Sharp Object Injuries Research Articles

Sharp Object Injuries of Family Health Workers Working in Primary Health Care Services and Related Factors.

AimThe aim of this study was to evaluate family health workers’ exposure to injuries with needlestick and sharp instruments and its related factors.MethodThe universe of the relational descriptive study consisted of 150 family health workers working in 26 family health centers in the Bornova district, and the study was completed with 115 family health workers who voluntarily accepted to participate in the research. The data consisted of 4 sections and 26 questions in total: the questionnaire form created by the researchers in line with the literature, the sociodemographic information form, the questions regarding the needlestick and sharp injuries. In the evaluation of the data, using SPSS 20.0 package program, number, percentage distributions, mean and standard deviation were calculated, and Kruskal–Wallis analysis and logistic regression analysis were performed.ResultsAll of the family health workers included in the research were women and the average age was 38.6 ± 6.38. It was determined that 81.7% of family health workers received occupational health and safety training, and the average score they gave to the level of knowledge about what to do in case of a cutting-edge injury was 7.62 ± .96. In the study group, the ratio of history of needlestick and sharp instrument injury was 79.1%, and the average number of injuries was 6.72 ± 4.01.ConclusionAs a result of the research, it has been determined that family health workers’ occupational health and safety training increases the use of protective equipment, where the rate of injuries is high and the rate of reporting in case of injury is very low.

Evaluation of emergency general surgery operations in COVID-19 patients in a pandemic hospital: a single center experience

Background: During the pandemic, the decision on delaying elective surgeries was implemented country-wide, and emergency surgeries were excluded from this scope. In this study, the patients diagnosed with COVID-19 and who underwent an emergency general surgery operation were evaluated regarding indications, demographic characteristics, and preoperative and postoperative clinical features.Methods: In the study, emergency surgeries performed by the department of general surgery between 1st June and 30th September, when our center cared only patients diagnosed with COVID-19, were reviewed retrospectively.Results: A total of 13 patients, 7 women and 6 men, were included in this study. The most common surgical diagnosis was acute appendicitis (9/13). For all of the patients with appendicitis, a conventional appendectomy procedure was performed. 2 patients were diagnosed with an incarcerated femoral hernia and then operated (2/13). One patient was operated on due to a sharp object injury, and one due to an acute abdomen caused by a perforation. Only 3 of the operated patients developed postoperative wound site complications (23%). No mortality was observed by the end of a 15-day follow-up.Conclusions: The most common cause of emergency surgeries during the pandemic, changelessly, remains to be acute appendicitis. Besides, cases of trauma, perforated peptic ulcer, and incarcerated hernia are also commonly encountered. While the pandemic continues full steam, these conditions that are associated with the pandemic but among causes of mortality and morbidity other than COVID-19 and that may require an emergency surgery should be considered. All emergency surgical procedures should continue to be performed punctually by using necessary protective types of equipment.

Pattern and risk factors of sharp object injuries among health care workers in two tertiary hospitals, Al Taif-Kingdom of Saudi Arabia 2016–2018

