scholarly journals Assessment of the Awareness and Attitude of Emergency Physicians towards the use of Computed Tomography in patients with head injury in various hospitals in Anambra State, Nigeria

2020 ◽  
pp. 01-14
Author(s):  
Okechukwu Mary-Ann C
Keyword(s):  
Computed Tomography ◽  
Head Injury ◽  
Ct Scan ◽  
Imaging Modality ◽  
Head Injuries ◽  
Cross Sectional Study ◽  
Emergency Physicians ◽  
Cross Sectional ◽  
X Ray ◽  
Anambra State

The use of x-ray and computed tomography scan is critical in the management of traumatic conditions, particularly head injuries. This study was carried out to assess the level of awareness and attitude of Emergency physicians towards the use of CT in cases of head injury. A cross-sectional study was done among emergency physicians working in five different government hospitals in Anambra State. Among the respondents were 29% males and 4% females: mean age was 35.7 years while their modal age was 31-40 years. All the respondents, 33 (100%) stated they find CT scan as a useful diagnostic medical imaging modality. However less than half of them, 15 (45.5%) stated they refer patients for CT scan for those patients that need it. Whereas most of them, 20 (64.5%) stated that head injury patients should undergo both X-Ray and CT scan virtually all of them 32 (97%), responded that computed tomography, (CT) is better than skull x-ray in the examination of head injury. Though majority of the respondents 31 (93%), stated that CT scan subject the patient to some risks. All those who responded and thought that CT scan should continue to be used as medical diagnostic imaging modality were 33 (100%). The result of the study showed that most of the emergency physicians are aware of the usefulness of CT in the examination of patients presenting with head injury, but the non- availability and cost of services of the CT imaging equipment greatly affected the rate of request for the examination and has affected their attitude towards the use of this imaging modality in the examination of this category of patients in need of it.

scholarly journals Knowledge, Practice and Attitude of Dentists towards Cone Beam Computed Tomography

2021 ◽  
Vol 10 (38) ◽  
pp. 3413-3418
Author(s):  
Fatma Fayez Badr ◽  
Mohammed Abdulaziz Barayan ◽  
Fatima Mohammed Jadu ◽  
Hanadi Mohammed Khalifa
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Imaging Modality ◽  
Cross Sectional Study ◽  
Basic Knowledge ◽  
Cone Beam ◽  
Cross Sectional ◽  
Policy Makers ◽  
Knowledge Practice ◽  
General Dentists

BACKGROUND Cone beam computed tomography (CBCT) was first introduced in 2008 and has since seen a tremendous growth in both private dental clinics and dental institutions. This has led to the normalization of CBCT use by general dentists. Therefore, it is essential to assess how and why general and specialist dentists use CBCT. The purpose of this study was to assess the knowledge, practice and attitude towards CBCT among general and specialist dentists working in the kingdom of Saudi Arabia. METHODS In this cross-sectional study, a questionnaire was electronically distributed via email and social media from October 2018 to September 2020. The self-administered questionnaire was divided into five segments: demographics, knowledge, current practice, training and attitude. RESULTS A total of 221 dentists filled the questionnaire including 85 general dentists and 135 post graduate students or specialists. The majority of dentists (81.9 %) demonstrated poor knowledge. Orthodontists and endodontists were most aware of CBCT terms. Most dentists (71.5 %) have a CBCT unit in their practice. Only 34.8 % received CBCT training, the majority of which was theoretical. A positive attitude was noted in 83.2 % of dentists by agreeing to a statement regarding CBCT justification. CONCLUSIONS Poor CBCT knowledge was evident in majority of dentists despite having CBCT in their practice. Dentists are highly aware of the importance of CBCT justification and professional interpretation; however, they lack basic knowledge and training related to this imaging modality. This highlights an institutional gap that policy makers should address in order to ensure the highest quality of patient care. KEY WORDS Cone Beam Computed Tomography; CBCT; Survey

scholarly journals Skull Fracture and Haemorrhagic Pattern in Cases of Fatal Blunt Trauma Head Injury Autopsied at Tertiary Healthcare Centre in Eastern Nepal

