scholarly journals Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

2021 ◽  
Author(s):  
Rahul Singh ◽  
Ravi Shankar Prasad ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
Nityanand Pandey
Keyword(s):  
Retrospective Study ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Motor Response ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Age Group ◽  
Female Ratio ◽  
Severity Of Injury

Abstract Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clinical presentation was altered sensorium (98.25%). The most common comorbidity was hypertension (n = 32, 28.07%). GCS at admission, severity of injury, pupillary changes, and best motor response (p < 0.0001) were significantly associated with surgical outcome. Conclusion GCS at admission, severity of injury, pupillary changes, and best motor response were significantly (p < 0.05) associated with surgical outcome. Age and gender of patients were not found to be significantly associated.

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 Epidemiological study of burn injury with special reference to its prevention- A Nine-year retrospective study from a tertiary care hospital of West Bengal, India

2015 ◽  
Vol 7 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Shib Shankar Kuiri ◽  
Bikash Chandra Ghosh ◽  
Nilay Mandal ◽  
Mintu Mohan Nandi ◽  
Tusar Kanti Saradar ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Injury Risk ◽  
West Bengal ◽  
Burn Injury ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Age Group

Aims and Objectives: We conducted a retrospective analysis among 1984 burn patients to study the incidence, prevalence of burn injury, its various types and modes (actual event behind the burn injury), risk factors and to find out the preventive measures.Materials and Methods: The retrospective study was carried out among 1984 patients having burn injuries, admitted in a tertiary care hospital of West Bengal, India over a period of nine years. The sources of information were the admission registers and the patients' folders from the medical records department. The Ethical clearance was taken from the Institutional Ethical Committee. The information obtained included age, sex, whether accidental or suicidal, etiology of burn injury and particularly the mechanism of injury. Results: Females were mostly affected (83%) in comparison to males. Among the study population, most of the burn patients were in the age group of 21-30yrs i.e. 35.3%. The number of burn patients were less in number in the age group of 11-20yrs i.e. 7.3%. Most of the burn injuries (87%) were accidental. Suicidal burns occurred in 10% cases. Of which about 1/3rd of the cases were due to dowry related issues.  A significant number of teenagers also attempted suicides due to trivial reasons (e.g. failure in examination, quarrelling with parents). Gas oven related injuries occurred in 2.7% cases. Oil lamps (‘kupi’), candles and hurricane-lanterns, diyas were also responsible to some extent in rural India for flame burns(5%). Smoking related burn injuries occurred in 1.7% cases. Scald injuries occurred in 14% cases. Chemical injuries (0.3%) were due to spillage of unlabelled bottles of acid/alkali. Electrical burn injury occurred in 4.9% cases. Conclusion: Burn injury prevention is not easy, but to avoid the significant morbidity and mortality following injury we have to prevent it by any means. A coordinated and dedicated approach among social workers , medical and paramedical personnel, administrators can only minimize the incidence of burn.Asian Journal of Medical Sciences Vol.7(1) 2015 70-75

scholarly journals A RETROGRADE STUDY OF MYIASIS IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 3-5
Author(s):  
Ayesha Goel ◽  
Ritu Nigam
Keyword(s):  
Oral Cavity ◽  
Head And Neck ◽  
Tertiary Care ◽  
Personal Hygiene ◽  
Intracranial Extension ◽  
Atrophic Rhinitis ◽  
Time Interval ◽  
Age Group ◽  
Predisposing Factor ◽  
Female Ratio

Myiasis in head and neck region is a rare occurrence and is usually found in tropical countries like India. Poor hygiene, unsanitary living conditions, mental retardation, neglected wounds, diabetes mellitus and old age along with a warm and humid climate lay down a conducive environment for the larva of dipterous fly to infest humans. Maggots due to their tissue destructive properties can affect many regions in otolaryngorhinology like nasal cavity, ears, oral cavity, tracheostomy site ostoma, PNS, the skin and ulcerative lesions of head and neck. The burden of the disease lies in the fact that the complications range from minor tissue destruction, perforation of either the tympanic membrane, palate or septum, vertigo, angioedema to severe neurological manifestations, intracranial extension or rarely even death. Objective: To assess the commonly affected age group and gender infested by myiasis, it’s seasonal trend, socioeconomic status of the affected patients and the relationship of myiasis infestation with various predisposing factors. Methodology: Retrograde study was conducted on 95 patients of department of otorhinolaryngology. The study was done from January 2015 to October 2018 by collecting data of 3 years 10 months time interval and results tabulated. Ethical clearance was sort and patients consent obtained. Result: The most commonly affected age group was found to be elderly, in the 7th decade of life (56.84%). Females were more commonly affected than males consisting of 55 out of 95 cases (57.89%), with a male female ratio of 1:1.4. Majority of cases presented in the months of October-January, with a peak in November (32/95). Nasal myiasis was found to be more common (69 cases) in comparison to aural and oral cavity myiasis. The most common predisposing factor was found to be Atrophic Rhinitis in 66.7% cases. Conclusion : With awareness and improved personal hygiene a devastating disease like myiasis is easily preventable and curable.

