Trauma Monthly
Volume:28 Issue: 6, Nov-Dec 2023

Post-traumatic growth or Positive Posttraumatic Changes refers to development of an individual’s experience involving accidents or incidents etc., as a result of coping with trauma, war, tragedy etc. (collectively known as stressors).  This issue has wide-ranging consequences on the economy, society, culture, and psychology. Military nurses deployed to war zones face the dual pressure of providing healthcare and being involved in military activities. The study sought to assess post-traumatic growth among nurses deployed to war zones. This qualitative study was conducted at the Baqiyatallah Nursing Faculty, Tehran, Iran, using the conventional content analysis approach from 2021 to 2023. Data were collected through semi-structured individual interviews with 11 nurses. Sampling was purposeful and continued until data saturation was achieved. Data were analyzed using MAXQDA10 software. After analyzing the data, we identified 22 subcategories and 6 main categories, which included: "divine growth," "empowering interpersonal relationships," "learning new cultures," "Finding new learning opportunities," "increased personnel resilience," and "changes in attitude." The results of this study showed that post-traumatic growth in nurses following trauma, war, and tragedy is a complex, multidimensional, and contextual concept that may be affected by various factors namely stressors, mental and psychological status, previous encounter with stress. The findings of this study can provide nursing leaders and dispatch nurses with a deeper recognition of the factors that contribute to successful coping among Iranian nurses deployed to war zones and development of positive post-traumatic growth.

Shoulder pain is a common orthopedic complaint, with rotator cuff tear (RCT) and impingement syndrome as prevalent causes. The critical shoulder angle (CSA), the angle between the glenoid and acromion, has been implicated in the development of RCT. However, comprehensive evaluations of CSA in Iranian patients with impingement syndrome and RCT are lacking.
This case-control study assessed CSA in patients with RCT and impingement syndrome. Patients presenting with severe shoulder pain between 2019 and 2021 were included, with CSA measurements taken from anterior-posterior radiographs. Diagnostic performance was evaluated. The control group comprised patients with other shoulder pathologies.
Of 135 patients, those with RCT exhibited significantly higher CSA values (37.3) compared to the impingement syndrome group (30.25) and control group (29.9). CSA showed high sensitivity (100%) and specificity in diagnosing RCT at a cut-off value 35.1. In diagnosing impingement syndrome, CSA demonstrated a sensitivity of 60% and specificity of 66.7% at a cut-off of 30.25.
CSA emerged as a promising diagnostic tool for RCT, with its value exceeding the critical threshold. This finding aligns with international studies, suggesting the utility of CSA in the Iranian context. The study provides valuable insights into the diagnostic potential of CSA, particularly in the differentiation of shoulder pathologies within the Iranian population.
As assessed through radiographs, the critical shoulder angle is a reliable diagnostic measure to identify RCT and distinguish it from impingement syndrome. This research contributes to understanding shoulder pathologies in the Iranian population, emphasizing the clinical significance of CSA as a predictor for RCT.

Hand function is influenced by various diseases and trauma. Finite Element Analysis (FEA) is a method used to evaluate the impact of these conditions on the joint contact forces of wrist bones. This review aims to assess the feasibility of using FEA to determine the effects of diseases, trauma, and surgical interventions on wrist joint biomechanics.

A search was conducted in several databases, including Google Scholar, ISI Web of Knowledge, Ebsco, Scopus, and PubMed. The primary keywords used in this review were ‘finite element analysis’ and ‘finite element model’, combined with ‘wrist joint’.

There were seven studies on using FEA for the wrist joint. Three of these studies evaluated the efficiency of various surgical procedures on wrist joint stress. The remaining four studies determined the joint contact forces in various diseases.

The results of the available studies on using FEA for the wrist joint confirm the high feasibility of this approach in determining the effects of various diseases or surgical interventions on wrist joint contact forces. It appears that various conditions, such as fractures, stroke, and rheumatoid arthritis, increase joint contact forces.

