Related Injuries Research Articles

Comparing the Effectiveness of Oral Celecoxib with Oral Tramadol as Pre-Emptive Analgesia in Ambulatory Surgery

Nociception pathway is thought to be pre-emptively inhibited in hope to reduce acute pain in an anticipated procedural related tissue injury intraoperatively or postoperatively when pre-emptive analgesics are administered preoperatively. High intensity of pain is expected after surgical removal of the third molar which is associated with jaw swelling and limited opening of the jaw. We compared the pre-emptive analgesia effect of oral celecoxib and oral tramadol in elective ambulatory dental surgery under general anaesthesia. Informed consents were obtained from 84 patients with American Society of Anesthesiologists (ASA) physical status I or II and aged between 18 to 56 years. They were randomised to receive either oral celecoxib 200 mg (Group A) or oral tramadol 50 mg (Group B) one hour before induction of anaesthesia. Intraoperative and postoperative fentanyl consumption were compared. Numeric Rating Scale (NRS), ranging from 1 to 10, was used to assess postoperative pain scores. Group A showed a significant reduction in fentanyl consumption intraoperatively compared to Group B (p=0.047). Both groups of patients experienced mild pain at various times assessed postoperatively ranging between 0-2 NRS scores. Comparison between the groups did not detect significant reduction in pain scores and postoperative fentanyl consumption. We concluded that neither medication was found to be effective as pre-emptive analgesia, however, intraoperative fentanyl consumption was reduced by pre-emptive administration of oral celecoxib.

An overview of preclinical models of traumatic brain injury (TBI): relevance to pathophysiological mechanisms

BackgroundTraumatic brain injury (TBI) is a major cause of morbidity and mortality, affecting millions annually worldwide. Although the majority of TBI patients return to premorbid baseline, a subset of patient can develop persistent and often debilitating neurocognitive and behavioral changes. The etiology of TBI within the clinical setting is inherently heterogenous, ranging from sport related injuries, fall related injuries and motor vehicle accidents in the civilian setting, to blast injuries in the military setting.ObjectiveAnimal models of TBI, offer the distinct advantage of controlling for injury modality, duration and severity. Furthermore, preclinical models of TBI have provided the necessary temporal opportunity to study the chronic neuropathological sequelae of TBI, including neurodegenerative sequelae such as tauopathy and neuroinflammation within the finite experimental timeline. Despite the high prevalence of TBI, there are currently no disease modifying regimen for TBI, and the current clinical treatments remain largely symptom based. The preclinical models have provided the necessary biological substrate to examine the disease modifying effect of various pharmacological agents and have imperative translational value.MethodsThe current review will include a comprehensive survey of well-established preclinical models, including classic preclinical models including weight drop, blast injury, fluid percussion injury, controlled cortical impact injury, as well as more novel injury models including closed-head impact model of engineered rotational acceleration (CHIMERA) models and closed-head projectile concussive impact model (PCI). In addition to rodent preclinical models, the review will include an overview of other species including large animal models and Drosophila.ResultsThere are major neuropathological perturbations post TBI captured in various preclinical models, which include neuroinflammation, calcium dysregulation, tauopathy, mitochondrial dysfunction and oxidative stress, axonopathy, as well as glymphatic system disruption.ConclusionThe preclinical models of TBI continue to offer valuable translational insight, as well as essential neurobiological basis to examine specific disease modifying therapeutic regimen.

Clinical analysis of 1301 children with hand and foot fractures and growth plate injuries.

