In the response phase the most important step is to assess disaster after occurrence. By disaster ASSESSMENT, we can obtain all the needed information for controlling, decision-making and also disaster planning. Lack of disaster ASSESSMENT causes you to make unsuitable decisions based on limited or inadequate data which leads to imperfect disaster response. According to IFRC, disaster response operation will have an unsuitable function without disaster ASSESSMENT. This paper presents the principles and concepts of disaster ASSESSMENT.

Background: The Single ASSESSMENT Numeric Evaluation (SANE) is a simple, one-question PATIENT-reported OUTCOME measure (PROM). We systematically reviewed correlations between SANE and more extensive PROMs. Methods: We identified studies with correlation coefficients between SANE and other shoulder, knee, and anklespecific PROMs. We calculated mean, median and range across studies and time points of data collection. Results: Eleven studies provided 14 correlations, six shoulder-specific PROMs in four studies, six knee-specific PROMs in six studies and two ankle specific PROMs in one study. The mean correlation comparing SANE and knee-specific PROMs was 0. 60 (SD 0. 24), median 0. 66, and range 0. 12 to 0. 88. Among studies comparing SANE and shoulderspecific PROMs mean correlation was 0. 59 (SD 0. 20), median 0. 62 and range 0. 20 to 0. 89. The mean correlation between SANE and ankle-specific PROMs was 0. 69 (SD 0. 17), median 0. 69 and range 0. 75 to 0. 81. Conclusion: There seems to be moderate correlation amongst PROMs, even those that are a single question. Future research might address whether PATIENT reported OUTCOME measure a common underlying construct even when they consist of a single question.

Background: It is generally accepted that total knee arthroplasty (TKA) after high tibial osteotomy (HTO) is technically more difficult; however, there is still disagreement whether the subsequent arthroplasty is compromised. Objectives: The current case series study aimed to assess PATIENTs treated by knee arthroplasty after a previous high tibial osteotomyand to determine the influence of this osteotomy on the clinical and radiologic OUTCOMEs of subsequent arthroplasty. Methods: Up to April 2013, twenty-three PATIENTs with a history of twenty-five proximal tibial osteotomies prior to TKA were identifiedand compared with a matched group who underwent primary TKA in Shafa Orthopedic Hospital, Tehran, Iran. Demographicparameters of PATIENTs, surgical details, the knee range of motion (ROM), and American functional knee society (AKS) scores beforeand after TKA were recorded in the HTO and control groups. Weight bearing alignment radiographs were taken preoperatively andat the last follow-up. At the latest visit, PATIENTs’ satisfaction was recorded. Results: After an average of 49 months follow-up, all PATIENTs in the HTO and control groups were satisfied with their current levelof function. In the HTO group, the rectus snip had to be used for better exposure in eight cases. There was no statistically significantdifference between the two groups in postoperative knee ROM, mechanical leg alignment and mean functional knee society score, but the mean of operation time in the HTO group was significantly longer than that of the TKA time in the control group. Conclusion: Although knee arthroplasty after HTO is technically more challenging than a primary procedure, the results of clinicalscores, postoperativeROMand radiological evaluation in the study subjects were comparable with those of the primary TKA in midtermfollow-up. Rectus snip is a safe procedure in such difficult cases for better exposure.

Background: The disease burden of acute ischemic stroke (AIS) is an important health issue in today’, s PATIENT care. Urgent intravenous thrombolytic (UIT) therapy is one of the most popular treatments in these cases. Objectives: This study aimed to evaluate the 1-month OUTCOME of PATIENTs with AIS who received urgent intravenous fibrinolytic therapy. Methods: In a prospective cross-sectional study, we evaluated the 1-month OUTCOME of cases with a confirmed diagnosis of AIS who had received UIT therapy at the emergency department. Demographic data, mortality and morbidity, hospital length of stay, admission functional disability by Modified Rankin Scale (MRS), National Institutes of Health Stroke Scale (NIHSS), and final disposition of PATIENTs were all evaluated and recorded via their medical records or structured telephone inquiries. We compared all variables between the 2 groups (i. e., survived and expired groups). Results: Among 490 cases we assessed, age had a mean, SD of 69. 41, 12. 25 years, and most cases were males (74. 3%). The 1-month mortality rate in our sample was 4. 08% (20 cases). The mean, SD of hospital length of stay was 6. 84, 7. 32 days, with no significant difference between the 2 groups (P = 0. 869). Demographic data showed no significant differences between the 2 groups. NIHSS and MRS scores were significantly higher in the expired group than in the survived group (P = 0. 005 and P = 0. 001, respectively). Conclusions: NIHSS and MRS scores were significantly higher in the expired cases. The 1-month mortality rate in this study was 4. 08%.

