scholarly journals Analysis of genitourinary trauma patients admitted to the emergency department

2021 ◽  
Vol 15 (2) ◽  
pp. 32-37
Author(s):  
İrfan Aydın ◽  
Erdal Yavuz
Keyword(s):  
Emergency Department ◽  
Tertiary Hospital ◽  
Trauma Patients ◽  
Abdominal Organ ◽  
Survivor Group ◽  
Genitourinary Trauma ◽  
Accompanying Injuries ◽  
Hospital Patients ◽  
Time Of Admission

Background and objective: Genitourinary injuries are commonly encountered in the emergency department but may be over looked in case of multi-trauma. Determining the clinical features of genitourinary injuries will help physicians in the management of genitourinary trauma. Methods: The study was conducted in a tertiary hospital. Patients of all ages, admitted in the emergency department, with trauma between 2015 and 2020 were included and analyzed. The cause of genitourinary trauma, affected organs, any accompanying injury, treatments, mortality status, and laboratory tests related to mortality were obtained from the hospital records and analyzed. Results: During the study period, 87 patients admitted to the emergency department with genitourinary trauma were included in the study. The majority of these patients (n=79) were male. Of the patients, 9.2% died. All the patients in the mortality group had additional injuries. The most frequently injured organ was determined as the kidney (51.7%), followed by the scrotum (25.3%) and penis (8.1%). Additional injuries were observed in 81.6% of the patients. Intra-abdominal organ injuries (19.5%) were the most common accompanying injuries. White blood cell count (WBC), aspartate aminotransferase (AST), alanine aminotransferase ( ALT), blood glucose and creatinine values measured at the time of admission to the emergency department were found to be higher in the non-survivor group. The majority of the patients (81%) were discharged with conservative treatment and follow-up. Conclusion: It was determined that genitourinary injuries were frequently seen with additional injuries. Genitourinary injury should be evaluated carefully, especially in the presence of intra-abdominal organ injuries. Ibrahim Med. Coll. J. 2021; 15(2): 32-37

scholarly journals The Hanging Chin Sign As A Mortality Predictor In Geriatric Patients At The Emergency Department: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Anneloes NJ Huijgens ◽  
Laurens J van Baardewijk ◽  
Carolina JPW Keijsers
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Geriatric Patients ◽  
Lateral View ◽  
X Ray ◽  
Hospital Patients ◽  
Chest X Ray

Abstract BACKGROUND: At the emergency department, there is a need for an instrument which is quick and easy to use to identify geriatric patients with the highest risk of mortality. The so- called ‘hanging chin sign’, meaning that the mandibula is seen to project over one or more ribs on the chest X-ray, could be such an instrument. This study aims to investigate whether the hanging chin sign is a predictor of mortality in geriatric patients admitted through the emergency department. METHODS: We performed an observational retrospective cohort study in a Dutch teaching hospital. Patients of ≥ 65 years who were admitted to the geriatric ward following an emergency department visit were included. The primary outcome of this study was mortality. Secondary outcomes included the length of admission, discharge destination and the reliability compared to patient-related variables and the APOP screener.RESULTS: 396 patients were included in the analysis. Mean follow up was 300 days; 207 patients (52%) died during follow up. The hanging chin sign was present in 85 patients (21%). Patients with the hanging chin sign have a significantly higher mortality risk during admission (OR 2.94 (1.61 to 5.39), p < 0.001), within 30 days (OR 2.49 (1.44 to 4.31), p = 0.001), within 90 days (OR 2.16 (1.31 to 3.56), p = 0.002) and within end of follow up (OR 2.87 (1.70 to 4.84),p < 0.001). A chest X-ray without a PA view or lateral view was also associated with mortality. This technical detail of the chest x-ray and the hanging chin sign both showed a stronger association with mortality than patient-related variables or the APOP screener. CONCLUSIONS: The hanging chin sign and other details of the chest x-ray were strong predictors of mortality in geriatric patients presenting at the emergency department. Compared to other known predictors, they seem to do even better in predicting mortality.

scholarly journals Incidence of COVID-19 in random trauma patients at DHQ Teaching Hospital, Rawalpindi, measures to prevent its spread among patients and health care workers

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 67-70
Author(s):  
Tariq Nawaz ◽  
Bilal Mehmood ◽  
Muhammad Waqas Ayub ◽  
Irfan Malik ◽  
Umar Qaisar
Keyword(s):  
Emergency Department ◽  
Preventive Measures ◽  
Trauma Patients ◽  
Penetrating Injuries ◽  
Blunt Injuries ◽  
Accident And Emergency ◽  
Care Workers ◽  
Total Female ◽  
Male Patients ◽  
Time Of Admission

