Clinical evaluation of cases of lower genitourinary tract trauma with special reference to primary realignment in cases of posterior urethral distraction defect

Background: The exact management strategy for lower genitourinary tract trauma remains controversial. Primary realignment with/without suprapubic catheterization provides definitive procedure with low complications and avoids the need for further open surgeries.Methods: This was a prospective longitudinal study done on 31 cases with different complaints related to lower tract genitourinary trauma. All patients underwent suprapubic catheterization and/or primary realignment. The outcome was measured in the terms of time for discharge, urinary incontinence, stricture formation, erectile dysfunction and impotence.Results: Maximum proportion of patients with lower genitourinary injuries in the study was in 10-20 years age group (48.4%). Blunt trauma was accounted for 93.6% of lower genitourinary injuries. Road traffic accidents were the most common cause (90.32%) of lower genitourinary injuries. Urinary bladder injuries accounted for 41.9% of all lower genitourinary injuries. Blood at meatus is present in only about half of the significant urethral injuries. Primary realignment of urethral injury results in lesser duration of hospital stay (9.24±2.44 days), shorter length of suprapubic catheterization (11.67±4.78 days) and early spontaneous voiding (40.93±15.79 days). The stricture rate following primary realignment is low (31.25%). Erectile dysfunction was noted only in two patients (16.6%).Conclusions: Management of traumatic urethral disruption by primary realignment serves as ultimate therapy in majority of patients.

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Change in Frequency and Predictors of Erectile Dysfunction With Changes in the International Index of Erectile Function-Erectile Function Domain Score in Patients With ST-Elevation Myocardial Infarction: A Prospective, Longitudinal Study

Journal of Sexual Medicine ◽

10.1016/j.jsxm.2020.03.002 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1101-1108

Author(s):

Emre Karabay ◽

Nejdet Karsiyakali ◽

Goksel Cinier ◽

Gonul Zeren ◽

Serdar Duvar ◽

...

Keyword(s):

Myocardial Infarction ◽

Erectile Dysfunction ◽

Longitudinal Study ◽

Erectile Function ◽

St Elevation Myocardial Infarction ◽

Domain Score ◽

Prospective Longitudinal Study ◽

St Elevation ◽

Function Domain ◽

Prospective Longitudinal

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Blunt abdomen trauma: a study of 50 cases

International Surgery Journal ◽

10.18203/2349-2902.isj20181447 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1763

Author(s):

Hardik J. Solanki ◽

Himanshu R. Patel

Keyword(s):

Mortality Rate ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Traffic Accidents ◽

Road Traffic ◽

Morbidity And Mortality ◽

Urethral Injury ◽

Care Hospital ◽

Road Traffic Accidents ◽

Female Ratio

Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. Identification of serious intra-abdominal pathology is often challenging; many injuries may not manifest during the initial assessment and treatment period.Methods: This study was conducted on 50 patients of blunt abdominal trauma admitted in a Tertiary Care Hospital, Including All patients with blunt abdominal trauma and Patients of all age groups.Results: In present study age group affected was 11 to 20 years and 41 to 50 years (20% each). Next group was 21 to 30 years (18%), male: female ratio was 2.8:1, most common mode of injury was road traffic accidents. Incidence of road traffic accidents was 48%. In study 2 patients out of 3 patients expired due to late presentation, liver injured (34%), followed by spleen (16%). Other injuries were small intestine and mesentery (14%), Urethral injury (12%) and muscular hematoma (8%), clinical presentation was abdominal pain (90). Extremity fractures 14% of cases, postoperative complication of respiratory infections (50%). Wound infection was 25% of patients. 2 patients who died suffered postoperative complications. Mortality rate (40%) in hemodynamically unstable patients than in hemodynamically stable patients (3%), Survival rate 94% while mortality rate 6%.Conclusions: Morbidity and mortality can be prevented by timely initial resuscitation and correct diagnosis as well as management (operative or non-operative) which depend on patient’s hemodynamic stability and findings of imaging studies.

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Peritraumatic distress but not dissociation predicts posttraumatic stress disorder in the elderly

International Psychogeriatrics ◽

10.1017/s1041610213000069 ◽

2013 ◽

Vol 25 (6) ◽

pp. 1007-1012 ◽

Cited By ~ 8

Author(s):

Alain Brunet ◽

Steven Sanche ◽

Aude Manetti ◽

Bruno Aouizerate ◽

Régis Ribéreau-Gayon ◽

...

