فهرست مطالب فرزاد پناهی

''Lichtenstein'' tension-free mesh repair is the most common surgical techniques used for inguinal hernia repair." Read-Rives" method is tension-free, too, but here prosthesis is placed just over the peritoneum, and there is no weak area. The aim of this study was to compare the results of "Read-Rives" and Lichtenstein method in the hernioplasty. Methods and Materials: In this prospective randomized clinical trial 126 patients who had unilateral inguinal hernia were examined: 64 patients operated with Lichtenstein and 62 patients operated with Rives method. They evaluated for early post-operative complications, duration of surgery and hospital stay, return to normal activity, and then they followed for recurrence of hernia.

Postoperative pain was significantly lower and the return to normal activity was shorter in Rives group. Duration of surgery and hospital stay and recurrence rate was equal, lower postoperative wound infection was found within Rives method.

Although the ''Read-Rives'' method is not technically as simple as ''Lichtenstein'' method, but this procedure is easy to learn, so it is recommended because of its better final outcome in comparison with Lichtenstein repair.

Primary prevention has remained one of the most important ways to reduce the burden of injuries. M any deaths and much long-term disabilities can also be prevented through strengthening trauma and emergency care. The purpose of this study was to survey the prehospital emergency performance of Iran.

­ In this cross-sectional descriptive study during April to August 2009, 15 managers and experts of medical emergency and incident management working in health, treatment and medical education ministry were selected by achievable sampling method evaluated. Data gathering done by interview, information gathering especial form and analysis of documents. Data analysis was conducted by SPSS 11 software.

Response time in whole urban zones of country except Tehran city was 7 minutes and 14 minutes in suburban zones, generic coverage by incident managment was 33%, number of ambulances were 3.19 for every 100 thousand of population, dispatch coverage was 80%, proportion of early aids pervasives were 58% and used care model was mixed. Conclution: Prehospital emergency is nearly good in Iran but distances from desirable and standard condition.

The accuracy of the pre-hospital care has not been evaluated in Iran so that the purpose of the present study was to evaluate the efficacy of the pre-hospital care performed by Tehran Emergency Service in traumatic patients referred to “Sina Hospital”.

This prospective study was conducted on traumatic patients referred to emergency department of “Sina hospital” by Tehran Emergency Service from September 2003 to September 2004. The accuracy of the pre-hospital care performed by Tehran Emergency technicians, regarding the patients’ general condition was evaluated. The on-call physicians in emergency department of “Sina hospital” were responsible for gathering the data and filling the questionnaires based on their observation and the EMS forms.

994 patients were enrolled in the study. Wound bandage and homeostasis were done correctly in 80% of the cases. Splint was applied correctly in 50% of the patients, while other therapeutic procedures such as collar and spinal bed were not performed among 80% of the cases. IV-line was obtained in 91.2% of the patients, while serum infusion was initiated in only 20% of patients.

It is recommended to compile evidence-based protocols for the pre-hospital procedures and train the emergency technicians to follow the rules, in order to improve the efficacy and the accuracy of the pre-hospital care. According to the principal changes recently made in the quality and quantity of the care offered by Iran's Emergency Service, it is necessary to perform a new study to evaluate the present condition and compare the results of these qualitative and quantitative changes with the current study.

Road traffic crashes are the main cause of trauma mortality in most of world countries especially Iran. The objective of this study is to evaluate RTC mortality and morbidity in the last 10 years (1997-2006).

Data were obtained from Iran official reports of police, health sources and the Statistical Centre of Iran (SCI). These data include population, registered motor-vehicles number, RTC, RTC injuries and deaths, during the period of 1997–2006. Statistical analysis was performed by Stata 8 software and significance of mortality change was evaluated by Poison distribution.

RTC fatalities increased between 22.1 (95%CI, 21.7-22.4) per 100,000 and 40.5 (95%CI, 40.1-41.0) per100,000 from 1997 to 2005, but in the last year of 2006, this trend is reversed and there was declined to 39.1 (95%CI, 38.7-39.6) per 100,000. RTC injuries has been increased from 110 to 401 per 100000 population from 1997 to 2005, but decreased to the 393 per 100000 in 2006.

This paper shows road traffic crashes mortality and morbidity in Iran in recent ten years and the decrease in the last year. This decline was most probably the result of a variety of interventions, including legislation, police enforcement, improvements in traffic and transport, health care facilities and media and public education. It is recommended that efforts of all responsible organizations continue in unique leadership.