scholarly journals Prevalence of Head Injury of Patients Arriving in a Tertiary Care Center

2020 ◽  
Vol 2 (1) ◽  
pp. 38-41
Author(s):  
Arbindra Kumar Yadav ◽  
Jagat Narayan Rajbanshi ◽  
Saroj Kumar Kushwaha ◽  
Pankaj Raj Nepal
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Emergency Admission ◽  
P Value ◽  
Cross Sectional ◽  
Severity Of Injury

Background and purpose: The prevalence of head injury is increasing with increasing number of automobiles, especially motorbike. With the objective to evaluate the prevalence of head injury and factors that could affect the severity of head injury, this study was performed in a tertiary hospital at far- eastern Nepal. Methodology: This is a cross-sectional study over the duration of one year. Association of age, gender, and mode of injury was checked with severity of injury using Chi-square test where P-value was kept significant at <0.01. Result: Total numbers of patient admitted through the emergency department, during the study period, were 832. Mean age of patient in the study group was 34.59 (SD 18.92) years. Majority of them falls in the category of 20-29 years. Among the different categories of head injuries, mild head injury (76%) was the most common presentation followed by moderate head injury and severe head injury, which were 14% and 10% respectively.  Conclusion: Head injury seems to be the major cause of emergency admission in for eastern part of Nepal. Among them road traffic accidents seems to be the major burden which is more common in young gentlemen with significant number of severe head injury.

Neurotrauma Audit at Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh

2019 ◽  
Vol 16 (02/03) ◽  
pp. 109-112
Author(s):  
Ambuj Kumar ◽  
Ketan Hedaoo ◽  
Jitin Bajaj ◽  
Mallika Sinha ◽  
Shailendra Ratre ◽  
...  
Keyword(s):  
Head Injury ◽  
Injury Severity ◽  
Road Traffic ◽  
Spinal Injury ◽  
Care Center ◽  
Clinical Status ◽  
Tertiary Care ◽  
Treatment Strategies ◽  
Spine Injury ◽  
Severity Of Injury

Abstract Introduction For the prevention and better management of traumatic brain and spine injury patients, it is mandatory to understand the demographic and clinical profiles of cases of a particular region. This study was aimed at describing the epidemiology, pattern, and outcomes of head and spine injury patients at a tertiary care center in central India. Materials and Methods All the patients with head and spine injury admitted to the Department of Neurosurgery between September 1, 2018, and August 31, 2019 were included in the study. Data of all these patients were collected from the medical record section and analyzed for age, sex, mode of injury, severity of injury, management, and outcomes. Results During the study period, 932 patients with head injury and 241 patients with spine injury were admitted to our department. Around 65% of the patients in both head and spine injury categories fell in the age group of 26 to 55 years. Approximately 80% of all neurotrauma patients were male. The most common mode of injury was road traffic accident followed by fall from height. Mortality for severe head injury was 39% and that for ASIA A (American Spinal Injury Association grade A) cervical spine injury was 65%. Conclusion Even after aggressive treatment strategies, morbidity and mortality are very high, and the ultimate outcome depends mainly on the clinical status immediately after trauma. The data from this study can be helpful in strategy-making for the prevention and management of head and spine injury patients, especially in the central Indian population.

scholarly journals Pattern of Injury among Orthopaedic Inpatients in a Teaching Hospital in Central Nepal

2020 ◽  
Vol 16 (4) ◽  
pp. 208-214
Author(s):  
Suraj Bidary ◽  
Suresh Pandey ◽  
Hemant Kumar Gupta ◽  
Roshani Aryal ◽  
Kushal Bhattarai
Keyword(s):  
Head Injury ◽  
Teaching Hospital ◽  
Traffic Accidents ◽  
Clinical Decision Making ◽  
Road Traffic ◽  
Tertiary Care ◽  
Physical Assault ◽  
Cross Sectional ◽  
Pattern Of Injury ◽  
Associated Injury

