A STUDY OF PROFILE OF MULTIDETECTOR COMPUTED TOMOGRAPHY IN MAXILLO-FACIAL INJURIES IN A TERTIARY CARE CENTER

2021 ◽  
pp. 23-26
Author(s):  
Saurabh Shivprasad Kakani ◽  
Saurabh Padiya ◽  
Asmita Surywanshi ◽  
Ejaj Patel
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Ct Scan ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Age Group ◽  
Maxillofacial Injuries ◽  
Facial Injuries ◽  
Orbital Wall

Maxillofacial injuries account for a large group of patients in the emergency department in tertiary care hospital, presenting as an isolated injury or a part of poly trauma. Road trafc accidents are the commonest cause of maxillofacial injuries. Such injuries are clinically important as they cause facial disgurement and thus imposing emotional, morbidity and cosmetic dependence. To observe these fractures and decide appropriate management lines, there is a need for imaging aid. The main purpose of imaging guidance is to nd and characterize the fractures and associated injuries. Aim:Study of prole of multi detector computed tomography in maxillo-facial injury in a tertiary care centre. Materials and methods: The cases coming to the emergency department and then forwarded to department of Radiology, MGM medical college and hospital, Aurangabad for CT scan formed the source of the data and were studied in detail. Detailed history of the cases was taken. Written and informed consent were taken for undergoing CT scan examination. Patients were scanned using 16 slice Toshiba acquilion machine. The data was tabulated and observed and conclusions were made. Results: Total 175 number of patient were included in the study and CT scan for maxillo-facial injuries were conducted. Diagnosis of the maxillofacial injuries were done and the fractures were classied according to age, gender, location and its subsets. According to our study 21-30 years of age group was the most common age group to be involved in maxillo-facial injuries. Frequency of maxillo-facial injuries was found to be more in male than female. Maxillo facial injuries occurred mostly due to road trafc accidents. Orbit was seen as the most common bone to be fractured followed by fracture of maxilla bone. Orbital wall fracture happen to be overall most common bone affected amongst all the other facial bones.

scholarly journals Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki
Keyword(s):  
Tertiary Care Hospital ◽  
Organophosphorus Compounds ◽  
Care Center ◽  
Tertiary Care ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Age Group ◽  
Psychiatric Illnesses ◽  
History Of ◽  
One Year

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

scholarly journals Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Noman Ali ◽  
Nadeem Ullah Khan ◽  
Shahid Waheed ◽  
Syed Mustahsan
Keyword(s):  
Emergency Department ◽  
Enteric Fever ◽  
Care Center ◽  
Tertiary Care ◽  
Practical Importance ◽  
University Hospital ◽  
Categorical Variables ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Continuous Variables

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital. Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever. Results: A total of one hundred and fifty five patients were included. Out of these 97 (62.6%) were males and 58 (37.4%) were females. Most patients (25.2%, n= 39) were diagnosed as malaria followed closely by dengue fever (n=33, 21.3%) and then enteric fever (n= 10, 6.5%). while 41.9% (n=65) were diagnosed as suspected viral fever based on clinical judgment and inconclusive laboratory results. Conclusion: Malaria was found to be the most common confirmed cause of acute undifferentiated fever followed by dengue and enteric fever. The provision of accurate epidemiological data will enable resources to be directed towards key areas and will be of practical importance to clinicians. doi: https://doi.org/10.12669/pjms.36.6.2334 How to cite this:Ali N, Khan NU, Waheed S, Mustahsan S. Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2334 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Donor and tissue profiling at the time of eye donation at a tertiary care hospital in western India

2018 ◽  
Vol 5 (6) ◽  
pp. 2349
Author(s):  
Devdatta J. Gohel ◽  
Atul Kamath M. ◽  
Dhananjay A. Bhosale ◽  
Binita N. Gadhavi
Keyword(s):  
Cause Of Death ◽  
Care Center ◽  
Tertiary Care ◽  
Western India ◽  
Corneal Tissue ◽  
Care Hospital ◽  
Age Group ◽  
Common Cause ◽  
Tissue Profiling ◽  
Eye Donation

