Frontiers in Emergency Medicine

Diaphragmatic hernia is a rare condition that can result from blunt or penetrating trauma. It is often asymptomatic for years, making diagnosis challenging. In fact, up to 66% of diaphragmatic ruptures can go unnoticed at the time of trauma. Delayed diagnosis can lead to complications, including faecopneumothorax. Faecopneumothorax caused by strangulated diaphragmatic hernia is an extremely rare clinical condition. We report the case of a 15-year-old Iranian female who had a history of a motor vehicle accident 1 year prior to being referred to our center. She presented with tension faecopneumothorax, which occurred due to the incarceration and strangulation of the large bowel in the thoracic cavity. the patient was urgently transferred to the operating room for exploratory surgery. In patients presenting with symptoms of pulmonary or intestinal obstruction and a history of thoracoabdominal injury, the clinician should consider diaphragmatic hernia as a potential diagnosis. Prompt recognition of this condition is crucial as complications can significantly increase morbidity and mortality rates.

Ali Yamini

Sara Alipour

Ramin Mansouri

Kiana Kimiaei Asadi

A case of faecopneumothorax resulting from a delayed diagnosis of traumatic diaphragmatic injury

创伤性膈肌损伤延误诊断致粪气胸一例

Mohammad Eftekhari

Love protects us; we should take care of it

爱保护我们；我们应珍惜它

Objective: Preparing patients for emergency surgeries requires accurate consideration of their clinical condition and medical history to avoid potential hemodynamic instability and compromise the immune system. This study aims to compare the effects of dexmedetomidine and magnesium sulfate infusions in maintaining stable hemodynamics during emergency orthopedic surgery. Methods: The present study was conducted as a randomized and double-blind clinical trial with the participation of 80 patients who were candidates for an emergency orthopedic surgery during 2021. Magnesium sulfate was administered as an intravenous bolus at a loading dose of 50 mg/kg over 10 minutes, followed by a continuous infusion at a rate of 15-20 mg/kg/hour. Dexmedetomidine was administered as an intravenous bolus at a loading dose of 1 mcg/kg over 10 minutes, followed by a continuous infusion at a rate of 0.2-0.7 mcg/kg/hour, depending on patient response. These infusions were initiated 15 minutes before induction of anesthesia and continued until the end of surgery. All drugs (dexmedetomidine and magnesium sulfate) were diluted in a 50-cc syringe and infused. The hemodynamic status (diastolic blood pressure (DBP), systolic blood pressure (SBP) mean arterial pressure (MAP) and heart rate (HR)) of the patients between the two groups was recorded and finally compared with each other. Results: The hemodynamic status (DBP, SBP, MAP and HR) between the two groups at all (perioperative time) times were without significant statistical differences (P&gt;0.05). Conclusion: Both dexmedetomidine and magnesium sulfate are effective and safe options for achieving hemodynamic stability during emergency orthopedic surgery.

Mohammad Irajian

Mohammad Reza Moharrami

Mahdi Nazari

Nina Pilehvar

Comparison of infusion of dexmedetomedine and magnesium sulfate on the stability of hemodynamic status during emergency orthopedic surgery: a randomized double-blind clinical trial

急诊骨科手术中输注右美托咪定与硫酸镁对血流动力学状态稳定性的比较：一项随机双盲临床试验

Objective: Delirium is characterized by impaired attention and awareness, accompanied by cognitive deficits. It develops rapidly and poses a considerable burden on healthcare systems. Patients in the intensive care unit (ICU) are particularly vulnerable to developing delirium. This study aims to determine the incidence and predictors of delirium among ICU patients at Jimma Medical Center in southwest Ethiopia in 2023. . Methods: A prospective observational cohort study was conducted on 403 patients aged≥18 years admitted to emergency, surgical, and medical ICUs at Jimma Medical Center in southwest Ethiopia. Patients were assessed twice daily for delirium using the Richmond agitation sedation scale (RASS) and confusion assessment method (CAM). The association between independent variables and delirium incidence was analyzed using Cox proportional hazards (PH) regression. A univariate Cox PH model screened variables at a 0.25 significance level, followed by a multivariable Cox PH model for significant variables. Variables with a P-value≤0.05 were considered significantly associated with delirium incidence among ICU patients. Results: The findings of this study revealed that the overall occurrence of delirium among critically ill ICU patients was 118 (29.3%) (95% CI: 25%,34%), and the rest, 70.7% of the participants, were censored (95% CI: 66,75). The incidence rate of delirium among intensive care unit patients was 21.2 (95% CI: 17.8,25.4) per 1000 person-days of observation. Chronic obstructive pulmonary disease (AHR: 1.94; 95% CI: 1.23,3.56), stroke (AHR: 1.8; 95%CI: 1.98,3.73), Oxygen Saturation less than 90% (AHR:1.61; 95% CI: 1.11,2.34) and Obesity (AHR: 0.35; 95%CI: 0.13,0.84) were independent predictors of delirium among ICU patients. conclusion: This study found that, with an incidence rate of 21.2 occurrences per 1000 person-days of observation, delirium greatly affects the outcome of intensive care unit patients in the Jimma Medical Center. The study identifies several factors that independently predict the occurrence of delirium in ICU patients, including obesity, stroke, low oxygen saturation levels, and COPD. Interestingly, our findings suggest that admission for heart failure may have a protective effect against delirium. Therefore, health professionals ought to give special attention to patients with identified predictors.

