Iranian Red Crescent Medical Journal
Volume:26 Issue: 1, Jan 2024

The current study aimed to successively assess the applicability of trauma scoring systems.

To evaluate the outcomes, prognosis, and mortality in trauma patients.

The present study was conducted on all 221 injured patients referred to Shahid Rajaee Hospital from January 2014 toDecember 2020 with International Classification of Diseases-10th Revision (ICD-10) injury mechanism codes of W32.0-34.09, indicating afirearm injury. Univariate analysis and Chi-square test were employed to discover the individual relationship between each variable andthe injury outcome. Logistic regression analysis was performed to control the confounder. Finally, the area under the Receiver OperatingCharacteristic (ROC) curve was used to compare the predictive efficiency of the injury severity scales.

The mortality rate of the gunshot was 15 (6.78%). The cause of the gunshot was related to assaults in 73.68% of the survivingpatients. Meanwhile, suicide attempt was the second cause of death in gunshot patients (16.67%). Most of the injuries that occurredamong 20-24-year-old patients resulted from assaults. The odds of mortality in gunshot victims increased by 4.25 times (95% CI [1.99,9.10]) for each additional unit AIS. In the random forest model, the Trauma Injury Severity Score (TRISS) was the most importantmortality predictor. The TRISS was the highest area under the ROC curve for death prediction among firearms gunshot patients.

Injury Severity Score (ISS) had the least, and TRISS had the most area under the curve. Therefore, TRISS was found to be thebest predictor in determining the death or survival of firearms gunshot patients.

Context:

 The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.

Therefore, this study has been done with the goal of estimating overall prevalence in-hospital death due to COVID-19 disease in iranian patients.Evidence Acquisition: Articles were identified through iranian searching databases including Health.barakatkns, IranDoc, SID, Civilica and MagIran and international searching databases including Scopus, Web of Science, PubMed and Elsevier . Additional search was also done by Google Scholar search engine. We reviewed systematically all studies reporting the prevalence of in-hospital death due to COVID-19 disease. In this study meta-analysis method with random effect model has been used to estimate the pooled in-hospital death.

118 records were identified by the electronic search, of which 43 studies were identified as relevant documents that were meta-analyzed for the pooled in-hospital death due to COVID-19 prevalence. Overall, prevalence of death were 12.16% (95% CI: 10.72%-13.61%). The highest and lowest death prevalence has been reported in Northern Provinces (Gilan, 27.27% (95% CI: 8.66%-45.88%) and Mazandaran, 21.27% (95% CI: 18.14%-24.40%)) and Turkish-speaking provinces (Azerbaijan, East, 3.29% (95% CI: 2.11%-4.47%) and Zanjan, 3.42% (95% CI: 1.82%-5.02%)) respectively.

Considering the death rate obtained in this study and its comparison with other countries, it can be said that the performance of the Iranian medical system in COVID-19 pandemic is acceptable.

A new worldwide pandemic of coronavirus disease 2019 (COVID-19) has resulted in a healthcare crisis with high mortality and morbidity. Presently, several drugs are under accelerated research without established efficacy and are being used to treat COVID-19 patients either as unapproved drug use or as clinical trials. To optimally use the drugs, several factors, such as the gene effects, drug interactions, and drug toxicity, should be considered. Genetic polymorphisms are a type of genetic diversity within a populations gene pool that constitute the basis of pharmacokinetics, which causes alteration in the drug function and response. Since there was a limited time to check individual pharmacogenomics markers, it seems population pharmacogenomics tests could be helpful in expecting drug treatment failure in COVID-19 patients. We genotyped and investigated allele frequencies of 33 SNPs located on 10 pharmacogenes from 150 healthy individual samples.A total of 32 potential pharmacogenomics variants relevant to COVID-19 treatment were identified in the Iranian population. Considering them in patients' pharmacotherapy could influence the treatment optimization and reduce severity of adverse effects.

Lumbar spine fracture is one of the most common spinal fractures. Following lumbar vertebra surgery, prolonged bed rest is required, leading to increased negative emotions and various complications that hinder recovery. Therefore, it is necessary to develop effective interventions during the operation.

To assess the application effect of rapid rehabilitation intervention in posterior lumbar laminectomy decompression, resection of nucleus pulposus, and pedicle nail internal fixation for patients with lumbar fracture.

We randomly assigned 134 patients with lumbar fractures who received treatment in our hospital from May 2019 to September 2022 to either the research group (RG) or the control group (CG), with 67 patients in each group. In addition to the basic intervention, the RG received rapid rehabilitation intervention, while the CG only got the basic intervention. The study compared intraoperative blood loss, operation and hospitalization periods; the scores of the visual analog score (VAS), Japanese orthopaedic association (JOA), and Oswestry Disability Index (ODI); the incidence of complications; and satisfaction with the intervention in both groups.

