JOURNAL OF SURGERY AND TRAUMA
Year:2021 | Volume:9 | Issue:3|Papers Count:7

Dear Editor, The COVID-19 pandemic is the most serious threat to national health systems in a century. The rapid development and spread of the COVID-19 disease necessitated a significant shift in clinical practice and a restructuring of institutional structures. Elective surgery has been drastically reduced in Spinal Surgery Units around the world since the start of the pandemic, and spine trauma management techniques have changed dramatically. All elective treatments, including spinal surgeries, were cancelled due to the virus's highly contagious nature, reduced nosocomial infection, and freed up extra beds for COVID-19 diseases (1). Emergencies, such as growing neurological deficits or spine instability caused by fractures, infections, or malignancies, could not be postponed (2). While different considerations should have been made before performing routine spine procedures, the latter was rendered more difficult due to unknown characteristics of the COVID-19 infection (2). . .

Introduction: Thyroidectomy is one of the most common surgeries that can be accompanied by postoperative hematoma. The present study aimed to evaluate the impact of the Trendelenburg position on the homeostasis of the surgery site during and after thyroidectomy. Methods: This clinical trial was performed on 60 euthyroid patients in the age range of 18-70 years within 2019-2021. Patients were randomly assigned to the two groups of routine surgery and Trendelenburg using a table of random numbers. The primary outcome was the number of bleeding points immediately after the Trendelenburg position, and secondary outcomes included demographics, final pathology, postoperative hematoma, duration of operation, rate of fluid and seroma accumulation, and patient satisfaction. Data were analyzed in SPSS software (version 19) using Mann Whitney, Chi-square, and Fisher’ s exact test. The significance level was set to 5%. Results: The mean age of the patients was 40± 13 years, and the majority of them (n=48) were female. The mean number of bleeding points identified intraoperatively was significantly higher in the Trendelenburg group, as compared to that in the routine surgery group (8. 7± 3. 8 vs 5. 4± 1. 8; P<0. 001). In the Trendelenburg group, the mean scores of intra-operative blood loss and duration of operation were obtained at 6. 4± 1. 8 g and 118. 0± 32. 0 min, respectively. Conclusion: As evidenced by the obtained results, the Trendelenburg position significantly increased the number of bleeding points in patients undergoing thyroidectomy; nonetheless, it had no effect on the amount of bleeding and operation duration.

Introduction: Chronic rhinosinusitis may require referral to an ear, nose, and throat specialist for possible endoscopic sinus surgery if medical management fails. Vitamin D is one of the essential vitamins for the body that is effective in inflammatory processes. Therefore, it seems necessary to confirm the association between the deficiency of this vitamin and the occurrence of chronic rhinosinusitis with nasal polyposis. This study aimed to determine the relationship of vitamin D3 deficiency and chronic rhinosinusitis with nasal and sinus polyposis in patients referring to the Otorhinolaryngology Department of Valiasr Hospital, Birjand, Iran, in 2017. Methods: A case-control study was performed on individuals, including a group of patients with rhinosinusitis and a control group (n=20 each), referring to the Department of Ear, Nose, and Throat Diseases Department of Vali-asr Hospital. Among patients diagnosed with chronic rhinosinusitis, the cases that had polyps on endoscopic examination were included in the study. After completing the consent form, venous blood samples (10cc) were collected from the patients in fasting conditions. The electrochemical luminescence method was used for measuring the level of serum vitamin D. A questionnaire containing demographic information and clinical findings was completed by reviewing the patients' records. Data analysis was performed in SPSS software (Version. 22) using Chi-square and Mann-Whitney U-tests. Results: The mean and median scores of vitamin D level were obtained at14. 13± 12. 99 and 10. 25 in the case group, and 18. 72± 9. 29 and 18. 77 in the control group, respectively. The level of vitamin D was significantly higher in the control group than in the chronic group (P=0. 04). In the case group, 16 (80%) patients lacked vitamin D and 3 patients had an insufficient level of vitamin D. In the control group, 13 (65%) patients lacked vitamin D and 4 cases had an insufficient level of vitamin D. There was no significant difference in vitamin D levels between the two groups (P=0. 61). No significant difference was observed between the two clinical symptoms. Conclusion: It was revealed that the lack of vitamin D was likely to be an effective factor in the rhinosinusitis disease; therefore, proceedings need to be taken to cure the deficiency of this vitamin.

