Managing laryngotracheal trauma: 3 year experience at a tertiary hospital in North India

2020 ◽  
Vol 6 (3) ◽  
pp. 459
Author(s):  
Manish Munjal ◽  
Japneet Kaur ◽  
Porshia Rishi ◽  
Harjinder Singh ◽  
Nitika Tuli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Hospital ◽  
Aerodigestive Tract ◽  
North India ◽  
Common Finding ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Emergency Procedures ◽  
Acute Injuries ◽  
Life Threatening

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Laryngotracheal trauma includes life threatening injuries that are encountered by emergency care physicians, trauma surgeons and ENT surgeons. These injuries can occur in the most remote areas or in the busiest metropolitan setting. Earlier intervention is vital in order to reduce the mortality and morbidity associated with insult to the aerodigestive tract and surrounding structures.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This is a retrospective study of 21 patients who presented to the emergency department of Dayanand Medical College and Hospital, Ludhiana, for management of injuries to aerodigestive tract over a period of 3 years from January 2016 to December 2019.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>Twenty-one patients were seen with acute injuries to the airway in the emergency department. There were 12 males and 9 female patients out of which there were 10 men and 5 women, 3 girls and 2 boys ranging in age from 9 to 60 years. Although most of these injuries occurred as a result of blunt trauma, 6 were due to penetrating injuries out of which 2 were due to homicidal assault. Stridor was the most common finding followed by surgical emphysema. Twelve patients were in acute respiratory distress requiring emergency procedures to secure the airway. All patients underwent successful repair of the injuries. All patients except 1 had a good airway.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Laryngotracheal injury is rare but very crucial and life-threatening surgical emergency. Timely intervention is crucial in the management of laryngotracheal trauma in order to prevent complications.</p>

scholarly journals Ectopic pregnancy: Interventional Outcome at Tertiary Hospital

2017 ◽  
Vol 27 (Number 2) ◽  
pp. 7-12
Author(s):  
S Sultana ◽  
S Yesmin ◽  
A N Noor ◽  
S Dewan ◽  
N F Aman
Keyword(s):  
Ectopic Pregnancy ◽  
Tertiary Hospital ◽  
Pelvic Surgery ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Life Threatening ◽  
A Prospective Study ◽  
To Receive

The aim of this study is to determine the incidence and to evaluate and analyse the clinical presentation, risk factor and treatment of ectopic pregnancy in Holy Family Red Crescent Medical College Hospital, Dhaka. A prospective study was conducted in Department of Obstetrics and Gynaecology from August 2016 to December 2017. The study subjects included 50 women diagnosed with ectopic pregnancy (EP) to receive the treatment of medical and surgical procedure. In this study group the incidence was 4.7% among total gynecological admitted patient (2017) and the risk were within the age group 27-35 years. Majority of patients were having triad of symptom such as abdominal pain, secondary amenorrhoea and vaginal bleeding. Past NO abortion and abdomino-pelvic surgery were 66%. The commonest modality of treatment was Laparotomy (41 of 50, 86%), others were conservative with Inj. Methotrexate, failed conservative followed by Laparotomy (4%) and Laparoscopy (2%). EP is a common and life threatening entity. Women with infertility and past abdomino-pelvic surgery, MR, abortion are particularly at risk. Early diagnosis and intervention can reduce the mortality and morbidity of women having EP.

scholarly journals Abruptio placenta and its maternal and fetal outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 3323
Author(s):  
Ritu Mishra ◽  
Aditya Prakash Misra
Keyword(s):  
Neonatal Morbidity ◽  
Fetal Outcome ◽  
Age Group ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Life Threatening ◽  
Abruptio Placenta ◽  
The Common