Occupational exposure of healthcare workers to blood and body fluids following skin injury constitutes a risk for transmission of blood-borne pathogens. The risk of exposure is greater as well. The present study aimed to determine the burden and risk factors of sharp object injuries in two tertiary hospitals in the Taif City KSA. Retrospective review of needle stick injury records was included from the two hospital's staff clinics. A Total of 131 health professionals (employees) recorded as exposed to sharp object injuries from both hospitals were enrolled during period 2016–2018. The collected data was cleaned, reviewed and analyzed using Statistical Package of Social Sciences SPSS ver. 25. The result of the study revealed that, the mean age for the 131 enrolled participants was 31 ± 6.6, Male to Female Ratio was 1:3. The most affected age group was 20–30 years (55.7%). Females were more affected 98 out of 131 (74.8%) than male (33out of 131 (25.2%). And there is increasing incidence rates of exposure from 2.89 /10.000 patient/day in 2016 to 3.42/ 10.000 patients'/day in 2017, with highest exposed nationalities; Filipino 42 (32.1%), Saudi 31 (23.7%), and Indians 26 (19.8%), the remaining 24.5% were from 10 mixed nationalities. The frequent affected divisions were: ER, surgical ward, operation room, ICU, laboratory, Medical W, Medical waste facilities (19.8%, 15%, 12.2%, 9.2%, 92% respectively). The most affected HCWs categories were nurses 74(56.5%), doctor 23(17.6%) and housekeeping 18 (13.7%). And the needle prick 104(79.4%) and cut wound 15(11.5%) constitute the highest type of injuries and were during operation 23 (17.6%), waste collection 15 (11.5%), cannulation 12 (9.2%) and giving injection 12 (9.2%). The common devices caused injuries were bore hole needle 63(48.1%), suture needle **(13.7%), cannula and insulin syringe 13 (9.9%) each. This study concluded that, as from 2016−2018, there was an increasing rate of reported accidental exposure to sharp needle injuries amongst HCWs from 3.0 to 3.4/10.000 patient/day, and the younger and nurses were mostly impacted. Workplace, distress, work types and load had influences on injuries rates and types. Fortunately, no exposure among employee with HBV, HCV and HIV seroconversion were documented.

Impact of COVID-19 Pandemic on Orthopedics and Traumatology Service

Objectives: Each country has followed different paths in the fight against the COVID 19 pandemic that started in 2019. The pandemic and the measures taken have affected the whole country. The aim of this study was to investigate how the pandemic affected the practice in the orthopedic clinic.
 Methods: Patients who presented at the Orthopedic Outpatients Clinic and Emergency Department with orthopedic complaints between March 15, 2020 and April 15, 2020, were screened. The diagnoses and treatments applied to these patients were recorded. These data were compared with equivalent periods in 2019 and 2018.
 Result: There was a significant increase in home accidents, sharp object injuries and diabetic foot wounds compared to the last two years, and a decrease in workplace accidents, traffic accidents and sports injuries (p= 0.040, p=0.000, p=0.037, respectively). The frequency of hip and wrist fractures increased, and the frequency of ankle fractures decreased (p=0.044, p=0.002, p=0.001, respectively).
 Conclusion: It was seen that dealing with the pandemic should not only include interventions against the causative agent. Psychological support for individuals, attention focussed on home accidents, and the provision of home exercises, especially for senior citizens, should be recommended.

Occupation-Related Injuries Among Healthcare Workers: Incidence, Risk Groups, and the Effect of Training.

Background and objectiveOccupation-related injuries (ORIs) are undesirable and harmful situations among healthcare workers (HCWs) and may have serious consequences. In this study, we aimed to identify and analyze ORI incidences, risk groups, and the outcomes of a training program to prevent them.Materials and methodsBetween January 2011 and December 2019, HCWs who applied for infection prevention and control (IPC) due to ORIs (percutaneous needlestick and sharp-object injury or contact with blood or body fluids) were included in the study. Their characteristic features, vaccine histories, injury types, viral serologies, and administered prophylaxis were recorded. After 2014, a periodic ORI training program was started. We used joinpoint regression analysis to compare the ORI incidences before and after the education program.ResultsDuring the nine-year study period, 965 ORIs were registered. The mean age of HCWs was 39.3 ± 8.4 years, and 67.9% of them were female. The total injury incidence for all professions was 34.1 (95% CI: 33.1-37.5) per 1,000 HCWs. The injury incidences were significantly higher in nurses compared to other HCWs (p<0.01). Most of the injuries occurred in the ward setting (37%). HCWs were injured most commonly while administering treatment (36.7%). The trend analysis for the incidence of injuries showed no significant change throughout the study period. The trend in personal protective equipment (PPE) use showed a significant increase (annual percentage change: 1.7, p<0.01).ConclusionsThe major finding of this study with respect to its implication on the healthcare system is that nurses are an important risk group for ORIs. Although the ORI incidence did not change during the study period, a significantly increased use of appropriate PPE following a systematic training program implementation was observed.

