Evaluating mechanism and severity of injuries among trauma patients admitted to Sina Hospital, the National Trauma Registry of Iran / 中华创伤杂志(英文版)

PURPOSE@#Injuries are one of the leading causes of death and lead to a high social and financial burden. Injury patterns can vary significantly among different age groups and body regions. This study aimed to evaluate the relationship between mechanism of injury, patient comorbidities and severity of injuries.@*METHODS@#The study included trauma patients from July 2016 to June 2018, who were admitted to Sina Hospital, Tehran, Iran. The inclusion criteria were all injured patients who had at least one of the following: hospital length of stay more than 24 h, death in hospital, and transfer from the intensive care unit of another hospital. Data collection was performed using the National Trauma Registry of Iran minimum dataset.@*RESULTS@#The most common injury mechanism was road traffic injuries (49.0%), followed by falls (25.5%). The mean age of those who fell was significantly higher in comparison with other mechanisms (p < 0.001). Severe extremity injuries occurred more often in the fall group than in the vehicle collision group (69.0% vs. 43.5%, p < 0.001). Moreover, cases of severe multiple trauma were higher amongst vehicle collisions than injuries caused by falls (27.8% vs. 12.9%, p = 0.003).@*CONCLUSION@#Comparing falls with motor vehicle collisions, patients who fell were older and sustained more extremity injuries. Patients injured by motor vehicle collision were more likely to have sustained multiple trauma than those presenting with falls. Recognition of the relationship between mechanisms and consequences of injuries may lead to more effective interventions.

Disability and post-trauma stress in the population over 15 years old in Kashan, Iran: A population-based study / 中华创伤杂志(英文版)

PURPOSE@#One of the consequences of trauma-related injuries is disability. There are more than one billion people with disabilities worldwide. Disability in people reduces their quality of life. The goal of this study was to determine the rate of post-trauma stress and disability related to trauma in the population over 15 years old in Kashan during a solar year of 2018-2019.@*METHODS@#This is a cross-sectional population-based study. A cluster sampling method was used in the city of Kashan, and 3880 persons were interviewed with individuals randomly selected in each household. If a person had trauma during one year ago, the World Health Organization Disability Assessment Schedule 2.0 and Post Trauma Stress Disorder (PTSD) Checklist were applied for further interview. Data were analyzed using Chi-square test or t-test.@*RESULTS@#Among the 3880 participants residing in Kashan, 274 (7.1%) reported a history of traumatic injury during one year ago in 2018-2019. Incidence of all injuries was estimated to be 70.61 (62.60-78.70) per 1000 people. For the trauma population, 213 (77.7%) were male and 75.1% were married. About half of them (50.3%, 138/274) aged 21-39 years. The most common cause of injuries was related to traffic accidents: 140 (51.1%). Of the 274 trauma participants, 47 (17.2%) reported PTSD; 244 (89.1%) had a mild disability, and 30 (10.9%) reported moderate disability.@*CONCLUSION@#One of the main causes of disability in the human community is the traumatic injuries. According to the results of this study, 89.1% of trauma participants have sustained at last mild disability following trauma. These people require follow-up and post-treatment support. It should be noted that psychological complications such as PTSD are as significant as physical symptoms.

Bilateral subdural hygroma in a case with sylvian arachnoid cyst

Arachnoid cysts are congenital lesions arising from the arachnoid membrane. The incidence of arachnoid cysts in the general population is around 0.1% and their most common location is the middle fossa. Arachnoid cysts usually present during the childhood and are identified incidentally. When symptomatic, the most common presentations include headache and seizure. The popular treatment for this lesion is surgery. In this case report, we describe a 12 year-old boy with a middle cranial fossa arachnoid cyst presenting with progressive headache, and bilateral subdural hygroma following a trivial head trauma

Assessment of the neural-like cells differentiation from endometrial stem cells following fluoxetine treatment