Background: The purpose of this study was to analyse the donor and tissue profiling of eyes donated at a tertiary care center in western India.Methods: Eye bank records were analysed for the period December 2014- December 2016. Variables studied included donor demographics (age, gender, ethnicity) cause of death of donor, consent for donation, whether the donation was voluntary or motivated, death to preservation interval, preservation to utilization interval, corneal suitability for transplantation and corneal tissue utilization.Results: During this study period, 200 corneal tissues were retrieved from 100 donors (male: female= 33: 17). The mean age of donors was 63 years (range: 18-91 years). Most common age group of donors belonged to 70-79 year age group. Most of the donors belonged to the class III of socio-economic status (35%). The most common cause of death was cardiorespiratory arrest (63%). Majority donors were voluntary (71%). Most consent for eye donation was given by sons (51%) or daughters (17%). Most of the donations were done at the deceased houses (64%). Mean death to preservation interval was 2.8 hours. Total corneas suitable for transplantation were 43% out of which 20% were utilised with the most common cause for disuse being septicaemia (23%) and poor quality of tissue (57%). Majority of patients had comorbidities with hypertension being most common (76%).Conclusions: With fairly less corneal tissue utilization, there is need for awareness among people in order to know the proper technique of preservation of eyes once death occurs and to increase motivational donations. 

scholarly journals Pattern of skin disorders among pediatric age group cases attending a tertiary health care center

2020 ◽  
Vol 6 (4) ◽  
pp. 511
Author(s):  
Shahul Hameed G. ◽  
Karthik Raja S.
Keyword(s):  
Skin Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Age Group ◽  
Pediatric Age ◽  
Skin Disorders ◽  
College Hospital ◽  
Health Care Center ◽  
Pediatric Age Group

<p class="abstract"><strong>Background:</strong> Skin diseases among the pediatric age group people are more common and it contributes to significant burden to health sectors. Also, the pattern of skin diseases changes consistently with reference to place and time. Hence the present study was conducted to assess the pattern of skin diseases in pediatric age group patients attending a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> The cross-sectional study was conducted by the department of Dermatology, Venereology and Leprosy at Sri Muthukumaran Medical College Hospital and Research Institute, among the pediatric age group patients attending the outpatient department, during the month of October to December 2019. A total of 412 pediatric age group patients with skin disorder were included in the study. The study was conducted using a proforma with the clinical history and diagnosis of the participants. Data was entered in Microsoft excel and data analysis was done using SPSS version 17.<strong></strong></p><p class="abstract"><strong>Results:</strong> The common skin disorders reported in this study includes infections (34.7%) followed by dermatitis (32.3%), infestations (11.4%), miliaria (8.3%), popular urticaria (7.5%) and urticaria (6.1%). Among the infections fungal, bacterial and viral pathogens contributes to 16.3%, 10.9% and 7.5% of cases, respectively. Also 11.2% of cases were found to be infested with scabies (9.2%) and pediculosis (2.2%).</p><p class="abstract"><strong>Conclusions:</strong> Skin disorders in the pediatric age group are common and showing increasing trend. Hence health education of the parents and the school children about good nutrition, hygiene practices, and proper hydration of skin can be promoting in order to reduce the burden of skin disorders.</p>

scholarly journals Evaluation of the frequency of patients with cancer presenting to an emergency department

2020 ◽  
Vol 66 (10) ◽  
pp. 1402-1408
Author(s):  
Cem Isikber ◽  
Muge Gulen ◽  
Salim Satar ◽  
Akkan Avci ◽  
Selen Acehan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Services ◽  
Care Center ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Care Hospital ◽  
Oncological Emergency ◽  
Frequency Of Use ◽  
Hospital Patients ◽  
Use Of Emergency Services

SUMMARY OBJECTIVE: This study aims to determine the demographic characteristics of cancer patients admitted to an emergency department and determine the relationship between the frequency of admission to the emergency department and oncological emergencies and their effect on mortality. METHODS: This observational, prospective, diagnostic accuracy study was performed in the ED of a tertiary care hospital. Patients over the age of 18 who were previously diagnosed with cancer and admitted to the emergency service for medical reasons were included in the study. We recorded baseline characteristics including age, gender, complaints, oncological diagnosis, metastasis status, cancer treatments received, the number of ED admissions, structural and metabolic oncological emergency diagnoses in the ED, discharge status, length of hospital stay, and mortality status. RESULTS: In our study, 1205 applications related to the oncological diagnosis of 261 patients were examined. 55.6% of the patients were male, and 44.4% were female. The most common metabolic oncological emergency was anemia (19.5%), and the most common structural oncological emergency was bone metastasis-fracture (4.6%.) The mean score of admission of patients to the emergency department was four times (min: 1 max: 29) during the study period. A total of 49.4% (n: 129) of the patients included in the study died during follow-up, and the median time of death was 13 days after the last ED admission. CONCLUSION: The palliation of patient symptoms in infusion centers that will be established in the palliative care center will contribute to the decrease in the frequency of use of emergency services.

