TRAUMA MONTHLY
Year:2020 | Volume:25 | Issue:6|Papers Count:8

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Background: Background: Fracture healing is important in medicine; thus seeking new techniques with fewer side effects to improve the speed of the healing is prudent. Objectives: This experimental study sought to assess the effect of the nano ostrich eggshell (N-OES) and hydroxyapatite (HA) composite on bone defect healing in rat calvaria. Methods: In this study, a 7-mm bone defect was created in the calvaria of 45 male Sprague– Dawley rats. The animals were randomly divided into three groups, and the defects in each group were filled with N-OES, HA, or as control group. The animals were euthanized and histological and serological assessments were carried out at 14, 28 and 42 days after operation. Results: At 14 and 28 days after operation, in the edges of the defect, there was a significant difference between the treatment and control groups (p ≤ 0. 05). However, there were no statistically significant differences between N-OES and HA treatment groups (p > 0. 05). At this time, in the center of the defect, there was a statistically significant difference between the N-OES group with HA and control groups (p ≤ 0. 05). On day 42, no significant difference in the edges of the defect was observed between all groups. However, there was a statistically significant difference in the center of the defect between the N-OES group with HA and control groups (p ≤ 0. 05). Results of the serological assessment indicated that the applied treatments increased the serum levels of alkaline phosphatase. Conclusions: The results of this study indicate the potential efficacy of nano ostrich eggshell as a bone substitute in rat calvaria defects.

Background: Assessing patients’ readiness for weaning through spontaneous breathing trial (SBT) is a reliable method for weaning and extubation of patients. Until now, there are controversies regarding the best SBT method. Objective: This study sought to compare the clinical outcomes of the T-piece and pressure support ventilation (PSV) SBT methods among patients with traumatic brain injury. Methods: In this randomized controlled trial, 72 patients under mechanical ventilation were recruited from the intensive care unit of Shahid Rajaei hospital, Qazvin, Iran, and randomly allocated to an intervention or control group. SBT was conducted in the study group. In the control group, it was done through the T-piece and PSV (with pressure support of less than 8 cm H2O), respectively. The groups were compared with each other respecting weaning outcomes, extubation success, length of mechanical ventilation, length of hospital stay, and mortality rate. Data were compared using the Chi-square and the independent-sample t-tests. Results: Weaning success rate in the T-piece group was significantly greater than the PSV group (P=0. 024), while the post-weaning length of hospital stay in the T-piece group was significantly shorter than the PSV group (P=0. 05). There were no significant differences in extubation success rate and length of mechanical ventilation between the groups (P>0. 05). Conclusion: The T-piece method for SBT could be better tolerated by patients with traumatic brain injury compared with PSV.

Background: Iran is one of the most disaster-prone countries in the world. Hospital readiness is important for providing services to patients in times of crisis and can be considered an important indicator in crisis management. Objectives: The present study was conducted to determine the functional preparedness of selected military hospitals in response to tragedy and disasters. Methods: This cross-sectional-analytical study was conducted in two AJA-military hospitals in Tehran in 2020. A random sampling method was used to select hospitals. A checklist of functional preparedness of hospitals in response to disasters was used to collect data. Data were analyzed and coded with SPSS software. Results: According to the results, the mean and standard deviation of the functional preparedness score for hospitals A and B were 86. 17± 4. 24 and 81. 76± 10. 52, respectively, and the total average score was 83. 97± 8. 21, which indicated good conditions. The results of the independent t-test showed that there was no significant difference in the preparedness between the two studied hospitals (p=0. 124). In hospital A, Recovery after Disaster, Increase capacity and Continuation of vital services and in hospital B, Support and Procurement Management, Continuation of vital services and Human resources areas had the lowest level of readiness. Conclusion: According to the results, the studied hospitals were weak in functional preparedness, and hence should be repaired and improved in this field.

