Ventricular septal necrosis after blunt chest trauma

Ventricular Septal Defect (VSD) after blunt chest trauma is a very rare traumatic affection. We report here a case of blunt chest injury-related VSD and pseudoaneurysm. A 30-year old male truck driver was referred from a trauma center to our hospital seven days after a blunt chest trauma and rib fracture. The patient had severe pulmonary edema and echocardiography showed large VSD. Several mechanisms are involved in the pathogenesis of this affection including an acute compression of the heart muscle between the sternum and the spine, leading to excessive changes in the intrathoracic and most likely the intracardiac pressure after blunt chest injury. Traumatical patients with the same symptoms may be at risk of sudden death. Therefore, a high grade of suspicion is mandatory even without solid evidence of myocardial damage on the initial evaluation. In continue some hidden angles of this case was discussed. Given the prognostic implications of traumatic VSD with associated pseudoaneurysm, its detection has critical value for preventing its clinical sequelae.     

Oxytocin and the Biological Basis for Interpersonal and Political Trust

Political scientists have documented the many ways in which trust influences attitudes and behaviors that are important for the legitimacy and stability of democratic political systems. They have also explored the social, economic, and political factors that tend to increase levels of trust in others, in political figures, and in government. Neuroeconomic studies have shown that the neuroactive hormone oxytocin, a peptide that plays a key role in social attachment and affiliation in non-human mammals, is associated with trust and reciprocity in humans (e.g., Kosfeld et al., Nature 435:673–676, 2005; Zak et al., Horm Beh 48:522–527, 2005). While oxytocin has been linked to indicators of interpersonal trust, we do not know if it extends to trust in government actors and institutions. In order to explore these relationships, we conducted an experiment in which subjects were randomly assigned to receive a placebo or 40 IU of oxytocin administered intranasally. We show that manipulating oxytocin increases individuals’ interpersonal trust. It also has effects on trust in political figures and in government, though only for certain partisan groups and for those low in levels of interpersonal trust.     

Traumatic injuries in pregnant women: a case of motor vehicle accident for "Ground Round" discussion

The main objective for introducing this case study is to create a platform from which the importance of road traffic related injuries and traumas can be emphasized and discussed within and across various fields of investigation. The long term goal is to entice public campaign around unmet needs for higher road safety measures to reduce primary, secondary, and tertiary risks of injuries and traumas. CASE: a 28-year-old pregnant woman with a 16-week gestational age fetus was involved in a road car crash resulting in multiple traumas. Evaluation and treatment was initiated in the local Urgent Care Unit and continued in the emergency department and operation room. Patient underwent the following procedures: laparotomy, diverting colostomy, terminating pregnancy, right calcaneal traction and long leg splint, as well as multiple irrigation-debridements. Finally, the wound was left open and the patient was admitted to Intensive Care Unit. We hope that the introduction of this case for a "Ground Round" discussion will stir up a comprehensive discussion regarding the injury and trauma related preventive measures as well as treatment approaches in cases involving pregnant women in car accidents, and will bring about a holistic overview of this issue by the experts in various fields. ?     

Expert Consensus on Factors Reducing Policy Coherence in the Context of Iran: Delphi-AHP

A web of public policies needs to display coherence to achieve their superior goal-improving quality of people’s live. Policy coherence (PC) ideally means policies with no contradictory effects. This article addresses complex issue of PC bottlenecks in general and in Iran in particular. In the first stage, Delphi Technique is used to identify factors reducing PC. A panel of experts reached on consensus on factors that are categorized in nine groups. In the second stage, the experts determined relative weightings of identified factor based on analytic hierarchy process (AHP). This article is focused on the more important factors. These Findings may be useful for other developing countries and developed countries.     

The puzzle of populism in Iran’s electoral politics

The article examines the impact of an unsettled electoral market and evolving political predispositions on the rise and fall of populism in Iran. The article argues that the absence of a polarized electoral contest between reformists and conservatives paved the way for the victory of the populist candidate in the 2005 presidential election in Iran, while the deep economic recession resulting from conservative administration policies created a long-term political experience which influenced voters and led to the victory of the pragmatist candidate in the 2013 and 2017 elections. Quantitative analysis indicates that in the 2005 election, the struggle between conservatives and reformists did not impact the competition between candidates, and consequently depoliticized attitudes, for example distributive demands, ideology, and anti-ruling elite sentiment gained significance, whereas polarization between conservatives and a coalition of reformists and pragmatists enhanced the role of partisanship and triggered the fall of populism in the 2013 election.