Fractures of hands and feet are common in children, but relevant epidemiological studies are currently lacking. We aim to study the epidemiological characteristics of hand and foot fractures and growth plate injuries in children and provide a theoretical basis for their prevention, diagnosis, and treatment. We retrospectively analyzed the data of children with hand and foot fractures who were hospitalized at Shenzhen Children's Hospital between July 2015 and December 2020. Data on demographic characteristics, fracture site, treatment method, etiology of injury, and accompanying injuries were collected. The children were divided into four age groups: infants, preschool children, school children, and adolescents. The fracture sites were classified as first-level (the first-fifth finger/toe, metacarpal, metatarsal, carpal, and tarsal) and second-level (the first-fifth: proximal phalanx, middle phalanx, distal phalanx, metacarpal, and metatarsal) sites. The changing trends in fracture locations and injury causes among children in each age group were analyzed. Overall, 1301 children (1561 fractures; 835 boys and 466 girls) were included. The largest number of fractures occurred in preschool children (n = 549, 42.20%), with the distal phalanx of the third finger being the most common site (n = 73, 15.57%). The number of fractures in adolescents was the lowest (n = 158, 12.14%), and the most common fracture site was the proximal phalanx of the fifth finger (n = 45, 29.61%). Of the 1561 fractures, 1143 occurred in the hands and 418 in the feet. The most and least common first-level fracture sites among hand fractures were the fifth (n = 300, 26.25%) and first (n = 138, 12.07%) fingers, respectively. The most and least common first-level foot fracture locations were the first (n = 83, 19.86%) and fourth (n = 26, 6.22%) toes, respectively. The most common first-level and second level etiologies were life related injuries (n = 1128, 86.70%) and clipping injuries (n = 428, 32.90%), respectively. The incidence of sports injuries gradually increased with age, accounting for the highest proportion in adolescents (26.58%). Hand and foot fractures had many accompanying injuries, with the top three being nail bed injuries (570 cases, 36.52%), growth plate injuries (296 cases, 18.96%), and distal severed fracture (167 cases, 10.70%). Among the 296 growth plate injuries, 246 occurred on the hands and 50 on the feet. In contrast to previous epidemiological studies on pediatric hand and foot fractures, we mapped the locations of these fractures, including proximal, shaft, distal, and epiphyseal plate injuries. We analyzed the changing trends in fracture sites and injury etiologies with age. Hand and foot fractures have many accompanying injuries that require attention during diagnosis and treatment. Doctors should formulate accident protection measures for children of different ages, strengthen safety education, and reduce the occurrence of accidental injuries.

Susceptibility to Hepatotoxic Drug-Induced Liver Injury Increased After Traumatic Brain Injury in Mice.

The early stages of brain injury can induce acute liver injury, which can be recovered in the short term. Continued medication treatment during hospitalization for brain injury alleviates the prognosis and contributes to a high incidence of drug-induced liver injury (DILI). We hypothesize that there is an interaction between changes in the hepatic environment after brain injury and liver injury produced by intensive drug administration, leading to an upregulation of the organism's sensitivity to DILI. In this study, mice models of TBI were established by controlled cortical impact (CCI) and models of DILI were constructed by acetaminophen (APAP). All mice were divided into four groups: Sham, TBI, APAP, and TBI+APAP, and related liver injury indicators in liver and serum were detected by Western blot, Quantitative real-time PCR (qRT-PCR), and immunohistochemical staining. The results suggested that liver injury induced in the early stages of brain injury recovered in 3 days, but this state could still significantly aggravate DILI, represented by higher liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), oxidative stress (increase in malondialdehyde [MDA] concentration and deregulation of glutathione [GSH] and superoxide dismutase [SOD] activities), inflammatory response (activation of the HMGB1/TLR4/NF-κB signaling pathway, and increased messenger RNA [mRNA] and protein levels of pro-inflammatory cytokines including tumor necrosis factor alpha [TNF-α], interleukin [IL]-6, and IL-1β), and apoptosis (TUNEL assay, upregulation of Bax protein and deregulation of Bcl-2 protein). In summary, our results suggested that TBI is a potential susceptibility factor for DILI and exacerbates DILI.