Asaminew Habtamu

Taye Mezgebu

Abdata Workina

Bulcha Lemma

Feyissa Tolessa

Edmialem Getahun

Adebabay Wondimagegn

Achalu Kelbessa

Fikadu Abebe

Incidence and predictors of delirium among the intensive care unit patients at Jimma Medical Center, Southwest Ethiopia

埃塞俄比亚西南部吉马医疗中心重症监护病房患者谵妄发生率及预测因素

Objective: Road traffic injuries (RTIs) have been recognized globally as an important public health problem. Effective road safety initiatives should address the traffic system as a whole to find a solution and look at the traffic system as a collective to discuss interactions between vehicles, road users and road infrastructure. Therefore, epidemiological data from different geographies of the country should be available. Hence, an electronic-based comprehensive and integrated RTI surveillance system was established in five centres located across the country to assess the burden of RTIs, including the outcome. Methods: This paper is a cross-sectional multi-centric study conducted using an electronic-based comprehensive and integrated RTI surveillance system. Results: A total of 15,319 participants were enrolled under the surveillance of road traffic events for a period of one year. Self-fall/skid was the most common (34.87%) type of accident, followed by a crash between two vehicles (25.77%) and a crash with a pedestrian (16.59%). Among them, 88.94% were the injured, who were alive with or without rehabilitation, and 673 (4.43%) were dead. Mostly, two-wheelers (geared or non-geared) were involved in the accident as they shared a significant portion (75.54%) of the total accidents. Conclusion: The study highlights the epidemiological issues related to road accidents and RTIs that need to be addressed in order to find appropriate solutions for reducing the RTI burden. It gives an understanding of the manner of trauma, the pattern of injuries, and the outcome of road traffic accidents required to adopt efficient preventive and comprehensive trauma care.

Yogita Sharma

Ponnaiah Manickam

Kamalabai R. John

Jugal Kishore

Daya K. Mangal

Rajesh Singh

Ashish Joshi

Bontha V. Babu

Road traffic accidents and injuries, 2018: a multi-centric epidemiological study from India

2018年道路交通事故与伤害：来自印度的多中心流行病学研究

Abbreviation
Journal Impact	1.27
Quartiles(Global)	EMERGENCY MEDICINE(Q3)

Publication Information	Publisher: Tehran University of Medical Sciences，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2021，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate: 0.00

Frontiers in Emergency Medicine

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A case of faecopneumothorax resulting from a delayed diagnosis of traumatic diaphragmatic injury

Love protects us; we should take care of it

Comparison of infusion of dexmedetomedine and magnesium sulfate on the stability of hemodynamic status during emergency orthopedic surgery: a randomized double-blind clinical trial

Incidence and predictors of delirium among the intensive care unit patients at Jimma Medical Center, Southwest Ethiopia

Road traffic accidents and injuries, 2018: a multi-centric epidemiological study from India

A case of faecopneumothorax resulting from a delayed diagnosis of traumatic diaphragmatic injury

Love protects us; we should take care of it

Comparison of infusion of dexmedetomedine and magnesium sulfate on the stability of hemodynamic status during emergency orthopedic surgery: a randomized double-blind clinical trial

Incidence and predictors of delirium among the intensive care unit patients at Jimma Medical Center, Southwest Ethiopia

Road traffic accidents and injuries, 2018: a multi-centric epidemiological study from India

ISSN	2717-3593
h-index	7