Introduction: Hallux valgus is a prevalent deformity of the forefoot, characterized by deviation of the great toe (hallux) toward the second toe and prominence of the metatarsal, along with the formation of a bony structure known as a bunion on the medial edge of the foot. The purpose of this retrospective study was to compare the efficacy, VAS pain scale scores, and patient satisfaction between the Chevron and SERI (Simple, Effective, Rapid, Inexpensive) surgical techniques in the correction and treatment of moderate halluxvalgus. Method: This was a non-randomized clinical trial of 70 patients who underwent surgery for correction of hallux valgus using one of two techniques (Chevron technique, n = 35; SERI technique, n = 35) at Baqiyatallah Hospital in the second half of 2022. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured preoperatively and one year after the operation using radiographic and medical records. Patient pain levels were evaluated using the Visual Analog Scale (VAS), and subjective satisfaction was also assessed. Both parameters were evaluated and documented in patients' medical records. Data were analyzed using SPSS software version 26, with comparisons made using the t-test and chi-square test. Result: In the preoperative evaluation, the mean intermetatarsal angle (IMA) was 12.97 +/- 1.70 (range: 11.27-14.67) in the SERI group and 12.08 +/- 1.24 (range: 10.84-13.32) in the Chevron group. The mean preoperative hallux valgus angle (HVA) was 32.80 +/- 3.26 (range: 29.54-36.06) in the SERI group and 32.17 +/- 1.94 (range: 30.23-34.11) in the Chevron group . At the one-year postoperative follow-up, the mean IMA was 8.14 +/- 1.50 (range: 7.64-10.64) in the SERI group and 9.37 +/- 1.03 (range: 8.34-10.40) in the Chevron group. The mean postoperative HVA was 10.28 +/- 1.60 (range: 8.68-11.88) in the SERI group and 14.4 +/- 1.41 (range: 12.99-15.81) in the Chevron group. Postoperative HVA and IMA measurements showed a statistically significant difference between the two groups (P < 0.05). The SERI group experienced significantly lower pain levels compared to the Chevron osteotomy group (P < 0.05). Additionally, patient satisfaction was significantly higher in the SERI group compared to the Chevron group (P < 0.05). Conclusion : The results of this study demonstrate that the SERI technique provides higher patient satisfaction and lower pain levels compared to the Chevron technique at the one-year follow-up. This study showed better surgical outcomes with the SERI technique for moderate hallux valgus.
Introduction: Over-pronated feet (OPF) are associated with altered lower-limb mechanics and elevated injury risk during running. Longterm training on different sport surfaces may modulate neuromuscular control, including knee muscular co-contraction; however, surface-specific adaptations in individuals with OPF remain insufficiently characterized . To determine the long-term effects of training on natural grass, artificial turf, and synthetic surfaces on knee muscular co-contraction during running in individuals with OPF. Method: In this randomized controlled trial (IRCT20170806035517N5), thirty-two adults (aged 18-30 years) with clinically diagnosed OPF were randomly allocated to one of three intervention groups (natural grass, artificial turf, or synthetic surface) or a no-training control group. The intervention groups completed a supervised, eight-week running program with standardized frequency and progression. Surface electromyography (sEMG) was used to quantify knee muscular co-contraction during treadmill running at a controlled speed. General co-contraction and directed flexor-extensor co-contraction indices were computed over discrete stance sub-phases (heel-contact, mid-stance, and push-off) using established processing pipelines. Assessments were performed pre-and post-intervention by the same blinded operators. Group-by-time effects were examined for primary outcomes, with alpha set at 0.05. Result: No significant changes emerged for general knee co-contraction across time or between groups. In contrast, significant group-by-time interactions were observed for directed flexor-extensor co-contraction during mid-stance (p = 0.035) and push-off (p = 0.020), indicating that training induced surface-specific neuromuscular adaptations rather than uniform joint stiffening. A main effect of time was also noted at heel-contact (p = 0.050), consistent with a generalized training-related modulation early in the stance phase. Collectively, these patterns suggest that extended exposure to distinct surfaces selectively re-tunes knee muscle coordination strategies in individuals with OPF without globally increasing co-contraction. Conclusion : Eight weeks of running training on different surfaces prompted targeted adjustments in knee flexor-extensor coordination in runners with OPF, while general co-contraction remained unchanged. Although such adaptations may be beneficial for control, they might not fully mitigate injury risk in this at-risk population. Individualized surface selection alongside integrative neuromuscular conditioning should be considered in rehabilitation and return-to-running planning for individuals with OPF.
