Pattern of Skull Fractures and Its Outcome in Pediatric Head Injury Patients

Objective: Skull fractures are common in pediatric age group. The surgical management of paediatric patients with a skull fracture differs among institutions and surgeons. Our object of this study was to assess the pattern of skull fractures and outcome in paediatric population. Material and Methods: This study was conducted in the department of neurosurgery of a tertiary care hospital from June 2018 to April 2020. We included 152 children between ages 5 to 11 years who were brought with the head trauma and diagnosed to have skull fracture on computerized tomography (CT) Scan brain. Results: The mean age of patients was 6.91 + 1.84 years. There were 59.8% males and 40.1% females. The most common type of fracture at presentation was depressed fracture in 42% patients, followed by linear (35%) and compound fractures (23%). Parietal fractures were the commonest (63.1%) in our study. Associated intracranial hematomas were seen in 37.5% patients, epidural hematoma being the most common. Surgically treated patients were 36%. Good recovery was seen in 73% patients while mortality was 10.5%. Conclusion: Isolated skull fractures are overall benign conditions. Linear parietal skull fractures have good outcome amongst all fracture types.

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Seroprevalence of Enterically Transmitted Hepatitis in North West India

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v2i1.5862 ◽

2016 ◽

Vol 1 (2) ◽

pp. 29

Author(s):

Rekha Bachhiwal ◽

Rajni Sharma ◽

Pooja Gupta ◽

Jyotsna Shukla

Keyword(s):

Hepatitis A ◽

Seasonal Pattern ◽

Tertiary Care ◽

Hepatitis E ◽

Care Hospital ◽

Subacute Hepatitis ◽

North West ◽

Pediatric Age Group ◽

Male Preponderance ◽

Current Infection

Introduction: To ascertain the seroprevalence of enterically transmitted Hepatitis A (HAV) and Hepatitis E (HEV) in cases with acute/subacute hepatitis attending a tertiary care hospital in North West India. Methods: A total of 2936 cases were examined for the presence of current infection with HAV and HEV, determined by demonstration of HAV-IgM and HEV-IgM antibodies using ELISA. Results: Overall seroprevalence for enterically transmitted hepatitis was found to be 24.89%. HAV IgM was present in 7.35% and HEV IgM was present in 17.54% of total cases. HAV infection was predominantly found in pediatric age group while HEV infection was mostly seen among adults. Male preponderance was noted. Enteric hepatitis cases occurred throughout the year. No definitive seasonal pattern was observed. Conclusion: Our data demonstrated high seropositivity of enterically transmitted hepatitis indicating the need for improvement in personal and public hygiene, and development of HEV vaccine.

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Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

Indian Journal of Neurotrauma ◽

10.1055/s-0040-1718780 ◽

2021 ◽

Author(s):

Sukriti Das ◽

Bipin Chaurasia ◽

Dipankar Ghosh ◽

Asit Chandra Sarker

Keyword(s):

Head Injury ◽

Road Traffic ◽

Head Injuries ◽

Skull Fracture ◽

Tertiary Care ◽

Acute Subdural Hematoma ◽

Care Hospital ◽

Female Ratio ◽

Mortality And Morbidity ◽

The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

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A Comparative Analysis of Outcomes of Conventional Cold Dissection Versus Laser Tonsillectomy in Pediatric Cases in a Tertiary Care Hospital in Haryana

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-020-02301-1 ◽

2021 ◽

Author(s):

Amit Kumar ◽

Surender Kumar ◽

Anand Krishnan ◽

Manish Verma ◽

Uma Garg ◽

...

Keyword(s):

Operative Time ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Paediatric Population ◽

Care Hospital ◽

Secondary Complications ◽

Post Operative Pain ◽

Secondary Bleeding ◽

Paediatric Age ◽

Cold Dissection

AbstractTonsillectomy is one of the commonest ENT procedures done in paediatric population, the technique of which has evolved over years to decrease the morbidity associated with the surgery. This prospective randomized comparative study is done to evaluate the efficacy of two different techniques of this surgery, conventional cold dissection and laser tonsillectomy based on operative time, blood loss, post-operative pain and occurrence of secondary complications. The study was done in 68 patients of paediatric age group, 34 in each group underwent cold dissection and laser tonsillectomy. Operative time and bleeding were significantly low for laser group. Pain score was comparable in early post-operatives days, but was high towards the end of first week. Our study reported only one incidence of complication in the form of a secondary bleeding.

