scholarly journals Emergency management of maxillary dentoalveolar fracture: A case report

2021 ◽  
Vol 9 (2) ◽  
pp. 76-79
Author(s):  
Archana H. Dhusia ◽  
Heena Sonawane ◽  
Rishi S Verma ◽  
Pooja Uchale ◽  
Harshada Jagdale
Keyword(s):  
Traffic Accidents ◽  
Alveolar Bone ◽  
Road Traffic ◽  
Physical Violence ◽  
Sports Injury ◽  
Arch Bar ◽  
Good Patient Compliance ◽  
History Of ◽  
Tissue Attachment

Dentoalveolar trauma occurs in relation to injuries of fall, road traffic accidents, sports injury or physical violence. There may be injury limited to the tooth, or may involve the periodontium around, or in severe cases, alveolar bone or oral mucosa may be traumatised. There can be myriad injuries of the same structure depending upon the severity of impact. The injuries of tooth most commonly being crown fractures, followed by root fractures, luxation or complete avulsion of the tooth. Every type of dentoalveolar injury requires a specific set of clinical protocols to be followed in order to successfully diagnose and manage the particular case.We hereby report a case of a 29-year-old male patient with a history of fall under the influence of alcohol, who had fallen flat on his face and had suffered intrusive luxation of permanent maxillary right central incisor and avulsion of permanent maxillary left central and lateral incisors. The exarticulated teeth still had slight soft tissue attachment to the socket. On the patients first visit to dental OPD, being a dental emergency, the avulsed teeth were immediately restored back into the socket under local anaesthesia after adequately irrigating and debriding the socket, followed by repositioning of the internally luxated tooth, so that all were in their correct anatomical position. After checking for occlusion, they were splinted in position with Erich’s arch bar and 26 gauge SS wire and after giving post-operative instructions patient was asked to follow up after 6 weeks. At 6 weeks, the affected teeth were found to be firm and so arch bar were removed. Patient was advised to follow up further. At periodic follow ups, the patient was asymptomatic and maintained adequate oral functioning of the injured teeth, thus with good patient compliance and proper diagnosis and treatment, dentoalveolar fractures can be managed successfully. The main purpose of this article is to lay emphasis on the timing of treatment of the dentoalveolar injuries. The earlier they are managed, the better is the outcome.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

scholarly journals Assessment of the Sexual Violence Situation in a Regional Hospital in Guatemala: The Need for a Multidisciplinary Clinic

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S105-S105
Author(s):  
Blanca Soto ◽  
Miriam Canet ◽  
Diego Erdmenger
Keyword(s):  
Sexual Violence ◽  
Physical Violence ◽  
Negative Impact ◽  
Epidemiological Data ◽  
Depth Analysis ◽  
Significant Negative Impact ◽  
Comprehensive Health ◽  
History Of ◽  
Hepatitis B Testing

Abstract Background Sexual violence is a global health problem, in terms of age and sex, showing a significant negative impact on health. Incidence in Guatemala is among the highest of the region reaching an average of 23 cases reported daily nationally per statistics from the Ministry of Health in 2015. Methods Retrospective analysis of the database of all sexual violence cases reported from a secondary -level national hospital in Guatemala from January 2005 to September 2015 (period A) and in-depth analysis on demographic and epidemiological data along with information of the follow-up of cases between January 2012 and September 2015 (period B) was performed. Results Period A: 500 cases; female (96%; 481/500). Assault occurred between 16–20 years (34%; 163/481) 11–15 years (22.25%; 107/481), and 21–30 years (22.04%; 106/481). From all reported male cases, 73.68% (14/19) occurred under 15 years. Period B: 154/217 (70.96%) cases included; female (95.45%; 147/154), mean age: 17.87 years. Assault occurred in public spaces (57.14%; 88/154) and victim’s home (29.87%; 46/154). Almost 13% of victims reported history of previous assault, 5.84% by the same aggressor. More than one aggressor participated in 36.37% of assaults. Physical violence was associated in 57.79% of cases. Most victims (92.76%; 141/152) consulted within 72 hours of the assault. HIV, VDRL, and Hepatitis B testing performed in 100, 52, and 33.77%, respectively, were negative. Follow-up visits at 3, 6, and 12 months after the aggression were attended by 20.78% (30/154), 1.95% (3/154), and 1.95% (3/154) of victims, respectively. Psychology support was completed only in 18.18% (28/154). Emergency contraception was provided when indicated; pregnancy as result of the aggression was reported in nine cases (5.84%). Conclusion The study shows that young women were the most vulnerable group for sexual violence. There is a lack of multidisciplinary approach and follow-up. Interventions on infectious diseases screening have to be optimized to reduce the risk of ETS transmission. This evidence supports the need for a specialized clinic to ensure access to comprehensive health services for victims. Disclosures All authors: No reported disclosures.

