فهرست مطالب mohammad javad forozanmehr

In recent years, the prevalence of attacks perpetrated by humans against other humans has increased worldwide. The injuries suffered by attack victims are severe and multi-organ. Iran’s neighboring countries have been the scenes of attacks in the recent past. This study assessed the type and severity of injuries sustained by victims transferred to Iran during the time period 2005-2007.

This study was conducted on injured civilians transferred to hospitals in Iran. Data regarding cause of injury, type and severity of injuries, diagnostic-therapeutic interventions, and patient outcomes was collected and statistically analyzed using SPSS version 14 software.

In the studied time period, 214 attack victims were transferred to 3 Level 1 trauma centers in Iran. The mechanisms of injury were explosion in 130 cases, gunshot in 48, and other causes in the remaining victims. The mean Injury Severity Score (ISS) was 5.91 ± 4.54 (range = 1-34), and the median was 4; 109 cases (51%) had an ISS between 1 and 8, 73 cases (34%) were scored between 9 and 14, 15 cases (7%) were scored from 16 to 24, and 17 cases (8%) had an ISS ≥25. In terms of the number of injured organs, 42 patients (20%) had one, 124 (58%) had 2, 36 (17%) had 3, and 12 patients (5%) had 4 or more injured organs. Procedures included 86 orthopedic, 25 general surgical, 21 ear, nose, and throat (ENT), 18 plastic, 15 neurosurgical, and 10 ophthalmic operations; 25 patients received psychiatric counseling. The mean (±SD) hospital stay was 13.43 (±19.76) days (range = 1-230).

The injury pattern in attacks is more severe and differs from other traumas. The medical team should have adequate knowledge in this respect to provide comprehensive healthcare.

At present, the use of ventilator support is an important part of treatment in ICU patients. However, aside from its wellknown advantages, the use of these devices is also associated with complications, the most important of which is pulmonary infection (PI). PI has a high rate of morbidity and mortality.

This study aimed to evaluate the prevalence of PI in mechanically-ventilated patients and the role that factors, such as age, sex, and duration of intubation, play in this regard.

This descriptive cross-sectional study evaluated the prevalence of PI in mechanically ventilated patients, with no underlying condition which could compromise their immune system. Age, sex, and duration of intubation were assessed. Data were analyzed using SPSS (version 16) software.

A total of 37 ICU patients on ventilators were evaluated, including 21 males (56.8%) and 16 females (43.2%). The mean age of the patients was 54 ± 19 years (range 19 to 86 years), with a mean age of 52 ± 20 years in men, and 56 ± 18 years in women (P = 0.52). The mean duration of ventilation was 6 ± 4 days (range 2 to 20 days). The mean duration of ventilation was 5 ± 2 days in men, and 6 ± 5 days in women (P = 0.42). A total of 16 patients (43.2%) developed ventilator-associated pneumonia (VAP); of whom, 50% were male and 50% female (P = 0.46). Patients who developed a pulmonary infection had a significantly longer duration of ventilation. The mean duration of ventilation was 8 ± 4 days in patients who had developed VAP, while this duration was 4 ± 2 days in the non-affected patients (P = 0.005). Overall, 17 patients died, and 7 of these deaths were attributed to VAP.

The prevalence of VAP in this study was approximately 43%, which is relatively high. In total, the percentage of deaths due to VAP among the patients was 18.91%. Duration of ventilator support was significantly correlated with the prevalence of PI.