Comparison of computed tomography imaging with traditional autopsy results

The role of computed tomography (CT) images in forensic identification has been widely recognized. Such images can provide an important basis for identification of the cause of death in complicated and difficult cases, including falls from a height, drowning, explosion and gunshot cases, traffic accidents, and sudden death. However, few reports have focused on the application of CT images in cases of death caused by sharp object injuries. Therefore, the CT images and autopsy findings were compared in a case of death caused by sharp object injuries to the chest and abdomen, and the importance of CT images in cases of death from common sharp object injuries is herein discussed.

Evaluation of trauma cases in different types of mass gathering events.

There are several factors affecting trauma cases in mass gatherings (MG). Event type, mood of the crowd, age, gender and educational background are among these factors. It is to identify the relationship between the event types of trauma cases and temperature variables observed in MG. It is a descriptive epidemiological study. The universe of the research consists of 112 emergency medical service records (ambulance) in organizations such as Çanakkale Victory and Martyrs' Memorial Day (ÇVMMD), Zeytinli Rock Fest, Deaflympics, and European Youth Olympic Winter Festival (EYOF). For the statistical evaluations of the study, frequency analysis, Chi-square test, and logistic regression were used. Within the scope of the research, 474 emergency medical service cases were examined. About 49.5% (n=235) of the cases took place at the DEAFOLIMPICS. About 57.6% (n=273) of the cases are male. The age average of the cases is 30.3±16.5 (Min: 0, Max: 92). When the pre-diagnosis range at the ÇVMMD is examined, it is seen that 27.7% (n=20) of the cases are trauma cases while 72.2% (n=52) are non-trauma cases. Among the trauma cases, the most frequently observed ones are soft-tissue trauma, multi-trauma, lower limb injury, and head trauma. When the other cases are examined, the most common ones are angina pectoris, nausea-vomiting, asthma, and ache. In the research, 38.3% (n=90) of the cases at the DEAFOLIMPICS are trauma cases, while 61.7% (n=145) are non-trauma cases. While the trauma cases mostly consist of soft-tissue injury and lower limb injury, the non-trauma cases include nausea-vomiting and upper respiratory infections. While the trauma cases were caused by multi-trauma, sharp object injury, soft-tissue injury, and head trauma, the pre-diagnosis of the non-trauma cases mainly included mental confusion and behavioral disorder due to use of alcohol; conversion; behavioral changes due to use of substance and drug use; hypotension; and allergic reaction. As a consequence of the logistic regression modeling, the trauma cases were found to be 1.6 times (p<0.05) higher in men than women and 9.5 times more in those who participated in the EYOF event than those who participated in the ÇVMMD event (p<0.05).

Vaccination status and Seroprevalence of Hepatitis B surface Antigen among Health Care Workers in Taiz, Yemen Republic

Background: Exposure to Hepatitis B virus (HBV) infection is one of the most common occupational diseases among the providers of the health care services. During the course of their clinical work; Health Care Workers (HCWs) are at risk of acquitting HBV infection or transmitting it to their patients. Vaccination for medical personnel against HBV in Yemen Republic is recommended but not strictly enforced. Detection of the viral hepatitis B surface antigens (HBsAg) is one of the accurate and cheap methods to assess HBV prevalence. This method is used in this study to assess HBV prevalence among HCWs in Taiz; to in order to improve on methods of interventions to control this infection among them. Objectives: The objective of this study was to assess the vaccination status and the seroprevalence of HBsAg among HCWs in Taiz; Yemen republic. Methods: This cross sectional study was conducted through the period between January and March, 2018, and from April and July, 2019, in the part of Taiz City; Yemen Republic belonging to legitimate authorities. 362 HCWs were included in this study and are selected through repeated casual visits to hospitals and medical centers. A questioner was made to get information on the participants’ characteristics and their vaccination status, medical hestory and risk factors for HBV transmission. Five ml venous blood was then collected from every participant to assess HBsAg. Results: the overall vaccination percentage was 21.54% (27.5% in male and 17.9% of female). The seroprevalence of HBsAg was 2.76%, all vaccinated participants were HBsAg negative. Needle stick and sharp object injury was an important risk factor of HBV infection.

