scholarly journals Utility of CT in Head Injury- A Prospective Study

2020 ◽  
Vol 8 (1) ◽  
pp. 64-68
Author(s):  
Anil Kumar Bansal ◽  
Anil Kumar Gupta

Background: Head injury is defined as an impairment in brain function as a result of mechanical force. The dysfunction can be temporary or permanent, and may or may not result in underlying structural changes in the brain. Head injuries are a major public health problem worldwide. A limited amount of neurological damage occurs at the time of impact (primary injury). Subjects and Methods: The study was a prospective observational study took place in the Department of Radiology, over a 8 month period which involves all type of head injuries. Informed consent was obtained by the subjects who participated in the study. All head injury patients attending the emergency department were included, while those with no clear history of trauma as the primary event and neurologic deficit that could not be explained by head trauma were excluded. Results:  A total of 1000 patients underwent CT for a head injury. Table 1 shows baseline characteristics as age, gender, referred cases, type  of injury, mode of injury and clinical features where we observed 48.2% cases were in the age group between 21-40 years with 80% of male subjects. While observing for the mode of injury, we found most of the cases falls in the category of road traffic accidents (77%) with external injury (83.5%) and loss of consciousness (63.4%) as highly observed clinical features. Conclusion: This study showed a significant association of overall CT positivity with patients sociodemographic and clinical factors such as: male gender, elderly age group (>60 years), history of alcohol consumption, LOC >5 min, history of vomiting, history of seizures, evidence of ear bleed, evidence of nosebleed, and GCS 12 (moderate and Severe head injury). From the results of this study, we recommend the following indications for doing CT in head injury patients: (1) CT is indicated in all patients with moderate and severe head injury (GCS ≤12).

2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade

Background: Head injury can be defined as trauma in which the head is struck or moves violently, resulting in transient or permanent alteration of consciousness of an individual. We profiled and analyzed the cases of head injuries reporting to a government hospital a rural Indian setting.Methods: All the patients with history of antecedent head injury were firstly assessed by detailed history, with emphasis on history of unconsciousness/vomiting/convulsions/ENT bleed. Then a thorough clinical examination was undertaken, including Glasgow Coma Scale (GCS) scoring. Further, all the patients were subjected to CT scan of head for correlation of clinical findings, confirmation of diagnosis, delineation of extent of disease and suitability of operative intervention etc.Results: Majority of the patients belonged to 15-44 years age group (30, 60%) and were males (38, 76%). Road traffic accidents accounted for majority (38, 76%) of the cases. GCS score was found to range between 13-15 (mild) in 18 (36%) patients, 9-12 (moderate) in 21 (42%) patients and 3-8 (severe) in 11 (22%) patients. Best recovery (88%) was shown by patients of GCS score between 13-15. Among the critical symptoms and signs, unconsciousness and abnormal plantar reflex were the commonest ones. Generalized cerebral edema without associated lesion (50%) was the commonest finding followed by extradural hematoma (EDH) (40%) on CT scan of head. As for recovery w.r.t. CT scan findings, highest rate of recovery (100%) was reported in patients with fracture without intracranial pathology, while highest mortality was reported in those having mixed lesion (90%).Conclusions: Road traffic accidents in young age group is the commonest mode of head injury and GCS score is a good predictor of recovery in head injury cases.


Author(s):  
Kana Ram Patel ◽  
Jagdish Jugtawat ◽  
Shalender Kumar ◽  
P.C. Vyas

Accidents are not due to external factors all the time but often they occur due to failure of control of self-conscience and free thoughts. Road Traffic Accidents is still the major cause of death worldwide including India. A retrospective study has been conducted in Dr. S.N. Medical College, Jodhpur (Raj.), in the year 2019 to study the pattern and distribution of Head Injuries of fatal road traffic accidents and to prepare the demographic profile of it. Out of total 901 cases, male to female ratio was 9:1, and commonest age group affected was 21-30 years (39.8%). Among total victims, Hindus were 748 (83%) and rests were Muslims 103 (11.4%) and other religions. Head injury was the most common injury, present alone in 509 cases (56.4%) and in 392 (43.6) cases along with other injuries. Skull fractures were found in 451 (50.5), in which linear/fissure fracture (32.9%) was most common. Most common bone fractured was temporal bone. The commonest variety of intracranial hemorrhage was subdural hemorrhage and craniotomy was done in 29 (3.2%) cases. Keywords: Accidents, Road traffic, Head injury, Fractures.


Author(s):  
Naresh Pal ◽  
Vineet Mishra ◽  
Udit Jain ◽  
Poonam .

