Trauma Monthly
Volume:29 Issue: 5, Sep-Oct 2024

This report highlights the critical position of ML and DL in revolutionizing the treatment of spinal injuries. These cutting-edge technologies are improving diagnostic approaches for evaluating vertebral fractures and significantly broadening the capability to predict fractures in both the short and long term. Their impact is particularly profound in enabling precise diagnoses and effectively distinguishing between non-cancerous and cancerous fractures. While less frequently explored, predictive studies deliver essential comprehension into the development of vertebral collapse and the treatment-related risk influences. With their advanced computational capabilities, these approaches perfectly address the intricate challenges associated with spinal injuries, paving the way for genuinely personalized care strategies. As these technologies evolve, they promise to substantially contribute to the medical administration and scientific acceptance of spinal injuries. Future studies in spinal fracture care must order developing and refining prognostic algorithms through ML to elevate pre-operative and post-operative patient care.

There are several occasions that a surgeon needs to perform bone grafting in the Maxillofacial region, such as when there are developmental defects and acquired defects due to trauma. Biological signals, degradable scaffolds, and host cells are used to induce the body's natural regenerative response and reinstate tissue function. Combining natural and synthetic polymers as scaffolds can increase cell interactions and provide mechanical stability. The effect of luteolin on extracellular matrix (ECM) in combination with a synthetic polymer has only been evaluated in skin tissue engineering. This study aimed to synthesize and assess the efficacy of a polycaprolactone-chitosan (PCL/CHT) polymer scaffold containing nanohydroxyapatite (nHA) loaded with luteolin for the regeneration of calvarial bone defects.
In this histological study, 30 rats were randomly assigned to 6 groups (n=5); 8 mm defects were created in each rat calvaria. The defects remained empty in group 1 (negative control), filled with scaffold in group 2 (positive control), and loaded with 0.01, 0.1, 1, and 10% luteolin in groups 3 to 6, respectively. A combination of PCL with fish ECM and CHT was used to improve the polymeric properties of the scaffold. The rate of new bone formation (NBF) was assessed histomorphometrically at 8 weeks after surgery. After an in vitro assessment of the physical and mechanical properties of the scaffold and their agreement with native ECM requirements, an in vivo assessment of the PCL/CHT scaffold was conducted. Data were analyzed using ANOVA and the Tukey test.
The rate of osteogenesis in the 0.01% luteolin-loaded scaffold group was significantly higher than that in the other concentrations (P=0.00). The lowest mean number of inflammatory cells was recorded in the 0.1% group; 0.01% luteolin was the most effective for calvarial bone regeneration in rats.
Proper luteolin concentration on the PCL/CHT/nHA scaffold can enhance osteogenesis in bone tissue regeneration.

The Kocher approach is the most commonly used technique for treating fractures in the posterior wall and column of the acetabulum. This approach requires cutting the short external rotator muscles. In many cases, it becomes impossible to repair these muscles due to inadequate tissue quality, as the pressure from the fractured bone fragments may damage them. This study aims to assess the limitations in internal and external hip rotation compared to the intact side and to evaluate changes in clinical symptoms using the Harris Hip Score (HHS).

The study involved 30 patients with acetabular fractures who underwent surgery at Taleghani Hospital between March 2021 and September 2022. Only the Kocher approach was utilized for the surgeries. The assessment tools included a goniometer to measure the internal and external rotation of the hip and the Harris Hip Score questionnaire. Patients were evaluated six months after their surgery.

All patients in the study were men, with an average age of 36 ± 2 years. The most common type of fracture observed was the posterior wall fracture, which accounted for 60% of the cases. The results revealed no statistically significant difference in the external rotation between the operated and intact hip. However, there was a significant difference in the internal rotation of the operated hip compared to the intact hip. The average score on the HHS questionnaire was 89.56, indicating a satisfactory outcome.

The degree of external rotation in the hip is not solely reliant on the short external rotator muscles; other muscles, such as the gluteus maximus, sartorius, and psoas, also influence it. However, damage to the external rotator muscles, if not repaired, can reduce hip internal rotation. The HHS was also recorded at 89/56, which falls within the acceptable range and did not indicate a statistically significant decrease.

The healthcare system faces numerous challenges when dealing with pandemics, and hospitals play a crucial role in controlling such outbreaks. Comprehensive preparation and planning for managing hospital crises during emergencies are essential. This systematic review aims to identify the factors that influence disaster management during epidemiological crises.

