar. In total, 46 articles were found, of them 17 articles -which mainly focused on anterior shoulder dislocation reduction by means of two above methods-were included in this review. The results showed that both techniques were effective, safe, relatively painless, and were well tolerated with no complications, but the external rotation method was superior.