Trauma Outcomes in Pediatric Nonfatal Road Traffic Accidents

Background: By 2025, road traffic injuries are projected to rank third in the global burden of disease, posing a significant challenge that affects health, social well-being, and economic aspects. According to data from the Romanian Police National Statistics Center, there have been an average of 342 traffic accidents per year involving pediatric patients over the past 10 years. Materials and Methods: A retrospective research study was conducted, encompassing 358 cases of road traffic accidents identified for the study, with data collected over a span of eight years, and with the aim of analyzing the types of injury and treatment methods in relation to age and sex, while also focusing on the duration of hospitalization and the occurrence of complications. Results: An oscillating trend is observed from 2015 to 2020, with its lowest value recorded in 2017 at around 6.8% and its peak in 2019 at 20.1%. Notably, post-pandemic (COVID-19), the cases underwent a substantial decline of approximately 60%. At least 78.7% of those who did not undergo orthopedic reduction required surgery, whereas among those who underwent orthopedic reduction, only 23.4% needed surgery. Regarding the frequency of complications 17.3% of the total cases experienced complications. Conclusions: According to our findings, age has a significant effect on the type of accident (p < 0.05). Complications occurred in 17.3% of patients, most commonly surgical (24 cases, 38.7%), orthopedic (17 cases, 27.4%), and neurological (15 cases, 24.2%).

Impaired Kidney Function, Cerebral Small Vessel Disease and Cognitive Disorders: The Framingham Heart Study.

It remains unclear if the relation of chronic kidney disease (CKD) with cognitive dysfunction is independent of blood pressure (BP). We evaluated kidney function in relation to premorbid BP measurements, cerebral small vessel disease (CSVD) and incident mild cognitive impairment (MCI) and dementia in Framingham Offspring Cohort participants. We included Framingham Offspring participants free of dementia, attending an examination during midlife (exam cycle 6, baseline) for ascertainment of kidney function status, with brain MRI late in life (exam cycles 7-9), cognitive outcome data and available interim hypertension and blood pressure assessments. We related CKD (estimated glomerular filtration rate<60ml/min/1.73m2) and albuminuria (urine albumin-to-creatinine ratio≥30mg/g) to CSVD markers and cognitive outcomes using multivariable regression analyses. Among 2604 participants (mean age 67.4±9.2, 64% women, 7% had CKD and 9% albuminuria), albuminuria was independently associated with covert infarcts (adjusted OR, 1.55 [1.00-2.38]; P=0.049) and incident MCI and dementia (adjusted HR, 1.68 [1.18-2.41]; P=0.005 and 1.71, [1.11-2.64]; P=0.015, respectively). CKD was not associated with CSVD markers but was associated with higher risk of incident dementia (HR, 1.53 [1.02-2.29]; P=0.041), While albuminuria was predictive of the Alzheimer's disease subtype (Adjusted HR=1.68, [1.03-2.74]; P=0.04), CKD was predictive of vascular dementia (Adjusted HR, 2.78, [1.16-6.68]; P=0.023). Kidney disease was associated with CSVD and cognitive disorders in asymptomatic community dwelling participants. The relation was independent of premorbid BP, suggesting that the link between kidney and brain disease may involve additional mechanisms beyond blood pressure related injury.

Association of impulsive behavior and cerebrospinal fluid/plasma oxidation and antioxidation ratio in Chinese men

ObjectivesImpulsive behavior is the precursor of many psychiatric and neurological conditions. High levels of impulsive behavior will increase health risk behavior and related injuries. Impulsive behavior is produced and regulated by central and peripheral biological factors, and oxidative stress (OS) can aggravate it. However, previous studies only showed that impulsive behavior was related to the level of the peripheral OS. Therefore, this study aims to clarify the relationship between OS and impulsive behavior in the brain and peripheral blood. MethodsWe recruited 64 Chinese men. We measured superoxide dismutase (SOD) (including copper, zinc and manganese) and nitric oxide synthase (NOS) (including total, inducible and constitutive) in cerebrospinal fluid (CSF) and plasma. The Barratt Impulsiveness Scale version 11 (BIS-11) was used to evaluate impulsive behavior. The relationship between OS and impulsive behavior was evaluated by partial correlation analysis and stepwise multiple regression analysis. ResultsPartial correlation analysis showed that the ratio of total NOS-to-MnSOD and iNOS-to-MnSOD in CSF were negatively correlated with the BIS-11 motor scores (r = −0.431, p = −0.001; r = −0.434, p = −0.001). Stepwise multiple regression analysis showed that the ratio of CSF iNOS-to-MnSOD was the most influential variable on the BIS-11 motor scores(β = −0.434, t = −3.433, 95 %CI(−0.374, −0.098), p = 0.001). Conclusions and RelevanceThe imbalance of central oxidation and antioxidation is related to impulsive behavior, which broadens our understanding of the correlation between impulsive behavior and OS.

