Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Early Tracheostomy in Trauma Patients with Acute Respiratory Distress Syndrome due to Novel Coronavirus Disease 2019 (COVID-19)1331344683610.30476/beat.2020.86487ENFariborzGhaffarpasandMD, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-1721-9987Mohammad RezaSakiTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranNazaninDadashpourDepartment of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, IranZahraGhahramaniTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-7394-952XShahramPaydarTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-6980-2576Journal Article20200513The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) was first reported in Wuhan, China in December 2019 [1, 2] and was rapidly spread all over the world, being announced as a pandemic on March 11<sup>th</sup>, 2020 by the World Health Organization (WHO) [3]. Approaching the mid of August, approximately 20 million people are infected worldwide and 720,000 have died due to the infection and its complications [4]. The virus causes respiratory infection and involves both the upper and lower respiratory tract as well as the gastrointestinal tract, hepatic, neurologic and renal systems [5]. Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Real-Time Visual Feedback Device Improves Quality Of Chest Compressions; A Manikin Study1351414651410.30476/beat.2020.83080ENJoaoAugusto1Department of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal; 2Institute of Cardiovascular Science, University College London, London, United Kingdom; 3Barts Heart Centre, St Bartholomew’s Hospital, London, United Kingdom0000-0003-0040-5270MiguelSantosDepartment of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalDanielFariaDepartment of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalPauloAlvesDepartment of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalDavidRoqueDepartment of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalJose;MoraisDepartment of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalVictorGilDepartment of Cardiology, Hospital dos Lusíadas, Lisbon, PortugalCarlosMoraisDepartment of Cardiology, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalJournal Article20190825<strong>Objective:</strong> To evaluate the impact of a real-time visual feedback device on CCs rate and depth delivered by healthcare professionals.<br /><strong>Methods:</strong> In a simulated scenario a sensor was placed on a manikin’s chest and connected to a defibrillator which provided real-time visual feedback on the rate and depth of CCs. Thirty-two healthcare professionals performed sequentially 5 cycles of 30 CCs without (FeedOFF) and with (FeedON) feedback. CCs with a depth between 50 and 60mm and a rate between 100 and 120cpm were considered optimal.<br /><strong>Results:</strong> Visual feedback resulted in a significant increase in the proportion of CCs with optimal depth (median 8.7 [interquartile range 0.7–55.5]% FeedOFF vs 63.3 [17.6–88.1]% FeedON, p=0.002) and optimal rate (median 51.3 [1.3–81.3]% FeedOFF vs 68.3 [45.3–86.1]% FeedON, p=0.018). Overall, CCs were too shallow and too fast in the FeedOFF cycle. There was also a significant increase in optimal CCs (optimal depth and rate) with the use of the feedback device (from median 0.7 [0–26.9]% FeedOFF to 31.9 [3.6-59.9]% FeedON, p=0.001). Participants’ factors such as age, sex, body mass index, job or time since last CPR training did not have a significant impact on CPR quality.<br /><strong>Conclusion:</strong> In the absence of visual feedback, there is a tendency towards lower depth and higher rate of CCs. The use of feedback technology significantly improves the quality of CCs.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Comprehensive Analysis of Pediatric Supracondylar Fractures in the Emergency Department; A Single Center Experience1421474657210.30476/beat.2020.83195ENJose RamonAuso-PerezAv. Alcalde En Jaume Botella Mayor, 7, 03570 Villajoyosa, Alicante, Spain0000-0002-5617-8153Gloria MariaRodríguez-BlanesOccupational Health Unit. Public Health Center of Alcoy, Alicante. Conselleria of Universal Health and Public Health, Generalitat Valenciana. Spain.Journal Article20190904<strong>Objective:</strong> To describe the demographic characteristics and to assess possible risk factors related to the moment of presentation at Emergency Department (ED) for pediatric humeral supracondylar fractures.<br /> <strong>Methods:</strong> This was cross-sectional study being conducted during 5-year period from 2013 to 2017 at ED of a regional hospital in Spain. We have included all the pediatric patients ( <strong>Results:</strong> We have included 52 pediatric patients with supracondylar fractures in this series. The mean age was 7.48 ± 2.97 years with a minimum age of 2 years and a maximum of 14 years. Among the patients there were 32 (61.54%) male and 20 (38.46%) female. Age less than 7 years found to be a protective factor against unstable fractures [OR 0.33 (0.10 - 1.02)]. Fractures presented during daytime hours showed a greater instability [OR 3.49 (1.07-11.39)]. However, the risk of presentation at nighttime was higher during the summer months (June to September).