Background: Chest trauma constitutes a major public health problem which  includes the injuries to chest wall, pleura, tracheobronchial tree, lungs, diaphragm, oesophagus, heart and great vessels. It consist of more than ten percent of all traumas and twenty five percent of death due to trauma occurs because of chest injury. Chest trauma is increasing in frequency in urban hospitals. Penetrating and nonpenetrating thoracic injuries the most serious injuries leading to significant morbidity and mortality.Methods: This study was prospective observational study of 220 patients of thoracic trauma both penetrating and non-penetrating. These patients admitted in general surgical units from August 2017 to May 2018  of Pandit Bhagwat Dayal  Sharma,  PGIMS  Rohtak Haryana India. The study was pertaining to both penetrating  and non-penetrating chest trauma.Results: Out of 220 chest injury patients who were studied during the said period, Males were 203 and females 17 by a ratio of 12:1 and age ranged from lowest 18 years to 85 years of age. Majority of the patients (90.45%) sustained blunt injuries. RTA was the common mechanism of blunt injury affecting (50.45%) of patients. Multiple Rib fractures was the commonest type of chest injury (21.36%) followed by head injury (17.27%). Head injury was the commonest associated injury seen in our patients. Conclusions: Chest trauma resulting from road traffic accident remains a major mechanism of chest injury. The  measures to decrease the trauma are, educating people about traffic rules and regulations and strictly implementing them is necessary to reduce incidence of chest injuries.


Author(s):  
Rajeshwar S. Pate ◽  
Rohan C. Hire ◽  
Mohit V. Rojekar

Background: In India, the developing economy and growing population simultaneously made a strong impact on increase in motor vehicle population. This increase in motorization has some adverse effects such as increase in road accidents with economic and functional loss. Head injury is the most common cause of mortality in road traffic accidents. The aim of this study was to know the incidence, pattern, mechanism, mode of head injury along with its distribution in relation to site of vault fracture and intracranial hemorrhage.Methods: Total 391 post-mortem cases of head injury were enrolled during study period. The information regarding age, sex, residence, marital status, date and time of time of accident and of death was gathered from police inquest report, relatives, dead body challan and clinical details from hospital records. During autopsy, detailed examination was carried out and data regarding both external and internal injuries were carefully recorded and analyzed.Results: The peak incidence of head injury was observed in the age group of 21-30 years. Most of deceased were from early age group and the male deceased were more than females. Majority victims of head injury were from road Traffic Accidents followed by fall from height, railway accidents and assault. Fissured fracture of vault was found in almost half cases. Subdural and subarachnoid hemorrhage were the most common one we encountered.Conclusions: Head injury due to RTA is well known public health problem causing death and disability. It is required from concerned government authority to take appropriate and immediate measures for reducing the incidence of head injury.


Author(s):  
K. Myl Kumaran ◽  
Pragadeesh Raja ◽  
M. Jasmine

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury. Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients. Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21. Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM. Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.


Author(s):  
Ananya M. Balakrishna ◽  
Usha Rani S. Padmanabha ◽  
Rajappa Maheswaran

Background: Anaemia affects 1.62 billion people globally which corresponds to 24.8% of the population and the prevalence of anaemia in pregnant women is 56 million. In India 16% of maternal deaths are attributed to anaemia with prevalence of 50.3%. Hence, this study was done to assess the prevalence of anemia and its associated factors among the pregnant women attending the maternity hospital.Methods: A hospital based cross section study was done among pregnant women receiving antenatal care over a period of 2 months. Based on the prevalence rate of anaemia; 39.6%, the estimated sample size was 368. Haemoglobin was estimated by cyanmethaemoglobin method. All pregnant women who voluntarily agreed to participate were selected by systematic sampling method.Results: Majority of subjects were in the age group of 15 to 24 years, 60.6%. Nearly 90% were Hindus, 83.2% were homemakers and 62% belonged to nuclear family. The prevalence of anaemia was 56% in which 46.6% had mild anaemia, 51.9% had moderate and 1.5% were severely anaemic. Univariate analysis showed religion, occupation, gestational age and history of abortion being associated with anaemia. In multivariate analysis women in first trimester of pregnancy and history of abortion were significant factors for anaemia.Conclusions: In developing nations like India anaemia is a major public health problem contributing to maternal and infant mortality and morbidities; henceforth there is a need for an effective intervention in the form of health education modules to the community and nutritional counseling for women in the reproductive age group about the importance of Iron supplementation during antenatal period.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Syilvia Jiero ◽  
Ayodhia Pitaloka Pasaribu

Abstract Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.


Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.


2018 ◽  
Vol 7 (1) ◽  
pp. 4-9
Author(s):  
Md Mahamudur Rahman ◽  
Md Akram Hossain ◽  
Shyamal Kumar Paul ◽  
Salma Ahmed ◽  
Md Murshed Alam ◽  
...  

