Common Cause Of Trauma Research Articles

The relationship of tumor necrosis factor alpha levels and neutrophils with skin wound age caused by sharp trauma

Background: Sharp force injuries are the second most common cause of trauma after blunt force injury. TNF- α is a cytokine that triggers the expression of adhesion molecules, other cytokines and chemokines by endothelial cells, stopped and migrated to damaged tissues or infections that trigger inflammation. Furthermore, the initial population of leukocytes leading to the wound comprises mostly neutrophils. This study aimed to assess the correlation between TNF-α levels in the blood and skin tissues and neutrophils number with the wound age of wounds caused by sharp trauma. Methods: This study is an experimental study using animal models. The samples were divided into the control group and the group in which the blood and the skin tissue samples were taken 1-, 3-, 12-, 24-, 48- and 72 hours after being sharp traumatized. The Elisa method examined the samples from the blood, and the skin of the right back of the mice was examined for TNF-α levels. Others from the left-back skin of the mice were microscopically examined to assess the number of neutrophils. Results: The TNF- α level from the skin samples were detected in wound tissue as the peak levels were in the 24 hours post-traumatic group. The TNF-α levels from blood samples indicated a significant difference in TNF-α levels in each group (p < 0.05). However, TNF-α levels from skin samples showed no significant difference between each group. From the microscopic examination, there was a significant difference in the infiltration of neutrophil cells in all groups (p<0,05). The neutrophils peak at 24 hours post-traumatic. Conclusion: There was no significant correlation between the TNF-α levels and the number of neutrophils with the wound age in wounds caused by sharp traumas.

Emergency General Surgery Experience Of A Tertiary Center

Background: We aimed to present the emergency General Surgery patient profile and results of our hospital.Materials and Methods: This retrospective study was conducted in Diyarbakır Gazi Yaşargil Training and Research Hospital Clinic between 1 January 2016 and 31 December 2019. Patients who were admitted to the emergency department and underwent emergency operations at the General Surgery clinic were included in the study. Gender, age, anamnesis, laboratory tests, radiological findings, preoperative diagnoses, surgery notes, and postoperative results of the patients were recorded.Results: A total number of 2820 cases including 1201 (42.6%) female, and 1619 (57.4%) male patients were enrolled in the study. The mean age of the patients was 37.32 years (min: 14, max: 94). The most common age range was between the ages of 21-30 years.Most of the emergency surgeries were performed due to nontraumatic indications in 2645 (93.8%) , and 1790 of them (67.67%) were cases of appendicitis. Other indications of nontrau-matic emergency surgeries were abscess, incarcerated hernia, ileus, and perforation. 175 (6.2%) patients who came to our general surgery emergency department were operated on due to trauma. The most common causes of trauma in these patients were sharp force and stab in-juries in 43.4% and gunshot wounds in 39.4% of the cases.Conclusions: The frequency and distribution of emergency cases vary according to the locations of the hospitals. Epidemiological studies and increasing data on emergency surgery enable the determination of the emergency surgery profile of the regions and the preparation of the hos-pital staff for the patients who will seek medical help.

Effect of Delay of Care for Patients with Craniomaxillofacial Trauma in Rwanda.

ObjectivesCraniomaxillofacial (CMF) trauma represents a significant proportion of global surgical disease burden, disproportionally affecting low- and middle-income countries where care is often delayed. We investigated risk factors for delays to care for patients with CMF trauma presenting to the highest-volume trauma hospital in Rwanda and the impact on complication rates.Study DesignThis prospective cohort study comprised all patients with CMF trauma presenting to the University Teaching Hospital of Kigali, Rwanda, between June 1 and October 1, 2020.SettingUrban referral center in resource-limited setting.MethodsEpidemiologic data were collected, and logistic regression analysis was undertaken to explore risk factors for delays in care and complications.ResultsFifty-four patients (94.4% men) met criteria for inclusion. The mean age was 30 years. A majority of patients presented from a rural setting (n = 34, 63%); the most common cause of trauma was motor vehicle accident (n = 18, 33%); and the most common injury was mandibular fracture (n = 28, 35%). An overall 78% of patients had delayed treatment of the fracture after arrival to the hospital, and 81% of these patients experienced a complication (n = 34, P = .03). Delay in treatment was associated with 4-times greater likelihood of complication (odds ratio, 4.25 [95% CI, 1.08-16.70]; P = .038).ConclusionDelay in treatment of CMF traumatic injuries correlates with higher rates of complications. Delays most commonly resulted from a lack of surgeon and/or operating room availability or were related to transfers from rural districts. Expansion of the CMF trauma surgical workforce, increased operative capacity, and coordinated transfer care efforts may improve trauma care.