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Aetiological Outcome of Mesenteric Lymphadenopathy and Pain Abdomen in Paediatric Population at a Tertiary Care Hospital (MRIMSHyderabad) - A Hospital Based Prospective Observational Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/480 ◽

2021 ◽

Vol 8 (29) ◽

pp. 2601-2608

Author(s):

Dileep Kumar Allagadda ◽

Harikrishna Appana ◽

Ramu Pedada ◽

Deepika Gurram ◽

Ditin Joseph

Keyword(s):

Abdominal Pain ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care ◽

Paediatric Population ◽

Etiological Agent ◽

Parasitic Infections ◽

Care Hospital ◽

Age Group ◽

Mesenteric Lymphadenitis

BACKGROUND Abdominal pain is a common disorder in children and adolescents worldwide with prevalence rate ranging from 20 - 25 % in school-going children in India. It is a frustrating concern to the child, parents and the physician. Even though abdominal pain is one of the most common complaints in children, it poses a diagnostic challenge owing to the variety of underlying causes. The purpose of this study was to evaluate the aetiology of abdominal pain associated with significant mesenteric lymphadenopathy in a paediatric population. METHODS This is a hospital based prospective, observational study done in Department of Paediatrics, Malla Reddy Institute of Medical Sciences (MRIMS), Hyderabad. RESULTS Out of the 65 children studied, 30.8 % were of 5 - 8 years age group, 36.9 % were 9 - 12 years age group and 32.3 % were 13 - 15 years age group. In our study, we found 50.8 % were boys and 49.2 % were girls. 20 % of them were having fever, 16.9 % were having cough, 16.9 % were having diarrhoea, 13.8 % were having sore throat, 16.9 % dysuria, and 15.4 % were having constipation. All patients in our study group underwent ultrasound of abdomen. All cases were having significant mesenteric lymphadenopathy (more than 5 mm in short axis with three or more number of lymph nodes). In 53.8 % cases, etiological agent for the mesenteric lymphadenopathy was not proved with our investigations. In the remaining 46.2 % of children, cause of mesenteric lymphadenopathy was proved and 38.5 % were bacterial infections, 6.2 % were viral infections and 1.5 % were parasitic infections. CONCLUSIONS It is important to recognise mesenteric lymphadenitis as a clinical entity in paediatric cases presenting with abdominal pain. They should be evaluated for an etiological agent and if no proven source of infection and etiological agent is found, it can be considered as functional abdominal pain. If we are able to get a proper etiological diagnosis in these cases, we could treat them and we could make huge difference in terms of quality of life. KEYWORDS Abdominal Pain, Mesenteric Lymphadenitis, Ultrasound, Significant Mesenteric Lymphadenopathy

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A Prospective Study of Spectrum of Depressed Fractures of Skull and its Surgical Outcome

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1242 ◽

2015 ◽

Vol 6 (4) ◽

pp. 134-138

Author(s):

Vishwanath Sidram ◽

PC Chandra Kumar ◽

Bellara Raghavendra

Keyword(s):

Prospective Study ◽

Neurological Deficit ◽

Surgical Outcome ◽

Skull Fracture ◽

Clinical Profile ◽

Care Hospital ◽

Associated Injuries ◽

Depressed Fracture ◽

Case Series Study ◽

A Prospective Study

ABSTRACT Background Depressed skull fracture is a very serious type of trauma occurring in 11% of severe head injuries, and there is a consistent association between the presence of cranial fracture and higher incidence of intracranial lesions, neurological deficit, and poor outcome. Depressed cranial fractures have to be treated aggressively because of their association with infection and late epilepsy. Objectives To study the clinical profile and surgical outcome of patients with depressed cranial fractures. Materials and methods A case series study of 44 patients with depressed fracture was conducted in a tertiary care hospital setting at the Department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, during the period from June 2013 to January 2015. Among the selected patients, the clinical profile, radiological profile, and surgical interventions were undertaken and the outcomes were noted. Appropriate descriptive statistics were used to analyze the findings and to draw inferences. Results There were 30 males and 14 females. The mean age of the patients was 26.95 ± 14.87 years (6–65 years). The common cause of depressed fracture was road traffic accident (45%) and assault (40.9%); 63% of them had compound type and half of the fractures were located in the frontal region. Common associated injuries were extradural hematoma (50%) followed by dural tear (27.3%). Common complications were wound infection (9.1%) and cerebrospinal fluid leak (9.1%). Conclusion The management of depressed fractures should be individualized depending on factors like the degree of depression, communication with the exterior, neurological deficit and presence of associated injuries. How to cite this article Sidram V, Kumar PCC, Raghavendra B. A Prospective Study of Spectrum of Depressed Fractures

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Case series of paediatric adnexal torsion: rare yet urgent entity

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164685 ◽

2016 ◽

Vol 6 (1) ◽

pp. 315 ◽

Cited By ~ 1

Author(s):

Vineet Mishra ◽

Shaheen Hokabaj ◽

Priyankur Roy ◽

Rohina Aggarwal ◽

Bhumika Vyas ◽

...

