Authors’ affiliation: *Sina Trauma and Surgery Research Center, Sina
General Hospital, Tehran University of Medical Sciences, Tehran, Iran.
•Corresponding
author and reprints: Ali Khaji MD,
Sina Trauma and Surgery Research Center; Sina General Hospital, Hassan Abad
Square, Imam Khomeini St, Tehran, Iran. P.O. Box 11365/3876
Tel:
+98-216-670-5503, Fax: +98-216-671-7422
E-mail:
akhaji@razi.tums.ac.ir
Accepted
for publication: 9 September 2009
Background: Injuries are a major
health problem in developing countries. Recently, the occurrence of injuries
and those related to mortality have increased dramatically in Iran. We have
conducted this study to report domestic research publications in the field of
trauma from 2000 to 2006 in Iran.
Methods: The contents of 128
biomedical journals were analyzed. Sina Trauma Data Bank (STDB) was selected as
an indicator of trauma related articles that have been published in Iranian
biomedical journals.
Results: The number of trauma related articles in Iran increased during the seven year period (2000 – 2006), but the percentage of total
publications was not significantly different. The mean number of authors per
article was 2.7+1.3 (1 to 12) and all first authors were Iranian. Females
constituted 15.4% (n=156) of first authors. Original articles were the most
frequently published articles (n=871; 86.2%). Treatment of injuries and ensuing
complications were the most common topics (42%) followed by war injuries
(14.1%). Traffic accidents, as the leading cause of trauma death in Iran, were
investigated in 27 (2.7%) articles.
Conclusion: According to our results, it seems that more
attention from researchers and health-policy makers towards trauma is necessary
in our country. In addition, publishing a journal with the main theme of injury
and trauma could be an effective means for increasing the proportion of trauma
related articles.
Archives of Iranian Medicine, Volume 13,
Number 1, 2010: 17 – 20.
Keywords: Injury · Iran · neglected problem · Sina Trauma Data Bank (STDB) · trauma
Introduction
njuries are an important public health problem and a
leading cause of death and disability among adults and children. This high
burden is due to the fact that injuries affect the young population who are in
the period of their maximum productivity.1,2
It is estimated that injury deaths will increase
to 8.4 million in 2020, up from 5.1 in 1990 with traffic accidents as the
prominent cause.3
The importance of injury and its consequences
is incompletely understood and it is often neglected in
health research and policy.4
In recent years, the incidence of injuries
and its related mortality has increased dramatically in Iran.5,6 In
fact, injuries are the second cause of death after cardiovascular disease and
the first cause of years of life lost (YLL) in Iran.6
The bulk of research in the field of
trauma has been growing in our country. Nevertheless, a considerable proportion
of trauma related articles in Iran are published in national Iranian journals
which are not indexed in Medline and thus are not available to other
researchers with similar interests. The Sina
Trauma Data Bank (STDB) has been developed to overcome this deficiency. This
databank comprises abstracts of published trauma related articles in Iranian
biomedical journals.7 We have
conducted this study to report on national research publications in the field
of trauma in Iran from 2000 to 2006.
Materials and Methods
The present study was
conducted in March 2008 using the Sina
Trauma Data Bank (STDB). This database has been developed by the Sina Trauma
and Surgery Research Center (STSRC) and includes abstracts of published trauma
and injury related articles in Iranian biomedical journals.
For this purpose, injury was defined as
follows: physical damage resulting from
exposure of the human body to energy in amounts that exceed the threshold of
physiological tolerance, or from a lack of one or more vital elements. The
energy could be mechanical, thermal, chemical or radiant.8
STDB is available online at www.sinatrc.ac.ir/stdb/htm for
free. Article
searching is provided through a variety of terms including title, abstract,
author(s), journal name, keyword(s), ISSN, publication type and language. It is
possible to search for single or multiple items within any specific category.
The Iranian Ministry of Health and Medical
Education has approved 128 biomedical journals for publishing medical
papers in Iran. Of these, three journals are indexed in Medline (Archives of Iranian Medicine, Urology Journal,
Iranian Journal of Allergy, Asthma and Immunology). The abstracts of all papers
published in these 128 journals are indexed in STDB.
