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 02 March 2025
Abstract
Objective: Orthopedic injuries involving the ankle joint are very common and incur high costs. To reduce unnecessary radiographic screening, diagnostic tools have been developed, such as the widely accepted Ottawa Ankle Rules (OARs), whose accuracy in excluding fractures remains uncertain. A new diagnostic ...
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Objective: Orthopedic injuries involving the ankle joint are very common and incur high costs. To reduce unnecessary radiographic screening, diagnostic tools have been developed, such as the widely accepted Ottawa Ankle Rules (OARs), whose accuracy in excluding fractures remains uncertain. A new diagnostic test, the Shetty Test (ST), has been introduced recently. This prospective comparative study aims to evaluate the diagnostic accuracy of the "ST" in comparison to the "OARs" in screening for ankle and foot fractures.Patients and Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study, who presented in the Emergency Department of a University Hospital of Alexandroupolis due to an ankle or foot injury. Data were collected over a six-month period, from November 1, 2022, to May 1, 2023.Results: The sensitivity of the ST was 68.4%, the specificity was 76.3%, the positive predictive value was 37.1% and the negative predictive value 92.2%. The sensitivity of OARs was 94.7%, the specificity was 15%, the positive predictive value was 18.5% and the negative predictive value was 93.3%. When at least one of the tests was positive, the sensitivity and negative predictive value increased to 100%.Conclusion: The ST was found to be reliable, but did not perform better than the OARs in this study. It seems that when the two tests are used in conjunction, the sensitivity and the negative predictive value increase significantly. Moreover, due to its simplicity and reproducibility, it could be implemented in daily practice, especially by 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 02 March 2025
Abstract
Objectives: Intertrochanteric femur fractures are prevalent injuries among the elderly, significantly affecting their quality of life and functional status. This study evaluates the function and quality of life (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 and functional status. This study evaluates the function and quality of life (QOL)in elderly patients one year after sustaining an intertrochanteric femur fracture.Methods: This retrospective observational study, conducted at Shahid Beheshti Hospital in Kashan, Iran, the function 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.The necessary information was collected from the patients' files, which included sociodemographic and clinical data at the time of admission, as well as the shortened form of the SF-36 questionnaire and the Barthel questionnaire.Results:The study found that 60.8% of the patients were women, with a mean age of 79.81 ± 7.07 years. The mean Barthel index score was 11.49 ± 2.22, indicating that participants achieved approximately 60% of the maximum function score. The mean overall QOL score was 50.59 ± 9.54, suggesting that patients attained approximately 51% of the maximum QOL score. Furthermore, the final linear regression model indicated that as patients' age increased, their QOL and functional abilities significantly declined. (R-square for functioning =0.53, and QOL=0.39, p<0.001 )Additionally, patients receiving physiotherapy demonstrated significantly better function compared to those who did not receive it.Conclusion: This study highlights the significant impact of intertrochanteric femur fractures on the functional status and QOL of older adults. The findings emphasize the importance of rehabilitation services and the need for further research on comorbidities to improve patient outcomes.
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 02 March 2025
Abstract
Background: Lactate clearance can be considered as a prognostic biomarker associated with the mortality rate and hospital stay of trauma patients. The present study aimed to investigate the prognostic role of lactate clearance associated with the incidence of trauma patients’ outcomes.Methods: ...
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Background: Lactate clearance can be considered as a prognostic biomarker associated with the mortality rate and hospital stay of trauma patients. The present study aimed to investigate the prognostic role of lactate clearance associated with the incidence of trauma patients’ outcomes.Methods: This retrospective cohort study was conducted on the people who were referred to the emergency department. The serum lactate levels of the subjects were measured at admission and 2 hours later. The patients were followed up within 72 hours in terms of discharge, hospitalization in other wards, and mortality.Results: The results showed a significant difference between the mean age, GCS (Glasgow Coma Scale), SBP (systolic blood pressure), PR (pulse rate), and O2 Sat of the trauma patients concerning their death prognosis (P value<0.05). There was also a significant difference between primary lactate, two-hour-later lactate, and lactate clearance levels according to the patient's prognosis (P value<0.01). The results of the multivariate logistic regression indicated that lactate clearance was associated with a decrease in the mortality rate of trauma patients (OR=0.907, P value<0.05).Conclusion: The results of this study showed well that as an independent predictive factor, the lactate clearance level was associated with a worse prognosis and increased mortality rates of the patients.
Original Article
Shima Farokhi; Azim Azizi; Masoud Khodaveisi; Eesa Mohammadi; Khodayar Oshvandi
Articles in Press, Accepted Manuscript, Available Online from 02 March 2025
Abstract
Objective: Ensuring the quality of home care services is a primary concern for trauma patients. Identifying and implementing quality improvement strategies can help mitigate the challenges associated with transitioning from hospital to home care. This study aimed to elucidate strategies for enhancing ...
