scholarly journals A fatal near-range gunshot below the chin in a child

2019 ◽  
pp. 52-53
Author(s):  
Youssef Nouma
Keyword(s):  
Short Distance ◽  
Bone Fractures ◽  
Massive Hemorrhage ◽  
Facial Trauma ◽  
Metal Object ◽  
X Ray ◽  
Exit Wound ◽  
Entry Wound ◽  
Scene Investigation ◽  
Witness Statements

A 14-year-old child was shot from distance in a neighboring country. The all available data was taken from the father without any idea about the scene investigation or the witness statements. On external examination, we have found a near-range gunshot entry wound with an ovalshaped entrance defect in the submental region. The defect edges were crenellated and scalloped showing the appearance of a "rat-hole" surrounded by concentric soot area with deposited burned grains and enfumage zone (Image 1). A reentry wound surrounded by a red-purple zone in the tongue underside (Image 2) and an exit wound in its upper side were found. At the frontal region, a stellate exit wound was seat of brain matter and bone splinter (Image 3). X-ray showed bone fractures without any metal object (Image 4). At autopsy, the tongue was shredded and there was a massive hemorrhage in the aero digestive crossroads. The external beveling of the exit wound was associated with skull bursting, sub- and extra-dural hematomas, and multiple brain hemorrhagic foci. Lack of ballistic study, we only confirmed that "penetrating cranio-facial trauma with at least one near-range gunshot below the chin" was the cause of death. Thus, all hypotheses of accident, suicide or homicide were possible provided the shot was fired from short distance. After confronting the father to this finding, he confessed that he tried to conceal the truth in order to protect his older son. The deceased was shot by his 16-year-old brother, while they were playing "cops and robbers" game.

Bone density and bone health alteration in boys with Duchenne Muscular Dystrophy: a prospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Renu Suthar ◽  
B. V. Chaithanya Reddy ◽  
Manisha Malviya ◽  
Titiksha Sirari ◽  
Savita Verma Attri ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Bone Health ◽  
Prospective Observational Study ◽  
Bone Fractures ◽  
Long Bone ◽  
Vertebral Compression Fractures ◽  
Serum Osteocalcin ◽  
Z Score ◽  
X Ray ◽  
Compression Fractures

Abstract Objectives Boys with Duchenne Muscular Dystrophy (DMD) are at increased risk for compromised bone health, manifesting as low-impact trauma long bone fractures and vertebral compression fractures. Methods In a prospective observational study, we studied bone health parameters in North Indian boys with DMD. We consecutively enrolled ambulatory boys with DMD on glucocorticoid therapy. Bone health was evaluated with X-ray spine, Dual-energy X-ray absorptiometry (DXA), serum calcium, vitamin D3 (25[OH]D), 1,25-dihyroxyvitamin D3 (1,25[OH]2D3), serum osteocalcin, osteopontin, and N terminal telopeptide of type 1 collagen (Ntx) levels. Results A total of 76 boys with DMD were enrolled. The median age was 8.5 (interquartile range [IQR] 7.04–10.77) years. Among these, seven (9.2%) boys had long bone fractures, and four (5.3%) had vertebral compression fractures. Fifty-four (71%) boys underwent DXA scan, and among these 31 (57%) had low bone mineral density (BMD, ≤−2 z-score) at the lumbar spine. The mean BMD z-score at the lumbar spine was −2.3 (95% confidence interval [CI] = −1.8, −2.8), and at the femoral neck was −2.5 (95% CI = −2, −2.9). 25(OH)D levels were deficient in 68 (89.5%, n=76) boys, and 1,25(OH)2D3 levels were deficient in all. Mean serum osteocalcin levels were 0.68 ± 0.38 ng/mL (n=54), serum osteopontin levels were 8.6 ± 4.6 pg/mL (n=54) and serum Ntx levels were 891 ± 476 nmol/L (n=54). Boys with low BMD received glucocorticoids for longer duration, in comparison to those with normal BMD (median, IQR [16.9 (6–34) months vs. 7.8 (4.8–13.4) months]; p=0.04). Conclusions Bone health is compromised in North Indian boys with DMD. BMD at the lumbar spine is reduced in more than half of boys with DMD and nearly all had vitamin D deficiency on regular vitamin D supplements. Longer duration of glucocorticoid therapy is a risk factor for low BMD in our cohort.