Investigation of Registered Work-related Accidents for Urban Sanitation Workers of Kashan Municipality from 2015 to 2018

Introduction: Urban sanitation workers, including waste disposal workers and street cleaners, are exposed to a wide range of occupational hazards and accidents. No study regarding such accidents has been carried out so far in Kashan city. Therefore, the incidents that occurred for this group of workers at the Kashan municipality from 2015 to 2018 were examine in this study.&#x0D; Methods: This is a descriptive cross-sectional study. Demographic data and injury data were collected through periodic medical examination reports of workers who were injured in a work-related accident during the period of this study. Also, official accident forms completed by authorities were used for gathering information about the accidents. Descriptive and analytical statistics were utilized to analyze data.&#x0D; Results: Two out of 95 occupational accidents resulted in death. Garbage collection workers (69.5%) had the highest amount of accidents. Among those, individuals who were involved in accidents, those who had work experience of one year (45.26%), those who had primary school education (43.2%), those having two children (32.6%), and were in the age group of 30 to 39 years had the highest number of accidents. The most common cause and type of accidents were the sharp objects injuries into hands and feet (26.3%) and sprains/strains (50.5%). Most accidents injured limbs (hands and feet). There was a statistically significant correlation between the cause and effect of accidents (P = 0.001).&#x0D; Conclusion: The results demonstrated that urban sanitation workers suffer from occupational injuries more commonly from bruises and sprains/strains that require medical interventions. The application of personal protective equipment (PPE) is widely accepted as an essential factor in preventing occupational injuries. Therefore, the application of this equipment is recommended.&#x0D;

Factors Affecting the Incidences of Needle Stick Injury on The Nurses Emergency Department of Hospital East Java

Hospital with all the facilities and equipment that can be a source of health and safety hazards of potential, especially for health workers if no management following the standards of safety and health procedure kerjaNeedle stick and sharp object injuries is a significant challenge for health workers, and nurses are jobs are most often associated with the incidence of needle stick injury. The purpose of this study was to determine the factors that influence the prevalence of needle stick injury to nurses in the emergency department of hospital Eas Java. This study using 64 samples from a total of as many as 76. The ER nurse that most of the variables age category ? 29 years, ? five years of working life, has never participated in occupational safety and health training, and education level diploma 3 — workers who perform unsafe actions as much as 37.5%. The Bivariable analysis showed that age, work periode, education level, and training has a significant value above 0.05 was no meaningful relationship to the needle stick injury. Unsafe action was a value of 0.026, which means significance was a substantial relationship with a needle stick injury. The multivariable nurses who perform dangerous activities are at increased risk of needle stick injury 4x compared to nurses who work safely. Prevention of occupational accidents to human factors include labor regulations taking into account the limits of the abilities and skills of workers, nullify the things that reduce the concentration of workers, enforce work discipline, avoid actions that bring accidents and eliminate their physical and mental incompatibility.

A Retrospective Records-Based Cohort of 1,082 Pediatric Forensic Cases Presenting to the Emergency Department