Introduction: Total hip arthroplasty (THA) is an effective treatment for advanced hip conditions, yet postoperative dislocation remains a significant complication, especially in patients with spinal disorders. Altered spinopelvic alignment and reduced spinal mobility can lead to prosthetic instability. Given the growing prevalence of coexisting conditions, this study aimed to develop a predictive model to identify individuals at increased risk of hip dislocation after THA with spinal abnormalities. Method: This descriptive cross-sectional study was conducted over 10 years, until 2023, at Shohada Hospital, including 225 patients (75 with spinal disorders and 150 controls) who experienced hip dislocation after total hip arthroplasty. Key variables, including demographic data, surgical factors, comorbidities, and medication history, were analyzed. Result: In this study, two predictive models were developed to assess the postoperative risk of hip dislocation in patients with spinal disorders. Model I, based on logistic regression, included 14 variables and showed moderate discrimination (C-index=0.67) but limited calibration and low R-2 (0.04). Model II, using elastic net regression, selected nine key predictors-including hip rotation, anemia, BMI 30-35, and certain medications-and achieved better discrimination (AUC=0.73), though with similarly low explanatory power (R-2 = 0.02). Conclusion : This study identified demographic variables (age, BMI), clinical factors (history of psychosis, preoperative anemia), surgical parameters (type of femoral fixation, preoperative hip internal rotation, surgical indication), and medication use (antiepileptic drugs, muscle relaxants, antidiabetic medications) as significant predictors of postoperative hip dislocation risk following total hip arthroplasty in patients with spinal disorders.
Introduction: Investigation of ground reaction forces and electromyographic activity can help clinicians examine mechanical changes in the feet of individuals in pronation during rehabilitation. Method: Twenty adult males with pronated feet and twenty healthy adult males volunteered to participate in this study. A force plate was embedded in the middle of an 18-m walkway to collect ground reaction forces. Muscle activity was recorded using an EMG system. Ground reaction forces and lower limb muscle activities were recorded during walking with and without foot orthoses. A two-way ANOVA with repeated measures was used for statistical analysis. Result: Paired-wise comparison demonstrated lower peak medial ground reaction force, peak anterior and posterior ground reaction forces, peak negative free moment, and time-to-peak of medial ground reaction force during walking with foot orthoses than without them. Results did not show any significant group-by-foot orthoses interactions for ground reaction force components during walking. Significant group-by-time interactions were found for rectus femoris activities. Post-hoc analysis demonstrated lower rectus femoris activity in the healthy group and greater rectus femoris activity during loading phases while walking with foot orthoses compared with without them. Conclusion : Double-density foot orthoses can effectively alter ground reaction forces and muscle activations in individuals with pronated feet, potentially reducing the risk of injury and improving walking mechanics.
