BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents (MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients. METHODS: This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department (ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED. Age, sex, cause of trauma, clinical causes of death, causes of death defined by autopsy, way of transfer to the ED, time of ambulance arrival at the scene of trauma, and time elapsed to enter the ED from the scene of trauma were studied. RESULTS: In the 100 patients, 21 (21％) patients were female and 79 (79％) male. Forty-three patients were older than 60 years. Trauma was largely due to pedestrian accidents in 31％of the patients, and 33％ had a hypo-volemic shock. About 80％ of deaths were due to intra-cranial hemorrhage (ICH) or intra-ventricular hemorrhage (IVH), and spinal injuries were not preventable. Autopsy revealed that 28％ of the patients suffered from internal injuries. Autopsy revealed that 19％of the deaths were not preventable and 81％ were considered preventable. In our patients, 76 were transferred to the hospital by emergency medicine services (EMS). Analysis of time for ambulance arrival to the scene and frequency of death revealed that 52.2％ of the deaths occurred between 11 and 15 minutes. Analysis of time for admission to the ED from the scene of trauma showed that 74.6％ deaths occurred between 6 and 10 minutes. CONCLUSIONS: The rate of hospital preventable deaths is about 80％, a high mortality rate, which denotes a lack of proper diagnosis and treatment. The time for arrival of EMS at the scene of trauma is longer than that in other countries.

PURPOSE: Nosocomial infection is a major threat to the health care system and patient welfare. After the pandemic, new protocols were established in hospitals and communities to protect against the transmission of COVID-19, which may have changed the incidence of nosocomial transmission. This study was conducted to compare the incidence of nosocomial infection before and after the COVID-19 pandemic. METHODS: This was a retrospective cohort study performed on trauma patients who were admitted, from May 22, 2018 to November 22, 2021, to the largest level-1 trauma center in Shiraz, Iran (Shahid Rajaei Trauma Hospital). All the trauma patients over 15 years old admitted during the study time were included in this study. Individuals who were declared dead upon arrival were excluded. Patients were evaluated in 2 periods: before the pandemic (May 22, 2018 - February 19, 2020) and after the pandemic (February 19, 2020 - November 22, 2021). Patients were assessed based on demographic information (age, gender, length of hospital stay, and patient outcome), the occurrence of hospital infection, and the type of infection. The analysis was done using SPSS version 25. RESULTS: Overall, 60,561 patients were admitted, with a mean age of 40 years. Nosocomial infection was diagnosed in 4.00% (n = 2423) of all admitted patients. The incidence rate of post-COVID-19 hospital-acquired infections decreased by 16.28% (p < 0.001) when compared to before the pandemic; in contrast, surgical site infection (p < 0.001) and urinary tract infection (p = 0.043) were responsible for this change, while hospital-acquired pneumonia (p = 0.568) and bloodstream infection (p = 0.156) were not significantly different. Overall mortality was 1.79%, while 28.52% of all patients with nosocomial infections died. During the pandemic, there was a 25.78% increase (p < 0.001) in the overall incidence rate of mortality, which was also observed among patients with nosocomial infections (17.84%). CONCLUSION The incidence of nosocomial infection has decreased during the pandemic, possibly due to the use of more personal protective equipment and modified protocols after the outbreak. This also explains the difference in the change in incidence rates of nosocomial infection subtypes.
Humans ; Adult ; Adolescent ; Cross Infection/prevention & control* ; Incidence ; Retrospective Studies ; COVID-19/epidemiology* ; Pandemics/prevention & control* ; Prospective Studies ; Infection Control

A 68-year-old female presented with a 1-month history of lower back pain with right-sided radiculopathy and numbness. She was diagnosed with lumbar spondylosis and treated conservatively with analgesia and physiotherapy. Imaging showed multiple susuk, a metal alloy, in the lower back region and other regions of the body. The patient had undergone traditional medicine consultation 10 years earlier when the susuk was inserted in the lower back as talisman. The practice of the insertion of susuk is popular in rural East Malaysia and Indonesia. These foreign bodies act as possible causes of chronic inflammation and granuloma formation. In addition, the localised heighten peril upon imaging. This report suggests that the insertion of multiple susuk as talisman carries risk to safety of patients when imaging, and this practice complicates the management of musculoskeletal disorders

PURPOSEUnsafe behaviors are an important cause of accidents in adolescent age groups. This study was designed to examine the behaviors of adolescent pedestrians in southern Iran.

METHODSThis is a descriptive analytical cross-sectional study. The study population consisted of high school students in Shiraz, capital city of Fars Province, Iran. Five hundred and sixteen students were selected by multi-stage sampling. Data were collected by the use of three questionnaires, which included Persian copies of adolescent road user behavior questionnaire (ARBQ), Duke University Religious Index (DUREL), as well as the context and independent variables questionnaire.

RESULTSThe results showed that a decrease in dangerous behaviors on the road resulted in an increase in respondents' intrinsic religiosity. Also, engagement in unsafe crossing behavior in the road decreased with increasing respondents' intrinsic religiosity. Another finding showed that female students were less involved in dangerous play and planned protective behaviors on the road.

CONCLUSIONFindings clearly indicate that intrinsic religiosity has a significant role in reducing the risky road behaviors of students. Hence, religion may improve road safety in school students' road behavior in Iran.