An Interesting Case of Penetrating Brain Injury by a Self-Hammered Nail

2018 ◽  
Vol 15 (02/03) ◽  
pp. 062-066
Author(s):  
Saurav K. Besra ◽  
Viraat Harsh ◽  
Parijat Mishra ◽  
Chandra B. Sahay
Keyword(s):  
Foreign Bodies ◽  
Brain Injuries ◽  
Attempted Suicide ◽  
Medical Literature ◽  
Interesting Case ◽  
Loss Of Consciousness ◽  
Review Of Literature ◽  
Intracranial Injury ◽  
Work Related ◽  
History Of

AbstractPenetrating brain injuries by nails are rare. These usually have been reported as work-related accidents such as from falls or nail gun misfires and in cases of assault. The authors present a case of a 38-year-old psychiatric patient who attempted suicide by self-impalement of nail in the vertex near the midline of the head. Surprisingly, he was asymptomatic after a brief loss of consciousness, and with a Glasgow Coma Scale of 15. There was no history of vomiting or seizures. Intraoperative and postoperative periods were uneventful. Many unusual intracranial foreign bodies have been reported in medical literature, but one of a self-inflicted intracranial injury by hammering a nail is rare. In this article, the authors describe their case report and discuss the challenges encountered in the management of a patient with intracranial injuries by nail, along with a brief review of literature.

Foreign Body Nose: An Unusual Presentation

2021 ◽  
Vol 28 (3) ◽  
pp. 282-284
Author(s):  
Ankit Gulati ◽  
Surinder K Singhal ◽  
Shashikant A Pol ◽  
Nitin Gupta
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Interesting Case ◽  
Alar Cartilage ◽  
Open Approach ◽  
Medial Canthus ◽  
History Of ◽  
Foreign Body Impaction ◽  
Nasal Bleed ◽  
High Index Of Suspicion

Introduction This is a very interesting case of retained homicidal foreign body in the nose in contrast to most of the foreign bodies which are accidental. Case Report A 27 year old male presented to ENT emergency with alleged history of assault over face with sharp object following which patient developed nasal bleed. On examination vertical laceration of approximately 8 cm in length was present along left naso-orbital groove extending superiorly from medial canthus of left eye and inferiorly to nasal alar cartilage. On anterior rhinoscopy a metallic foreign body was seen in both nasal cavities, which appeared to be crossing from left to right side piercing the nasal septum. Foreign body was removed via open approach. Discussion Penetrating maxillofacial injury with foreign body impaction are less common. High index of suspicion is required in diagnosing these cases. Radiological intervention should be done to get idea of exact location and extent of foreign body. Lateral rhinotomy is a useful approach in removing these foreign bodies.

scholarly journals LO95: A prospective evaluation of mild traumatic brain injuries in a working population in Edmonton, AB

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S61
Author(s):  
L. Gaudet ◽  
L. Eliyahu ◽  
J. Lowes ◽  
J. Beach ◽  
M. Mrazik ◽  
...  
Keyword(s):  
Return To Work ◽  
Attention Deficit Disorder ◽  
Brain Injuries ◽  
Work Outcomes ◽  
Continuous Variables ◽  
Chi Square ◽  
Work Related ◽  
Persistent Symptoms ◽  
History Of

Introduction: Patients with mild traumatic brain injury (mTBI) frequently present to the emergency department (ED); however, wide variation in diagnosis and management has been demonstrated in this setting. Sub-optimal mTBI management can contribute to post-concussion syndrome (PCS), affecting vocational outcomes like return to work. This study documented the work-related events, ED management, discharge advice, and outcomes for employed patients presenting to the ED with mTBI. Methods: Adult (>17 years) patients presenting to one of three urban EDs in Edmonton, Alberta with Glasgow coma scale score ≥13 within 72 hours of a concussive event were recruited by on-site research assistants. Follow-up calls ascertained outcomes, including symptoms and their severity, advice received in the ED, and adherence to discharge instructions, at 30 and 90 days after ED discharge. Dichotomous variables were analyzed using chi-square testing; continuous variables were compared using t-tests or Mann-Whitney tests, as appropriate. Work-related injury and return to work outcomes were modelled using logistic or linear regression, as appropriate. Results: Overall, 250 patents were enrolled; 172 (69%) were employed at the time of their injury and completed at least one follow-up. The median age was 37 years (interquartile range [IQR]: 24, 49.5), both sexes were equally represented (48% male), and work-related concussions were uncommon (16%). Work-related concussion was related to manual labor jobs and self-reported history of attention deficit disorder. Patients often received advice to avoid sports (81%) and/or work (71%); however, the duration of recommended time off varied. Most employed patients (80%) missed at least one day of work (median=7 days; IQR: 3, 14); 91% of employees returned to work by 90 days, despite 41% reporting persistent symptoms. Increased days of missed work were linked to divorce, history of sleep disorder, and physician’s advice to avoid work. Conclusion: While work-related concussions are uncommon, most employees who sustain a mTBI at any time miss some work. Many patients experience mTBI symptoms past 90 days, which has serious implications for workers’ abilities to fulfill their work duties and risk of subsequent injury. Workers, employers, and the workers compensation system should take the necessary precautions to ensure that workers return to work safely and successfully following a concussion.

