scholarly journals Pattern of head injuries in patients admitted in tertiary trauma Centre.

2020 ◽  
Vol 27 (05) ◽  
pp. 921-928
Author(s):  
Muhammad Ali ◽  
Muzamil Dilber ◽  
Moti Ram Bhatia ◽  
Abdul Razaque Mari ◽  
Hamid Akbar Shaikh ◽  
...  
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Head Injuries ◽  
Tertiary Care ◽  
Trauma Centre ◽  
University Hospital ◽  
Trauma Unit ◽  
Bone Window ◽  
Medical University

Objectives: The aim of study to know the pattern of injury in terms of severity & outcome in patients with head injuries admitted in trauma unit of a tertiary care Centre. Study Design: Descriptive Study. Setting: Trauma Centre, Peoples medical university hospital Nawabshah. Period: From June, 2018 to May, 2019. Material & Methods: This included 385 patients admitted in trauma unit of Neurosurgery Department of Peoples medical university hospital Nawabshah, through emergency Department with head injury sustained due to road traffic accident, fall, sports related injuries or Assault etc as evident on CT scan brain (plain) with bone window. Patients with poly trauma, bleeding disorders, previously operated and those who failed to turn up in OPD for follow up were excluded.  Glasgow Coma Scale (GCS) was used for categorizing the subjects with head injury into mild (GCS 14-15), moderate (GCS 9-13) and severe injury (GCS 3-8). CT scan brain with bone window was done in all patients. These were then managed accordingly according to the severity of the injuries. Follow up Glasgow Coma Outcome scale was used to assess the outcome in these patients. Results: Regarding nature of traumatic injuries in these patients commonest were contusion (21.8%), extradural hematoma (27.5%), subdural hematoma (22.3%), diffuse axonal injury (13.2%), and subarachnoid hemorrhage (4.2%). This was followed by skull fracture (7.3%) and intracerebral hemorrhage (3.6%). Majority of the patients were with severe head injury. Glasgow Outcome Scale of Patients at Follow- up reveled complete recovery in 106 (27.5 %), Mild disability in 81(21.0%), Moderate Disability in 64 (16.6%), Severe Disability in 72 (18.7%), Persistent Vegetative state in 36 (9.4%), and death in 26 (6.8 %). Conclusion: Good outcome is observed in patients who are properly treated by continuous monitoring & timely surgical intervention in a tertiary care hospital.

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

scholarly journals Clinical and laboratory follow-up after hospitalization for COVID-19 at an Italian tertiary care center

2021 ◽  
Author(s):  
Michele Spinicci ◽  
Iacopo Vellere ◽  
Lucia Graziani ◽  
Marta Tilli ◽  
Beatrice Borchi ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
Tertiary Care Center ◽  
Persistent Symptom ◽  
Post Discharge

Abstract We evaluated 100 post-acute COVID-19 patients, a median of 60 days (IQR 48-67) after discharge from the Careggi University Hospital, Italy. Eighty-four (84%) had at least one persistent symptom, irrespective of COVID-19 severity. A considerable number of hospital re-admission (10%) and/or infectious diseases (14%) during the post-discharge period was reported.

Follow-Up Care Barriers for Patients with Orofacial Clefts

2021 ◽  
pp. 105566562110421
Author(s):  
Joshua Van Swol ◽  
Bethany J. Wolf ◽  
Julia Toumey ◽  
Phayvanh Pecha ◽  
Krishna G. Patel
Keyword(s):  
Outcome Measure ◽  
Tertiary Care ◽  
University Hospital ◽  
Exclusion Criteria ◽  
Actual Patient ◽  
The Mean ◽  
Return Visits ◽  
Significant Factors ◽  
Patient Attendance

Objective The aim of this study was to evaluate whether a patient with a cleft's age, associated syndrome, cleft phenotype or travel distance affects their follow-up rate. Design This study is a retrospective review of patients with CL/P treated by a craniofacial clinic. Setting The setting was a craniofacial clinic at a tertiary care university hospital. Patients, Participants Candidates were patients seen by the craniofacial clinic between January 2007 and December 2019. An initial pool of 589 patients was then reduced to 440 due to exclusion criteria. Interventions None Main Outcome Measure(s) The outcome measure was actual patient attendance to the craniofacial team compared to the team goal expectation of annual return visits. Results The mean age of participants at the end of the study was 9.0 ±  5.4 years with a mean follow-up period (total possible follow-up period length based on patient age at presentation and study window) of 5.5 ±  3.6 years. There was no association between cleft phenotype, type of syndrome, or distance to the clinic with attendance. Children with syndromes had an 11% decrease in the odds of attending follow-up visits with each 1-year increase in age compared to a 4% decrease in children without syndromes. Conclusions The only significant factors determining patient attendance were the presence of a syndrome and increasing age.