Introduction: Since the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, the disease has spread rapidly throughout the world and became a traumatic stressor. Identification of the factors affecting the spread of the disease makes it possible to prevent its further propagation and save more people in similar situations. Environmental and climatic parameters are among the factors affecting the prevalence of diseases. Determination of environmental effects on Coronavirus disease (COVID-19) prevalence can help develop policies to suppress the spread. Methods: This study investigated the effect of climatic parameters on the spread of COVID-19 disease in County Maricopa from March 11, 2020, to November 30, 2020. These parameters include maximum, minimum, and mean daily temperature as well as maximum, minimum, and mean daily humidity, wind speed, solar radiation, and Air Quality Index (AQI) of particulate matter10 (PM10), PM2. 5, and O3. A Shapiro-Wilk test was used to evaluate the normality of variables and the Spearman correlation test was used to determine the correlation between parameters and daily COVID-19 cases. A simple linear regression was applied on parameters that had significant Spearman’ sranked correlation with the daily COVID-19 cases to determine their contribution to the pandemic. Results: The present study showed that the maximum, minimum, and mean temperature parameters and PM10 and PM2. 5 particles had a positive and significant correlation (P<0. 01) with the prevalence of COVID-19 disease. The effect of PM10 particles was higher than the other parameters (0. 488, P<0. 01). The parameters of maximum, minimum, and mean relative humidity along with solar radiation and O3 AQI had a significant and negative correlation with the development of COVID-19 disease (P<0. 01). The effect of maximum humidity was higher than that of the other parameters (-0. 364, P<0. 01). A linear regression test showed that O3 (β =-15. 16, P<0. 001) and Tmean (β =18. 47, P<0. 01) significantly predicted daily COVID-19 cases. Conclusion: It can be concluded that climatic parameters can affect the COVID-19 pandemic and should be addressed.

Introduction: Injuries and violence are significant causes of death and health problems in all countries; however, they are not equally distributed across the world or within countries. Injuries result from road traffic crashes, falls, drowning, burns, poisoning, and acts of violence against oneself or others, among other causes. The present study aimed to describe the causes, their characteristics, frequencies, types, and outcomes of the injuries reported to the Forensic Medicine Center, Zahedan, Iran. Methods: This cross-sectional study was conducted in the Forensic Medicine Center, Zahedan, South-East Iran. A total of 1400 intentional and unintentional injuries were systematically extracted from the administrative records between January 1, 2008, and December 31, 2018. The data were analyzed using the Chi-square test and multiple logistic regression models. Furthermore, the Stata statistical software (version 14; StataCorp, USA) was used for all analyses. Results: In this study, three major causes of injuries included accident, fight, and burn in the order of priority. The overall frequencies of intentional and unintentional injuries among the subjects were 40. 3% and 59. 7%, respectively. Moreover, death occurred in 45. 6% of the cases. Here, the odds of death in unintentional injuries were more than those in intentional ones (P<0. 001). Multiple logistic regression modeling showed that increasing age (P=0. 001), education level (P<0. 001), holiday time (P=0. 02), and urban setting (P=0. 02) for injury were associated with increased odds of intentional injuries. Conclusion: According to the results, younger age groups were more likely to be injured, compared to other categories. Therefore, it is necessary to implement any planning and prioritization for the reduction of family injuries and violence in school education by instructing this age group regarding injuries and their health risk consequences. Decision-makers should focus their attention on the issue locally. The implications of this study could be highly influential to identify intervention opportunities and determine local and cultural problematic health issues.

Throughout the coronavirus disease 2019 pandemic, patients using oral anticoagulants for mechanical valve replacement and/or another clinical-pathological condition might have faced various clinical scenarios. Rectus sheath hematoma is one of the acute abdominal pain syndromes. This study presented a patient with developed anticoagulation-induced rectus sheath hematoma after mitral valve replacement.

Arrhythmia is one of the most common cardiovascular complications during anesthesia. Its occurrence has been reported in 70% of patients undergoing general anesthesia for various surgical procedures. Premature ventricular complex usually follows a benign course and shows a good response to medical therapy. In this study, a case was reported that did not respond to the usual treatment of ventricular tachycardia and frequent premature ventricular complex.