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El-Menyar A.,Cornell College | El-Menyar A.,Clinical Research | Mekkodathil A.,Clinical Research | Al-Thani H.,Trauma Surgery Section
Journal of Emergencies, Trauma and Shock | Year: 2016

Diabetes mellitus (DM) is associated with increased in-hospital morbidity and mortality in patients sustained traumatic injuries. Identification of risk factors of traumatic injuries that lead to hospital admissions and death in DM patients is crucial to set effective preventive strategies. We aimed to conduct a traditional narrative literature review to describe the role of hypoglycemia as a risk factor of driving and fall-related traumatic injuries. DM poses significant burden as a risk factor and predictor of worse outcomes in traumatic injuries. Although there is no consensus on the impact and clear hazards of hyperglycemia in comparison to the hypoglycemia, both extremes of DM need to be carefully addressed and taken into consideration for proper management. Moreover, physicians, patients, and concerned authorities should be aware of all these potential hazards to share and establish the right management plans. © 2016 Journal of Emergencies, Trauma, and Shock Published by Wolters Kluwer-Medknow.

Abdulrahman Y.,Trauma Surgery Section | Musthafa S.,HGH | Hakim S.Y.,Trauma Surgery Section | Nabir S.,HGH | And 9 more authors.
World Journal of Surgery | Year: 2015

Introduction The clinical significance of extended Focused Assessment with Sonography for Trauma (EFAST) for diagnosis of pneumothorax is not well defined. Objectives To investigate the utility of EFAST in blunt chest trauma (BCT) patients. Study design A single blinded, prospective study. Participants: All patients admitted with BCT (2011-2013). Settings Level 1 trauma center in Qatar. Procedures and outcome measures Patients were screened by EFAST and results were compared to the clinical examination (CE) and chest X-ray (CXR). Chest-computed tomography (CT) scoring system was used to confirm and measure the pneumothorax. Diagnostic accuracy of diagnostic modalities of pneumothorax was measured using sensitivity, specificity, predictive values (PVs), and likelihood ratio. Results A total of 305 BCT patients were included with median age of 34 (18-75). Chest CT was positive for pneumothorax in 75 (24.6%) cases; of which 11% had bilateral pneumothorax. Chest CT confirmed the diagnosis of pneumothorax in 43, 41, and 11% of those who were initially diagnosed by EFAST, CE, and CXR, respectively. EFAST was positive in 42 hemithoraces and its sensitivity (43%) was higher in comparison to CXR (11%). Positive and negative PVs of EFAST were 76 and 92%, respectively. The frequency of missed cases by CXR was higher in comparison to EFAST and CE. The lowest median score of missed pneumothorax was observed by EFAST. Conclusion EFAST can be used as an efficient triaging tool in BCT patients to rule out pneumothorax. Based on our analysis, we would recommend EFAST as an adjunct in ATLS algorithm. © Socié té Internationale de Chirurgie 2014.

Al-Thani H.,Trauma Surgery Section | El-Menyar A.,Clinical Research | El-Menyar A.,Cornell College | Latifi R.,Trauma Surgery Section | And 2 more authors.
North American Journal of Medical Sciences | Year: 2014

Background: The impact of prehospital intubation (PHI) in improving outcome of trauma patients has not been adequately evaluated in the developing countries. Aims: The present study analyzed the outcome of PHI versus emergency room intubation (ERI) among trauma patients in Qatar. Materials and Methods: Data were retrospectively reviewed for all intubated trauma patients between 2010 and 2011. Patients were classifi ed according to location of intubation (PHI: Group-1 versus ERI: Group-2). Data were analyzed and compared. Results: Out of 570 intubated patients; 482 patients (239 in group-1 and 243 in group-2) met the inclusion criteria with a mean age of 32 ± 14.6 years Head injury (P = 0.003) and multiple trauma (P = 0.004) were more prevalent in group-1, whereas solid organ injury predominated in group-2 (P = 0.02). Group-1 had signifi cantly higher mean injury severity scoring (ISS), lower Glasgow coma scale (GCS), greater head abbreviated injury score and longer activation, response, scene and total emergency medical services times. The mortality was higher in group-1 (53% vs. 18.5%; P = 0.001). Multivariate analysis showed that GCS [odds ratio (OR) 0.78, P = 0.005) and ISS (OR 1.12, P = 0.001) were independent predictors of mortality Conclusions: PHI is associated with high mortality when compared with ERI. However, selection bias cannot be ruled out and therefore, PHI needs further critical assessment in Qatar.

Peralta R.,Trauma Surgery Section | Latifi R.,Trauma Surgery Section | Latifi R.,University of Arizona
World Journal of Surgery | Year: 2012

Introduction: Advances in the acute management of the severely injured and critically ill patients have had a significant impact in survival and have increased our exposure to complex repair of large abdominal wall defects. The purpose of this article was to review the long-term (5-year or greater) outcomes of reconstruction of abdominal wall defects and the different modalities and materials currently available in the management of this challenging clinical condition. Methods: A review of published literature. Results: Our review of literature, in English language from 1984 to May 2011, identified six studies. The minimum average follow-up of the studies examined was 63 months. The hernia recurrence rate ranged from 1.1 to 16% at 5 years. A 10-year cumulative recurrence rate of 63% has been reported for suture repair and a 32% for prosthetic repair in incisional hernia. Conclusions: There is a need for long-term studies of complex abdominal wall reconstruction, using biologic prosthetics mesh. © 2012 Société Internationale de Chirurgie.

El-Menyar A.,Clinical Research | El-Menyar A.,Cornell University | El-Hennawy H.,Trauma Surgery Section | Al-Thani H.,Trauma Surgery Section | And 7 more authors.
Journal of Trauma Management and Outcomes | Year: 2014

Background: Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported.Aim: To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women.Methods: We conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words " trauma" , " gender" , " female" and " women" .Results: Among 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported.Conclusion: There is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs. © 2014 El-Menyar et al.; licensee BioMed Central Ltd.

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