Centiles for the shock index among injured children in the prehospital setting

ObjectiveThe shock index (SI), the ratio of heart rate to systolic blood pressure, is a clinical tool for assessing injury severity. Age-adjusted SI models may improve predictive value for injured children in the out-of-hospital setting. We sought to characterize the proportion of children in the prehospital setting with an abnormal SI using established criteria, describe SI values among injured children, and determine prehospital interventions by SI. MethodsWe performed a multi-agency retrospective cross-sectional study of children (<18 years) in the prehospital setting with a scene encounter for suspected trauma and transported to the hospital between 2018 and 2022 using the National Emergency Medical Services (EMS) Information System datasets. Our exposure of interest was the first calculated SI. We identified the proportion of children with an abnormal SI when using the SI, pediatric age-adjusted (SIPA); and the pediatric SI (PSI) criteria. We developed and internally validated an age-based distributional model for the SI using generalized additive models for location, scale, and shape to describe the age-based distribution of the SI as a centile or Z-score. We evaluated EMS interventions (basic airway interventions, advanced airway interventions, cardiac interventions, vascular access, intravenous fluids, and vasopressor use) in relation to both the SIPA, PSI, and distributional SI values. ResultsWe analyzed 1,007,863 pediatric EMS trauma encounters (55.0% male, median age 13 years [IQR, 8–16 years]). The most common dispatch complaint was for traffic/transport related injury (32.9%). When using the PSI and SIPA, 13.1% and 16.3% were classified as having an abnormal SI, respectively. There were broad differences in the percentage of encounters classified as having an abnormal SI across the age range, varying from 5.1 to 22.8% for SIPA and 3.7–20.1% for PSI. The SIPA values ranged from the 75th to 95th centiles, while the PSI corresponded to an SI greater than the 90th centile, except in older children. The centile distribution for SI declined during early childhood and stabilized during adolescence and demonstrated a difference of <0.1% at cutoff values. An abnormal PSI, SIPA and higher SI centiles (>90th centile and > 95th centiles) were associated with interventions related to basic and advanced airway management, cardiac procedures, vascular access, and provision of intravenous fluids occurred with greater frequency at higher SI centiles. Some procedures, including airway management and vascular access, had a smaller peak at lower (<10th) centiles. DiscussionWe describe the empiric distribution of the pediatric SI across the age range, which may overcome limitations of extant criteria in identifying patients with shock in the prehospital setting. Both high and low SI values were associated with important, potentially lifesaving EMS interventions. Future work may allow for more precise identification of children at higher risk of significant injury using cutpoint analysis when paired to outcome-based criteria to define the presence of major trauma. These may additionally be combined with other physiologic and mechanistic criteria to assist in triage decisions.