Med Phoenix ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 71-74
Author(s):  
Bikash Sah ◽  
Bishwanath Yadav ◽  
Shivendra Jha ◽  
Abdul Sami Khan
Keyword(s):  
Head Injury ◽  
Subarachnoid Haemorrhage ◽  
Blunt Trauma ◽  
Intracranial Haemorrhage ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Skull Vault

Background: Head injury is regarded as a main health problem that is a common cause of morbidities and mortalities and makes great demand to control and prevent it. For this, policy makers need to see the pattern of head injury and this study is done to describe the pattern.Methods: Hospital based, descriptive cross sectional study done on one year autopsy cases of fatal blunt trauma head injury which was 76 in which proportion of different types of head injuries, their causes and their distribution as per age, sex, and duration of survival were studied.Results: Skull-vault fractures were present in 57 (75%) cases in which most common type of fracture was linear fracture constituting 29(49.12%). 50% of the cases were with skullbase fracture in which the most common was of anterior cranial fossa fracture(60.5%). 56.34% of the victims were with subarachnoid haemorrhage (SAH) followed by subdural haemorrhage (SDH) and extradural haemorrhage (EDH). 6.6% victims were without any intracranial haemorrhage. Road traffic accident alone accounted for 71% of total blunt trauma causations of this fatal head injury. 70% cases were in age group from 11 to 50 years and 78.9% were male. 51.3% died at the spot. Conclusions: The research findings have shown that among the fatal blunt trauma head injury cases, skull vault fracture was present in 75% and skull base fracture was present in 50%. The most common intracranial haemorrhage was subarachnoid haemorrhage (56.34%) followed by subdural and extradural haemorrhage.  Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 71-74                                                         

scholarly journals Head injury from falls in children younger than 6 years of age

2015 ◽  
Vol 100 (11) ◽  
pp. 1032-1037 ◽  
Author(s):  
P Burrows ◽  
L Trefan ◽  
R Houston ◽  
J Hughes ◽  
G Pearson ◽  
...  
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Skull Fracture ◽  
Cross Sectional Study ◽  
Skull Fractures ◽  
Sectional Study ◽  
Intracranial Injury ◽  
Cross Sectional ◽  
Serious Injury ◽  
The Relationship

The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described.MethodCross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results.ResultsOf 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65).ConclusionsMost HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.

CLINICAL CORRELATION AND AGREEMENT BETWEEN THE CHEST CT SCAN AND CHEST X-RAY FINDINGS IN TUBERCULIN-POSITIVE CHILDREN: A PROSPECTIVE CROSS SECTIONAL STUDY

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 40S
Author(s):  
Beverly D. Delacruz ◽  
Nerissa A. Deleon ◽  
Milagros S. Bautista ◽  
Fernando Ayuyao ◽  
Teresita Deguia
Keyword(s):  
Ct Scan ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Clinical Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

scholarly journals The impact of helmet use on oral and maxillofacial injuries associated with electric-powered bikes or powered scooter: a retrospective cross-sectional study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yafit Hamzani ◽  
Dror Bar Hai ◽  
Nir Cohen ◽  
Michael J. Drescher ◽  
Gavriel Chaushu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Head Injury ◽  
Head Injuries ◽  
Soft Tissue Injuries ◽  
Cross Sectional Study ◽  
Maxillofacial Injuries ◽  
Sectional Study ◽  
Cross Sectional ◽  
Helmet Use ◽  
The Impact