Introduction: Kienbock disease is defined by avascular necrosis of the lunate bone. If left untreated, the condition often progresses, leading to bone collapse, wrist shortening, and the need for ankle fusion. In this study, we performed a novel surgical method for treating Kienbock disease. We evaluated and compared the outcomes of lunate decompression with and without bone marrow injection in patients affected by Kienbock disease. Method: In this study, 20 patients with Kienbock disease stages I to IIIa were assessed in two groups: one group received core lunate decompression. In contrast, the other group underwent core lunate decompression followed by an injection of bone marrow. This study took place from April 2015 to April 2016. The researchers assessed the patient's pain levels, range of motion, functional disability, and radiographic indices before and one year after the procedure. Result: The average age of patients in the Bone Marrow (BM) group was 35.66 years (standard deviation: 13.02), compared to 30.33 years (standard deviation: 0.66) in the control group (P = 0.126). The mean postoperative Mayo score for the BM group was 88.12 (standard deviation: 6.51), while the control group had a mean score of 76.66 (standard deviation: 2.88) (P = 0.126). Additionally, the mean postoperative performance score in the BM group was 24.37 (standard deviation: 1.76), compared to 18.33 (standard deviation: 2.88) in the control group (P = 0.09). Bone vascularization and mineralization were more significant in the BM group than in the control group. Conclusion : The results of this study indicate that core lunate decompression is an effective treatment for Kienbock disease. The outcomes in the BM group were significantly better than those in the control group. Additionally, improvements in bone density and radiological changes were observed in the BM group. However, further studies with larger sample sizes and longer follow-up durations are necessary for a more comprehensive evaluation of the BM treatment.
Introduction: Although the importance of anatomical repair and fixation for syndesmotic injury has been emphasized, the best surgical approach remains a topic of discussion. This study sought to evaluate and compare the post-operative pain and surgical outcomes between screw fixation and the suture endobutton method in patients with Weber type C ankle fractures. Methods: A total of 56 consecutive patients with Weber type C ankle fractures participated in this prospective cohort study and underwent either screw fixation or suture endobutton surgery in 2022. Pain, infection, and the Foot and Ankle Outcome Score (FAOS) were monitored 3, 6, and 12 months' post-operation. Results: The study included 14 women and 42 men, aged 18 to 47 years. There were no differences in age and sex between the two surgical groups. The pain score was significantly lower in the suture endobutton group compared to the screw fixation group three months after the operation (P=0.042). However, the two groups had no significant differences in pain scores at six and twelve months. Within each treatment method, the pain scores were statistically significantly different over time (Ptotal<0.001 in two groups). The suture endobutton method resulted in higher FAOS scores compared to the screw fixation method at three, six, and twelve months after surgery. The difference in this score within each group during the follow-up period was statistically significant (Ptotal<0.001 in two groups). Conclusion: The suture endobutton method has demonstrated advantages over screw fixation surgery. Patients have improved performance at three, six, and twelve months' post-surgery, indicating that it may be a potentially superior approach to treating syndesmosis injuries.
Introduction: Physical anthropometry, which includes the measurement of human anatomical structures such as lumbar vertebrae, is generally used to evaluate and measure human body dimensions. Its morphometry branch is used to define these structures. Today, the best standard for fusion inside the spine uses pedicular screw fixation. Objectives: This study aimed to analyze the three-dimensional tomography of the lumbar vertebrae based on gender and ethnicity in Gorgan, North of Iran. Methods: This descriptive-analytical study was performed on three different ethnical populations: Native Fars, Turkmen, and Sistani, which included 120 participants divided into three groups of 40 cases (20 females and 20 male), in the age group of 18-45 years, with the average heights of 165-180 cm for men and 165-170 cm for women. The dimensions of the intervertebral discs, bodies, and foramina of lumbar vertebrae were determined from the main axial view by coronal and sagittal reconstruction in 1.5 mm slices by a Computed Tomography (CT) scan. Results: Based on the findings, differences were observed in the dimensions of intervertebral discs, bodies, and foramina of lumbar vertebrae based on gender and ethnicity using CT between the two genders (P<0.05). The above dimensions were higher in men than in women. The evaluation of the height and width of the vertebral body based on ethnicity showed a difference only in the width of the L1 lumbar vertebrae between Native Fars and Turkmen (P<0.05). Also, there were differences in the width of the foramina in the L3, L4, and L5 vertebrae among the Native Fars, Turkmen, and Sistani groups. Conclusion: The present study found that dimensions of the intervertebral discs, bodies, and foramina of lumbar vertebrae were different based on gender and ethnicity, though, in terms of the lumbar disc, the difference was only observed in the two genders
