Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20

Search results for: shoulder lesions

20 Work-Related Shoulder Lesions and Labor Lawsuits in Brazil: Cross-Sectional Study on Worker Health Actions Developed by Employers

Authors: Reinaldo Biscaro, Luciano R. Ferreira, Leonardo C. Biscaro, Raphael C. Biscaro, Isabela S. Vasconcelos, Laura C. R. Ferreira, Cristiano M. Galhardi, Erica P. Baciuk

Abstract:

Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.

Keywords: Work-related accidents, cross-sectional study, shoulder lesions, labor lawsuits.

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19 Exploiting Global Self Similarity for Head-Shoulder Detection

Authors: Lae-Jeong Park, Jung-Ho Moon

Abstract:

People detection from images has a variety of applications such as video surveillance and driver assistance system, but is still a challenging task and more difficult in crowded environments such as shopping malls in which occlusion of lower parts of human body often occurs. Lack of the full-body information requires more effective features than common features such as HOG. In this paper, new features are introduced that exploits global self-symmetry (GSS) characteristic in head-shoulder patterns. The features encode the similarity or difference of color histograms and oriented gradient histograms between two vertically symmetric blocks. The domain-specific features are rapid to compute from the integral images in Viola-Jones cascade-of-rejecters framework. The proposed features are evaluated with our own head-shoulder dataset that, in part, consists of a well-known INRIA pedestrian dataset. Experimental results show that the GSS features are effective in reduction of false alarmsmarginally and the gradient GSS features are preferred more often than the color GSS ones in the feature selection.

Keywords: Pedestrian detection, cascade of rejecters, feature extraction, self-symmetry, HOG.

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18 Oral Examination: An Important Adjunct to the Diagnosis of Dermatological Disorders

Authors: Sanjay Saraf

Abstract:

The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their   importance in   early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: Vesiculobullous lesions, Desquamative gingivitis, Nikolsky’s sign, Erythema.

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17 Objectivity, Reliability and Validity of the 90º Push-Ups Test Protocol Among Male and Female Students of Sports Science Program

Authors: Ahmad Hashim, Mohd Sani Madon

Abstract:

This study was conducted to determine the objectivity, reliability and validity of the 90º push-ups test protocol among male and female students of Sports Science Program, Faculty of Sports Science and Coaching Sultan Idris University of Education. Samples (n = 300), consisted of males (n = 168) and females (n = 132) students were randomly selected for this study. Researchers tested the 90º push-ups on the sample twice in a single trial, test and re-test protocol in the bench press test. Pearson-Product Moment Correlation method's was used to determine the value of objectivity, reliability and validity testing. The findings showed that the 900 pushups test protocol showed high consistency between the two testers with a value of r = .99. Likewise, The reliability value between test and re-test for the 90º push-ups test for the male (r=.93) and female (r=.93) students was also high. The results showed a correlation between 90º push-ups test and bench press test for boys was r = .64 and girls was r = .28. This finding indicates that the use of the 90º push-ups to test muscular strength and endurance in the upper body of males has a higher validity values than female students.

Keywords: Arm and shoulder girdle strength and endurance, 900 push-ups, bench press

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16 A New Graphical Password: Combination of Recall & Recognition Based Approach

Authors: Md. Asraful Haque, Babbar Imam

Abstract:

Information Security is the most describing problem in present times. To cop up with the security of the information, the passwords were introduced. The alphanumeric passwords are the most popular authentication method and still used up to now. However, text based passwords suffer from various drawbacks such as they are easy to crack through dictionary attacks, brute force attacks, keylogger, social engineering etc. Graphical Password is a good replacement for text password. Psychological studies say that human can remember pictures better than text. So this is the fact that graphical passwords are easy to remember. But at the same time due to this reason most of the graphical passwords are prone to shoulder surfing. In this paper, we have suggested a shoulder-surfing resistant graphical password authentication method. The system is a combination of recognition and pure recall based techniques. Proposed scheme can be useful for smart hand held devices (like smart phones i.e. PDAs, iPod, iPhone, etc) which are more handy and convenient to use than traditional desktop computer systems.

Keywords: Authentication, Graphical Password, Text Password, Information Security, Shoulder-surfing.

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15 Brain MRI Segmentation and Lesions Detection by EM Algorithm

Authors: Mounira Rouaïnia, Mohamed Salah Medjram, Noureddine Doghmane

Abstract:

In Multiple Sclerosis, pathological changes in the brain results in deviations in signal intensity on Magnetic Resonance Images (MRI). Quantitative analysis of these changes and their correlation with clinical finding provides important information for diagnosis. This constitutes the objective of our work. A new approach is developed. After the enhancement of images contrast and the brain extraction by mathematical morphology algorithm, we proceed to the brain segmentation. Our approach is based on building statistical model from data itself, for normal brain MRI and including clustering tissue type. Then we detect signal abnormalities (MS lesions) as a rejection class containing voxels that are not explained by the built model. We validate the method on MR images of Multiple Sclerosis patients by comparing its results with those of human expert segmentation.

