OBJECTIVES

his quantitative cross-sectional study aimed to determine the level of knowledge, attitude, and practices
regarding COVID-19 vaccination of unvaccinated adult patients admitted at Region II Trauma and Medical Center
(R2TMC). This may help determine the knowledge gap regarding COVID-19 vaccination, address it, and to achieve
the goal to vaccinate all eligible Filipinos. Furthermore, this may also be a springboard for future researches and
management regarding novel infections needing new vaccinations.

METHODS

Collected data from the sample size of 197 using the formula for finite population with 95% confidence
level, population proportion of 50%, population size of 400, allowing 5% margin of error were summarized in a
Microsoft excel database and tables, then were analyzed using Jamovi version 2.6.22 software. Frequency, mean,
and standard deviation were calculated to measure the knowledge, attitude, and practices; Pearson correlation and
Kendall’s Tau b correlation for its relationship.

RESULTS

There is moderate level of knowledge (MS: 9.80-11.8), a positive attitude (MR: 2.35-2.60), and good preventive
practices (MS: 12.00-13.00) regarding SARS-CoV-2 (COVID-19) vaccination among the unvaccinated adult in-patients
of R2TMC post-pandemic. Knowledge, attitudes, and practices statistically differed (pCONCLUSION

There is a significant correlation among the knowledge of the respondents about COVID-19 vaccination,
their attitude towards it, and their practices, implying that promoting preventive behaviors toward COVID-19 would
require promoting both knowledge and efficacy beliefs among the public.

Human ; Bacteria ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Wounds And Injuries ; Population Density ; Cross-sectional Studies ; Forecasting ; Sars-cov-2 ; Sars Virus ; Covid-19

Diffuse infiltrating retinoblastoma is an extremely rare form of retinoblastoma which is characterized by its atypical growth pattern. This unusual presentation adds complexity to the diagnostic process. The purpose of this paper is to report a rare presentation of diffuse infiltrating retinoblastoma presenting after an ocular trauma. We described a 7-year-old Filipino boy presenting with total hyphema following an ocular trauma. Comprehensive ophthalmologic clinical and diagnostic evaluations were performed including visual acuity, slitlamp biomicroscopy, ocular ultrasound, neuroimaging, and histopathology post enucleation to determine diagnosis. The misleading, atypical presentation of diffuse infiltrating retinoblastoma may delay diagnosis. While this dilemma is expected in these scenarios, it should be remembered that timing of diagnosis in retinoblastoma is crucial, as this also equates to optimal management. One should remain vigilant for these uncommon presentations especially in the setting of any intraocular inflammation in children.

Human ; Male ; Child: 6-12 Yrs Old ; Wounds And Injuries ; Visual Acuity ; Retinoblastoma ; Research Report ; Neuroimaging ; Inflammation ; Hyphema ; Contusions

INTRODUCTION

Diffuse cutaneous mastocytosis (DCM) is a rare and severe form of cutaneous mastocytosis which may present in the neonatal period; thus early recognition is essential. Symptoms of mastocytosis are exacerbated by mast cell degranulating agents more commonly from heat, friction, local trauma, drugs and food. This is a case of DCM presenting with bullous eruptions after immunization.

CASE REPORT

An 11-month-old boy presented with generalized erythematous to hyperpigmented macules and patches initially at birth, with progression to bullous eruptions immediately after immunization without any systemic symptoms. Biopsy revealed superficial and deep mixed cell infiltrates consisting of lymphocytes, histiocytes and numerous mast cells. Giemsa stain highlighted the metachromatic mast cell granules. Serum tryptase was elevated by 13 times (130 ug/L). The patient was prescribed oral antihistamines and topical steroids that offered good response. Avoidance of all potential triggers was instructed.

DISCUSSION

The extensive cutaneous involvement in DCM (generalized erythema, diffuse papules that develop pachyderma, darker skin, peau d’orange) are due to the diffuse infiltration of the dermis with mast cells, accompanied with an elevated serum tryptase.

Unique to this local case are exacerbations triggered by vaccination. There is literature to support evidence of vaccination reactions to pentavalent vaccine in children with DCM though the pathway associated with mast cell degranulation after immunization has not yet been specified.