Several large cities in Iran, especially Tehran, recently observed peak air pollution. That has exceeded the acceptable concentration of air pollutants, especially particulate matter, black carbon, sulfur dioxide, and ozone levels. The primary origins of air pollutants in Tehran include human activities, such as road transportation, oil refineries, industrial bases, and mines, as well as natural origins, such as local and regional dust events, which can expose citizens to high levels of air pollutants. Although guidelines are in position and massive actions are being taken to manage air pollution issues in Iran, performance and enforcement could be more practical. The significant challenges are the inefficiency of policies and management approaches, the requirement for more air quality monitoring techniques and technology, especially in industrial cities rather than Tehran, and the demand for examinations on the efficiency of principles. Screening such information can carry possibilities for global cooperation, which is essential in addressing air pollution worldwide. It is critical to be aware of the hazards of air pollution and report them to people to minimize their exposure threats by supplying air purifiers, clean spaces, and masks.

The ICU liberation campaign helping improve quality of intensive care and reduces post-intensive care syndromes through the release of ABCDEF bundle, which utilizes an interprofessional approach. Evidence has shown barriers to proper bundle implementation (such as complexity and multiplicity of bundle interventions, limited bundle understanding by staff, poor interprofessional collaboration, shortage of staff) may play an important role. A multistage study was conducted to localize the ABCDEF bundle.
 Firstly, the ABCDEF bundle was translated into Persian using the WHO protocol. The initial Persian translation was performed by both a nonmedical and medical individual. After combining and enhancing the translations, it was transformed into a checklist comprising 6 elements and 53 items, which were directed to experts to evaluate its face validity and qualitative content validity. After adjustment, the first expert panel validated the checklist, and a 5-point Likert rating system for assessment of importance, relevance, and feasibility were scored by them. Based on the results of descriptive analysis by SPSS, the experts' consensus led to elimination of one item and inclusion of other 52 items. Next, the second expert panel was held.
The final ABCDEF bundle was prepared with 52 items and, the plan, the proper time and implement responsible, for its management is proposed.
 Due to absence of the Iranian version of the ABCDEF bundle, our study provided a fluent and eloquent translation, to be both comprehensible and practical for the intensive care team members. The expert panel's opinion, adapted the bundle for implementation in the ICUs of Iran. We recommend that the localized ABCDEF bundle be implemented in specialized intensive fields (such as medical, surgical, trauma, etc). The contents of the bundle could not only be incorporated into ongoing training of staff, but also into the curriculum of undergraduates and medical residents.

This study aimed to assess the role of personality traits, childhood trauma, and alexithymia in of PTSD and PTG symptoms in patients with COVID-19. Data for 156 persons (including 131 females and 25 males) who recovered from COVID-19 were collected using NEO inventories, the childhood trauma questionnaire, the Toronto alexithymia scale, the Mississippi Scale for PTSD, and the PTG inventory. PTG symptoms were significantly and positively associated with personality traits (extraversion, agreeableness, and conscientiousness). The PTSD symptoms were positively correlated with neuroticism and negatively associated with agreeableness and conscientiousness. Moreover, a negative correlation was observed between emotional neglect and PTG symptoms. PTSD symptoms were seen to be positively and significantly correlated to the four dimensions of childhood trauma (p < 0.001). Finally, the most significant predictors of PTSD were symptoms including alexithymia (β = 0.38) and the physical abuse trait of childhood trauma (β = 0.259). PTG symptoms could be best predicted by conscientiousness (β = 0.2) and extraversion traits (β = 0.196). The variables including alexithymia, personality traits, and childhood trauma can be used to decrease the adverse effects of trauma and increase positive psychological symptoms in our patients.

Fracture healing is a major concern in orthopedic surgery, necessitating the identification of new techniques with minimal side effects to expedite the healing process. This study aimed to evaluate the effect of topical nanofibers loaded with Pistachio hull extract on the healing of bone defects in rat calvaria

Defects of 7 mm were induced in the calvaria of 45 male Wistar rats. The animals were divided into three groups, with defects in each group being treated with nanofibers loaded with Pistachio hull extract (PVA-PH), PVA nanofibers (PVA), or left empty as a control group. Histopathological evaluation was conducted on days 14, 28, and 42.

On day 14, a significant difference was observed between the PVA/PH and the control, while no significant difference was found between the PVA/PH and PVA. As the days progressed to 28 and 42, the PVA/PH exhibited a significantly higher healing rate compared to both the PVA and controls.

The results from this study demonstrate that nanofibers loaded with pistachio hull extract can significantly enhance osteogenesis and promote the healing process of calvarial defects in rats over a 42-day period. This finding holds promise for developing improved approaches to facilitate fracture healing with reduced side effects.