Introduction: Traumatic experiences are commonplace worldwide and have been proven to have detrimental effects on health. Unlike traditional survival analysis, which focuses on a single endpoint, multistate models are beneficial for evaluating the progression of multiple health conditions over time. The primary goal of this paper is to employ a multistate model to ascertain the patterns in hospitalizations among traumatic patients. Method: In this longitudinal study, 502 eligible trauma patients who were referred to Shahid Rajaee Hospital in Shiraz, Iran, were chosen and followed from July 2018 to March 2019. A Semi-Markov Multistate model was utilized in the current study. Patients were assumed to transition between five states. Transition times (triage-general ward, triage-death, general ward-Intensive Care Unit [ICU], general ward-death, and surgical ward-death) were assumed to follow an exponential distribution. The hazard ratio (HR) for each covariate was estimated for each transition. Result: Based on in-hospital triage evaluations, some patients needed surgery. Injury Severity Score (ISS) more than 15 (HR= 1.41), blunt trauma with brain injury (HR=2.15), hypotension (HR=1.41), and low pulse rate (HR=1.40) increased the probable requirements of the surgery. Following surgical treatments, patients with moderate Glasgow Coma Scale (GCS) were more likely to die (HR=1.42). Further, those who had experienced blunt trauma and brain damage had a lower chance of death following surgery (HR=0.62). The need for intensive care directly after triage is more likely in cases with a severely low GCS score. Conclusion : This study confirmed that elderly patients are at lower risk of surgical interventions after ICU. Cases with more injuries were more likely to require surgery after triage. Identifying specific prognostic factors that significantly impact the progression and outcomes of traumatic care can help healthcare providers prioritize interventions and allocate resources more effectively, ultimately enhancing patient outcomes.
Introduction: Drowning is a leading cause of unintentional injury-related deaths worldwide, with significant geographical variations in mortality rates. This study aims to identify high-risk drowning areas and assess epidemiological trends using Geographic Information Systems (GIS) from 2016 to 2022. Method: A cross-sectional analytical study was conducted using data recorded by the Emergency and Medical Incident Management Center of Gilan Province. A total of 588 drowning incidents were analyzed, considering variables such as age, gender, seasonality, and geographical location. GIS software was used to map high-risk areas using Spot and Heatmap techniques, while statistical analyses were conducted in Stata. The Odds Ratio (OR) index was used to assess risk levels. Result: Of the 588 reported drowning incidents, 497 were non-fatal, while 91 resulted in fatalities. The majority of incidents (474 cases) occurred in high-risk locations. Male individuals accounted for 77.21% of the total cases and 81.98% of fatalities, highlighting gender disparities in drowning rates. Rasht County recorded the highest number of fatalities (20 deaths), while Shaft and Sowme'eh Sara had zero reported drowning deaths. Geographic analysis using GIS mapping revealed that most drowning incidents occurred along the shorelines and river confluences, particularly in Bandar Anzali, Rasht, Astarabad, and Rudsar. Odds Ratio (OR) indicated that men had significantly higher drowning risks than women (OR = 2.57, 95% CI: 2.21-2.96), and drowning risk was notably elevated in coastal zones (OR = 3.19, 95% CI: 2.65-3.85) Conclusion : Drowning mortality in Gilan Province is disproportionately higher among older men, primarily due to occupational exposure, risky behaviors, and environmental factors. Preventive measures such as enhanced safety regulations, swimming education programs, improved tourist signage, and stricter enforcement of occupational safety standards are recommended to reduce drowning incidents. Identifying high-risk zones through GIS analysis provides valuable insights for targeted interventions and policy development.
The Zionist state of Israel struck the Islamic Republic of Iran on 13th June 2025 with sudden and unprovoked air attacks in a blatant act of aggression assassinating many military commanders, nuclear scientists, and killing civilians, mostly women and children (1,2). This 12 days of US-Israeli aggression also destroyed houses, apartments, schools, clinics, hospitals, industrial areas and defense and military facilities. It was condemned by the world community including UN. International Organizations should be reminded and are hereby emphasized to observe ethical and humanitarian principles in wars, especially not to harm relief and medical personnel.