It is advised that patients with DCM follow scheduled immunization guidelines with precautionary measures.

Human ; Male ; Infant: 1-23 Months ; Wounds And Injuries ; Research Report ; Pharmaceutical Preparations ; Mastocytosis, Cutaneous ; Hot Temperature

BACKGROUND AND OBJECTIVES

Natural disasters occur frequently in Indonesia, so the community must understand the impact of these disasters. Nurses, on the other hand, can perform trauma prevention care and carry out interventions in areas prone to natural disasters. The concept of trauma prevention care is not new in nursing. However, it needs to be analyzed further because there are still unclear definitions and inconsistencies in its implementation.

This study aims to describe the concept of trauma prevention care using the Walker & Avant analysis method.

METHODS

The Walker and Avant concept analysis method was used which consists of eight systematic steps. Information sources include electronic databases such as ScienceDirect, PubMed, EBSCO, and SAGE, for articles published from January 2006 to June 2024. Embase was searched for the terms "trauma prevention," AND "trauma prevention care," AND "trauma prevention natural disasters."

RESULTS

The literature search identified 80 articles in the fields of medicine, nursing, sociology, and psychology. After analysis, 13 articles were selected for this study. Data extraction and analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Trauma prevention care is defined as 1) knowledge, 2) recognition, 3) caring, 4) respect, and 5) communication. The idea of antecedents includes trauma, education, and skills, while consequences comprise assessment, safety, resources, psychological stress, unidentified trauma, and limitations of nurses.

CONCLUSION

Understanding the attributes of trauma prevention care, along with its antecedents and consequences, can facilitate development in nursing practice. This concept of trauma prevention care can be used to conduct trauma assessment and prevention in natural disaster-prone areas to minimize the impact that will occur.

Natural Disasters ; Wounds And Injuries

BACKGROUND

Burn injuries remain a significant global public health problem, causing substantial morbidity, mortality, and economic burden, particularly in low- and middle-income countries where nearly 90% of cases occur. Despite the importance of timely and appropriate first aid in reducing complications, community responses to burn injuries in many settings continue to rely on traditional or non-evidence-based practices.

OBJECTIVES

This qualitative phenomenological study explored community-based knowledge and responses related to the causes and first aid of burn injuries.

METHODS

The study involved ten (10) purposively selected informants residing in South Mangga Dua Urban Village, Central Jakarta, Indonesia. Data collection methods included semi-structured interviews, direct observations, and focus group discussions (FGDs). Thematic analysis was used.

RESULTS

Three (3) core domains were identified: (1) community perceptions of burn causes and classifications, (2) indigenous first aid practices used in domestic settings, and (3) sources of knowledge and information pathways related to burn first aid. Participants commonly attributed burns to incidents involving fire, hot liquids, and electrical faults. Their understanding of burn severity was limited to superficial assessments, with little awareness of clinical classifications. First aid responses were largely based on traditional practices such as the application of toothpaste, honey, or aloe vera, while evidencebased practices like using running water were rarely mentioned. Notably, most participants relied on familial teachings and informal community experiences as their primary sources of knowledge, with limited exposure to health professionals or verified media content.

CONCLUSION

Community knowledge is culturally rooted but misaligned with medical standards, potentially leading to unsafe practices. Culturally sensitive health education integrating traditional beliefs and accurate information is essential to improve outcomes in burn injury management.

Wounds And Injuries ; Residence Characteristics ; Public Health ; Mortality ; Insemination, Artificial, Heterologous ; Income ; Financial Stress ; Burns ; Health Education ; Attitude ; First Aid ; Medicine ; Health Communication ; Urban Population

BACKGROUND

Penetrating brain injury (PBI) is a leading cause of combat mortality but local outcome data is limited. The authors examined combat-related PBI cases to describe patient characteristics and identify clinical and radiologic predictors of functional recovery

METHODS

This is a retrospective cohort study of military personnel aged 18–56 years with combat-related PBI referred to VLGH AFPMC between January 2017 to June 2022. The authors collected demographics data, injury mechanism, pre-hospital and transfer details, admission clinical and radiologic findings, treatments, and follow-up outcomes. The Glasgow Outcome Scale (GOS), dichotomized into unfavorable (GOS 1–3) and favorable (GOS 4–5), was used to assess functional status. Associations were tested with Fisher’s Exact Test.