Keyword(s):

Ovarian Function ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Series ◽

Conservative Surgery ◽

Paediatric Population ◽

Ovarian Torsion ◽

Care Hospital ◽

Paediatric Age ◽

High Degree

Ovarian torsion is a true emergency which warrants early diagnosis and timely surgical management to avoid the catastrophic consequences of further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation of disease. This leads to delay in surgical exploration and loss of ovarian function. We encountered 6 cases of ovarian torsion in paediatric age group during a period of 2 years, at a tertiary care hospital in Ahmedabad. After enquiry of the symptoms and a series of investigations, a provisional diagnosis of torsion ovary was made and they were taken up for surgery. Intra-operatively all the patients were found to have non-salvageable ovary and fallopian tube on the affected side, and subsequently they underwent salpingo-oophorectomy. Diagnosis of ovarian torsion requires clinician awareness and a high degree of suspicion. Conservative surgery, in the form of ovarian detorsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

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Pediatric Basilar Skull Fracture Mechanisms and Trends From 2007 to 2018

Otolaryngology ◽

10.1177/0194599820960727 ◽

2020 ◽

pp. 019459982096072

Author(s):

Anthony Magit ◽

Joshua A. Stramiello ◽

Raquel Good ◽

Javan Nation

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

Skull Fracture ◽

Tertiary Care ◽

Retrospective Chart Review ◽

International Classification Of Diseases ◽

Common Mechanism ◽

Fracture Mechanisms ◽

Skull Fractures ◽

Age Group

Objectives To evaluate the specific mechanism and trend of injury resulting in pediatric basilar skull fractures. Study Design Retrospective chart review of a trauma database. Setting Tertiary care children’s hospital. Methods Patients ≤18 years old with basilar skull fractures were identified via the trauma database for admissions from 2007 to 2018. Patients were identified with ICD-9 codes (801.0, 801.1, 801.2, 801.3 or 801.4) and ICD-10 codes (S02.1, S02.10, S02.11, S02.19) for skull base fractures ( International Classification of Diseases, Ninth Revision and Tenth Revision). Results A total of 729 patients were included: 251 females and 478 males. The 2 most common mechanisms of injury are multilevel falls and unhelmeted rider falls. Multilevel falls occur more in the toddler age group (average age, 4 years), and unhelmeted rider falls are seen in the older age group (average age, 11.2 years). Helmeted rider and motor vehicle accident basilar skull injuries are relatively uncommon. There was a spike in television/entertainment center mechanisms of injury in toddlers from 2007 to 2011 but has since decreased. Conclusion Pediatric basilar skull fractures are costly to the health care system, as patients spent more time in intensive care unit beds with a charge limited to hospital rooms between $1.7 and $2.7 million per year. The protective effect of helmets is demonstrated by unhelmeted rider injuries being the second-most common mechanism of basilar skull fractures and by helmeted rider injuries being rare. The small proportion of basilar skull fractures from motor vehicle accidents is an example of policy and behavioral changes resulting in decreased injury.

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Adverse drug reactions or events in children with assessment of causality and severity: a retrospective analysis from Bhavnagar

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20205127 ◽

2020 ◽

Vol 9 (12) ◽

pp. 1883

Author(s):

Jayendra R. Gohil ◽

Aniket B. Sarwade ◽

Hardik R. Chauhan ◽

Jay R. Jasani ◽

Hinal R. Gujrati

Keyword(s):

Adverse Drug Reactions ◽

Adverse Drug Events ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Drug Reactions ◽

Pediatric Age Group ◽

Skin Redness ◽

The Common ◽

Probable Category

Background: Objective was to study the occurrence of adverse drug reactions in pediatric age group in a tertiary care hospital setting.Methods: A retrospective study was undertaken to analyze adverse drug events in pediatrics wards of a tertiary care hospital. Any event marked as ‘suspected adverse drug reaction’ was included in the study and ADR forms were analyzed for causality and severity. Other parameters like age and sex, class of drug, types of ADR, commonly involved systems and polypharmacy were studied.Results: Total 74 cases of admitted patients (13 deaths: 11 infants, 6 neonates) with severe ADR were studied of whom 39% were females. Antimicrobials were the commonest drug class (54%) with Skin most commonly involved. 77% cases were of probable category according to Naranjo’s scale of causality assessment. 11% cases were prescribed polypharmacy.Conclusions: Antibiotics were the class of drug causing maximum ADRs. The commonest system involved was skin. Redness, itching & rashes were the common symptoms. Antimicrobials should be used judiciously. Polypharmacy should be avoided. ADR reporting should be strengthened. Extra vigilance is required for infants and neonate’s prescriptions.

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