Soil transmitted helminthes (STHs) infections are common throughout the tropics and subtropics and represents a major public health problem in developing countries. The rate of STHs infection found in the present study was very high in comparison to other countries of this Subcontinent, though they are taking antihelmintics every 6 months interval under Government National Health Program. The present study was carried out to see the Prevalence of STHs infection among the school children in Mymensingh, Bangladesh. A total of 500 stool samples from healthy individuals were collected during April, 2012 to February, 2013 from 20 schools comprising 10 rural and 10 urbans under Sadar upazila, Mymensingh, Bangladesh. The samples were examined in the department of Microbiology, Mymensingh Medical College using saline and iodine preparation microscopy and McMaster technique for the detection of ova of STHs.  The STHs prevalence irrespective of the age and sex of the individuals were 37.0% (185) out of 500 specimens where 68.0% (340/500) individuals were male represents the prevalence 38.0% (129/340) and 32.0% (160/500) individuals were female represents the prevalence 35.0% (56/160). Majority of the cases belonged to the age group >5-10 years 50.2% (251/500) of the total, constituted the prevalence 20.2% (101/500) of the total population and 40.2% (101/251) of the individual age group. The distribution of different STHs with their prevalence in the study population where Ascaris lumbricoides (AL) was 63.8% (118), Trichuris trichiura (TT) 37.3% (69), Enterobius vermicularis (EV) 8.1% (15), Ancylostoma duodenale (AD) 7.5% (14), and mixed infection was 15.1% (28). The upper socio-economic class constituted 5.0% (25/500) of the total study population with the prevalence of 20.0% (5/25). The middle socio-economic class constituted 50.0% (250/500) of the total study population with the prevalence of 37.2% (93/250) and the lower socio-economic class constituted 45.0% (225/500) of the total study population with the prevalence of 38.6% (87/225). The urban population constituted 34.0% (170/500) of the total population representing the prevalence 31.2 % (53/170) and rural population constituted 66.0% (330/500) of the total population representing the prevalence 40.0% (132/330).  In this study, STHs detection by McMaster method was satisfactory. Thereby, McMaster method could be adapted for rapid detection and quantification of STHs. Moreover, one more frequent administration of antihelmintics with close monitoring of drug administration may reduce the prevalence of STHs infection in Bangladesh. CBMJ 2018 January: Vol. 07 No. 01 P: 04-09


Author(s):  
Dr. Dileep Kumar Jha ◽  
Dr. Rajnikant Narsinhbhai Chauhan

Introduction: In human body there are many causes of the injuries. Among all the injuries head injury is also one of the most important injuries which may cause morbidity and mortality. Craniocerebral injuries or Traumatic brain injury (TBI) is defined as any structural skull traumatic injury with alterations of cerebral physiology as a result of an external force either in the form of chemical energy, mechanical energy, electrical energy or thermal heating. Globally craniocerebral injuries or Traumatic brain injury (TBI)is cause of disability in young patients, especially those  <40 years of age. TBI is classified as mild, with most showing adequate and quick recovery. Nevertheless there are some kinds of TBI which showed persistent disabling symptoms that interrupt with their normal daily routine activities. Brain imaging is very important for the patients who suffer traumatic brain injury. In the emergency services Computed tomography (CT) is recommended as first assessment that provides initial information and diagnosis to identify the need of surgery. It also helps in the following of the patient and the evolution of pathology. Many studies suggest that CT can be used to predict patient outcomes. Computed tomography (CT) is an imaging technique which uses as dynamics of injected contrast material, allows rapid quantitative and qualitative evaluation of cerebral perfusion by generating cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) maps providing clinically important information with stroke subarachnoid hemorrhage (SAH)and head injury. Aim: The main aim of this study is to evaluate the computed tomography findings sustaining head injury and role of computed tomography scan in head injury. Material and Methods: During the study total 90 patients with head injury were included with different age group from 20 to 70 years old. Glasgow coma score (GCS) range 4–15 (mild head injury: GCS >14; moderate head injury: GCS = 9–13; severe head injury GCS <8) were also included in this study. For all the patients with head injury Computed tomography (CT) image were performed with siemen's somatom spirit dual slice spiral CT machine and a protocol of contiguous axial 5-mm sections through the posterior fossa and a contiguous 10 mm axial sequential scans for the rest of the brain and thinner cuts were also taken whenever required. For visualize any fractures of the skull bone algorithms with wide window settings were studied. After initial resuscitation, severity of the cranio-cerebral trauma was graded with the help of Glasgow Coma Scale (GCS) into mild head injury (GCS13- 15), moderate head injury (GCS 9-12) and severe head injury (GCS 3-8). Result: Among total patients sixty five (72.2%) patients were male and twenty five (27.8 %) were female with age range from 20 to 70 years old. In the age group 31-50 year group showed highest frequency of head trauma. The most common causes of head injury were RTA (65.6%) followed by fall injuries (20%) and physical assaults (14.4%). Among patients with head injuries Loss of consciousness and vomiting were the commonest clinical features brought to emergency. Out of 90 cases 59 (65.5%) cases showed mild head injury followed by 14(15.6%) cases sustained moderate head injury and 17(18.9%) had severe head injury. In all types of severity of head injury RTA was the prime etiological factor. Out of total cases 31(34.4%) had normal CT findings and 59(65.6%) had abnormal CT findings. Abnormal CT findings were seen in 59(65.6%) sustaining mild head injury and in all the patients with moderate and severe head injury. Out of 90 cases 13 cases with severe head injury had mortality. The most common mode of injury to cause the mortality was RTA. Five patients with severe head injury also had cervical spine injury Conclusion: This study concludes that use of CT in head trauma can finds high prevalence of head trauma related to CT. Therefore CT should be done when clinically necessary that helps to reduce cost and avoids unnecessary exposure to radiation. Keywords: Head injury, Traumatic brain injury (TBI), computed tomography (CT), Glasgow coma scale (GCS)


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