IntroductionThis study was conducted to determine the pediatric forensic case type and demographic characteristics of patients presenting to the emergency department. MethodsThis study was a medical record–based cohort design, with a descriptive correlational analysis. Records were retrieved from the emergency department of a university hospital, in the Central Anatolia Region, for visits between 2013 and 2018. The study population comprised 1,082 cases that were evaluated at the emergency department, as forensic cases, in children aged 0 to 18 years. The data were assessed, using descriptive statistical analyses and chi-square test. ResultsA total of 24.1% of the pediatric cases were female, and 75.9% were male. The most frequent type of forensic cases, was from assault (55.2%), followed by 16.3% with sharp object injuries, 13.7% fall from height, 3.9% traffic accidents, 2.9% exposure to drugs and chemicals, and 8.0% from other causes. Most pediatric forensic cases, were adolescents (aged 13-18 years). There were significant differences by sex for assault (34.9% girls vs. 61.6% boys), fall from height (20.7% girls vs. 11.4% boys), exposure to drugs and chemicals (8.0% girls vs. 1.2% boys), and sexual abuse (6.1% girls vs. 1.0% boys) types of forensic cases. DiscussionThe study results have implications for nurses and health professionals to increase awareness of high-risk groups and diagnoses. This evidence can be used to inform standard protocols and education programs about pediatric forensic cases in emergency care.

Üçüncü basamak bir hastanede sağlık çalışanlarında kesici-delici alet yaralanmalarının değerlendirilmesi

Amaç: Sağlık çalışanları kan yoluyla bulaşan enfeksiyonlar açısından risk altındadır. Bu çalışmada, kan ve vücut sıvıları ile temasa maruz kalan sağlık çalışanlarına ait verilerin değerlendirilmesi amaçlanmıştır. Yöntem: 01 Ocak 2016-31 Aralık 2017 tarihleri arasında, hastanemizde, kesici-delici aletlerle yaralanma ya da kan ve vücut sıvıları ile mukozal temas nedeniyle başvuran sağlık çalışanlarına ait veriler hastane kayıtlarından retrospektif olarak incelendi. Bulgular: İki yıllık sürede kesici-delici aletle yaralanan ya da kan ve vücut sıvıları ile temasa maruz kalan 101 sağlık çalışanı vardı. Bunların %35.6’sı hemşire, %27.7’si stajyer hemşire, %23.8’i temizlik personeliydi. Perkütan yaralanmalar en sık (%37.2) işlem sonrası iğne ucunun atık bertarafı sırasında gerçekleşmişti. Bunu, uygunsuz olarak atılmış atıkların toplanması sırasında (%25.5), uygulanan tıbbi işlem sırasında (%24.5) ve iğne ucunun kapatılması (%12.8) sırasındaki yaralanmalar takip etmekteydi. Çalışanların %22’si işlem sırasında koruyucu ekipman kullanmamıştı. Koruyucu ekipman kullanmayanların %59’u stajyer hemşire ve %27.3’ü hemşireydi. Yaralanmaların %54.5’i kliniklerde, %19.8’i yoğun bakım ünitelerinde, %7.9’u ameliyathanede gerçekleşmişti. Yaralanan sağlık çalışanlarının %8’inde Hepatit B virüsüne karşı bağışıklık mevcut değildi. Sonuç: Bulgular, kesici-delici alet atık kutularının doğru kullanımının ve atıkların doğru ayrıştırılmasının yaralanma riskinin azaltılması açısından önemini göstermektedir. Tıbbi atık yönetimi ve kişisel koruyucu ekipman kullanımı ile ilgili verilen eğitimlerin etkinliğinin gözden geçirilmesi gerekmektedir.

DETERMINATION OF THE KNOWLEDGE ATTITUDE AND PRACTICES OF HANDLING AND DISPOSING SHARP OBJECTS AFTER SURGERY AMONGST AUXILLARY STAFF.

