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

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.

2020 ◽  
Vol 2 (1) ◽  
pp. 38-41
Author(s):  
Arbindra Kumar Yadav ◽  
Jagat Narayan Rajbanshi ◽  
Saroj Kumar Kushwaha ◽  
Pankaj Raj Nepal

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.


Author(s):  
Rishabh Gupta ◽  
Shavi Mahajan ◽  
Deepika Dewan ◽  
Rajat Gupta

Background: Hand injuries are very common in this industrialized world. Significant number of patients report every day to the emergency department with various patterns of hand injuries. It is important to understand these patterns in order to plan proper management and develop safety protocols aimed at preventing these injuries.Methods: The present cross sectional study was conducted among 150 patients presenting with Open hand injuries, in the OPD and emergency of Post Graduate Department of Orthopaedics, Government Medical College, Jammu over a period of one year from January 2010 to December 2010.Results: Out of 150 cases 131(87.33%) were males and 19 (12.67%) were females. The commonest age group affected was 21-30 years (34%) followed by 11-20 years (23%). Maximum injuries 90 (60%) occurred in the time interval from 4 pm to midnight. Majority of patients 67 (45%) sustained injury while at work.  Occupation-wise 37 (25%) patients were unskilled workers, mainly laborers, 35 (23%) were farmers, while the remainder belonged to various other professions. In this series machine injuries, assault and road traffic accidents accounted for most injuries, representing 61 (41%), 25 (17%) and 16 (11%) patients respectively. Traumatic amputation (30%) was the most common injury. The index (21%) and middle (21%) fingers were involved more commonly. Tendon injuries (31%) were more frequent than compound fractures (23%).  Conclusions: Hand trauma predominantly affects young males who have occupational exposure to different machines. A proper understanding of the pattern of injury will help in better management.


Author(s):  
Thankamma P. George ◽  
C. S. Sreedevi ◽  
Sreekumari K.

Background: Injuries of the chest causing disruption of the thoracic cage, damaging the great vessels are increasing daily. Aorta is most vulnerable to injury in deceleration trauma from road and air accidents, fall from height and penetrating injuries. Incidence of traumatic rupture of the aorta is rising with higher travel speed.  Methods: In this study we analysed the pattern of injury to great vessels and the socio-demographic pattern of the victims in trauma. 250 cases brought to a tertiary care institution for autopsy were studied from 1st January 2005 to 30th November 2005 (1st July 2005 - 30th November prospectively, and 1st January - 30th June 2005, retrospectively). A cross sectional study design including all cases of trauma to the chest was done with consecutive sampling. Data was collected in pro forma and analysed.Results: 206 victims were males. Commonest cause of chest injury was trauma. 130 (52%) were victims of road traffic accidents and the vehicle implicated the most was bus (41 cases, 16.4%). Pedestrians constituted the majority (26.4%). 15 cases (6%) involved major blood vessels of the thorax. Descending part of the thoracic aorta was vulnerable, with transection of the great vessels in 5 cases (2%). Haemothorax was observed in 102 cases on right side and 94 cases on the left side. 9 cases (4%) of bronchial or tracheal ruptures with 6 cases of severance and 3 incidences of tear were recorded.Conclusions: The wound of aorta or pulmonary artery are immediately fatal and commonly seen in case of vehicular accident or fall from height due to the intense compression to the chest with or without any sign of external injury. Most ruptures are due to automobile accidents and the mechanism of injury is sudden motion of the heart and great vessels.


2022 ◽  
Vol 9 (3) ◽  
pp. 16-21
Author(s):  
Sudatta Waghmare ◽  
ashish Aswar ◽  
Hiranya Deka ◽  
Aman Singh ◽  
Arjav Nanavati ◽  
...  

Abstract Background: Head injury is considered as a major health problem in developed and developing nations. Analysis of etiology, patterns, and outcome of head injury in trauma patient is essential for understanding and planning for better management. Materials and Methods: The prospective observational study carried out among patients who presented with head injury at the tertiary care hospital, Mumbai from July 2015 to July 2017. Demographic details recorded were age, sex, blood pressure on arrival, Glasgow Coma Scale (GCS) score, the interval between injury and admission, associated injury, co-morbidities, hospital stay, and outcome. Results: The age group at which maximum patients of head injury were admitted was 18-29 years (31%) followed by 40-49 years (21%). Eighty one percent patients were males and 19% patients were females, the male to female ratio being 4:1. Road traffic accidents (36% cases) were the commonest cause leading to acute head injury followed by accidental fall (21% cases). 47% patients presented with mild head injury according to GCS. Conclusion: Head injuries mainly caused by vehicular accidents and affect mainly the young men. Road traffic accidents were the commonest mode of head injury, but railway accident had the worst outcome in our study. Factors associated with outcome were Pre-hospital delay, GCS on arrival, Blood pressure on arrival, Associated injury, Need for ventilator support, CT scan findings.