scholarly journals OUTCOME OF CEREBRAL CONTUSIONS DUE TO TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 11 (1) ◽  
pp. 39-43
Author(s):  
Zubair Ahmed Khan ◽  
Habib sultan ◽  
Amir Aziz ◽  
Shahrukh Rizvi ◽  
Tauqeer Ahmed ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
Male And Female ◽  
Duration Of Hospital Stay ◽  
History Of ◽  
Age Range

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traffic accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.

scholarly journals Visual Function of Drivers and its Relation to the Occurrence of Road Traffic Accidents in Saudi Arabia

2021 ◽  
Vol 9 (B) ◽  
pp. 1016-1020
Author(s):  
Sulaiman Aldakhil ◽  
Godwin Ovenseri-Ogbomo ◽  
Majid Moafa ◽  
Waleed Alghamdi ◽  
Muhammed Alluwimi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Binocular Vision ◽  
Visual Function ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Health Examination ◽  
Road Traffic Accidents ◽  
Good Visual Acuity ◽  
History Of ◽  
Eye Examination

BACKGROUND: The mortality rate due to road traffic accidents (RTA) is significantly high in Saudi Arabia (SA) compared to other countries. The visual function which includes good visual acuity (VA) and binocular vision are very important factors that can contribute to the incidence of RTA. AIM: The aim of this study is to investigate the association between refractive errors (REs) and the RTA in SA. METHODS: A total of 354 participants (mean age 22.67 ± 3.22 years) were recruited randomly to participate in this study from the population of Qassim district. Data collected using the questionnaire included participants’ age, sex, and education level, ocular and medical history, driving history as well as history of RTA. Ocular health examination including VA, RE measurements, and binocular vision function vision was measured and analyzed. RESULTS: The results of this study show that 48.3% of drivers had some form of REs with 3.4% being visually impaired. 217 (61.3%) of participants have had an RTA, and 119 (54.9%) of them have had more than two accidents in the past two years. The findings show no significant association between the occurrence of RTA and uncorrected REs or binocular vision dysfunction. CONCLUSION: Our data showed significantly higher rate of RTA among Saudi drivers which is much higher than any country in the world. The current Saudi regulations for obtaining driving license need to be modified, with implementing a comprehensive eye examination prior to acquiring or renewing drivers’ licenses.

scholarly journals Titanium Clamps for a Simple Low-Profile Autologous Osteosynthesis in the Reconstruction of Posttraumatic Craniofacial Convexital Skeletal Disruption

2017 ◽  
Vol 10 (1) ◽  
pp. 29-34 ◽  
Author(s):  
AmosOlufemi Adeleye ◽  
ToluyemiAdefolarin Malomo
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Low Cost ◽  
Low Resource ◽  
Low Profile ◽  
The Aesthetic ◽  
Craniofacial Defects ◽  
Profile Technique ◽  
Prospective Database

Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up. The clinical data of 18 patients, all males, mean age 31.3 years (standard deviation, 9.7), were analyzed. Road traffic accidents (RTAs) were the cause of trauma in 14 of 18 patients (78%) and motorcycle crash, none helmeted, in 10 of the 18 patients (71% of RTAs). Out of 18 cases, 17 were open fractures; 89% suffered mild head injury, and associated brain injury on CT scan included pneumocephalus in 6 (5 of them significant); acute extradural hematoma in 4 and subdural in 2, and brain contusions in 9. The surgery was successful in all the cases: operative time <3 hours in 10 cases (56%), the in-hospital outcome was good in 95%. The median follow-up time was 24 months, in 6 of the 18 cases for ≥36 months. There was no case of surgical site infection in the perioperative or the follow-up period to date. The aesthetic outcome was also acceptable. This surgical technique for the reconstruction of PTCD appears effectual. Although its low cost makes it very attractive therein, it appears to be actually also recommendable even outside the low-resource developing countries.

Death from a driverless vehicle

2017 ◽  
Vol 86 (1) ◽  
pp. 52-54
Author(s):  
Siddhartha Das ◽  
Ritesh G Menezes
Keyword(s):  
Carbon Monoxide ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Carbon Monoxide Poisoning ◽  
Road Traffic Accidents ◽  
Traffic Fatalities ◽  
Autopsy Findings ◽  
Sequence Of Events ◽  
The World ◽  
History Of

Road traffic accidents are a major cause of fatalities around the world, and a number of deaths are caused by moving traffic on public roads. Deaths from vehicles that are off the highway may be called non-traffic fatalities which can be due to a vehicle reversing, carbon monoxide poisoning, weather-induced over-heating inside the vehicle and electric windows. Children (and animals) are the usual victims. We report a case from India where a man was found lying dead by the roadside with a lorry nearby. The autopsy findings indicated that he had been run over, but as there was no history of a vehicular collision and with no eyewitnesses, the investigators were unsure of the probable sequence of events that led to his death. The autopsy findings, history, circumstantial evidence and chemical analysis enabled us to work out what had happened.