Introduction: Injury is a major cause of morbidity and mortality globally with the majority of them being orthopaedic in nature and are the resultants of fall, road traffic accidents (RTA), physical assault amongst others. The aim of this study was to determine the patterns of musculoskeletal injury among orthopaedic inpatients in a tertiary care teaching hospital in Nepal. Methods: It was a cross-sectional study conducted in the department of orthopaedic surgery at College of Medical Sciences and Teaching Hospital (COMS-TH), Bharatpur from January to December 2019. Patients presenting with orthopaedic injury and admitted and treated as inpatients were assessed for their demographic details, mode of injury and other patterns of injury and descriptive analysis was done. Results: In a total of 1027 patients, the mean age was 33.4 years (range: 1.0 - 95.0). Most of them (74.5%) were male. Right side was the most predominant side of injury (53.8%). Students were most commonly affected groups (34.8%). RTA was the most common mode of injury (66.9%). The commonest pattern of injury was fracture (70.1%). Closed bony injuries were sustained by 74.1%. Head injury was the most commonly associated injury. Conclusions: The commonest mode of injury was RTA. Closed fracture was the most common type of fracture. Extremity injury was the most common site and head injury was the commonest associated injury. These patterns can serve as valuable tools in clinical decision making and further research studies.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Thyroid dysfunction in patients of metabolic syndrome: A study from a tertiary care center in India

2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Cross Sectional

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.

scholarly journals The estimated cost of surgically managed isolated traumatic head injury secondary to road traffic accidents

2018 ◽  
Vol 44 (5) ◽  
pp. E7 ◽  
Author(s):  
Xinli You ◽  
Boon S. Liew ◽  
Azmin K. Rosman ◽  
Kamarul Imran Musa ◽  
Zamzuri Idris ◽  
...  
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Cost Of Care ◽  
Road Traffic Accidents ◽  
Traumatic Head Injury ◽  
Traumatic Head ◽  
The Mean ◽  
Mean Cost

OBJECTIVETraumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury.METHODSRelevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method. These values were then tabulated to generate the total costs for each patient, via a combination of macro-costing and micro-costing methods. Malaysian currency values were converted to US dollars according to the average conversion rate for the period from January to May 2016: RM1 = US$0.2452.RESULTSThis costing study analyzed data from 49 patients. The estimated cost for the 1st year of care for all patients was RM1,471,919.80 (US$360,914.735), with a mean (± SD) cost per case of RM30,039.18 ± 22,986.25 or $7365.61 ± $5636.23. The mean cost of care per case was RM11,041.35 ± 10,936.88 or $2707.34 ± $2681.72 for mild head injury, RM32,550.00 ± 20,998.76 or $7981.26 ± $5148.90 for moderate head injury, and RM36,917.86 ± 23,697.34 or $9052.26 ± $5810.59 for severe head injury. Severe head injury (p = 0.001), sustaining 2 or more intracranial pathologies (p = 0.01), having a poor Glasgow Outcome Scale (GOS) score (GOS score 1–3) (p = 0.02), requiring a tracheostomy (p < 0.001), and contracting pneumonia (p < 0.001) were significantly associated with higher cost. Logistic regression analysis revealed that cost of care increased by RM591.60 or $145.06 per year increment of age (β = RM591.60, p = 0.05).CONCLUSIONSThe mean cost of treatment for traumatic head injury is high compared to the per capita income of RM37,900 in 2016. The cost values generated in this study provide baseline cost estimates that the authors hope will be used as a guide to determine where adequate funding should be allocated to provide timely and appropriate delivery of care.

scholarly journals Incidence of Benign Paroxysmal Positional Vertigo in Head Injury Patients