SURGICAL MANAGEMENT OF EXTRA-ARTICULAR PROXIMAL TIBIA FRACTURE USING MINIMALLY INVASIVE TECHNIQUE WITH LOCKING COMPRESSION PLATE: AN OBSERVATIONAL STUDY

Methods: This study evaluated the outcome of 23 patients with total 24 proximal tibia fractures, treated with Minimally Invasive Plate Osteosynthesis using LCP from 13 March 2020 – 30 September 2021 at MMIMSR, Mullana. Results: There were 17 males and 6 females, with mean age of 51 years. RTA was the most common cause of trauma (65%). Most common fracture type as per AO classication was 41-A3.1 (41.7%). The average injury to surgery interval was 2.1 ± 1.4 days. The mean duration of surgery was 98.91 ± 16.5 minutes. Average follow-up period was 20.5 weeks. Union was seen in duration of 12 ± 3.9 weeks. Full weight bearing was achieved by 12.9 ± 4.5weeks. American Knee Society Score is subdivided into knee score and function score. At 6 months follow-up, the mean Knee Score was 86.7 ± 11.5 and the mean Functional Score was 88.1 ± 13.2. The mean range of motion at 108.5° ± 16.8° at 6 months. There was 1 instance of supercial infection, 3 instances of knee stiffness and 1 instance of non-union. Conclusion: MIPPO technique for management of extraarticular proximal tibia fractures using LCP leads to excellent clinical and functional outcome.

Airway Management in Pediatric Patients With Burn Contractures of the Face and Neck.

Burn injury is a common cause of trauma. Non-fatal burn injuries are a leading cause of morbidity, and significant numbers of the victims are children. Scar contracture after burn injury can cause severe functional limitation, pain, and aesthetic and psychological problems and patients may present for contracture release and reconstructive surgery. The aim of this systematic review was to identify research relevant to airway management of children with burn contracture of the face and neck with special emphasis on awake airway management and airway anesthesia, and synthesize results that can aid practice. Literature search was performed on Medline, PubMed, Cochrane Library, and Google Scholar with selected keywords. The search was restricted to human subjects of ≤18 year age, there was no language or time restriction, and the final search was concluded in July 2021. The review included 41 articles involving airway management of 56 patients in 61 anesthesia episodes. Patients aged between 8 months to 18 years. Mask ventilation and direct laryngoscopy, video laryngoscopy, optical stylet, supraglottic airway, flexible scope intubation and tracheostomy, and extracorporeal membrane oxygenation were the devices and methods used for securing the airway and oxygenation while the patients were awake or after anesthesia induction. Detailed planning and patient preparation are the fundamentals of airway management of pediatric patients with burn contracture of the face and neck; awake airway management with airway anesthesia can be safely used in selected patients. This review provides information for good clinical practice and might serve to improve the care of such children.

The burden of road traffic accident-related trauma to orthopaedic healthcare and resource utilisation at a South African tertiary hospital: a cost analysis study

