Review Article
Amir Hossein Rajabi; Samaneh Zafarabadi; Kimia Jazi; Maryam Moghbel Baerz; Omid Bahrami; Gelareh Azarinoush; Pardis Habibi; Negar Azami; Shahram Paydar
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objectives: This systematic review explored gene expression and DNA methylation patterns to identify key pathways and molecular targets associated with post-traumatic stress disorder (PTSD), particularly its war-related subtype.Methods: A comprehensive search of PubMed, Scopus, and Web of Science was ...
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Objectives: This systematic review explored gene expression and DNA methylation patterns to identify key pathways and molecular targets associated with post-traumatic stress disorder (PTSD), particularly its war-related subtype.Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted using keywords related to PTSD, gene expression, and DNA methylation. Studies published between 2000 to 2024 involving adult military personnel with confirmed PTSD based on the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria were included. Animal studies, psychological interventions, and pharmacological research were excluded. Only cross-sectional, case-control, or cohort studies utilizing blood, saliva, or brain tissue samples were considered. Data from 28 studies were extracted using a predefined framework, focusing on population characteristics, study design, and identified hub genes.Results: Key findings revealed the upregulation of immune-related genes (e.g., CCL4, NF-κB) and hypomethylation of inflammation-related genes. Downregulation of neurodevelopmental genes, such as Brain-Derived Neurotropic Factor (BDNF) and Down syndrome cell adhesion molecule (DSCAM), highlighted disruptions in synaptic plasticity. The identified pathways suggested potential biomarkers and therapeutic targets for precision medicine approaches.Conclusion: This review highlighted the role of gene expression alterations in war-related PTSD. The identified genes might serve as candidates for personalized therapies. Further research is required to validate these findings and develop targeted interventions.
Original Article
Konstantinos Georgios Makiev; Ioannis Spyridon Vasios; Anthimos Keskinis; Reichan Molla Moustafa; Georgios Petkidis; Konstantinos Tilkeridis; Athanasios Ververidis; Efthymios Iliopoulos
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs ...
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Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs in excluding fractures remains uncertain. Recently, a new diagnostic test, the Shetty Test (ST), has been introduced. This prospective comparative study aimed to evaluate the diagnostic accuracy of the “ST” in comparison to the “OARs” for detecting ankle and foot fractures.Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study. They were presented to the Emergency Department of a University Hospital in Alexandroupolis due to an ankle or foot injury. Data were collected over 6 months, from November 2022 to May 2023.Results: The sensitivity of the ST was 68.4%, specificity was 76.3%, positive predictive value (PPV) was 37.1%, and negative predictive value (NPV) was 92.2%. For the OARs, sensitivity was 94.7%, specificity was 15%, PPV was 18.5%, and NPV was 93.3%. When at least one of the tests was positive, the sensitivity and NPV increased to 100%.Conclusion: The ST was found to be reliable; however, it did not outperform the OARs in this study. Nevertheless, when used in conjunction, the two tests significantly improved sensitivity and the NPV. Due to its simplicity and reproducibility, the ST could be a valuable tool in daily clinical practice, particularly for non-orthopedic emergency department personnel.
Original Article
Elaheh Mianehsaz; Fateme Aghaei; Seyed Mohammadreza Tabatabaee; Babak Haghpanah; Mohammad Javad Azadchehr; khadijeh kalanfarmanfarma
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objectives: Intertrochanteric femur fractures are prevalent injuries among the elderly, significantly affecting their quality of life (QOL) and functional status. This study aimed to evaluate functional outcomes and QOL in elderly patients one year after sustaining an intertrochanteric femur fracture.Methods: ...
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Objectives: Intertrochanteric femur fractures are prevalent injuries among the elderly, significantly affecting their quality of life (QOL) and functional status. This study aimed to evaluate functional outcomes and QOL in elderly patients one year after sustaining an intertrochanteric femur fracture.Methods: This retrospective observational study was conducted at Shahid Beheshti Hospital in Kashan, Iran. The functional status and QOL of 79 elderly patients with intertrochanteric femur fractures, who were at least one year post-injury were assessed between February 2020 to February 2021.Data were collected from patient’s records, which included sociodemographic and clinical information at the time of admission. Functional status was evaluated using the Barthel Index, and QOL was assessed using the shortened form of the SF-36 questionnaire.Results: The study population comprised 60.8% women, with a mean age of 79.81±7.07 years. The mean of the Barthel index score was 11.49±2.22, indicating that participants achieved approximately 60% of the maximum functional score. The mean overall QOL score was 50.59±9.54, suggesting that patients attained approximately 51% of the maximum QOL score. A final linear regression model indicated that increased age was significantly associated with declines in both functional abilities (R²=0.53, p<0.001) and QOL (R²=0.39, p<0.001). Additionally, patients who received physiotherapy demonstrated significantly better functional outcomes than those who did not.Conclusion: This study highlighted the significant impact of intertrochanteric femur fractures on the functional status and QOL of older adults. The findings emphasized the critical role of rehabilitation services, such as physiotherapy, in improving patient outcomes. Further research is warranted to explore the influence of comorbidities and optimize interventions for this vulnerable population.
