Introduction Trauma is one of the most common causes of morbidity and mortality worldwide. Since the definition of preventable death has been described many studies like current one were conducted to evaluate this issue. Methods This cohort retrospective study investigated archived medical files of trauma victims from 2017 to 2020 in a referral single-center trauma hospital. Registered demographic data, vital signs, Glasgow coma scale (GCS), timing of trauma and death, executed interventions, type and mechanism of trauma in addition to time errors, clinical mismanagements, and missed injuries were extracted. Injury severity score, revised trauma score, and probability of survival based on TRISS method for each case were calculated. Eventually preventable and non-preventable death were defined and compared. Results Finally from the all 413 trauma deaths 246(54.9 %) files were enrolled. Dead persons were from 18 to 95 years. Of all 189(76.8 %) were males. Analysis manifested 135(54.9 %) of all deaths were potentially preventable and the rest 49.1 % was non-preventable for expiration(p = 0.001). Data showed that from all variables systolic blood pressure ≥80 mmHg, respiratory rate >19 per minute, GCS>8, higher RTS, road traffic accidents and control of external bleeding were contributed to prediction of preventable trauma related mortality. Conclusion This study implied on that frequency of trauma related preventable death was regionally high and associating factors that could influence the number of these mortalities included systolic blood pressure, respiratory rate, GCS, revised trauma score, mechanism of trauma, and external bleeding of trauma patients.

Background: To our knowledge, data on the effects of melatonin supplementation on biomarkers of inflammation and oxidative stress in subjects with breast cancer are scarce. This research was done to assess the effects of melatonin supplementation on biomarkers of inflammation and oxidative stress in subjects with breast cancer. Methods: This randomized double-blind, placebo-controlled trial was conducted on 40 subjects diagnosed with breast cancer aged >25 years old. Subjects were randomly assigned into two groups to take either melatonin (n=20) or placebo (n=20) for 24 weeks. Inflammation and oxidative stress biomarkers were quantified at baseline and after the 24-week intervention. Results: After the 24-week intervention, compared with the placebo, melatonin supplementation significantly increased plasma total antioxidant capacity (TAC) (+21.3±26.2 vs. -6.3±34.5 mmol/L, P=0.007), and decreased plasma malondialdehyde (MDA) concentrations (-0.2±0.3 vs. +0.1±0.2 µmol/L, P=0.002). We did not observe any significant effect of melatonin supplementation on other biomarkers of oxidative stress. Conclusions: Overall, melatonin intake for 24 weeks in patients with breast cancer had beneficial effects on TAC and MDA levels, but did not affect other biomarkers of oxidative stress.

Background Tube thoracostomy (TT) insertion is common and painful. Since thoracic pain concludes to lung atelectasis and following disadvantages, therefore pain control is fundamental. There is no general consensus on any analgesic method in this regard. This study aims to compare intercostal nerve blockage (ICNB) and local anesthesia (LA) considering postoperative effects. Method This is a randomized controlled double-blinded survey. Eligible conscious subjects were selected randomly from non-traumatic patients who were admitted in hospital but not candidate for further surgery. The only surgical intervention was a classic TT insertion. Preoperative anesthesia was conducted through ICNB or LA approach with total 15 mL bupivacaine 0.5% for every patient. Severity of pain was demonstrated using visual analogue scale method for five times. Also total administered opioid was registered. Results Data was adopted from 64 eligible patients. There was no difference between demographic variables(P > 0.05). Pain significantly mitigated following ICNB during TT insertion and also last for at least 6 h after surgery(p < 0.001). Additionally, cumulative dose of prescribed pethidine after ICNB was obviously lower than when LA approach was conducted(p < 0.001). There was no remarkable postoperative side effect among participants. Conclusion Preoperative ICNB anesthesia for TT insertion is advised because of its capability to reduce whether postoperative pain or need for opioid injection that both potentially are associated with respiratory depression. Highlights

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BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.