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

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.

scholarly journals Incidence of Benign Paroxysmal Positional Vertigo in Head Injury Patients

2021 ◽  
pp. 188-194
Author(s):  
Celastina Synthia ◽  
. Rameshwar
Keyword(s):  
Head Injury ◽  
Traffic Accidents ◽  
Benign Paroxysmal Positional Vertigo ◽  
Road Traffic ◽  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: Traumatic brain injury is a common secondary cause of  Benign Paroxysmal  Positional Vertigo(BPPV). Objective: To determine the incidence and clinical profile of patients with BPPV in mild and moderate head injury. Materials and Methods: A prospective observational study done in patients admitted with  mild and moderate head injury who developed BPPV from January 2020 to March 2020 in a tertiary care hospital of  South India. Demographic and clinical parameters were noted and were treated with canalith repositioning procedures. Results: Among 42 patients admitted with mild and moderate head injury, 9(21.4%) were diagnosed with BPPV in the follow up. The male female ratio was 2.5:1. The mean age was 44 ±21.4years.Two wheeler accidents contributed to nearly half of (55.6%) traumatic BPPV. Posterior canal was commonly involved in 7(77.8%) followed by horizontal in 2 (22.2%).The type of head injury was mild in 7 (77.8%) and moderate in 2 (22.2%) in traumatic BPPV patients. 5 (55.6%) patients with BPPV had abnormal findings in neuroimaging. 4 (44.4%) patients developed recurrent BPPV in our cohort. Conclusion: The incidence of traumatic BPPV was 21.4% in our study. Road traffic accidents due to two wheeler accidents were the common mode of head trauma. Posterior canal was commonly involved in three fourth of cases. Recurrence of vertigo was documented in 4 (44.4%).

scholarly journals Comparative study of pattern of head injury in a rural community hospital and a tertiary care hospital

2019 ◽  
Vol 6 (12) ◽  
pp. 4272
Author(s):  
Suhas Patil ◽  
Tanweerul Huda ◽  
Sheel C. Jain ◽  
Bharati Pandya ◽  
Ravinder Narang
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Rural Community ◽  
Road Traffic ◽  
Tertiary Care Hospital ◽  
Head Injuries ◽  
Tertiary Care ◽  
Care Hospital ◽  
Coma Scale ◽  
Significant Difference

Background: The objective of the study was to compare clinical patterns of head injuries in reference to the Glasgow coma scale including neurological examination and also to determine morbidity and mortality in head injury patients admitted to a nodal tertiary care hospital and a rural community hospital.Methods: This prospective study was done at the emergency department of Kasturba Hospital attached to Mahatma Gandhi Institute of Medical Sciences and Sushrut Hospital, Maharashtra on a total of 1000 cases during one-year study duration. The severity of the head injury was analysed using a Glasgow coma scale and outcome in terms of management and death was assessed.Results: Out of 1000 cases with head injuries, 900 cases were admitted in tertiary care hospital and 100 cases in a rural hospital. A significant difference was observed in terms of age group (p=0.01), mode of trauma (p=0.04) and symptoms (p=0.03) among the patients admitted with head injuries in both hospitals. The mortality rate was 1% and 3% in tertiary care and rural hospitals respectively.Conclusions: Head injuries are predominantly affecting the male population and most of them are due to road traffic accidents. Early assistance of medical aid and emergency room care results in good outcomes with minimal deaths. 

scholarly journals A Prospective Clinical Study of Depressed Skull Fractures with Special Reference to Its Management

2021 ◽  
Vol 8 (18) ◽  
pp. 1195-1200
Author(s):  
Dhruba Jyoti Kurmi ◽  
Kunal Deka ◽  
Jishan Ahmed
Keyword(s):  
Head Injury ◽  
Hospital Stay ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Prospective Clinical Study ◽  
Skull Fractures ◽  
Female Ratio ◽  
Wide Range ◽  
Gcs Score