Since our data bank has complete coverage
of all the issues of Iranian medical journals from 2000 through 2006, a seven
year period, we considered this time frame for our investigation. The collected
information included: number of articles in each issue, field of journals,
publication type, journal language, subject of papers, year and issues of
articles, number(s) of authors and author gender.
|
 
|
|
Figure 1. Trends of
trauma-related articles publishing in Iranian Journals
|
|
Table 1. Subject of trauma
related articles in Iran (2000 – 2006)
|
|
Subject
|
Frequency (%)
|
|
Burns
|
47 (4.7)
|
|
Dental
injuries
|
12 (1.2)
|
|
Disaster
|
33 (3.3)
|
|
Fall
|
2 (0.2)
|
|
Firearm
|
5 (0.5)
|
|
Foreign
body
|
25 (2.5)
|
|
Management*
|
425 (42)
|
|
Miscellaneous
|
66 (6.3)
|
|
Mortality
|
8 (0.8)
|
|
Noise
induced injuries
|
11 (1.1)
|
|
Poisoning
|
58 (5.7)
|
|
Psychological
|
4 (0.4)
|
|
Road
traffic crashes
|
27 (2.7)
|
|
School
injuries
|
2 (0.2)
|
|
Trauma
scoring system
|
4 (0.4)
|
|
Sports
injuries
|
7 (0.7)
|
|
Violence
|
107 (10.7)
|
|
War
injuries
|
142 (14.1)
|
|
Work
related injuries
|
25 (2.5)
|
|
Total
|
1010 (100)
|
|
٭Articles that have discussed the treatment of injuries in trauma
patients without emphasis on the mechanism of injury
|
Results
Of the 28,880 published articles in
Iranian biomedical journals during this seven year period, 1010 (3.5%) were
trauma related. The number of trauma-related articles has shown an increasing
trend (Figure 1), but the percentage of total publications was not
significantly different. The majority of articles were in Persian (Farsi)
(90.4%) and the others were published in English (96; 9.6%). Out of 128 journals, 32 (25%) were in English. The mean
number of authors per article was 2.7±1.3 (1:12) and all first authors were
Iranian. Females constituted 15.4% (n=156) of first authors meanwhile, 13%
(360) of the total authors were female. Original articles were the most
frequently published (n= 871; 86.2%). Management of injuries and its complications
were the most common topics of the published papers (42 %; Table 1). Apart from
this group, the main subject was war injuries and its complications which were
seen in 142 (14.1%) articles. Injuries resulting from exposure to chemical
gases have been reported in more than 48.6% (69/142) of the war-related
articles. Traffic accidents were investigated in 27 articles (2.7%). No papers
were found on drowning accidents. Injuries in children were discussed in 78
articles (7.8%). From 128 biomedical journals, 27 (21.1%) did not publish any
trauma-related articles. Overall, 76 (59.4%) of the journals’ publication
offices are located in Tehran, the capital of Iran. No journal exists with the
main theme of trauma and/or injury in Iran.
Discussion
During the past few years, there has been
an increasing trend in the number of published articles in the field of
trauma and injury in our country. This was consistent with previous reports
that, in recent years, Iranian medical articles have undergone a steady growth.9
Though publication of trauma related articles
has recently enjoyed a remarkable growth, their share of total publications has
not significantly increased during the last seven years. There has been an
obvious reduction in the number and percentage of trauma articles for the year
2005; however, the reason was not clear.
Our results have shown that traffic accidents and
burns comprise respectively 2.7% and 4.7% of trauma related articles in Iran.
On the other hand there were no reports on drowning, the third most important
cause of trauma death in Iran. During the past ten years, at least 1,100
drowning deaths have been reported annually. On the other hand, there were only
two articles that discussed injuries resulting from falls.
Apart from management of injuries, war-related
injuries were the most common topic in the trauma-related articles. Meanwhile,
over half of the war-related articles reported injuries in victims of chemical
gas exposure.
Injuries in children were discussed in 78
articles (7.8%) and school injuries have been reported in two (0.2%) articles.
Meanwhile, children comprised nearly one-third of our population in 2007, with
nearly 14,000,000 school children.10
The majority of published articles were in
Farsi. Although all of them have an English abstract, this could be a problem
in sharing the information with other countries.
According to the above; it seems that there are two
important facts regarding trauma research in Iran. First, the proportion of
trauma related articles does not appear to be appropriate in comparison to its
rank as the national’s first public health priority. It is doubtful that this
unremarkable share of trauma related articles could be satisfactory for injury
prevention and control. This might be an indicator that the importance of
injuries is not acknowledged by investigators, research funding bodies and
health policy makers.
Secondly, it seems that medical researchers in the field of injuries in Iran spend their resources
investigating unnecessary areas that are not the highest priorities as far as
the health issues of the nation are concerned.
In addition, there is not a journal that
specifically focuses on trauma and injuries in Iran. The present journals have different areas and
priorities for accepting papers, of which trauma might be or might not be on
the list. Thus publication of a journal that accepts articles in the field of
trauma and injury could be an effective step
in improving both the quality and quantity of trauma related articles in Iran.
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