The RG had less blood loss and shorter surgery and hospital stay than the CG (P<0.05). The RG exhibited lower VAS and ODI scores but higher JOA scores than the CG (P<0.05). The occurrence of postoperative complications in the RG was decreased in comparison to the CG (P<0.05). The total intervention satisfaction was higher in the RG than in the CG (P<0.05).

Rapid rehabilitation intervention can accelerate the recovery of the condition, improve the dysfunction, reduce the occurrence of complications in patients with lumbar fracture surgery, and thereby boost intervention satisfaction, which is worthy for clinical promotion.

Endometrial cancer is the most common type of reproductive system cancer. The present study aimed to investigate the diagnostic value of abnormal hysteroscopic findings in endometrial lesions.

In this retrospective cohort study, 669 cases with suspected endometrial lesions detected by B-scan ultrasonography were further examined using hysteroscopy. The biopsy results were considered the gold standard, and the diagnostic value of abnormal hysteroscopic findings and diagnostic efficacy of specific hysteroscopic findings in endometrial lesions were compared and analyzed. Moreover, the clinical features of the participants were evaluated.

Among patients, the complete coincidence rate between diagnosis made by hysteroscopy and pathological diagnosis was 91.33% (611/669), and the Kappa value of the consistency test was 0.951 (2). Regarding the major abnormalities detected under hysteroscopy, the most common finding in patients with normal endometrium, validated by biopsy results, was irregular thickening of the endometrium. In patients with endometrial hyperplasia, validated by the biopsy results, abnormality of the blood vessel was the most common finding. However, it should be noted that the sensitivity was low. Abnormality of blood vessels was also the most common finding in patients with endometrial carcinoma. The sensitivity and positive predictive values (<50%) were low. (3) The age difference between patients with normal endometrium and endometrial hyperplasia was statistically significant (P<0.01). There was a statistically significant difference between the patients with normal endometrium and In cases with normal endometrium and endometrial lesions, the morbidity difference was statistically significant between the group of patients with either obesity or hyperlipidemia and the group without comorbidities (X2=231.253, P<0.01, X2=106.086, P<0.01). There was a statistically significant difference between patients with endometrial hyperplasia and those with endometrial cancer in terms of morbidity of obesity or hyperlipidemia (P=0.042).

Hysteroscopy has high accuracy and stable diagnostic efficiency in the diagnosis of endometrial diseases. Nevertheless, the diagnostic value of abnormal blood vessels seen under hysteroscopy is insufficient for the diagnosis of endometrial lesions. Therefore, it cannot be used as the sole criterion for the diagnosis of endometrial lesions. Patients with irregular thickening of the endometrium are more likely to have a normal endometrium, and such patients can avoid unnecessary biopsy if they have no other risk factors. Obesity and hyperlipidemia are significant independent risk factors for endometrial cancer.

This study investigated the influence of age, gender and geographical region on the incidence of four types of injuries among pedestrians, cyclists, motorcyclists and motor vehicle drivers in Iran. The geographical correlation between the different provinces of the country was also examined.

The present study aimed to investigate 4 common type of road traffic injuries by provinces in Iran.

The data was taken from the Global Burden of Disease (GBD) study. The data were analyzed in terms of age group, gender and type of injury in different provinces, and the effect of geographical region on the incidence of RTIs were investigated through a multilevel analysis. Provinces were included in the model as random intercepts, and Moran's I test was used to examine geographic correlation and identify hot spots and cold spots. A significance level of 5% was used for all tests.

Elderly people were the main victims of pedestrian accidents, and young people were most frequently injured in cycling accidents. On the other hand, adults were the most frequently injured age group in motor vehicle accidents. Men were injured more often than women in all four types of injury. Although the injuries were not related to the province where the accident occurred, the geographical distribution of injuries caused by cyclists showed a geographical correlation, with Sistan and Baluchistan (southeast) and Tehran (the capital) being the areas with the highest and lowest risk of these types of injuries, respectively.

According to the results of this study, the causes of different types of road traffic injuries are very different for different age groups, genders and geographical areas. Therefore, different plans should be developed for each type of injury in order to prevent road traffic accidents.

Coronavirus disease 2019 (COVID-19), a severe disease caused by severe acute respiratory syndrome coronavirus 2, has a weak prognosis, and biological markers may predict disease severity.

The present study aimed to assess the impact of vitamin D levels on COVID-19 outcomes in diabetic people.