<br /> <strong>Conclusion:</strong> The older is the child, the greater is the risk of suffering an unstable fracture, which increases the need for surgery. This risk is greater during the daytime. Otherwise, during the summer months, there is a higher risk of patient presentation at nighttime.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Prognosis of the Trauma Patients According to the Trauma and Injury Severity Score (TRISS); A Diagnostic Accuracy Study1481554657710.30476/beat.2020.84613ENRezaHosseinpourDepartment of General Surgery, Clinical Research Development Unit of Beheshti Hospital, Yasuj University of Medical Sciences0000-0002-2692-7395AmirBarghiClinical Research Development Unit of Beheshti Hospital, Yasuj University of Medical SciencesSaadatMehrabiClinical Research Development Unit Beheshti Hospital, Yasuj University of Medical SciencesShirvanSalaminiaClinical Research Development Unit of Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran0000-0002-2572-1029PariaTobehDepartment of Pediatrics, Yasuj University of Medical Sciences, Yasuj, IranJournal Article20191218<strong>Objective:</strong> To investigate the prognosis and survival rates of a group of Iranian patients with traumatic injuries using the trauma and injury severity score (TRISS) model.<br /> <strong>Methods:</strong> In this prospective cohort study, all the patients with multi-trauma referring to the Yasuj Shahid Beheshti hospital during 2018 were included. The patients’ demographic information, trauma and history of previous illness were recorded. Vital symptoms including respiratory rate, heart rate, hypertension, pulse rate and Glasgow coma scale (GCS) score were assessed. The injury severity score (ISS) was calculated based on the type and location of the injuries and according to the abbreviated injury scale (AIS) classification. The survival probability of the patients was assessed according to the TRISS model.<br /> <strong>Results:</strong> Overall, 252 trauma patients were evaluated out of whom, 195 (77.4%) were men and 57 (22.6%) women. The mean TRISS score was 24.2 ± 9.32 and the maximum score was 99.7. If we consider the TRISS score probability above 0.5 as the chance of being alive, the mortality rate was 6.75%, that was lower than our series (7.1%). The ISS score and GCS had a positive significant relationship with other variables except respiratory rate, body temperature and hospitalization. Revised trauma score (RTS) was significantly associated with other variables including age, GCS, hemoglobin, systolic blood pressure and respiratory rate. TRISS had an area under curve (AUC) of 0.988 indicating a high prognostic accuracy.<br /> <strong>Conclusion:</strong> The mortality rate was lower than that of being predicted by TRISS. This might be due to treatment effectiveness and care for traumatic patients leading to decreased mortality. TRISS had high prognostic accuracy in trauma patients. We also reported an association between hemoglobin and survival rate. Therefore, it seems that considering the laboratory parameters can be useful in patients with trauma.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Effects of Foot Massage on Pain Severity during Change Position in Critically Ill Trauma Patients; A Randomized Clinical Trial1561624677010.30476/beat.2020.86094ENKhodayarOshvandiDepartment of Nursing, Research Center for Maternal and Child Care, Hamadan University of Medical Sciences, Hamadan, Iran0000-0002-2224-8870ZahraVeladatiMedical Surgical Nursing Student, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IranMarziehMahmoodiDepartment of Biostatistics, School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, IranFarshidRahimi BasharAnesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, IranAzimAziziChronic Diseases (Home Care) Research Centre, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran0000-0003-1379-0024Journal Article20200415 <br /> <strong>Objective:</strong> To determine the effects of foot massage on pain severity during in unconscious trauma patients admitted to the intensive care unit (ICU).<br /> <strong>Methods:</strong> In this randomized clinical trial (RCT), 80 unconscious trauma patients admitted in the ICU of a hospital in an urban area of Iran were included using the convenience sampling method. They were randomly assigned to the intervention and control groups (n=40 in each group). In both groups, the intensity of pain was measured immediately, 10 minutes after the first change position and without any intervention before the change of position using the Critical Care Pain Observation Tool (CCPOT). In the intervention group, before the second position change, classic foot massage was performed for 20 minutes, but the control group received routine care. Pain was re-evaluated after the change position at desired times. The pain intensity was compared between the two study groups.