scholarly journals Management of Chest Trauma in Bangladesh Perspective: Experience of a Decade

2019 ◽  
Vol 12 (1) ◽  
pp. 3-8
Author(s):  
Md Anisuzzaman ◽  
Suman Nazmul Hosain ◽  
Md Mohsin Reza ◽  
Md Golam Kibria ◽  
Shahnaz Ferdous
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Medical College ◽  
The Mean ◽  
Fractured Ribs ◽  
Complications And Mortality ◽  
Simple Indicator ◽  
Overall Mortality

Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this study, we present our 10-year experience in the management and clinical outcome of 437 chest trauma cases as a result of blunt and penetrating injuries in two medical college hospitals of Bangladesh. Methods: We reviewed 437 cases of chest trauma between January 2006 and December 2015.The mean age of our patients was 33 ± 15 years mostly males with blunt injuries. Patients were evaluated and compared according to age, sex, etiology of trauma, thoracic and extra-thoracic injuries, complications, and mortality. Results: The leading cause of the trauma was road traffic accident (61%) followed by violence (23%). Hemothorax (62%), Pneumothorax (51%), rib fractures (38%), and lung contusion (35%) were the most common types of injury. Associated injuries were documented in 35% of patients (extremities 18%, abdomen 12%, head 5%). Minority of the patients required thoracotomy (6%), and tube thoracostomy (56%) was sufficient to manage the majority of cases. Mean hospital stay was 5.5 ± 4.8 days. The overall mortality rate was 3.6%. Conclusion: Road traffic accident was the most common cause of chest trauma rather than violence in this series, this necessitates epidemiologic or multi-institutional studies to know what are the causes of RTA contributes to chest trauma in Bangladesh. The number of fractured ribs can be used as simple indicator of the severity of trauma. Cardiovasc. j. 2019; 12(1): 3-8

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

scholarly journals Management of jaw fractures in oral surgery in public and private practice: a retrospective study from 2006 to 2017

2019 ◽  
Vol 26 (1) ◽  
pp. 3
Author(s):  
Corentin Buron ◽  
Christian Mounier ◽  
Carine Guiavarc'h ◽  
Cédric Lansonneur ◽  
Matthieu Conan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Public Hospital ◽  
Road Traffic ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Jaw Fractures ◽  
The Mean

Introduction: To date, no epidemiological studies on jaw fracture have examined its characteristics according to hospital status (public vs private). The aim of this study was to examine their differences in terms of patient- and injury-related variables. Methods: A retrospective study was conducted using patients' medical records in 2 types of hospital located in the northern area of Brittany (France). All patients hospitalized for jaw fracture between 2006 and 2017 were eligible. Comparisons between centres according to age, gender, anatomic location of fracture, mechanism of injury, and length of stay were undertaken using χ2, Fisher exact test, t-test, and Cochrane-Armitage trend test. Results: A total of 142 patients were included: 45.1% in the public and 54.9% in the private hospitals. Of them, 84.5% were men and the mean age was 32.0. Main causes of fractures were assault (56.3%), fall (30.3%) and road traffic accident (10%). A small number of patients had polytrauma (4.2%). The mean duration of stay was less than 2 days. Compared to patients who were admitted in private hospital, those who were likely to be admitted in public hospital were those: who had a jaw fracture in context of road traffic accident (18.8% vs 2.6%), with polytrauma (9.4% vs 0.0%) and maxilla fracture (9.4% vs 1.3%), and who had a longer stay (2.2 vs 1.1 days). Conclusion: This study showed that differences observed in characteristics of jaw fractures between public and private hospitals may be due to recruitment process: more severely affected patients are likely to be admitted in the public hospital.

scholarly journals Epidemiologic Characteristics of Patients Presenting with Head Injury due to Road Traffic Accident and Factors Associated with Outcome: Experience of a Tertiary Care Center in Northern Kerala

2019 ◽  
Vol 08 (01) ◽  
pp. 039-046
Author(s):  
Mandaka Rajeev ◽  
Vattaparambil Shinihas ◽  
Pankaj Chauhan
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Alcohol Intake ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Health Resources ◽  
Medical College ◽  
History Of ◽  
Limited Health