Keywords: EM algorithm, Magnetic Resonance Imaging, Mathematical morphology, Markov random model.

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14 Pathomorphological Features of Lungs from Brown Hares Infected with Parasites

Authors: Mariana Panayotova-Pencheva, Anetka Trifonova, Vassilena Dakova

Abstract:

790 lungs from brown hares (Lepus europeus L.) from different regions of Bulgaria were investigated during the period 2009-2017. The parasitological status and pathomorphological features in the lungs were recorded. The following parasite species were established: one nematode - Protostrongylus tauricus (7.59% prevalence), one tapeworm – larva of Taenia pisiformis Cysticercus pisiformis (3.04% prevalence) and one arthropod – larva of Linguatula serrata – Pentastomum dentatum (0.89% prevalence). Macroscopic lesions in the lungs were different depending on the causative agents. The infections with C. pisiformis and P. dentatum were attended with small, mainly superficial changes in the lungs. Protostrongylid infections were connected with different in appearance and burden macroscopic changes. In 77.7%, they were nodular, and in the rest of cases, they diffuse. The consistency of the lesions was compact. In most of the cases, alterations were grey in colour, rarely were dark-red or marble-like. In 91.7% of these cases, they were spread on the apical parts of large lung lobes. In 36.7% middle parts of the large lung lobes, and, in 26.7% small lung lobes, were also affected. The small lung lobes were never independently infected.

Keywords: Cysticercus pisiformis, Lepus europeus, lung lesions, Pentastomum dentatum, Protostrongylus tauricus.

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13 Computer-Aided Classification of Liver Lesions Using Contrasting Features Difference

Authors: Hussein Alahmer, Amr Ahmed

Abstract:

Liver cancer is one of the common diseases that cause the death. Early detection is important to diagnose and reduce the incidence of death. Improvements in medical imaging and image processing techniques have significantly enhanced interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate.  This paper presents an automated CAD system consists of three stages; firstly, automatic liver segmentation and lesion’s detection. Secondly, extracting features. Finally, classifying liver lesions into benign and malignant by using the novel contrasting feature-difference approach. Several types of intensity, texture features are extracted from both; the lesion area and its surrounding normal liver tissue. The difference between the features of both areas is then used as the new lesion descriptors. Machine learning classifiers are then trained on the new descriptors to automatically classify liver lesions into benign or malignant. The experimental results show promising improvements. Moreover, the proposed approach can overcome the problems of varying ranges of intensity and textures between patients, demographics, and imaging devices and settings.

Keywords: CAD system, difference of feature, Fuzzy c means, Liver segmentation.

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12 Massive Lesions Classification using Features based on Morphological Lesion Differences

Authors: U. Bottigli, D.Cascio, F. Fauci, B. Golosio, R. Magro, G.L. Masala, P. Oliva, G. Raso, S.Stumbo

Abstract:

Purpose of this work is the development of an automatic classification system which could be useful for radiologists in the investigation of breast cancer. The software has been designed in the framework of the MAGIC-5 collaboration. In the automatic classification system the suspicious regions with high probability to include a lesion are extracted from the image as regions of interest (ROIs). Each ROI is characterized by some features based on morphological lesion differences. Some classifiers as a Feed Forward Neural Network, a K-Nearest Neighbours and a Support Vector Machine are used to distinguish the pathological records from the healthy ones. The results obtained in terms of sensitivity (percentage of pathological ROIs correctly classified) and specificity (percentage of non-pathological ROIs correctly classified) will be presented through the Receive Operating Characteristic curve (ROC). In particular the best performances are 88% ± 1 of area under ROC curve obtained with the Feed Forward Neural Network.

Keywords: Neural Networks, K-Nearest Neighbours, SupportVector Machine, Computer Aided Diagnosis.

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11 Analysis of DNA-Recognizing Enzyme Interaction using Deaminated Lesions

Authors: Seung Pil Pack

Abstract:

Deaminated lesions were produced via nitrosative oxidation of natural nucleobases; uracul (Ura, U) from cytosine (Cyt, C), hypoxanthine (Hyp, H) from adenine (Ade, A), and xanthine (Xan, X) and oxanine (Oxa, O) from guanine (Gua, G). Such damaged nucleobases may induce mutagenic problems, so that much attentions and efforts have been poured on the revealing of their mechanisms in vivo or in vitro. In this study, we employed these deaminated lesions as useful probes for analysis of DNA-binding/recognizing proteins or enzymes. Since the pyrimidine lesions such as Hyp, Oxa and Xan are employed as analogues of guanine, their comparative uses are informative for analyzing the role of Gua in DNA sequence in DNA-protein interaction. Several DNA oligomers containing such Hyp, Oxa or Xan substituted for Gua were designed to reveal the molecular interaction between DNA and protein. From this approach, we have got useful information to understand the molecular mechanisms of the DNA-recognizing enzymes, which have not ever been observed using conventional DNA oligomer composed of just natural nucleobases.

