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 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 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 23 (1) ◽  
pp. 19-24
Author(s):  
Md Mahmudul Islam ◽  
Khondkar A K Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Flail Chest ◽  
Ventilatory Support ◽  
Tube Thoracostomy ◽  
Female Ratio ◽  
Chest Wall Injury ◽  
One Year

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after trauma. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Methods: This is an observational study carried out in the department of Casualty, Chittagong Medical College Hospital over a period of one year (from April 2015 to March 2016). All the patients (both male and female) admitted in the casualty units within the specified period were included in this study. Result: The mean age was found 37.7±18.1 years and male-female ratio was 11.8:1. Almost one third (35.7%) patients were affected by road traffic accident. 42(27.2%) patients were found open pneumothorax followed by rib fracture-41(26.6%), haemopneumothorax-31(20.1%), pneumothorax- 14(9%), haemothorax-12(7.8%), chest wall injury-6(3.9%), tension pneumothorax-5(3.2%), and flail chest-3(1.9%). 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. Re-insertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients recovered well, 43(27.9%) patients developed complications and 6(3.9%) patients died. Conclusion: Most of the patients were in 3rd decade with male predominance. Road traffic accident was the commonest cause and open pneumothorax was the commonest chest trauma. Three-fourths were managed by tube thoracostomy. Nearly one third of the patients had developed complications and about four percent of patients died. Journal of Surgical Sciences (2019) Vol. 23 (1) : 19-24

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 Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Medical College Hospital ◽  
Care Hospital ◽  
Vaginal Fistula ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Vesico Vaginal Fistula

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117

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 Epidemiological Analysis of Maxillofacial Injuries in Road Traffic Accidents: A Peripheral Hospital Based Study

2020 ◽  
Vol 28 (1) ◽  
pp. 10-16
Author(s):  
Satadal Mondal ◽  
Indranil Sen ◽  
Rabi Hembrom ◽  
Swagato Roy ◽  
Rupam Sinha ◽  
...  
Keyword(s):  
Young Adults ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Common Type ◽  
Medical College Hospital ◽  
Road Traffic Accidents ◽  
College Hospital ◽  
Medical College ◽  
Number Of Patients ◽  
Maxillofacial Fractures

Introduction The aetiology of maxillofacial fractures is greatly influenced by geographic location, socioeconomic status of the cohort, and the period of investigation. The aim of this study is to analyze and identify characteristics of maxillo-facial fractures that took place in and around Midnapore- Kharagpore city of West Bengal and who presented to a peripheral medical college hospital during a period of 1 year. Materials and Methods    A detailed database analysis was performed based on data collected from the patients of Road Traffic Accidents (RTA) with sustained facial trauma admitted to General Surgery and Otorhinolaryngology ward of a peripheral medical college hospital. Detailed clinical examination as well as radiological data was collected. Results The highest frequency of maxillo-facial injury due to RTA was among the young adults 18-40 years. Most common type of injury encountered is abrasion (44%) followed by bruise and closed fracture. Mandible is the most common bone to get fractured and most common type of Le fort type is Type II. Significant number of patients having RTA were young adults under the influence of alcohol riding in two-wheeler . ConclusionWith the increasing incidence of RTA awareness must be created concerning safety rules and more policies need to be addressed.

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