Surgical Treatment of Gunshot Injuries to the Mandible

2003 ◽  
Vol 129 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Shawn D. Newlands ◽  
Sreedhar Samudrala ◽  
W. Kevin Katzenmeyer
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Gunshot Wounds ◽  
Reconstructive Procedures ◽  
Gunshot Injuries ◽  
Mandibular Injuries ◽  
Severity Of Injury ◽  
Tertiary Care Centers ◽  
Mandible Fractures ◽  
Very High

OBJECTIVES: Our goal was to review and identify risk factors for complications from treatment of mandible fractures due to gunshot wounds. STUDY DESIGN AND SETTING: We conducted a retrospective review of treatment outcomes in 90 patients with gunshot wounds to the mandible treated over a 10-year period at 2 tertiary care centers. RESULTS: Our series of 90 patients with mandibular injuries due to gunshot wounds included 68 patients who underwent surgical procedures on the mandible. There were 14 complications in this group. Complications were more common in patients whose mandibles were rigidly fixated; however, these patients' injuries were more severe. Complications were significantly increased in patients who lost a segment of mandible in the injury. CONCLUSIONS: Complications were related to severity of injury and independent of treatment modality. SIGNIFICANCE: The complication rate for patients with gunshot injuries can be very high, particularly if bone is missing. Stabilization of remaining mandibular segments with potentially multiple subsequent reconstructive procedures is often required to restore mandibular continuity in these patients.

scholarly journals Epidemiologic Profile of Erectile Dysfunction in Patients with Systemic Lupus Erythematosus: The Latin American Landscape

2019 ◽  
Vol 46 (4) ◽  
pp. 397-404 ◽  
Author(s):  
Javier Merayo-Chalico ◽  
Ana Barrera-Vargas ◽  
Sandra Morales-Padilla ◽  
Roberto Reyna-De la Garza ◽  
Ricardo Vázquez-Rodríguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Erectile Dysfunction ◽  
Latin American ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Epidemiologic Profile ◽  
Tertiary Care Centers

Objective.The aim of this study was to describe the prevalence of erectile dysfunction (ED), as well as associated demographic and clinical features, in men with systemic lupus erythematosus (SLE), by means of a systematic, standardized evaluation.Methods.We performed a transversal study in 8 tertiary care centers in Latin America. We included male patients ≥ 16 years who fulfilled ≥ 4 American College of Rheumatology criteria for SLE and had regular sexual activity, and evaluated them with the International Index of Erectile Function-5 questionnaire. Relevant demographic, clinical, and serological characteristics were recorded. We included 2 control groups: the first was made up of healthy men and the second of men with autoimmune diseases other than SLE (non-SLE group).Results.We included 590 subjects (174 SLE, 55 non-SLE, and 361 healthy controls). The prevalence of ED in the SLE group was 69%. Mean age in that group was 36.3 ± 1.03 years. Among SLE patients with and without ED, these factors were significantly different: the presence of persistent lymphopenia (p = 0.006), prednisone dose (9.3 ± 1.2 vs 5.3 ± 1.3 mg, p = 0.026), and the Systemic Lupus International Collaborating Clinics damage score (1.25 ± 0.14 vs 0.8 ± 0.16 points, p = 0.042). Independent risk factors for ED in patients with SLE were persistent lymphopenia (OR 2.79, 95% CI 1.37–5.70, p = 0.001) and corticosteroid use in the previous year (OR 2.15, 95% CI 1.37–3.37, p = 0.001).Conclusion.Regardless of comorbidities, treatment (excluding steroids), and type of disease activity, patients with SLE have a high prevalence of ED, especially considering that most patients are young. Recent corticosteroid use and persistent lymphopenia, which could be related to endothelial dysfunction, are risk factors for this complication in men with SLE.

scholarly journals Prevalence and risk factors of acid peptic ulcer disease at a tertiary care hospital

