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ABSTRACT: On January 9, 2011 Iran Air Flight 277 crashed during approach to Urmia, Iran. Out of 105 passengers, 27 survived. This brief report presents a perspective of the passengers' sustained injuries.
We reviewed the recorded injuries of all passengers as provided by the Legal Medicine Organization authorities. The Injury Severity Score (ISS), an anatomical scoring system, was used to provide an overall code for those who survived with multiple anatomical injuries.
There were a total of 96 ISS body region injuries among those who survived. Facial injuries (83%) were the most frequent injuries noted among fatalities, which was statistically significant (P = 0.000). In those who survived, injuries to the head and neck (37%) and facial (33%) regions were relatively less frequent than other anatomical regions. The most serious injuries among survivors belonged to the extremity (85%) region, particularly lower limb fractures (62%). Differences in extremity injuries between the survivors and fatalities were not statistically significant.
The findings of this study were similar to other studies where the most frequent serious injuries were fractures of the extremities, particularly the lower limbs.
Archives of Iranian medicine 05/2012; 15(5):317-9. · 0.97 Impact Factor
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ABSTRACT: During a cross-sectional study, patients who were admitted to the orthopedic department of the Urmia University of Medical Sciences were asked about opium/opioid abuse. Demographic characteristics, the pattern of consumption, the substance, the duration of the use, the duration of hospital stay and the cause of their injuries were recorded. Among 2,867 patients, 74 (2.5%) patients (71 men and 3 women) with the mean age of 38 were opium/opioid users. Most of the patients used opium through inhalation. The mean duration of the substance use was 7.4 years. The mean duration of hospital stay between the regular orthopedic patients and the opium/opioid abuser orthopedic patients was statistically significant. (P=000). Among four Hepatitis C Virus (HCV) infected patients, three subjects were injection users and Human Immunodeficiency Virus (HIV) also infected two of them. Road traffic accidents (37.8%), and work related injuries (17.5%) were the two most common reasons for the patient's injuries.
Acta medica Iranica 01/2012; 50(1):66-9.
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ABSTRACT: This report presents the "penumbra sign" of a Brodie's abscess in a 69-year-old male patient. The lesion was located in the proximal metaphysis of the left tibia. Histopathology confirmed the diagnosis of subacute osteomyelitis. The penumbra sign on magnetic resonance (MR) images is a helpful sign for the diagnosis of Brodie's abscess.
Iranian Journal of Radiology 12/2011; 8(4):245-248. · 0.05 Impact Factor
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ABSTRACT: This report presents the “penumbra sign” of a Brodie’s abscess in a 69-year-old male patient.
The lesion was located in the proximal metaphysis of the left tibia. Histopathology
confirmed the diagnosis of subacute osteomyelitis. The penumbra sign on magnetic
resonance (MR) images is a helpful sign for the diagnosis of Brodie’s abscess.
Iranian Journal of Radiology 12/2011; 8(4-4). · 0.05 Impact Factor
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The Journal of hand surgery 10/2011; 36(10):1681-2. · 1.33 Impact Factor
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Ahmadreza Afshar
The Journal of hand surgery, European volume. 09/2011; 36(9):821-2.
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Ahmadreza Afshar
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ABSTRACT: Avicenna contributed to development in many fields of medicine. The Canon of Medicine is the masterpiece of Avicenna's medical books in which he wrote on the anatomy of the upper extremity, fractures, dislocations, and nerve and tendon injuries. Reviewing these subjects pertinent to hand disorders reveals Avicenna's concepts about hand disorders a millennium ago.
The Journal of hand surgery 07/2011; 36(9):1509-14. · 1.33 Impact Factor
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Ahmadreza Afshar
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ABSTRACT: This manuscript offers a brief review of the orthopedic subjects in the Canon of Medicine. Highlights include, but are not limited to, the anatomy of the musculoskeletal system, fractures and dislocations, nerve and tendon injuries, different types of wounds and ulcers, and bone infections. Some of the concepts regarding musculoskeletal disorders remain relevant to current orthopedic knowledge. Reviewing the orthopedic subjects in the Canon of Medicine reveals that Avicenna has made a significant contribution to the evolution of orthopedic knowledge.
