Review Article
Narges Nazari harmooshi; Hamidreza Khankeh; Mehrdad Farrokhi; Mohammad Esmail Motlagh; Seyed timoor hosseini; Mohammad Saatchi
Volume 14, Issue 2 , April 2026, Pages 49-58
Abstract
Objective: This study aimed to map national and international evidence on the challenges associated with reducing road traffic fatalities and injuries. Methods: This systematic scoping review was conducted in 2025 following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines and ...
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Objective: This study aimed to map national and international evidence on the challenges associated with reducing road traffic fatalities and injuries. Methods: This systematic scoping review was conducted in 2025 following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines and the Arksey and O’Malley framework. A search of the gray literature and four key databases, including PubMed, Scopus, and Web of Science, was performed from 1956 to September 2025. Of the 9,048 records identified, 36 studies were eligible for inclusion. Data were extracted using a standard format and analyzed through the Haddon Matrix and qualitative content analysis. Results: Challenges hindering the reduction of road traffic fatalities were identified across several domains: human, vehicle, environmental, sociocultural, administrative-organizational, prehospital, and research. Key problems included dangerous driving behaviors, poor education, low vehicle safety standards, weak law enforcement, lack of institutional coordination, absence of integrated data systems, and minimal prehospital services. The following strategies were identified as planned interventions: strengthening law enforcement, enhancing infrastructure, designing safetyrelated technologies, fostering education and culture change, and creating an integrated traffic management system. Conclusion: The findings indicated that reducing traffic fatalities requires a multidimensional and coordinated approach that addresses structural and informational dimensions in addition to human and technical factors. These findings could serve as a foundation for developing evidence-based policies and interventions to improve road safety.
Original Article
Farzad Bozorgi; Farzane Doodiyan; Shiv Kumar Mudgal; Vipin Patidar; Iraj Goli Khatir; Mohammad Sazgar; Zohreh Hosseini Marznaki; Fatemeh Hosseini Aghamalaki; Seyed Mohammad Hosseininejad
Volume 14, Issue 2 , April 2026, Pages 59-67
Abstract
Objective: This study aimed to investigate the epidemiological characteristics, clinical outcomes, and emergency department (ED) utilization patterns among trauma patients in northern Iran.Methods: This retrospective cross-sectional study was conducted in northern Iran from January 2021 to December ...
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Objective: This study aimed to investigate the epidemiological characteristics, clinical outcomes, and emergency department (ED) utilization patterns among trauma patients in northern Iran.Methods: This retrospective cross-sectional study was conducted in northern Iran from January 2021 to December 2023. Systematic random selection was used to choose 2,350 trauma patients from the hospital’s electronic health record (EHR) system. Data regarding demographic, trauma-related characteristics, clinical outcomes, and ED utilization were extracted from the EHR. Descriptive statistics and inferential analyses, including Chi-square and independent t-tests, were used to examine factors associated with patient outcomes. Results: Trauma-related mortality was significantly associated with the 19–39-year age group, marital status, severe head injury (indicated by a low Glasgow Coma Scale score), driver status, and early-morning accidents (all p<0.001). Prolonged ED length of stay (LOS; >6 hours) was significantly associated with therapeutic procedures, including fracture immobilization, fixation, wound dressing, arterial blood gas analysis, and oxygen therapy. Conversely, diagnostic imaging (CT scans and sonography) showed no significant independent effect on ED LOS. The most common ED interventions were fracture immobilization (96.8%), sonography (85.1%), and CT scans (77.5%). Prolonged LOS in the ED was strongly associated with therapeutic procedures such as fixation, wound dressing, arterial blood gas analysis, and oxygen therapy, whereas diagnostic imaging showed no significant effect.Conclusion: The findings underscore the necessity for targeted preventive measures aimed at young adult drivers and the expeditious delivery of therapeutic interventions, such as wound care and fracture immobilization, to reduce ED LOS. These region-specific insights regarding emergency service utilization are essential for trauma system planning in resource-limited settings.
Original Article
Mohammadjavad Moshtaghi; Tooraj Zandbaf; Jamshid Yousefi; Ali Khakshour; Fateme Omid; Seyed Mohammad Ali Raisolsadat
Volume 14, Issue 2 , April 2026, Pages 68-73
Abstract
Objective: This study aimed to evaluate and compare the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) and the pediatric appendicitis score (PAS) in pediatric patients with suspected acute appendicitis (AA). Methods: This cross-sectional study included 300 children presenting with ...
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Objective: This study aimed to evaluate and compare the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) and the pediatric appendicitis score (PAS) in pediatric patients with suspected acute appendicitis (AA). Methods: This cross-sectional study included 300 children presenting with suspected AA who underwent appendectomy at Akbar Children’s Hospital in Mashhad, Iran, between March 2022 and February 2024. Preoperative white blood cell count, neutrophil count, NLR, and PAS were assessed. Following appendectomy and histopathological confirmation, patients were stratified into three groups: negative appendicitis (normal appendix), uncomplicated appendicitis, and complicated appendicitis. Diagnostic parameters were then compared among these groups. Results: A total of 300 children aged 6 to 18 years suspected of having AA were studied, including 175 boys (58.3%), with a mean age of 9.7±3.18 years. For the diagnosis of AA, an NLR cutoff of >2.82 yielded a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 97.15%, 92.59%, 98.35%, and 87.72%, respectively. Conversely, a PAS cutoff of >6.5 yielded a sensitivity, specificity, PPV, and NPV of 89.43%, 94.44%, 98.65%, and 66.23%, respectively. Conclusion: Both NLR and the PAS were significantly elevated in children with AA. The NLR had higher sensitivity, whereas the PAS had greater specificity. Given its sensitivity, simplicity, and availability, the NLR could be effectively integrated into other clinical evaluations to enhance the diagnostic accuracy for AA in pediatric patients.