Background: The objective of the study was to see the incidence of COVID-19 positive, in random trauma patients received in the emergency of abdomen or chest may be penetrating or blunt. Materials and Methods: This study was conducted in the Accident and Emergency department of District Head Quarter Hospital, Rawalpindi. All trauma patients of abdomen or chest either penetrating or blunt admitted from 1-3-20 to 10-6-20 were included, irrespective of age, gender, comorbidities, and COVID-19 status at the time of admission to hospital. Also to see steps of preventive measures taken in the emergency department, operation theatres, and inwards. Results: Total number of trauma patients received in the emergency department of District Headquarter Hospital Rawalpindi during this period was 163. Total male patients: 116. Total female patients:47. Penetrating injuries (firearm or stab wounds): 93. Blunt injuries: 70. All the penetrating injuries were operated as an emergency. Among blunt injuries, 51 were operated 19 were treated conservatively. Preoperatively none of the patients’ COVID-19 test was performed because none of them showed any symptoms likely of COVID-19 such as chest infection, flue, malaise, or fever. After the second postoperative day, 12 of the patients developed respiratory distress and their COVID-19 test was sent. Out of 12 patients, 7 turned out to be COVID-19 positive. Other on the second or third postoperative day 7 patients had fever without chest symptoms and underwent COVID-19 testing. 3 turned out to be COVID-19 positive. So a total of 11 patients were found to be positive for COVID-19. The percentage became 6.7% which is quite high. Conclusion: From this study, its clear in acute trauma patients where you can’t go for the COVID-19 test even then we have to operate may be positive. So every trauma patient should have suspected COVID-19 positive and preventive measures should be taken starting from the emergency department till operation theatres.

Epidemiology of pseudomembranous conjunctivitis in a tertiary hospital: A 2-year retrospective study

2020 ◽  
pp. 112067212095758
Author(s):  
Fernando de-Arriba-Palomero ◽  
Teresa Salvá-Palomeque ◽  
Pablo de-Arriba-Palomero ◽  
Francisco Arnalich-Montiel
Keyword(s):  
Emergency Department ◽  
Complication Rate ◽  
Symptomatic Treatment ◽  
Tertiary Hospital ◽  
Incidence Rates ◽  
Demographic Variables ◽  
Duration Of Symptoms ◽  
Annual Distribution ◽  
Similar Peak

Purpose: To describe the incidence, duration, and complication rate of patients with a clinical diagnosis of pseudomembranous viral conjunctivitis. Methods: A retrospective observational study is performed compiling the data of patients diagnosed as pseudomembranous conjunctivitis at the hospital’s emergency department from June 2016 to May 2018. Demographic variables, duration of symptoms, and follow-up until resolution of the pseudomembranes and associated complications are collected. Results: The incidence rate of pseudomembranous conjunctivitis is 3.47/10,000 people-year and 0.123% of emergency department consultations. The incidence of pseudomembranous conjunctivitis is approximately 20% of the total adenoviral conjunctivitis, with similar peak incidence rates and annual distribution. The presence of pseudomembranes shows a mean duration of 7.86 days. In this series of pseudomembranous patients, 38.4% had at least one of the following complications: 16.7% subepithelial infiltrates (IC 13.0%–21.1%), 20.81% corneal erosions (SE 0.0218, IC 16.7%–25.5%), 3.5% filamentary keratitis (SE 0.010, IC 1.8%–6.0%), and 6.1% subtarsal fibrosis (SE 0.128, IC 3.8%–9.1%). Conclusion: To the best of our knowledge, this is the first study to investigate the incidence and rate of complications of pseudomembranous conjunctivitis. Complications occurred in almost 4 out of 10 patients. The mean duration of the follow-up in the ED was higher in patients with any complication compared with non-complicated patients. The high complication rate makes a closely follow-up advisable, until pseudomembrane resolution, to assess possible complications and symptomatic treatment.

scholarly journals The Burden of Hand Injuries at a Tertiary Hospital in Sub-Saharan Africa

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
P. Makobore ◽  
M. Galukande ◽  
E. Kalanzi ◽  
S. C. Kijjambu
Keyword(s):  
Road Traffic ◽  
Tertiary Hospital ◽  
Hand Injuries ◽  
Sub Saharan Africa ◽  
Trauma Patients ◽  
The Road ◽  
Injury Occurrence ◽  
Sub Saharan ◽  
On The Road