Keyword(s):

Mixed Model ◽

Stress Disorder ◽

Road Traffic ◽

The Elderly ◽

Self Report ◽

Systematic Evaluation ◽

Ptsd Symptoms ◽

Prospective Longitudinal Study ◽

Traumatic Distress ◽

Prospective Longitudinal

ABSTRACTBackground: Post-traumatic stress disorder (PTSD) is a severe anxiety disorder whose symptoms include re-experiencing, avoidance, and hyperarousal after a particularly intense event. In view of the aging of the population, increased clinical knowledge is required for better understanding of PTSD in the elderly. Extending previous research in this field in adults and children, the aim of our study was to assess the utility of peri-traumatic dissociation and distress as a predictor of PTSD in the elderly.Methods: A prospective longitudinal study was conducted in a consecutive cohort of subjects aged 65 years and over admitted to emergency departments after a physical assault or a road traffic accident. Peri-traumatic responses of distress and of dissociation were measured. One, 6, and 12 months after trauma exposure, PTSD symptoms and diagnosis were assessed using both a dimensional and a semistructured interview.Results: Thirty-nine male and female participants with an average age of 72.4 years were recruited. Mixed model regression analyses did not detect a significant effect of age, sex, nor time. Significant associations were detected between peri-traumatic distress and the self-report PTSD Checklist (p = 0.008), as well as the Clinician-administered PTSD scale (p = 0.03). No association was detected between peri-traumatic dissociation and PTSD.Conclusions: Peri-traumatic distress predicts PTSD symptoms and diagnosis in the elderly, thereby suggesting its systematic evaluation at the emergency department would be a worthwhile thing to do.

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Prevalence of poor psychological morbidity following a minor road traffic accident (RTA): The clinical implications of a prospective longitudinal study

Counselling Psychology Quarterly ◽

10.1080/09515070701403679 ◽

2007 ◽

Vol 20 (2) ◽

pp. 149-155 ◽

Cited By ~ 15

Author(s):

Ben Smith ◽

Sarah Mackenzie-Ross ◽

Peter Scragg

Keyword(s):

Longitudinal Study ◽

Road Traffic Accident ◽

Traffic Accident ◽

Road Traffic ◽

Psychological Morbidity ◽

Clinical Implications ◽

Prospective Longitudinal Study ◽

Minor Road ◽

A Minor ◽

Prospective Longitudinal

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Prospective Study on Sexual Dysfunction in Male Chinese Liver Transplant Recipients

American Journal of Men s Health ◽

10.1177/1557988319835139 ◽

2019 ◽

Vol 13 (2) ◽

pp. 155798831983513

Author(s):

Miu Yee Chan ◽

Kenneth Siu Ho Chok ◽

James Yan Yue Fung ◽

Sau Loi Ng ◽

Ming Kwong Yiu ◽

...

Keyword(s):

Erectile Dysfunction ◽

Liver Disease ◽

Sex Hormone ◽

Significant Drop ◽

Prospective Longitudinal Study ◽

Hormone Levels ◽

End Stage Liver Disease ◽

Before And After ◽

End Stage ◽

Prospective Longitudinal

In patients with end-stage liver disease, hypogonadism and erectile dysfunction are often seen. This study was to determine the incidence of erectile dysfunction before and after liver transplantation (LT) with correlation to change in sex hormone levels from a Chinese cohort. This prospective longitudinal study was registered with The University of Hong Kong Clinical Trials Centre (HKUCTR-1563). The Institutional Review Board approval number is UW-12-273. The study period was from January 2012 to December 2016. Adult male patients with end-stage liver disease enlisted for LT were recruited on informed written consent. All recruited patients were to complete a cross-sectional cohort questionnaire—International Index of Erectile Function, version 5 (IIEF5)—and to receive serum sex hormone checks before and after LT. Twenty-eight patients who underwent LT were included in the analysis. The included patients had significantly reduced prolactin ( p < .001) and 17-beta-estradiol ( p = .024) after LT. There was also a significant drop of IIEF5 score at 1 month after LT, but the score returned to pre-LT level at 6 months. This study demonstrated that there was improvement in sex hormone levels after LT, namely, normalization of estradiol level and lowering of prolactin and progesterone levels. However, improvement in sex hormone levels did not translate into improvement of erectile dysfunction.

