Journal of Surgery and Trauma
Volume:6 Issue: 2, Summer 2018

Dear Editor,
As you know physical and mental wellness of physicians and nurses, as the main role in the treatment of patients, in conditions such as burnout, compassion fatigue, depression, and poor work-life balance, is one of the top priorities in the U.S.A. National Academy of Medicine (1-4).
Although healthcare team members are generally known as a caregiver to others; their high workload commonly lead to lack of enough self-care, which ultimately can result in medical errors.
Medical errors are known as the third leading cause of death in the U.S.A. accounting for approximately 50 percent of deaths in hospitalized patients (5, 6).
In Iran, due to the absence of a comprehensive system for registration of medical errors, no precise statistics are available. However, by different social and economic factors, the prevalence of medical errors is higher than reports from global standards and scientific data (7).
Systematic review studies showed that poor wellbeing and moderate to high levels of burnout were significantly related to medical errors (5, 6).
Studies also indicated that work shifts longer than 12 hours per day or 40 hours per week were significantly associated with the occurrence of medical errors (8-12).
On the other hand, the unhealthy work environment of staff causes noxious effects on the wellbeing of the health team and ultimately leads to increased occurrence of medical errors (4).
Considering the above-mentioned issues and in line with this fact that a comprehensive study of effective variables on environmental conditions, physical and mental wellbeing of health team members, especially surgeons and surgery wards nurses, has not been conducted in Iran yet, it is suggested that providing and conducting encouraging programs for authors can disseminate studies in this field. Therefore, with a meta-analysis study of gathered data, necessary approaches and actions to identify and resolve these factors and obstacles can be achieved, which can successfully result in decreasing medical errors rate.

Structured surgical training is vital to ensure that the next generation of surgeons is equipped with the skills necessary to guarantee safe patient care, as well as the skills required to ensure effective ongoing professional development. Numerous instructional strategies and educational approaches, which are commonly used in the operating room, have recently been described in the literature. The aim of this review article is to highlight current teaching methods for training surgical residents in the operating theatre. A literature search on the current teaching methods for training surgical residents in the operating room was carried out using PubMed, Scopus, Google Scholar, ScienceDirect, and ERIC databases between the years 1990 and 2018, and selected articles were retrieved. This review demonstrates that most surgical training programs make use of a variety of teaching methods and models for training surgical residents in the operating room, including the apprenticeship model, the BID model, the Zwisch model, the one-minute preceptor, Koens et al.’s model, and Morbidity and Mortality Meetings. Effective use of these novel educational tools by surgical educators may serve to improve the quality and efficiency of intraoperative resident education.

Since surgical treatment for tumorous lesions does not always lead to complete patient recovery, it is possible for the attacks to continue. To help plan for the patients' health, this study aimed to compare the therapeutic effects of adjuvant therapy and surgery in controlling seizure of low-grade glioma (LGG) patients in Firoozgar Hospital in 2013-2014. In this analytical cross-sectional study, 114 patients with LGG (grade 2) tumors admitted in Firoozgar Hospital during 2013-2014 were divided into two groups of adjuvant therapy and surgical treatment. All of these patients were followed by telephone and were asked about the incidence, frequency, and intensity of seizure attacks up to one year after surgery. The age and sex of the patients, along with the drug used after surgery, were also recorded on a checklist. Electroencephalography (EEG) was performed on all the patients under the supervision of a neurologist. Patient information was entered into the SPSS V.16 and analyzed. Chi-2 test was used to analyze and compare the qualitative variables, and T-test was employed to compare quantitative variables between the two groups. Alpha values below 0.05 were considered significant. In the present study, the incidence of seizure after surgery and adjuvant therapy were 16 (1.28%) and 20 (35.1%), respectively. The severity of seizure before and after treatment was not significantly different between the two groups. However, in both groups, the severity and frequency of seizure decreased significantly after treatment, although there was no significant difference between the two groups before and after treatment. In the surgery group, 17 patients (29.82%) and in the adjuvant therapy group, 19 patients (33.33%) had an unusual EEG. There was a significant correlation between the post-treatment seizure and abnormal EEG (p <0.001). Based on the results of this study, it can be concluded that the incidence, severity, and frequency of seizure in patients with LGG were decreased after surgical treatment or adjunct therapy, but there is no significant difference between the two methods.