RESULTS

Thirty-seven patients met inclusion criteria: 31 survivors with follow-up and 6 who died in hospital. All were male; gunshot wounds accounted for 81% of injuries. At a median follow-up of 27 months, among survivors, 74% had a Glasgow Coma Scale (GCS) of 15 and 45% achieved good recovery (GOS 5). Pre-hospital timing measures (evacuation time, interval to surgery, and transfer delays) were not significantly associated with outcome. Favorable outcomes correlated strongly with higher admission GCS (p < 0.001), preserved baseline motor function (p < 0.001), smaller hemorrhage volume (p = 0.01), and injury limited to a single lobe (p < 0.001). Unfavorable outcomes were associated with intracranial infection, post-traumatic seizures, and need for multiple surgeries (all p < 0.001).

CONCLUSION

Functional recovery after combat-related PBI in this cohort was principally determined by initial neurologic status, injury extent, and subsequent complications The lack of association with pre-hospital timing possibly reflects survivorship bias and incomplete capture of early fatalities.

Human ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Wounds, Gunshot ; Brain Injuries, Traumatic

BACKGROUND

Traumatic peripheral nerve injury (TPNI) is a debilitating condition that may result in significant disability. There is variability in the epidemiology, clinical profile, and mechanism of injury worldwide, but data for low- and middle-income countries (LMICs) such as the Philippines are sparse.

OBJECTIVE

We aimed to determine the demographic and clinical characteristics, management, and outcomes of patients who sustained TPNI in our center.

METHODS

We performed a retrospective cohort study of all patients referred for TPNI at our institution from 2013 to 2019. Data on demographics, clinical features, etiology, surgical management, and status on last follow-up were collected.

RESULTS

Forty-four patients with injuries to 62 peripheral nerves were included in the cohort, which had a strong male predilection (98%). The mean age at diagnosis was 35.5 years, with 78% of patients aged between 16-45 years. The most common etiologies were laceration due to sharp objects (39%), stab wound (23%), hacking injury (14%), and vehicular crash (14%). In terms of mechanism of nerve injury, the most common was sharp laceration (80%), followed by stretch injury/nerve injury in continuity (14%). The most commonly injured nerves were the ulnar (36%) and median nerves (32%), more often on the right side (66%). Nerve repair surgery was performed in 80% of cases.

CONCLUSION

TPNIs in a tertiary center in the Philippines most commonly involved young males in the working age group and were caused by occupational and domestic accidents. Appropriate surgical management of TPNI is feasible in low resource settings.

Human ; Peripheral Nerve Injuries ; Trauma ; Wounds And Injuries ; Philippines

INTRODUCTION: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus emerged and caused a worldwide pandemic, leading to measures being imposed by many countries to reduce its transmission. Singapore implemented the 'circuit breaker', which restricted all movements except for access to necessities and healthcare services. We aimed to investigate the impact of lockdown measures on the pattern of trauma and its effects. METHODS: An observational, retrospective, single-centre descriptive study was conducted using the trauma registry in Singapore General Hospital. It included patients above 18 years old who presented to the emergency department with trauma and were subsequently admitted. Patients admitted from 1 February 2020 to 31 July 2020 and those admitted during the same timeframe in 2019 were studied. Subgroup analyses were performed for patients aged ≥65 years and those <65 years. RESULTS: A total of 1,037 patients were included for analysis. A 17.6% increase in trauma presentations was seen from 2019 to 2020. Patients aged ≥65 years accounted for the rise in admissions. The predominant mechanism of injury was falls at home for older patients and vehicular accidents in patients <65 years. There were no significant differences in injury severity score, intensive care/high-dependency unit admission rates, length of stay, mortality rate, and subsequent need for inpatient rehabilitation. CONCLUSION Our study provided information on differences in trauma presentations before and during the COVID-19 pandemic. Further studies are required to better inform on additional precautionary measures needed to reduce trauma and improve safety during future lockdowns and pandemics.
Humans ; COVID-19/prevention & control* ; Aged ; Retrospective Studies ; Singapore/epidemiology* ; Male ; Female ; Wounds and Injuries/epidemiology* ; Aged, 80 and over ; Middle Aged ; SARS-CoV-2 ; Hospitalization/statistics & numerical data* ; Adult ; Emergency Service, Hospital/statistics & numerical data* ; Registries ; Accidental Falls/statistics & numerical data* ; Pandemics ; Patient Admission/statistics & numerical data* ; Length of Stay ; Accidents, Traffic/statistics & numerical data*