Oronasal Transfixion Suture to Prevent Uplifted Nasal Floor Deformity in Cleft Lip and Palate Patients: A 5-Year Follow-Up

2018 ◽  
Vol 56 (3) ◽  
pp. 390-394
Author(s):  
Yuta Nakajima ◽  
Shunsuke Yuzuriha ◽  
Fumio Nagai ◽  
Kenya Fujita ◽  
Masahiko Noguchi
Keyword(s):  
Private Practice ◽  
Cleft Lip ◽  
Chart Review ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
University Hospital ◽  
Nasal Floor ◽  
Orbicularis Oris Muscle

Objective: In unilateral cleft lip and palate, the reconstructed nasal floor is sometimes uplifted regardless of the reconstructive method used. We used a 5-0 absorbable anchoring suture, the oronasal transfixion suture (ONT suture), to fasten the reconstructed nasal floor to the orbicularis oris muscle to prevent this deformity. This study was performed to evaluate the effects of the ONT suture. Design: Blind retrospective study of photography and chart review. Setting: Shinshu University Hospital, tertiary care, Nagano, Japan. Private practice. Patients: Ninety-three consecutive patients with unilateral complete cleft lip and palate who had undergone primary nasolabial repair in our department and affiliated hospitals between 1999 and 2011 participated in this study. Finally, 45 patients were included. Interventions: The ONT suture was put in place at the time of primary nasolabial repair. Main Outcome Measure: The height of the nasal floor was evaluated on submental view photographs at 5 years old. Results: The ONT suture was applied in 21 patients. The height of the nasal floor on the cleft side was significantly closer to that on the noncleft side with the ONT suture than without the ONT suture ( P = .008). Conclusions: The ONT suture is effective to prevent uplifted nasal floor deformity on the cleft side// in unilateral complete cleft lip and palate at the time of primary nasolabial repair.

scholarly journals Post-infectious Bronchiolitis Obliterans: HRCT, DECT, Pulmonary Scintigraphy Images, and Clinical Follow-up in Eight Children

2020 ◽  
Vol 8 ◽  
Author(s):  
I-Chen Chen ◽  
Jui-Sheng Hsu ◽  
Yu-Wen Chen ◽  
Yi-Ching Liu ◽  
Yen-Hsien Wu ◽  
...  
Keyword(s):  
Bronchiolitis Obliterans ◽  
Study Data ◽  
University Hospital ◽  
Pulmonary Scintigraphy ◽  
Chest X Ray ◽  
Clinical Profiles ◽  
Medical University ◽  
Post Infectious ◽  
Hrct Finding

Background: Bronchiolitis obliterans (BO), first mentioned in 1901, is a severe and rare chronic lung disease in children. BO has various etiologies and the most common in children is post-infectious BO (PIBO). High resolution CT (HRCT) is an often-used image tool for the diagnosis of BO, and pulmonary scintigraphy is an alternative tool that can functionally evaluate BO. Recently, dual-energy computed tomography (DECT) have also been applied to BO for its accuracy and safety. Here we described the characteristics of HRCT, pulmonary scintigraphy, DECT, and the clinical profiles of patients with PIBO.Methods: This is a retrospective and descriptive study. Data were collected from patients diagnosed with PIBO from 2014 to 2019 in the Pediatric Cardiopulmonary Outpatient Clinics of Kaohsiung Medical University Hospital. The diagnosis was based on clinical, chest X-ray, and HRCT findings. Clinical profile, radiological characteristics, and images of pulmonary scintigraphy were documented.Results: Eight children (4 boys and 4 girls) were diagnosed with PIBO at a mean age of 25.8 months (range 15 to 41 months). Two of our patients developed pulmonary hypertension. The most common HRCT finding is mosaic pattern, where match ventilation/perfusion (V/Q) defects is a general feature in pulmonary scintigraphy. DECT pulmonary blood vasculature images revealed various degrees of decreased perfusion and is compatible with the decreased perfusion on pulmonary scintigraphy.Conclusion: The therapeutic strategy of PIBO is still lacking of standardization. HRCT and V/Q scans are important image tools in diagnosis and follow-up of BO. DECT may be used in BO patients as it has no additional radiation exposure and add value on functional information of HRCT.