scholarly journals Reducing radiation exposure in newborns with birth head trauma

2017 ◽  
Vol 5 (4) ◽  
pp. 24-30
Author(s):  
Irina A. Kriukova ◽  
Evgeniy Y. Kriukov ◽  
Danil A. Kozyrev ◽  
Semen A. Sotniкov ◽  
Dmitriy A. Iova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Head Trauma ◽  
Bone Structure ◽  
Bone Fractures ◽  
Diagnostic Methods ◽  
Cranial Bone ◽  
X Ray ◽  
Reduce Radiation Exposure ◽  
Risk Of Cancer

Background. Birth head trauma causing intracranial injury is one of the most common causes of neonatal mortality and morbidity. In case of suspected cranial fractures and intracranial hematomas, diagnostic methods involving radiation, such as x-ray radiography and computed tomography, are recommended. Recently, an increasing number of studies have highlighted the risk of cancer complications associated with computed tomography in infants. Therefore, diagnostic methods that reduce radiation exposure in neonates are important. One such method is ultrasonography (US). Aim. We evaluated US as a non-ionizing radiation method for diagnosis of cranial bone fractures and epidural hematomas in newborns with cephalohematomas or other birth head traumas. Material and methods. The study group included 449 newborns with the most common variant of birth head trauma: cephalohematomas. All newborns underwent transcranial-transfontanelle US for detection of intracranial changes and cranial US for visualization of bone structure in the cephalohematoma region. Children with ultrasonic signs of cranial fractures and epidural hematomas were further examined at a children’s hospital by x-ray radiography and/or computed tomography. Results and discussion. We found that cranial US for diagnosis of cranial fractures and transcranial-transfontanelle US for diagnosis of epidural hematomas in newborns were highly effective. In newborns with parietal cephalohematomas (444 children), 17 (3.8%) had US signs of linear fracture of the parietal bone, and 5 (1.1%) had signs of ipsilateral epidural hematoma. Epidural hematomas were visualized only when US was performed through the temporal bone and not by using the transfontanelle approach. Sixteen cases of linear fractures and all epidural hematomas were confirmed by computed tomography. Conclusion. The use of US diagnostic methods reduced radiation exposure in newborns with birth head trauma. US methods (transcranial-transfontanelle and cranial) can be used in screening for diagnosis and personalized monitoring of changes in birth head trauma as well as to reduce radiation exposure.

scholarly journals Pelvic Venous Congestion Secondary to a Circumaortic Renal Collar in an Adolescent Female: Report of a Case

2021 ◽  
Vol 09 (01) ◽  
pp. e56-e60
Author(s):  
Verónica Alonso-Arroyo ◽  
Jose Javier Velasco ◽  
Sonia Pérez-Bertólez ◽  
Maria Elena Molina ◽  
Jose Manuel Marugan-de-Miguelsanz ◽  
...  
Keyword(s):  
Renal Vein ◽  
Varicose Veins ◽  
Left Renal Vein ◽  
Recurrent Abdominal Pain ◽  
Massive Hemorrhage ◽  
Resonance Imaging ◽  
X Ray ◽  
Abdominal Palpation ◽  
Internal Iliac ◽  
Pelvic Congestion

AbstractWe report a 13-year-old girl who presented with a recurrent abdominal pain that started after her menarche. The abdominal palpation revealed tenderness over the left ovarian point. The laboratory study, ultrasonography, and abdominal X-ray were normal. The computed tomography and magnetic resonance imaging showed a double left renal vein with a retroaortic component, an increased left parauterine circulation, and ipsilateral ovarian vein engorgement. A diagnostic and therapeutic phlebography allowed a selective catheterization of a group of pelvic varicose veins draining to the left ovarian and to the internal iliac veins. There were no complications during the procedure and the symptoms disappeared 2 days later. Circumaortic left renal vein may cause hematuria, proteinuria, pelvic congestion syndrome, and massive hemorrhage during surgery. A conservative treatment is recommended for patients without gynecourological/renal symptoms or with mild hematuria. The endovascular treatment by gonadal venous embolization is safe and effective.