Original Article
mojtaba fazel; Mina kakhki; Elham Afshari
Volume 14, Issue 2 , April 2026, Pages 74-78
Abstract
Objective: This study aimed to investigate the demographic characteristics, etiology, and fracture patterns of maxillofacial traumas in patients aged 18 years or less in Gorgan, northern Iran.Methods: In this cross-sectional study, 132 patients (≤18 years old) were enrolled. These patients were ...
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Objective: This study aimed to investigate the demographic characteristics, etiology, and fracture patterns of maxillofacial traumas in patients aged 18 years or less in Gorgan, northern Iran.Methods: In this cross-sectional study, 132 patients (≤18 years old) were enrolled. These patients were referred to the emergency department (ED) of 5 Azar Hospital, a major tertiary referral center in Gorgan, Iran, between October 2020 and September 2021. Medical records and computed tomography (CT) scans were reviewed. Data regarding age, sex, mechanism of injury, and fracture type were extracted and analyzed using STATA software (version 12).Results: Most of the patients were male (male: female ratio, approximately 4:1), with a mean age of 12.6±0.5 years. Road traffic accidents (RTAs) were the most prevalent cause of injury (63.1%), followed by falls (32.3%). Motorcycles were involved in 79% of RTA cases. Fractures were identified in 30.3% (n=40) of patients. Among these, midface/maxillary fractures were the most common (72.5%), followed by mandibular (15%) and combined fractures (12.5%). No statistically significant associations were found between fracture type and age, sex, or trauma mechanism.Conclusion: In northern Iran, pediatric maxillofacial trauma predominantly affects teenage male adolescents and is primarily caused by RTAs, particularly those involving motorcycles. These findings underscored the critical need for enhanced traffic safety regulations and targeted public health interventions to protect children and adolescents.
Original Article
Zahra Shahabinia; Azam Sadat Hosseini; Seyed Mohammad Reza Hosseini; Hamid Moghaddasi
Volume 14, Issue 2 , April 2026, Pages 79-91
Abstract
Objective: Stroke is a leading global cause of death and disability, with Emergency Medical Services (EMS) critical for timely management, requiring accurate and systematic data. This study developed a Minimum Data Set (MDS) for a prehospital stroke emergency information dashboard in Iran.Methods: This ...
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Objective: Stroke is a leading global cause of death and disability, with Emergency Medical Services (EMS) critical for timely management, requiring accurate and systematic data. This study developed a Minimum Data Set (MDS) for a prehospital stroke emergency information dashboard in Iran.Methods: This applied study followed four phases. Phase 1 involved a scoping review (Arksey and O'Malley framework, PRISMA-ScR) of PubMed, Scopus, and Web of Science databases on August 20, 2024. Phase 2 extracted and refined data items from included studies and aligned them with key domestic and international clinical guidelines. Phase 3 classified elements with expert input. Phase 4 assessed content validity (CVR and CVI) among 10 experts and finalized elements based on necessity, clarity, and simplicity.Results:Data elements were organized into two main categories: management data and clinical data. The validated MDS contains 91 essential elements. Management data (41 elements) comprised identity and mission information (17 elements: mission identifier, patient information, incident location, dispatch team), key time indicators (11 elements: golden times, standard time intervals), and structural/logistical indicators (13 elements: equipment, human resources). Clinical data (50 elements) included initial assessment and stroke screening (5 elements: level of consciousness, FAST test, symptom onset time), vital signs and clinical findings (18 elements:continuous monitoring, associated symptoms, medical history), prehospital interventions (10 elements:airway/ABC, specialized measures, pharmacotherapy), in-hospital interventions (2 elements: diagnostic and therapeutic measures), and outcome/final diagnosis (15 elements: dispatch/technician/in-hospital diagnoses, patient outcome, prehospital quality of care).Conclusion:This standardized MDS integrates prehospital data, reduces documentation burden, and supports dashboards for performance monitoring, outcome feedback, benchmarking, reduced delays, and improved stroke outcomes.
Letter to the Editor
Mehrdad Karajizadeh; Mohammadreza Khosravi; Sharam Paydar; Mahnaz Yadollahi; Sajed Arabian
Volume 14, Issue 2 , April 2026, Pages 92-94
Abstract
Accurate and rapid patient identification remains a persistent challenge in emergency and trauma care. Patients frequently present unconscious, unaccompanied, or without valid identification, thereby elevating the risk of medication errors, delayed treatment, duplicate records, and medicolegal ...
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Accurate and rapid patient identification remains a persistent challenge in emergency and trauma care. Patients frequently present unconscious, unaccompanied, or without valid identification, thereby elevating the risk of medication errors, delayed treatment, duplicate records, and medicolegal complications. A robust and automated identification system is therefore essential to enhance patient safety and clinical efficiency.