Incidence of head injury and traumatic brain injury among people with Alzheimer’s disease

2019 ◽  
Vol 73 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Sarianna Ilmaniemi ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Jari Tiihonen ◽  
Sirpa Hartikainen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Injuries ◽  
Community Dwelling ◽  
University Hospital ◽  
Health Concern ◽  
Increased Risk

BackgroundInjuries caused by falling are a major health concern among older population. For older people, falls are the leading cause of head injuries; especially, persons with cognitive disorders have an increased risk of falling.ObjectiveTo compare the incidence of head injury and traumatic brain injury (TBI) among persons with Alzheimer’s disease (AD) with persons without AD.MethodsThis register-based study was conducted on a nationwide cohort, which includes all community-dwelling persons diagnosed with AD in Finland in 2005–2011. Persons with previous head injuries were excluded, leaving 67 172 persons with AD. For each person with AD, a matching person without AD and previous head injury were identified with respect to age, sex and university hospital district. The Cox proportional hazard model and competing risk analyses were used to estimate HR for head injury and TBI.ResultsPersons with AD had 1.34-fold (95% CI 1.29 to 1.40) risk of head injuries and 1.49-fold (95% CI 1.40 to 1.59) risk of TBIs after accounting for competing risks of death and full adjustment by socioeconomic status, drug use and comorbidities.ConclusionPersons with AD are more likely to have a head injury or TBI incident than persons without AD.

scholarly journals Acute and Chronic Posterior Pituitary Insufficiency Among Traumatic Brain Injury Patients at a Tertiary Care Center

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A623-A623
Author(s):  
Imtiyaz Ahmad Bhat ◽  
Moomin Hussain Bhat ◽  
Shariq Rashid Masoodi ◽  
Javid Ahmad Bhat ◽  
Zafar A Shah ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Diabetes Insipidus ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Posterior Pituitary ◽  
Urinary Osmolality ◽  
Pituitary Dysfunction

Abstract Background: Traumatic brain injury (TBI) is the leading cause of death and disability in young adults. Disorders of salt and water balance are the most commonly recognized medical complications in the immediate post-TBI period and contribute to early morbidity and mortality. Objective: We aimed to evaluate the prevalence of acute (during hospital stay) and chronic posterior pituitary dysfunction in patients of head injury admitted at our tertiary care hospital. Study Design: Prospective, Observational study. Participants: 136 patients, attending tertiary care in North India with TBI with radiological evidence of head injury. Methodology: The severity of brain injury was assessed by the Glasgow Coma Scale (GCS), and Modified Rankin Scale (MRS) score at the time of admission. Lab measurements, apart from routine CBC and biochemical tests, included tests of serum and urinary osmolality, serum sodium, cortisol, and thyroid function test during the hospital stay. All patients were monitored closely during the hospital stay. Surviving patients were evaluated at 3, 6, and 12 months of follow-up. Urinary output and water deprivation tests were done to determine chronic posterior pituitary dysfunction. The results were compared against normative data obtained from 25 matched, healthy controls. Serum & urinary osmolality was measure by the freezing point method. Diabetes insipidus (DI) and Syndrome of inappropriate ADH secretion (SIADH) were diagnosed according to standard criteria. Results: Of 136 patients admitted, 61 (44.85%) had a mild head injury (GCS, ≤8), 47 (35.55%) had a moderate injury (GCS, 9-12), and 27 (19.85%) had a severe injury (GCS, 13-15). DI occurred in 10 patients (7.4%), while SIADH was observed in 4 patients in the immediate TBI period. Risk factors for diabetes insipidus were GCS of ≤ 8 at admission, midline shift, and surgical intervention. DI was an independent risk factor for death. There was a negative correlation between the presence of DI and GCS score (r, -0.367). Most of the patients with DI (8 out of 10) died during the hospital stay. One patient persisted to have partial diabetes insipidus and another one SIADH at three months post-TBI; both patients had recovered at six months of follow-up. No new case of DI or SIADH occurred on the follow up to 12 months. Conclusion: The incidence of acute DI in severe head injury (GCS ≤ 8) could be an indicator of the severity of TBI, and associated with increased mortality as most of our patients died during the hospital stay.

