Journal of Emergency Medicine, Trauma and Acute Care - Volume 2012, Issue 1

Traffic accidents resulting from the collision of motor vehicles with wildlife occur worldwide. In the United States, Canada, Europe, the Middle East and Australia these collisions usually involve deer, moose, camels and kangaroos. Because these are large animals, the collisions are frequently associated with high morbidity and mortality rates. Camel-vehicle collisions in the Middle East—especially Saudi Arabia—have risen to such disturbing proportions that definitive action is necessary for mitigating the trend. Arabian camels, weighing up to 726 kg, form a crucial part of the socio-cultural experience in Saudi Arabia, where about half a million of them are found. Saudi Arabia presents a case of habitat fragmentation, especially in rural communities, where good road systems coexist with domesticated camels. This environment has made camel-vehicle collisions inevitable, and in 2004 alone two hundred such cases were reported. Injuries are directly related to the size of the camel, the speed of the vehicle, passengers' use or avoidance of seat belts, and the protective reflex movements taken to avoid collision. Cervical and dorsal spinal injuries, especially fractured discs, head and chest injuries, are the most commonly reported injuries, and the fatality rate is four times higher than for other causes of traffic accidents. Various mitigation measures are considered in the present work, including measures to improve driver's visibility; the construction of highway fencing; under- and over-passes allowing free movement of camels; the use of reflective warning signs, and awareness programs.

Objective: To assess the occurrence and severity of thrombocytopenia in hospitalized vivax malaria patients. Design and setting: Retrospective and descriptive hospital based case series from March 2005 to March 2007, conducted in the medical unit of Al Khor Hospital. Patients and methods: Seventy-eight patients with peripheral smear positive were enrolled in the study. Peripheral smear examination for malaria parasites was used as the method of choice for the diagnosis of malaria. Hematological parameters were determined by using an automated analyzer. Low platelet counts were re-evaluated by manual methods. Results: Study sample was 78 patients, of which 65 patients (83.3%) were thrombocytopenic. Of these, 41 patients (52.6%) had mild thrombocytopenia, 23 patients (29.5%) had moderate thrombocytopenia and 1 patient (1.3%) had severe thrombocytopenia. All patients (100%) were male. Conclusion: High prevalence of thrombocytopenia was seen in vivax malaria patients, making it a common hematological feature in vivax malaria.

Accidental loss of a part of a peripheral intravenous cannula is an uncommon event. We report a case of an accidentally missed particle of a peripheral venous cannula presenting as a foreign body in the subcutaneous tissue, three months after the event that dislodged it. We explore this in terms of its diagnosis and management.

A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA) and bilateral internal iliac artery aneurysms (IIAAs); the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.