WCN24-2058 Point-of-care creatinine testing for early detection of pregnancy related acute kidney injury in Sierra Leone. A case report

WCN24-2058 Point-of-care creatinine testing for early detection of pregnancy related acute kidney injury in Sierra Leone. A case report

How does classification score affect falls in wheelchair basketball? A video-based cross-sectional study on the Italian national team during the European Para Championships 2023

ObjectivesThe aim of this study was to investigate the mechanism of falls in male elite wheelchair basketball (WB) players and to analyse the falls characteristics considering their classification score which ranges from 1.0 to 4.5 and it is related to their functional capacity and particularly to their volume of action. DesignA cross-sectional video analysis was conducted using European para championships 2023official match videos. SettingPlayers of the sample team were divided into 2 groups according to their classification point: low-point players (LPP) and high-point players (HPP). Every occurred fall was systematically analysed focusing on falling related characteristics and game circumstances. ParticipantsTwelve WB players of the Italian national team. Main outcomeNumber of falls and mechanism of falls. ResultsThe results showed a higher number of falls for HPP and highlighted a statistically significant differences between LPP and HPP for the fall direction, the playing time and the first anatomical site in contact with the floor. ConclusionResults reported significant differences between LPP and HPP in terms of mechanism of fall. Further studies should focus on the development of new preventive training strategies tailored to WB players with different levels of impairments to reduce fall related injuries.

Maturity measurement in road traffic injury prevention

Road traffic related death and injury continues to be a major challenge globally. Unsafe road use is particularly evident in low- and middle-income countries while also being a growing concern for private sector organisations. The Safe System approach is recognized internationally as the leading approach to improving road safety and previous work has codified the essential management functions and interventions evident in its successful implementation. Tracking the development of Safe System adoption within the public and private sectors is of interest for several reasons. This paper presents recent development and use of road safety maturity frameworks and discusses the utility of these approaches for road safety practitioners and researchers.

Characteristics and Injury Patterns in Traumatic Brain Injury Related to E-Scooter Use in Riga, Latvia: Multicenter Case Series

Background and Objectives: In recent years, electronic scooters (e-scooters) have gained popularity, whether for private use or as a publicly available transportation method. With the introduction of these vehicles, reports of e-scooter-related accidents have surged, sparking public debate and concern. The aim of this study was to analyze the epidemiological data, characteristics, and severity of traumatic brain injury (TBI) related to e-scooter accidents. Materials and Methods: This retrospective case series evaluated patients who were admitted to the three largest neurosurgery clinics in Riga, Latvia, from the time period of April to October in two separate years—2022 and 2023—after e-scooter-related accidents. The data were collected on patient demographics, the time of the accident, alcohol consumption, helmet use, the type of TBI, other related injuries, and the treatment and assessment at discharge. Results: A total of 28 patients were admitted with TBI related to e-scooter use, with a median age of 30 years (Q1–Q3, 20.25–37.25), four individuals under the age of 18, and the majority (64%) being male. In 23 cases, the injury mechanism was falling, in 5 cases, collision. None were wearing a helmet at the time of the injury. Alcohol intoxication was evident in over half of the patients (51.5%), with severe intoxication (&gt;1.2 g/L) in 75% of cases among them. Neurological symptoms upon admission were noted in 50% of cases. All patients had intracranial trauma: 50% had brain contusions, 43% traumatic subdural hematoma, and almost 30% epidural hematoma. Craniofacial fractures were evident in 71% of cases, and there were fractures in other parts of body in three patients. Six patients required emergency neurosurgical intervention. Neurological complications were noted in two patients; one patient died. Conclusions: e-scooter-related accidents result in a significant number of brain and other associated injuries, with notable frequency linked to alcohol influence and a lack of helmet use. Prevention campaigns to raise the awareness of potential risks and the implementation of more strict regulations should be conducted.