Abstract Background Electric bikes (E-bikes) and powered scooters (P-scooters) have become increasingly popular modes of public transportation, but they have been associated with injuries of all kinds, including dental trauma. Helmet use is promoted as a means of reducing injuries in accidents involving motorized and unmotorized vehicles. The aim of the study was to evaluate the impact of helmet use on the number and severity of oral and maxillofacial injuries caused by E-bikes and P-scooters. Methods A retrospective cross-sectional study design was used. The cohort included all patients referred to the emergency department of a tertiary medical center in 2014–2020 with oral and maxillofacial injuries involving E-bikes or P-scooters. Data were collected from the medical files on demographics, types of injuries, circumstances of occurrence, work-up, treatment, and outcome. Use of a helmet was recorded in each case. Results Of the total 1417 patients referred to the emergency department for E-bike and P-scooter-related trauma, 62 had oral and maxillofacial injuries, including 57 riders and 5 pedestrians. All had hard- or soft-tissue injuries; 20 (32.2%) had head injuries and 22 (35.5%) had dentoalveolar injuries. Eleven riders had worn a helmet at the time of injury (17.7%). Helmet use was associated with time of injury (weekday/weekend, daytime/night-time), type of motorized vehicle (E-bike or P-scooter), head injury, and number of bone fractures. Head injuries occurred more often on the weekend (57.9%) than during the week (20.9%) and were more likely to occur in riders who were not protected by a helmet (37.3% vs 18.2%). Patients who used helmets also had a lower rate of fractured bones (18.2%) and dentoalveolar injuries (23.7%) than patients who did not (68.8 and 37.3%, respectively). Interestingly, helmet use had no protective effect on soft-tissue injuries. Conclusions Helmet use by E-bike and P-scooter riders decreased the probability of head injury and of hard tissue and dentoalveolar injuries. These results may provide guidance for effective legislation and regulation of helmet use and improved treatment protocols for general and dental physicians.

scholarly journals Computed Tomography-based determinants for predicting death and ICU requirement in patients suffering COVID-19

2020 ◽  
Author(s):  
Marzie Dehgan ◽  
Nasrin Khalesi ◽  
Masumeh Akbari ◽  
Rogheyeh Fallah ◽  
Neda Hosseininezhad
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Ct Scan ◽  
Scoring Systems ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Multivariable Logistic Regression Model ◽  
Cross Sectional ◽  
Main Determinants ◽  
Diffuse Distribution

Abstract Background: What has received special attention in recent months is the use of a combination of clinical findings, laboratory markers, and, in addition, the findings of lung Computed Tomography (CT) scan in the design and delivery of risk scoring systems for Coronavirus Disease 2019 (COVID -19) patients. The present study aimed to determine main lung CT-related correlates of disease severity (Intensive Care Units (ICU) requiring) as well as death in COVID -19 patients.Methods: This cross-sectional study was performed on 515 consecutive patients with definitive diagnosis of COVID-19 admitted to one of the COVID -19 referral hospitals in Tehran. All patients' information was collected through a review of their archives. All patients were evaluated by CT scan of the lungs.Results: The mean follow-up of patients from the time of admission was 10.85±6.11 days between 1 and 30 days. During this period, a total of 29.1% were admitted to the ICU. Also, the mortality rate of patients was equal to 28.2%. According to multivariable logistic regression model with the presence of death-related correlates, crazy paving pattern, diffuse distribution of lesions, CT Severity Score (CTSS) score >12, the presence of plural effusion or emphysema were the main determinants of COVID -19 related death and should be considered for presenting new scoring system for predicting death following COVID -19 disease. In similar model, CTSS score >12 along with the presence of plural effusion, emphysema, or pulmonary hypertension were the main determinants of requiring ICU admission. Conclusion: The CT score higher than 12 along with observing the pattern of diffuse distribution of lesions especially accompanied with emphysema, pleural effusion or pulmonary hypertension can predict patient mortality or will determine the need for hospitalization in the ICU.

scholarly journals Selecting children for head CT following head injury

2016 ◽  
Vol 101 (10) ◽  
pp. 929-934 ◽  
Author(s):  
A Kemp ◽  
E Nickerson ◽  
L Trefan ◽  
R Houston ◽  
P Hyde ◽  
...  
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
General Hospital ◽  
Diagnostic Yield ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Hospital Inpatient ◽  
Cross Sectional ◽  
Nice Guidelines ◽  
Head Ct