Abstract Background In India, most factors related to road traffic accident (RTA) causation and outcome go improperly documented, and database regarding RTA-related traumatic brain injury (TBI) seems inadequate. Two-wheeler drivers form the largest segment of people affected by RTA. The socioeconomic and neurologic burden, imposed by TBI due to RTAs (largely preventable), is overwhelmingly significant, especially for a developing country like India. Materials and Methods Descriptive study involving patients, presenting to the casualty of Government Medical College, Kozhikode, Kerala, was performed, and various demographic features were analyzed. Usage of helmet and history of alcohol intake were also noted. Patients were evaluated according to their presenting Glasgow coma scale (GCS), investigated and either operated or managed conservatively, and their outcome was assessed with Glasgow outcome score (GOS) at 3 months. Results Bike drivers formed the single largest proportion of RTA victims (53.7%). Proportion of helmet users was 17.9%, whereas 21.9% were found with history of alcohol intake. There was a consistent trend toward a favorable outcome in patients with no alcohol intake (17.08% deaths compared with 34.07% patients with alcohol intake) and with helmet usage (14.55% compared with 22.18% in patients without helmet). However, the absolute contribution of these factors cannot be inferred. Conclusion Various factors related to RTA need evaluation for pooling and compilation of data at regional and national levels. Mandatory helmet laws and strict implementation and provision of subsidized helmets (standard, full coverage) will go a long way in reducing the burden on limited health resources.

scholarly journals Outcome of Antegrade Interlocking Intramedullary Nailing in Fracture Shaft of the Femur in Community Based Medical College Hospital, Bangladesh

2015 ◽  
Vol 4 (1) ◽  
pp. 13-17
Author(s):  
Mamunur Rashid Chowdhury ◽  
Md Anwarul Haque ◽  
Md Nasir Uddin ◽  
Md Saiful Islam ◽  
Sabrina Alam Mumu ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Medical College Hospital ◽  
Community Based ◽  
College Hospital ◽  
Common Cause ◽  
Medical College

Day by day road traffic accident in Bangladesh is increasing. Mymensingh-Dhaka highway passes beside the Community Based Medical College Hospital, Bangladesh. We often have to manage a greater number of traumatic patients. In road traffic accident the incidence of fracture shaft of femur is the most common. That's why my study was done to evaluate the result of management of fracture shaft of the femur with antegrade interlocking intramedullary nailing under the department of Orthopedic Surgery in CBMCH,B in the period between January 2009 to July 2013. Total 88 patients were selected for interlocking nailing initially in the study. Out of them 8 patients did not report in subsequent follow up. So the result of the study was based on 80 patients (48 males; 32 females) with the range of 20- 68 years of age. The average age of the patient was 36 years. Motor vehicle accidents was the most common cause of fracture shaft femur (65%) and the second most common cause was fall from height (20%) specially fall from tree. Among the patients; right sided femur involvement was 67.5% (54) and left sided femur involvement was 32.5% (26). The majority fracture of the shaft of the femur was lower third (70%). The patients were mostly in the day-laborers' groups (35%), and, the next group was students. The mean union time was 18 weeks with the range of 15-30 weeks. After operation, complications were found such as; infection 3.75%(3), non-union 1.25% (1). Excellent functional outcome was found in 82.5% (66), good in 12.5% (10), fair in 5%(4). This functional outcome study was evaluated by Klemm & Borner 1 criteria. CBMJ 2015 January: Vol. 04 No. 01 P: 13-17

scholarly journals EXTENSIVE ANTERIOR WALL ST ELEVATED MYOCARDIAL INFARCTION FOLLOWING STEERING WHEEL IMPACT AND BLUNT CHEST TRAUMA IN A ROAD TRAFFIC ACCIDENT: A RARE CASE REPROT

2020 ◽  
Vol 8 (12) ◽  
pp. 1059-1064
Author(s):  
Sayani Banerjee ◽  
◽  
Pranay Anil Jain ◽  
Santosh Kumar Singh ◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Road Traffic Accident ◽  
Blunt Chest Trauma ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Anterior Wall ◽  
Steering Wheel