2021 ◽  
Vol 8 (14) ◽  
pp. 904-908
Author(s):  
Kumaran R ◽  
Yogaraj S

BACKGROUND Road traffic accidents (RTA) account for most of the injury patients encountered in the department of emergency resulting in significant death and morbidity. The current research was conducted to analyse the demographic, clinical and radiological profile of patients presenting with RTA to a tertiary care teaching hospital (Velammal Medical College Hospital and Research Institute). METHODS This cross-sectional observational study was done among 68 subjects presenting with RTA to the department of emergency medicine. Detailed history taking, clinical & radiological investigations including plain radiographs, ultrasound and computed tomography (CT) were done. Site of injury was considered as primary outcome of the study. The data was analysed statistically by deriving mean and standard deviation. International Business Machines Statistical Package for the Social Sciences (IBM SPSS) version 22 was used for statistical analysis. RESULTS Among the study population, the mean age was 36.18 ± 13.73 years. 83.82 % were males. Individuals aged less than 40 years of age were greatly involved in RTA. Majority (77.9 %) had abdominal injuries followed by 36.7 % with craniofacial trauma, 25 % had thoracic trauma, 17.6 % had spinal trauma, and 10.2 % had extremity and pelvic bone injuries. In abdominal trauma, spleen (26.4 %) was the commonly affected organ. Liver (25 %) and renal injuries (16.17 %) were next commonly observed. A significant difference (P-value < 0.05) was found in abdominal injuries due to different types of vehicles. CONCLUSIONS RTIs are common in the younger population. The predominance of the male population was seen. The most common organ to be injured was spleen. Proper understanding of the pattern of trauma may help in improving the outcome. Early diagnosis, aggressive resuscitation and timely surgical intervention were essential in improving the outcome in trauma patients. KEYWORDS Road Traffic Accidents, Road Traffic Injuries, Head Injury, Blunt Abdominal Trauma, CT Scan


Author(s):  
Siddharth Rao P. S. ◽  
Sumayya Nazneen Sayyada ◽  
Souri Reddy Pyreddy

Background: Road traffic accidents (RTAs) are a major cause of misery, disability and death globally, with a disproportionate number occurring in developing countries. With COVID-19 reaching pandemic proportion, a nationwide lockdown was announced on 24 March 2020 which resulted in the complete closure vehicular movement. This study aimed to assess the impact of lockdown on the number of RTAs brought to our rural tertiary care teaching hospital situated on National highway number 65.Methods: Medico-legal records were reviewed retrospectively at Kamineni institute of medical sciences hospital. The cases were classified into two groups. The pre-lockdown group included cases reporting to casualty from 1 April 2019 to 31 July 2019. The lockdown group included cases reporting to casualty from 1 April 2020 to 31 July 2020. Patient demographics, type of injury, time of injury, mode of injury were collected for all cases and analysed using simple mathematical tools.Results: There was a significant decrease in the total number of RTAs during lockdown phases 1 and 2 and during unlocking phases 1 and 2 by 52.1%. Bike skid was the most common mode of injury. The highest number of RTAs was observed between 6 am to 6 pm and the most commonly affected gender was male especially in the age group of 15-45 years.Conclusions: RTA numbers can be reduced by strict implementation of traffic rules and better road infrastructure. One positive effect of the measures implemented to control the spread of COVID-19 was the reduction of traffic accidents and mass casualties.


Author(s):  
Celastina Synthia ◽  
. Rameshwar

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%).


2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.


Author(s):  
Tanuja R. Brahmankar ◽  
Sachin K. Sharma

Background: Medico-legal case (MLC) can be defined as a case of injury or ailment, etc., in which investigations by the law-enforcing agencies are essential to fix the responsibility regarding the causation of the said injury or ailment. Medico-legal cases are an integral part of medical practice that is frequently encountered by medical officers working in casualty. Hence the present study is carried out to find out the frequency and pattern of medico-legal cases reported at a tertiary care hospital and to highlight the vulnerable gender, age, residence and the cause. Methods: It is a record based cross sectional study in which all the MLC cases registered in MLC record book during a period of 6 months (January 13– June 13) were included. Cases found non medico-legal were excluded. Variables considered were gender, age, residence and cause. Findings were expressed in numbers and percentages. Results: Total cases were 2350, of which 1866 (79.4%) were males and 484 (20.6%) were females. Maximum cases were from the age group of 21-30 years i.e., 828 (35.2%). 1440 (61.27%) were residents of urban area. Most of the medico-legal cases registered were due to assault (27.2%) followed by medical examination of prisoners(25.9%), road traffic accidents (19.7%), fall (6.9%), snake bite (6.6%), poisoning (4.3%), domestic injuries (4.3%), unknown bite (2.2%), unknown found at railway station (1.6%), brought dead (0.6%), burn (0.2%) & others (0.5%). Conclusions: Majority of the victims were males, young adults and urban inhabitants. Most common indication for medico-legal cases was assault followed by medical check-up of prisoners and road traffic accidents. 


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