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Preoperative clinical and paraclinical predictors of choledocholithiasis

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Hepatobiliary & Pancreatic Diseases International 2008年第3期7卷 304-307页

作者： Ali Yaghoobi Notash javad salimi Farzaneh Golfam Gholamreza Habibi Kamyab Alizadeh Medical Sciences/University of Tehran Tehran Iran Department of Surgery Medical Sciences/University of Tehran TehranIran

BACKGROUND:Choledocholithiasis is the most common cause of obstructive jaundice and cholangitis and occurs in about 10%of patients with symptomatic *** aim of this study was to find preoperative and non-invasive tests for predicting common bile duct stones(CBDs). METHODS:Findings of clinical examination,history laboratory tests and ultrasound(US)in 60 patients with CBDs were compared retrospectively,with 60 patients with *** data were collected from medical charts The sensitivity,specificity and positive predictive value (PPV)were determined. RESULTS:The comparison between the two groups showed significant differences in anorexia,itching,dark urine subicterus(slightly elevated serum bilirubin without clinical evidence of jaundice)and jaundice appearance increased bilirubin level,aspartate aminotransferase(AST) and alanine aminotranferase(ALT),CBD diameter>6 mm and stone observation under US(P<0.05).The highest specificity(100%)and PPV(100%)were found in dark urine and pale colored stool,history of cholangitis,and *** paraclinical tests,alkaline phosphatase (ALP)had the highest specificity(72.1%)and PPV(12.5%) Under US,stone observation in CBD was the most important factor with a sensitivity of 94.5%,a specificity of 100%and a PPV of 100%. CONCLUSIONS:The most important factors for predicting CBDs are history of cholangitis and pancreatitis,presence of icterus,dark urine,pale colored stool,elevation of ALP and sonographic evidence of chledocholithiasis.

关键词： choledocholithiasis gallstone predicting factor diagnosis

Analysis of 274 patients with extremity injuries caused by the Bam earthquake

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Chinese Journal of Traumatology 2009年第1期12卷 -页

作者： javad salimi Maryam Abbasi Ali Khaji Moosa Zargar Sina Trauma & Surgery Research Center Tehran University of Medical Sciences Tehran Iran

Objective: The extremity injury pattern after a major earthquake is not well understood because data on this type of injury and management are limited. The aim of this study was to analyze the data of trauma patients with ex-tremity injury in the earthquake of Barn Iran, registering 6.6 on the Richter ***: We reviewed medical records of 486 patients admitted to hospitals of Tehran University of Medical Sciences. Among them, 274 patients sustained extremity injuries. This group was composed of 138 females (50.4%) and 136 males (49.6%) and 213 cases (77.7%) were under 40 years of ***: Fracture was the major type of injury (58.4% of extremity injuries). The most common sites of injury were lower extremities (185 patients, 67.5% of all victims). Pelvic & rib fractures and abdominal injuries were the most fre-quently associated injuries. The mean ISS was 6.2±4.0, and 61% of the patients had ISS≤7. Amputation and death occurred in 2.9% and 2.5% of cases, ***: Special attention should be given to deal-ing with orthopedic injuries in similar disasters in the future.

关键词： Natural disasters Wounds and injuries Extremities

Hospital management of abdominal trauma in Tehran, Iran: a review of 228 patients

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Chinese Journal of Traumatology 2009年第5期12卷 -页

作者： javad salimi Mohammad Ghodsi Maryam Nassaji Zavvarh Ali Khaji Sina Trauma & Surgery Research Center Tehran University of Medical Sciences Tehran 11364 Iran