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Objective: Ensuring the quality of home care services is a primary concern for trauma patients. Identifying and implementing quality improvement strategies can help mitigate the challenges associated with transitioning from hospital to home care. This study aimed to elucidate strategies for enhancing the quality of home care for trauma patients.Methods: This study, conducted using a conventional qualitative content analysis approach, took place from Sept. 2023 to Sept. 2024 in Hamadan, located in northwest Iran. A total of 18 participants, including home care managers, nurses, trauma patients, and the families 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 v 20 software.Results: Analysis of the data yielded 430 initial codes, 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 use strategies to improve the quality of home care services for trauma patients. Some of these actions 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 dynamism in service delivery." Implementing these strategies can guide policymakers and home care nurses to improve care quality for trauma patients and increase satisfaction. The research results can enhance planning and implementation of home care services, facilitating the transition from hospital to home.
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 02 March 2025
Abstract
Background: Severe burns cause significant intravascular albumin loss, leading to hypoalbuminemia. This study evaluated the association between serum albumin levels and clinical outcomes in burn patients.Methods: A retrospective, single-center study was conducted at Velayat Hospital, including burn patients ...
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Background: Severe burns cause significant intravascular albumin loss, leading to hypoalbuminemia. This study evaluated the association between serum albumin levels and clinical outcomes in burn patients.Methods: A retrospective, single-center study was conducted at Velayat Hospital, including burn patients aged ≥16 admitted between April 2019 and March 2020. Serum albumin levels were recorded on day 1, day 7, and at discharge. The main variables included albumin levels, length of stay, skin graft rate, mechanical ventilation, and mortality.Results: Among the 74 patients in the study, 14 (18.9%) died, while 60 (81.1%) survived. The mean serum albumin levels at days 1, 7, and discharge were significantly higher in survivors (3.09 ± 0.22, 3.12 ± 0.23, and 3.18 ± 0.28 g/dL, respectively) compared to nonsurvivors (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 those without mechanical ventilation (2.86±0.47 vs.3.09±0.13, P=0.03). Additionally, an inverse and significant relationship was found 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 is associated with poor outcomes in patients with severe burns. Serum albumin levels may 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 02 March 2025
Abstract
This study explores the underlying reasons for non-compliance with seat belt usage among rear-seat passengers.Methods: This research is a qualitative study conducted in2023on a group of driving instructors, drivers, psychologists, rear-seat passengers, and experts in the field of accidents and driving ...
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This study explores the underlying reasons for non-compliance with seat belt usage among rear-seat passengers.Methods: This research is a qualitative study conducted in2023on a group of driving instructors, drivers, psychologists, rear-seat passengers, and experts in the field of accidents and driving in Tehran, Khuzestan, and Golestan. Data were collected through semi-structured interviews and focus group discussions and analyzed using conventional content analysis. The interviews lasted between 40 to 90 minutes and were recorded using two digital recorders. The interviews were transcribed and analyzed following the conventional qualitative content analysis method.Results: The results showed that various factors such as lack of sufficient awareness of laws and regulations, incorrect behavioural and cultural attitudes, social and economic factors, the insufficient role of the police and other organisations, and poor quality of safety belts influence the lack of seat belt usage by rear seat passengers. Accordingly, solutions such as continuous education and awareness, improving the quality of safety belts, and organisational collaboration to promote traffic culture have been proposed. Education and information on the importance of using seat belts should start comprehensively from a young age and continue into adulthood, with the family playing a crucial role.Conclusion: This study identified key factors behind the non-use of rear seatbelts, including awareness of laws, cultural attitudes, socio-economic influences, and poor seatbelt quality. It recommends prioritizing ongoing education on seatbelt use, improving seatbelt quality, and fostering collaboration among traffic police, media, and schools. These steps aim to enhance traffic safety and compliance with seatbelt laws, ultimately reducing road accident deaths and injuries.
Case Report
Mridula Goswami; Vashi Narula; Babita Jangra
Articles in Press, Accepted Manuscript, Available Online from 02 March 2025
Abstract
Background- Dental injury is a significant issue in children due to immature physical, cognitive, and physiological processes. They are generally more fearful and behaviorally compromised during their first visit after trauma. This severely degrades their chances of receiving quality treatment leading ...
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Background- Dental injury is a significant issue in children due to immature physical, cognitive, and physiological processes. They are generally more fearful and behaviorally compromised during their first visit after trauma. This severely degrades their chances of receiving quality treatment leading to poor prognosis of the affected tooth. Silver Diamine Fluoride (SDF) is a colorless solution, approved by the US FDA, for treating dental hypersensitivity and caries. It is used in a simple, painless, non-invasive, paint-on technique with a powerful fluoride combination making it a suitable material for initial management of enamel and dentin fracture in primary teeth of uncooperative young children. Case Description- The present case series describes four cases where SDF has been successfully used, with minimal armamentarium, for the primary management of Ellis Class IX anterior tooth trauma in very young children with negative behavior in the dental setting. Conclusion- Each case showed successful, satisfactory results with favourable prognosis and a positive dental attitude.Practical Implication- This case series presents a novel idea of using SDF in initial management of Traumatic Dental Injuries (TDIs) in primary teeth.
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