Trauma Monthly
Volume:30 Issue: 1, Jan-Feb 2025

Falls are the second leading cause of unintentional injury deaths globally, posing a significant public health issue. This study compared injury patterns between patients who experienced falls from heights and those who had ground-level falls.

This hospital-based registry study analyzed data from Sina Hospital in Tehran, including all patients with fall-related traumas from September 2016 to August 2022. The variables included were demographics, fall mechanisms, length of stay (LOS) in the hospital, admission to the intensive care unit (ICU), ICU LOS, mortality, Glasgow Coma Score (GCS), injured body regions, and types of injuries.

The study included 1,484 patients, with 50.3% experiencing falls from heights and 49.7% having ground-level falls. Falls from heights were more common among males (80.1%) and individuals aged 18-64 (77.1%). After adjusting for age and gender, it was found that patients who fell from heights had a higher rate of moderate head injuries (1.5% vs. 0.3%), longer hospital stays (8.2 days vs. 6.9 days), and more frequent injuries to the chest, spine, upper extremities, and multiple trauma compared to ground-level fallers. Forearm fractures were more prevalent in patients who fell from heights (21.5% vs. 12.4%), while femur fractures were more common in ground-level fallers (42.6% vs. 13.2%).

There are significant differences in injury patterns between falls from heights and ground-level falls. Falls from heights disproportionately affect males and working-age individuals, leading to a higher incidence of upper extremity injuries, forearm fractures, and multiple traumas. In contrast, ground-level falls are more common among the elderly and result in a higher incidence of lower extremity injuries, particularly femur fractures. These findings highlight the importance of recognizing these differences in injury patterns to inform targeted prevention strategies and improve patient outcomes.

Trauma Brain Injury (TBI) is nerve damage caused by mechanical forces such as linear forces with acceleration and deceleration, rotational forces (force created by the winds resulting from the explosion), and penetration of the object thrown to the head can cause impaired in various aspects of communication, cognitive, and language skills including the grammar and morphology. The present study aims to investigate and compare grammar production skills (morphology) in patients with TBI and healthy non-TBI people.
This study is of cross-sectional type and morphological skills (morphological derivations and tenses of verbs) of 20 patients with moderate severity (GCS=8-13) in the sub-acute phase (one to three weeks after the trauma) with healthy non-TBI people compared. The age range of people was 18-45 years old, and they were classified into four educational subgroups. The morphological derivations section of the bilingual aphasia test (BAT), the verb tense test and the Mann-Whitney statistical test were used.
The results showed that there is a significant difference in the morphological derivations and the correct production of verb tenses in all three tenses (past, present, and future) between patients with TBI and healthy non-TBI people (p<0.05). In such a way, the skills required to produce correct verb tenses and morphological derivations are significantly lower in patients with TBI.
The correct production of verb tenses and morphological derivation skills are significantly impaired in patients with TBI compared to non-TBI people. Most problems with verb tenses in patients with moderate TBI were seen in the past tense and then the future tense, with a slight difference in the present tense of verbs. Impairing to these items can cause problems in the production of their daily speech and, as a result, reduce the communication skills of these patients.

The patient's perception of postoperative medical advice effectively affects treatment outcomes. Some factors, including education level, patient-physician communication, and financial limitations, can affect the patient's perception. This study assessed the patient’s perception of medical recommendations after orthopedic surgery.

This cross-sectional study was conducted on patients who referred for postoperative follow-up visit during the first half of 2022. Two separate questionnaires, for patients' and companions' questions and a surgeon's recommendations form, were designed and were asked to patients and their companions 10 minutes after finishing the visit. Education level, marital status, and city of residence were assessed among the samples. Also, the data were analyzed by R software.

Literacy level was significantly related to patient perception (P-value = 0.004). In 15.9%, neither the patient nor the companions understood the surgeon’s recommendations (Kapa Coefficient = 0.34).

Perception of the post-surgical recommendations at the postoperative follow-up is important in the final outcomes of orthopedic surgery. The patient's literacy level can affect the patient's perception.