Original Article
sayyed majid sadrzadeh; Vahid Talebzadeh; Seyed Mohamad Mousavi; Behrang Rezvani Kakhki; elnaz vafadar moradi; Hamideh Feiz Disfani
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objectives: This study aimed to investigate the prognostic role of lactate clearance in predicting outcomes among trauma patients admitted to the emergency department.Methods: This retrospective cohort study was conducted on patients referred to the Emergency Department. Serum lactate levels were measured ...
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Objectives: This study aimed to investigate the prognostic role of lactate clearance in predicting outcomes among trauma patients admitted to the emergency department.Methods: This retrospective cohort study was conducted on patients referred to the Emergency Department. Serum lactate levels were measured at admission and 2 hours later. The patients were followed up for 72 hours to assess outcomes, including discharge, hospitalization in other wards, and mortality.Results: The results showed a significant difference between the mean age, Glasgow Coma Scale (GCS), systolic blood pressure (SBP), pulse rate (PR), and oxygen saturation (O2 Sat) of the trauma patients in relation to mortality prognosis (p<0.05). Additionally, significant differences were found in primary lactate, lactate levels two hours post-admission, and lactate clearance levels based on the patient’s prognosis (p<0.01). Multivariate logistic regression analysis revealed that lactate clearance was associated with a reduced mortality rate among trauma patients (OR=0.907, p<0.05).Conclusion: The findings of this study showed that lactate clearance, as an independent predictive factor, was associated with poorer prognosis and increased mortality rates in trauma patients.
Original Article
Shima Farokhi; Azim Azizi; Masoud Khodaveisi; Eesa Mohammadi; Khodayar Oshvandi
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objectives: This study aimed to identify strategies for enhancing the quality of home care for trauma patients.Methods: Using a conventional qualitative content analysis approach, this study was conducted from September 2023 to September 2024 in Hamadan, located in northwest Iran. A total of 18 participants, ...
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Objectives: This study aimed to identify strategies for enhancing the quality of home care for trauma patients.Methods: Using a conventional qualitative content analysis approach, this study was conducted from September 2023 to September 2024 in Hamadan, located in northwest Iran. A total of 18 participants, including home care managers, nurses, trauma patients, and the family members of trauma patients, were selected through purposive sampling. Data were collected using semi-structured interviews and analyzed using Graneheim and Lundman’s method with the assistance of MAXQDA software (version 20).Results: Analysis of the data yielded 430 initial codes, which were categorized into 36 subcategories and 6 main categories: patient-centered care, safe care provision, spiritual care, effective educational program development, service effectiveness enhancement, and dynamic service delivery.Conclusion: The study results showed that nurses employed various strategies to improve the quality of home care services for trauma patients. Key strategies included adhering to the principle of patient-centered care, providing safe care for trauma patients, providing spiritual care, developing effective educational programs, enhancing service effectiveness, and ensuring dynamism in service delivery. Implementing these strategies could guide policymakers and home care nurses to improve care quality for trauma patients and increase satisfaction. The findings of the present study can enhance the planning and implementation of home care services, facilitating the transition from hospital to home for trauma patients.
Original Article
Maryam Ramezanian; Parissa Bagheri; Cyrus Emir Alavi; Mohaya Farzin; MohammadReza Mobayen; Moein Moghaddam Ahmadi; Mohammad Tolouei; Siamak Rimaz; Mehdi Karimian; Hojat Eftekhari; Kiana Baghi; Ali Shabbak
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objectives: Severe burns often result in significant intravascular albumin loss, leading to hypoalbuminemia. This study aimed to evaluate the association between serum albumin levels and clinical outcomes in burn patients.
Methods: A retrospective, single-center study was conducted at Velayat Hospital ...
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Objectives: Severe burns often result in significant intravascular albumin loss, leading to hypoalbuminemia. This study aimed to evaluate the association between serum albumin levels and clinical outcomes in burn patients.
Methods: A retrospective, single-center study was conducted at Velayat Hospital (Rasht, Iran), including burn patients aged ≥16 years, who were admitted between April 2019 and March 2020. Serum albumin levels were recorded on day 1, day 7, and at discharge. The main variables analyzed included albumin levels, length of hospital stay, skin graft rate, need for mechanical ventilation, and mortality.
