Phenytoin Prophylaxis in Posttraumatic Head Injury

1996 ◽  
Vol 12 (4) ◽  
pp. 160-164
Author(s):  
Stephen O Ohimor ◽  
Robert E Falcone
Keyword(s):  
Head Injury ◽  
Trauma Center ◽  
Severe Head Injury ◽  
Seizure Activity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Posttraumatic Epilepsy ◽  
Trauma Service ◽  
The Face

Objective: To identify the effectiveness of prophylactic phenytoin in preventing posttraumatic epilepsy. Design: Retrospective cohort study. Setting: Urban tertiary-care hospital and trauma center. Subjects: Patients admitted to the trauma service in 1989 with moderate to severe head injury surviving to discharge. Interventions: Divided into two groups based on prophylaxis with phenytoin. Measurements and Main Results: Ninety-one patients with moderate to severe head injury were admitted during the study period; 6 were excluded from analysis for prehospital seizure activity. Forty-one patients received no anticonvulsants; 44 received phenytoin alone or in combination with other agents. None of the patients experienced a seizure during hospitalization. Seventy-four percent of all phenytoin concentrations were subtherapeutic (serum phenytoin 10–20 μg/mL). Conclusions: The lack of seizure activity in the face of absent or subtherapeutic phenytoin concentrations brings into question the benefit of prophylactic therapy.

scholarly journals Prospective study of Ear, Nose and Throat manifestations in head injury cases at a tertiary care hospital

2020 ◽  
Vol 3 (2) ◽  
pp. 42-45
Author(s):  
Apurva Anil Jarandikar ◽  
◽  
Siddhartha S. Shrivastava ◽  
Parmanand D Chawan ◽  
Sneha S Bansode ◽  
...  
Keyword(s):  
Head Injury ◽  
Prospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Nose And Throat

Efficacy of different hypertonic solutes in the treatment of refractory intracranial hypertension in severe head injury patients: A comparative study of 2ml/kg 7.5% hypertonic saline and 2ml/kg 20% mannitol

2007 ◽  
Vol 04 (02) ◽  
pp. 101-107 ◽  
Author(s):  
Nilay Chatterjee ◽  
Arpan Chaudhury ◽  
Sujoy Mukherjee ◽  
Gouri Kumar Prusty ◽  
Tapas Chattopadhyay ◽  
...  
Keyword(s):  
Head Injury ◽  
Intracranial Hypertension ◽  
Hypertonic Saline ◽  
Severe Head Injury ◽  
Randomized Study ◽  
Tertiary Care ◽  
Hypertonic Solution ◽  
Care Hospital ◽  
Hypertonic Saline Solution ◽  
The Mean

AbstractA prospective, randomized study to evaluate the clinical benefit of increasing the osmotic load of the hypertonic solution administered for the treatment of refractory intracranial hypertension episodes in patients with severe head injury. 25 patients with severe head injury and persistent coma, admitted in a Neurocritical Care Unit of a Tertiary Care Hospital, who required infusions of osmotic agents to treat episodes of intracranial hypertension resistant to well defined standard modes of therapy were randomly allocated to one of the two groups to receive isovolume infusions of either 7.5% hypertonic saline solution; HS [2400 mOsm/kg H2O] or 20% mannitol [1160 mOsm/kg of H2O] given 2ml/kg of either solution, i.e. 331.5 +/− 35.4 mOsm of hypertonic saline or 174.2 +/− 18 mOsm of mannitol per infusion. The variables recorded in the study were the duration and number of episodes of intracranial hypertension per day during the study period, which was stopped after the last episode of intracranial hypertension was recorded from intracranial pressure recording or after the allocated treatment failure. Patients of HS group were monitored for 7 +/− 6 days and those in the mannitol group for 8 +/− 5 days [p=NS]. The rate of failure for each treatment was also evaluated which was defined as the persistence of intracranial hypertension despite the two successive infusions of the same osmotic agent. The mean number of osmotic solute infusions was 3.4 +/− 4.5 in the HS group and 3.8 +/− 5.1 in mannitol group p=NS]. The mean number [7.1+/-2.9 vs. 14.6+/−3.4] of episodes of intracranial hypertension per day and the duration of such episode [62.6+/−28.1 vs. 93.4+/−37.2 min] was also significantly lower in the HS group [p<0.05]. The numbers of treatment failures were significantly lower in HS group: 1 out of 14 patients vs. 6 out of 11 patients [p<0.01]. In this study we have found that in patients with severe head injury requiring treatment with hypertonic solute for refractory intracranial hypertension, 2ml/kg body weight of 7.5% HS [356 +/− 14 mOsm] was more effective than giving 2ml/kg 20% mannitol [178 +/− 11mOsm]. Within the limitations of present study, the collected data suggest that giving 2ml/kg HS solution is an effective and safe initial treatment for intracranial hypertension episodes in head injury patients when there is indication of osmotherapy.