scholarly journals Mineralising Angiopathy of Lenticulostriate Vessels in Childhood: Series of Four Cases

2021 ◽  
Author(s):  
Kapil Jetha ◽  
Rashmin Cecil ◽  
Sarthak Soni ◽  
Somashekhar M Nimbalkar
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Acute Onset ◽  
Healthy Children ◽  
Paediatric Hospital ◽  
Excellent Functional Outcome ◽  
History Of ◽  
Work Up

Mineralising lenticulostriate vessels’ angiopathy is becoming an important recognisable cause of ischaemic stroke in healthy children post trauma or fall. The usual presentation is a focal neuro-deficit of acute onset following trivial trauma in infancy with or without seizures/dystonia. The authors conducted a retrospective chart review of children diagnosed with stroke in a tertiary care paediatric hospital. Based on clinical and radiological features, children diagnosed with mineralising angiopathy with basal ganglia stroke in the last two years were identified, data was retrieved from the hospital’s electronic database and included in the study. Also, the patients were contacted telephonically in case of missing data. Out of the four cases, three were less than 18-month-old, and one was 52- month-old. All were normal before illness and had a history of trivial trauma {except one who had Road Traffic Accident (RTA)} followed by hemiparesis. Investigations for other aetiologies of stroke were non contributory. With antiplatelet therapy and iron supplements, most did well with an excellent functional outcome at follow-up. None of the children had recurrence during follow-up. In a typical case, an extensive work-up is not required.

scholarly journals Study of cases of head injury in a government hospital in rural Indian setting

2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Government Hospital ◽  
History Of ◽  
Gcs Score

Background: Head injury can be defined as trauma in which the head is struck or moves violently, resulting in transient or permanent alteration of consciousness of an individual. We profiled and analyzed the cases of head injuries reporting to a government hospital a rural Indian setting.Methods: All the patients with history of antecedent head injury were firstly assessed by detailed history, with emphasis on history of unconsciousness/vomiting/convulsions/ENT bleed. Then a thorough clinical examination was undertaken, including Glasgow Coma Scale (GCS) scoring. Further, all the patients were subjected to CT scan of head for correlation of clinical findings, confirmation of diagnosis, delineation of extent of disease and suitability of operative intervention etc.Results: Majority of the patients belonged to 15-44 years age group (30, 60%) and were males (38, 76%). Road traffic accidents accounted for majority (38, 76%) of the cases. GCS score was found to range between 13-15 (mild) in 18 (36%) patients, 9-12 (moderate) in 21 (42%) patients and 3-8 (severe) in 11 (22%) patients. Best recovery (88%) was shown by patients of GCS score between 13-15. Among the critical symptoms and signs, unconsciousness and abnormal plantar reflex were the commonest ones. Generalized cerebral edema without associated lesion (50%) was the commonest finding followed by extradural hematoma (EDH) (40%) on CT scan of head. As for recovery w.r.t. CT scan findings, highest rate of recovery (100%) was reported in patients with fracture without intracranial pathology, while highest mortality was reported in those having mixed lesion (90%).Conclusions: Road traffic accidents in young age group is the commonest mode of head injury and GCS score is a good predictor of recovery in head injury cases.

scholarly journals Crooked nose correction: an institutional experience

2019 ◽  
Vol 5 (5) ◽  
pp. 1270
Author(s):  
Anandita Das
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Physical Violence ◽  
Nasal Reconstruction ◽  
Road Traffic Accidents ◽  
Blunt Force ◽  
The Road ◽  
Crooked Nose ◽  
Blunt Force Trauma ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Crooked noses pose a particular challenge in nasal reconstruction, even for the most experienced of surgeons, as there is inevitably a combination of functional and aesthetic abnormalities which need to be addressed. Crooked nose deformity is a common presentation in the ENT clinic due to raise in the road traffic accidents.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study conducted in the Department of ENT, GMCH. All the cases of crooked noses presenting to our department was included in the study. The patients were subjected to a proper history and thorough physical examination. Preoperative nasal analysis was done using photography and nasal endoscopy. The type of intervention for each patient and their outcome was analyzed.  </p><p class="abstract"><strong>Results:</strong> The majority of the crooked nose was due to blunt force trauma sustained during road traffic accidents (RTA) or during physical violence. In all crooked nose with an external deformity, there is an underlying septal deformity. The aim of the surgery is to achieve an aesthetically pleasing and a physiologically functioning nose.</p><p><strong>Conclusions:</strong> From the present study, we can conclude that the majority of the crooked nose was due to blunt force trauma sustained during road traffic accidents or due to physical violence. Besides having a considerable external deformity, majority of the cases also had functional problems too and this two aspects could be addressed properly by doing a septorhinoplasty. </p>

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