Fluoxetine is a common antidepressant which selectively inhibits serotonin reuptake at synaptic level. Some research findings have proposed the effect this drug on neurogenesis, neuronal survival as well as proliferation of the neural progenitor cells. Endometrium is a part of uterus which harbors mesenchymal stem cells. This source of stem cells can be differentiated into neural cells which may potentially be used in treating many diseases. Given the above, this study was designed to assess the effect of fluoxetine on neural cells differentiation from endometrial stem cells. Endometrial stem cells obtained from stem cell banking were cultured in Dulbecco's modified eagle's medium [DMED] containing fetal bovine serum [FBS] in the presence of Retinoic Acid, fluoxetine and Retinoic Acid+fluoxetine for 10 days. To assess the differentiation of endometrial stem cells into neural-like cells, we used immunocytochemistry and RT-PCR. The viability of cells was assessed using the trypan blue test. Data analysis revealed that 61% of endometrial stem cells differentiated to neural-like cells. Moreover, the biopotency of neural-like cells on fluoxetine treatment was more pronounced across differentiation days. Based on our findings, fluoxetine was shown to be a suitable inducer for the differentiation of neural-like cells from endometrial stem cells

A seven-year study on head injuries in infants, Iran---the changing pattern / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Head injury (HI) is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this study was to survey infant HI patients admitted to Shahid Behest Hospital in Kashan, Iran from 2004 to 2010, and to identify the causes of HIs in this age group.</p><p><b>METHODS</b>In this retrospective study, all HI patients under the age of two who were hospitalized for more than 24 hours between January 2004 and January 2010 were enrolled in the study. Demographic, etiologic, and injury data were collected and a descriptive analysis was performed.</p><p><b>RESULTS</b>Infants comprised 20.8% of all children (under 15 years old) with HIs and 65.1% of the injuries occurred in the home. Falls were the most common cause of injury (63.4%). In hospital mortality was 6.6 per 100 000 infants. A decreasing trend was seen in home events, but HIs caused by traffic accidents were increasing during the study period. The amount of HI infants resulting from car accidents has tripled from the years 2004 to 2010.</p><p><b>CONCLUSION</b>Although home events and falling are the main causes of infant HIs and need attention, our study showed an increase of HIs caused by road traffic accidents, especially by car accidents, thus legislation for the implementation of protective equipment such as child safety seats and programs is urgently needed.</p>

Cerebral state index versus Glasgow coma scale as a predictor for in-hospital mortality in brain-injured patients / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To compare the value of Glasgow coma scale (GCS) and cerebral state index (CSI) on predicting hospital discharge status of acute brain-injured patients.</p><p><b>METHODS</b>In 60 brain-injured patients who did not receive sedatives, GCS and CSI were measured daily during the first 10 days of hospitalization. The outcome of prognostic cut-off points was calculated by GCS and CSI using receiver operating characteristic (ROC) curve regarding the time of admission and third day of hospitalization. Sensitivity, specificity and other predictive values for both indices were calculated.</p><p><b>RESULTS</b>Of the 60 assessed patients, 14 patients had mild, 13 patients had moderate and 33 patients had severe injuries. During the course of the study, 17 patients (28.3%) deteriorated in their situation and died. The mean GCS and CSI in patients who deceased during hospitalization was significantly lower than those who were discharged from the hospital. GCS<4.5 and CSI<64.5 at the time of admission was associated with higher mortality risk in traumatic brain injury patients and GCS was more sensitive than CSI to predict in-hospital death in these patients. For the first day of hospitalization, the area under ROC curve was 0.947 for GCS and 0.732 for CSI.</p><p><b>CONCLUSION</b>GCS score at ICU admission is a good predictor of in-hospital mortality. GCS<4.5 and CSI<64.5 at the time of admission is associated with higher mortality risk in traumatic brain injury patients and GCS is more sensitive than CSI in predicting death in these patients.</p>

Epidemiology of pediatric burn injuries in Isfahan, Iran

Burns are major cause of death and disability worldwide, particularly in the developing countries. The aim of this study was to determine the incidence and causes of burns in children under the age of 15 years in Isfahan province, Iran. All children admitted to the burn center of Isfahan, the largest city in central Iran, between 2007 and 2009 were enrolled in this study. We analyzed the data on age, sex, location, cause and spread of the burn, duration of admission, and cause of mortality. Out of 2229 burn patients, 1014 [45.5%] were under the age of 15, indicating an annual incidence of 50 in 100,000 children. Of the 1014 patients, 610 [60%] were boys and 404 [40%] were girls; the male-to-female ratio was 1.5:1. Most of the patients were in the age range of 3 to 6 years. Scald was the most common type of burn injury [51.8%]. Six-hundred and sixty-eight cases [65.7%] were from urban areas, while 346 [34.3%] were from rural areas. Fifty-six patients [5.5%] died. Burn injury is a major health concern in the pediatric age group, and specific consideration and planning are required for its management