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BackgroundIntubation and maintaining airway are crucial in the management of critically ill patients in the emergency department. Correct tracheal intubation should be confirmed by the physician, otherwise oesophageal intubation could lead to hypoxia with detrimental consequences and even death. Sonography can be used to determine proper placement of the tracheal tube.MethodsIn this study, 75 patients, with an indication of intubation and age older than 18 years entered the study. An emergency medicine performed real-time sonography of the trachea to evaluate the correct placement of endotracheal tube. Tube passage (snowstorm) and vocal cord angel widening (bullet sign) were evaluated, and then both lungs sliding and diaphragm movement were evaluated to confirm correct tube placement and ventilation.ResultsIn this study, 75 patients entered the study. The mean age of the patients was 61.12; 47 patients (62.7%) were male and 28 (37.3%) were female. The reason of intubation was the decreased level of consciousness in 22 cases (29.3%), cardiopulmonary arrest in 22 patients (29.3%), respiratory distress in 9 patients (12%), shock in 10 patients (13.3%), and seizure in 1 case. Snowstorm sign was seen in 72 patients (96%). Bullet sign was objected in 24 cases (32%). Lung sliding was seen bilaterally in 63 patients (84%) and unilaterally in 7 patients (9.3 %), but it was not noticed in 6.7% of the patients (5 patients).ConclusionsTransverse tracheal and lung sonography in the emergency department can be a fast measure to confirm correct endotracheal intubation.

Infectious diseases have threatened human health throughout the history. One way of transmission of such diseases is exposing to the needle sticks. The present study was carried out aiming to introduce and investigate risk factors related to needle sticks and ways of prevention of infectious diseases related to needle stick among health care staff.Searching key words including needle sticks, occupational injuries, occupational exposures (OEs) and infectious diseases, the researchers undertook a comprehensive investigation regardless of publication year of the reviewed articles in references including, Medline, CINAHL, Google Scholar, ScienceDirect and Scopus. Then the collected articles were scrutinized and processed.Dealing with needle sticks can transmit more than 20 types of pathogens including Hepatitis B, C and human immunodeficiency virus (HIV). Among health care staff, nurses are more vulnerable compared to others.Exposure to blood and other risky body liquids is a serious risk factor among health care workers. Training medical staff, establishing reporting systems, changing high risk behaviors and vaccination can play an important role in prevention of the infectious diseases.Citation: Elmi S, Babaie J, Malek M, Motazedi Z, Shahsavari-Nia K. Occupational exposures to needle stick injuries among health care staff; a review study.

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Objective: Having cosmetic breast implants increases a woman's chance of suicide, which is now a global challenge. This systematic review evaluated the possible risk of suicide among women who undergo cosmetic breast implants. Method: This meta-analysis was done based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). In the current systematic review and meta-analysis, we systematically searched for all articles written in both English or Persian that estimated the prevalence of suicidal ideation in women who had cosmetic breast implants. We systematically searched different databases, including MEDLINE (PubMed), Web of Science, Embase, Cochrane, Library ProQuest, Scopus, and Google Scholar, from inception to March 2021. There was also a search for references. Suicidal ideation, a suicide plan, or suicide attempts were the outcomes. In order to determine the total pooled prevalence of suicidal ideation, we utilized a random-effects model. To examine the risks of bias in each study, we applied the Joanna Briggs Institute Critical Appraisal method. Results: We identified 218 citations in our initial search. After omitting duplicated citations and excluding irrelevant studies according to the title and abstract selection, 42 studies were chosen for the full text analysis. Finally, 11 research, examining a total of 324,332 women were incorporated into the systematic review and critical appraisal assessment. Eight of these studies were found to be eligible for meta-analysis. The frequency of suicide in women with cosmetic breast implant was 0.2% (95% CI: 0.1% to 0.4%; P < 0.001) (Q-value: 168.143, I2:95.83). Most of the included studies had moderate quality. Conclusion: There might be a correlation between cosmetic breast implants and suicide risk, which could be stronger in the presence of a history of mental illnesses. The evidence about the possible effects of breast implants.