The Arbaeen walking ceremony is a significant religious event that draws millions of people to the Arbaeen terminals in Iraq annually. Like other mass gatherings, this religious activity can cause numerous health concerns. Heatstroke is one of the main concerns in this event. This study was conducted to assess the risk perception of Arbaeen pilgrims with regard to heat stroke in 2023. This descriptive cross-sectional study assessed statistical population which included everyone who participated in the Arbaeen Walk in 2023. The sampling was random. The sample size was determined by using the statistical formula: (1067 people). The data collection tool was a demographic information checklist and a researcher-made questionnaire to assess the risk of heat stroke. The data was analyzed using SPPS24 software, descriptive statistics, t-tests, and variance analysis. The average score of people's risk perception based on cognitive, functional, physical, and psychological dimensions was 4.12±31.36, 1.88±16.92, 3.31±23.35 and 25.28±5.15, respectively. Also, the mean and standard deviation of the total risk perception score was 96.92±14.47. 51. Eighteen percent of pilgrims were in a good situation regarding risk perception. The results showed that the average score of people's risk perception based on age, gender, and level of education were significant in all dimensions (P=0.00). According to the study results, the studied pilgrims had a high-risk perception of heat stroke. Public training for climate risk reduction management should be promoted and widely implemented to prevent heat stroke.

Hip fractures are a critical issue among the elderly, often resulting from osteoporosis, and pose a significant global health challenge. With an estimated 10 million cases annually, the complexity of anesthesia choice is heightened by the elderly's prevalent comorbidities. This retrospective cohort study, conducted at Rasool Akram Hospital from April 2017 to April 2021, investigates the 30-day postoperative mortality rates in over 50 patients undergoing hip fracture surgery. It compares outcomes between general and neuraxial anesthesia and examines the influence of comorbidities and fracture types on mortality. The study encompassed 437 patients, with a notable difference in mortality rates: 5.6% for general anesthesia versus 13.8% for neuraxial anesthesia (P = 0.006). A propensity for neuraxial anesthesia was observed in patients over 75 and those with cardiac conditions (P = 0.004 and P = 0.006, respectively). Smokers and patients with intertrochanteric fractures also exhibited higher mortality under neuraxial anesthesia. The mortality rates did not significantly vary among neuraxial anesthesia subtypes. The anesthesia method significantly impacts the 30-day mortality rate in elderly hip fracture patients with comorbidities. General anesthesia is associated with lower mortality than neuraxial anesthesia. These findings highlight the importance of meticulous preoperative evaluation and tailored anesthesia strategies to enhance patient outcomes. The study advocates for personalized care to navigate the complexities of anesthesia selection and improve surgical success rates in this vulnerable population.

Arbaeen is an annual religious procession in Iraq in which millions of people participate by walking 80 kilometers from the city of Najaf to the city of Karbala. Foot blisters are a common problem for hikers, runners, and endurance athletes, and this study aimed to evaluate the risk factors for foot blisters among Arbaeen pilgrims. In this cross-sectional study, 6,972 participants were included, and 4,399 were selected for evaluation during the 2017 Arbaeen ceremony. Demographic data such as age, sex, type of foot covering, presence of underlying diseases, educational level, number and frequency of Arbaeen pilgrimages, traveled distance, and locations of foot blisters were captured. The type of foot covering and the distance walked were significantly associated with the number of foot blisters (P-value<0.05). However, no association was found between underlying diseases such as diabetes mellitus, hypertension, cardiovascular disease, and thyroid dysfunction and the risk of foot blisters (P-value>0.05). Women were found to be at a higher risk of developing foot blisters (P-value<0.05). The study concluded that proper footwear and regular foot care are essential to prevent foot blisters during the Arbaeen pilgrimage.

Medical ethics are sacrificed in Gaza and the international organizations are watching. In these short comments, we have a quick overview of the current state of medical ethics in different groups of people in Gaza.