Results: Among the 74 patients included in the study, 14 (18.9%) died, while 60 (81.1%) survived. The mean serum albumin levels on days 1, 7, and at discharge were significantly higher in survivors (3.09±0.22, 3.12±0.23, and 3.18±0.28 g/dL, respectively) than non-survivors (2.22±0.29, 2.74±0.29, and 2.07±0.69 g/dL, respectively) at all time points (p<0.001). The serum albumin level measured on day 1 was significantly lower in patients who required mechanical ventilation than in those who did not (2.86±0.47 vs.3.09±0.13, p=0.03). Additionally, a significant inverse relationship was observed between serum albumin levels and both total body surface area burned (TBSA) and graft extent (day 1: rs=-0.76, day 7: rs=-0.74, discharge: rs=−0.62; p<0.001 for TBSA; and day 1: rs=-0.59, day 7: rs=-0.58, discharge: rs=−0.50; p<0.001 for graft extent).
Conclusion: Hypoalbuminemia was associated with poor clinical outcomes in patients with severe burns. Serum albumin levels might serve as a specific marker of burn severity and a predictor of mortality.
Original Article
Ali Delpisheh; Rezvan Feyzi; Goljamal Jorjani; Raha Davatgar; Hadi Panahi; Mohammad Hossein Panahi
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objective: This study explored the underlying reasons for non-compliance with seatbelt usage among rear-seat passengers in Iran.Methods: This qualitative study was conducted in 2023 with a diverse group of participants, including driving instructors, drivers, psychologists, rear-seat passengers, and ...
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Objective: This study explored the underlying reasons for non-compliance with seatbelt usage among rear-seat passengers in Iran.Methods: This qualitative study was conducted in 2023 with a diverse group of participants, including driving instructors, drivers, psychologists, rear-seat passengers, and experts in the field of traffic accidents and driving from Tehran, Khuzestan, and Golestan (n=39 persons). Data were collected through semi-structured interviews and focus group discussions and analyzed using conventional content analysis. The interviews, which lasted between 40 and 90 minutes, were recorded using two digital recorders, transcribed verbatim, and analyzed following the conventional qualitative content analysis method.Results: The findings revealed several factors contributing to the non-use of rear seatbelts, including lack of sufficient awareness of laws and regulations, incorrect behavioral and cultural attitudes, socio-economic influences factors, inadequate law enforcement and related organizations, and poor quality of seatbelts. Based on these findings, potential solutions were proposed, such as continuous education and awareness campaigns, improvements in seatbelt quality, and enhanced collaboration among relevant organizations to promote traffic safety culture. Education on the importance of seatbelt use should begin comprehensively in early childhood and continue into adulthood, with families playing a pivotal role in fostering this awareness.Conclusion: This study identified key factors influencing the non-use of rear seatbelts, including awareness of laws, cultural attitudes, socio-economic influences, and seatbelt quality issues. To address these challenges, the study recommended prioritizing ongoing education on seatbelt use, improving the quality of seatbelts, and fostering collaboration among traffic police, media, and educational institutions. These measures aimed to enhance traffic safety, increase compliance with seatbelt laws, and ultimately reduce fatalities and injuries resulting from road accidents.
Case Report
Mridula Goswami; Vashi Narula; Babita Jangra
Articles in Press, Accepted Manuscript, Available Online from 01 January 2025
Abstract
Objective: Dental injury is a significant issue in children due to their immature physical, cognitive, and physiological development. These factors often result in heightened fear and behavioral challenges during their first visit following trauma, which can compromise the quality of treatment and lead ...
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Objective: Dental injury is a significant issue in children due to their immature physical, cognitive, and physiological development. These factors often result in heightened fear and behavioral challenges during their first visit following trauma, which can compromise the quality of treatment and lead to a poor prognosis for the affected tooth. Silver Diamine Fluoride (SDF), a colorless solution approved by the US FDA for treating dental hypersensitivity and caries, offers a simple, painless, and non-invasive treatment option. Its application involves a paint-on technique with a powerful fluoride formulation, making it an ideal choice for the initial management of enamel and dentin fractures in primary teeth, particularly in uncooperative young children.Case Description: This case series described four cases in which SDF was successfully used as the primary treatment for Ellis Class IX anterior tooth trauma in very young children with negative behavior responses in the dental setting. The procedure required minimal armamentarium and was well-tolerated by all patients.Conclusion: In each case, the use of SDF yielded successful and satisfactory outcomes, with a favorable prognosis for the affected teeth. Additionally, the treatment contributed to a positive shift in the children’s attitudes toward dental care.
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