scholarly journals PROFILE OF PLASTIC SURGERY TRAUMA PATIENTS AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

2019 ◽  
pp. 1-4
Author(s):  
Darwin Firmansyah Siregar ◽  
Frank Bietra Buchari ◽  
Utama Abdi Tarigan ◽  
Aznan Lelo
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Bone Fractures ◽  
Soft Tissue Injuries ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Adult Age ◽  
Common Etiology ◽  
Tissue Injuries ◽  
Age Range

Introduction: According to data from Perhimpunan Dokter Bedah Plastik Rekonstruksi dan Estetik Indonesia (PERAPI), there are only 193 plastic surgeons throughout Indonesia. There is no sufcient data that described pattern of incidence, workload, and role of Plastic Surgery in trauma cases at Indonesian Referral Center Hospital, especially in the Province of North Sumatra. Methods: This research is a descriptive study with a retrospective approach. Sample of this study was medical records of trauma patients who required Plastic Surgery who came to the H. Adam Malik General Hospital Medan Emergency Room (1 January 2016-31 December 2018). This study used total sampling method. Results: This study involved 536 patients and 40.85% included in the adult age range. Men vs women ratio is 3:1 (405 vs 131). Based on type of injury, the most common injury is facial trauma, followed by burns and soft tissue injuries (291, 178 and 66). The most common etiology is trafc accidents (90 cases). Most of facial bone fractures located at mandibular bone (segmental fracture). Inhalation trauma due to burns only occurred in 6 cases (3.24%). Most of soft tissue injuries occurred at lower extremities (upper limbs). Conclusion: Trafc accidents are the most common etiology for trauma in Plastic Surgery. Most of the patients are men and included in the adult age range. Facial trauma is the most common injury in Plastic Surgery. Most facial bone fractures located at mandible (symphysis and parasymphysis). Most of burns injury are re burns. Most soft tissue injuries are located at lower extremities (upper limbs).

scholarly journals Studies of Cases of Reduced Facial Bone Fractures. The Role of the "Facial Trauma Center".

2001 ◽  
Vol 94 (10) ◽  
pp. 899-903
Author(s):  
Takahiro YAMANISHI ◽  
Sumihito KINOSHITA ◽  
Yasuaki SADANAGA
Keyword(s):  
Trauma Center ◽  
Bone Fractures ◽  
Facial Trauma ◽  
Facial Bone

scholarly journals Frontal Mucocele following Previous Facial Trauma with Hardware Reconstruction

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Megan EuDaly ◽  
Chadd K. Kraus
Keyword(s):  
Emergency Department ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Early Recognition ◽  
Interdisciplinary Approach ◽  
Motor Vehicle Crash ◽  
Facial Trauma ◽  
Facial Bone ◽  
Vehicle Crash ◽  
Frontal Sinuses

Mucoceles are cysts that can develop after facial bone fractures, especially those involving the frontal sinuses. Despite being rare, mucoceles can result in serious delayed sequelae. We present a case of a frontal mucocele that developed two years after extensive facial trauma following a motor vehicle crash (MVC) and review the emergency department (ED) evaluation and treatment of mucocele. Early recognition, appropriate imaging, and an interdisciplinary approach are essential for managing these rare sequelae of facial trauma.

scholarly journals In situ analysis of foliar zinc absorption and short-distance movement in fresh and hydrated leaves of tomato and citrus using synchrotron-based X-ray fluorescence microscopy

2014 ◽  
Vol 115 (1) ◽  
pp. 41-53 ◽  
Author(s):  
Yumei Du ◽  
Peter M. Kopittke ◽  
Barry N. Noller ◽  
Simon A. James ◽  
Hugh H. Harris ◽  
...  
Keyword(s):  
Fluorescence Microscopy ◽  
Short Distance ◽  
In Situ Analysis ◽  
Zinc Absorption ◽  
X Ray

scholarly journals Correction of a Posttraumatic Orbital Deformity Using Three-Dimensional Modeling, Virtual Surgical Planning with Computer-Assisted Design, and Three-Dimensional Printing of Custom Implants