scholarly journals Hypocalcemia in Elderly Population in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Sangita Thapa ◽  
Rabindra Jang Rayamajhi
Keyword(s):  
Serum Calcium ◽  
Elderly Population ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Age Group ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Introduction: As the medical facilities are improving, the life expectancy is increasing which has led to rapid rise in elderly population. The epidemiology of many diseases in elderly has been modified, including calcium imbalance. This study aims to know the prevalence of hypocalcemia in elderly population visiting a tertiary care center of Kathmandu. Methods: A descriptive cross-sectional study was conducted in a tertiary care center of Kathmandu from March to July 2020 after obtaining ethical clearance (Ref: 2003202007). Total 402 participants at or above 60 years of age groups visiting outpatient departments were included in the study by convenience sampling method excluding those under vitamin D and calcium supplements. Serum total calcium level was measured using standard routine method and corrected with albumin. The serum calcium value less than 8 mg/dl was considered as hypocalcemia in accordance with the reference range of our laboratory. Data analysis for calculation of frequency and proportion was done in Statistical Package of Social Sciences. Results: The prevalence of hypocalcaemia in elderly was found to be 97 (24.1%). Out of 286 participants of age group 60-74 years, hypocalcemia was seen in 75 (26.2%) and among 116 participants of age group >74 years, 22 (19%) were hypocalcemic. Among 181 male participants, 44 (24.3%) had hypocalcemia and out of 221 female participants, 53 (24%) had hypocalcemia. Conclusions: The finding of present study suggests that hypocalcemia is common among elderly which can be life threatening. Therefore, regular monitoring of serum calcium is recommended for this age group.

scholarly journals Lung ultrasound in the emergency department - a valuable tool in the management of patients presenting with respiratory symptoms during the SARS-CoV-2 pandemic

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bonaventura Schmid ◽  
Doreen Feuerstein ◽  
Corinna N. Lang ◽  
Katrin Fink ◽  
Rebecca Steger ◽  
...  
Keyword(s):  
Emergency Department ◽  
Ct Scan ◽  
Lung Ultrasound ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Information ◽  
Clinical Work ◽  
Chest Ct ◽  
Work Up ◽  
Chest Ct Scan

Abstract Background Typical lung ultrasound (LUS) findings in patients with a COVID-19 infection were reported early on. During the global SARS-CoV-2 pandemic, LUS was propagated as a useful instrument in triage and monitoring. We evaluated LUS as a rapid diagnostic triage tool for the management of patients with suspected COVID-19 in the emergency department (ED). Methods The study retrospectively enrolled patients with suspected COVID-19, who were admitted from 1st April to 25th of April 2020 to the ED of a tertiary care center in Germany. During clinical work-up, patients underwent LUS and polymerase chain reaction (PCR) testing for SARS-CoV-2. The recorded ultrasound findings were analyzed and judged regarding typical signs of viral pneumonia, blinded for clinical information of the patients. The results were compared with PCR test and chest computed tomography (CT). Results 2236 patients were treated in the ED during the study period. 203 were tested for SARS-CoV-2 using PCR, 135 (66.5%) underwent LUS and 39 (28.9%) of the patients were examined by chest CT scan. 39 (28.9%) of the 135 patients were tested positive for SARS-CoV-2 with PCR. In 52 (38.5%) COVID-19 was suspected from the finding of the LUS, resulting in a sensitivity of 76.9% and a specificity of 77.1% compared with PCR results. The negative predictive value reached 89.2%. The findings of the LUS had - compared to a positive chest CT scan for COVID-19 - a sensitivity of 70.6% and a specificity of 72.7%. Conclusions LUS is a rapid and useful triage tool in the work-up of patients with suspected COVID-19 infection during a pandemic scenario. Still, the results of the LUS depend on the physician’s experience and skills.

scholarly journals Illness profile of the patients and risk factors for violence against health care workers working in emergency department

2020 ◽  
Vol 7 (5) ◽  
pp. 1968
Author(s):  
Dharmendra Kumar Gupta ◽  
Rajendra Pal Singh ◽  
Ajay Kumar Agarwal ◽  
Shailja Bisht
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Workers ◽  
Group Discussion ◽  
Common Factor ◽  
Tertiary Care ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Care Workers

