scholarly journals Epidemiologic Characteristics of Patients Presenting with Head Injury due to Road Traffic Accident and Factors Associated with Outcome: Experience of a Tertiary Care Center in Northern Kerala

2019 ◽  
Vol 08 (01) ◽  
pp. 039-046
Author(s):  
Mandaka Rajeev ◽  
Vattaparambil Shinihas ◽  
Pankaj Chauhan
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Alcohol Intake ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Health Resources ◽  
Medical College ◽  
History Of ◽  
Limited Health

Abstract Background In India, most factors related to road traffic accident (RTA) causation and outcome go improperly documented, and database regarding RTA-related traumatic brain injury (TBI) seems inadequate. Two-wheeler drivers form the largest segment of people affected by RTA. The socioeconomic and neurologic burden, imposed by TBI due to RTAs (largely preventable), is overwhelmingly significant, especially for a developing country like India. Materials and Methods Descriptive study involving patients, presenting to the casualty of Government Medical College, Kozhikode, Kerala, was performed, and various demographic features were analyzed. Usage of helmet and history of alcohol intake were also noted. Patients were evaluated according to their presenting Glasgow coma scale (GCS), investigated and either operated or managed conservatively, and their outcome was assessed with Glasgow outcome score (GOS) at 3 months. Results Bike drivers formed the single largest proportion of RTA victims (53.7%). Proportion of helmet users was 17.9%, whereas 21.9% were found with history of alcohol intake. There was a consistent trend toward a favorable outcome in patients with no alcohol intake (17.08% deaths compared with 34.07% patients with alcohol intake) and with helmet usage (14.55% compared with 22.18% in patients without helmet). However, the absolute contribution of these factors cannot be inferred. Conclusion Various factors related to RTA need evaluation for pooling and compilation of data at regional and national levels. Mandatory helmet laws and strict implementation and provision of subsidized helmets (standard, full coverage) will go a long way in reducing the burden on limited health resources.

scholarly journals An Experience with Management of Hemoperitoneum in Blunt Injury of Abdomen at Tertiary Care Center of Western Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 37-41
Author(s):  
Santosh Mishra ◽  
Kailash Chandra ◽  
Kumar Paudel
Keyword(s):  
Hospital Stay ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Operative Management ◽  
Blunt Injury ◽  
Physical Assault ◽  
Non Operative Management

INTRODUCTION: Blunt abdominal trauma results in huge burden of morbidity and mortality among all age groups caused mainly by road traffic accident, fall from height and physical assault. This study was designed to evaluate the outcome of management of hemoperitoneum in blunt injury of abdomen. MATERIAL AND METHODS: This is a prospective observational study involving 100 cases of blunt abdominal injury during the period from 1st December, 2014 to 13th  March 2016 in UCMS-TH, Bhairahawa, Nepal. Documentation of the patients which included identification, history, clinical findings, diagnostic tests, operative findings, operative procedures, complications during hospital-stay was done. The decision regarding operative or non- operative management was made by specialist surgeon. RESULTS: The majority of the patients belonged to 21- 30 years age group. 72 cases were male while 28 were female. 93 patients were managed conservatively while 7 patients were operated. Most common mode of injury was road traffic accident (RTA) (74%) followed by fall form height (20%). Most common organ to be injured was spleen (65%) followed by liver (26%). 93 % patients underwent non-operative management while 7 % were operated. Mortality rate was 0% among the  non- operative and 14.29% in operative cases. CONCLUSION: Non operative management in patient with hemoperitoneum with regular monitoring of vitals and repeated clinical assessment can reduce the operative need , morbidity and length of hospital stay. Non-operative Management (NOM) for blunt abdominal injuries was found to be highly successful in 93% of the patients in this study.

scholarly journals Determinants of road traffic accidents cases in tertiary care hospital at Ranchi, Jharkhand

2019 ◽  
Vol 6 (11) ◽  
pp. 4955
Author(s):  
Manisha Kujur ◽  
Asha Kiran ◽  
Anuj Pankaj Xaxa ◽  
Vivek Kashyap
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Medical Science ◽  
Care Hospital ◽  
Unusual Behavior ◽  
Cross Sectional ◽  
Safe Driving

Background: Worldwide, road traffic accident (RTA) poses a public health and development challenge and greatly affects the human capital development of every nation. This study aims in providing tangible evidences about determinants of road traffic accident cases at tertiary care center with a good area coverage giving insight into burden of RTA.Methods: This study was cross sectional hospital based study done in Rajendra Institute of Medical Science Ranchi, Jharkhand. Patients coming to emergency department were recorded and followed in ENT, neurosurgery and orthopedics department of RIMS, Ranchi in the period of one month (15th January to 20th Febuary2019).Results: Most of the patients were (59%) among the age group of 19-35 years of which 89.5% of the patients were male. 84.8% of the accident took place while motorcycle was driven. 53.3% of the patients were without license. Majority of the cases were driving between the speed of 30-60 km/hr at the time of accident. Majority of cases were not wearing helmet at time of accident (76%). Majority of accidents took place in state highway (53.3%) (roads connecting major cities of states). 59% of the accident took place at T-type junction. Major factor responsible was unusual behavior of man and animal (19%) and followed by overtaking (18.1%). Majority of the accidents were due to front collision (34.3%).Conclusions: There is a need for encouraging and promoting safe driving behavior among community members by the awareness through road safety campaigns and enforcement of road traffic laws to bring down the burden of RTA. 

scholarly journals ANKLE FRACTURES;

2018 ◽  
Vol 25 (08) ◽  
pp. 1160-1163
Author(s):  
Umar Zia Khan ◽  
Wali Muhammad ◽  
Abdur Rehman Qureshi
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Open Fracture ◽  
Road Traffic ◽  
External Rotation ◽  
Care Center ◽  
Tertiary Care ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Supination External Rotation

Objectives: To evaluate the pattern of ankle fractures presented to our regionaltrauma and tertiary care center. Study Design: Prospective Study. Place & Duration of Study:Lady Reading Hospital, Peshawar from November 2016 to October 2017-Twelve months.Methods: The study group included 107 patients with ankle fractures where age, gender,mechanism of injury, presence of closed or open fracture was recorded. The fractures wereclassified according to Lauge-Hansen and Danis-Weber classifications. Medial malleoluscomminution and presence of talar shift was recorded. The pattern of fractures was analyzedand compared with literature. Results: 52.3% sustained these fractures while running/walkingfollowed by road traffic accident in 25.2%. Supination external rotation injures and Weber B werethe commonest followed by supination adduction injuries and Weber A fractures. 25 % of anklefractures were open. 27.1 % showed medial malleolus comminution and talar shift was noticedin 77% cases. Conclusion: We observed high proportion of open and unstable fractures alongwith higher rate of medial malleolus comminution in our patients. High proportion of supinationadduction injuries were recorded which is associated with impaction injury of medial tibialplafond.

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

scholarly journals Accidental tramadol ingestion in children admitted in tertiary care centre

2019 ◽  
Vol 8 (12) ◽  
pp. 2661
Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra
Keyword(s):  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Care Centre ◽  
Medical College ◽  
History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

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