<br /> <strong>Results:</strong> The baseline characteristics were comparable between the two study groups and no difference was found. There was no statistically significant difference between the mean scores of pain after the change of position (immediately and ten minutes later) before the intervention in the groups (p=0.915 and 0.660, respectively). However, after the intervention, the pain intensity was significantly lower in the intervention groups compared to the control group (p<0.001).<br /> <strong>Conclusion: </strong>Foot massage decreases the pain intensity related to the change of position in unconscious trauma patients admitted in the ICU. Due to its simplicity and low cost, this method can be used along with analgesic drugs to reduce pain in patients.<br /> <strong>Clinical trial registry: </strong>IRCT2016121031327N1Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Association between Adult Attention-Deficit/Hyperactivity Disorder and Driving Behaviors among Iranian Motorcyclists1631684667510.30476/beat.2020.84937ENAliAkbaryDepartment of Psychiatry, Faculty of Medicine, Social Development & Health Promotion Research Centre, Gonabad University of Medical Sciences, Gonabad, IranSeyed TaghiHeydariPhD, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-7711-1137YaserSarikhaniStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, IranMehrdadVossoughiOral and Dental Disease Research Center, Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranRezaTabriziHealth Policy Research Center, Shiraz University of Medical SciencesMaryamAkbariHealth Policy Research Center, Shiraz University of Medical SciencesNajmehMovahhedianOral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranArashManiResearch Center for Psychiatry and Behavioral sciences, Shiraz University of Medical Sciences, Shiraz, IranHomayounSadeghi-BazarganiRoad Traffic Injury Research Center, Statistics & Epidemiology Department, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-0396-8709TaherehOstovarStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, IranKamran BagheriLankaraniHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences,
Shiraz, IranJournal Article20200114<strong>Objective:</strong> To investigate the association between attention-deficit/hyperactivity disorder (ADHD) score and driving behaviors among motorcycle drivers in Iran.<br /> <strong>Methods:</strong> This multi-center cross-sectional study was conducted on 1747 motorcyclists in three cities of Iran. We used a random sampling method in this study and gathered data using two standard questionnaires. Data were presented using descriptive statistics, also t-test, and ANOVA used for analysis.<br /> <strong>Results:</strong> The mean age of participants was 27.41±8.80 years. ADHD scores of the participants ranged from 0 to 87, with a mean score 31±15.86. All risky driving behaviors (RDBs) were significantly associated with a higher mean of ADHD score. For example, driving with illegal speed (<em>p</em><0.001), not wearing a crash helmet (<em>p=</em>0.016), driving while exhausting (<em>p</em><0.001), talking with other passengers (<em>p</em><0.001), being fined by the police in the past year (<em>p</em>=0.028), and maneuvering while driving (<em>p</em><0.001) were related to a higher mean of ADHD score.<br /> <strong>Conclusion:</strong> All RDBs were significantly associated with the ADHD score among motorcyclists in Iran. In this regard, health care providers should inform people with ADHD about the negative consequences associated with driving and ADHD. Public health policymakers should consider management of ADHD through a comprehensive approach to improve driving performance and competencies among motorcyclists in order to decrease RDBs and traffic accidents.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Evaluation of Beneficial Influence of Local Application of Crocus Pallasii Subsp. Haussknechtii Boiss. Extract on Healing of Full Thickness Excisional Infected Wounds in Diabetic Rats1691784656110.30476/beat.2020.82567ENMohammad AliAshja ZadehFaculty of Medicine, AJA University of medical sciences, Tehran, Iran0000-0001-7439-969XMohsenEbrahimiDepartment of Toxicology and pharmacology, Faculty of Medicine, AJA University of Medical
Sciences, Tehran, Iran0000-0001-6862-6972Amir AhmadSalarianDepartment of Toxicology and Pharmacology, Faculty of Medicine, AJA University of Medical
Sciences, Tehran, IranSeyyed RezaAbtahiDepartment of Toxicology and Pharmacology, Faculty of Medicine, AJA University of Medical
Sciences, Tehran, IranAlirezaJahandidehDepartment of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University,