Background. Hand injuries are common worldwide and lead to heavy financial losses in terms of treatment, job loss, and time off duty. There is paucity of data on hand injuries in sub-Saharan Africa. The aim of this study was to determine the burden and early outcomes of hand injuries at a tertiary hospital.Method. A descriptive prospective study. Eligible patients were recruited over 5 months and followed up for four weeks. Pain, nerve function, and gross functions of the hand were assessed.Results. In total 138 patients were enrolled out of 2940 trauma patients. Of these, 122 patients returned for follow-up. The majority of the patients were males (83%). Mean age was 26.7 years (SD 12.8). The commonest places of injury occurrence were the workplace (36%), home (28%), and on the road (traffic crushes) (23%). Machines (21.3%) were the commonest agent of injuries; others were knives (10%) and broken glass (10%). Sixty-three (51%) patients still had pain at one month.Conclusions. Hand injuries accounted for 4.7% of all trauma patients. Road traffic crushes and machines were the commonest causes of hand injuries. Men in their 20s were mostly involved. Sensitization for prevention strategies at the workplace may be helpful.

scholarly journals Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
David A. Jaques ◽  
Patrick Saudan ◽  
Chantal Martinez ◽  
Axel Andres ◽  
Pierre-Yves Martin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Blood Pressure Monitoring ◽  
Laboratory Data ◽  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
Renal Transplant Recipients ◽  
Linear Regression Models ◽  
Hospital Patients

Abstract Background Hypertension (HT) is associated with adverse outcomes in kidney transplant (KTX) recipients. Blunting of physiological decrease in nighttime compared to daytime blood pressure (non-dipping status) is frequent in this setting. However, weather non-dipping is independently associated with renal function decline in KTX patients is unknown. Methods We retrospectively screened KTX outpatients attending for a routine ambulatory blood pressure monitoring (ABPM) (T1) at a single tertiary hospital. Patients had two successive follow-up visits, 1 (T2) and 2 (T3) years later respectively. Routine clinical and laboratory data were collected at each visit. Mixed linear regression models were used with estimated glomerular filtration rate (eGFR) as the dependent variable. Results A total of 123 patients were included with a mean follow-up of 2.12 ± 0.45 years after ABPM. Mean age and eGFR at T1 were 56.0 ± 15.1 and 54.9 ± 20.0 mL/min/1.73m2 respectively. 61 patients (50.4%) had sustained HT and 81 (65.8%) were non-dippers. In multivariate analysis, systolic dipping status was positively associated with eGFR (p = 0.009) and compared to non-dippers, dippers had a 10.4 mL/min/1.73m2 higher eGFR. HT was negatively associated with eGFR (p = 0.003). Conclusions We confirm a high prevalence of non-dippers in KTX recipients. We suggest that preserved systolic dipping is associated with improved renal function in this setting independently of potential confounders, including HT and proteinuria. Whether modification of dipping status by chronotherapy would preserve renal function remains to be tested in clinical trials.

scholarly journals Comparison of the Characteristics of Asymptomatic and Presymptomatic Patients with Coronavirus Disease 2019 in the Republic of Korea

2021 ◽  
Vol 11 (4) ◽  
pp. 354-363
Author(s):  
Miri Hyun ◽  
Ji Yeon Lee ◽  
Jae Seok Park ◽  
Jin Young Kim ◽  
Hyun Ah Kim
Keyword(s):  
Clinical Manifestations ◽  
Tertiary Hospital ◽  
Chest Radiographs ◽  
Reactive Protein ◽  
Asymptomatic Patients ◽  
Group A ◽  
The Republic ◽  
Group B ◽  
Time Of Admission

Abstract Purpose This retrospective study aimed to evaluate the baseline characteristics of asymptomatic patients with coronavirus disease 2019 at admission and to follow-up their clinical manifestations and radiological findings during hospitalization. Methods Patients with coronavirus disease 2019 who were asymptomatic at admission were divided into two groups—those with no symptoms until discharge (group A) and those who developed symptoms after admission (group B). Patients who could not express their own symptoms were excluded. Results Overall, 127 patients were enrolled in the study, of whom 19 and 108 were assigned to groups A and B, respectively. The mean age and median C-reactive protein level were higher in group B than in group A. All patients in group A and one-third of patients in group B had normal initial chest radiographs; 15.8% and 48.1% of patients in groups A and B, respectively, had pneumonia during hospitalization. One patient in group B, whose condition was not severe at the time of admission, deteriorated due to aggravated pneumonia and was transferred to a tertiary hospital. Conclusion We summarize the clinical characteristics during hospitalization of patients with coronavirus disease 2019 who were purely asymptomatic at the time of admission. The majority of asymptomatic patients with coronavirus disease 2019 were discharged without significant events during hospitalization. However, it may be difficult to predict subsequent events from initial chest radiographs or oxygen saturation at admission.

scholarly journals Pain assessment and management of trauma patients in an emergency department of a tertiary hospital in Tanzania