This study was conducted using a systematic review methodology. The PRISMA guidelines were followed. Databases such as MEDLINE (PubMed), Web of Science, Google Scholar, Embase, ProQuest, Scopus, IRANMEDEX, SID, and ISC, as well as reference lists of selected studies and systematic reviews, key journals, and conference proceedings, were searched for relevant studies on factors affecting hospital disaster management during pandemics from the 1st of January, 1990 to the 1st of February, 2023.

The study identified influential factors in hospital disaster management during pandemics, categorizing them into three main categories and 15 sub-categories. Key findings include the importance of strategic planning by hospital officials and administrators, the need for sufficient diagnostic equipment and trained staff, and the critical role of standardized programs in preparedness and response phases.

Hospital preparedness is crucial for effectively managing pandemics and disasters. By recognizing and tackling the challenges hospitals face, we can boost their resilience and capacity to deliver high-quality care during crises.

Traumas have always been one of the most significant types of injuries to the body, among which burn wounds are notable. The recent study was designed to investigate the characteristics of chitosan hydrogel and Burdock root extract, along with the effect of high-intensity interval training (HIIT) on burn wounds.

chitosan hydrogel containing Burdock root extract was designed as a wound dressing. Additionally, a HIIT regimen was designed and implemented for the groups three weeks prior to the start of the study. Seventy-two male Wistar rats were randomly divided into four equal groups. All groups were evaluated on days 7th, 14th, and 21st days after wound induction based on macroscopic and microscopic parameters.

The results of macroscopic evaluation indicated that the wound contraction percentage in the first and second weeks showed a statistically significant difference in the group receiving HIIT and hydrogel, compared to other groups. In the third week, although there was no difference between the groups received only HIIT, H2, and H3 which only received hydrogel, all three groups demonstrated a statistically significant difference compared to the control group. Regarding the microscopic evaluation, all three groups performed better than the control group in terms of angiogenesis, re-epithelialization, inflammatory cells, collagen deposition, and fibroplasia, with slight differences among them. Among these groups, H2 showed superior performance in all parameters compared to other groups.

The recent study demonstrated that HIIT prior to wounding and the use of chitosan hydrogel containing Burdock root extract as a wound dressing, each individually, and positively influenced wound contraction and improved pathological wound healing factors. Additionally, the combined approach of HIIT and the use of this hydrogel can enhance the effects of each one on wound healing and rehabilitation.

Traumatic brain injury represents a significant public health concern that can manifest at any age. It also stands as one of the primary causes of disability and mortality in the ensuing years of a patient's life. The present study aims to discern predictors of mortality stemming from traumatic brain injury among individuals aged 18 to 45 in Isfahan City.
This retrospective cross-sectional study included all TBI adult cases (18-45 years) presented to the trauma registry (Kashani and Al-Zahra Hospitals) in Esfahan City - from September 2020 to February 2023. The data was exported into SPSS (version 16) for analysis.
A total of 1942 individuals with TBI aged 18 to 45 years were enrolled in the study. The frequency of mortality from traumatic brain injury was 482 (24.8 %) of patients During the study period (30 months). 191 (39.63%) patients with severe trauma died. When these variables were tested at multivariate logistic regression, being low GCS level, having concomitant injury, patients' condition at presentation SBP, hyperthermia during hospital stay, and high ISS Score were found to be statistically significant with p-value < 0.05 at 95% CI.
Most studies, spanning all age groups, identified the GCS, followed closely by the Injury Severity Score and accompanying injuries, as principal indicators of mortality risks. Moreover, there is a pressing need to routinely monitor adults for variations in systolic blood pressure and episodes of hyperthermia during their hospital stay.

Prolonged wound drainage (PWD) increases the risk of infection by compromising the skin barrier and promoting bacterial growth. Desmopressin, known for its hemostatic properties, has demonstrated the potential to reduce bleeding and accelerate wound healing in various surgical procedures.

In study, 50 patients aged between 18 and 65 undergoing total joint arthroplasty and any femoral fractures were divided into intervention and control groups. Desmopressin spray with a daily dose of 80 micrograms for two days was prescribed for the intervention group. Wound discharge volume, hospitalization, and postoperative complications were compared between the two groups.

There was a notable reduction (P=0.016) in discharge volume observed within both the control (14.4 ± 14.3 milliliters) and desmopressin-administered (6.5 ± 7.8 milliliters) groups on the second day postoperative. Also, discharge volume decreased significantly in both groups (p<0.001), and a significant discrepancy emerged in the efficacy of discharge reduction between the two groups (p<0.001). However, hospitalization was significantly (P=0.008) lower in the intervention group (3.64 ± 2.51 days) than in the control group (6.36 ± 3.1 days).

Patients receiving desmopressin exhibited significantly reduced discharge and shorter hospitalization periods than controls.