BACKGROUND Depressed skull fractures (DSFs) cause wide range of injuries to the cranium and underlying structures, which influence the morbidity, mortality, and prognosis of the patient. This study was done to obtain a baseline clinical data regarding the management of such patients in Eastern part of our country. METHODS This prospective study was conducted in Assam Medical College and Hospital, Dibrugarh, from June 2016 to May 2017. Patients with depressed skull fractures fulfilling inclusion and exclusion criteria were included. After initial clinical evaluation, patients were put in conservative and surgical treatment groups. Surgical procedures were performed as per indication and intra-operative findings were recorded. All the patients were evaluated with regard to clinical findings, treatment provided, complications, outcome and other clinical variables during the hospital stay and follow up period. RESULTS A total of 65 patients out of the 1274 patients admitted for head injury were taken up for this study. Most patients were in the age group of 20 - 40 years. Male to female ratio was 5.5:1. The commonest mode of injury was road traffic accident followed by assault and others. Most common presenting symptom was brief loss of consciousness followed by post traumatic amnesia, ENT bleeding, seizures etc. Most commonly involved bone was frontal bone and most were compound fractures. At the time of presentation, 58.5 % of patients had Glasgow Coma Scale (GCS) score of 13 - 15, 33.8 % patients had a GCS score of 9 - 12 and 7.7 % had a GCS score of 3 - 8. Surgical intervention was required in 25 patients and rest received conservative treatment. Two patients expired during hospital stay. At the end of 3 months 78.46 % patients had good recovery, 6.1 % had moderate disability and 6.1 % patients had severe disability. CONCLUSIONS DSFs carry specific clinical features and problems which require individualised attention and care. These types of head injuries can be managed with good outcome in a peripheral government centre run by a single neurosurgeon. KEYWORDS Head Injury, Traumatic Brain Injury, Depressed Skull Fracture

scholarly journals A prospective cross-sectional study on the cases in a tertiary care hospital about the patterns of head injury caused by falling from heights

2021 ◽  
Vol 8 (4) ◽  
pp. 232-236
Author(s):  
Yuhesh Somasundaram ◽  
Amritha Sulthana ◽  
Shankar Subramanian ◽  
Manoharan Chellasamy
Keyword(s):  
Head Injury ◽  
Tertiary Care Hospital ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Head Impacts ◽  
Fall From Height

One of the most common injuries and death in India are caused by falling from heights. Although a majority of these bereavements are accidental and are due to a slip from higher altitudes like multi storey buildings, trees, construction sites, etc., alcohol consumption also plays a vital role. In such occurrences of death due to falling from heights, head injury is a very common phenomenon and it complicates the investigation procedure for the investigators and the medico legal experts to arrive at a conclusion because these injuries impersonate the injuries sustained from other accident cases like a road accident per say. Due to the absence of eyewitness in most of these cases, a detailed analysis on the pattern and the nature of the injuries is required to arrive at a conclusion. These injuries sustained vary owing to the site of impact and the stature from where the victim had fallen and the critical answer to the medico legal queries lies in a detailed autopsy of the victim’s body and a thorough examination at the scene of occurrence. On the account of a comprehensive study insufficiency in Tamilnadu, a modest attempt was made to analyse the pattern of head injuries sustained on the victims of fall from different heights and is presented as a cross- sectional study.The case study on the fatal incidents of fall from height was recorded and analysed statically in a sampling of one hundred cases which was subjected to detailed autopsy in a tertiary care hospital. In this analysis the nature and pattern of injuries, data regarding the nature of fall, the site of primary impact, period of survival and a detailed examination of head injuries were all noted. The statistical analysis was carried out using Microsoft Excel 2009.From the analysis, it is observed that the maximum number of fall from height cases seemed to be from the age group of 31 years ~40 years (30%) and males contributed to a majority of these cases (90%). Amongst head injury cases, 82% of the cases had intracranial haemorrhage and 10% had facial bone fractures. In the 82% of cases, 76% of cases had both subarachnoid haemorrhage and subdural haemorrhage. Also skull fracture was seen in 40% of the cases and the base of the skull fracture was noted almost equally in 37% of the cases. Injuries to head and cervical spine constituted to the salient features of primary head impacts, SAH alone is rare in such cases.On the account of observation and analysis, it is noted that most of these cases were accidental in nature (93%) and Males (90%) in the age group of 31-40 years were in highest number (30%). Cranial injuries with subarachnoid and subdural haemorrhage seemed to be the most common cause of death amongst victims falling from heights. Also skull fracture were seen in 40% of the cases and base of skull fracture noted almost equally in 37% of the cases. While SAH alone in rare in these cases, injuries to head and cervical spine were the key impacts of primary head impacts.

scholarly journals An Analysis of Aetiology, Pattern and Outcome of Head Injury in Trauma Patients