BACKGROUND: Road traffic accidents (RTAs), the second commonest cause of trauma in South Africa (SA), are on the rise. It is therefore important to study and understand the burden of RTA-related injuries on our orthopaedic healthcare and healthcare in general, in order to devise new prevention strategies to minimise the number of RTAs METHODS: A retrospective analysis of data from orthopaedic trauma intake records was done for patients admitted with RTA-related injuries to the orthopaedic department at a South African tertiary hospital between February 2019 and January 2020. Hospital records and the PAC (picture archiving and communication) system were analysed for radiological studies done. The Uniform Patient Fee Schedule (UPFS) was analysed for individual costing of all variables being studied RESULTS: There were 642 patients seen and managed with RTA-related injuries included in this study. Seventy-one per cent of them were males, with an average age of 35 years. The majority (76.2%) were motor vehicle occupants, whereas 17% were pedestrians. Seventeen per cent of them had polytrauma. Four hundred and sixty-two (76%) patients required some form of surgical intervention and spent an average of 171 minutes in theatre per procedure. Ten per cent of these patients required ICU/HCU admission for an average of 13 days. The total length of hospital stay was an average of 21.8 days. The majority of patients (67%) had some form of orthopaedic implant inserted, with an average of 1.3 implants per patient. The average cost per patient was R92 737.39. The major cost drivers were hospital stay, ICU/HCU stay, implant cost, radiological studies and theatre utilisation, respectively CONCLUSION: Management of RTA-related trauma puts a significant burden on orthopaedic healthcare management and resource utilisation. While we may not be able to directly influence other contributing factors to high costs, reducing the use of temporary external fixators may help reduce the cost of managing RTA victims These findings provide scientific data which will help support the implementation of preventative measures aimed at minimising the numbers of RTAs we see on our roads, thereby minimising the burden this puts on our healthcare system. Level of evidence: Level 3

Study of the Medicolegal aspect of Trauma, Cases came to Emergency Department at Beni-Suef University Hospital “Egypt”

Trauma is the 6th leading cause of death worldwide resulting in 5 million of all deaths. It is the 5th leading cause of significant disability. In Egypt, injuries the fifth leading cause of death and the most common cause of hospitalization and account for at least 1/4 of all inpatients. The aim is to identify the medico-legal importance of different causes of orthopedic trauma to patient admitted at Beni-Suef university hospital and identify their relation with different demographic data of the patient. Data of 207 patients with orthopedic trauma admitted at Beni-Suef university hospital period from September 2016 to December 2016. Age, sex, residence, cause, site, number of trauma, type of fracture, investigation done, treatment and also associated other injuries are reported. The most common cause of trauma is motorcycle accidents (25.6%) followed by fall on ground (25.1%). Lower extremities are the most common site of trauma (44.9%). Most of cases have single fracture (71.5%) with simple type (50.3%). X-ray is the most common investigation done to patients (71%). (68.1%) of cases need operative treatment. (84%) of cases came with orthopedic trauma only not associated with other injury. While the most common associated injury is wounds over skin (5.4%). Limb injuries are a common problem among the physically active, and such injuries may result in diminished performance, reduced participation, and in the longer term loss of function, chronic joint disease, and disability. Limb injuries represent the commonest form of injury involved in road traffic accidents

To Describe Clinical Profile of Medico-Legal Cases at Tertiary Hospital in Ahmedabad

Background: Ophthalmologists play an important role in the management and fixing of legal responsibility in ocular medico legal cases (MLCs). All penetrating or non-penetrating intentional ocular trauma causing loss of an organ or part of organ and which have as consequence the facial disfigurement or post trauma complication have forensic implications.Objective: To describe the clinical profile and meticulous documentation in ocular medico-legal cases attending the ophthalmic unit at a tertiary care hospital in Ahmedabad.Methods: Medical records of ocular MLC from May 2018 to November 2020 were considered. A total of 112 cases of ocular injury constituted the sample size. The injuries were categorized as adnexal and globe injuries. The clinical profile was recorded in the clinical record forms and analyzed accordingly.Results: A total of 112 patients with ocular trauma were recruited with follow up to 6 months following recruitment. The most affected age group was 26-40 years (25.89%). The most common mode of injury was assault with fist in 22 (18.74) of cases. Most patients had open globe injury (28, 25%), while 20 (16.5%) had closed globe injury, 38 (33.93%) had the adnexal injury, 7 (6.25%) had open plus adnexal, 7 (6.25%) had closed plus adnexal and 12 (10.71%) had chemical injury. Adnexal injuries were the most common n=38 (33.93%). Lid / periorbital contusion and subconjunctival hemorrhage were the most common presentations among adnexal and globe injuries respectively. Malingering was present in 3 % (3). Furthermore, among the adult population, majority 28 (25%) had ocular injury at workplace, while most pediatrics injuries 23 (20.54) occurred at home during play. The incidence of monocular blindness 2 (9%) was at 6 months follow up after the initial presentation. Factor that was associated with monocular blindness was open globe injuries.Conclusion: Fist injury was the most common cause of trauma to the eye. A substantial number of patients who had adnexal injuries or subconjunctival hemorrhage had good vision, contrary to open globe injuries which resulted in very poor vision.