ObjectiveIndicators for head CT scan defined by the 2007 National Institute for Health and Care Excellence (NICE) guidelines were analysed to identify CT uptake, influential variables and yield.DesignCross-sectional study.SettingHospital inpatient units: England, Wales, Northern Ireland and the Channel Islands.PatientsChildren (<15 years) admitted to hospital for more than 4 h following a head injury (September 2009 to February 2010).InterventionsCT scan.Main outcome measuresNumber of children who had CT, extent to which NICE guidelines were followed and diagnostic yield.ResultsData on 5700 children were returned by 90% of eligible hospitals, 84% of whom were admitted to a general hospital. CT scans were performed on 30.4% of children (1734), with a higher diagnostic yield in infants (56.5% (144/255)) than children aged 1 to 14 years (26.5% (391/1476)). Overall, only 40.4% (984 of 2437 children) fulfilling at least one of the four NICE criteria for CT actually underwent one. These children were much less likely to receive CT if admitted to a general hospital than to a specialist centre (OR 0.52 (95% CI 0.45 to 0.59)); there was considerable variation between healthcare regions. When indicated, children >3 years were much more likely to have CT than those <3 years (OR 2.35 (95% CI 2.08 to 2.65)).ConclusionCompliance with guidelines and diagnostic yield was variable across age groups, the type of hospital and region where children were admitted. With this pattern of clinical practice the risks of both missing intracranial injury and overuse of CT are considerable.

scholarly journals Atypical presentation of cholecystitis with torsion of the gallbladder diagnosed preoperatively in an unusual location

2021 ◽  
Author(s):  
Sowmiya Kalyanasundaram ◽  
Suresh Fernando
Keyword(s):  
Gall Bladder ◽  
Ct Scan ◽  
Acute Cholecystitis ◽  
Imaging Modality ◽  
Cross Sectional Study ◽  
Imaging Modalities ◽  
Anatomical Location ◽  
Sectional Study ◽  
Cross Sectional ◽  
Upper Abdomen

Objective: An 87-year-old attended the emergency department with sharp upper abdominal pain, radiating to back with a pain score of 10/10. On examination, severe epigastric tenderness was noted. Past surgical history: bilateral salphingo-oopherectomy. Repair for paraumblical hernia and right total hip replacement. No history of cholecystectomy. Inflammatory markers were raised. Cholecystitis/gall bladder perforation was suspected and contrast CT was performed. Methods: CT abdomen and pelvis – in comparison to the previous CT scan which was done in 2018, where gall bladder was in the correct anatomical location, the gall bladder was not seen in the gall bladder fossa in the current study. However, a gall bladder like suspicious structure was noticed within the upper abdomen to the left of midline anterior to the gastric pylorus with significant inflammatory changes. Therefore, considering the clinical picture and CT findings, it was suggestive of acute cholecystitis with torsion of gall bladder. Results: Patient was started on i.v. antibiotics and laparoscopic assessment was carried out on the following day. Intraoperatively, the surgeons were unable to locate the gall bladder in its normal anatomical position, but incidentally found a mass in the left upper abdomen which appeared gangrenous. This was removed and sent for histopathology. Histology report confirmed that the specimen was gall bladder with features suggestive of pre-existing chronic cholecystitis, with recent venous infarction. Conclusion: Torsion of gall bladder is a very rare entity and if left untreated could lead to fatal sequelae of gangrene and perforation resulting in biliary peritonitis. There is evidence which suggest that torsion of gall bladder is more common in elderly females due to loss of visceral fat but the pre-operative diagnosis using imaging modalities has always been challenging. But in this particular case, the radiologist was able to make the precise diagnosis pre-operatively using the cross-sectional study of an advanced imaging modality like the CT scan with contrast which also helped the surgeons in making the decision for immediate surgery rather than planning for routine conservative management for acute cholecystitis. The importance of cross-sectional study with intravenous contrast in diagnosing unusual presentation of gall bladder related and potentially life-threatening abdominal pathology has been highlighted in this case study. It is also evident that how imaging modalities play a significant role in altering acute management plan.

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