2018 ◽  
Vol 11 (1) ◽  
pp. 078-082 ◽  
Author(s):  
Kristopher M. Day ◽  
Paul M. Phillips ◽  
Larry A. Sargent
Keyword(s):  
Computer Technology ◽  
Surgical Planning ◽  
Bone Fractures ◽  
Three Dimensional ◽  
Lower Eyelid ◽  
Frontal Bone ◽  
Facial Trauma ◽  
Computer Assisted ◽  
Virtual Surgical Planning ◽  
Three Dimensional Modeling

We describe a case of complex, posttraumatic skull and orbital deformities that were evaluated and treated with advanced computer technology, including virtual surgical planning, three-dimensional (3D) modeling, and printed patient custom implants (PCI) fabricated by 3D printing. A 50-year-old man presented to our craniofacial referral center 1 year after failed reduction of complex left orbital, zygomatic, and frontal bone fractures due to a motorcycle collision. The patient's chief complaint was debilitating diplopia in all fields of gaze. On examination, he had left enophthalmos, left canthal displacement, lower eyelid ectropion, vertical orbital dystopia, and a laterally and inferiorly displaced, comminuted zygoma with orbital rim and frontal bone defects. The normal orbit was mirrored to precisely guide repositioning of the globe, orbital reconstruction, and cranioplasty. Preinjury appearance with normal globe position was restored with complete resolution of diplopia. Modern 3D technology allows the surgeon to better analyze complex orbital deformities and precisely plan surgical correction with the option of printing a PCI. These techniques were successfully applied to resolve a case of debilitating diplopia and aesthetic deficits after facial trauma. Further application of advanced 3D computer technology can potentially improve the results of severe orbital and craniofacial trauma reconstruction.

scholarly journals Case report of isolated impaling lung injury with successful outcome

2017 ◽  
Vol 4 (10) ◽  
pp. 3548
Author(s):  
Tushar Goel ◽  
Sameer Bhate
Keyword(s):  
Foreign Body ◽  
Good Condition ◽  
Vascular Trauma ◽  
Primary Objective ◽  
Successful Outcome ◽  
X Ray ◽  
Satisfactory Condition ◽  
Entry Wound ◽  
Chest X Ray ◽  
Selection Of

Impalement thoracic injuries are rare of great importance due to severity and high chances of mortality. It is essential to prevent possible vascular injury by the object avoiding major haemorrhage. This study’s primary objective is to discuss 22-year-old male patient admitted in emergency with impaling thoracic trauma by metallic sharp object post battery blast at home. X-ray reveals linear foreign body: penetrating thorax and lung. CT Chest was done and assessment was made for further management with cardiothoracic department. Patient details were collected by patient’s IPD file. Complete detailed history, patient vitals, hemogram, ABO, ABG, CXR along with USG chest and abdomen and CECT chest was done. Post op daily chest X-ray and hemogram along with chest physiotherapy and spirometry was done. Treatment diagnosis was impaled linear foreign body penetrating thorax and lung, patient was shifted to OT, under GA sternotomy was performed. Foreign object passing just lateral to subclavian penetrating upper pole of lung was identified and under specific vision pulled out carefully through entry wound keeping in mind vascular trauma. Necrosed lung part was stapled and wedge resected, on POD 8 patient was discharged with satisfactory condition. Impalement thoracic traumas are rare and have high mortality. Selection of line of treatment is necessary. Indication of surgery under high risk is performed for further trauma. In our case sternotomy was planned and under specific vision impaled object which was passing just by subclavian penetrating through lung was removed safely and patient went home in good condition.

scholarly journals Medicolegal aspects of Nasal Bone Fractures

2016 ◽  
Vol 9 (4) ◽  
Author(s):  
Tahir Qadeer Khan ◽  
Khawja Khurshid Ahmad ◽  
Asim Shaukat ◽  
Yasser Yamin ◽  
Sarfraz Ahmad ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Clinical Suspicion ◽  
Medicolegal Aspects ◽  
X Ray ◽  
The Face

Conducted in the Department of Radiology, Lahore in collaboration with Surgeon Medico Legal and his team, this study contained 50 patients who presented with trauma to the face and the clinical suspicion was of Nasal Bone fracture. All the patients underwent X ray examination of the Nose. The x ray examination showed that all of the patients did not have Fractures 40 patients had fracture of Nasal bone and this changed the management as well as the severity of the injury and hence the punishment

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