Objective: Today, trauma is a major public health problem in some countries. Abdominal trauma is the source of significant mortality and morbidity with both blunt and penetrating injuries. We performed an epidemiological study of abdominal trauma (AT) in Tehran, Iran. We used all our sources to describe the epidemiology and outcome of patients with ***: This study was done in Tehran. The study population included trauma patients admitted to the emergency department of six general hospitals in Tehran during one year. The data were collected through a questionnaire that was completed by a trained physician at the trauma center. The statistical analysis was performed using the SPSS software (version 11.5 for Windows). The statistical analysis was conducted using the chi-square and P＜0.05 was accepted as being statistically ***: Two hundred and twenty-eight (2.8%) out of 8 000 patients were referred to the above mentioned centers with abdominal trauma. One hundred and twenty-five (54.9%)of the patients were in their 2nd and 3rd decades of life and 189 (83%) of our patients were male. Road traffic accidents (RTA) were the leading cause of AT with 119 (52.2%) patients. Spleen was the commonly injured organ with 51 cases. Following the analysis of injury severity, 159 (69.7%) patients had mild injuries (ISS＜16) and 69 (30.3%) patients had severe injuries (ISS= 16). The overall mortality rate was 46 (20.2%).Conclusions: Blunt abdominal trauma is more common than penetrating abdominal trauma. Road traffic accidents and stab wound are the most common causes of blunt and penetrating trauma, respectively. Spleen is the most commonly injured organ in these patients. The mortality rate is higher in blunt trauma than penetrating one.

关键词： Wounds and injuries Mortality Abdominal injuries

Diagnostic accuracy of CT scan in abdominal blunt trauma

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Chinese Journal of Traumatology 2009年第2期12卷 67-70页

作者： javad salimi Khadyjeh Bakhtavar Mehdi Solimani Patricia Khashayar Aft Pasha Meysamie Moosa Zargar Sina Trauma & Surgery Research Center Sina Hospital Medical Sciences/University of Tehran TehranIran Sina Hospital Medical Sciences/University of TehranTehran Iran Research and Development Center Sina HospitalMedical Sciences/ University of Tehran Tehran Iran Medical Sciences/University of Tehran Tehran Iran

Objective： To evaluate the sensitivity and specificity of CT scan findings in patients with blunt abdominal trauma admitted to the university hospital. Methods： All the patients with blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study. In the absence of any clinical manifestations, the patients underwent a diagnostic CT scan. Laparatomy was performed in those with positive CT results. Others were observed for 48 hours and discharged in case no problem was reported; otherwise they underwent laparatomy. Information on patients＇ demographic data, mechanism of trauma, indication for CT scan, CT scan findings, results of laparotomy were gathered. The sensitivity, specificity and accuracy of the CT-scan images in regard with the organ injured were calculated. The sensitivity, specificity and accuracy of the CT scan were calculated in each case. Results： CT scan had the highest sensitivity for detecting the injuries to liver （100%） and spleen （86.6%）. The specificity of the method for detecting retroperitoneal hematoma （100%） and injuries to kidney （93.5%） was higher than other organs. The accuracy of CT images to detect the injuries to spleen, liver, kidney and retroperitoneal hematoma was reported to be 96.1%, 94.4%, 91.6% and 91.6% respectively. Conclusion： The findings of the present study reveal that CT scan could be considered as a good choice, especially for patients with blunt abdominal trauma in teaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.

关键词： Wounds, nonpenetrating Abdominalinjuries Tomography, X-ray computed Diagnosis

Applying Finite Difference Method to Simulate the Performance of a Perforated Breakwater Under Regular Waves

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Journal of Marine Science and Application 2019年第3期18卷 314-324页

作者： javad Mohammadbagheri Fouad salimi Maryam Rahbani Department of Civil Engineering Amirkabir UniversityTehran 1134Iran Department of Engineering University of HormozganBandar Abbas 79131Iran Department of Marine Science and Technology University of HormozganBandar Abbas 79131Iran

Using a discretized finite difference method, a numerical model was developed to study the interaction of regular waves with a perforated breakwater. Considering a non-viscous, non-rotational fluid, the governing equations of Laplacian velocity potential were developed, and specific conditions for every single boundary were defined. The final developed model was evaluated based on an existing experimental result. The evaluated model was used to simulate the condition for various wave periods from 0.6 to 2 s. The reflection coefficient and transmission coefficient of waves were examined with different breakwater porosities, wave steepnesses, and angular frequencies. The results show that the developed model can suitably present the effect of the structural and hydraulic parameters on the reflection and transmission coefficients. It was also found that with the increase in wave steepness, the reflection coefficient increased logarithmically, while the transmission coefficient decreased logarithmically.

关键词： Perforated breakwater Transmission coefficient Reflection coefficient Numerical model Finite difference method Regular waves