Introduction: This study aimed to determine the types of trauma inflicted on different areas of the body as a result of shotgun injuries, while also evaluating the diagnostic and therapeutic interventions performed. Method: This was a descriptive-analytical cross-sectional study conducted on individuals injured by a shotgun during the 2022 unrest in Tehran. A total of 180 individuals were included. Injured individuals were categorized into police or security and protester groups and compared in terms of type of injury and severity. Data were collected from hospital records, including demographic information, injured body areas, trauma-related complications, and diagnostic and therapeutic measures. The Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS) were calculated based on available data. Statistical analysis was performed using SPSS software. Result: Out of 180 injured patients included in the study, 172 were male and eight were female. The mean age was 31.82 +/- 11.47 years, ranging from 10 to 63 years. Among them, 106 were police or security personnel and 74 were protesters . The mean ISS for all patients was 1.48 +/- 0.96. Comparison between the two groups showed that police or security personnel sustained more severe injuries (1.69 +/- 1.24 vs. 1.18 +/- 0.55; P = 0.01). Injuries to the head, face, neck, and chest were significantly more common among police or security personnel (P = 0.024), while abdominal, pelvic, and lower limb injuries were more prevalent among protesters (P = 0.015) . Imaging tools such as plain radiography and CT scans were used for diagnostic evaluation. All 21 cases of chest trauma were diagnosed by chest X-rays. Two cases required chest CT scans, which showed no lung or cardiac injury. In abdominal injuries, 51% of radiological assessments had positive findings. Among 40 cases of head and neck trauma, only one showed pellet penetration of the skull bone, and no brain tissue injury was observed . Regarding treatment, 42 patients (23.3%) required hospitalization, while 138 (76.7%) were treated on an outpatient basis. None required CPR or airway management. Conclusion : Shotgun pellets has not high energy and usually cause minor injury but sometime may cause serious injuries. Removal during early hospitalization is not recommended. Deep pellets in limbs generally do not require removal unless surgery is indicated due to vascular or neurological damage. Chest injuries with deep or multiple wounds require more radiographic study. Deep or multiple wounds in the abdomen need additional evaluation to rule out serious intra-abdominal injuries. Greater caution is needed in managing facial and neck injuries, necessitating more intensive care.
Introduction: Clinical education in trauma wards presents unique challenges for nursing internship students, which can adversely affect their learning outcomes and professional development. Understanding these challenges is critical to enhancing the quality of nursing education and student preparedness. This study aimed to explain the challenges faced by nursing internship students in trauma departments of hospitals not affiliated with Baqiyatallah University of Medical Sciences. Method: Seventeen participants, including 12 nursing trainees (mean age 22.3 years) and five clinical instructors (mean age 42.4 years), were purposively sampled to achieve maximum diversity. Data were collected through semi-structured interviews conducted in Tehran from September 2024 to December 2024. Conventional content analysis was conducted using the Graneheim and Lundman approach and MAXQDA version 10 software to identify categories and subcategories reflecting the participants' experiences. Result: In this study, 12 nursing students with a mean age of 22.3 and 5 nursing instructors with a mean age of 42.4 were identified. Their experiences of trauma ward challenges were categorized into three main categories and seven subcategories. The main categories included psychological factors with two subcategories: fear and stress of violence and high workload; organizational factors with three subcategories: irregular shuttle service, lack of staff familiarity with event recording objectives, inadequate facilities and equipment; and educational factors with two subcategories: poor collaboration between nursing staff and students, and limited time available. Conclusion : Nursing trainees in trauma units face multifaceted psychological, organizational, and educational challenges that hinder optimal clinical learning. Addressing these challenges requires targeted interventions such as improving clinical staff awareness of students' educational goals, ensuring adequate resources, strengthening supportive relationships between staff and students, and optimizing logistical arrangements. Such measures can improve the clinical learning environment and better prepare students for professional roles in trauma care. Given that the study was conducted in selected trauma units affiliated with non-university hospitals in Tehran, the study's findings cannot be generalized to other healthcare settings.