Keywords: Deaminated lesion, DNA-protein interaction, DNA-recognizing enzymes

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10 Reduction of False Positives in Head-Shoulder Detection Based on Multi-Part Color Segmentation

Authors: Lae-Jeong Park

Abstract:

The paper presents a method that utilizes figure-ground color segmentation to extract effective global feature in terms of false positive reduction in the head-shoulder detection. Conventional detectors that rely on local features such as HOG due to real-time operation suffer from false positives. Color cue in an input image provides salient information on a global characteristic which is necessary to alleviate the false positives of the local feature based detectors. An effective approach that uses figure-ground color segmentation has been presented in an effort to reduce the false positives in object detection. In this paper, an extended version of the approach is presented that adopts separate multipart foregrounds instead of a single prior foreground and performs the figure-ground color segmentation with each of the foregrounds. The multipart foregrounds include the parts of the head-shoulder shape and additional auxiliary foregrounds being optimized by a search algorithm. A classifier is constructed with the feature that consists of a set of the multiple resulting segmentations. Experimental results show that the presented method can discriminate more false positive than the single prior shape-based classifier as well as detectors with the local features. The improvement is possible because the presented approach can reduce the false positives that have the same colors in the head and shoulder foregrounds.

Keywords: Pedestrian detection, color segmentation, false positives, feature extraction.

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9 Cutaneous Application of Royal Jelly Inhibits Skin Lesions in NC/Nga Mice, a Human-Like Mouse Model of Atopic Dermatitis

Authors: Junki Miyamoto, Mariko Kiyomi, Yuuki Nagashio, Takuya Suzuki, Soichi Tanabe

Abstract:

Anti-allergic effects of royal jelly were evaluated in a human-like mouse model of atopic dermatitis. NC/Nga mice were cutaneously applied with royal jelly for 6 weeks. Royal jelly-treated mice exhibited lower levels of serum total immunoglobulin E in comparison with controls. We found that the treatment decreased (11% to the control) expression of mRNA for aquaporin-3, which is involved in the modulation of epidermal hydration. Microarray analysis revealed more than 10-fold changes in the expression of several genes, such as transglutaminase 2, repetin, and keratins. In normal human epidermal keratinocytes, royal jelly extract suppressed interleukin-8 elevation induced by TNF-α and interferon-γ, suggesting direct anti-inflammatory activity in keratinocytes. Collectively, topical application of royal jelly may be useful for amelioration of lesions and inflammation in atopic dermatitis.

Keywords: Aquaporin 3, immunoglobulin E, NC/Nga, royal jelly.

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8 Patterns of Malignant and Benign Breast Lesions in Hail Region: A Retrospective Study at King Khalid Hospital

Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

Abstract:

Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: Age incidence, breast carcinoma, fine needle aspiration, Hail Region.

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7 Pre-Malignant Breast Lesions, Methods of Treatment and Outcome

Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

Abstract:

This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: Ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment.

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6 Superior Performances of the Neural Network on the Masses Lesions Classification through Morphological Lesion Differences

Authors: U. Bottigli, R.Chiarucci, B. Golosio, G.L. Masala, P. Oliva, S.Stumbo, D.Cascio, F. Fauci, M. Glorioso, M. Iacomi, R. Magro, G. Raso

Abstract:

Purpose of this work is to develop an automatic classification system that could be useful for radiologists in the breast cancer investigation. The software has been designed in the framework of the MAGIC-5 collaboration. In an automatic classification system the suspicious regions with high probability to include a lesion are extracted from the image as regions of interest (ROIs). Each ROI is characterized by some features based generally on morphological lesion differences. A study in the space features representation is made and some classifiers are tested to distinguish the pathological regions from the healthy ones. The results provided in terms of sensitivity and specificity will be presented through the ROC (Receiver Operating Characteristic) curves. In particular the best performances are obtained with the Neural Networks in comparison with the K-Nearest Neighbours and the Support Vector Machine: The Radial Basis Function supply the best results with 0.89 ± 0.01 of area under ROC curve but similar results are obtained with the Probabilistic Neural Network and a Multi Layer Perceptron.