Tehran, IranJournal Article20190707<strong>Objective:</strong> To evaluate the wound healing activity of <em>Crocus pallasii subsp. haussknechtii boiss</em> leaves extract on infected wounds in diabetic rats.<br /> <strong>Methods:</strong> Fifty male diabetic rats were randomized into two sets of 25 animals each. Each group was sub divided into five groups of five animals, each for excisional and incisional wound models, respectively. Induction of diabetes was achieved using 60 mg/kg streptozotocin. In group I, 0.1 mL sterile saline 0.9% solution was added to the wounds with no infection. In group II, the wounds were infected with Methicillin-resistant staphylococcus aureus (MRSA) and only treated with 0.1 mL the sterile saline 0.9% solution. In group III, infected wounds were treated with application of base formulation ointment. In group IV, animals with infected wounds were treated with 0.1 mL topical application of 1 mg/mL methicillin and base formulation ointment. In group V, animals with infected wounds were treated with topical application of 0.1 mL solution of methicillin (1 mg/mL) and with 1g of powder extract of the plant material in ointment. The healing of the wound was assessed based on planimetry, hydroxyproline estimation, microbiological, biomechanical and biochemical studies<br /> <strong>Results:</strong> Microbiological examination, planimetric, histological and quantitative morphometric studies and determination of hydroxyproline levels showed that there was significant difference between animals in group V compared to other groups (<em>p</em>=0.001). Biomechanical indices in incisional groups showed there was significant difference between animals in group V compared to other groups (<em>p</em>=0.001).<br /> <strong>Conclusion: </strong>It was possible to conclude that the ointment of the extract of <em>Crocus pallasii subsp. haussknechtii boiss</em>. leaves have significant wound-healing activity in diabetes.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Effects of Topical Sesame Oil Extracted from Tahini (Ardeh) on Pain Severity in Trauma Patients: A Randomized Double-Blinded Placebo-Controlled Clinical Trial1791854683110.30476/beat.2020.82561ENMaryamGholamiClinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-4302-4233SedighehTorabi DavanTransplantation Unit, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranMaryamGholamiIntensive Care Unit, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranShahramBoland ParvazTrauma Research Center, Department of Surgery, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranMehrnazGholamiSchool of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Cognitive Neuroscience, Institute for Cognitive Science Studies, Shahid Beheshti University, Tehran, Iran; Cognitive ScienceParisaChamanparaClinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-3263-7060LeilaShayanTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-2357-0690Journal Article20190701<strong>Objective: </strong>To investigate the effects of sesame oil extracted from tahini (Ardeh) on pain severity in patients with upper or lower limbs trauma.<br /> <strong>Methods: </strong>This double-blinded randomized clinical trial study was conducted on 120 patients with upper or lower trauma in Shahid Rajaee Hospital, Shiraz, Iran, from May the 1<sup>st</sup> through November 30<sup>th</sup>, 2016. The patients were randomly assigned to two groups using block randomization. The intervention group received topical sesame oil extracted from tahini (Ardeh) and the placebo group received cooking oil. Pain severity, pain sensitivity and heaviness of painful site were assessed.<br /> <strong>Results: </strong>Overall, we included 90 patients with traumatic limb injuries in this study who were randomized to two study groups. The mean age of the patients was 28.3 ± 6.8 (ranging from 25 to 35) years and there were 63 (70%) men and 27 (30%) women among the patients. In the sesame oil group, the mean changes in the pain severity (-1.53 ± 0.57, p <0.001), pain sensitivity (-1.45 ± 0.64, p <0.001) and heaviness of painful site (-1.56 ± 0.68, p <0.001) were significantly lower when compared to the placebo group in the second day of the intervention. None of the patients experience adverse drug effects.<br /> <strong>Conclusion:</strong> Our findings suggest that the topical use of sesame oil extracted from Tahini has a pain reliever effect on the skin after bruising and it helps prevent skin discoloration in patients with traumatic injuries of limbs.<br /> <strong>Clinical Trial Registry: </strong>IRCT20171017036838N1Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Utilization of the Parenteral Morphine in Emergency Department using the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) System1861924661410.30476/beat.2020.86225ENFarzadBozorgiOrthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran0000-0002-5316-8339EbrahimSalehifarPharmaceutical Research Center, Mazandaran University of Medical Sciences, Sari, IranSeyed MohammadHosseininejadDiabetes Research Center, Mazandaran university of Medical Sciences, Sari, Iran0000-0002-1713-5791SiavashMoradiFaculty of Medicine, Mazandaran University of Medical Sciences, Sari, IranGhazalehJanbaziStudent Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IranAroonaChabraStudent Research Committee, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, IranJournal Article20200429<strong>Objective:</strong> To evaluate the utilization of the parenteral morphine in Emergency Department (ED) using the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) system.