Introduction: Trauma is one of the leading causes of death and disability worldwide. This study aimed to investigate the severity and patterns of trauma, as well as to analyze the treatment outcomes for victims of urban riots who were referred to a general hospital in Tehran from October to December 2022. Methods: This cohort study involved 1,032 individuals injured during urban riots, all of whom were referred to a Hospital in Tehran between October and December 2022. The severity of their injuries was assessed based on operational descriptions, CT scans of the brain and other organs, and ultrasound examinations, all of which were obtained from patient records. The likelihood of survival for each patient was calculated using the TRISS method. Results: One thousand thirty-two individuals were injured, consisting of 1,030 males and two females. The patients ranged in age from 14 to 65, with an average age of 30.9 +/- 9.9 years (median age of 30 years). Among the injured, two people (0.19%) were aged between 0 and 15, 1,008 people (97.7%) were between 15 and 55, and 22 people (2.1%) were over 55 years old. The average Injury Severity Score (ISS) was 1.8 +/- 3, with a median score of 1. The average survival probability of patients using the TRISS model was 99.487 +/- 2.7%. The overall average TRISS score was 0.513 +/- 2.7%. Conclusion: TRISS can be utilized to evaluate the quality of various programs, such as educational initiatives, the establishment of cardiopulmonary resuscitation teams, and trauma surgical teams. Given the potential for urban accidents, it is essential to develop trauma care protocols based on the severity of patients' injuries. Additionally, it is recommended to establish a trauma registration center that utilizes standard questionnaires and checklists.
Introduction: Traumatic Brain Injury (TBI) is a significant public health problem. Detecting effective therapeutic compounds for the management of TBI patients is essential. Nuclear factor E2-related factor 2 (Nrf2) is a transcription factor that regulates oxidative stress and inflammation after TBI. This study aimed to assess Targeted Therapeutic Compounds by inhibiting the degradation of Nuclear Factor E2-Related Factor 2 for TBI management. Methods: The compounds that inhibit Nrf2 degradation by suppressing Nrf2 inhibitors, such as Kelch-like ECH-associated protein 1 (Keap1), E3 ligase adapter (3-TrCP, and glycogen synthase kinase 3 (GSK-3), were identified by a literature review. Possible active sites for identified target proteins were determined. Molegro Virtual Docker (MVD) software predicted the protein-ligand interaction study. The interaction compounds that inhibit Nrf2 degradation (Keap1, GSK-3, and (3-TrCP proteins) with over 274000 drug-like compounds from the ZINC database were analyzed by molecular docking. Selected compounds from the molecular docking analysis were subjected to ADME prediction for pass drug parameters. The molecules were imported to Swiss Similarity software, and screening was performed using the Food and Drug Administration (FDA) approved drugs library. To assess the structural stability of the hit compounds, molecular dynamics (MD) simulation using the GROMACS package version 2020.1 was performed. Results: Four molecules, including ZINC435885061, ZINC469515563, ZINC119772060, and ZINC550706912, can suppress all three Nrf2 inhibitors and are capable of penetrating the blood-brain barrier. The ADME analysis of the compounds showed that these four molecules could be used therapeutically. Nebivolol is an FDA-approved drug identified for neuroprotective effects and can be used as a potential candidate for treatment. Conclusion: Targeted therapeutic compounds that inhibit Nrf2 degradation can be used for TBI treatment. Nebivolol, an FDA-approved drug, has neuroprotective effects and can be used for TBI treatment, but further studies, such as animal studies and clinical trials, are necessary.