AN OBSERVATIONAL STUDY ON CLINICAL FEATURES, MANAGEMENT AND OUTCOMES OF CHEST TRAUMA

Introduction-Trauma is one of the leading causes of death worldwide. Approximately two thirds of trauma cases have chest injuries with varying severity.Mortality is second highest after head injuries,which underlines the importance of prompt diagnosis and treatment.Methods-An observational prospective study was carried out for chest trauma patients including polytrauma. Parameters like demographic prole,mode of injury,management and outcomes were studied.Results-Mean age of the patients was 38.5 years with male to female ratio of 2.4:1. RTAs are most common cause of trauma(60%) followed by assaults(34%).Many patients were managed conservatively(58%), others needed tube thoracostomy(42%).Mortality is seen in 5% due to other associated severe injuries.Conclusion-Blunt thoracic trauma is frequent but emergency open surgical interventions are rare.Mortality is directly related to severity of injury.There is need for implementation of evidence based road safety interventions and promote strong policies to decrease the incidence of RTAs.

Injuries and Interventions on Transported Military Working Dogs Within the US Central Command.

Limited veterinary care is available in the far forward environment, leading to human medical personnel being responsible, in part, for treatment of military working dogs (MWD). Though guidelines for MWD care exist, there is little research on the care and treatment of MWDs by human medical personnel. There is a lot of research on the care and treatment of MWDs. This is a secondary analysis of a dataset from the Transportation Command (TRANSCOM) Regulating Command & Control and Evacuation System (TRAC2ES) database within the US Central Command (CENTCOM) from 2008 to 2018. Within this dataset specific to regulated transport from locations within CENTCOM, we abstracted all entries involving MWDs and analyzed causes of injury, type of injury, and interventions performed on traumatically and non-traumatically injured MWDs. Within our dataset, there were 84 MWD cases for analysis. Of those, 36 (43%) were transported for traumatic injuries, and the remaining 48 (57%) were transported for other medical ailments. The most common cause of trauma was gunshot wound (31%), followed by explosion (22%). The majority of trauma MWDs had injuries to the extremities (67%), and hemorrhage requiring intervention occurred in 25%. The most common interventions performed on traumas were analgesia (67%), antibiotics (31%), IV fluids (28%), and surgery (31%). The most common indications that occurred in MWDs treated for nontraumatic medical indications were gastrointestinal diseases (33%), followed by nontraumatic orthopedic injuries (21%). Of the MWDs in our dataset, most were transported for nontraumatic medical events. The most frequent intervention performed was medication administration for both traumatic and medical ailments. Our dataset adds to the limited body of MWD data from theater.

Kafa Travması Olgularına Ait Acil Servis Transferlerinin 2019-2020 Yıllarına Ait Retrospektif Analizi

Aim: The aim of this study was to analyze respectively the frequency of head traumas and case transfer information by retrospective analysis of emergency department transfers of head trauma cases.
 Method: In this retrospective study, transfers made by Malatya 112 Coordination Center to emergency services of all pediatric or adult head trauma cases in 2019 and 2020 were examined. The data were evaluated retrospectively. Statistical analyses were performed by using SPSS 24.0 statistical package program.
 Results: It was detected that a total of 4793 patients were transferred due to head trauma in 2019 and 2020; of these 2297 (47.9%) patients were transferred in 2019, and 2496 (52.1%) in 2020. The most common causes of head traumas were found to be falls (35.3%), in-vehicle traffic accidents (24.5%), and trauma due to an unknown/ unspecified cause (20.7%), respectively. When the calls to 112 coordination centers were examined the most common places where the calls were made were found to be places open to traffic (31.6%), open areas /streets (29.6%), and health institutions (20.7%). It was found that 99.6% of the cases were alive before the transfer. When the cases were evaluated according to the Glasgow Coma Scale (GCS), it was found that 97.1% of the cases were in mild group (13-15), 1% in moderate (9-12), and 1.9% were in the severe group (3-8). 
 Conclusion and Suggestion: It was observed that head trauma transfers to emergency services were common and falls and in-vehicle traffic accidents were the most common causes of trauma. The most common symptoms at presentation were found to be nausea-vomiting, loss of consciousness, dizziness, and headache.