INTRODUCTION: Diaphragm rupture (DR) is a rare pathological event usually caused by trauma. We aimed to analyse the characteristics of acute diaphragmatic injuries due to trauma and the treatment of such injuries. METHODS: This study included the data of 15 patients who sustained diaphragmatic injuries due to trauma and underwent surgery at the Diyarbakır Gazi Yaşargil Training and Research Hospital General Surgery Service between January 2016 and December 2019. RESULTS: There were 240 patients who presented with abdominal trauma during the study period, and DR was detected in 15 (6.25%) of these patients. The male to female ratio was 14 to 1, and the average age of the patients was 29.66 ± 10.56 (15-46) years. The most common cause of diaphragmatic injury was penetrating abdominal injuries (86.7%). Blunt abdominal trauma accounted for 13.3% of the DR cases. Preoperative shock was present in four (26.7%) patients. Preoperative diagnosis was made in only one (6.7%) of 15 patients with DR. Other patients were diagnosed during operation. Thirteen (86.7%) patients had additional organ injuries, and two patients had isolated diaphragmatic injuries. The most frequently injured organ was the lung ( n = 7, 46.6%). Complications developed in six patients (morbidity rate 40%), and pulmonary complications were most frequently encountered ( n = 5, 33.3%). The mortality rate was 6.7%. CONCLUSION As traumatic DRs are uncommon and often associated with additional organ injuries, a careful general assessment of the patient should be made.
Humans ; Male ; Female ; Adult ; Diaphragm/surgery* ; Middle Aged ; Adolescent ; Young Adult ; Abdominal Injuries/complications* ; Rupture/surgery* ; Wounds, Penetrating/surgery* ; Wounds, Nonpenetrating/complications* ; Retrospective Studies ; Turkey/epidemiology*

INTRODUCTION

The social determinants of health refer to an individual's social, political, and economic situation and environment, which can have an impact on their health. On the other hand, disability-adjusted life years (DALYs) reflect the mortalities and morbidities incurred due to disease and injury.

OBJECTIVES

This study aims to analyze the social determinants of health indicators and their association with communicable, non-communicable, and injury-related DALYs and deaths.

METHODS

Data from World Health Organization, World Bank, and International Labor Organization were used and considered for the 17 Social Determinants of Health categories. Logistic regression was used to determine the relationship of social determinants of health indicators with communicable, non-communicable, and injury-related DALYs and deaths.

RESULTS

Results show that an increase in the population, monetary poverty, adult illiteracy, and fine particulate matter increase IPNN DALYs. This study also found correlations of socioeconomic factors to NCD deaths and DALYs attributable to the environment. NCD DALYs and deaths are found to increase with the number of poor living with 3.10 dollars a day, while median daily per capita income, and increase in persons above retiring age receiving pension decrease NCD DALYs attributable to the environment. Focusing on injury DALYs and deaths, an increase in the number of poor living at 3.10 dollars a day, non-agricultural informal employment, and total average concentration of f ine particulate matter increases injury DALYs while the latter is observed to decrease when there is an increase in the medial daily per capita income, agricultural employment outside the formal sector, and vulnerable persons covered by social assistance.

CONCLUSION

Socio-economic factors such as income, employment, education, and social welfare program affect morbidity, disability, and mortality.

Human ; Social Determinants Of Health ; Disability-adjusted Life Years ; Injury ; Wounds And Injuries ; Morbidity ; Mortality