Journal of Trauma & Treatment

Background: The face is a relevant part of the body which serves as a tool for identification. As man goes through the rigors of life, it is at risk of injuries. The effect of these injuries and the outcome of its management can affect the socioeconomic and psychological status of these patients.
Aim: To know those at risk of facial laceration and the part of the face that is most affected.
Method: We carried out a clinical audit of patients managed for facial Laceration in Irrua Specialist Teaching Hospital, Irrua Edo State, Nigeria from January 2008 to December 2011.
Statistical analysis used: SPSS
Result: There were 353 patients who had facial laceration as the main injury or part of their multiple injuries. Male to female ratio of those affected is 2.6: 1. Patients in the third decade of life are most affected followed by those in the first decade. Road traffic accident is the commonest aetiological factor. Conclusion: Facial laceration affects mostly the working class and students in higher institution. The part harboring the aesthetic features of the face is as vulnerable as the other part of the face. They are preventable.

Stress and trauma are a part of the human condition. Trauma that is a catastrophic stressor, being defined as“outside the range of usual human experience” such as war, torture, rape, or natural disaster commonly leads to PTSD. Stressors can be physical, emotional, or a combination of both. Current treatment modalities for treating PTSD include conventional pharmaceuticals together with psychological therapeutics including cognitive processing therapy (CPT), exposure therapy and a number of other approaches. The success rates of combined therapies noted above is dangerously low, considering the acute need for successful treatments. The necessity to change the treatment paradigm from the conversional to more effective approaches cannot be over stated. Fortunately, sympathetic nervous system (SNS) modulation treatments are currently available, and are showing significant
promise in the treatment of PTSD. One recent innovation is stellate ganglion block which is a selective sympathetic injection that can lead to normalization of over active SNS. In the near future, a combination of SNS based therapeutics with current approaches may lead to a marked improvement in the PTSD therapy success rates.

Background: Posttraumatic stress disorder (PTSD) syndrome is accompanied by the changes in autonomic nervous system, and heart rate variability (HRV) parameters assess the balance of sympathetic and parasympathetic influences on heart rate. HRV is a promising psychophysiological indicator of PTSD. The aim of this meta-analysis is to provide a quantitative account of the literature findings on PTSD and co-occurring HRV parameters. We first examined the effect size of PTSD on HRV in available published studies, and we then examined the effects of PTSD treatments on various HRV parameters.
 

Methods: A literature search was done using three electronic databases; Pubmed, PsycINFO and Google Scholar. From each of the selected studies, we extracted study characteristics and outcomes measured. The metaanalysis was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane Handbook guidelines, using Comprehensive Meta-analysis Software, ver. 2.0. We calculated the Hedges’g effect size with 95% confidence interval (CI), statistical significance (p), and heterogeneity for each effect size estimate. We considered several variables, and for each an individual meta-analysis was performed.

Results: Meta-analysis reveals the potential utility of HRV index variables as indicators of PTSD. For high frequency (HF) power, the aggregate mean effect size of 11 studies with 379 subjects was large and negative, showing reduced HF for PTSD patients relative to controls and indicating lower vagal activity in these patients. There were also significantly decreased RMSSD values, indicating lower vagal tone in subjects with PTSD. The aggregate mean effect size of low frequency (LF) power was small, negative, and significant, indicating slightly reduced LF in PTSD patients. The LF/HF ratio was statistically significantly higher in PTSD patients. The positive LF/HF effect size indicates increase in sympatho-vagal balance under the PTSD conditions as compared with the normal conditions, and further reflects non-linearity in co-occurring shifts in LF and HF power with proportionately greater reduction in HF than LF. Heart rate (HR) was significantly elevated in PTSD patients. Lastly, there was a decrease in SDNN in the patients, indicating decrease in the variability in RR intervals and a increase in sympathetic tone. These analyses showed no significant between-study heterogeneity for any of these parameters. Very few studies have examined changes in HRV variables pre- and post-treatment; using conservative random effect modeling, a significant increase in RMSSD could be discerned, and decrease in HR was nearly significant (p 1-tailed=0.08).
 

Conclusion: Currently available scientific literature clearly shows that reductions HF, RMSSD and LF/HF have utility as indicators of autonomic effects of PTSD, which can be associated with impaired vagal activity. Increased LF/HF index in patients suggests non-linear decreases in both LF and HF yielding excess of sympathetic relative to vagal imbalance in PTSD patients. Data are scarce for treatment effects on HRV, but RMSSD appears to be increased.

This paper explores the relationship between post-traumatic stress disorders and eating disorders. The
frequency with which the two types of disorders co-occur is explored. Additional exploration of comorbidity in specific populations is addressed. These populations include populations not widely explored in the literature, such as males,female veterans, and juvenile delinquents, as well as, populations that have been explored in the literature, such as clients who have experienced child sexual and physical abuse and neglect. Further, this paper explores specific core areas of dysfunction that overlap in eating disorders and post-traumatic stress disorder. Based on these core areas of dysfunction, focuses of additional symptomatology and treatment are discussed.

Despite the passage of time, some people who experienced the Great East Japan Earthquake are still living with the emotional trauma and stress. We provided horticultural therapy as an intervention to 39 elderly women with earthquake stress living in the affected areas of the coastal areas of the Great East Japan Earthquake. The participants were divided into two groups, an intervention group (n=20) and a control group (n=19). The intervention group underwent eight weeks of horticultural intervention. On the other hands, the control group underwent eight weeks of stress control education. After two months of horticultural therapy intervention, the Clinician-Administered PTSD Scale (CAPS) total score, Geriatric Depression Scale (GDS) score, the Posttraumatic Growth Inventory (PTGI-J) score, and the WHO Quality of Life 26 (WHO-QOL26) score in the intervention group improved significantly, and salivary cortisol level in the intervention group also improved significantly. After follow up, CAPS score, GDS score, PTGI-J score, and WHO-QOL26 score (psychological QOL score, social QOL score, environmental QOL score, and global QOL score), and salivary cortisol level in the intervention group was improved or almost the same as the post-intervention scores in the intervention group. These findings suggest that horticultural therapy has an effect on the symptoms of earthquake stress in elderly women, and that this effect may sustain.