scholarly journals Attempted Suicide Pact by Married couple: A Case Study

2017 ◽  
Vol 5 (1) ◽  
pp. 49-52
Author(s):  
A. Risal
Keyword(s):  
Case History ◽  
Attempted Suicide ◽  
Medical Literature ◽  
Married Couple ◽  
Psychiatric Case ◽  
Double Suicide ◽  
History Of

Suicide pact or a double suicide refers to the joint, actively induced death of two individuals at approximately the same time by mutual consent. News regarding these incidents is often found in media though scarcely published in medical literature. We report a psychiatric case history of a couple who attempted a suicide pact.  

Does an Isolated History of Loss of Consciousness or Amnesia Predict Brain Injuries in Children After Blunt Head Trauma?

PEDIATRICS ◽  
2004 ◽  
Vol 113 (6) ◽  
pp. e507-e513 ◽  
Author(s):  
M. J. Palchak ◽  
J. F. Holmes ◽  
C. W. Vance ◽  
R. E. Gelber ◽  
B. A. Schauer ◽  
...  
Keyword(s):  
Head Trauma ◽  
Brain Injuries ◽  
Loss Of Consciousness ◽  
Blunt Head Trauma ◽  
History Of

scholarly journals Ingestion of Bell Clappers by a Shaman in Jumla, Nepal: A Case Report

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Niresh Thapa ◽  
Subi Basnyat ◽  
Muna Maharjan
Keyword(s):  
Foreign Body ◽  
Psychiatric Illness ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Interesting Case ◽  
Foreign Body Ingestion ◽  
Ileocecal Junction ◽  
Post Operative Period ◽  
History Of ◽  
Significant Injury

Accidental foreign body ingestion is a common problem encountered in Emergency. Deliberate foreign body ingestion may result due to an act of insanity or an act of daring. A shaman locally known as Dhami was brought to Emergency with the history of ingestion of bell clappers. He denied the history of psychiatric illness or substance abuse. On physical examination, there were signs of peritonitis. Laparotomy was done to remove the foreign bodies. Post-operative period was uneventful. Apart from the surgical intervention, psychological counselling was given to him. This is a rare interesting case due to the fact that the 15 cm long foreign bodies passing all the way through without significant injury and finally causing obstruction in ileocecal junction and perforation in the distal ileum.

Post-infective pericarditis left ventricular pseudoaneurysm: a case report and review of literature

2014 ◽  
Vol 25 (2) ◽  
pp. 358-361 ◽  
Author(s):  
Manan Desai ◽  
Hemang Gandhi ◽  
Amit Mishra
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Literature ◽  
Surgical Intervention ◽  
Left Ventricular ◽  
Review Of Literature ◽  
Short History ◽  
Left Ventricular Pseudoaneurysm ◽  
English Medical Literature ◽  
History Of ◽  
Post Infectious

AbstractPost-infective pseudoaneurysm of the left ventricle in children is very rare, with only five cases reported in English medical literature so far. Patients usually have a short history of infection by Staphylococcus aureus. Timely surgical intervention has generally a good outcome. We present a case of post-infectious pseudoaneurysm in a 2-year-old girl with a review of literature.

scholarly journals Case report of a piece of dishwashing steel wool in a child’s pharynx

2020 ◽  
Vol 6 (2) ◽  
pp. 118-120
Author(s):  
Parvin Abbaslou ◽  
Maryam Ahmadipour
Keyword(s):  
Foreign Body ◽  
General Anesthesia ◽  
Foreign Bodies ◽  
Cervical Vertebrae ◽  
Diagnostic Procedures ◽  
Interesting Case ◽  
Medical Emergency ◽  
Steel Wool ◽  
History Of ◽  
Medical Emergencies

Objective: Foreign body swallowing is a common pediatric problem. A foreign body in the pharynx is a medical emergency that requires urgent intervention. Evaluation and treatment of pharyngeal foreign bodies is much more difficult in children than in adults and sometimes requires hospitalization and removal of the foreign bodies under general anesthesia due to children’s lack of cooperation. Fish and chicken bones are the most common swallowed foreign bodies, but an interesting case of a piece of dishwashing steel wool stuck in a child’s pharynx is reported in this article. Case Presentation: A 10-year old boy was presented with a history of dysphagia from five weeks ago. Oral examination did not reveal anything significant. In lateral neck radiographs of the patient, a metal wire was observed in the hypopharyngeal region opposite the 4th and 5th cervical vertebrae. Endoscopic attempts to remove the foreign body were not successful. Therefore, the foreign body was removed from the patient’s pharynx in the operating room under general anesthesia. No complications were observed. Conclusion: Despite the prevalence of swallowing foreign bodies in children, ingestion of a piece of dishwashing steel wool not diagnosed for three weeks was considered interesting to report. Pharyngeal foreign bodies are medical emergencies; therefore, it is particularly important to suspect the presence of a foreign body and perform diagnostic procedures.

