Multiple Trauma in Pregnant Women: Injury Assessment, Fetal Radiation Exposure and Mortality. A Multicentre Observational Study.

Purpose: Fetal radiation exposure in pregnant women with trauma is a concern. The purpose of this study was to evaluate fetal radiation exposure with regard to the type of injury assessment performed.Methods: It is a multicentre observational study. The cohort study included all pregnant women suspected of severe traumatic injury in the participating centres of a national trauma research network. The primary outcome was the cumulative radiation dose (mGy) received by the fetus with respect to the type of injury assessment initiated by the physician in charge of the pregnant patient. Secondary outcomes were maternal and fetal morbi-mortality, the incidence of haemorrhagic shock and the physicians’ imaging assessment with consideration of their medical specialty.Results: Fifty-four pregnant women were admitted for potential major trauma between September 2011 and December 2019 in the 21 participating centres. The median gestational age was 22 weeks [12-30]. Seventy-eight percent of women (n=42) underwent WBCT. The remaining patients underwent radiographs, ultrasound or selective CT scans based on clinical examination. The median fetal radiation doses were 38 mGy [23-63] and 0 mGy [0-1]. Maternal mortality (5.6%) was lower than fetal mortality (16.7%). Two women (out of 3 maternal deaths) and 7 fetuses (out of 9 fetal deaths) died within the first 24 hours following trauma.Conclusion: Immediate WBCT for initial injury assessment in pregnant women with trauma was associated with a fetal radiation dose below the 100 mGy threshold. Among the selected population with either a stable status with a moderate and nonthreatening injury pattern or isolated penetrating trauma, a selective strategy seemed safe.

Pearls of plastics in ENT practice that Conceals & Camouflages the Camber, Contour & Cosmesis in Facial Trauma

Facial trauma can involve soft tissue injuries such as burns, lacerations, bruises and even fractures of the facial bones such as nasal fractures and fractures of the jaw as well as injury to the eye. Symptoms are specific to the type of injury that can be either signs of inflammation or changes in facial definition. Facial injuries have the potential to cause temporary deviations in facial delineation to permanent disfigurement of facial structures.

Associated Injuries Related to Patients With Facial Fractures

Purpose To find out the incidence, type, and severity of injuries in other parts of the body in patients diagnosed with facial fractures. The study also analyzed any correlation between these injuries and facial fractures. Material & Methods A retrospective study of 991 patients with facial fractures during the period of 2006-2016. Results 111 patients reported associated injuries (11.1%). The most common type of injury was limb injury (33.33%), followed by head injury (22.5%), clavicle fracture (14.7%), rib fracture (10.9%), cervical spine injury (5.4%), and other injuries constituted (13.2%). Multiple associated injuries were observed in 14% of patients. Conclusion The findings show that facial fracture management is a multidisciplinary approach. Prompt diagnosis and proper management are important to reduce the mortality rate and improve the prognosis of the patient.

Dislocation of the penis: a rare case of genital trauma

Traumatic dislocation of the penis is one of the rarest types of genital trauma. This type of injury is accompanied by a violation of the integrity of the skin and the penile ligamentous apparatus, with the dislocation of the penis into the scrotum under the skin of the thigh, or the area of the pubic joint. The low occurrence frequency of such injuries and the small number of observations described in the literature entails the absence of generally accepted treatment tactics for this category of patients. The article describes a clinical case of successfully treated traumatic dislocation of the penis with penile transposition into the pubic joint area and the formation of subcutaneous urinary leakage after late treatment of the patient for medical care.

Complications in Patients with Cardiac Penetrating Trauma

Background: Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. Objective: The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. Methods: In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. Results: A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. Conclusion: The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.

Unintentional Injuries in Children: A Hospital-Based Study in Trivandrum

Unintentional injuries are a major cause of morbidity and mortality in children around the world. A hospital based retrospective descriptive study was done in the Department of Pediatric Surgery of a tertiary care hospital in Trivandrum, to find out the pattern of unintentional injuries in children. The study population constituted, all children admitted with unintentional injuries for a period of 5years from 2016 to 2020. Mechanical Trauma (44.2%) was the most common reason for admission followed by Burns (37.9%) and foreign body (17.1%). Major reason for trauma was fall from height, and head injury was the most common type of injury. Preschool children were affected most. Large proportion of these children belonged to low socioeconomic group (85.6%). Injuries occurred commonly at homes and surroundings (91%), compared to other places. Majority of the injuries were moderate (88.46%) and remaining (10.05%) was severe requiring ICU care. The study highlights the different types of unintentional injuries requiring hospitalization; this will help to devise strategies aimed at prevention of unintentional injuries in children especially preschool children and those living below poverty line. Keywords: Unintentional Injuries, Children, Trauma.