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Comparative Study of Ultrasonography and Computed Tomography in the Evaluation of Blunt Abdominal Trauma at CMS-TH

Nepal Medical Journal ◽

10.37080/nmj.7 ◽

2018 ◽

Vol 1 (01) ◽

pp. 11-14

Author(s):

Subash Thapa ◽

Madan Thapa

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Predictive Value ◽

Road Traffic ◽

Imaging Techniques ◽

Organ Injury ◽

Free Fluid ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

Introduction: This study was conducted to compare the role of USG and CT as noninvasive imaging techniques for assessing the patient with blunt abdominal trauma. Methods: A prospective longitudinal study was performed at the College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan in the department of Radiodiagnosis, from January 2011 through July 2013. Where 150 patients following abdominal injuries were recorded, including patient age group, sex and mode of injury. Patient underwent USG and CT evaluation. The role of USG and CT was compared in the diagnosis of blunt abdominal trauma. Results: In our study, 80% of patient with blunt abdominal injury were male with the M:F ratio of 4:1. Road traffic accident was the most common cause of blunt abdominal trauma (72%). There were 95 (92.22%) patients positive for free fluid by USG and CT where 15 had no organ injury. CT revealed organ injuries in 88 (85.43%) patients whereas USG detected 72 (69.90%) organ injuries. Spleen 42 (47.72%) was the most common organ to be injured followed by liver29 (32.95%), kidney 7 (7.9%) and pancreas 3 (3.4%). 16 (18.18%) patients out of 88 positive for organ injuries were not associated with free fluid. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of USG for organ injury were 81.81%, 100%, 100%, 79.48% and 89.3% respectively. Conclusions: USG and CT are useful noninvasive tools in detecting free intraperitoneal fluid and organ injuries in patients with blunt abdominal trauma. CT is superior to detect organ injuries in patients with blunt abdominal trauma.

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Various modalities of treatment of proximal tibial fractures: a prospective longitudinal study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20170784 ◽

2017 ◽

Vol 3 (2) ◽

pp. 259

Author(s):

Yash B. Rabari ◽

Ashish M. Somanni ◽

D. V. Prasad ◽

Krunal H. Thadeshwar

Keyword(s):

Tibial Plateau ◽

Road Traffic ◽

Tibial Plateau Fractures ◽

Clear Understanding ◽

Fracture Type ◽

Prospective Longitudinal Study ◽

Articular Fractures ◽

Tibial Condyle ◽

Schatzker Classification ◽

Prospective Longitudinal

Background: Tibial plateau fractures are one of the commonest intra-articular fractures. They result from indirect coronal or direct axial compressive forces. This makes about 1% of all fractures and 8% of the fractures in elderly. Nevertheless, tibial plateau fractures challenging remain because of their number, variety and complexity. With advancements the treatment of each fracture type is still not defined hence we have taken up this study to analyze various fracture patterns and its outcome.Methods: The study includes 40 patients having the fractures of the proximal tibial metaphyseal; metaphyseodiaphyseal with or without intra-articular extension (including upper third fractures of tibia), closed fractures, fractures with Open grade-I wounds (Gustillo Anderson Classification).The study excludes compound fractures having grade II and III (Gustillo Anderson) and Paediatric patients. The treatment method was based on the type of fracture, the amount of displacement , the amount of depression and surrounding skin condition of the tibial plateau. We used the Schatzker classification because it is closest to describing the specific fracture type and it is easy to apply.Results: In this study there were 40 patients with mean age of 39.18 (median 38.5 and min – max 25 to 55) with 25 male (62.5%) and 15 (37.5%) female with significant male preponderance. In this study road traffic accident was the commonest mode of injury (65%) and produced different types of fractures, followed by fall from height (22.5%), injury while playing sports (12.5%).Conclusions: The correct method of management of tibial condylar fractures depends on good clinical judgment. If rational treatment is to be instituted the surgeon must have sound knowledge of the personality of the injury and a clear understanding of the knee examination, imaging studies and must be familiar with variety of techniques available at present for treating tibial condyle fractures.

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