2022 ◽  
Vol 9 (3) ◽  
pp. 16-21
Author(s):  
Sudatta Waghmare ◽  
ashish Aswar ◽  
Hiranya Deka ◽  
Aman Singh ◽  
Arjav Nanavati ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Care Hospital ◽  
Road Traffic Accidents ◽  
Major Health Problem ◽  
Female Ratio ◽  
Associated Injury

Abstract Background: Head injury is considered as a major health problem in developed and developing nations. Analysis of etiology, patterns, and outcome of head injury in trauma patient is essential for understanding and planning for better management. Materials and Methods: The prospective observational study carried out among patients who presented with head injury at the tertiary care hospital, Mumbai from July 2015 to July 2017. Demographic details recorded were age, sex, blood pressure on arrival, Glasgow Coma Scale (GCS) score, the interval between injury and admission, associated injury, co-morbidities, hospital stay, and outcome. Results: The age group at which maximum patients of head injury were admitted was 18-29 years (31%) followed by 40-49 years (21%). Eighty one percent patients were males and 19% patients were females, the male to female ratio being 4:1. Road traffic accidents (36% cases) were the commonest cause leading to acute head injury followed by accidental fall (21% cases). 47% patients presented with mild head injury according to GCS. Conclusion: Head injuries mainly caused by vehicular accidents and affect mainly the young men. Road traffic accidents were the commonest mode of head injury, but railway accident had the worst outcome in our study. Factors associated with outcome were Pre-hospital delay, GCS on arrival, Blood pressure on arrival, Associated injury, Need for ventilator support, CT scan findings.

scholarly journals Epidemiology of Fatal Injuries reported in the mortuary of a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 633
Author(s):  
Subrat Kumar Pradhan ◽  
Himansu Prasad Acharya ◽  
Rudra Prasanna Mishra ◽  
Jay Kumar Panda ◽  
Durga Madhab Satapathy ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Adult Population ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Age Group ◽  
Microsoft Excel ◽  
Mortality And Morbidity ◽  
Fatal Injuries

Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or “accidental” causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases.Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages.Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%).Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.

scholarly journals DEMOGRAPHIC STUDY OF DEATHS DUE TO ROAD TRAFFIC ACCIDENTS, EXAMINED IN DR. S.N. MEDICAL COLLEGE, JODHPUR (RAJ.)

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Kana Ram Patel ◽  
Jagdish Jugtawat ◽  
Shalender Kumar ◽  
P.C. Vyas
Keyword(s):  
Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Subdural Hemorrhage ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female

Accidents are not due to external factors all the time but often they occur due to failure of control of self-conscience and free thoughts. Road Traffic Accidents is still the major cause of death worldwide including India. A retrospective study has been conducted in Dr. S.N. Medical College, Jodhpur (Raj.), in the year 2019 to study the pattern and distribution of Head Injuries of fatal road traffic accidents and to prepare the demographic profile of it. Out of total 901 cases, male to female ratio was 9:1, and commonest age group affected was 21-30 years (39.8%). Among total victims, Hindus were 748 (83%) and rests were Muslims 103 (11.4%) and other religions. Head injury was the most common injury, present alone in 509 cases (56.4%) and in 392 (43.6) cases along with other injuries. Skull fractures were found in 451 (50.5), in which linear/fissure fracture (32.9%) was most common. Most common bone fractured was temporal bone. The commonest variety of intracranial hemorrhage was subdural hemorrhage and craniotomy was done in 29 (3.2%) cases. Keywords: Accidents, Road traffic, Head injury, Fractures.

scholarly journals Clinicopathological study of gall bladder carcinoma with special reference to its management in a tertiary care hospital

2020 ◽  
Vol 7 (12) ◽  
pp. 4120
Author(s):  
Debmalya Saha ◽  
Saket Jha ◽  
Sukalyan Chhaule ◽  
Rabin Mandal ◽  
Anadi Acharya ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Gallbladder Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Rank Test ◽  
Common Symptom ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity

Background: Incidence of gallbladder carcinoma is increasing progressively among Indians and is regarded as a major cause of mortality and morbidity. In spite of this, limited studies have been conducted so far. Objective of the study was to know the prevalence, clinicopathological aspects, and prevalent treatment protocol of gall bladder cancer in a tertiary care hospital in Eastern India.Methods: 64 cases of histologically proven gallbladder cancer patients were studied. Patient characteristics were recorded using pretested proforma along with relevant investigations, and histopathology and treatment provided were recorded.Results: Our study reveals that gallbladder cancer has a prominent peak in the 7th decade of life with male: female ratio of 1:2.2. Most of the patients were having body mass index between 20.0 and 24.99, which is in sharp contrast to the available literatures. Pain is the most common symptom followed by constitutional symptoms. Majority of cases presented at advanced stage (64.1%) with significantly elevated CA19.9 level, and were managed with palliative chemotherapy.35.9% of our cases were respectable at the time of diagnosis, and extended cholecystectomy could be performed in 31.3%. Log rank test showed pattern of survival of the patients who were resected was significantly better than those of who were not resected.Conclusions: We know gallbladder cancer is a disease with very few patients amenable to surgery at the time of presentation. Thus, instead of retrospectively analyzing individual institutional data, high volume institutions with the necessary expertise for treating gallbladder cancer should collaborate with a view of generating strong evidence-based surgical guidelines.

scholarly journals Changing pattern of birth weight over a decade in rural India

2017 ◽  
Vol 6 (10) ◽  
pp. 4625 ◽  
Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit P. Gavhane ◽  
Swati D. Gagare ◽  
Kunal H. Aher ◽  
Dhruval K. Bhavsar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Economic Status ◽  
Tertiary Care ◽  
Childhood Mortality ◽  
Care Hospital ◽  
Maternal Weight ◽  
Mortality And Morbidity ◽  
The Government

Background: Birth weight is one of the important determinants of neonatal wellbeing. Birth weight has many determinants that mainly include maternal nutritional status and the term of gestation. Low birth weight is associated with high neonatal and childhood mortality and morbidity. Over the years the birth weight is showing the increasing trend in developing countries like India. The study aimed at finding out the changing pattern of birth weight over a decade in rural India.Methods: A retrospective analysis of over 45,000 births that took place in Tertiary care hospital from year 2008-2017was undertaken. The socio economic determinants of birth weight were studied.Results: The incidence of low birth weight declined from 47 percent to 35 percent over ten years. The mean rise in birth weight in ten years was observed in both male (176 grams) and female (151grams).The incidence of very low birth and extremely low birth was found declined. There was positive co relationship between improved birth weight and improved socio economic status, delay in age at marriage, higher maternal weight gain during pregnancy, improved pre pregnancy nutritional status of women.Conclusions: There is steady decline in incidence of low birth weight over last ten years in study area. Improved maternal health, better nutrition, improved quality of antenatal care and various efforts and actions from the government side have contributed in improving the birth weight.

scholarly journals Skull Fracture and Haemorrhagic Pattern in Cases of Fatal Blunt Trauma Head Injury Autopsied at Tertiary Healthcare Centre in Eastern Nepal

Med Phoenix ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 71-74
Author(s):  
Bikash Sah ◽  
Bishwanath Yadav ◽  
Shivendra Jha ◽  
Abdul Sami Khan
Keyword(s):  
Head Injury ◽  
Subarachnoid Haemorrhage ◽  
Blunt Trauma ◽  
Intracranial Haemorrhage ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Skull Vault

Background: Head injury is regarded as a main health problem that is a common cause of morbidities and mortalities and makes great demand to control and prevent it. For this, policy makers need to see the pattern of head injury and this study is done to describe the pattern.Methods: Hospital based, descriptive cross sectional study done on one year autopsy cases of fatal blunt trauma head injury which was 76 in which proportion of different types of head injuries, their causes and their distribution as per age, sex, and duration of survival were studied.Results: Skull-vault fractures were present in 57 (75%) cases in which most common type of fracture was linear fracture constituting 29(49.12%). 50% of the cases were with skullbase fracture in which the most common was of anterior cranial fossa fracture(60.5%). 56.34% of the victims were with subarachnoid haemorrhage (SAH) followed by subdural haemorrhage (SDH) and extradural haemorrhage (EDH). 6.6% victims were without any intracranial haemorrhage. Road traffic accident alone accounted for 71% of total blunt trauma causations of this fatal head injury. 70% cases were in age group from 11 to 50 years and 78.9% were male. 51.3% died at the spot. Conclusions: The research findings have shown that among the fatal blunt trauma head injury cases, skull vault fracture was present in 75% and skull base fracture was present in 50%. The most common intracranial haemorrhage was subarachnoid haemorrhage (56.34%) followed by subdural and extradural haemorrhage.  Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 71-74                                                         

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