Archives of Iranian medicine 03/2011; 14(2):157-9. · 0.97 Impact Factor
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Ahmadreza Afshar
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ABSTRACT: The aim of surgical treatment in the early stages of Kienböck's disease is to decrease compressive loading of the lunate to promote revascularization. Capitate shortening osteotomy is one technique that has been advocated in Kienböck's disease with ulnar neutral or positive variance and Lichtman stage I to IIIA. The purpose of this study was to examine the revascularization process of the lunate after capitate shortening osteotomy.
This was a retrospective study of 9 patients with Kienböck's disease with Lichtman stage II or IIIA and ulnar neutral or positive variance. I confirmed avascular necrosis of the lunate in all the patients by magnetic resonance imaging preoperatively. Capitate shortening osteotomy was performed through a dorsal approach and fixed with K-wires. I used magnetic resonance images with fat suppression to detect the revascularization of the lunate after surgery.
The mean follow-up was 12 months (range, 8-16 mo). All patients demonstrated partial revascularization of the lunate and the mean revascularization time was 4.7 months (range, 3-7 mo), which was interpreted as the beginning of the revascularization process.
Capitate shortening osteotomy is an efficient technique to induce the revascularization process in the early stages of Kienböck's disease.
Therapeutic IV.
The Journal of hand surgery 12/2010; 35(12):1943-6. · 1.33 Impact Factor
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ABSTRACT: Carpal tunnel syndrome is a common peripheral entrapment neuropathy. The purpose of this study is to determine whether high resolution ultrasonography can be an alternative diagnostic method to nerve conduction study in grading the severity of carpal tunnel syndrome.
A total of 164 wrists of 82 patients, bilaterally, were enrolled in the study. The cross-sectional area of the median nerve at the carpal tunnel inlet and outlet was measured in all patients with electrophysiologically confirmed carpal tunnel syndrome. All patients had nerve conduction study performed one week before ultrasonography. Then, comparisons between ultrasonography and nerve conduction study were made. The grading severity according to nerve conduction study was used as a gold standard reference.
The mean median nerve cross-sectional area at the tunnel inlet was 11.4±1.7 mm² for the carpal tunnel syndrome affected wrist and 5.78±0.9 mm² for the normal wrist (P<0.001). The mean median nerve cross-sectional area at the tunnel outlet was 9.9±1.2 mm² for the affected wrist with carpal tunnel syndrome and 4.7±0.7 mm² for the normal wrist (P<0.001).The best cutoff value of cross-sectional area at the tunnel inlet and outlet was 8.5 mm². The difference in cross-sectional area of the median nerve in mild, moderate and severe carpal tunnel syndrome was not statistically significant (P=0.2) neither in the carpal tunnel inlet nor outlet.
Based on this study, cross-sectional area of median nerve ultrasonography has a diagnostic value to confirm or exclude carpal tunnel syndrome, but could not be used for grading its severity.
Archives of Iranian medicine 11/2010; 13(6):516-21. · 0.97 Impact Factor
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Ahmadreza Afshar
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ABSTRACT: Many nations are indebted to Avicenna (Ibn-Sina) for their scientific progressions and civilization. Many countries in the Middle East, Africa, and Europe have honored Avicenna, the great Persian scientist, by depicting his vignette on their postage stamps. The symbolic value of Avicenna has been chosen to commemorate scientific occasions, achievements and anniversaries, which represents the ultimate performance of conscious honoring.
Archives of Iranian medicine 09/2010; 13(5):447-53. · 0.97 Impact Factor
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ABSTRACT: Osseous involvement in schwannoma (neurilemmoma) is rare. This report presents a case of intraosseous schwannoma in a child. The lesion was located in the second metacarpal of his right hand and had a soft tissue extension into the first web space.
The Journal of hand surgery 04/2010; 35(5):776-9. · 1.33 Impact Factor
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The Journal of hand surgery, European volume. 02/2010; 35(2):153-4.