Electrical pruning of Pinus radiata epicormic growths

A novel method for pruning epicormic growths with high voltage energy pulses is presented. This method could be utilized in autonomous forest management, for example by a drone carrying an electrical pulse generator and applicator pruning device. In a laboratory setting, short duration, high voltage pulses of electricity were generated using a capacitor network and a current source. These pulses were applied to Pinus radiata needles and the relative tissue injury to the needles was assessed by estimating electrolyte leakage from the needles in deionised water using electrical conductivity (EC) measurements. EC was positively correlated with the electrical energy applied. This validated the theory that electrical stimuli can cause increased cell death in plant matter. The cell damage, based on electrolyte leakage, caused by stimulating a Pinus radiata needle with a single 1.5 J pulse of energy was 21 % of the maximum, where the maximum was found to result in an EC of 333 µS/cm per gramme of needle in a 45 ml solution. These results from testing on needles removed from the tree confirm the potential of electrical pruning of epicormic growths. Future testing on live in-situ needles will be implemented to determine the level at which cell death induced by the application of high voltage pulses is sufficient to prune epicormic growths, given that mechanical and biotic factors of needles removed from the tree may enhance the rate of cell death in harvested samples.

Integrative proteomics and metabolomics data analysis exploring the mechanism of brain injury after cardiac surgery in chronic stress rats

ObjectivePreoperative chronic stress (CS) is associated with postoperative brain injury in patients undergoing open heart cardiac surgery. This research is to explore the potential molecular biological mechanisms of brain damage following cardiac surgery in preoperative CS rats by the analyses combining proteomics and metabolomics.MethodsWe constructed the chronic unpredictable stress (CUS) and cardiac surgery models in adult rats. We proved the brain injury in CUS cardiac surgery rats by Hematoxylin–Eosin (H&E) staining, followed by separating the hippocampal tissue and investigating the potential mechanisms of brain injury by the methods of data-independent acquisition proteomics and untargeted metabolomics.ResultsThe signaling pathways of glycoproteins and metabolism of amino acids were the main possible mechanisms of brain injury in CUS rats following cardiac surgery according to the proteomics and metabolomics. In addition, the pathways of animo acids metabolism such as the pathways of lysine degradation and β-alanine metabolism may be the main mechanism of cardiac surgery related brain injury in preoperative CUS rats.ConclusionsThe pathways of animo acids metabolism such as lysine degradation and β-alanine metabolism may be the potential mechanisms of brain injury in CUS rats following cardiac surgery. We should focus on the varieties of bioproteins and metabolites in these pathways, and related changes in other signaling pathways induced by the two pathways.

Bibliometric analysis of PTEN in neurodevelopment and neurodegeneration.

Phosphatase and tensin homologue deleted on chromosome ten (PTEN) was initially recognized as a significant regulator of cancer suppression and could impede cancer cell survival, proliferation, and energy metabolism. PTEN is highly expressed in neurons and performs crucial functions in neurogenesis, synaptogenesis, and neuronal survival. Disruption of PTEN activity may also result in abnormal neuronal function and is associated with various neurological disorders, including stroke, seizures, and autism. Although several studies have shown that PTEN is involved in the development and degenerative processes of the nervous system, there is still a lack of in-depth studies that summarize and analyse patterns of cooperation between authors, institutions, countries, and journals, as well as research hotspots and trends in this important field. To identify and further visualize the cooperation and comprehend the development and trends of PTEN in the nervous system, especially in neural development and neurological diseases, we used a bibliometric analysis to identify relevant publications on this topic. We first found that the number of publications displayed a growing trend with time, but this was not stable. Universities, institutions, and authors from the United States are leading in this area of research. In addition, many cutting-edge research results have been discovered, such as key regulatory molecules and cellular mechanisms of PTEN in the nervous system, which may provide novel intervention targets and precise therapeutic strategies for related pathological injuries and diseases. Finally, the literature published within the last 5 years is discussed to identify future research trends regarding PTEN in the nervous system. Taken together, our findings, analysed using bibliometrics, may reflect research hotspots and trends, providing a reference for studying PTEN in the nervous system, especially in neural development and neurological diseases. These findings can assist new researchers in developing their research interests and gaining basic information. Moreover, our findings also may provide precise clinical guidelines and strategies for treating nervous system injuries and diseases caused by PTEN dysfunction.