The study was conducted on 160 individuals with both COVID-19 and diabetes at Amir-Al-Momenin Hospital in Arak. Participants completed a questionnaire regarding their personal information, medical history, and medication use. Arterial and venous blood samples were collected after 12 hours of fasting to perform arterial blood gas (ABG) and brachial venous fasting blood glucose tests, respectively. The samples were sent to the laboratory for analysis. Serum levels of 25-hydroxyvitamin D were measured using the ELISA method. The study groups were classified based on the obtained PO2 levels from the ABG test, indicating varying degrees of respiratory impairment.

Patients were categorized as mild, moderate, or severe based on ABG test results. No significant difference was found in vitamin D levels among groups. Elevated levels of vitamin D in women and men with mild and moderate COVID-19 symptoms have been linked to a decrease in mortality rate. Nonetheless, significant correlations were observed between vitamin D and fasting blood sugar (FBS) levels in the mild and moderate groups, indicating varying relationships between vitamin D and FBS across these groups.

While immunizations and antiviral drugs work well against COVID-19, taking extra measures, such as vitamin D supplementation, plays a vital role in disease management.

As COVID-19 severity and related death is a challenging issue, the protective effect and predictive value of lymphocyte count are critical. The present study investigated the importance of lymphopenia on disease severity and death rate.

This retrospective cross-sectional study was performed from April 2020 to June 2020 on a total of 300 patients with confirmed COVID-19 who attended the Firoozgar Hospital affiliated with the Iran University of Medical Sciences, Tehran, Iran. All of the COVID-19 patients referred to the hospital during the study period and met the inclusion criteria were enrolled and divided into two groups of lymphopenia (lymphocyte count less than 1.0x109/L) (n=138) and non-lymphopenia (n=162). All patient data from the medical records were acquired and utilized for statistical analysis.

Of 300 patients 63.3% were male and 72% had underlying disease. The most common symptoms were dyspnea (50%), cough (41%), and lethargy (40%). Lymphopenia was associated with male gender (P=0.01). Additionally, mean age (P=0.02), ventilator need (P=0.03), and death (P=0.05) were significantly associated with lymphopenia compared to the non-lymphopenia group. The Lymphopenia group had lower levels of O2 saturation (P=0.04), AST (P=0.001), and ALT levels (P=0.02). Based on the chest CT scan results, there was a significant relationship between lymphopenia and the extent of pulmonary involvement (P=0.004)

Lymphopenia could clinically predict the severity of COVID-19. Lymphopenia was associated with male gender, older age, ventilator need, and death. Lymphopenia status had a significant relationship with reduced levels of O2 saturation, AST, ALT, and the extent of pulmonary involvement.

 Laparoscopic cholecystectomy is widely used in clinical treatment for gallbladder diseases. Rapid rehabilitation surgical nursing can significantly reduce the incidence of postoperative complications and shorten the hospital stay of patients. Moreover, it is supported by evidence-based medicine and has been widely used in clinical nursing. Nonetheless, there are few studies analyzing the influence of rapid rehabilitation surgical nursing on patients undergoing laparoscopic cholecystectomy.

 This study aimed to assess the clinical use of rapid rehabilitation surgical nursing on laparoscopic cholecystectomy patients.

 This study was performed on patients who underwent laparoscopic cholecystectomy in Suzhou Hospital of Anhui Medical University, Suzhou, China between June 2021 and July 2022. The participants were divided into a research group (RG) and a control group (CG) based on different nursing plans, with 51 cases in each group. A routine nursing plan was implemented for CG patients while rapid rehabilitation surgical nursing was implemented for RG patients.

 The bowel sound recovery time, the first time of anal exhaust and getting out of bed, as well as the length of hospital stay in the RG decreased, in contrast to the CG. Prior to nursing, no significance was found in visual analog scale (VAS) scores, interleukin 6 (IL-6) and C-reactive protein (CRP) levels, as well as World Health Organization Quality of Life Scale (WHOQOL-BREF) scores of both groups. After nursing, VAS scores decreased in both groups, and the scores of RG were lower, compared to those of CG. The IL-6 and CRP levels increased in both groups, but those in the RG were lower, in comparison with those in the CG. The WHOQOL-BREF scores of all dimensions increased in both groups, compared to the baseline, and those in the RG were higher, relative to the CG. Additionally, the total occurrence of complications in the RG decreased, compared to the CG. Besides, the total nursing satisfaction in the RG was elevated, relative to the CG (P<0.05).

 Application of rapid rehabilitation surgical nursing can expedite postoperative rehabilitation, reduce pain and stress response, promote quality of life, and lessen complications in patients undergoing laparoscopic cholecystectomy, thereby, increasing nursing satisfaction, which is worthy of promotion.