scholarly journals Non-accidental head injury in children: medical care direct economic cost in a tertiary care hospital

2019 ◽  
Vol 154 (6) ◽  
Author(s):  
Arturo Loredo-Abdalá ◽  
Abigail Casas-Muñoz ◽  
Gabriel Alejandro González-Garay ◽  
Raquel Ortiz-Hernández ◽  
Jessica María González-Corona ◽  
...  
Keyword(s):  
Head Injury ◽  
Medical Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Economic Cost ◽  
Care Hospital

scholarly journals Point-Prevalence Survey for the Hospital-Acquired Infections in Intensive Care Units of Trauma Center in a Tertiary Care Hospital of Northern India

2021 ◽  
Author(s):  
Sandeep Boora ◽  
Parul Singh ◽  
Arun Verma ◽  
Ashok Chauhan ◽  
Amit Lathwal ◽  
...  
Keyword(s):  
Trauma Center ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Point Prevalence ◽  
Care Hospital ◽  
Prevalence Survey ◽  
Hospital Acquired Infections ◽  
Point Prevalence Survey ◽  
Stewardship Program ◽  
Hospital Acquired

Abstract Background The burden of hospital-acquired infections (HAIs) is all assumption based, and the true burden remains unknown in most countries, particularly in the developing countries where healthcare facilities are suboptimal and knowledge is limited. Methodology This cross-sectional study was conducted at the trauma center of a tertiary care institute from August to September 2019, to assess the burden of HAI and antibiotic resistance pattern of HAI. The total sample size in our study was 105. Our objective was to estimate the point prevalence of HAI and study the associated factors in a tertiary care hospital. Result In this study, the point prevalence of HAI was five to six times higher when compared with that of developed countries. Gram-negative organisms were the predominant bacteria; with Acinetobacter baumannii the most common among them. Conclusion Point-prevalence survey is an important objective of the antimicrobial stewardship program; it will be helpful in controlling antimicrobial resistance and this tool plays a significant role in hospital settings. Our study is quite pertinent to assess the point prevalence of HAI. It will help in knowing the current prevalence and pattern of the HAI. Therefore, as healthcare administrators, we can further decrease the HAI for better patient outcomes in the future.

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 Comparison of efficacy of Tranexamic Acid Mesotherapy versus 0.9% normal Saline for Melasma; A split face study in a Tertiary Care Hospital of Karachi

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Sana Kaleem ◽  
Rabia Ghafoor ◽  
Sidra Khan
Keyword(s):  
Tranexamic Acid ◽  
Normal Saline ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Care Hospital ◽  
Directly Observed Therapy ◽  
Creative Commons ◽  
The Face ◽  
Split Face

Objectives: To compare the efficacy of tranexamic acid mesotherapy versus 0.9% normal saline for melasma by split-face study. Methods: It was a non-randomized clinical trial performed at the Dermatology ward of JPMC from September 2018 to June 2019 after getting approval from the Ethical Committee. A total of sixty patients were recruited in the study, who had symmetrical melasma on their faces. Both halves of the face were treated by Injection Tranexamic Acid (TA) with a dose of 4mg/ml and Normal Saline (NS) two weekly for twelve weeks. Hemi Modified Melasma Area and Severity Scoring (H-mMASI) was calculated at the start and end of the study. Analyses were done by SPSS version 23. P < 0.05 was taken as significant. Results: Mean of H-mMASI score was compared on both sides at the end of study, which showed significant reduction in mean score from 3.19 ±2.57 to 1.52 ± 1.2 (P < 0.05) on A side as compared to decline in scores on NS side from 3.46 ± 2.7 to 3.45 ± 2.6 (P > 0.05). Erythema, swelling, and burning were documented as temporary side effects on both sides. Conclusion: Tranexamic Acid (TA) mesotherapy can be considered as the most cost-effective, safe and directly observed therapy for melasma which showed significant improvement when old prior therapies have failed. doi: https://doi.org/10.12669/pjms.36.5.2379 How to cite this:Kaleem S, Ghafoor R, Khan S. Comparison of efficacy of Tranexamic Acid Mesotherapy versus 0.9% normal Saline for Melasma; A split face study in a Tertiary Care Hospital of Karachi. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2379 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sign in / Sign up

Export Citation Format

Share Document