Background: Abruptio placenta is one of the common cause of antepartum haemorrhage and is defined as premature separation of normally implanted placenta. It is more common in second half of pregnancy. Abruptio placenta is serious complication of pregnancy and causes high maternal and neonatal morbidity and mortality.Methods: This retrospective study of abruptio and its maternal and perinatal outcome was carried out between July 2016 and October 2017 at Rama Medical College Hospital and research centre.Results: Incidence of Abruptio placenta is 1.6%. It is most common in the women of age group 30-35 years. 75% of cases were associated with severe pre-eclampsia. Live births were 75% while stillbirths were 25%. PPH occurred in 30% of cases. DIC accounts for 25% of the complication.Conclusions: Abruptio placenta is life threatening complication of pregnancy and it is associated with poor maternal and fetal outcome if not managed appropriately. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.

scholarly journals Disseminated Cryptococcosis in a Non-HIV Patient in Singapore

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Jonathan See ◽  
Kok Choon Raymond Fong ◽  
Humaira Shafi
Keyword(s):  
Lupus Erythematosus ◽  
Pulmonary Involvement ◽  
Tertiary Hospital ◽  
Mortality And Morbidity ◽  
Therapeutic Modalities ◽  
Appropriate Treatment ◽  
Improved Outcomes ◽  
Atypical Clinical Presentation ◽  
Threatening Condition ◽  
Life Threatening

We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition.

scholarly journals A clinical study on paediatric aero digestive foreign body in emergency department

2018 ◽  
Vol 4 (3) ◽  
pp. 682
Author(s):  
Selvam D. K. ◽  
Nirmal Kumar J. ◽  
Anjan Kumar S. ◽  
Nagarajan P. S.
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Digestive Tract ◽  
Paediatric Population ◽  
Foreign Body Ingestion ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Paediatric Age ◽  
Madras Medical College ◽  
Careful Assessment

<p class="abstract"><strong>Background:</strong> Foreign body ingestion and aspiration is a common clinical condition among the paediatric population. The management of the aero digestive foreign body requires clinical acumen, coupled with the radiological diagnosis and the necessary infrastructure for their management, it demands skill and expertise for removal of a foreign body.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was carried in the department of Otorhinolaryngology, between December 2016- May 2017, at Institute of Child Health and Hospital for Children, Madras Medical College. 68 cases were analysis of the nature of the foreign body was done. All the patients reported to the emergency department and the ENT surgeon opinion sought with aim of maintaining airway. Clinical assessment, with history, radiographs were obtained to ascertain level and nature of the foreign body and prompt removal by oesophagoscopy/bronchoscopy/direct laryngoscopy under general anaesthesia.  </p><p class="abstract"><strong>Results:</strong> The study of 68 children who reported with history /suspicion of foreign body ingestion/aspiration. There were 32 boys and 36 females, 37 cases of foreign body ingestion and 31 cases of foreign body aspiration. The most common foreign body in digestive tract was coin in 26 cases and peanut in the airway.</p><p class="abstract"><strong>Conclusions:</strong> Foreign bodies in aero digestive tract in paediatric age group, is a common problem encountered by the otorhinolaryngologist. Careful assessment, clinical evaluation, radiological investigations with effective management in emergency department prompt removal of the foreign body in the aero digestive tract will lead to reduced mortality and morbidity.</p>

scholarly journals Dehydration in Children with Respiratory Tract Infections in a Pediatric Emergency Department of a Tertiary Hospital

2020 ◽  
pp. 1-6
Author(s):  
Rebeca Sosa ◽  
◽  
Luis Alonso Mata-Perez ◽  
Manuel E Soto-Quiros ◽  
Manuel E Soto-Martinez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Tract ◽  
Respiratory Infections ◽  
Pediatric Population ◽  
Fluid Management ◽  
Tertiary Hospital ◽  
Pediatric Emergency ◽  
Common Finding ◽  
P Value ◽  
Tract Infections

