Trauma Monthly
Volume:26 Issue: 1, Jan-Feb 2021

Since bone defects can result in different disabilities, many efforts have been made to bone tissue engineering. In this case, scaffolds play an important role as a key element of tissue engineering in providing three-dimensional structure for cell growth in vitro The aim of the present study was to provide the three-dimensional biological bioscaffold from the bovine femur dense bone and investigate the possibility of its potential for application in tissue engineering as biological 3D ECM bioscaffold via mesenchymal stem cells seeding and differentiation toward bone tissue. For the preparation of bioscaffolds, after cutting bovine femur bone into small pieces, demineralization and decellularization were done. Bioscaffolds biocompatibility was evaluated using an MTT assay. The morphological and cell adhesion characteristics of Bone marrow mesenchymal stem cells (BMSCs) on the bioscaffolds were evaluated using Scanning Electron Microscopy (SEM) technique. Finally, the cells were treated with an osteogenic differentiation medium and then evaluated for differentiation. Histological studies showed that the use of sodium dodecyl sulfate (2.5%) for 8 h eliminated the cells. Radiography and calcium oxalate test confirmed demineralization. MTT assay and SEM studies showed that the obtained bioscaffolds are biocompatible and could provide an optimum three-dimensional environment for cell adhesion and movement. Moreover, the Alizarin red staining showed a higher differentiation rate for BMSCs. In the present study, bone-derived 3D bioscaffold showed an important role in the growth and differentiation of BMSCs, due to the natural characteristics, cell adhesion properties, and potential to enhance differentiation toward bone tissue. It may have the potential for use as bioscaffold as supporting metrics for maintenance, growth in bone tissue engineering.

Given the undeniable role of nurses in caring for traumatic patients, the best method for teaching skills to nursing students should be selected. This study aimed to examine the effect of smartphone-based education on the clinical skills of undergraduate nursing students when confronting traumatic patients. This study was conducted on 82 nursing students. The students in both intervention and control groups were evaluated using the National Registry of Emergency Medical Technicians' Skills Sheets for trauma skills before and one month after the intervention. The mean post-test score in 9 clinical skills of trauma in the intervention group (113.26±11.39, t=18.715, p <0.001) was significantly higher than those of the control group (52.92±13.23, t=3.352, p=0.002). The effect of the intervention on the clinical skill of trauma was greater than 0.7, indicating that the smartphone software had a high effect on improving each skill. The smartphone-based education programs can be used as an accessible and easy method for the education of nursing students.

Post-partum haemorrhage (PPH) is a major cause of maternal mortality worldwide. Tranexamic acid, an anti-fibrinolytic agent, is a novel approach in an attempt to prevent this dreadful complication. This study aimed to evaluate the efficacy and safety of tranexamic acid in reducing blood loss during and after cesarean section (CS). In this prospective randomized placebo-controlled clinical trial, 50 pregnant women were randomized into two groups. In the study group, 25 women received tranexamic acid 10 minutes before CS, whereas in the control group 25 women received distilled water. Blood was collected during two periods. The first time was from placental delivery to the end of CS and the second was from the end of CS to 2 h postpartum. The volume of blood was measured and compared between the two groups. Tranexamic acid significantly reduced the quantity of blood from the end of CS to 2 h postpartum, which was 65.15±31.97 mL and 101.14±44.94 mL in the study and control groups, respectively (P =0.002). It also significantly reduced the volume of total blood from placental delivery to 2 h postpartum, which was 616.32±176.87 mL and 731.45±178.79 mL in the study and control groups (P =0.028). Total blood loss in the study group was 18.7% less than the control group. No complications or side effects were reported in the groups. Tranexamic acid statistically reduces the volume of blood loss from placental delivery to 2 h postpartum and its use was not associated with any side effects or complications. Therefore, tranexamic acid can be used as a safe and effective approach to reducing bleeding resulting from CS.

Judo as martial arts have a higher risk of trauma during training rather than competition. Thus, an efficient training procedure should be accomplished.

Since the use of trauma prohibition approaches and athletic performance enhancement is essential, this study aimed at investigating the effect of 8-week Judo Specific Functional Training (JSFT) on the Traumatic factors and athletic performance in male judokas.

46 subjects were randomly classified into 2 groups of experimental (N: 23) and control (N: 23) groups. For eight weeks, the experimental group attended a JSFT program designed by the researchers. The control group participated in the usual judo training program presented by the coaches. The exercises were accomplished 3 times per week for 90 minutes each session. The subjects participated in pre-and post-tests. In order to approve the data normality and compare the variables, Shapiro-Wilk, ANCOVA analysis was implemented at the significant level of p˂ 0.05 using SPSS (version 21).