2021 ◽  
pp. 188-194
Author(s):  
Celastina Synthia ◽  
. Rameshwar
Keyword(s):  
Head Injury ◽  
Traffic Accidents ◽  
Benign Paroxysmal Positional Vertigo ◽  
Road Traffic ◽  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: Traumatic brain injury is a common secondary cause of  Benign Paroxysmal  Positional Vertigo(BPPV). Objective: To determine the incidence and clinical profile of patients with BPPV in mild and moderate head injury. Materials and Methods: A prospective observational study done in patients admitted with  mild and moderate head injury who developed BPPV from January 2020 to March 2020 in a tertiary care hospital of  South India. Demographic and clinical parameters were noted and were treated with canalith repositioning procedures. Results: Among 42 patients admitted with mild and moderate head injury, 9(21.4%) were diagnosed with BPPV in the follow up. The male female ratio was 2.5:1. The mean age was 44 ±21.4years.Two wheeler accidents contributed to nearly half of (55.6%) traumatic BPPV. Posterior canal was commonly involved in 7(77.8%) followed by horizontal in 2 (22.2%).The type of head injury was mild in 7 (77.8%) and moderate in 2 (22.2%) in traumatic BPPV patients. 5 (55.6%) patients with BPPV had abnormal findings in neuroimaging. 4 (44.4%) patients developed recurrent BPPV in our cohort. Conclusion: The incidence of traumatic BPPV was 21.4% in our study. Road traffic accidents due to two wheeler accidents were the common mode of head trauma. Posterior canal was commonly involved in three fourth of cases. Recurrence of vertigo was documented in 4 (44.4%).

scholarly journals Comparison of Lymphocyte Neutrophil Ratio in Head Injury Patients with Blood and without Intracranial Bleeding in Dr. M. Djamil Hospital

2021 ◽  
Vol 7 (1) ◽  
pp. 164-180
Author(s):  
Muhammad Zaki Abdul Hafiz ◽  
Syaiful Saanin ◽  
Hesty Lidya Ningsih
Keyword(s):  
Head Injury ◽  
Intracranial Hemorrhage ◽  
Severe Head Injury ◽  
Injury Severity ◽  
Intracranial Bleeding ◽  
P Value ◽  
Mild Head Injury ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
The Mean

A B S T R A C TBackground: Head injuries occur every 15 seconds worldwide, with patientsdying every 12 minutes. The value of the Neutrophil Lymphocyte Ratio (NLR) is afactor that influences the assessment and prognostic value of patients withintracranial hemorrhage and without intracranial hemorrhage in head injury.The aim of this study was to determine the relationship between increased NLRbased on the severity of head injury patients with or without intracranialhemorrhage. Methods: This study is a retrospective cross sectional study of headinjury patients with hemorrhage and without intracranial hemorrhage who weretreated at Dr. M. Djamil Hospital Padang in 2020 from May to December 2020.Data was collected in the Medical Records Department of Dr. M. Djamil HospitalPadang who met the inclusion and exclusion criteria. Results : A total of 92patients were included in the inclusion criteria for this study. The results showedthat the mean NLR value in head injury patients was 11.72 with a variation of7.31. The mean NLR level based on the severity of mild head injury was 10.15with a variation of 6.38. The mean NLR level of moderate head injury severity was12.70 with a variation of 7.09. The mean NLR level of severe head injury, was14.69 with a variation of 9.30. The results showed that there was no difference inthe mean of NLR levels in mild head injury patients with hemorrhage and withoutintracranial hemorrhage. The results showed that there was a significantrelationship between NLR levels in moderate head injury patients withhemorrhage (14.20) and without intracranial hemorrhage (7.20) (p value = 0.029),whereas in severe head injury it could not be assessed because there was nosample without hemorrhage. Conclusion: There is an association betweenincreased NLR and intracranial bleeding in moderate head injury patients

scholarly journals A descriptive study of cranio-cerebral injuries admitted in tertiary care center of coastal Andhra Pradesh

2018 ◽  
Vol 32 (2) ◽  
pp. 384-390
Author(s):  
R. Sivakumar ◽  
B.V. Subrahmanyam ◽  
S.V. Phanindra ◽  
Ashok Munivenkatappa ◽  
S. Satish Kumar ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Care Center ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Clinical Aspects ◽  
Retrospective Data ◽  
Cerebral Contusion ◽  
Mean Values ◽  
One Year

