scholarly journals Association of aspartate aminotransferase in statin-induced rhabdomyolysis

2017 ◽  
Vol 9 (4) ◽  
pp. 316 ◽  
Author(s):  
Xu Cong Ruan ◽  
Lian Leng Low ◽  
Yu Heng Kwan
Keyword(s):  
Regression Model ◽  
Clinical Diagnosis ◽  
Aspartate Aminotransferase ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Delayed Diagnosis ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Aspartate Transferase

ABSTRACT INTRODUCTION The risk of rhabdomyolysis in the general population is elevated by the increased prevalence of statin use. As the presentation of rhabdomyolysis is varied, there is a risk of delayed diagnosis leading to patient complications and increased healthcare costs. Creatine kinase (CK) alone is not sufficiently predictive for risk stratification. Beyond serum CK, other biomarkers such as transaminases may be used as surrogates to evaluate rhabdomyolysis severity and predict complication risks. AIM To assess if other biomarkers are associated with peak CK and severity of rhabdomyolysis to aid in clinical diagnosis of rhabdomyolysis. METHODS A retrospective study was conducted at an acute care hospital from 2008 to 2011. Inclusion criteria were: (1) patients diagnosed with statin-induced rhabdomyolysis; and (2) peak CK levels of ≥1000 IU/L. Patients with post-operational rhabdomyolysis, acute myocardial infarction and who had suffered from road traffic accidents were excluded. A total of 24,332 patients were screened, and 78 patients fulfilled our inclusion criteria. RESULTS Aspartate aminotransferase (AST) was found to be positively associated with peak CK levels in the multivariable linear regression model after adjusting for alanine aminotransferase (ALT) levels (P = 0.002; β = 83.18). Aspartate aminotransferase was found to be associated with severity of rhabdomyolysis in the multivariable logistics regression model after adjusting for ALT levels (P = 0.015; OR = 1.01). DISCUSSION Aspartate transferase is associated with raised peak CK levels and severity of rhabdomyolysis. Clinicians may consider ordering AST to aid in the clinical diagnosis of rhabdomyolysis.

The aetiology of posterior glenohumeral dislocations and occurrence of associated injuries

2019 ◽  
Vol 101-B (1) ◽  
pp. 15-21 ◽  
Author(s):  
M. J. Kelly ◽  
A. E. Holton ◽  
A. J. Cassar-Gheiti ◽  
S. A. Hanna ◽  
J. F. Quinlan ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Web Of Science ◽  
Road Traffic ◽  
Glenohumeral Joint ◽  
Delayed Diagnosis ◽  
Associated Injuries ◽  
Inclusion Criteria ◽  
Posterior Shoulder ◽  
Male Patients ◽  
Insight Into

AimsThe glenohumeral joint is the most frequently dislocated articulation, but possibly due to the lower prevalence of posterior shoulder dislocations, approximately 50% to 79% of posterior glenohumeral dislocations are missed at initial presentation. The aim of this study was to systematically evaluate the most recent evidence involving the aetiology of posterior glenohumeral dislocations, as well as the diagnosis and treatment.Materials and MethodsA systematic search was conducted using PubMed (MEDLINE), Web of Science, Embase, and Cochrane (January 1997 to September 2017), with references from articles also evaluated. Studies reporting patients who experienced an acute posterior glenohumeral joint subluxation and/or dislocation, as well as the aetiology of posterior glenohumeral dislocations, were included.ResultsA total of 54 studies met the inclusion criteria. In total, 182 patients were included in this analysis; study sizes ranged from one to 66 patients, with a mean age of 44.2 years (sd 13.7). There was a higher proportion of male patients. In all, 216 shoulders were included with 148 unilateral injuries and 34 bilateral. Seizures were implicated in 38% of patients (n = 69), with falls, road traffic accidents, electric shock, and iatrogenic reasons also described. Time to diagnosis varied across studies from immediate up to a delay of 25 years. Multiple associated injuries are described.ConclusionThis review provides an up-to-date insight into the aetiology of posterior shoulder dislocations. Our results showed that seizures were most commonly implicated. Overall, reduction was achieved via open means in the majority of shoulders. We also found that delayed diagnosis is common.

scholarly journals Expressway Traffic Accidents Involving Human Injuries and Fatalities in Ethiopia: Negative Binomial Regression Model