Introduction: Amputations from trauma can lead to disability and pose a challenge for health care services. This study hopes to shed light on the trend, the changes, outcomes, and factors associated with trauma leading to amputations in Shiraz, Iran. Method: A cross-sectional study was conducted to assess patients who experience amputations due to trauma in Shiraz from 2017 to 2023. The sampling method consisted of patients hospitalized at Shahid Rajaee Hospital in Shiraz. We included participants who were hospitalized for traumatic amputations. Outpatients, follow-up cases, and non-trauma-related amputations were excluded from the analysis. Data collection included variables such as admission year, gender, age, and level of amputation. Result: 435 patients were included, and 92.2% were males. The average age of patients was 36.1 years, and the majority of patients (88.8%) underwent minor amputations. Amputation was most common among motorcycle riders (47.5%), while traffic accidents and lower limb injuries significantly contributed to major amputations, accounting for 21.9% and 51.3% of cases, respectively. The average hospital stay was 5 days. The majority of patients stayed over two days. Upper limb injuries and amputations had a significant association (p < 0.001), as well as contact with a blunt object and amputation (p = 0.002). The presence of many injuries was associated with shorter stays in a hospital (p = 0.045). We found a statistically significant increase in amputations by gender (p <0.001) and type (p=0.006) during the study period. The overall trend peaked in 2022. Conclusion: The pattern of limb loss rates among participants, mostly men, was worrisome. Motorbike drivers are clearly at greater danger, and road accidents play a big part in severe amputations. The association between arm injuries and amputations shows the need for focused ways to stop this.
Introduction: Limited research has been done on vascular traumas of the upper limb and their comparison with those of the lower limb. This research was conducted to determine and compare the therapeutic outcomes of penetrating vascular trauma of the upper and lower limbs in patients referred to Golestan Ahvaz Hospital in 2024. Methods: This was a descriptive-analytical and prospective study. The sample size was determined using the census (820 participants). Information was obtained through the medical records and entered into the checklist. Primary outcomes included mortality, rehospitalization, amputation, and revascularization interventions, and other outcomes included operative complications and neurological deficits, which were compared in two groups of upper and lower limb injuries. Results: The frequency of arterial involvement (P=0.003), compartment syndrome (P=0.014), and nerve injury (P=0.005) was higher in the upper limb group. The duration of hospitalization in the lower limb group was significantly longer (P=0.003). In treating penetrating arterial injuries, the rate of primary anastomosis (P=0.006) and ligation of arterioles (P=0.039) was significantly higher in the upper limb group. In comparison, the rate of using venous interposition graft (P=0.032) was significantly higher in the lower limb group. In treating venous injuries, the rate of fasciotomy (P=0.031) was significantly higher in the lower limb group. Mortality rate (P=0.023), amputation (P=0.001), need for reoperation (P=0.041), and need for therapeutic fasciotomy (P=0.001) in the lower limb group were significantly higher. At the same time, the frequency of nerve damage (P=0.003) was significantly higher in the upper limb group. Conclusions: The results show a difference between the initial manifestations, management, and surgery and the outcomes of penetrating injury of the upper and lower limbs, which suggests that attention to penetrating injury seems necessary to prevent mortality and morbidity.
Introduction: Given the importance of obtaining accurate information on the prevalence and causes of trauma in children, and the role of such data in informing health policy and prevention strategies, as well as the paucity of information on this topic in Qom province, this study aimed to investigate the causes of trauma and related factors. Method: This descriptive-analytical cross-sectional study focused on children with injuries who visited the emergency departments of public hospitals in Qom, Iran. Data were collected using a standardized form and by reviewing the medical records of hospitalized children during 2019. Result: In a study involving 1,447 children, 60.1% of the participants were boys. The most common cause of trauma was falling (46.5%), and the most common place of the accident for boys was outside the home (73%). There was a significant relationship between children's age and the cause of the trauma, so that the prevalence of traffic accidents was higher in older children (P <0.05). Conclusion: Considering that most of the patients referred to the hospital due to trauma were boys, the high prevalence of falls in children, and the increase in traffic accidents in children with increasing age, it is clear that there is a need for further research.
