Journal of Surgery and Trauma
Volume:9 Issue: 2, Summer 2021

It is estimated that the cost of road accidents in India is around 3% of the Gross Domestic Product of the country. On average, 400 persons die daily in road accidents in India, and cities, such as New Delhi and the national capital region are on the top of the list of road accident causalities. Based on the Basilica agreement, the Indian government has initiated various policy changes and infrastructure development along the national highways which include the redesign of blindspots on the roads and the infliction of heavy penalties for the violation of traffic rules and compliances. On the academic front, the Indo-US Emergency Medicine forum has inaugurated an academic college for emergency medicine in India that cooperates with various government and private healthcare providers and policymakers for the improvement of emergency/trauma care delivery. Lately, few business schools and healthcare educational institutes have focused on interdisciplinary training and research centers in the area of emergency care delivery. Policymakers are also proactively working with various organizations to implement new rules and compliance mechanisms. This prospective study entails a detailed review of the literature using keywords in the PubMed journals, news articles, and media reports. Authors encountered studies in the area of trauma care delivery in India and other countries in their comprehensive field research. Almost 100% of the cases were medico-legal and only one case out of 100 was an insured patient. Furthermore, 87% of the cases were new and only 13% were review cases. Based on the conducted analysis, the number of accidents reduced across the country after the implementation of the New Motor Vehicle Act in the year 2019. It is worth mentioning that, the government launched awareness programs for the public as well. Some of the major challenges identified included lack of coordination and institutional mechanisms for an integrated emergency care delivery, poor referral processes, inadequate ambulance services, lack of third-party coordination, and poor in-hospital resources, particularly in public healthcare organizations. Apart from these, there was an acute shortage of trained emergency medicine experts at all levels. Trauma care delivery is a complex issue and its accomplishment requires good coordination and collaboration among stakeholders. The study identified various challenges and opportunities for the improvement of trauma care delivery in India. There is an immense need and opportunity for the modification of the emergency care delivery system through the introduction of appropriate changes in the transportation policy, emergency care delivery models, institutional mechanisms, such as referral process, and appropriate resource allocation at different levels of care delivery system.

Hemorrhoid is one of the most common anorectal diseases which affects 5% of the general population. Complications and pain are inevitable after all surgeries with different intensities and degrees.Management and control of these complications is one of the most important aspects of postoperative care. There are surgical techniques and interventions for the treatment and control of pain after hemorrhoid. According to the contradictory results of the studies on surgical methods, the present study aimed to compare the effectiveness, complications, and safety of hemorrhoidectomy with Ligasureand Ferguson hemorrhoidectomy.

The study sample in this randomized controlled clinical trial studyincluded54 patientswhowere randomly divided into two groupsofLigasureandFerguson surgery. Prior to the surgery, patients were educated abouttheVisual Analogue Scale(VAS).Patients underwent general anesthesia and the same surgeon performed the surgery in both groups. Immediately after the surgery (oncethe patient regainedconsciousness and understoodthe environment), 6, 12, and 24 hours after the surgery, patients’ pain and complications were assessed.The collected data were analyzed using SPSS software (version 18)through independent t-test, Mann-Whitney, Friedman, Chi-square and Fisher’s exact test at a significance level of α=0.05.

The mean bleeding during the surgery was significantly lower in the Ligasuregroupthan the Ferguson group. The mean pain at 0, 6, 12, and 24 hafterthe surgery was not significantly different between the two groups.Postoperative complications were significantly higher in the Ligasuregroup than the Ferguson group.

Ligasurehemorrhoidectomy is not superior to the Ferguson method in terms of analgesia up to 24 h after the surgery; however, this method of surgeryis preferable to the Ferguson method in terms of bleeding during the surgery.

Motorcycle accidents are among the deadliest road traffic accidents, and the prevention of road traffic injury is a daunting challenge in numerous countries, including Iran. The present study aimed to investigate the motorcycle accidents that occurred in Gonabad, Iran.

This cross-sectional descriptive study was conducted using all standard pre-hospital emergency reporting forms related to motorcycle accidents registered in a software-based pre-hospital information management system (called ASAYAR in Persian) between March 2018 and 2019. The motorcycle accidents were assessed in terms of urban and rural settings, time and mission results of accidents, and demographic characteristics of injured people. Descriptive statistics (mean, standard deviation, frequency, and frequency percentage) were used for data analysis.