2018 ◽  
Vol 5 (4) ◽  
pp. 988
Author(s):  
Manohar Shankarrao Chavan ◽  
M. Bhaktavatsalam
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
General Medicine ◽  
Control Measures ◽  
Outpatient Department ◽  
Care Hospital ◽  
Coffee Intake ◽  
Peptic Disease ◽  
Number Of Patients ◽  
Very High

Background: In day to day practice, at outpatient department of General Medicine, at Mahavir Institute of Medical Sciences, Vikarabad, Telangana, India authors are coming across a significant number of patients with acid peptic disease (APD). This prompted us to carry out the present study. The objective is to study the prevalence, risk factors of acid peptic disease and to give suitable recommendationsMethods: Present study was hospital based cross sectional study carried out at outpatient department of General Medicine for a period of ten months from June 2017 to March 2018 among 307 outpatients.Results: The prevalence of acid peptic disease was found to be very high in the present study i.e. 38.1%. This was very high compared to the available literature. The prevalence of acid peptic disease was significantly associated with increasing age, lower social class, alcohol use, tea use and NSAID use. Acid peptic disease was not found to be associated with sex, residence, literacy, smoking, coffee intake, and obesity.Conclusions: Prevalence of acid peptic disease was found to be very high in the present study. Hence there is a need to institute the preventive and control measures to bring down the prevalence. At the same time the people in the surroundings should be made aware of this health problems and its risk factors.

scholarly journals Factors associated with facial weakness following surgery for benign parotid disease: a retrospective multicenter study

2020 ◽  
Vol 40 (5) ◽  
pp. 408-416
Author(s):  
Ahmad Albosaily ◽  
Turki Aldrees ◽  
Aseel Doubi ◽  
Lulu Aldhwaihy ◽  
Najd S. Al-Gazlan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Facial Nerve ◽  
Sample Size ◽  
Tertiary Care ◽  
Facial Weakness ◽  
Benign Diseases ◽  
Potential Risk Factors ◽  
Retrospective Nature ◽  
Tertiary Care Centers ◽  
Disease Location

ABSTRACT BACKGROUND: Facial nerve weakness is the most common and most concerning complication after parotidectomy. Risk factors for this complication following surgery for benign diseases remain controversial. OBJECTIVE: Review the frequency and prognosis of facial nerve weakness after parotidectomy and analyze potential risk factors. DESIGN: Retrospective review of medical records. SETTINGS: Two tertiary care centers. PATIENTS AND METHODS: We included all parotidectomies performed for benign diseases from January 2006 to December 2018. Details about the development and recovery of postoperative facial weakness were recorded. Patient, disease and surgery-related variables were analyzed using bivariate and multivariate analyses to identify risk factors. MAIN OUTCOME MEASURES: Frequency, recovery rates and risk factors for facial nerve weakness SAMPLE SIZE: 191 parotidectomies, 183 patients, 61 patients with facial weakness. RESULTS: The frequency of postoperative facial weakness was 31.9% (61/191 parotidectomies). Among patients with temporary weakness, 90% regained normal facial movement within 6 months. Steroid therapy was not associated with a faster recovery. Postoperative weakness was not associated with age, diabetes, smoking, disease location, use of an intraoperative facial nerve monitor or direction of facial nerve dissection. Risk factors for temporary weakness were total parotidectomy and surgical specimens larger than 60 cubic centimeters. Revision surgery was the only identified risk factor for permanent weakness. CONCLUSION: Larger parotid resections increase the risk of temporary facial nerve weakness while permanent weakness is mainly influenced by previous surgeries. LIMITATIONS: Retrospective nature, underpowered sample size, selection bias associated with tertiary care cases. CONFLICT OF INTEREST: None.

scholarly journals Risk Factors of Infective Endocarditis in Persons Who Inject Drugs

2020 ◽  
Author(s):  
Meera Shah ◽  
Ryan Wong ◽  
Laura Ball ◽  
Klajdi Puka ◽  
Charlie Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Tertiary Care ◽  
Distribution Networks ◽  
Persons Who Inject Drugs ◽  
High Prevalence ◽  
Injection Techniques ◽  
Tertiary Care Centers ◽  
Injection Materials ◽  
Injection Practices