Introduction: Burn injuries are a substantial public health concern worldwide. This study aimed to assess the characteristics and clinical outcomes of burn patients hospitalized in Kerman, Iran, using the ICD-10 classification. Methods: This cross-sectional study assessed the data of 437 burn inpatients admitted to the primary academic burn referral center in Kerman, Iran, in 2023. Data were extracted using a checklist that included ICD-10 coding, demographic variables, burn characteristics, causes, complications, comorbidities, and clinical outcomes. Results: Of the 437 patients, 75.1% were male and 24.9% female, with no reported pregnancies. The most represented age group was 35-45 (24.3%). Most (86.5%) were insured and lived in urban areas (57.2%). However, data on marital status (70.9%), education (65.9%), and employment (59.3%) were frequently missing. The most common burn etiology was flame (36.4%), and burns typically occurred in non-residential settings (60.9%). Most patients (94.1%) had third-degree burns, and 23.1% had burns covering 10-19% of total body surface area. Partial recovery was the most frequent outcome (62.9%), while the mortality rate was 12.1%. Conclusion: This study showed the need for comprehensive data improvement and standardization of burn documentation using the ICD-10 coding system. Improve preventive strategies and integrated data collection systems to improve outcomes and screening.
Introduction: Tendon injury is an important clinical issue for orthopedic surgeons. Tendon healing is a time-consuming process. This study aimed to investigate the effect of autologous Leukocyte-platelet-rich fibrin (L-PRF) on the healing of the superficial digital flexor tendon in a rabbit model. Method: Ten healthy adult rabbits of mixed breed were randomly divided into Treatment and Control groups. After cutting the superficial digital flexor tendon and suturing it, the autologous L-PRF membrane was applied locally in the Treated group. The tendon was sutured with the Bunnell-Mayer pattern with no material implantation in the Control group. Five animals from each group were euthanized, and their tendons were collected for histopathological evaluation on the 30th day post-surgery. Result: In morphological examination, a smaller tendon diameter and more adhesion were seen in the Treated group. There were significant differences in the total number of cells, cell maturation, the ratio of cellularity to matrix, and the alignment and order of cells between the Treated and Control groups at the histopathological level. The Treated group showed superiority over the Control group in tissue order, collagen fiber crimp pattern, inflammation, and vascularity; however, these differences were not significant. Conclusion : This study found that L-PRF has a beneficial effect on tendon healing. Due to the short treatment period, additional research and evaluations are necessary in this field.
Introduction: Burn injuries represent a critical medical challenge due to their prolonged healing time, susceptibility to infection, high treatment costs, and risk of systemic complications. Recent therapeutic approaches have focused on combining physical interventions and phytotherapeutic agents to enhance wound repair. This study aimed to investigate the synergistic effects of a polyvinyl alcohol-chitosan hydrogel infused with Moringa oleifera seed extract and high-intensity interval training (HIIT) on the healing of infected thirddegree burn wounds in rats. Methods: A hydrogel formulation based on polyvinyl alcohol and chitosan was synthesized incorporating Moringa oleifera extract. Male Wistar rats (n=72) were randomly assigned to four groups: T1 (HIIT alone), T2 (HIIT+ hydrogel), T3 (hydrogel alone), and T4 (control). HIIT was administered for three weeks prior to wound induction. All animals received third-degree burn wounds followed by infection with Staphylococcus aureus. Wound healing was assessed both macroscopically and microscopically on days 7, 14, and 21 post-injuries. Results: Macroscopic evaluation showed significantly greater wound contraction in T2 (combined HIIT and hydrogel) compared to other groups during the first and second weeks (p < 0.05). Bythe third week, although no significant difference was observed among the treated groups (T1-T3), all outperformed the control (p > 0.05). Histological analysis revealed enhanced angiogenesis, re-epithelialization, fibroplasia, collagen deposition, and reduced inflammatory infiltration in all treatment groups, with T2 consistently demonstrating the most pronounced improvements. Conclusion: Both HIIT and topical application of Moringa oleifera-enriched chitosan hydrogel individually contributed to improved wound healing outcomes. However, their combination resulted in synergistic effects, promoting accelerated wound closure, enhanced tissue regeneration, and better modulation of inflammatory cell infiltrations. This synergy may be due to HIIT-induced systemic increases in growth factors and antioxidants, potentiating the local anti-inflammatory and pro-angiogenic effects of Moringa oleifera extract.