2021 ◽  
Author(s):  
Yesuf Abdela Mustefa ◽  
Addis Belayhun
Keyword(s):  
Regression Model ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Negative Binomial ◽  
Road Traffic ◽  
Weather Condition ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Level Of Education ◽  
Binomial Regression

Abstract Background: Road traffic accident is a major public health as well as economic challenge that rated the eighth leading cause of death. The severity became higher in developing countries. Ethiopian is among the most confronted countries in the world. We utilized the Ethiopian Toll Roads Enterprise data to provide insights and model significant determinants of accidents involving injuries and fatalities. Besides utilizing recent dataset, we applied the most appropriate but forwent statistical model. Moreover, we examined the significance of the effects of drivers’ age and gender that have not been the cases in the literatures.Methods: We made descriptive insights available on the basis of graphs from integrated traffic accident and flow datasets. We tested for the presence of over-dispersion in a total of 1824 observations of accident data recorded from September, 2014 to December, 2019 for inferential analysis. Finally, we modeled the effects of significant variables on the number of injuries using the negative binomial regression model. Results: we found that the number of injuries in accidents were significantly determined by type of vehicles, ownership status of vehicles, accident time weather condition, driver-vehicle relationship, drivers’ level of education, and drivers’ age.Conclusions: Heavy trucks were more likely to cause more number of injuries than medium or small vehicles. Hot and windy weather conditions were associated with higher probability of the number of injuries. The likelihood of the number of injuries were lower when drivers are owner of the vehicle; drivers level of education is above secondary school; and the age of the driver is between 18 and 23 years old. Moreover, due concern needs to be given for traffic road rules.

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 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 An epidemiological study of road traffic accidents among patients admitted in a tertiary care hospital in Puducherry

2018 ◽  
Vol 5 (8) ◽  
pp. 3362
Author(s):  
Muthukumar T. ◽  
Zile Singh ◽  
Vishnu Prasad R. ◽  
Abel K. Samuel ◽  
Raja T. K.
Keyword(s):  
Large Scale ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care Hospital ◽  
Seat Belt ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Road Traffic Accidents ◽  
Modifiable Factors

Background: Road traffic accidents (RTA) are the only public health problem for which society and decision makers still accept death and disability among young people on a large scale. This study was undertaken to determine the various epidemiological factors influencing RTA with a view to suggest appropriate remedial measures for prevention of accidents.Methods: A hospital based prospective observational study was conducted at a tertiary care hospital in Puducherry. All the patients admitted in the hospital due to RTA from Jan to Dec 2014 were interviewed by using a pre-tested and pre-designed questionnaire. Data was entered in MS Excel and analysed using SPSS version 21.0. Institute ethics committee clearance was obtained.Results: Among 541 participants, 50% of the victims were in the productive age group of 20-40 yrs. The approximate speed of majority of the vehicles (55.6%) at the time of accident was 40-80 km/hr. Among the accident victims, 85.8% of the two wheeler riders did not use helmet and 70.9% of the car drivers did not wear seat belt at the time of accident. Around 39% of the drivers were under the influence of alcohol at the time of accident. Mobile phone is the major cause of distraction (51.9%) at the time of accident.Conclusions: Based on this study it is evident that prevention and control of most of the modifiable factors can bring about a change in the statistics that would ensure our future to be safer.

scholarly journals Anticipatory Guidance in Childhood Safety: How do Parents Fare? A Survey from a Tertiary Hospital

2021 ◽  
pp. 974-981
Author(s):  
Kishore Narayan ◽  
Daniel Paul Pragasam ◽  
P. Kesavaraj ◽  
Balamma Sujatha ◽  
S. Rajesh
Keyword(s):  
Middle Class ◽  
Parent Education ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Statistical Correlation ◽  
Care Hospital ◽  
Study Population ◽  
Home Injuries