Abstract Background: The rising incidence of infective endocarditis (IE) among people who inject drugs (PWID) has been a major concern across North America. The coincident rise in IE and change of drug preference to hydromorphone-controlled release (CR) among our PWID population in London, Ontario, intrigued us to study the details of injection practices leading to IE, which have not been well characterized in literature. Methods: A case-control study, using one-on-one interviews to understand risk factors and injection practices associated with IE among PWID was conducted. Eligible participants included those who had injected drugs within the last 3 months, were >18 years old and either never had or were currently admitted for an IE episode. Cases were recruited from the tertiary care centers and controls without IE were recruited from outpatient clinics and addiction clinics in London, Ontario. Results: 33 cases (PWID IE+) and 102 controls (PWID but IE-) were interviewed. Multivariable logistic regressions showed that the odds of having IE were 4.65 times higher among females (95% CI 1.85, 12.28; p=.001), and 5.76 times higher among PWID who did not use clean injection equipment from the provincial distribution networks (95% CI 2.37, 14.91; p<.001). Injecting into multiple sites and heating hydromorphone-CR prior to injection were not found to be significantly associated with IE. Hydromorphone-CR was the most commonly injected drug in both groups (90.9% cases; 81.4% controls, p = 0.197). Discussion: Our study highlights the importance of distributing clean injection materials for IE prevention. Furthermore, our study showcases that females are at higher risk of IE, which is contrary to the reported literature. Gender differences in injection techniques, which may place women at higher risk of IE, require further study. We suspect that the very high prevalence of hydromorphone-CR use made our sample size too small to identify a significant association between its use and IE, which has been established in the literature.

scholarly journals Antepartum haemorrhage: a retrospective analysis in a tertiary care centre

2020 ◽  
Vol 9 (11) ◽  
pp. 4531
Author(s):  
Mohini Rajoriya ◽  
Saurabh Dubey ◽  
Sanju Agarwal
Keyword(s):  
Risk Factors ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
Induced Hypertension ◽  
Very High

Background: Aim of the present study was to found the incidence of APH, demographic profile risk factors and maternal outcome.Methods: This was a retrospective study carried out in Department of Obstetrics and Gynaecology, MGM Medical College and associated M.Y., Hospital, Indore from August 2019 to July 2020.Results: The incidence of APH was 3.27%. 68.7% cases of APH were associated with pregnancy induced hypertension suggesting PIH is one of the major risk factors. Maternal morbidity was very high with increased rates cesarean section 91.7%, postpartum hemorrhage (32.6%), need of blood transfusion (86%). There were 2 mortalities and 3.1 % patients underwent Obstetric Hystrectomy and 24% required CCU admission.Conclusions: There is very high maternal morbidity and mortality in APH. 

scholarly journals Prevelance, risk factors and adverse perinatal outcomes of bacterial vaginosis in pregnancy

2021 ◽  
Vol 10 (9) ◽  
pp. 3407
Author(s):  
Prasanna Kumar Shetty ◽  
Akhila G. Menon ◽  
Rekha Rai
Keyword(s):  
Risk Factors ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Low Socioeconomic Status ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Lactobacillus Species ◽  
Care Hospital ◽  
Very High ◽  
In Pregnancy