A STUDY OF ERGONOMICS AND ITS EFFECT ON THE HOUSEKEEPING EMPLOYEES

Background: Ergonomics is the science of designing work as per the human body, it is used by the management to  make the work processes safe for their workers. Housekeeping involves lots of physical work, therefore it is necessary  that such research should be done on housekeeping department employees. Objectives: The objectives of this study  were: to understand the application of ergonomics in the housekeeping department, to study the effects and challenges  of ergonomics on the members of the housekeeping team, and to explore the awareness of ergonomics amongst the  housekeeping employees. Methodology: The research design was a combination of experimental &amp; descriptive. 100  housekeepers from 4 &amp; 5 star hotels in Delhi-NCR were participants of the work. A questionnaire consisting of close ended and few open-ended questions was circulated among the respondents on one to one basis. To study the fatigue  rate while working, oxygen and pulse rate of the respondents was also recorded. Data analysis was done on the basis of  gender. Results: The findings state that 98% of the housekeeping department employees were aware about the concept  of ergonomics and its application in housekeeping. Unfortunately, due to constraint of time and tight work schedule,  a housekeeper cannot always follow the practices of ergonomic. Oxygen level decreased (98.15±0.08) after doing the  task and the pulse rate increased (95.54±1.52) after completing their task. Conclusion: Housekeepers are exposed to a  range of ergonomic risk factors and are prone to posture related injuries. It has also been seen that there is a substantial  difference in level of energy lost when the housekeepers are working in a hurry. 

Emergency presentations for farm-related injuries in older adults residing in south-western Victoria, Australia.

Farm workers are at high risk for injuries, and epidemiological data are needed to plan resource allocation. This study identified regions with high farm-related injury rates in the Barwon South West region of Victoria, Australia, for residents aged ≥50yr. Retrospective synthesis using electronic medical records of emergency presentations occurring during 2017-2019 inclusive for Local Government Areas (LGA) in the study region. For each LGA, age-standardised incidence rates (per 1000population/year) were calculated. For men and women combined, there were 31218 emergency presentations for any injury, and 1150 (3.68%) of these were farm-related. The overall age-standardised rate for farm-related injury presentations was 2.6 (95% CI 2.4-2.7); men had a higher rate than women (4.1, 95% CI 3.9-4.4 versus 1.2, 95% CI 1.0-1.3, respectively). For individual LGAs, the highest rates of farm-related emergency presentations occurred in Moyne and Southern Grampians, both rural LGAs. Approximately two-thirds of farm-related injuries occurred during work activities (65.0%), and most individuals arrived at the hospital by transport classified as "other" (including private car, 83.3%). There were also several common injury causes identified: "other animal related injury" (20.2%), "cutting, piercing object" (19.5%), "fall ⟨1m" (13.1%), and "struck by or collision with object" (12.5%). Few injuries were caused by machinery (1.7%) and these occurred mainly in the LGA of Moyne (65%). This study provides data to inform future research and resource allocation for the prevention of farm-related injuries.

Genitourinary Fistula: epidemiology, changing trends in etiology and management: A tertiary care institute's perspective.

Urogenital fistula is a physically, socially and psychologically devastating condition for the patient. In developed countries, these fistulae are typically related to gynecological surgery, pelvic pathology like malignancy or post radiation therapy. In contrast, classical teaching is that urogenital fistulae in the developing countries like India are usually associated with prolonged labor and obstetric complications. This retrospective study conducted at a tertiary care health Institute shows a paradigm shift in epidemiology, etiology and management of genitourinary fistulae in India in recent times. This retrospective study included patients undergoing surgical repair for various genitourinary fistulae at our institute from 2016 to 2022. Epidemiology, etiology, site, size and number of fistulae, clinical presentation, and management records of these patients were recorded and reviewed retrospectively. In our study, the mean age of the patients was 38.4 ± 10.2 years. Vesicovaginal Fistula (VVF) was found to be most common fistula in the study population (87.5%) followed by vesicouterine (7.1%) and urethrovaginal fistula (5.4%). The causes of genitourinary fistula were iatrogenic (73.2%), carcinoma of cervix (16.1%), obstructed prolonged labor (7.1%), and genitourinary tuberculosis (3.57%). Among the 48 vesicovaginal fistulas that underwent surgery, 45.8% were treated using a transvaginal approach, 29.2% were managed through a laparoscopic transabdominal repair, and 25% were addressed using a robotic approach. Recurrence occurred in 7.1% of the operated patients. Enhanced healthcare services in the country have contributed to a decrease in the incidence of obstructed labor, subsequently reducing related injuries. Iatrogenic injuries resulting from gynecological surgeries and carcinoma cervix have given rise to more complex fistulas, necessitating the implementation of advanced treatment strategies.