Unintentional home injuries are a major cause for childhood morbidity and mortality. Aims and Objective: To find the KAP among mothers about common home injuries and methods to prevent them. To assess how safe the houses of the study population is. Materials and Methods: 200 mothers attending the paediatric OPD of a tertiary care hospital in a sub-urban area of South India were enrolled. They were interviewed with a structured questionnaire. Details regarding socio-demographic aspects, knowledge, attitude and practices about common household accidents and ways to prevent were asked. The safety aspects of their homes were also noted down. The collected data were analysed with sigma plot 13(system software, USA). In the above statistical tools the probability value <0.05 was considered as significant. Result: The mean age of mother was 28.82 ± 4.93 years and age at marriage, 21.7 ± 3.55 years. 54% belonged to lower middle class and nearly 20% each in upper lower and upper middle class. Fall from height, Road traffic accidents followed by electrical injuries were the commonest accidents known by mothers. Socioeconomic status and educational levels had statistical correlation with few of the variables. Conclusion: Knowledge about home accidents is poor in the study population. Most of the houses are not child safe. Parent education about home injuries and training on first aid should be part of newborn follow up.

scholarly journals A record based study of frequency and pattern of medico-legal cases reported at a tertiary care hospital in Miraj

2017 ◽  
Vol 4 (4) ◽  
pp. 1348 ◽  
Author(s):  
Tanuja R. Brahmankar ◽  
Sachin K. Sharma
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Road Traffic Accidents ◽  
Cross Sectional ◽  
Legal Cases ◽  
Legal Case

Background: Medico-legal case (MLC) can be defined as a case of injury or ailment, etc., in which investigations by the law-enforcing agencies are essential to fix the responsibility regarding the causation of the said injury or ailment. Medico-legal cases are an integral part of medical practice that is frequently encountered by medical officers working in casualty. Hence the present study is carried out to find out the frequency and pattern of medico-legal cases reported at a tertiary care hospital and to highlight the vulnerable gender, age, residence and the cause. Methods: It is a record based cross sectional study in which all the MLC cases registered in MLC record book during a period of 6 months (January 13– June 13) were included. Cases found non medico-legal were excluded. Variables considered were gender, age, residence and cause. Findings were expressed in numbers and percentages. Results: Total cases were 2350, of which 1866 (79.4%) were males and 484 (20.6%) were females. Maximum cases were from the age group of 21-30 years i.e., 828 (35.2%). 1440 (61.27%) were residents of urban area. Most of the medico-legal cases registered were due to assault (27.2%) followed by medical examination of prisoners(25.9%), road traffic accidents (19.7%), fall (6.9%), snake bite (6.6%), poisoning (4.3%), domestic injuries (4.3%), unknown bite (2.2%), unknown found at railway station (1.6%), brought dead (0.6%), burn (0.2%) & others (0.5%). Conclusions: Majority of the victims were males, young adults and urban inhabitants. Most common indication for medico-legal cases was assault followed by medical check-up of prisoners and road traffic accidents. 

scholarly journals Most Frequently Affected Body parts in Road Traffic Accidents Reporting to the Accident and Emergency Department of the Largest Tertiary Care hospital of Karachi in 2019

2021 ◽  
Author(s):  
Zaeema Ahmer ◽  
Aisha Siddiqui
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Body Parts ◽  
Road Traffic Accidents ◽  
Accident And Emergency ◽  
Significant Difference ◽  
Study Participants

Introduction Injuries sustained during Road Traffic Accidents (RTAs) amounts to a serious public health crisis. The aim of the study was to determine the body parts most likely affected in an RTA in patients brought to Accident and Emergency (A&E) department of Jinnah Postgraduate Medical Centre (JPMC), the largest tertiary care hospital of Karachi. Method A descriptive cross-sectional study was done in January-March 2019 among 371 respondents aged 15-65 years. Study participants were recruited through non-probability convenience sampling. A structured questionnaire was used to collect data on sociodemographic variables and type, severity and nature of injury. Chi Square test was used to determine the significant difference between using safety precautions with body parts affected. All analysis was performed on SPSS version 20. Results Out of 371 study participants, 64.4% (n=239) were between 15-35 years with 91.9% (n=338) males. In 77.1% (n=286) cases, emergency medical services responded in less than one hour and first aid was provided by doctor to 95.7% (n=355) at hospital. In 82.5% (n=306) cases, private vehicles were involved, with 46.1% (n=171) motorcycles. In 79.8% (n=296) cases, bone injury was prevalent, with 57.1% (n=212) leg injuries, which was the most frequently affected body part. Majority, 56.2% of the study participants who did not wear seat belts had chest area affected (p=0.006).  Conclusion It is concluded that males of 15-35 years who were motorcyclists were more prone to RTAs with lower limbs more frequently being affected. Safety precautions like wearing seatbelts provide protection against RTAs.  

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