In Relation to Morbidity, Mortality, and Hospital Stay, Determine the Predictive Value of Injury Severity Scores in Road Traffic Accidents

Objective: The purpose of this study is to calculate the predictive value of injury severity score in relation to morbidity; mortality and hospital stay of patients following road traffic accidents. Study Design: Retrospective cohort study Place and Duration: Study was conducted at the department of General Surgery, Saidu Teaching hospital Swat, Jinnah Hospital Lahore and Bakhtawar Amin Memorial Trust Hospital Multan for duration six months from June 2020 to December 2020. Methods: Total eighty patients of both genders were presented in this study. Patients with ages 18-70 years had injury because of road traffic accidents were included. Informed written consent was taken from all the patients for detailed demographics included age, sex, body mass index and type of injury. Patients were admitted in emergency ward for initial treatment. Outcomes were calculated in terms of predictive value of injury severity score in relation to morbidity, mortality and hospital stay of patients. Abbreviated injury scale (AIS) score was used to analyze severity score. SPSS 20.0 version was used to analyze complete data. Results: Majority of the patients 55 (68.8%) were males and 25 (31.2%) were females. Mean age of the patients was 30.17±3.55 years with mean BMI 24.13±6.71 kg/m2. 45 (56.3%) patients were literate and 60 (75%) cases were from urban areas. Motorcycle was the most common cause of trauma found in 48 (60%) patients followed by car accidents in 18 (22.5%) and 14 (17.5%) trauma were because of cycle or other traffic. Legs and arms fractures were the most common injuries found in 32 (40%) and 25 (31.3%) followed by head fractures in 23 (28.8%) cases. Mean injury severity score was 54.07±3.64. Mean hospital stay was 3.12±4.37 days. Rate of mortality was high found in 19 (23.8%) cases. Conclusion: We concluded in this study that the injury severity score among traumatic patients were significantly high with rate of mortality and limb fractures were the most common injury found. Injury severity score is becoming more widely accepted as a predictor of mortality. Keywords: Road Traffic Accident, Injury Severity Score, Mortality, Limb Fracture

Clinical Features, Management, and Outcomes of Chest Trauma at a Tertiary-Care Centre in India: A Retrospective Observational Study.

Introduction Chest is one of the main sites of injuries in trauma being a part of the torso. Many important organs lie in rib cage. However, data on chest injuries are scarce. Methods A retrospective study was carried out for chest trauma patients including polytrauma (n = 184) from hospital records for five years (2016–2020). Various parameters including demographic profile, mode of injury, management, and outcomes were studied. Results Mean age of patients was 37 ± 16 years with a male to female ratio of 2.4 : 1. Road traffic injuries remained the most common cause of trauma followed by assaults. Most of the patients were managed conservatively (55.43%). Mortality was seen in only 1.63% patients. Conclusion Young male patients are usually affected by trauma. Road traffic injuries are the commonest cause. However, most patients can be managed by conservative treatment and mortality is seen only in polytrauma patients in the present study.

686 Evaluating and Modernising the Management of Nasal Trauma in Emergency ENT Clinic

Abstract Aim 1. Optimise and compare management of nasal fractures at a single UK based centre with nationally excepted standards from ENT UK and published literature. 2. To measure the non-attendance (DNA) rate in the emergency ENT clinic for patients with nasal trauma. 3. To assess the ratio of face to face (F2F) appointments to patients listed for a manipulation under anaesthesia MUA. 4. To provide additional insight into the aetiology of nasal trauma Method Retrospective analysis of clinical notes for all nasal traumas reviewed in the ENT emergency clinic at a single centre from 1st July 2019 – 1st March 2020. Parameters investigated included – demographics, days from injury, F2F:MUA, DNA rate and aetiology of injury. Implementation of a video-based clinic and local anaesthetic MUA clinic. Results At total of 255 patients and 311 appointments notes were reviewed in this period. DNA rate was found to be 28%. F2F:MUA was found to be 4:1. Patients were reviewed on average 9 days post-injury. Most common causes of trauma were assault (39%), fall (31%), sport (13%), accidental hit (10%). Conclusions The DNA rate was found to be 20% higher than the national average for outpatient clinics and a F2F:MUA of 4:1 displays a high burden of unnecessary F2F contact. A video-based and local anaesthetic nasal fractures clinic has been implemented to combat these issues which will be re-audited.