Keywords: Neural Networks, K-Nearest Neighbours, Support Vector Machine, Computer Aided Detection

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5 Segmentation of Breast Lesions in Ultrasound Images Using Spatial Fuzzy Clustering and Structure Tensors

Authors: Yan Xu, Toshihiro Nishimura

Abstract:

Segmentation in ultrasound images is challenging due to the interference from speckle noise and fuzziness of boundaries. In this paper, a segmentation scheme using fuzzy c-means (FCM) clustering incorporating both intensity and texture information of images is proposed to extract breast lesions in ultrasound images. Firstly, the nonlinear structure tensor, which can facilitate to refine the edges detected by intensity, is used to extract speckle texture. And then, a spatial FCM clustering is applied on the image feature space for segmentation. In the experiments with simulated and clinical ultrasound images, the spatial FCM clustering with both intensity and texture information gets more accurate results than the conventional FCM or spatial FCM without texture information.

Keywords: fuzzy c-means, spatial information, structure tensor, ultrasound image segmentation

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4 Graphical Password Security Evaluation by Fuzzy AHP

Authors: Arash Habibi Lashkari, Azizah Abdul Manaf, Maslin Masrom

Abstract:

In today's day and age, one of the important topics in information security is authentication. There are several alternatives to text-based authentication of which includes Graphical Password (GP) or Graphical User Authentication (GUA). These methods stems from the fact that humans recognized and remembers images better than alphanumerical text characters. This paper will focus on the security aspect of GP algorithms and what most researchers have been working on trying to define these security features and attributes. The goal of this study is to develop a fuzzy decision model that allows automatic selection of available GP algorithms by taking into considerations the subjective judgments of the decision makers who are more than 50 postgraduate students of computer science. The approach that is being proposed is based on the Fuzzy Analytic Hierarchy Process (FAHP) which determines the criteria weight as a linear formula.

Keywords: Graphical Password, Authentication Security, Attack Patterns, Brute force attack, Dictionary attack, Guessing Attack, Spyware attack, Shoulder surfing attack, Social engineering Attack, Password Entropy, Password Space.

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3 Influence of Vegetable Oil-Based Controlled Cutting Fluid Impinging Supply System on Micro Hardness in Machining of Ti-6Al-4V

Authors: Salah Gariani, Islam Shyha, Fawad Inam, Dehong Huo

Abstract:

A controlled cutting fluid impinging supply system (CUT-LIST) was developed to deliver an accurate amount of cutting fluid into the machining zone via well-positioned coherent nozzles based on a calculation of the heat generated. The performance of the CUT-LIST was evaluated against a conventional flood cutting fluid supply system during step shoulder milling of Ti-6Al-4V using vegetable oil-based cutting fluid. In this paper, the micro-hardness of the machined surface was used as the main criterion to compare the two systems. CUT-LIST provided significant reductions in cutting fluid consumption (up to 42%). Both systems caused increased micro-hardness value at 100 µm from the machined surface, whereas a slight reduction in micro-hardness of 4.5% was measured when using CUL-LIST. It was noted that the first 50 µm is the soft sub-surface promoted by thermal softening, whereas down to 100 µm is the hard sub-surface caused by the cyclic internal work hardening and then gradually decreased until it reached the base material nominal hardness. It can be concluded that the CUT-LIST has always given lower micro-hardness values near the machined surfaces in all conditions investigated.

Keywords: Impinging supply system, micro-hardness, shoulder milling, Ti-6Al-4V, vegetable oil-based cutting fluid.

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2 Laser Doppler Flowmetry in Diagnostics of Vascular Lesions in Lower Extremities

Authors: Petr V. Vasilev, Eduard V. Volkov, Alexej N. Godok, Alexej A, Grischschuk, Vitalij A. Rybalchenko

Abstract:

Laser Doppler flowmetry is a modern method of noninvasive microcirculation investigation. The aim of our study was to use this method in the examination of patients with secondary lymphedema of the lower extremities and obliterating atherosclerosis of lower extremities. In the analysis of the amplitude-frequency spectrum of secondary lymphedema patients we have identified remarkable changes. To describe the changes we used a special amplitude rate. In both of patients groups this rate was significally (p<0.05) different with the control group. So the marker phenomena of the amplitude-frequency spectrum of the LDF signal were identified. It is suggested that there is a limfodynamics contribution to the formation of the output signal of laser Doppler flowmetry. These data have fundamental meaning and are interesting for practical medicine, as they give an opportunity to further developments for the use of laser Doppler flowmetry in the diagnostics and monitoring the effectiveness of the treatment.

Keywords: laser Doppler flowmetry, secondary lymphedema of the lower extremities, obliterating atherosclerosis, non-invasive diagnostics.

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1 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Authors: D. Farsi, Gh. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

Abstract:

Background and aim: It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FT versus fentanyl-midazolam (FM) in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods: In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccessful rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: Procedural Sedation and Analgesia, Thiopental, Fentanyl, Midazolam, Orthopedic Procedure, Emergency Department, Pain.

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