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
George D. Dilunga ◽  
Hendry R. Sawe ◽  
Irene B. Kulola ◽  
Juma A. Mfinanga ◽  
Nanyori J. Lucumay ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Assessment ◽  
Tertiary Hospital ◽  
Trauma Patients

scholarly journals Feasibility and Efficacy of Text-Messaging to Promote Care Among Trauma Patients Screened for HIV at an Urban Tertiary Emergency Department in Tanzania

2021 ◽  
Author(s):  
Gimbo M Hyuha ◽  
Hendry Robert Sawe ◽  
Said Kilindimo ◽  
Raya Mussa ◽  
Masuma Gulamhussein ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Text Messaging ◽  
Standard Care ◽  
Intervention Group ◽  
Text Message ◽  
Control Group ◽  
Trauma Patients ◽  
Hiv Negative

Abstract BackgroundDue the high prevalence of Human Immune Virus (HIV), provider-initiated HIV testing for patients attending any health care setting is recommended. However, follow-up and linkage to care by those tested remains poor. We determined the feasibility and efficacy of text-messaging to promote follow-up among otherwise healthy trauma patients who underwent provider-initiated HIV testing and counseling at an Emergency Department (ED) in Tanzania. Material and methodsThis randomized controlled trial was conducted at Muhimbili National Hospital (MNH) ED between September 2019 to February 2020. Adult trauma patients consenting to HIV testing and follow-up text messaging were randomized to standard care (pre and post-test counseling) or standard care plus a series of 3 text-message reminders for follow-up in an HIV clinic, if positive, or retesting, if negative. Investigators blinded to study assignment called participants 2-months after the ED visit if HIV positive, or 4 months if HIV negative. We compared the proportion of people in the intervention and control groups completing recommended follow- up. Secondary outcomes were proportion accepting testing, agreeing to receive SMS and follow-up compliance by HIV status. ResultsOf 290 patients approached, 255 (87.9%) opted-in for testing and consented to the study. The median age of the study population was 29 [IQR 24-40] years. 127 (49.8%) were randomized to the intervention group and 128 (50.2%) to the control group. The short message service (SMS) system verified that 381 text messages in total were received. We traced 242 (94.9%) participants: 124 (51.2%) from intervention group and 118 (48.8%) controls. 100 (39.2%) subjects reported attending a follow-up visit, of which 77 (60.6%) were from the intervention group and 23 (17.9%) were controls. (RR = 3.4, 95%CI (2.3-5.0) resulting in number needed to treat (NNT) of 2.3. Of 246 HIV negative participants, 37% went for repeat-screening: 59% of those in the intervention group and 16% in the control group (RR= 3.7, P =<0.0001, NNT 2.3). Among 9 positive patients, all 5 in the intervention group and 3 of 4 controls had follow-up visits. ConclusionAutomated text message is a feasible and effective way to increase follow up in HIV tested individuals in a limited income country.

scholarly journals Development of wound management record form for traumatic persons in Emergency Department, Maharaj Nakorn Chiang Mai Hospital

2021 ◽  
Vol 60 (2) ◽  
Author(s):  
P Kuntapanom ◽  
◽  
S Wangsrikhun ◽  
A Sukonthasarn ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Wound Management ◽  
Developmental Study ◽  
Trauma Patients ◽  
Emergency Nurses ◽  
Additional Information ◽  
Wound Assessment ◽  
Paper Form ◽  
Full Body

Objectives To develop a wound management record form for traumatic patients in the emergency department and to explore the feasibility of using the form to record wound management of traumatic patients in an emergency department. Methods This developmental study used the National Health and Medical Research Council’s Guide to the Development of Clinical Practice Guideline (1999) as the research framework for development of the record form. The form was tested for feasibility by 20 emergency nurses who recorded wound management for 70 trauma patients who also completed a Wound Management Record Form Feasibility Questionnaire. The data were analyzed using descriptive statistics. Results The Wound Management Record Form developed was a one-page paper form which includes a checklist, standard abbreviations, a full-body anatomical picture for recording location, and space for additional information. The form includes five components: wound assessment, wound cleansing, wound closure and dressing, antibiotics and vaccination, and follow-up. Evaluation of use of the form found the completeness of components 1-5 to be 88.57, 82.86, 90.00, 81.43, and 82.86 percent, respectively. The majority of participating nurses either agreed or strongly agreed that the form was easy and convenient, precise and valid, appropriate as a wound management record for the emergency department, and saved time in recording information. The majority felt the form to be effective and feasible for use in an emergency department. Conclusion The Developed Wound Management Record Form is both appropriate and feasible for use in emergency departments.

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