Backgrounds: Dehydration is a common finding the Emergency Department(ED). The main cause of dehydration in the pediatric population is acute gastroenteritis, but it can be present with other illness such as respiratory infections. The aim of this study was to determine the prevalence of dehydration in patients presenting with lower respiratory tract infection (LRTI). Methods: Prospective observational study of patients with LRTI admitted in the ED in a period of three-months. Patients with LRTI were included and assessed with the Clinical Dehydration Scale (CDS) to determine clinical dehydration. Patients were weighted on admission and 24-hours after admission to determine weight change after fluid management. Results: 88 patients with LRTI were included. A total of 23(26.1%) patients presented a degree of dehydration according to the CDS scale. Comparing weight changed on admission and 24-hours later 55.6% had an increased weight. When comparing the grade of dehydration with the CDS scale vs increased weight changed at 24-hours after fluid management, it was statically significant for patients 6 months-1 year(23% vs 64%;p value 0.01), 1-2 years(25% vs 50%;p value 0.05) and >2 years(16% vs 50%;p value 0.03). The most common clinical finding was mild dehydration in 22 patients and moderate/severe in only 1 patient. Conclusions: This is one of the few studies of dehydration in illness not related to gastroenteritis. The key finding of this study was that LRTI in some of the patients were associated with certain degree of dehydration. Not all patients with dehydration were detected using clinical findings and this difference was found using weight changed

Clinical profile of symptomatic congenital cytomegalovirus infection: cases from a tertiary hospital in north India

2020 ◽  
Vol 50 (3) ◽  
pp. 282-284
Author(s):  
Deepanjan Bhattacharya ◽  
Inusha Panigrahi ◽  
Chakshu Chaudhry
Keyword(s):  
Intracranial Haemorrhage ◽  
Tertiary Hospital ◽  
North India ◽  
Common Finding ◽  
Cmv Infection ◽  
Chain Reaction ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
The Mean ◽  
Polymerase Chain

We retrospectively analysed the records of nine infants with polymerase chain reaction proven congenital cytomegalovirus (CMV) infection, of which 66% were born preterm. Microcephaly was a universal finding, followed by hepatosplenomegaly in 89%, while chorioretinitis was seen in only 44% cases. The mean age at diagnosis was 3.5 months. Neuroimaging was abnormal in 78%, with ventriculomegaly being the most common finding followed by T2/FLAIR white matter abnormalities, periventricular cysts and intracranial haemorrhage.

scholarly journals Clinical Profile of Injuries due to Paragliding Accident Attended in a Tertiary Hospital of Western Region of Nepal

2018 ◽  
Vol 11 (02) ◽  
pp. 51-54
Author(s):  
Ishwar Sharma Kandel ◽  
K Acharya ◽  
S Gupta ◽  
B Shrestha ◽  
KB Bista ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Review ◽  
Bone Fractures ◽  
Tertiary Hospital ◽  
Steady Increase ◽  
Time Of Arrival ◽  
Western Region ◽  
Medical College ◽  
Natural Beauty ◽  
Minor Injuries

Introduction: Paragliding is an adventurous aerial sport which is performed regularly in and around Pokhara. The Western Region of Nepal (Especially Pokhara, Parbat, Baglung and Syanjya) is famous not only for its natural beauty but for adventurous sports like paragliding, ultraflight and bungee jumping etc. The growing popularity of paragliding sport has led to a steady increase in the number of associated injuries. Objectives: The main objective of this retrospective review is to find out characteristic of injuries in different of paragliding accidents. Methods: This is a retrospective review of paragliding injury cases who attended emmergency department of Gandaki Medical College, Pokhara, Nepal from June 2009 to May 2016. Demographic profile (Age, sex, address), type of flight, timing of accident, severity and pattern of injures were collected and analyzed using the frequency table. Results: Among 60 people who faced accidents and brought to hospital, four of them with severe multiple trauma were declared dead in the emergency department at the time of arrival. Fifty six patients were injured with varieties of injury. Among 56 survived patients, 14 (25%) were minor injuries and discharged from the Emergency Department after treatment for soft tissue trauma like abrasion or sprain. Twelve patients with polytrauma (Including four chest injury, two abdominal injury with multiple bone fractures) and rest of the patients were admitted and treated/reffered/discharged. Conclusion: Lower limb especially foot and ankle injury were the commonest type of injury followed by spine fracture in paragliding accidents.

