Journal of Surgery and Trauma
Volume:11 Issue: 1, Spring 2023

Adopting a suitable strategy to reduce the complications of cholecystectomy plays a significant role in the well-being of patients. We investigated the effects of atorvastatin on clinical symptoms, and inflammatory markers of patients undergoing cholecystectomy.

This double-blind randomized controlled trial was conducted in Imam Reza Hospital, Birjand in 2021. In this study, 47 patients received 40 mg atorvastatin (intervention group) and 47 patients received placebo both daily for 4 weeks (placebo group). Then, the frequency of fever, abdominal pain, and nausea before and after cholecystectomy, as well as peri-operative data (duration of operation, and intraoperative bleeding) and laboratory data [White Blood Count (WBC), C-Reactive Protein (CRP), Aspartate AminoTransferase (AST), and Alkaline Phosphatase (ALT)] was collected. The data was analyzed using (SPSS Version 22) based on chi-squared, and independent t-tests at the significance level of (P≤0.05).

The duration of hospitalization was not significantly different in both groups (P=0.26), however, the duration of operation was significantly longer in the intervention group (P<0.001). The frequency of fever, abdominal pain, and nausea after cholecystectomy was not statistically different (P>0.05). The volume of intraoperative bleeding in the placebo group was more than the intervention group (P=0.05). The decrease of WBC, CRP, and the ALT levels after cholecystectomy was not statistically different (P>0.05); however, AST level after cholecystectomy was higher in the intervention group (P=0.05).

The use of atorvastatin effectively reduced the volume of intraoperative bleeding. However, this intervention with this dose and duration could not have a significant role in reducing the duration of patients’ hospitalization, duration of operation, and levels of WBC, CRP, ALT, and AST.

 Trauma to the head and the resulting deaths are one of the major health problems in the world. Traffic accidents are the main reason for these traumas in motorcyclists though wearing a helmet can reduce the damage to a great degree. This study aimed to determine the "injured" motorcyclists’ attitudes about helmets based on the health belief model.

 This is a cross-sectional and descriptive-analytical study injured motorcyclists who were hospitalized in Shahid Rajaee hospital, Shiraz, were included in the study. Data was collected using a researcher-made questionnaire called “Awareness & Attitude Associated with Motorcycle Traffic Safety”. Independent t-test and One-way ANOVA were used to compare the factors affecting attitude and awareness based on the factors in the demographic information form. The significance level was considered (P< 0.05).

In this study, 253 participants had a mean age of 30.47± 0.4years. The results of this study showed that in this study 37.5% of the participants were self-employed and 30%, were employees. Moreover, 53.4% had high school education, while 1.2% were illiterate. 50.6% reported it as their first motorcycle accident. Most of the injured patients were vehicle riders70% and 20% of them reported drug abuse. However, none of the factors, including vehicle riders, certification, accident frequency, drug abuse, education, and employment status had a significant effect on the participants' attitudes.

 The results of this study showed that the overall mean scores of the health belief model in the participants were not in favorable level; it was revealed that none of the factors of being a rider, having or not having a certificate, frequency of accidents, drug use,  level of education,  and employment  status  significantly  influenced  the  participants’  knowledge  and  attitude.  In other words, the patients' attitudes toward helmets were deemed unfavorable.

Interprofessional Education (IPE) is concentrating on the expansion of suitable communication and a teamwork setting for all healthcare providers to conduct patient care well. This study was conducted with the aim of examining the readiness of medical and nursing students for IPE in the surgery department.

This descriptive-cross-sectional study was conducted on 42 nursing and medical students at Birjand University of Medical Sciences (2022) in Iran who were included in the study by the census. The Persian version of RIPLS (The Readiness for Inter-Professional Learning Scale) was used to collect data. Data analysis was performed using descriptive and analytic statistics and the Mann–Whitney U test (P≤0.05).

Totally mean score for RIPLS was (85.81±5.33). Comparisons of the mean scores in the roles and responsibilities subscale between the discipline (P=0.041) and gender (P=0.034) of students showed significant differences. But the mean scores in the other subscales as well as the total mean score of RIPLS did not show a significant difference between nursing and medical students (P>0.05).