Epidemiologic analysis of pediatric maxillofacial trauma

BPurpose: This study aimed to analyze epidemiology and the treatment approaches for pediatric maxillofacial trauma patients who presented to the Department of Plastic, Reconstructive, and Aesthetic Surgery during 5 years period.
 Materials and Methods: Age and gender distributions of the patients were determined. Duration of hospitalization, etiology of trauma, location of the fracture, and treatment methods applied was determined, and the results of these treatments and complications that developed were evaluated.
 Results: The fractures were the most common at the age of 17 years (18.3%). The most common cause of trauma in patients operated for maxillofacial trauma was fall (48.3%). Most operations were performed in the age range of 12–17 years (50.6%), and panfacial fractures were the most frequently operated fracture localization (27.58%).
 Conclusion: The simplest and most effective treatment should be applied for pediatric maxillofacial trauma. While conservative treatments may be sufficient in minimally displaced fractures, open reduction and internal fixation methods are applied in fractures with greater displacement. Fixation materials must necessarily be removed since they prevent bone growth. The use of bioabsorbable plates has been limited in recent years due to their high costs.

An Investigation of the Causes of Cardiac Arrest Cases Due to Multiple Trauma

Objective: This study aimed to examine the demographic characteristics of autopsy cases due to multiple trauma and contribute to the diagnosis and treatment process. Method: Our study was carried out by examining autopsy reports of multiple trauma cases. Accordingly, two groups were formed: those who died at the scene and those in the emergency department. In addition, the demographic data of the cases, the mechanism of multiple trauma, and the cause/causes of death were recorded. Results: A total of 278 cases involving 165 deaths at the scene and 113 deaths in the emergency service were included. The most common causes of trauma in both groups were in-vehicle traffic accidents and falling from height. The most common causes of mortality in both groups were hemothorax and subarachnoidal hemorrhage. Conclusions: Deaths due to multiple trauma were almost four times more common in males (82%); the number of trauma under the age of 65 was approximately four times higher. This result shows that young men are at a much higher risk of trauma, resulting in more fatal consequences. We think our study will help to reveal the prevalence, coexistence, and trauma mechanisms of existing pathologies.

Prevalence and attributes of traumatic dental injuries to anterior teeth among school going children of Kolkata, India

BackgroundTraumatic Dental Injuries (TDI) have emerged as a very significant public health and social problem, especially among children and adolescents. The aim of this study was to investigate the prevalence and associated risk factors of traumatic dental injuries to permanent anterior teeth in school going children of Kolkata aged 7-14 years. MethodA cross-sectional study was conducted among 3762 school going children attending various private and public schools of Kolkata aged 7–14 years. A multistage random clustering sampling technique was adopted to select the children.Type of trauma using Ellis and Davey classification of fractures along with Andresen’s Epidemiological Classification of Traumatic Injuries to Anterior Teeth, including WHO codes, was used. All values were considered statistically significant at P < 0.05. ResultsPrevalence of TDI to anterior teeth was found to be 9.89%. The mean age of children who presented with TDI was 11.06 ± 1.99.years. The most common place of occurrence of TDI was home. Falls were the most common causes of trauma. Children belonging to higher socioeconomic status were observed to have an increased prevalence of TDIs.The highest potential risk factor for the occurrence of trauma was a past history of trauma. ConclusionPresent study found a prevalence of 9.89%, and a very low percentage of children had received treatment.

Cost Analysis of Maxillofacial Trauma in Shiraz Shahid Rajayee Hospital

Introduction: Accidents are one of the most important cause of morbidity and mortality in different societies. One of the prevalent complications of crash and other accidents is maxillofacial fractures which in addition to abundant difficulties for patients has a high burden for health system of countries. So the aim of this study was analytical evaluation of financial burden of maxillofacial trauma with respect to demographic variables, therefore the costs of maxillofacial traumas were evaluated in Shiraz. Materials &amp; Methods: In this cross-sectional study, records of 200 patients hospitalized for maxillofacial trauma in Shiraz Shahid Rajayee hospital during 2018 to 2019 were evaluated. Costs of different parts of treatment, trauma mechanisms in addition to demographic characteristics (age and gender) were recorded for each patient. Data analysis was carried out by descriptive analysis. Results: Of total of 200 patients were hospitalized due to the maxillofacial injuries, 40 (20 %) were female and 160 (80%) were male. The age average was 39.9 years. The most common cause of trauma was crashes (81.5%). In average, 89272763 Rials was spent for each patient. Conclusion: Results of the current study demonstrated that a huge budget is spent each year for accident patients whom have maxillofacial fractures.