Introduction: Admission of PATIENTs with severe National Institutes of health stroke scale (NIHSS Score> 16) or moderate (NIHSS 8 through 16) acute stroks is different. Taking care of stroke PATIENTs admitted in stroke unit care (SCD) is costly.In comparison with admission in general neurology ward, we assessed the OUTCOME of such PATIENTs based on stroke care unit (SCD) versus general neurology ward admission, based on controlling hypertension, diabetes, bed sore, pneumonia, mortality and morbidity.Methods: In this perspective cohort study, 100PATIENTswith moderate or severe stroke according to NIHSS criteria are assessed. Treatment OUTCOME and complications of stroke were evaluated. The PATIENTs were allocated randomly in SCD or general ward and matching was according to age, sex and NIHSS. Blood pressure, blood glucose, evidence of pulmonary infections, bed sore, mortality and duration of admission were assessed. The results were analyzed using SPSS soft ware.Results: There was no significant difference between SCD and general ward in the cases of hypertension control, diabetes control or occurring pneumonia and mortality rate, but incidence of bed sore was significant between two wards with the relative risk of 1.5. The duration of being bedridden was significantly different (P<0.001).Conclusion: This study shows that there are not significant differences in the cares given in the SCD and general neurology ward. Thus, these costs analyzing studies will help physicians deciding to admit PATIENTs with stroke in different wards. Improving quality of care in general wards may be a suitable approach for hospitals to decline extra costs.

Introduction: Some studies have reported creatinine phosphokinase (CPK) as a new emergingway in predicting the OUTCOMEs of poisoned PATIENTs. This study aimed to evaluate the association of serum CPK level in the first 24 hours with OUTCOMEs of poisoned PATIENTs. Methods: This retrospective cross-sectional study was performed using the medical profiles of poisoned PATIENTs aged between 13 and 70 years old who were referred to the emergency department of a big referral medical toxicology center during 6 years and whose necessary data for this study was available. Results: 318 PATIENTs with the mean age of 34. 9§ 14. 5 years were studied (77. 1% male). The mean serum CPK level of PATIENTs was 4693. 1 § 10303. 8 (35– 89480) IU/L. There was no significant correlation between serum CPK level and cause of poisoning (r= 0. 16; p=0. 51), age (r =-0. 021; p = 0. 651), sex (r = 0. 131; p = 0. 281), seizure (r =-0. 022; p = 0. 193), level of consciences (r =-0. 138; p = 0. 167), and duration of hospital stay (r= 0. 242, p = 0. 437). The mean serum CPK level was significantly higher in ICU admitted (p<0. 0001), AKI (p<0. 0001), hyperkalemia (p<0. 0001), hypophosphatemia (p=0. 045), and hypocalcaemia (p=0. 008) cases. The best cut off point of serum CPK level in predicting acute kidney injury (AKI) was estimated to be 10000 IU/L (sensitivity = 83. 8% and specificity = 68. 8%). Conclusion: It seems that CPK could be considered as a candidate tool for screening the intoxicated PATIENTs in need for ICU admission and at risk for AKI.

Introduction: Road traffic injuries (RTI) are among the most important health problems worldwide as they cause more than 1.2 million deaths and 50 million injuries each year. The present study aims to evaluate the OUTCOME and aftermath of RTI in those who were injured and hospitalized due to traffic accidents.Methods: In the present retrospective cohort study with a one-year follow-up, data were extracted from the profiles of the RTI hospitalized PATIENTs. OUTCOME of the PATIENTs was evaluated at the time of discharge and 1-year later including their living state, presence of a disability or complete recovery.Results: 1471 PATIENTs were studied (mean age of 32.8§17.0, 80.3% male).571 (38.8%) had mild disability, 684 (46.5%) moderate disability, and 85 (5.8%) had severe disability at the time of discharge. In the end, 53 (3.6%) died. In the 1-year follow-up, 194 (13.2%) had mild disability, 43 (2.9%) had moderate disability, 9 (0.6%) had severe disability, and 7 (0.5%) were in a vegetative state. Presence of an underlying disease (p=0.03), loss of consciousness for more than 24 hours (p=0.04), spinal injury (p=0.002), presence of multiple trauma (p=0.01), increased ISS (p<0.001), need for ventilator (p<0.001), and organ injuries during hospitalization (p<0.001) are independent factors that increase the risk of poor OUTCOME in RTI PATIENTs.Conclusion: Based on the results of the present study, underlying illnesses, loss of consciousness for more than 24 hours, spinal injury, multiple trauma, increased ISS, need for ventilator, and organ injuries during hospitalization were independent factors that increased the probability of poor OUTCOME in RTI injuries.