---

Background and purpose: Despite growing use of energy-saving lamps or compact fluorescent lamps (CFLs), there are concerns about ultraviolet radiation in their output. In this study, the output of CFLs available in Iranian market in the range of infrared, visible, and ultraviolet were measured and the possibility of hydroxyl radical production by their radiation was evaluated.
Materials and methods: The spectrum and light intensity of 33 CFLs were recorded by a spectrometer and radiometers equipped with special infrared, visible, and ultraviolet sensors. The possibility of hydroxyl radical production by three lamps with highest ultraviolet emission intensity was examined and fluorimetric signal of the terephthalic acid dosimeters was evaluated. Parameters such as luminescence efficiency, spectrum integral and the output percentage of lamps were determined in different areas of the spectrum and compared with photopeak curve of human vision.
Results: In lamps with identical powers, there was no significant difference between the intensity of visible and infrared lights. In ultraviolet radiation, the intensity of daylight CFLs was twice as much as soft white CFLs, which had greater intensity compared to incandescent lights.  The infrared intensity in incandescent lamps is ten times more than CFLs. The chemical dosimetry showed that lamps produced by three manufacturers were able to generate hydroxyl radicals in short distances and during long radiations.
Conclusion: CFLs’ radiation is considered to be safe at more than one meter distance. However, at shorter distances and long exposures, some lamps may cause damage to eyes and skin due to ultraviolet radiation. Therefore, it is recommended to monitor specifications of CFLs released into the market.
 

---

Background and purpose: Acute scrotum syndrome is one of the complaints in emergency departments which has several causes. This study was performed to determine the causes and symptoms of acute scrotal pain in patients attending emergency departments in Mazandaran province, Iran.
Materials and methods: A cross-sectional study was done in all patients with acute scrotum syndrome in emergency departments affiliated to Mazandaran University of Medical Sciences, 2011- 2016. Patients’ medical records (clinical and paraclinical information, and diagnostic and therapeutic procedures) were investigated. Data analysis was done applying Chi- square test and t-test.
Results: The study included 205 patients with a mean age of 34.10±17.34. Patients were diagnosed with testicular torsion (n=60, 29.3%), epididymo-orchitis (n= 63, 30.7%), inguinal hernia (n= 69, 33.7%), varicocele (n=11, 5.4%), and testicular torsion (n=2, 2.1%). In testicular torsion, the pain was most sudden (23.9%) and the duration of symptoms onset and arrival at emergency department was 3.62±4.38 hours. The definitive diagnoses were consistent with ultrasound findings in 91.7% of the cases with testicular torsion, 96.8% of those with epididymis orchitis, 95.7% of patients with hernia, and in 54.5% of cases with varicocele.
Conclusion: Younger age, duration of pain, sudden pain, and cremaster reflex are helpful in differentiating testicular torsion from other causes of acute scrotum syndrome. Ultrasonography of the testis should be immediately performed as the main diagnostic measure for acute scrotum syndrome.
 
 

---

 Background and purpose: Investigation for an accurate, reliable, and non-invasive method for assessing volume responsiveness in septic shock patients is of high priority in the emergency department. Carotid artery Doppler sonography can be easily performed at the bedside. Therefore, this study used carotid Doppler sonographic parameters to determine and evaluate the need for volume in patients with septic shock.
Materials and methods: The present single-center, prospective, observational study was performed on all patients with septic shock admitted to emergency department during the study period. Vital signs, diameter of the inferior vena cava (IVC), and the carotid Doppler peak velocity (CDPV) were evaluated on arrival and two hours after resuscitation. Data description and analysis were done using SPSS.
Results: Forty-four patients enrolled in this study, of which 30 (68.2%) were men. The average age of these patients was 62.55±17.91 years.The findings indicated a statistically significant increase in IVC min (P=0.016), CDPV max (P=0.001), and ΔCDPV (P<0.0001) in patients after two hours of treatment.
Conclusion: Carotid Doppler sonographic parameters can be implemented, as a dynamic criterion, to determine the fluid responsiveness in patients.
 

---

Background and purpose: Trauma to the knee is one of the most common injuries in people, especially young people, and delay in the diagnosis of knee fractures and soft tissue injuries in the knee causes limitation of movement, instability, and constant knee pain. In this research can show the correlation between the initial symptoms of the patients and the need for further procedures. To be able to identify traumatic knee injuries that are not clear in the simple knee radiography and to evaluate the findings of the patients for further procedure.
Materials and methods: This research is an observational study in which all patients who presented with knee trauma during the course of the study were included in the study. All the information of these patients in a form including age, age group and sex, admission and discharge information such as visit date, discharge date, duration of hospitalization, mechanism of trauma, underlying disease, knee pain, limitation of range of motion, hemarthrosis, associate injury, skin abrasion, Inability to walk, history of knee trauma, radiography findings, knee CT findings, MRI findings, arthroscopy findings, Lysholm and Tegner knee score, probable diagnosis in the emergency room, type of treatment the emergency room, duration of hospitalization in the emergency room, discharge from the emergency room, in The hospitalization form of the performed procedures, the time of hospitalization in the ward and the definitive diagnosis were collected, and then 4 weeks after discharge, they were followed up by phone call with referral to the orthopedic clinic, and other diagnostic and therapeutic measures were reviewed in these patients. The information was provided by the project manager without interfering in the patient care process. Quantitative data were expressed as mean and standard deviation and qualitative data were expressed as frequency and percentage. Independent student t-tests were used to evaluate quantitative variables in two groups, and the Chi-Square test and Fisher's exact test were used to evaluate qualitative variables.
Results: During the study period, 177 people were studied. The average age of the patients was 24.21±13.08, of which 138 (76.7%) were men. Most of the injury was caused by traffic accidents. The initial diagnosis in the emergency department had a significant relationship with the definite diagnosis. A statistically significant relationship was seen between MRI findings with knee movement limitation and non-weight bearing. There was a statistically significant relationship between the existence of definitive injury in the knee, limitation of knee movement, lacerations and scratches on the knee, and non-weight bearing. The mechanism of knee injury and laceration, the inability to weight bearing, and the positive findings of X-ray and MRI in the patients who underwent invasive procedures were significantly different from those who received conservative treatment.
Conclusion: Injury mechanisms in patients and clinical symptoms such as knee range of motion limitation and non-weigh bearing and abrasion or laceration of the skin on the knee, despite the lack of findings in the initial investigations in the emergency department, is a high chance of injury to the knee joint and they need further evaluation and follow-up.