Injury is one of the leading causes of death worldwide, and the abdomen is the most common area of trauma after the head and extremities. Abdominal injury is often divided into two categories: blunt and penetrating injuries. This study aims to determine the epidemiological and clinical characteristics of these two types of abdominal injuries in patients registered with the National Trauma Registry of Iran (NTRI). This multicenter cross-sectional study was conducted with data from the NTRI from July 24, 2016, to May 21, 2023. All abdominal trauma patients defined by the International Classification of Diseases; 10th Revision (ICD-10) codes were enrolled in this study. The inclusion criteria were one of the following: hospital length of stay (LOS) of more than 24 h, fatal injuries, and trauma patients transferred from the ICU of other hospitals. Among 532 patients with abdominal injuries, 420 (78.9%) had a blunt injury, and 435 (81.7%) of the victims were men. The most injured organs in blunt trauma were the spleen, with 200 (47.6%) and the liver, with 171 (40.7%) cases, respectively. Also, the colon and small intestine, with 42 (37.5%) cases, had the highest number of injuries in penetrating injuries. Blood was transfused in 103 (23.5%) of blunt injured victims and 17 (15.2%) of penetrating traumas (p = 0.03). ICU admission was significantly varied between the two groups, with 266 (63.6%) patients in the blunt group and 47 (42%) in penetrating (p < 0.001). Negative laparotomies were 21 (28%) in penetrating trauma and only 11 (7.7%) in blunt group (p < 0.001). In the multiple logistic regression model after adjusting, ISS ≥ 16 increased the chance of ICU admission 3.13 times relative to the ISS 1–8 [OR: 3.13, 95% CI (1.56 to 6.28), P = 0.001]. Another predictor was NOM, which increased ICU chance 1.75 times more than OM [OR: 1.75, 95% CI (1.17 to 2.61), p = 0.006]. Additionally, GCS 3–8 had 5.43 times more ICU admission odds than the GCS 13–15 [OR:5.43, 95%CI (1.81 to 16.25), P = 0.002] respectively. This study found that the liver and spleen are mostly damaged in blunt injuries. Also, in most cases of penetrating injuries, the colon and small intestine had the highest frequency of injuries compared to other organs. Blunt abdominal injuries caused more blood transfusions and ICU admissions. Higher ISS, lower GCS, and NOM were predictors of ICU admission in abdominal injury victims.

Background: Patients undergoing orthopedic surgery are at risk of nosocomial infections, and antibiotic resistance is known to increase the risk of such infections. Objectives: We aimed to determine the rate of antibiotic resistance in patients admitted to orthopedic wards in one of the largest referral hospitals in Iran. We also ascertained responsible antibiotic-resistant microorganisms in patients with bone and joint infections. Methods: The present cross-sectional investigation was concluded over a period of five years, from March 2018 to February 2023, at a great referral hospital in Tehran. Laboratory data, including the organisms isolated and their antibiotic resistance patterns, were collected by reviewing the hospital information system. Results: In total, 2650 specimens obtained from patients with suspected bacterial infections were transferred to the hospital’s laboratory, 880 (33.2%) of which were positive for bacterial infections. The maximum antibiotic resistance rate against an antibiotic was observed to be 58% for Staphylococcus aureus (erythromycin), 75% for Klebsiella pneumonia (ampicillin/sulbactam), 64.5% for Escherichia coli (imipenem), 76.2% for coagulase-negative Staphylococcus (vancomycin), 100% for Acinetobacter baumannii (imipenem), 52% for S. epidermidis (erythromycin), 85.9% for Enterobacter species (gentamycin), and 65.6% for Pseudomonas aeruginosa (ampicillin/sulbactam). The overall rate of multi-drug resistance was obtained as 27.6%. Conclusions: A high rate of resistance of various bacterial strains to common antibiotics, especially erythromycin, ampicillin, imipenem, vancomycin, and gentamycin, was denoted in orthopedic wards. Also, a high rate of multi-antibiotic resistance was encountered in these wards, where more than a quarter of the bacterial strains showed such resistance.

