Amputations due to landmine and unexploded ordinances in post-war Iran. (65/205)

BACKGROUND: In view of lack of comprehensive data on landmine casualties that lead to amputation in Iran, we conducted this study to determine the pattern and demographic features of landmine explosions that result in amputation of the victims. METHODS: To define the pattern of landmine- and unexploded ordinances-induced amputations and to understand the most common types of underlying activities at the time of the blast, a retrospective study was conducted among the victims in 5 western provinces of Iran, West Azerbaijan, Kermanshah, Kurdistan, Ilam, and Khuzestan between 1988 and 2003. RESULTS: Of a total of 3713 victims, 1499 had undergone amputations. The mean age of the victims at the time of accident was 23 years; 92% of the victims were male, 48.4% of them were of very poor education and all were civilians. Below knee amputation was the commonest type of amputation. CONCLUSION: The occurrence of lower limb amputations from landmine injuries in Iran is a significant burden on the healthcare system; rendering allocation of more resources to provide preventative and rehabilitation measures is therefore a must.  (+info)

Battlefield brain: unexplained symptoms and blast-related mild traumatic brain injury. (66/205)

A 40-year-old male military Veteran* presents to a family physician with chronic symptoms that include recurrent headaches, dizziness, depression, memory problems, difficulty sleeping, and relationship troubles. He has not had a family physician since leaving the military 2 years ago. His Military Occupation Classification had been infantry. He explains that he had been deployed to war zones and that during a firefight several years earlier an enemy weapon exploded nearby, killing a fellow soldier and wounding others. He does not recall being injured, but remembers feeling a thump and that his "computer had to reboot." This was followed by headaches and a few days of ringing in his ears. He also suffered a concussion during a military hockey game. He was assessed and treated for persistent headaches in the service and recalls that results of a head computed tomography scan were negative. Veterans Affairs Canada (VAC) granted him a disability award for posttraumatic headache and provided certain treatment benefits. He took medication for the headaches. Following transition to civilian life he had difficulty holding jobs, but had been reluctant to seek help. He saw stories on television about blast-induced minor traumatic brain injury in Iraq and Afghanistan, and wonders if he "has MTBI." Findings from his physical examination, bloodwork, and Mini Mental State Examination are normal, but his Montreal Cognitive Assessment score is 24, suggesting possible cognitive impairment. The physician organizes follow-up appointments and a neurology consultation. After reading about Canada's military-aware operational stress injury (OSI) clinics in a medical journal, he refers the Veteran to a VAC district office for access to mental health assessment.  (+info)

Blast injury: lessons learned from an autopsy. (67/205)

Blast injury is becoming more common in the non-military population but it is still rare to see such injuries and deaths unrelated to terrorist acts. The exact mechanisms involved in blast injuries are unclear. Civilian physicians and surgeons need to have a basic understanding of the patho-mechanics and physiological effects of blast injuries. We report a case where a 31-year-old male accidentally detonated a diesel storage tank. His autopsy findings provide useful information for those who investigate explosive-related deaths.  (+info)

Quality of medical care provided to service members with combat-related limb amputations: report of patient satisfaction. (68/205)

A group of 158 service members who sustained major limb amputations during the global war on terrorism were surveyed on their satisfaction with the quality of care received from the Walter Reed Army Medical Center (WRAMC) Amputee Clinic from the time of their injury to their inpatient discharge. Of these participants, 96% were male, 77% were Caucasian, 89% were enlisted personnel, and 68% had sustained lower-limb amputations. WRAMC inpatient therapy, peer visitors, overall medical care, and pain management received particularly high satisfaction ratings. Age, race, rank, and level and side of amputation had little effect on overall satisfaction ratings. Significant differences, however, were found by location of injury (Iraq vs Afghanistan, Cuba, and Africa) regarding satisfaction with care received while in Europe and with the education process at WRAMC. Study findings strongly support the rehabilitation-based, integrative care approach designed by the U.S. military to care for service members with amputations.  (+info)

Bomb blast mass casualty incidents: initial triage and management of injuries. (69/205)

Bomb blast injuries are no longer confined to battlefields. With the ever present threat of terrorism, we should always be prepared for bomb blasts. Bomb blast injuries tend to affect air-containing organs more, as the blast wave tends to exert a shearing force on air-tissue interfaces. Commonly-injured organs include the tympanic membranes, the sinuses, the lungs and the bowel. Of these, blast lung injury is the most challenging to treat. The clinical picture is a mix of acute respiratory distress syndrome and air embolism, and the institution of positive pressure ventilation in the presence of low venous pressures could cause systemic arterial air embolism. The presence of a tympanic membrane perforation is not a reliable indicator of the presence of a blast injury in the other air-containing organs elsewhere. Radiological imaging of the head, chest and abdomen help with the early identification of blast lung injury, head injury, abdominal injury, eye and sinus injuries, as well as any penetration by foreign bodies. In addition, it must be borne in mind that bomb blasts could also be used to disperse radiological and chemical agents.  (+info)

In-vitro approaches for studying blast-induced traumatic brain injury. (70/205)

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Blast-related brain injury: imaging for clinical and research applications: report of the 2008 st. Louis workshop. (71/205)

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Pericardial tamponade consequent to a dynamite explosion: blast overpressure injury without penetrating trauma. (72/205)

Acute cardiac tamponade is a life-threatening emergency that requires prompt treatment by either percutaneous or surgical pericardiocentesis. It may occur after penetrating or blunt chest trauma. We report a case of pericardial tamponade in the absence of penetrating trauma, due to blast overpressure injury after a dynamite explosion-which has not, to our knowledge, been reported before. Physicians should be aware of the possibility of pericardial tamponade in victims of barotraumatic events such as dynamite or bomb explosions, even in the absence of penetrating trauma. Cardiac tamponade, although life-threatening, is easy to treat when recognized.  (+info)