Effect of salt stress on relative membrane injury, lipid peroxidation content and reactive oxygen species content of isabgol (Plantago ovata Forsk.) genotypes 

Under the uncongenial growth condition imposed by salts in the edaphic environment, several biochemical changes take place in plants, which help them to survive under such a hostile environment. In the present study, an attempt has been made to obtain basic information about the effect of salt stress on relative membrane injury, lipid peroxidation content and reactive oxygen species content in isabgol (Plantago ovata Forsk.) genotypes. The changes in relative membrane injury, lipid peroxidation content and reactive oxygen species (ROS) content of P. ovata genotypes viz. GI-2, HI-96, PB-80 and HI-5 were studied under NaCl salt stress at different EC levels viz. control (without salt), 5 and 10 dS/m of nutrient supplemented NaCl salt solutions in sand filled polythene bags during 1st week of November 2022 in the Department of Botany Government College, Hisar. RMI, lipid peroxidation (MDA content) and ROS content of leaves increased with increasing EC levels in all the isabgol genotypes as studied at 58 days after showing. The highest increase in RMI was found in the genotype PB-80 and lowest in the genotype GI-2 at higher (10 dS/m) EC level over control. Increase in lipid peroxidation content which was measured in terms of MDA content was found highest in the genotype PB-80 while the lowest increase was detected in the genotype HI-5 at higher level (10 dS/m) of salt stress over control. Highest enhancement in ROS content of leaves in the genotype PB-80 and lowest increase in the genotype GI-2 was observed at higher (10 dS/m) EC level over control. The relative order of these parameters in various genotypes under salt stress was PB-80 greater than HI-5 greater than HI-96 greater than GI-2.

Pattern of Lightning Related Injuries to Human in Bangladesh

Introduction: In recent past, the incident of lightning strikes and related injuries has increased significantly which is the detrimental consequence of climate change. Therefore, it is recognized as one of the cause of weather related death in Bangladesh. Objective: To present the pattern of lightning related injuries in Bangladesh. Materials and Methods: A cross sectional study carried out on September 2021 among 40 people who were victim of lightning on the way to attend a wedding reception in Shibganj upazila of Chapainawabganj on 4 August 2021. Detail information was received from one relative of each 16 deceased family and 24 survivors. Further, data were collected from the doctors and nurses of Chapainawabganj Government Hospital Results: In addition to the two fatalities on the route to the hospital, 14 individuals died on the spot. Further, among 24 survivors, 16 people survived with moderate and rest 8 survivors had mild injuries. 45% lightning victims were dead and 35% were survived with major injuries by lightning and 20% victims survived with minor injuries. Majority (35%) of death were due to direct strike which is followed by ground strike (30%). Injury to nervous and cardiovascular system is the usual site of injury for human organ where percentage of injury is 35% and 30% respectively. The victims remain admitted to hospital in varying range and survivors had multiple symptoms of minor injuries. Among them, majority victims (9 people) 40.91% left hospital after initial observation. Conclusion: Lightning kills few hundred and injures several thousand people in our country every year. However, lightning survivors should be taken to hospital for further investigation and treatment. Field management is very important for a patient to survive. For this, lightning education will immensely help not only to minimize the death cases but also help them to manage the lightning victims on the spot. JAFMC Bangladesh. Vol 19, No 1 (June) 2023:18-21