<br /> <strong>Methods: </strong>In this retrospective cross-sectional study, morphine administration was recorded in 4-year time period from January 2013 to December 2016 in the ED of a referral center. The dose of the administered morphine was evaluated using the ATC/DDD system. The ATC/DDD of the parenteral morphine was calculated based on the world health organization (WHO). The data was evaluated based on the different diagnosis and conditions using the ATC/DDD protocol.<br /> <strong>Results:</strong> In this study, 500 patients referred to ED with mean age of 48.29 ± 10.10 years were included. There were 306 (61.2%) men and 194 (38.8%) women among the patients. The lowest and highest DDD of parenteral morphine were 0.1 and 0.43, respectively. The utilization of parenteral morphine was significantly higher in men when compared to women (<em>p</em><0.001). Those with history of tricyclic anti-depressant (TCA) consumption (<em>p</em><0.001) and opium addiction (<em>p</em><0.001) had significantly higher parenteral morphine utilization. Those with pain in the extremities and chest pain had significantly higher parenteral morphine utilization (<em>p</em><0.001).<br /> <strong>Conclusion:</strong> The utilization of parenteral morphine in the ED of our center was higher than the WHO standard dosage. The morphine utilization was associated with male gender, opium addiction and TCA consumption.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701“Crown of Death”; Corona Mortis, a Common Vascular Variant in Pelvis: Identification at Routine 64-slice CT-Angiography1931984677110.30476/beat.2020.84118ENRohitBhoilDepartment of Radiodiagnosis, IGMC Shimla0000-0002-5155-8325NeetiAggarwalDepartment of Radiodiagnosis, IGMC ShimlaVineetAggarwalDepartment of Orthopaedics, IGMC ShimlaMukeshSuryaDepartment of Radiodiagnosis, IGMC ShimlaSanjivSharmaDepartment of Radiodiagnosis, IGMC ShimlaAjay KumarAlhuwaliaDepartment of Radiodiagnosis, IGMC ShimlaSabinaBhoilDepartment of Cardiac Anesthesia, IGMC ShimlaSurya PratapSinghResident, IGMC ShimlaManveerThakurResident, Radiology, IGMC ShimlaSiddharthSoodResident, Orthopaedics, IGMC, ShimlaJournal Article20191105Objective: To establish the incidence of arterial corona mortis variant in angiographic studies being performed using a 64 slice CT scan machine in a series of patients.<br />Methods: This was a prospective cross-sectional study including 100 consecutive patients undergoing routineclinically indicated, standard protocol, CT-angiography for the abdominal aorta and/or lower limbs using a 64 slice CT scanner. Patients having severe arterial insufficiency (Grade 4 stenosis on CT angiography), pelvic infections and tumours, patients with past pelvic trauma and those who had previous pelvic surgery were excluded from the study. In total 200 hemi-pelvises were evaluated for the presence or absence of corona morti.<br />Results: Overall, we included 100 patients in this series including 67 men and 33 women with mean age of 40.1±2.3 (ranging from 22-74) years. The arterial variant was identified on thin, 0.625-mm-thick images in 24 out of 100 patients studied (unilateral in 20 patients and bilateral in 4 patients; 28 out of 200 hemipelvises evaluated, having an incidence of 14%). We found that the distance of corona mortis artery from the symphysis was significantly greater for women compared to men, both on right (p=0.034) and left sides (p=0.046).<br />Conclusion: Corona mortis may be prospectively identified at contrast-enhanced multidetector CT especially in pelvic trauma patients and help guide subsequent endovascular embolization or surgical interventions.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Our Experience of Trauma Management During Novel Coronovirus 2019 (COVID-19) Pandemic in a Busy Trauma Center in Southern Iran1992014683210.30476/beat.2020.87029ENHosseinAkbarialiabadStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-2018-6378HosseinAabdolrahimzadeh FardShiraz University of Medical Sciences0000-0003-1225-9186Hamid RezaAbbasiDepartment of Surgery, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, IranShahramBolandparvazTrauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.0000-0002-8875-5998ShahinMohseniOrebro University Hospital / Orebro University0000-0001-7097-487XVahidMehrnoushSection of Trauma, Acute Care, and Global Surgery,Division of general surgery, Department of surgery,University of British ColumbiaMinaSalehiMSc in surgery student,Department of surgery ,University of British ColumbiaSimaRoushenasStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, IranShahramPaydarTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-6980-2576Journal Article20200620During the past few months, the novel coronavirus 2019 (COVID-19) pandemic has significantly