Nursing and medical students were highly ready for IPE. It is suitable that before the start of IPE, educational workshops have been conducted to learn interprofessional principles, and also recommended the use of IPE in the official curriculum.

Trauma is one of the most critical health problems worldwide. In the trauma of the elderly, the rate of complications and mortality is high. This study aimed to investigate the relationship between Base Deficit (BD) and morbidity and mortality in elderly trauma patients.

This cross-sectional study was performed on elderly trauma patients who were referred to the emergency department of Imam Reza Hospital in Birjand from 2018 to 2019. Our inclusion criteria were age over 65 years, no history of diabetes mellitus and kidney diseases, no alcohol and aspirin consumption, and no history of conditions that cause severe volume loss and dehydration. The Injury Severity Score (ISS) measures trauma intensity based on the abbreviated injury scale (AIS). The Patient’s BD results were extracted from their Venous Blood Gas (VBG) test. Data were analyzed in SPSS Statistics software (Version 23) using the Chi-square test, Kruskal-Wallis test, and Mann-Whitney (P<0.05) was considered significant.

This study, 77 patients were enrolled (the mean age of individuals: (80.65±7.28) male/female ratio: 1.02). BD mean was (7.58±0.63 mmol/L). The level of consciousness was statistically different between BD groups (P-value=0.001). The injury severity score mean had a significant association with the BD level (P<0.001). Also, with increasing BD level, the length of hospitalization in the ICU increased significantly (P-value=0.001).

BD can predict the severity of traumatic injury in the elderly. Along with other available factors such as serum lactate, BD can be reliable predictor of outcomes in trauma elderly patients.

Nicolau syndrome (NS) is a rare aseptic cutaneous adverse reaction and necrosis caused by intra-muscular, subcutaneous,intravenous, or intra-articular injection of various drugs. We report a case of this syndrome. A 20-year-old male who developedintense pressure pain, the local sensation of heat, and reddish discoloration of the skin after receiving an intramuscular injection ofdiclofenac for renal colic. The complaints started two days after the injection. The patient was managed at peripheral health care center as a case of post-injection site abscess. However, the patient developed gluteal necrosis and was referred to our tertiary care center for further management. The patient was treated with antibiotics, and aggressive multiple debridements, and healed with secondary intention with an ugly scar. The observed syndrome was due to the injection of the drug into subcutaneous tissue instead of proper muscular planes. Medical and paramedical personnel must be properly educated and sensitized to such a complication that can occur during drug administration. They should follow the standard and appropriate injection techniques and take all necessary precautions to avoid this severe complication, which increases the patient's morbidity. Proper teachings of injection techniques to junior medical and paramedical staff should be exercised at the apex and peripheral centers for the prevention of this syndrome.

This article presents a case of extensive External Root Resorption (ERR) involving the distal root of the left mandibular second molar due to the pressure of wisdom tooth in its neighborhood in a 32 year‑old female patient. Clinical and radiographic examination revealed no pulp in respond to the vitality test, periapical radiolucency in the apical of the mesial root, and root resorption of the distal root. A definite diagnosis of pulpal necrosis with chronic apical periodontitis and ERR of the distal root was made. The tooth was managed by nonsurgical endodontic treatment. One‑year follow‑up revealed satisfactory results clinically and radiographically.

The limbus vertebra is formed due to anterior herniation of the nucleus pulposus between the ring apophysis and the adjacent vertebral body, resulting in the formation of a triangular, smooth bony fragment that ossifies separately. It is commonly located in the mid-lumbar spine, usually at the antero-superior margin of a single vertebral body. We present the case of a 31-year-old male who presented to the Emergency Department with complaints of sciatica after bending forwards. The plain radiograph of the lumbosacral spine was suspicious for a L5 chip fracture but was diagnosed to have limbus vertebra and discharged. Limbus vertebra is generally identified incidentally, and most patients with anterior limbus vertebra are asymptomatic. Some patients with posterior limbus vertebra can present with symptoms of nerve compression. It can be mistaken for vertebral fracture, infection, degenerative disease of the spine or tumour, resulting in further diagnostic evaluation. Most patients are management conservatively, while those patients with symptoms of nerve compression requiring total laminectomy. Emergency physicians should consider the limbus vertebra as a differential diagnosis in patients presenting with lumbar pain, particular in young patients.