Background: Blunt trauma chest may rarely lead to acute myocardial infarction. Shear force generated from trauma causes tearing, laceration of coronary vascular intima and results in intraluminal thrombosis. Left anterior descending (LAD) artery is the most common to be involved secondary to its proximity to anterior chest wall. Case Presentation: We report a case of 38year old hypertensive male presented in emergency room with complaints of left sided chest pain & diaphoresis for one hour following trauma to his chest from steering wheel following a collision between two four wheeler. During primary survey as per ATLS guideline 12 ECG revealed acute extensive anterior wall STEMI. Other associated injuries were left frontal non hemorrhagic contusion, bilateral minimal pneumothorax, multiple bilateral rib fractures, mild hemoperitoneum with small hematoma in retroperitoneum and serosal surface of stomach. Urgent coronary angiography done by cardiologist on call and patient was diagnosed with single vessel coronary artery disease involving LAD with severe systolic LV dysfunction. Percutaneous transmural coronary angioplasty (PTCA) was done by a drug eluting stent in LAD. Conclusion: An emergencyphysician should consider cardiac complications in patients with chest trauma including myocardial infarction, early diagnosis of which is critical to save the myocardium.Any delay in diagnosis can be detrimental. What we already know? There are quite a few case reports that already mentioned about possibility of acute myocardial infarction after blunt chest trauma following road traffic accident secondary to intimal laceration of coronary artery and intraluminal thrombosis. Most coomonly left anterior descending artery is involved. What this paper adds?This is rare case report of acute & extensive anterior wall myocardial infarction secondary to single vessle coronary artery involvement after blunt chest trauma by steering wheel in a road traffic accident. We specifically points towards the fact that noobvious Clinical guideline to manage these kind of cases mentioned in literature.Hence proper clinical guidelines to manage such kind of cases. Also, in acute myocardial infarction post blunt trauma chest, PCI seems to be a better option than thrombolysis keeping in mind of other injuries.

scholarly journals Clinical Evalution of the Results of Jewett Nail Plate Fixation for Trochanteric Fracture

1970 ◽  
Vol 15 (2) ◽  
pp. 78-80
Author(s):  
Bipul Kumar Dam
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Plate Fixation ◽  
Nail Plate ◽  
Trochanteric Fracture ◽  
Trochanteric Fractures ◽  
Medical College ◽  
Type Of Fracture

This study was carried out on 53 patients admitted in the Department of Orthopaedics,Rajshahi Medical College who were admitted with trochanteric fractures and were operated.Among them, 37 (69.81%) patients had their fracture due to fall on the ground during walkingand 16 (30.19%) sustained injury due to road traffic accident. Regarding type of fracture 30(56.60%) had stable fracture and 23 (45.40) had unstable fracture.doi: 10.3329/taj.v15i2.3913TAJ December 2002; Vol.15(2): 78-80

A Study of Injury Pattern among Road Traffic Accident Victims Admitted in a Medical College in Amritsar

2016 ◽  
Vol 7 (4) ◽  
pp. 59
Author(s):  
Harpreet Kaur ◽  
Rana Ranjit Singh ◽  
Manbachan Singh
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Injury Pattern ◽  
Medical College

scholarly journals Postmortem Study of Head Injury in Fatal Road Traffic Accidents

1970 ◽  
Vol 5 (2) ◽  
pp. 24-28 ◽  
Author(s):  
M Ahmad ◽  
FN Rahman ◽  
MH Chowdhury ◽  
AKMS Islam ◽  
MA Hakim
Keyword(s):  
Head Injury ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Parietal Bone ◽  
Medical College ◽  
Abdominal Organs ◽  
One Year ◽  
Type Of Fracture

This study was conducted at the Dhaka Medical College (DMC) morgue among 100 postmortem cases of Road Traffic Accident (RTA) victims over a period of one year. The objective of this study was to find out incidences of head injury among the RTA victims along with other injuries and also to overview the present situation of RTA in the country. Out of 100 cases, 64% were male and 36% female. The highest incidence of RTA (28%) was observed among the age group 31 to 40 years. The highest number of victims were pedestrians (68%). Considering recorded causality by type of collision, hit pedestrian was the most common (39%), followed by head on collision (20%). Regarding injury pattern in different parts of body, all the victims had multiple abrasion and bruise, 90% had laceration, 78% had injury to brain and 77% victims had injury to abdominal organs like liver and spleen. In the skull, Linear/fissured fracture was the commonest type of fracture (36%), followed by comminuted fracture (18%). Temporal bone was observed most prone to be fractured (23%), followed by parietal bone (17%). Most of the victims had subdural haemorrhage (43%), followed by sub arachnoid haemorrhage (36%). Key words: Road traffic accident, head injury, postmortem. DOI: 10.3329/jafmc.v5i2.4579 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.24-28

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