Introduction: Splenic artery aneurysms (SAAs) account for more than half of all visceral artery aneurysms. Small SAAs are usually asymptomatic, but giant aneurysms are more likely to cause symptoms and result in life-threatening complications; these aneurysms treatment can be challenging. Splenic artery aneurysms treatment includes laparotomy, laparoscopy, or endovascular techniques. Case presentation: This case series reports the details of successful management of three patients with huge splenic artery aneurysms who underwent hybrid surgery, endovascular inflow control with a balloon, and open aneurysm resection. Discussion: Although endovascular treatment options are increasingly favored, only selected aneurysms are suitable for these procedures, as marked tortuosity of the artery or SAA in the proximal splenic artery may not be suitable for endovascular management. Conclusion: Open surgery escorted by endovascular techniques can be considered an ideal treatment of SAA in the proximal region of the splenic artery. Highlights:

Patients with deep venous disease can be classified into two distinct categories: those with disease resulting from known deep vein thrombosis (DVT), which may subsequently lead to post-thrombotic syndrome (PTS), and those with disease caused by compressive factors or non-thrombotic iliac vein lesions (NIVL). The major factor causing the symptoms in patients with PTS and NIVL is venous hypertension which happens due to venous stenosis or venous obstruction. Nowadays Venous stenting offers a noninvasive approach for treatment of NIVL and PTS demonstrating high patency rate. We comprehensively reviewed relevant published papers from 2008 to 2023 that surveyed various influencing factors including the site of occlusion and etiology of occlusions, proper diagnostic imaging, ideal characteristics of venous stents, different dedicated venous stents, pre-operative, concomitant, and post-operative interventions and factors that challenge stenting in both PTS and NIVL patients. The papers were identified by searching the keywords "venous stenting", "PTS", "NIVL", "occlusion", and "stenosis" in PubMed central library MEDLINE and Google Scholar. Patency rates, post-stent complications, and relevant data according to the patient's quality of life were included and analyzed from 476 identified studies. There is no validated protocol and guideline for using stents in patients with PTS and NIVL. As there is no validated protocol and guideline for using stents in patients with PTS and NIVL, our study may provide comprehensive information to assist researchers interested in writing the protocol and give them insight.

Patients with COVID-19 presenting with acalculous cholecystitis. Both patients had gangrenous gallbladder and had to undergo cholecystectomy. Upon surgery, one of the patients showed patchy gangrene on gallbladder and the other, a fully gangrenous gallbladder. Conclusion: There may be a possibility for COVID-19 patients with cholecystitis to develop ischemic gallbladder....

Introduction: Changes in body composition after different bariatric surgeries have been studied extensively, but most of them have emphasized on Roux-en-Y gastric bypass. Only a few studies have assessed the effects of sleeve gastrectomy (SG). Also, the effect of one anastomosis gastric bypass (OAGB) on body composition is not fully apprehended. Furthermore, there is no agreement on how much fat-free mass (FFM) loss is tolerable in weight loss interventions. Therefore, we decided to assess the reduction in fat mass (FM) and FFM at 1, 3, 6, and 12 months after two types of bariatric surgery in a single center. Methods: In the current retrospective cross-sectional study, the patients' hospital records were analyzed. We included patients who had SG or OAGB and a complete 1-year follow-up record. We recorded demographic data as well as weight, body mass index (BMI), FM, and FFM before and at 1, 3, 6, and 12 months after surgery in a predesigned checklist. Results: We analyzed 311 patients (43 males and 268 females) in the SG ( N = 192, 61.7%) and OAGB ( N = 119, 38.3%) groups. Both the SG and OAGB groups demonstrated a statistically significant reduction in weight, BMI, FM, and FFM indices at 12 months after the intervention ( P < .001). Moreover, no statistically significant difference was observed between the SG and OAGB groups regarding the mean of all body composition indices at 3, 6, and 12 months after the intervention. Conclusion: We found that SG and OAGB effectively decreased weight and body composition indices, comprising FM and FFM, with no significant difference between each other.