Background: The Cluster model designed to promote humanitarian response management is used as an effective model for cooperation and participation of the relevant aid organizations. Objective: We sought to identify the type and method of humanitarian aid to support people affected by the Kermanshah earthquake and to discuss the importance of the cluster approach in humanitarian response. Methods: In this descriptive cross-sectional study, data were collected in two phases. First, news and national reports were reviewed and then scientific articles were studied for implementation of the cluster approach for humanitarian aids in disaster. Finally, the findings were compared using the cluster approach of humanitarian aid, analyzed gap and duplication issues in the aid related to the Kermanshah earthquake. Results: Finding showed 308 pieces of news and reports on humanitarian aid transmission were found, 38 % (33) of which were from government agencies and 62% from non-governmental institutes. Review of the NEWS agencies revealed that 150 non-governmental organizations (NGO) and 33 government agencies had helped Kermanshah by sending financial and non-financial aids. The cluster approach was necessary for improving humanitarian responses in developing countries, especially countries located in disaster-prone zones. The cluster model can be used in social donation and can be managed by volunteer organizations during disasters for collecting and transferring the donations. Conclusion: The Cluster model is designed as a solution to promote humanitarian response management. This approach is used as an effective model for cooperation and participation of the relevant aid organizations. There are currently 11 clusters including agriculture, camp management, rapid recovery, education, shelter, telecommunications, health, support, water and sanitation, nutrition, protection and health.

Background: Probiotics may have a role in preventing ventilator-associated pneumonia (VAP) by inhibiting the natural flora from transforming into pathogenic flora. Objective: We sought to assess the effects of probiotics on the prevalence of VAP in multitrauma patients hospitalized in a neurosurgical intensive care unit (ICU). Methods: This randomized clinical trial was performed from 2018 and 2019 with the participation of 150 patients hospitalized in the Neurosurgical ICU. After randomizing the participants (using the permutable blocking method) into the intervention (probiotic) and control (placebo) groups, the interventions were implemented. Each participant received one capsule every 12 hours by gavage and their VAP symptoms were evaluated and recorded. Data were assessed via SPSS-22 and then compared using the chi-square, independent t-test, Fisher's exact test, and repeated measures ANOVA. Results: The prevalence of VAP was significantly lower in the intervention group than in the control group (p=0. 001). A significant difference was observed between the two groups in pH (p=0. 029) and WBC (p=0. 042). The between-group difference in other variables was not significant. Conclusion: Probiotics are effective in reducing the prevalence of VAP in trauma patients hospitalized in ICU.

The outbreak of coronavirus disease-2019 (COVID-19) began in Wuhan, Hubei Province, China, and has spread worldwide rapidly. In this case series study, we evaluated orthopedic patients who referred to the orthopedic trauma ward of Imam Hossein Hospital, Tehran, Iran, as a central hospital for both orthopedic trauma and COVID-19 patients from the beginning of the outbreak of COVID-19 in Iran. We incidentally detected six cases of COVID-19 infection during work-up for trauma management. These patients were managed and treated for both COVID-19 infection and trauma.

Background: Vision Zero is a public policy approach that aims to achieve a road traffic system with no fatalities or serious injuries caused by road traffic crashes (RTCs). Objective: This study aimed to investigate the history of Vision Zero's evolution and trends in road safety worldwide. Methods: This scoping review was conducted based on the Arksey and O’ Malley and the Joanna Briggs Institute framework. This framework consists of five steps: research question identification; identifying relevant studies; selection of study; data charting; gathering, summarizing, and reporting the results. Results: Finally, 37 articles met the inclusion criteria. The trending of deaths caused by RTCs in the countries implementing Vision Zero shows a decline. There is a intercountry variation with the most substantial decrease in Sweden. Conclusion: Vision Zero has had an evolutionary development in many countries. Due to the significant impact of the implementation of the Vision Zero, many countries are seeking to adopt or implement this approach. Although there are some challenges in implementing Vision Zero in different countries but based on its philosophy, there is a growing rate for implementing it in different settings.