Post-traumatic stress disorder (PTSD) probability among parents who live in Kandahar, Afghanistan and lost at least a child to armed conflict.

The last 4 decades of conflict in Afghanistan resulted in incalculable deaths, injuries, and millions of displacements. Although there are routine reports on casualties of the warfare, the information on its long-term psycho-social sequelae is somehow discounted. This study aimed to assess post-traumatic stress disorder (PTSD) probability and its associated factors among parents who live in Kandahar, the southern province of Afghanistan, and lost at least one child to armed conflict. We conducted a health-facility-based cross-sectional study involving 474 bereaved parents in Kandahar province from November/2020 to January/2021. The questionnaire was composed of sections on socio-demographic characteristics and mental and medical histories of the parent, features of the traumatic event and the time elapsed since then, age and gender of the lost child, and PCL-5. We performed multivariable logistic analysis to determine factors associated with PTSD probability in such parents. A staggering number of the parents (430; 90.72%) scored > 33 on PCL-5 denoting presence of probable PTSD. We noticed that several attributes of the bereaved parents (rural residence [AOR = 3.71 (95% CI 1.37-9.97)], older age [AOR = 2.41 (95% CI 1.03-5.57)], experiencing more than one traumatic event [AOR = 2.91 (95% CI 1.05-7.94)], pre-existing medical condition [AOR = 3.5 (95% CI 1.55-8.05)], and losing a < 5-years-old child [AOR = 2.38 (95% CI 1.16-4.70)] were significantly associated with PTSD probability. We assert that a very high number of bereaved parents are susceptible to probable PTSD. This finding signifies the eminent necessity of mental health services in such settings and provides implicit insights to relevant humanitarian assistance providers.

Epidemiology of surgically treated patient in road traffic accident with lower extremity vascular injury from a single centre in Kelantan

@#Introduction: Lower extremity vascular injury can result in either temporary or permanent disability. Methods: This is a clinical audit involving all patients admitted to our institution from January 2008 to June 2018 of those who had undergone revascularization surgery for lower limb trauma. Results: Fifty-nine patients were in this study with a mean age of 28.1 years. Most of the patients were motorcyclist involved in road traffic accidents with cars (n=30, 50.8%). The popliteal artery was most commonly seen injury (n=41, 69.5%). The mean duration of ischaemia was 14.1 hours. The limb salvage rate was 89.8%. Conclusion: Lower extremity vascular injury caused by RTA treated in our institution predominantly involved young patients aged between 18–30 years associated with long bone fractures causing contusion and thrombosis of the popliteal artery.

Clavicle fracture and subclavian vessels disruption with massive haemothorax mimic intrathoracic injury.

We report a case of open fracture of the clavicle with subclavian artery and vein laceration and perforation of the parietal pleural below the first rib that caused massive haemothorax. Emergency thoracotomy and exploration followed by repair of both vessels were able to salvage the patient and the extremity.