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.     

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. ?     

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.     

Profile of Hospital Admissions due to Self‐Inflicted Harm in Los Angeles County from 2001 to 2010

We aimed to describe the demographic profile of self‐inflicted harm (SIH) in Los Angeles County between 2001 and 2010 and to investigate trends over this 10‐year period. We used the California Hospital Discharge Data to investigate all cases of hospital admission due to SIH, including suicide attempts and if they had a concurrent psychiatric diagnosis based on ICD‐9 codes. African‐Americans (AA) had the highest 10‐year SIH admission rates. SIH admission rates remained steady throughout the 10‐year study period. Median age of SIH was significantly lower in Latinos. Episodic mood disorders were the most common psychiatric comorbidity. The use of solid/liquid poisoning was the most common SIH method among all racial/ethnic groups. We found major disparities in SIH admissions across racial/ethnic subgroups. The importance of programs to identify, prevent, and treat SIH in these groups is discussed.