In Iran, few studies have been carried out on the frequency of drowning cases in the country's southern and northern coasts. The aim of this study is to evaluate the frequency of drowning cases in the provinces with northern and southern coastal margins from 2011 to 2014 and to examine the risk factors related to drowning mortality. This cross-sectional analytical study made use of the data from The Country’s Reports of Drowning in the Provinces Bordering the Caspian Sea, the Persian Gulf and the Oman Sea by the Center of Disaster Management and Emergency Response, Office of Disaster Prevention and Safety Promotion, Iran, which were also registered at the Health Departments of Universities of Medical Sciences in Mazandaran, Guilan, Golestan, Khuzestan, Bushehr, and Hormozgan. The data were statistically analyzed by SPSS V.16 software. For descriptive analysis, frequency percentage, mean, and standard deviation were used. The highest frequency of drowning was related to Mazandaran Province (65.3 percent). Among instances of drowning, the majority of them led to death (64.7%). Men (79.5%) had the highest percentage of cases. Age group 20-24 years (20.4%) had the highest number of drowning. Most drowning incidents happened during summer, the month of August (30.6), and guest people (from other provinces) (72.9%). With regard to the findings of this study and the rate of drowning and deaths related to drowning, it is required that more comprehensive prevention programs be designed to deal with this health problem and to reduce losses and tolls. Improving the beaches and increasing the protected areas at coastal stretches of the country are among the safety measures that can be helpful in this regard.

Circumcision is proposed as the world’s oldest and most controversial operation and meatal stenosis as the most common complication of neonatal circumcision. Published studies in Iran are deficient regarding this complication. This research shows the rate of meatal stenosis in children less than one year in Birjand-Iran. This descriptive study incorporated all children younger than 12 months who had normal penile anatomy and were circumcised using the plastic disposable device by one urologist from March 2005 to January 20th, 2009. Children were examined 14 days after circumcision. Parents of the children were subsequently called for meatal stenosis screening. Those that had symptoms were examined in the office, and their urine flow was observed. During the study period, 518 children (mean age: 47.6 ± 2.7 days) were circumcised. Operation time for circumcision was 4 ± 0.8 minutes. Mean follow-up period was 26.5 ± 11.5 (8-55) months. A total of 12 (2.3%) children had meatal stenosis. Meatal stenosis was the most common complication of circumcision in this study. There is a need for more research on the prevention of this complication.

Postpartum depression and anxiety is an important and disabling disorder that, if not diagnosed and treated in a timely manner, could worsen and develop into a chronic condition. Different factors play a role in this disorder, including psychiatric capitals. This study plans to investigate the relationship between psychiatric capitals and prevalence of postpartum depression and anxiety in females referring to different medical centers of Birjand. the Current study is a description of correlations. Women who had a history of delivery 6 to 8 weeks prior to the study were enrolled. Of all available medical centers, 5 were chosen using the randomized-clustered method and 162 patients where picked. These patients were asked to fill Edinburgh’s postnatal depression scale (EPDS), Zung’s self-rating anxiety scale (SAS) and Lathan’s psychological capital questionnaires. Data were gathered and analyzed using SPSS version 18 and Pearson correlation coefficient tests. Mean age of participants was 32.25±4.44. There was a significant reverse correlation between psychiatric capitals and depression and anxiety of postpartum (p-value <0.05). This study shows that psychiatric capital and its elements could predict psychological well-being accurately and reliably. With this in mind, medical centers supporting pregnant women should hold different related workshops aiming to improve psychiatric capital of their clients.

development of squamous cell carcinoma from sebaceous cyst is uncommon.in this report , we report a77- old female patient who has had a sebaceous cyst for 20 years. The cyst started to grow during the last year. The patient underwent an operation for excision biopsy and The diagnosis was squamous cell carcinoma

Snakebites are a common problem in tropical regions, especially in South Asia, which is sometimes overlooked. The common side effects of snakebites include blood, neural and muscular reactions. However, psychiatric symptoms have been reported less frequently.
The patient was a 19-year-old man, who was diagnosed with snake-biting by an adder snake in the maleol area of the right foot. The patient complained of the presence of visual hallucinations (seeing objects around him in colored droplets), and reported this symptom once at the time of the bite and once again upon his arrival at the general health center. The psychiatric and neurologic examination of the patient did not reveal a differential diagnosis.
By observing this symptom, it can be concluded that uncommon psychiatric symptoms can also occur in snake-bitten patients, while these symptoms may be overlooked.