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Ahmadreza Afshar
The Journal of hand surgery 01/2010; 35(1):164; author reply 164-5. · 1.33 Impact Factor
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Ahmadreza Afshar
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ABSTRACT: Medical philately provides a useful medium for the study of medical history. There are a handful of Iranian stamps which have been issued with a medical theme. This report briefly reviews the history of Iranian medicine through Iranian commemorative postage stamps. Some notable stamps are presented.
Archives of Iranian medicine 01/2010; 13(2):161-5. · 0.97 Impact Factor
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Ahmadreza Afshar
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ABSTRACT: This report describes a rare case of secondary carpal tunnel syndrome due to a lipofibromatous hamartoma of the median nerve. Excision of the fibrofatty tissue between the nerve fascicles without risking damage to the fascicles was impossible. The transverse carpal ligament was incised and an epineurotomy was performed. Within six months, the 25-year-old female patient's symptoms were much improved.
Archives of Iranian medicine 01/2010; 13(1):45-7. · 0.97 Impact Factor
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ABSTRACT: Background/Objective: Carpal tunnel syndrome (CTS) is a common peripheral entrapment
neuropathy. This study was performed to evaluate whether high-resolution ultrasonography
may be an alternative diagnostic method for nerve conduction study (NCS) in the diagnosis
of carpal tunnel syndrome.
Patients and Methods: 132 wrists of 82 patients and 152 wrists of controls were enrolled in
the study. The cross sectional area of the median nerve was measured at the carpal tunnel
inlet and outlet in all patients and controls. All patients had a nerve conduction study. Then
comparison between ultrasonography and NCS was performed. Combination of clinical diagnosis
and NCS was used as the gold standard.
Results: The mean cross-sectional area (CSA) of the median nerve at the tunnel inlet was
11.4±1.7 mm
2
for the patient group and 5.78 ±0.9 mm
2
for the control group (P<0.001). The
mean cross-sectional area at the tunnel outlet was 9.9±1.2 mm
2
for the patient group and
4.7±0.7 mm
2
for the control group (P<0.001). The best cut-off value of CSA at the tunnel
inlet and the outlet was 7.5 mm
2
.
Conclusion: In patients with clinical diagnosis of CTS we confirmed that the diagnostic value
of ultrasonography is similar to NCS and sonography may be used in primary evaluation of
CTS.
Iranian Journal of Radiology 09/2009; 6(3-3):147-152. · 0.05 Impact Factor
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ABSTRACT: Meniscal injuries are frequently associated with anterior cruciate ligament (ACL) tears. Clinical tests that are useful for detecting meniscal tears may not be valid in this setting. The Thessaly test, a newly described dynamic clinical examination, has been shown to have a very high diagnostic accuracy for detecting meniscal tears. This study evaluates the accuracy of the Thessaly test in patients with combined ACL and meniscus injuries. We examined eighty patients with ACL deficiency for meniscal injuries using the Thessaly test (at 20 degrees of knee flexion), the lateral and medial joint line tenderness tests, and the McMurray test. Examiners were blinded to the MRI report on the conditions of the menisci. All patients underwent arthroscopic ACL reconstruction during which the menisci were evaluated by direct vision and probing. During the Thessaly test, six patients developed severe pain and could not complete the test. Sensitivity, specificity, likelihood ratios and predictive values were calculated for all tests. The Thessaly test had a sensitivity of 79%, specificity of 40%, positive predictive value of 56%, negative predictive value of 66%, positive likelihood ratio of 1.33, negative likelihood ratio of 0.51%, and overall accuracy of 60%. We concluded that the Thesally test has a low specificity in patients with combined ACL and meniscal injuries and can not be recommended as a diagnostic test in this setting.
The Knee 09/2009; 17(3):221-3. · 1.74 Impact Factor
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Ahmadreza Afshar
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ABSTRACT: This report presents a palmaris profundus tendon anomaly in the carpal tunnel. The case was a 19-year-old female who underwent carpal tunnel surgery. After dividing the transverse carpal ligament, the palmaris profundus tendon was discovered. The abnormal tendon was within the carpal tunnel, laying over the investing tissue of the median nerve, and inserted deeply into the palmar aponeurosis. A segment of the abnormal tendon was excised and the patient's symptoms resolved completely.
Archives of Iranian medicine 08/2009; 12(4):415-6. · 0.97 Impact Factor