TO FIND OUT ELECTRO-CARDIOGRAPHIC CHANGES & ECHO CHANGES IN ALUMINIUM PHOSPHIDE AND ETHYLENE DIBROMIDE POISONING

2020 ◽  
Vol 4 (10) ◽  
Author(s):  
Hemant Nargawe ◽  
Sumeet Sisodiya
Keyword(s):  
Biochemical Analysis ◽  
Histopathological Examination ◽  
Common Finding ◽  
Histopathological Changes ◽  
Ethylene Dibromide ◽  
Medical College ◽  
Aluminium Phosphide ◽  
Urine Examination ◽  
Cardiovascular Involvement ◽  
Careful Clinical Examination

Background & Method: The study was conducted in the Department of Medicine Shyam Shah Medical College and Associated Sanjay Gandhi Memorial Hospital, Rewa (M.P). History was followed by a careful clinical examination i.e. cardiovascular, respiratory and gastrointestinal and nervous system. Investigations had done included routine haematological examination, Biochemical analysis, urine examination, ECG, 2 D. Echo & Histopathological examination was done. Result: ST-T changes were most common finding in Aluminium phosphide poisoning in relation to mortality. However hyperkalemia was the most ominous finding associated with 100% mortality, ECG finding in EDB was normal ECG. The most ominous finding was arrhythmia which was associated with 100% mortality. Survivors of ethylene dibromide poisoning echocardiography was normal in 11 (84.61%) followed by pericardial effusion in 2 (15.38%) patients. Conclusion: Noteworthy finding was absence of correlation between cardiovascular involvement, histopathological changes and ECG findings. It was seen that even if ECG showed normal pattern there were significant histopathological changes in heart. Keywords: electro-cardiographic, Aluminium phosphide, ethylene dibromide & poisoning.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

scholarly journals Profile of Organophosphorus Poisoning

KYAMC Journal ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 133-135
Author(s):  
Joya Debnath ◽  
Arpan Kumar Basak ◽  
Md Zubaidur Rahman ◽  
Anujit Saha
Keyword(s):  
Organophosphorus Compound ◽  
Economic Status ◽  
Frequency Pattern ◽  
Major Health Problem ◽  
Major Health ◽  
The Public ◽  
Medical College ◽  
Phosphorus Poisoning ◽  
Life Threatening ◽  
The Government

Background : Self poisoning with organophosphate pesticides is a major health problem in world wide. Organophosphorus compound poisoning is a very common toxicological emergency encountered at Mirzapur in Tangail. It is particularly common among the rural agricultural worker's which comprise a substantial group of the population of this region.Objective: The objective of this study was to find out the incidence, frequency, pattern of poisoning, outcome and aetiological aspect of Organo phosphorus poisoning patient admitted in Kumudini Women's Medical college Hospital.Methods: A total 366 cases of OPC poisoning were analysed during 1 year from January 2015 to December 2015. The emphasis was given on age, sex, socio-economic status, occupation, motive of poisoning, types of compound consumed its quality, place, distance from referral place and the ultimate outcome.Results: Young population of rural background, particularly agricultural workers were the commonest patients (51.91%). The most common motive of poisoning was with a suicidal intent, both in males (27.59%) and females (66.39%). Financial crisis was one of the most common reasons analysed as the motive behind the poisoning (54.20%). Three hundred forty four Patients recovered and 22 were expired. The major cause of death in these cases was respiratory failure followed by multi-organ failure.Conclusion : Strict of the pesticide act and involving a new policy by the government to educate the public and youth in large about the dangerous, life threatening effects of Organophosphorus compound could help amelerioating the harmful effects of such poisoning.KYAMC Journal Vol. 9, No.-3, October 2018, Page 133-135

Sign in / Sign up

Export Citation Format

Share Document