scholarly journals Effect of Designed Practice Guidelines on Nurses’ Performance and Outcome of Children with Head Injuries

2020 ◽  
Vol 1 (2) ◽  
pp. 12
Author(s):  
Khadiga M. Said ◽  
Safaa F. Deraz ◽  
Amal G. Sebaq
Keyword(s):  
Brain Injury ◽  
Head Injury ◽  
Practice Guidelines ◽  
Head Injuries ◽  
Management Strategies ◽  
Pediatric Neurosurgery ◽  
Personal Characteristic ◽  
University Hospital ◽  
Knowledge And Practice ◽  
Nurses Knowledge

Contexts Acute head injury resulting from a trauma to the head, leading to brain injury or bleeding within the brain, it can cause edema and hypoxia. Head injury is the leading cause of death in the first four decades of life. Effective nursing management strategies for children with severe traumatic brain injury are still a remarkable issue and a difficult task for neurologists, neurosurgeons, and nurses. Aim: To evaluate the effect of designed practice guidelines on nurses' performance regarding the care of children with head injuries. Methods: A quasi-experimental research design utilized to conduct the current study on pediatric neurosurgery departments of Benha University Hospital and Benha Teaching Hospital. A purposive sample of 72 children with head injuries and a convenient sample of all available nurses. They were 62 nurses who are working on the previously mentioned study settings. Four tools used to collect data in this study. A structured interviewing questionnaire sheet developed to assess the studied nursing personal characteristic of the studied nurses and nurses' knowledge regarding head injuries. Child medical data record developed to assess children's personal and head injuries characteristics for children. Glasgow coma scale adopted to assess the child conscious level. Observational checklists to assess the actual nurses' practices regarding the care of children with head injuries. Results: There was a statistically significant improvement in nurses' knowledge and practice regarding the care of children with head injuries before and after the implementation of designed practice guidelines (p˂0.001). There was a statistically significant improvement regarding the occurrence of convulsion after the implementation of the program. Conclusion: The study concluded that the implementation of designed practice guidelines for nurses improves their knowledge and practice as well as reduced occurrence of frequency, duration, and timing of convulsion, which support the current research hypotheses. The study emphasizing the importance of implementing of designed practice guidelines for nurses caring of children with a head injury to reduce the occurrence of head injury complications, which is an effective and safe non-invasive intervention in neurosurgery and emergency departments as a standard of care for all head-injured children.

The “swing-ding”: a golf-related head injury in children

2011 ◽  
Vol 7 (1) ◽  
pp. 111-115 ◽  
Author(s):  
Arthur Wang ◽  
Alan R. Cohen ◽  
Shenandoah Robinson
Keyword(s):  
Head Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Golf Club ◽  
Temporal Region ◽  
Cerebral Contusion ◽  
Neurological Sequelae ◽  
Unique Pattern ◽  
Adult Supervision

Object In recent years there has been an increased incidence of golf-associated head injuries in children and adolescents. At the authors' institution, they have identified a unique pattern of head injury associated with a swinging golf club. In this study, the authors highlight the mechanism of this injury and report their experience treating it. Methods The authors reviewed the database of Rainbow Babies and Children's Hospital Trauma Center and performed a retrospective analysis of golf injuries recorded over a 10-year period (January 2000–April 2010). They identified 13 children (9 boys and 4 girls) who sustained head injuries in golfing accidents. All patients were 10 years of age or younger. The medical charts were reviewed and follow-up interviews were conducted to better delineate the details of the injuries. Results Injuries included 13 depressed skull fractures, 7 epidural hematomas, and 1 cerebral contusion. All 13 patients sustained their injuries after being struck in the head by a golf club. Seven sustained injuries on the follow-through of the initial swing and 3 sustained injuries on the backswing. All but one patient required neurosurgical intervention. Five patients developed neurological sequelae. None of the children had prior experience with golf equipment. All but one injury occurred in the child's own backyard. There was no direct supervision by an adult in any of the cases. Conclusions Golfing can lead to serious head injuries in children. The authors noticed a unique pattern of golf-related head injuries, previously not described, that they have termed the “swing-ding.” This golf club–inflicted injury occurs when a child stands too close to a swinging golfer and is struck in the head, subsequently sustaining a comminuted depressed skull fracture in the frontal or temporal region, with or without further intracranial injury. The study suggests that a lack of adult supervision, minimal previous golf experience, and proximity of the child to the swinging golfer are all implicated in this head injury pattern.

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