Drug use in Canadian patients with trauma after cannabis legalization

Background:The federal Cannabis Act came into force on Oct. 17, 2018, in Canada, making Canada only the second country in the world to legalize the cultivation, acquisition, possession and consumption of cannabis and its by-products. This provided a unique opportunity to evaluate the impact of this legislation on drug-related trauma.Methods:We performed a prospective observational study on the use of cannabis and other illicit drugs in the trauma population at a lead Canadian trauma centre in London, Ontario, in the 3 months before (July 1 to Sept. 30, 2018) and 3 months after (Nov. 1, 2018, to Jan. 31, 2019) the legalization of cannabis in Canada. We defined cannabis use as a positive cannabinoid screen result at the time of assessment by the trauma team. We also screened for opioids, amphetamines and cocaine.Results:A total of 210 patients were assessed by our trauma service between July 1 and Sept. 30, 2018, and 141 patients were assessed between Nov. 1, 2018, and Jan. 31, 2019. Motor vehicle collisions were the most common cause of trauma both before (101 [48.1%]) and after (67 [47.5%]) legalization. The mean Injury Severity Score was 17.6 (standard deviation [SD] 13.0) and 19.7 (SD 14.8), respectively. Drug screens were done in 88 patients (41.9%) assessed before legalization and 99 patients (70.2%) assessed after legalization. There was no difference in the rate of positive cannabinoid screen results before and after legalization (22 [25%] v. 22 [22%]). There was a trend toward higher rates of positive cannabinoid screen results (2/10 [20%] v. 5/8 [62%]) and positive toxicology screen results (5/10 [50%] v. 6/8 [75%]) after legalization among patients with penetrating trauma, but our sample was too small to achieve statistical significance.Conclusion:We found no difference in the rates of positive cannabinoid screen results among patients assessed at our trauma centre in the 3 months before and the 3 months after legalization of cannabis; however, there was a trend toward an increase in the rates of positive results of toxicology screens and cannabinoid screens among those with penetrating trauma. These preliminary single-centre data showing no increased rates of cannabis use in patients with trauma after legalization are reassuring.

Dog bite wounds in cats: a retrospective study of 72 cases.

Bite wounds are a common cause of trauma in cats; nevertheless, large-scale studies of this trauma in cats are lacking. The aims of the present study were to characterise the clinical and clinicopathological findings in these cats, to assess the association of these variables and therapeutic measures with survival, and to assess the association between the animal trauma triage (ATT) score and severity of injuries score (SS) at presentation with survival. The medical records of cats presented to a veterinary teaching hospital and two large referral clinics were reviewed retrospectively. The study included 72 cats diagnosed with canine bite wounds (with the dog attacks having been witnessed). Seventy-one percent of cats suffered multiple injuries, and there was a significant association between the number of injured body areas and survival, and between severity of injury and survival (P = 0.02 and P = 0.012, respectively). The median ATT scores and SSs for non-survivors were significantly higher compared with survivors (P <0.0001). There was a strong and significant correlation between ATT scores and SSs (r = 0.704, P <0.0001). Total protein and albumin were significantly lower and alanine aminotransferase significantly higher in non-survivors compared with survivors (P ⩽0.032). Fifty percent of cats were treated conservatively, 32% by local surgical debridement and 18% of cats required an exploratory procedure. Cats undergoing more aggressive treatments were significantly less likely to survive (P = 0.029). Fifty-seven cats (79%) survived to discharge. Cats sustaining canine bite wounds have a good overall prognosis for survival to discharge. High ATT score, high SS, multiple body area injuries, penetrating injuries, radiographic evidence of vertebral body fractures and body wall abnormalities, as well as hypoproteinaemia and elevated alanine aminotransferase, are negative predictors of survival.