The outcomes showed that the scores of functional movement screening (p=0.001), upper extremity Y balance test (p=0.001), vertical jump (p=0.001) and JSFT (p=0.001) significantly increased among the experimental group in comparison to the control group.

The JSFT program simultaneously modifies or decreases the Traumatic factors and improves athletic performance and offers more efficiency and effectiveness rather than the usual judo training programs.

Caregiving for trauma patients has many challenges. Inadequate knowledge of these challenges can affect the patients and worsen their conditions.

We aimed to explore the caregivers’ experiences about these challenges and problems of caring for patients with trauma emergencies.

The study adopted a concurrent triangulation mixed-method and was conducted in Shahid Rajaee Hospital, southern Iran, in 2019. Semi-structured interviews, focus groups, observation and ward document assessments were conducted with focusing on the challenges experienced by the caregivers. A checklist was used to assess the performance of caregivers and measure the indices related to the care process. Statistical results and qualitative data on the main categories were compared and integrated for data analysis.

In total,307 codes were extracted by analyzing the content of the interviews and available evidence. The codes were summarized in 20 subcategories, and six main categories were extracted as follows: lack of professional capability, uncoordinated team response, deficits in managerial commitments, inadequate work motivation, complex nature of trauma emergency, and lack of clinical communication. The quantitative results indicated that caregivers’ performance was considerably far from the expected scores and also many indices indicated a waste of time in responding to the patient needs.

Various dimensions of trauma care challenges indicate that professional capability, team coordination and communication, managerial commitments and work motivation considering the complex nature of trauma emergency wards are crucial to enhance patients' access to optimum quality care. Caregivers’ performance and quality of indices also affect the care process. Future studies are required for compiling strategies and protocols for the quality of care for trauma patients.

Injuries and deaths from RTC are critical health problems of societies and one of the main causes of death especially among the young.

This study aimed to design and compile a guideline for emergency medical communication centers (EMCC) staff to provide direct assistance offered by road traffic crash (RTC) bystanders.

Based on prior literature, the RTC bystanders' initial draft guideline contained 20 domains and 28 items. As a validation step, the draft guideline was reviewed by content experts (one emergency medicine and two disaster specialists) and modified based on their recommendations. The subsequent draft guideline was then reviewed in three Delphi rounds by 67 participants, including health professionals in emergencies and disasters, emergency medicine, nurses, emergency medical experts, and EMCC staff. The accepted agreement coefficient was set at ≥70%. As the final step, an expert consensus meeting was held to review the guideline.

The participants agreed on 56 items regarding 20 domains, including scene safety, hand precautions, and personal protection, alertness assessment, respiration, cardiopulmonary resuscitation (CPR), bleeding control, recovery position, splinting, rapid evacuation, scene management, patient transfer, triage, spinal cord injury prevention and immobilization, injured transportation, psychological support, hypothermia prevention, water and food, amputated limb protection, and support of deceased people. Two items in relation to airway opening maneuvers were added to the guideline during the expert consensus meeting.

Compared to other RTC bystander guidelines for EMCC staff, more comprehensive guidelines can be served as a basis for directing RTC bystanders to provide assistance. Important areas of hand care and personal protection, breathing, airway, splinting, scene management, mental and psychological support, and support of deceased people were included in this guideline. EMCC staff can provide guidance to be performed by RTC bystanders. RTC bystanders can play important roles at crash scenes, including preventing secondary injury, supporting scene management, and providing first aid for the injured people. This guideline can be used to help direct appropriate care and behavior by RTC bystanders.

Knee and hip replacement surgeries are associated with chronic postoperative pain, and since their management is a clinical challenge to nurses.

The present meta-analysis aimed at investigating preoperative education for pain relief after the lower limb joint replacement surgery.

Quasi-experimental studies and clinical trials of preoperative education for the management of pain after hip and knee replacement surgeries published in English were searched in the databases of Web of Science, Cochrane Library, CINAHL, PubMed, Embase, and Scopus.

Out of 209 articles retrieved, five were eligible to enter the meta-analysis. Based on the obtained results, the difference in the mean scores of pain on days 1, 2, and 3 after surgery in the intervention groups was lower than that of the control groups; however, the relationship was statistically insignificant.

Evidence from study results suggests that pre-THA and Total knee arthroplasty (TKA) training may not significantly reduce pain; However further studies are required.