Context: Medical waste is a grave problem for health care staff, public health and ecosystem. Due to inappropriate handling and disposing of sharp waste after surgery there is an increase in spread infectious diseases and hence a threat to human life. AIM and OBJECTIVES: To determine the knowledge regarding needle-stick and sharp object injury, practices regarding disposal of used sharp instruments and attitude towards sharp instrument waste management amongst auxillary staff. MATERIALS AND METHODS: It was descriptive analytical study. Ethical clearance was taken from institutional review board. Informed consent was taken from the participants. 275 subjects (nurses and auxillary staff) were given a questionnaire which consisted of 15 sets of questions based on knowledge, attitude and practices of disposing and handling sharp objects after surgery. As per the answers, scores were given as Weak &lt;50%, Moderate 50 – 74.99%, Good 75 to 100%. Results: Statistical analysis was done using chi square test. Study showed that the knowledge and awareness as well as practice protocol adopted were moderate (50-75%) while their attitude towards handling and disposing sharp objects was definitely good. Conclusion: There is dearth of knowledge about sharp waste management and also practice protocol followed have to be improved. Keywords: biomedical waste, auxillary staff, ecosystem, health hazards, sharp objects. Key message: There is a void in the knowledge about sharp waste handling and management and the practices followed have to be upgraded and this lacunae can be filled by introducing more continuing education and training programmes.

Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals

BackgroundThe aim of this study was to evaluate the dentists’ knowledge and practice regarding HIV positive individuals’ oral care in Rio de Janeiro State.MethodsDentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests.ResultsFrom the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: “Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?” (p = 0.044), and “Do the negative HIV tests surely indicate that the persons are free of viruses?” (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001).ConclusionMost dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.

An Assessment Of Incidents From Needle Stick And Sharp Objects Injuries Among Healthcare Staff In The Last 5 Years Of A University Hospital

An Assessment Of Incidents From Needle Stick And Sharp Objects Injuries Among Healthcare Staff In The Last 5 Years Of A University Hospital

Comparison of obese and non-obese patients in terms of sharp object injuries: A retrospective evaluation

Aim: In our study, we aimed to investigate the effect of BMI on surgical treatments and general outcomes, as well as on the severity of the injury caused by the sharp object. From an anatomical point of view, increased body mass index (BMI) is expected to have a protective effect in limiting organ damage in the case of sharp object injuries. Material and Methods: Data of the patients with penetrating abdominal injuries who applied to the emergency service of the University between January 2015 and January 2020 were analyzed retrospectively. Patients’ ages, genders, body mass indexes (BMIs), needs for surgical intervention, injury severity scores (ISS) and mortality were evaluated. Patients were divided into 2 groups: obese patients (BMI>30; Group1) and non-obese patients (BMI30; Group2). Results: Seventy-eight patients whose data were available were included in the study. Thirty-three of the patients were determined to be obese (Group1) while 45 were determined to be non-obese (Group2). The mean age of the patients in group1 was significantly higher than the patients in group 2 (p=0.011). The mean ISS of the patients in group 1 was 11.03±8.24 while it was 16.93±13.68 in group 2. The ISS was significantly higher in group2 (p=0.031). Alcohol intoxication levels of the patients in Group 2 were significantly higher than Group 1 (p=0.006). A statistically significant difference was not present between the groups in terms of number of past surgical interventions (p=0.627); however, it was determined that 57% of the surgical interventions in Group 1 were performed for diagnostic purposes and that no pathologies were detected in 45% thereof. Discussion: As a result, increased BMI is associated with lower injury severity scores and decreased need for operation in sharp object injuries. Slim patients are more likely to need surgery and be severely injured.

The Knowledge and Experience of Nursing Students about Occupational Health and Safety

Objective: This study was conducted to find out the knowledge and experience of student nurses on occupational health and occupational safetyMethods: This descriptive study was conducted on nursing students studying in the Health Sciences Faculty of a University between 26 May and 16 June 2017. The universe of the study consisted of all students studying in the department of nursing (N=446), while the sample consisted of 332 student nurses determined according to “Raosoft” sample size calculation program. The data were collected through face to face interview technique with “Questionnaire Form” developed by the researchers.Results: It was found that 76.5% of the student nurses in the study were trained about occupational health and safety before they went out to practice areas and 85.5% were vaccinated before they went out to clinical areas. 43.7% of the student nurses stated that they had occupational accident, 31% of these stated that they were injured with a sharp object and 67.6% stated that they did not report the accident. A statistically significant association was found between student nurses’ ages, their year of study and their state of experiencing occupational accident (p&amp;lt;0.05). Conclusion: It was found that almost half of the student nurses in the study underwent occupational accident, most of the reasons for occupational accidents was sharp object injury and most of the students who had occupational accident did not report these.