Background: Emergency services are the back bone of the every hospital, providing 24×7 health care services. Health care workers (HCWs) working in emergency department are always at a greater risk of violence. Factors leading to violence against HCWs need to be addressed to curb these incidents. Aim and objective: To study illness profile of admitted patients through emergency, find out factors leading to violence against health care workers (HCWs) working in emergency, and to recommend development of optimum skills and measures for minimizing violence.Methods: It was a cross-sectional retrospective record and focus group discussion based study. Study included patient of all age group admitted through emergency department in a tertiary care hospital in Uttar Pradesh between 01 August 2019 to 31October 2019. Data was taken from the hospital record and focal group discussion held with casualty medical officers, consultants, senior residents, junior residents, PG students, intern nursing staff and quality department. The information collected was analysed using SPSS version 20.0.Results: Out of 7094 participants, 50.4% were female. Majority of the participants (33%) were 17-32 years of the age group. Most common factor responsible for the violence was poor communication skills followed by harsh voice, poor behavior and death of the patient.Conclusions: Large number of the HCWs working in the emergency department are victims of violence by patients and their relatives. Most of the cases are underreported. There is a need to train doctors in soft skills and handling sensitive situations through appropriate measures for the safety of staff.

scholarly journals Audit of Computed Tomography (Brain) Referrals from the Accident and Emergency Department in a Tertiary Care Hospital

2021 ◽  
Author(s):  
Ravinder Sahdev ◽  
Yashasvi Shukla ◽  
Akhilesh Rao
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Medical Officer ◽  
Central India ◽  
Care Hospital ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Introduction: Non-contrast Computerised Tomography (NCCT) Brain is a common referral made from the Accident and Emergency (A&E) department both for traumatic and non traumatic causes. Aim: To evaluate the veracity of the referrals made by the Accident and Emergency Department clinicians for non-contrast computed tomography Head. Materials and Methods: This was the Retrospective evaluation of diagnostic yield of head Computed Tomography (CT) referrals made from A&E Department of a tertiary care hospital located in northern-central India over three year period between January 2015 to December 2017. CT reports were first grouped into two major group’s trauma and non trauma referrals with further subdivision into positive and negative scan on the basis of presence of abnormality. Subsequently, the positive trauma reports were classified into Major findings (three subgroups extra-axial haemorrhage, brain contusions and other miscellaneous findings) and minor findings like undisplaced fractures of the skull or facial bones with or without subgaleal haematoma. Distribution of trauma cases as per National Institute for Health and Care Excellence (NICE) criteria was then tabulated. Non-trauma reports were also further classified in to the two major clinically important findings of haemorrhage and infarct as well as non-specific minor findings. Results: Of the total data of 2185 head CT (980 trauma cases and 1205 in non trauma cases) referrals done by A&E Department during the study period. The 144 (58.5%) out of trauma cases and 328 (27.2%) out of non trauma cases were with major findings. 788 (80.4%) of trauma cases and 965 (80.1%) out of non trauma cases were referred by Medical Officer (MO)/ Resident as revealed from the audit. Positivity percentages for traumatic and non traumatic causes were 25.1% and 27.2%, respectively. Conclusion: Due to non adherence to existing guidelines or due to poor clinical knowledge, there is poor diagnostic yield of CT referrals made from A&E department. Thus clinical Audit is essential at Department of Radiodiagnosis to streamline the referring protocols and improves the overall efficiency of the healthcare system.

scholarly journals ROLE OF COMPUTED TOMOGRAPHY IN PATIENT WITH MINOR HEAD INJURY IN TERTIARY CARE HOSPITAL

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Sanjay Narayangiri Gosavi ◽  
Sambhav Lodha ◽  
Apoorva Poonia
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Ct Scan ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Minor Head Injury ◽  
Ct Scans ◽  
Care Hospital

Aim: Approximately 2 million people sustain traumatic brain injury (TBI) annually in India. A CT scan of the head is the initial choice of radiological investigation to evaluate patients with suspected head injury. The need for neurosurgical intervention is based on the clinical status of the patient and the radiological finding on head CT. Material and Methods: This was a prospective observational study done over a period of 6 months. A total of 201 patients were included in the study. Patients of traumatic brain injury above 15 years of age who were subjected to two or more CT scans of the brain. Patients were followed for a maximum of up to 5 scans. The decision of repeat scan was taken by the treating neurosurgeon. Patients who were taken up for surgery based upon the findings of the first CT scan. Patients who were discharged or who expired after the first CT scan. Results: A total of 201 consequent head injury patients with 2 or more CT scans were studied. 192 were male. The mean age was 38.6 years (Range: 16e80). Road traffic accidents was the most common cause of trauma (134, 67%) followed by fall from height (47, 24%) and assault (17, 10%). Progression of lesion was seen more frequently in mixed lesions (21.8%), followed by SDH (12.5%) and EDH (6.2%). Conclusions: Repeat CT scans were found to be of value in detecting new lesions or enlargement of existing lesions resulting in change of management in a significant proportion of patients. Keywords: Computed Tomography, Minor Head Injury, Tertiary Care Hospital, Traumatic Brain Injury (TBI), Lesions.

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