scholarly journals Clinical Profile of Patients Presenting with Carcinoma Stomach in North-East District of Bangladesh

2014 ◽  
Vol 15 (2) ◽  
pp. 118-121
Author(s):  
Aparna Das ◽  
Modhusudan Saha ◽  
Bimal Chandra Shil ◽  
Rubina Yasmin ◽  
Gobinda Banik ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Metastatic Lymph Node ◽  
Outlet Obstruction ◽  
Western World ◽  
Age Group ◽  
Female Ratio ◽  
Upper Gi ◽  
North East ◽  
Number Of Patients ◽  
Carcinoma Stomach

Background: The pattern and incidence of Carcinoma Stomach vary widely in different parts of the world. Overall it is the 2nd most common cause of death but in some Asian countries, it is still the commonest cause of cancer death in patients of > 50 years.Aim: To analyze the clinical presentation and histological findings of patients of carcinoma of the stomach. Methods and materials: This study was done over a period of 2 years between January 2011 and December 2012. Adult patients (Age more than 18 years) of histologically confirmed as having carcinoma stomach were included in the study. Studied variables included age, gender, socioeconomic status, clinical presentations, site of lesion, histopathological subtypes. Diagnostic modalities included abdominal ultrasound, upper GI (gastrointestinal) endoscopy and endoscopic biopsy to confirm the diagnosis. Results: Total number of patients included in this study was 150. The number of patients in <50 years age group and >50 years age group were 50 (33.33%) & 100 (66.66%) respectively. The median age at presentation was 57 years. The peak incidence was in 61-70 years age group. In our study,male: female ratio being 2.3:1. By occupation, farmer 74 (49%), housewife 37(24.6%), serviceholder12(8%), business man 5(10%) and others12 (8%). 71 (47.4%) patients were from lower socioeconomic group, middle74 (49.4%), upper class 5 (3.4%) & only 63 (42%) were literate. The common clinical features were vomiting 28%, abdominal pain 18%, weight loss and anorexia 17.3% , dyspepsia 16% , Anaemia (26% ), Abdominal mass 4%, Metastatic lymph node 4%, Ascites 1.3%. lesions are involved in Cardia 14%, Body &Antrum 6.6%, Antrum 2.6%, Body 23.3%, Fundus 2% and Diffusely in 1.3% cases. Conclusion: As regards to clinical presentation, patients in our country are presenting more with features of gastric outlet obstruction whereas abdominal lump and upper GI bleeding are more common in Western world. If gastric carcinoma is diagnosed at an early stage, patients can have a highly favorable prognosis.DOI: http://dx.doi.org/10.3329/jom.v15i2.20683 J MEDICINE 2014; 15 : 118-121

scholarly journals Clinical presentation and outcome of ectopic pregnancies in a tertiary care rural hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 692
Author(s):  
Indu Verma ◽  
Punya Priya ◽  
Charvi Chugh ◽  
Harsharan Kaur ◽  
Dinesh Sood
Keyword(s):  
Ectopic Pregnancy ◽  
Rural Areas ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
First Trimester ◽  
Rural Hospital ◽  
Reproductive Age ◽  
Age Group ◽  
Pain Site ◽  
Tract Infections

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.

scholarly journals P.082 Traumatic inter hemispheric subdural hematomas – clinical presentation, management and outcome

2016 ◽  
Vol 43 (S2) ◽  
pp. S39-S40
Author(s):  
R Bokari ◽  
S Schur ◽  
C Couturier ◽  
A Al-Azri ◽  
J Marcoux ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Conservative Management ◽  
Subdural Hematoma ◽  
Trauma Center ◽  
Complete Resolution ◽  
Clinical Presentation ◽  
Acute Subdural Hematoma ◽  
Detailed Review ◽  
Subdural Hematomas ◽  
Level I

Background: There is currently little data on the incidence, clinical outcome and management of traumatic interhemispheric subdural hematomas (IHSDHs). Methods: All patients admitted with an acute subdural hematoma (SDH) over a 5-year period at a Level I trauma center were included. A detailed review of all cases of large IHSDH (≥7 mm) was performed to document clinical presentation, management and outcomes. Results: Of 1182 patients with acute subdural hematomas (SDHs), 420 had IHSDHs (24%), and 50 were large IHSDHs. For patients with large IHSDH, the average age was 76 years (±11) and 44% were female. The average GCS was 12 on presentation (±4), and the average GOSE was 4 (±2). 66% of patients had associated cranial/ intracranial injuries (fracture, subarachnoid/epidural/SDH) and 26% required operations for acute convexity SDH. Three patients required operations for their IHSDH by inter hemispheric approach. By 10 weeks, 82% had a complete resolution of the IHSDHs. Conclusions: IHSDHs are often referred to as rare entities. Our results show they are common. Conservative management is often appropriate to manage even large IHSDHs, as most resolve spontaneously. This study will help document the occurrence of falx syndrome, as well as the management and outcomes of larger IHSDHs.