A total of 1,555 traffic accidents were recorded in the ASAYAR system, out of which 746(48%) accidents were related to motorcycle accidents, and out of 746 cases in the county, 431 cases had occurred in Gonabad. The majority of motorcycle accidents (49%) took place in the age group of 15-25 years. The time analysis of accidents demonstrated that the majority of accidents had happened in the spring with 34% (n=147) and in June with 11.86% (n=51). Moreover, 77% of the injured were motorcycle riders, and 82% of all the injured have been taken to hospital.

As evidenced by the obtained results, nearly half of all road accidents are caused by motorcycles. Given that most of the injured in motorcycle accidents are adolescents and young people, it is necessary to take practical measures to control and manage this major health threat.

Anger, as a major factor in traffic accidents and beatings, plays an important role in the mortality of the people. According to the statistics from the World Health Organization, beatings and traffic accidents are predominant causes of trauma incidents. An increase in violence, as a risk factor, is effective in traumatic and mental health injuries and has an important role in creating incidents. This study aimed to compare anger control and its relationship with mental health in trauma patients after incidents.

This cross-sectional study was conducted in Shahid Rajaee Hospital affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, on 214 patients who were selected based on systematic randomization using the available sampling method. Novacochr('39')s Anger Control Questionnaire, as a standard questionnaire, and General Mental Health Questionnaire were used for comparing the anger control and assessing the mental health, respectively. The collected data were analyzed in SPSS software (Version. 18) using the independent t-test and Pearson correlation coefficient. A p-value less than 0.05 was considered statistically significant.

According to the results of demographic characteristics, the mean age of the patients was 32.65±8.318 years. Out of 214 patients who participated in this study, 120 and 94 cases were injured by beatings and traffic accidents, respectively. The results of statistical analysis indicated a significant relationship between mental health and anger control in these subjects.

The injury caused by an increase in violence in traffic accidents and beatings is a dangerous risk factor lurking in the population, which leads to irreparable damages to the countrychr('39')s economy. These findings showed a significant relationship between anger control and mental health in the two groups of traffic accidents and beatings. Therefore, the development of anger control training packages can reduce damages caused by anger in people.

Domestic violence is the most common form of violence against women that has negative effects on the health of the mother, children, family, and society. This study aimed to evaluate the trauma caused by physical violence in women referred to the Emergency Department of Imam Khomeini Hospital, Urmia, Iran.

This descriptive cross-sectional study was performed on women referred to the Emergency Department of Imam Khomeini Hospital, Urmia, Iran, with trauma in the First quarter of 2016. The patient files were used to collect the required data. Subsequently, the obtained data were analyzed in SPSS software (version 18) through the chi-square test (P<0.001)

In total, 1746 women with trauma were referred to the Emergency Department in the First quarter of 2016, 38 of whom reported physical domestic violence. The mean age of the women was 37.57±5.54 years; moreover, 16 (42.1%) cases had elementary education, and 20 (52.6%) women were urban dwellers. Regarding the marital status, 33(86.8%)women were married. Considering the relationship between trauma severity and demographic characteristics, only education level showed a correlation with trauma severity. In total 14 (36.8%) and 11 (29%) cases had mild and severe traumas, respectively. Furthermore, the most injured parts were the limbs (n=16; 42.1%).

The results showed a significant increase in the severity of trauma in women with lower education levels. Accordingly, improvements in the level of education may decrease the prevalence and severity of physical domestic violence, which requires appropriate planning to increase womenchr('39')s education level.

Type of anesthesia during elective cesarean is very important and is chosen according to the decision of the specialist as well as the mother’s desire. This study aimed to determine the rate and associated factors of choosing general or regional (spinal and epidural) anesthesia among pregnant women who underwent elective cesarean in hospitals of Northern Iran in 2017.

This descriptive-analytic study included the pregnant women referred to the hospitals in Sari with indications for both kinds of anesthesia. The reasons for choosing the type of anesthesia were asked and collected in a researcher-made checklist. The collected data were described and analyzed using SPSS software (version 24) through the Chi-square or Fisherchr('39')s exact tests and Logistic regression. A p-value less than 0.05 was considered statistically significant.

Out of 384 pregnant women who participated in the study, 60% and 40% of the cases chose general and regional anesthesia, respectively. Fear of spinal cord damage (64.3%) and fear of observing and hearing in the operation room (53.3%) were the most reasons for the rejection of the regional methods of anesthesia. However, the fear of not waking up (54.3%) and being interested in seeing the baby during childbirth (40.7%) were the main reasons for choosing spinal anesthesia. Most of the women who had experienced regional anesthesia selected this procedure in the current operation (53%), while general anesthesia was chosen by women without previous history of regional anesthesia (62%).

Although most of the pregnant women selected general anesthesia, the reasons for rejecting the spinal method were mainly non-scientific and could be managed with maternal education.