Injury
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Eye injuries comprise 10-13% of civilian improvised explosive device (IED) injuries. The bomb blast wave induces a normal and shear forces on the tissues, causing a large acute IOP elevation. This study calculated the biomechanical stresses and strains in the eye due to IED explosion via eye-specific fluid-structure interaction (FSI) models. ⋯ The stresses and strains were highest for the frontal blast. Both side and frontal blasts caused higher stresses and strains at the rectus muscle insertions where the sclera is thinnest and prone to rupture. Blast angle has no considerable role in the resultant IOP. Front blast with a heavier IED resulted a higher stresses and deformations in the eye connective tissues compared to the side blast.
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Proximal femur fractures in geriatric patients are associated with substantial mortality. Management of intracapsular proximal femur fractures has been based on age, displacement, cognition, and pre-injury mobility. However, over the last decade, there has been a tendency to offer arthroplasty rather than internal fixation for these patients irrespective of displacement, to allow early mobilisation and negate the higher rate of reoperation due to failed internal fixation. There are no previous investigations analysing whether the severity of fracture displacement is related to different patient characteristics. ⋯ In patients sustaining intracapsular proximal femur fractures, the degree of displacement is not a caveat for a different patient group. Fracture displacement is not predicted by the pre-injury level of function and does not predict short or long-term mortality.
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Mortality caused by Traumatic Brain Injury (TBI) remains high, despite improvements in trauma and critical care. Polytrauma is naturally associated with high mortality. This study compared mortality rates between isolated TBI (ITBI) patients and polytrauma patients with TBI (PTBI) admitted to ICU to investigate if concomitant injuries lead to higher mortality amongst TBI patients. ⋯ There was no difference in mortality rates between PTBI and ITBI patients, suggesting TBI-severity as the predominant factor for ICU mortality in an era of ever improving acute trauma care.
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Hip fracture is a significant public health problem, with associated high morbidity and mortality. Orthopedic surgeons are concerned to improve prognosis and stratify mortality risk after hip fracture surgery. This study established a nomogram that combines the Charlson Comorbidity Index (CCI) with specific laboratory parameters to predict mortality risk after hip fracture surgery in geriatrics. ⋯ This novel nomogram for stratifying the mortality risk after hip fracture surgery in geriatrics incorporated age, CCI, serum albumin, sodium, and hemoglobin. Internal validation indicated that the model has good accuracy and usefulness. This nomogram had improved convenience and precision compared with other models. External validation is warranted to confirm its performance.
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With the rapidly growing population and expanding vehicle density on the roads, there has been an upsurge in road accidents in developing countries. Knowledge about the causes and patterns of trauma-related amputations helps in the formulation of strategies for limb savage, timely management, and effective rehabilitation. ⋯ A 2.5% incidence of post-trauma amputation reflects on the severity of injury related to road and industrial accidents which predominantly affect the lower limbs at the peak of productive work life. In the absence of national amputation registries, the results underscore the need to focus on road safety protocols, patient transfer methods, and the up-gradation of local hospitals.