scholarly journals Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ramakrishna Pai Jakribettu ◽  
Rekha Boloor ◽  
Andrew Thaliath ◽  
Sharanya Yesudasan George ◽  
Thomas George ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Leucocyte Count ◽  
Clinical Presentation ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Haematological Parameters ◽  
Total Leucocyte Count ◽  
Care Hospital ◽  
Significant Difference

Dengue is one of the arthropod-borne (arbo) viral diseases transmitted by female mosquitoAedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P<0.05to 0.0001). Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P<0.05to 0.0001). Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients), required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.

scholarly journals Clinico-epidemiological profile of hepatitis A virus and hepatitis E virus co-infection in pediatric age group: a hospital based retrospective study

2019 ◽  
Vol 6 (2) ◽  
pp. 588 ◽  
Author(s):  
Shikha Handa ◽  
Sanober Wasim ◽  
B. P. Kalra ◽  
Anil Rawat ◽  
Vipan Chandar ◽  
...  
Keyword(s):  
Developing Countries ◽  
Retrospective Study ◽  
Hepatitis E Virus ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group

Background: Hepatitis-A virus (HAV) and Hepatitis E virus (HEV) are two major hepatotropic viruses of great public health importance in the developing countries like India. Both HAV and HEV are enterically transmitted and there are speculations that their co-infection might be associated with a more severe clinical course and increased rate of mortality. The objective of this study is to determine the prevalence, clinical features and biochemical parameters of Hepatitis A and Hepatitis E co-infection in hospitalized patients at a tertiary care centre in Uttarakhand.Methods: It is a retrospective study, covering a period of 4years and conducted in Himalayan Institute of Medical Sciences, SRHU Jolly Grant, Dehradun. Records of the patients with Hepatitis A and Hepatitis E co-infection were retrieved and analyzed.Results: Out of total 125 patients of acute viral hepatitis, 13 patients had HAV and HEV co-infection. 100% of the patients with co-infection presented with complaints of fever and jaundice, followed by 76.92% with vomiting, 69.23% with pruritis, 61.53% with pain in abdomen and 23.07% with altered sensorium. Mean Bilirubin, ALT, AST were 8.69±7.27 mg/dl, 2030.69±1726.93IU/L and 1880.07±1881.11IU/L respectively. Average duration of stay was 8.2 days. Encephalopathy was seen in 2 patients. However, no mortality was reported.Conclusions: Co-infection of HAV and HEV is not rare in pediatric age group. Knowledge about this will be of immense help for planning of future vaccination strategies and for better sanitation program in developing countries like India.

scholarly journals A retrospective study on palmoplantar psoriasis and its associations in a tertiary care centre

2019 ◽  
Vol 5 (2) ◽  
pp. 277
Author(s):  
Saradha K. Perumal ◽  
Sudha R. Gopinath
Keyword(s):  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Plaque Psoriasis ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Plaque Type ◽  
One Year

<p class="abstract"><strong>Background:</strong> Psoriasis is a chronic immune mediated inflammatory condition of the skin. Palmoplantar psoriasis (PPP) is a clinical variant of plaque psoriasis affecting palms and soles extending to the wrist and the margins of the soles and heels. This study was done to find out the prevalence of palmoplantar psoriasis in our setting. The aim of the study was to determine the prevalence, demographic features and other co-morbidities of the palmoplantar plaque psoriasis in a tertiary care centre.</p><p class="abstract"><strong>Methods:</strong> We conducted retrospective study for a period of one year (January 2017 to December 2017) on palmoplantar plaque psoriasis patients attending the dermatology OPD.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 552 enrolled psoriasis patients, 85 were clinically diagnosed to have palmoplantar psoriasis. The mean age of the patient was 45 years. Most of them belong to 4<sup>th</sup>, 5<sup>th </sup>and 6<sup>th</sup> decade of life. The male to female ratio was 1:2.26. The duration of the disease was more than one year in 73% of patients at the study time. Occupation of the patients included house-wives (50%), manual labourers (36%) and office goers, (13%). Hyperkeratotic plaque type psoriasis with scaling and fissures was the predominant morphological pattern recorded. Dyslipidemia (22%), overweight and obesity (56%), hypothyroidism (6%) and diabetes mellitus (12%) were the observed co-morbidities in this study.</p><p class="abstract"><strong>Conclusions:</strong> The prevalence of palmoplantar psoriasis (0.09%) was low in our study. Palmoplantar psoriasis affected middle aged adults and had a female predominance in this study. Overweight, obesity, dyslipidemia, diabetes mellitus and hypothyroidism were the co-morbid conditions observed in this study. Being a relapsing and chronic condition the disease poses a poor quality of life than plaque type psoriasis.</p>

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