Current situation of vaccine injury compensation program and a future perspective in light of COVID-19 and emerging viral diseases

Background: Vaccines have had a great impact on disease prevention and reducing mortality. Very rarely, vaccines also can result in serious adverse effects. In consideration of this fact, vaccine injury compensation programs have been implemented in many countries to compensate a vaccinee for associated adverse effects. The existing vaccine injury compensation system addresses routine immunization schemes. However, there are rising concerns about the compensation for adverse effects caused by new vaccines such as those developed for coronavirus disease 2019 (COVID-19). This review focuses on vaccine injury compensation programs and highlights the necessity to include all upcoming new vaccines for COVID-19 and other emerging viral diseases in the compensation schemes. Methods: Published articles relating to vaccine compensation injury programs, vaccines, injuries, disabilities, illnesses, and deaths resulting from vaccination were searched in data bases. Through a careful review of the abstracts, 25 relevant articles were selected for analysis. Results: We identified 27 countries on four continents with vaccine injury compensation schemes: 17 countries in Europe, 7 countries in Asia, the United States, a Canadian Province and New Zealand. No programs were identified in Africa and in South America. Program design, funding, and eligibility for compensation vary vastly between countries. We identified 17 countries operating well-established vaccine injury compensation programs. However, minimal information is available on numerous other countries. Conclusion: We conclude that the vaccine injury compensation programs are available in limited number of countries across four continents - mostly in Europe. Lack of standard approach and scope of injury prevention and compensation programs across the countries exists. Some important limitations include limited scientific material, which hindered our research. Therefore, additional data concerning payout for each type of injury and the number of claimants related to a specific vaccine injury worldwide could provide a more comprehensive analysis.

Trauma in Children during Lockdown for SARS-CoV-2 Pandemic. A Brief Report

Purpose: The national lockdown established by the Italian government began on the 11th of March 2020 as a means to control the spread of SARS-CoV-2 infections. The purpose of this brief report is to evaluate the effect of the national lockdown on the occurrence and characteristics of trauma in children during lockdown. Methods: All children admitted to our paediatric orthopaedic unit with a diagnosis of fracture or trauma, including sprains and contusions, between 11 March 2020 and 11 April 2020, were retrospectively reviewed. Their demographic data, type of injury, anatomical location and need for hospitalisation were compared with the equivalent data of children admitted for trauma in the same period of 2018 and 2019. Results: Sixty-nine patients with trauma were admitted in 2020, with a significant decrease in comparison with 2019 (n = 261) and 2018 (n = 289) (p < 0.01). The patients were significantly younger, and the rate of fractures significantly increased in 2020 (p < 0.01). Conclusions: Home confinement decreased admissions to the emergency department for trauma by shutting down outdoor activities, schools and sports activities. However, the rate of fractures increased in comparison with minor trauma, involved younger children and had a worse prognosis.

Evaluation The Effects of Home Accidents to The Traumatic Dental Injuries of Primary Teeth

Objective:The primary aim of this study was to retrospectively evaluate the effects of home accidents(HAs) on the traumatic dental injuries(TDIs) of primary teeth. Furthermore, the secondary aim was to bring attention to the importance of preventive measures for HAs, especially in this pandemic period where children all over the world spend most of their time in their homes due to coronavirus(COVID-19) disease. Material and Methods:The records of the patients with TDIs of the primary teeth, aged 6 months-8 years, who applied to the xxxxxxxxxUniversity, Faculty of Dentistry, Department of Pedodontics, between the years 2000¬2010 and yyyyyyyyUniversity, Faculty of Dentistry, Department of Pedodontics, between the years 2012–2019 were investigated. Results:The sample consisted of 504 children that had TDIs to the primary teeth. The age range of the children was 1–8 years(3.5±1.8years old) and 37.3%(n=188) of the patients were girls and 62.7%(n=316) boys. The prevalence of the TDIs due to HAs was found to be 43.25%(n=218). A total of 380 teeth in the 218 patients who were found to have TDIs due to HAs were examined. The highest prevalence of traumatized children was in the age range 2-4 years(63.3%). Collisions with objects(45%) were found to be most common causes of dental trauma and the most common type of injury was found to be lateral luxation(35.8%). Conclusions:Measures to prevent HAs should primarily target preschool children, the riskiest group. Accidents can be largely prevented by taking simple precautions such as providing a safe environment for children's healthy mental and physical development at home. Key words: Home accidents, Dental trauma, Primary teeth,

Isolated acute hemorrhagic cholecystitis in liver cirrhosis after blunt trauma

Isolated acute hemorrhagic cholecystitis (AHC) after blunt trauma is extremely rare. Thus, alcoholic liver cirrhosis can be a risk factor for this type of injury. The use of point-of-care ultrasound as a monitoring tool for suspicious gallbladder injuries facilitates rapid recognition and decision-making. Therefore, laparoscopic cholecystectomy was recommended for treating traumatic AHC in patients with hemodynamically stable liver cirrhosis.