affected medical service provision. In Iran, it has caused around 197,000 inflictions and 9200 deaths up to June 18, 2020. While many departments turned to telehealth in this era, the trauma service should provide non-stop in presence service to the trauma victims. Our trauma center is the largest in the southwest of Iran, with the mean annual admission of 18,500 polytrauma patients. In this center, we designed a safety protocol to mitigate the spread of disease and also have a more robust case finding system, especially among asymptomatic carriers who attend hospitals based on their trauma. In brief, all unstable patients were considered SARS-COV-2 positive and were directed toward the Specialized COVID-19 related ICU. For all stable patients, history, physical examination, CXR, and lab test (Complete Blood Count, Erythrocyte Sedimentation Rate, C-Reactive Protein) were ordered before entering the wards. If there was any suspicion of COVID-19, the stable patient was admitted to the COVID-19 specialized ward. Among all 1805 patients admitted during a ten weeks interval (from January 30, 2020, to April 14, 2020), 84 had a red flag and toward to COVID-19 related wards. Of those, 67 had positive PCR or evidence in CT in favor of the COOVID-19. Moreover, during regular workups, we found that 19 completely asymptomatic trauma victims had typical Chest CT scan findings of COVID-19.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Broken Knife Blade Completely Penetrating the Humerus: A Case Report and Literature Review2022044661810.30476/beat.2020.85769ENMauricioGonzalez-UrquijoTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Dr. Ignacio Morones Prieto O 3000. Monterrey, México. 647100000-0001-5101-1541MarioZambrano LaraDepartamento de Cirugía General. Hospital Metropolitano “Dr. Bernando Sepúlveda”. Adolfo López Mateos No. 4600, San Nicolás de los Garza, Nuevo León, México. 66400Journal Article20200316We present a case of a 23-year-old male patient who presented with a blade knife completely wedged and penetrated on his humerus after a stab wound to his left upper extremity. On palpation, a foreign body was palpated under the skin on the deltoid area. The blade was stuck in the bone, so the surrounding bone tissue was osteotomised until the blade was released. The patient evolved favorably, and at three months follow up, he has a full functional recovery of his arm. Stab wounds are prevalent in emergency departments; however, stab wounds with bone involvement have rarely been reported in the literature. When encountering a blade stuck in bone tissue, removing the blade while avoiding orthopedic, neurological and vascular injuries should be the main goal of the treatment. To the best of our knowledge, this is the third reported case of an intraosseous foreign body in the humerus secondary to a stab wound.Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Systematic Review of Drug-Related Hospital Admissions: Common Errors in Reporting2052064651510.30476/beat.2020.84167.1059ENMohammadBagherShamsiSchool of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran0000-0002-8401-6549SiavashVaziriDepartment of Infectious Diseases, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran0000-0002-3907-6155HamidRezaMozaffariDepartment of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran0000-0001-9351-1499MaryamMirzaeiSchool of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran0000-0001-7908-6035Journal Article20191110Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Letter to the Editor Regarding “Lateral Approach and Combined Lateral and Anteromedial Approach for Surgical Treatment of Terrible Triad of Elbow: A Meta-Analysis.”2072084651210.30476/beat.2020.86013ENUttam ChandSainiAssociate Professor, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India0000-0002-6812-5470DeepakNeradisenior resident , Department of Orthopaedics, PGIMER, ChandigarhDeepakKumarAssistant Professor, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India0000-0003-3482-7391VikasBacchalAssociate Professor, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, IndiaPraveenSodavarapuSenior Resident, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India0000-0003-2807-627XAkshayShettySenior Resident, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.Journal Article20200409<strong><em> </em></strong>Shiraz University of Medical SciencesBulletin of Emergency And Trauma2322-25228320200701Response to the Letter to Editor Regarding “Lateral Approach and Combined Lateral and Anteromedial Approach for Surgical Treatment of Terrible Triad of Elbow: A Meta-Analysis”2092094651310.30476/beat.2020.86026ENMukeshMeenaDepartment of Orthopedics, LHMC, New Delhi, India0000-0003-2541-8609KarmbeerSinghDepartment of Orthopedics, LHMC, New Delhi, IndiaSanjayMeenaDepartment of Orthopedics, LHMC, New Delhi, India0000-0002-8360-4920ChetanKumbhareDepartment of Orthopedics, LHMC, New Delhi, IndiaDushyantChouhanDepartment of Orthopedics, LHMC, New Delhi, India0000-0003-0578-5110Journal Article20200413