Epidemiological analysis of pediatric patients with thoracoabdominal trauma in emergency department

Objective: The aim of the study was to evaluate the causes of trauma, diagnostic treatment methods and the results in the patients who were admitted to the emergency department with pediatric thoracic and abdominal trauma. Method: In this study, between January 2014 and December 2018, 959 patients under 18 years of age who were admitted to emergency department due to thorax and abdominal trauma were included. Of these, 557 (58.1%) were male, with a mean age of 9.3 years (range, 1-16 years). Demographic characteristics, trauma patterns and mortality results of these patients were evaluated retrospectively. Results: 933 (97.3%) of the cases were blunt and 2 (2.7%) were penetrating traumas. Of the trauma cases, 436 (4.5%) were falls from lower than one meter, 323 (33.7%) were falls from higher than one meter, 174 (18.1%) were in or non vehicle traffic accidents, 26 (2.7%) were penetrating or sharp object injuries. Mortality was most common in men. In addition, mortality was observed in 11 (1.14%) cases with a fall from height and then 4 (0.4%) cases in a non-vehicle traffic accident. Abdominal organ injury was mostly in the liver, but mortality was more frequent in spleen injuries. Thoracal, lumbar and simple rib fractures were detected mostly in falls, and hemo and pneumothorax were detected in non-vehicle traffic accidents. Conclusions: Most of the thoracic and abdominal traumas can be treated by conservative methods. Mortality and morbidity rates can be decreased by determining the multidisciplinary approach of other system injuries and by giving early decision of procedures.

Penetrating Sharp Object Injury in the Gluteal Region and Small Bowel Perforation Due to Pelvic Penetration: A Case Report

Penetrating Sharp Object Injury in the Gluteal Region and Small Bowel Perforation Due to Pelvic Penetration: A Case Report

Prevalence of hepatitis B markers and vaccination status of healthcare personnel: Experience of the Tunis Military Hospital

Hepatitis B is the main cause of liver disease in the world. Chronic hepatitis B may lead to cirrhosis, liver insufficiency or liver cancer. Tunisia is considered as a country with intermediate endemicity, where hepatitis B presents a real public health problem. The aims of this study were to evaluate the prevalence of viral biomarkers of hepatitis B in healthcare personnel; to look for potential risk factors associated with HbS antigen carriage and to evaluate the prevalence of vaccination in this particular population. Sero-epidemiological, prospective and descriptive study, among 2411healthcare personnel in the Military Hospital of Tunis, during a 5-month period from September 2013to January 2014. Blood samples were collected from 1497 volunteers among the hospital staff. Two hundred and seventy-one individuals had a positive HbC antibody titer (prevalence 18.1%), including 229 who were positive for HbC and HbS antibodies (prevalence 15.3%), 12 positive for only HbC antibody (prevalence 0.8%), and 30 positive for HBsAg (prevalence 2%). Among HbS Ag carriers, 56.6% reported needle stick and sharp object injuries during their professional careers. Among HbS Ag carriers, there were three patients with a history of acute viral hepatitis with jaundice, and 27 patients (90%) who were asymptomatic and were diagnosed during our study. Among healthcare workers in the hospital, 56.1% were immunized through vaccination (positive HbS antibodies without HbC antibodies), of whom 66% had durable protective immunity (HbS antibodies>100mU/mL). Lastly, 25.8% of the hospital workers remained without any protection against hepatitis B (serology entirely negative) and were then offered a complete vaccination. Hepatitis B vaccine is the mainstay of hepatitis B prevention. Safe injection practices, blood safety and promoting wider access to monitoring and screening, care and treatment services for hepatitis B are the best guarantees to prevent and control this disease.