Suicidality in the Veterinary Profession

Crisis ◽  
2012 ◽  
Vol 33 (5) ◽  
pp. 280-289 ◽  
Author(s):  
Belinda Platt ◽  
Keith Hawton ◽  
Sue Simkin ◽  
Rachel Dean ◽  
Richard J. Mellanby
Keyword(s):  
Suicidal Ideation ◽  
Attempted Suicide ◽  
Preventive Measures ◽  
Workplace Relationships ◽  
Factors Associated ◽  
Work Related ◽  
Contributory Factors ◽  
Veterinary Profession ◽  
History Of ◽  
Recent Graduates

Background: Suicide rates are elevated in the veterinary profession in several countries, yet little is known about possible contributory and preventive factors. Aims: To obtain information from veterinarians with a history of suicidal ideation or behavior about the factors associated with suicidality in their profession. Methods: We conducted a mixed-methods interview study with 21 UK veterinarians who had attempted suicide or reported recent suicidal ideation. Interview topics included work and nonwork contributory factors, coping mechanisms, and preventive factors. Results: Self-poisoning was the most common method used or considered by participants. Common contributory factors were workplace relationships, career concerns, patient issues, number of hours and volume of work, and responsibility, although two-thirds of participants reported co-occurring difficult life events. Around half had received a psychiatric diagnosis following their suicidal behavior. Several possible preventive measures were suggested by participants. Conclusions: Several work- and non-work-related contributory factors to suicidality in the veterinary profession were identified. Future preventive measures may involve better promotion of support services, formal support for recent graduates, and improving employers’ attitudes toward work-life balance.

scholarly journals Penetrating Brain Injury in Children

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Mutammamin Ula ◽  
Ridha Dharmajaya
Keyword(s):  
Brain Injury ◽  
Foreign Bodies ◽  
Brain Injuries ◽  
Life Support ◽  
Interesting Case ◽  
Direct Vision ◽  
Preoperative Imaging ◽  
Advanced Trauma Life Support ◽  
Operating Table ◽  
Penetrating Brain Injury

Background: Accidental penetrating brain injury through supraorbital route is an unusual occurrence in emergency practice of civilian cases. At time, it could be potentially life threatening. We report an interesting case of supraorbital penetrating brain injury with an iron stick in a 12-year-old female patient. The stick was removed successfully through supraorbital exploration, without any neurovascular complications. Case Report: A 12-year-old female presented to our emergency department with injury to his right eye. History revealed that she was practicing marching band in her school as the leader. As she thrown the iron stick, she lost balance and that iron stick entered into her right supraorbital. Her Glasgow Coma Scale (GCS) score, on admission, was 15. There was circumferential laceration on the right supraorbital, flat margins, visible iron stick penetration with diameter 3 cm but no active bleeding was found. Rest of the physical and neurological examination findings were within normal limits. He was resuscitated promptly according to the advanced trauma life support system. Discussion: Intravenous fluids are given and efforts are taken to maintain high blood oxygen levels.Management of patients with transorbital brain injuries and foreign bodies in situ should follow basic surgical principles, including removal of the object under direct vision in order to reduce further brain tissue damage by the foreign bodies catching on bone fragments. Following removal of the foreign body, thorough debridement with removal of all involved skull bone and foreign materials, hematoma evacuation followed by careful hemostasis along the trajectory, and meticulous dural closure to reduce the possibility of CSF fistula are mandatory.  A transorbital or transcranial approach can be chosen depending on the location of the fragment. Conclusion: In conclusion, supraorbital penetrating brain injury caused by an iron stick is a rare but fatal event. High index of suspicion toward the presence of foreign bodies and emergent surgical intervention is to be considered in spite of consistent lack of evidence on CT scan. Retrieval should be performed on the operating table under direct vision only after preoperative imaging of neurovascular structures. Keyword: Penetrating brain injury, Iron Stick

Deuteronomy, Hosea, and the Theory of Northern Origins

2020 ◽  
Author(s):  
Bill T. Arnold
Keyword(s):  
Twentieth Century ◽  
Recent Work ◽  
Eighth Century ◽  
Work Related ◽  
Early Twentieth Century ◽  
History Of

Deuteronomy appears to share numerous thematic and phraseological connections with the book of Hosea from the eighth century bce. Investigation of these connections during the early twentieth century settled upon a scholarly consensus, which has broken down in more recent work. Related to this question is the possibility of northern origins of Deuteronomy—as a whole, or more likely, in an early proto-Deuteronomy legal core. This chapter surveys the history of the investigation leading up to the current impasse and offers a reexamination of the problem from the standpoint of one passage in Hosea.

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