Abstract Introduction: Demographic and clinical profile of traumatic brain injury (TBI) of a particular place is very crucial for strengthening the guidelines. The details of same are scant from a tertiary institute, Nellore district. The present study aims to explore the demographic, injury and clinical aspects of cerebro-cranial injury patients from an institute setup. Methods: The study consists of two years retrospective data and one year prospective data. The study was approved by institute ethical committee. The patient data was entered on pre designed proforma that includes the desired variables. The data analysis was done using StatsDirect software. Both prospective and retrospective data was merged for analysis. Percentages for categorical data and mean values for continuous data were calculated. Results: There were total of 336 patients. Patients in age group of 21 to 50 years constituted 67% and males were four times higher than females. Nearly one fourth of patients were influenced by alcohol. Three fourth of accidents were due to road traffic accidents (RTAs) followed by falls (17%) and assault (6%). About one tenth of patients were pedestrians. One fourth of patients had associated injuries other than head and brain. On CT findings majority of patients had cerebral contusion (46%) followed by skull fracture (40%), SDH (28%) and EDH (23%). Twenty two patients died in the study period. Conclusion: Knowledge of injury and its later consequences to public is very important. Strict rules to consider safety precautions and compulsory family insurances should be encouraged. Rules to prevent paediatric drive.

scholarly journals Male genital injuries attending a tertiary hospital in a western region of Nepal: A two-year snapshot.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 337
Author(s):  
Alok Atreya ◽  
Suman Baral ◽  
Ritesh G Menezes ◽  
Samata Nepal
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Medical College ◽  
Medical Issues ◽  
Clinical Scenarios ◽  
Male Genital ◽  
Genital Injuries

Background: Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic intervention may lead to chances of loss of fertility due to infections and anatomical disruption of normalcy. This study highlights the clinical scenarios, etiology and outcome of male genital injury cases that were managed at a tertiary care center in Nepal. Such injuries are not frequently encountered as lack of reporting by patients means cases are rare. The present study is the first from Nepal which depicts a comprehensive report on male genital injuries.   Methods: A retrospective analysis of discharge summaries was carried out and the cases of male genital injuries were reviewed during June 2020. All the treated cases during the two-year period from April 2018 to April 2020 at Lumbini Medical College, Nepal were included in the study.  Results: There were eight cases of genital trauma admitted and treated during the study period. All the patients were males and age ranged from six to 71 years with a mean age of 33 ± 21.45 years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause in the majority of cases.  Conclusion: Superficial injuries to the penis and scrotum do not require surgical exploration and could be managed conservatively. However, deeper and complicated injuries, testicular preservation, the functionality of the part and cosmetic issues are taken into consideration which might require a multi-disciplinary approach. Apart from the medical issues pertaining to genital injuries, there are legal and psychological aspects of such events too which should not be ignored.

scholarly journals A study of correlation of degree of midline shift on computed tomography scan and Glasgow coma scale in patients of acute traumatic head injury

2021 ◽  
Vol 8 (10) ◽  
pp. 3075
Author(s):  
A. K. Chaurasia ◽  
Lalit Dhurve ◽  
Rajneesh Gour ◽  
Rajpal Kori ◽  
Avias K. Ahmad
Keyword(s):  
Computed Tomography ◽  
Head Injury ◽  
Glasgow Coma Scale ◽  
Severe Head Injury ◽  
Road Traffic ◽  
Midline Shift ◽  
Traumatic Head Injury ◽  
Cross Sectional ◽  
Common Cause ◽  
Coma Scale

Background: Traumatic brain injury is one of most common cause of death in road traffic accident. Most of these classified as mild injury, with approximately 20% classified as moderate to severe. Approximate 50% of the 150,000 trauma deaths every year are caused by head injury.Methods: A prospective cross-sectional study was conducted on 150 patients with a head injury admitted in the Hamidia hospital, Bhopal. The assessment of the severity of head injury using Glasgow coma scale (GCS) at the time of admission, follow up on 5 days and 15 days respectively. The collected data were transformed into variables, coded and entered in Microsoft excel. Data were analyzed and statistically evaluated using statistical package for the social sciences (SPSS)-PC-21 version.Results: Out of 150, a total of 115 patients had no midline shift while 35 patients were having midline shift. Severe head injury patients (GCS 3-8) were having more morbidity and mortality. Moderate head injury (GCS 9-13) was associated with good prognosis and low mortality. A greater degree of midline shift of (more than 5 mm) is indicated severe head injury and is significantly associated with morbid outcome and higher mortality.Conclusions: In our study, road traffic accidents is the most common cause of head injury, with males being affected more than females. The degree of midline shift on computed tomography (CT) scan head in patients with head injuries was found to be significantly associated with high mortality and morbidity.

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