Background: Bacterial Vaginosis (BV) is the most common lower genital tract syndrome in women of age group 16 to 25years.BV is a disorder of the vaginal microbial ecosystem characterized by a shift in the vaginal flora, from the normally predominant Lactobacillus species to one dominated by a mixed flora. The prevalence of BV can be around 15-30% and upto 50% in pregnancy. This study aims to study the prevalence of BV and their adverse outcomes on pregnancy.Methods: It is a Cross Sectional Study at Department of Obstetrics and Gynecology, at a tertiary care hospital, for a period of one and half year from November 2016-April 2018.Pregnant women attending antenatal clinic were enrolled after obtaining an informed consent and vaginal swab examination done. The sample size was 200.Results: The prevalence of BV in pregnant females was 18%. The major risk factors for BV in pregnancy were young age, low socioeconomic status and recent sexual activity. All patients who took treatment for BV had good outcome. Amsel criteria had low sensitivity but very high specificity(95%).Individually vaginal PH had a very high sensitivity(91.6%) when compared to the gold standard Gram stain.Conclusions: Routine screening is recommended for all pregnant women with risk factors and with symptoms. Early diagnosis and treatment in pregnant women who are asymptomatic and with no risk factors can prevent adverse outcome.

scholarly journals Management of Intraoral Gunshot Injury – A Case Report

2014 ◽  
Vol 8 (1) ◽  
pp. 58-61
Author(s):  
A Agarwal ◽  
A Kumar ◽  
M Goel ◽  
P Puri ◽  
K Priya
Keyword(s):  
Maxillary Antrum ◽  
Treatment Plan ◽  
Gunshot Wounds ◽  
Gunshot Injury ◽  
Aesthetic Result ◽  
Gunshot Injuries ◽  
Initial Care ◽  
Severity Of Injury ◽  
Close Proximity ◽  
And Control

ABSTRACT Oral and Maxillofacial gunshot injuries are usually lethal due to close proximity with the vital structures. The severity of injury varies according to the caliber of the weapon used and to the distance from which the patient is shot. A case of gunshot injury that was successfully managed by surgical exploration and removal of bullet from left maxillary antrum under local anesthesia is presented. The initial care of facial gunshot wounds strictly adheres to the basics of trauma resuscitation. Early and appropriate surgical management have proved to be influential on the final outcome and aesthetic result. Treatment of gunshot injuries should be planned and carried out carefully. It takes different stages and procedures to achieve the targeted treatment plan. Prevention and control of infection are important in the success of the treatment.

scholarly journals Risk Factors and Outcome of Obstructed Labour at a tertiary care Hospital

2013 ◽  
Vol 4 (2) ◽  
pp. 43-46 ◽  
Author(s):  
Jinnat Ara Islam ◽  
Gulshan Ara ◽  
Farzana Rabee Choudhury
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Obstructed Labour ◽  
Medical College ◽  
Very High

Background: Obstructed labour is one of the most common preventable cause of maternal and prenatal morbidity and mortality in developing countries. Objective: The purpose of the present study was to determine the risk factors as well as to asses the outcome of obstructed labour. Method: This cross sectional study was conducted in the Department of Gynecology & Obstetrics at Shaheed Ziaur Rahman Medical College Hospital, Bogra during the period from January 2007 to December 2007. One hundred and five cases with features of obstructed labour were selected as per inclusion and exclusion criteria in a consecutive method. A detailed history included sociodemographic feature, obstetric history, features of obstruction, intrapartum events were recorded to detect risk factors. Condition of patients, mode of delivery, preoperative and post operative complications, maternal and fetal outcomes were recorded. Results: A total number of 3171 deliveries were conducted during this period and 132 cases of obstructed labour were found constituting an incidence of 4.2%. The highest frequency was found among the unbooked, primigravid patients that were illiterate or only having primary education level. The commonest cause was cephalo-pelvic disproportion (47.5%) followed by fetal malpostion (25.7%) and malpresentation (24.8%). The majority of the patients were between 25-29 years, caeserean section was the most common mode of delivery (78.09%). Maternal morbidity due to different complication accounted for 76.19% of the case while the fetal morbidity was 51.31% of the cases. The maternal mortality was 1% and prenatal mortality was 24.76%. Conclusion: In this study the incidence of obstructed labour was very high. The commonest cause was cephalo-pelvic disproportion followed by fetal malpostion and malpresentation. DOI: http://dx.doi.org/10.3329/jssmc.v4i2.14401 J Shaheed Suhrawardy Med Coll, 2012;4(2):43-46

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