Online ISSN: 2515-8260

Keywords : road traffic accidents

A Prospective Study to Assessment of Profile of Trauma Patients in a Tertiary Care Centre

Prashant Garhwal, B. S. Garhwal, Yusuf Ali Deora, Bimla Choudhary

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2240-2244

Background: Trauma is a major cause of morbidity and mortality in both developed and developing countries. The usual causes are road traffic accidents, fall from height, assaults, occupational injuries. The present study was conducted to assess profile of trauma patients in a tertiary care centre.
Materials and Methods: The present study was a prospective study of trauma patients carried over a period of 3 months.Details of history and physical examination findings of all patients were recorded. Triage priority level was noted. as follows: All patients had routine blood investigations and relevant radiological tests. In‑hospital outcome of all the admitted patients was noted. The recorded data was compiled, and data analysis was done.
Results: In the present study total trauma cases were 1800 in which 68.81% were males and 31.38% were females. Maximum trauma cases were in the age group 31-40yrs followed by18-30 yrs. Maximum injuries were of triage priority level 2 (57.33%). In two-wheeler, four-wheeler, auto, other vehicle accidents triage priority level 2 was in maximum patients. Two-wheeler accidents were followed by pedestrian injuries. Other modes of injury included fall on level ground, fall from height, assault had maximum injuries of triage priority level 2. In workplace injuries, sports injuries maximum injuries of triage priority level 3 and in others type of injury maximum injuries of Triage priority level 1. In head, face, thorax, spine, vascular, extremity maximum injuries were of triage priority level 2. In Neck, dorsum maximum injuries were of triage level 3. In abdomen maximum injuries were of triage priority level 1.
Conclusion: The present study concluded that road traffic accidents and falls were the major cause of trauma and the maximum injuries were of triage level 2.

A Study on Physiological Causes and Temporal Pattern of Trauma Death in a Tertiary Care Trauma Centre

N. Niranjan Kumar, M. Emil Phinehas, Angeline Neetha Radjou, Ashwin Chand .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3165-3173

Background: Trauma is a major public-health problem in India. With a population over one billion and an annual urbanization rate of 26%, the magnitude of the problem is a cause for concern. An unpresented increase in number of vehicles has outpaced the development of adequate roads and highways. Trauma especially RTA’S are the invariable fall out in the rapid motorization and urbanization in India. Aim: To study the physiological causes and temporal pattern of trauma death in the study population.
Materials and Methods: Study Design: Institutional based Retrospective and prospective study. Study area: The study was done in the Department of in medical college. Study Period: Retrospective period of 6 months and Prospective for 6 months. Study population: All trauma patients fatalities in the hospital and Patients brought dead to accident and emergency. Sample size: A total of 92 patients were included in the study. Prevalence of head injury = 60% (last year records) with an Absolute precision of 10% at 95% confidence interval. Required sample size = 92. Sampling method: Simple Random sampling method. Ethical consideration: Institutional Ethical committee permission was taken prior to the commencement of the study. Study tools and Data collection procedure: All severely injured patients will be evaluated from the time they arrive to the duration of stay in the hospital and eventual cause of death will be estimated. The reported time of death will be noted and its significant pattern of trauma deaths will be noted. A graphical illustration of modal distribution of death with a simple bar diagram showing the physiological cause of death and time duration from 0 - 6 hours, 6 – 12 hours, 12 – 24 hours, 24- 48 hours, 48 – 72 hours ,72 hours – 1 week, > 1 week will be done respectively. Statistical Analysis: The data was collected, compiled and compared statistically by frequency distribution and percentage proportion. Quantitative data variables were expressed by using Descriptive statistics (Mean ± SD). Qualitative data variables were expressed by using frequency and Percentage (%).
Results: Among these causes in our study Intractable intracranial hypertension was seen in 63% (n-58) cases, Hemorrhagic shock/ Bleeding 25% (n- 23), Sepsis/Multi organ failure 6% (n– 5), Intracranial Hypertension and Sepsis 3% (n- 3), Ventilation associated Problems 1% (n- 1), Intracranial Hypertension and Hemorrhagic shock 1% (n – 1), Hemorrhagic Shock and Sepsis 1% (n- 1).
Conclusion: Retrospective judgments on clinical decision-making, based on case record findings, must be examined with extreme caution, and this study has been careful to use only objective parameters, like prolonged operative time, or pre-operative physiological status. If the results remain valid in other Indian hospitals, it is worth noting that better identification and management of trauma patients could save a quarter of million lives each year, based on a 50% reduction of the estimated half a million annual hospital trauma deaths in India.

Clinical profile of patients with displaced proximal humeral fracture attending tertiary care hospital

Dr. Gopi HG, Dr. Arjun A, Dr. Nagesh Sherikar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1843-1847

Most fractures of proximal humerus occur through osteoporotic bones in older patients. High energy trauma may result in such fractures at any age. Most common mechanism is a simple fall on the arm. Strong muscular contraction is the proposed mechanism for greater Tuberosity fractures. This is seen in cases of electric shock or seizure. Once the fragments separate muscle forces contribute to their displacement. The shaft is generally drawn anteriorly and medially by the pectoralis major. Once the patient is fit for surgery, will under goes open reduction and internal fixation with proximal humerus interlocking system(PHILOS)plate and screws under brachial plexus block or general anesthesia, Patient will be placed in Beach chair. All the patients were approached by Deltopectoral approach, cephalic vein is dissected and retracted, internervous plane between deltoid and biceps tendon. Once fracture site is exposed, fracture is reduced provisionally with K wires and checked in fluoroscopy. And final fixation done with PHILOS plate and position is confirmed in fluoroscopy. The mode of injury commonly observed in our series was road traffic accidents accounting for 23 (76%), 7 (24%) patients had a history of fall. These observations was found to be consistent with the studies in literature which revealed 19 (45%) road traffic accidents, 20(50%) history of fall.

A Retrospective Analysis of Maxillofacial Trauma in a Tertiary Care Centre in central India: A 8-year study

Dr. Karuna Jindwani, Dr. Amit Kumar Sahu, Dr. Geeta Tripathi, Dr. Divashree Sharma, Dr. Juhi Singh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 2383-2395

Introduction: The incidence of maxillofacial fractures varies worldwide. The
information on epidemiological characteristics in association with the etiology and
incidence of injuries help in prevention and appropriate treatment of such injuries.
Purpose: Thus, the aim of this retrospective study was to describe the prevalence,
incidence, pattern, etiology, management of trauma cases at Shyam Shah Medical
College (S. S. M. C), in a span of 8 years.
Patients & Methods: The data collected included age, sex, date and month (seasonal
variations), etiology, site of fracture, associated injuries, treatment modalities used for
the management of maxillofacial trauma patients reporting in the Department of
Dentistry and emergency casualty department of S. S. M. C., Rewa from February 2013
till January 2021.
Results: A total of 892 cases depicted fractures of the facial skeleton. The mean age was
36 years. Though patients ranging from 4-75 years reported for treatment. Males
outnumbered females with a male: female ratio of 8:1. Injuries commonly occurred in
the 21-30 years age group. Road traffic accidents (RTAs) were the most common
etiological factor in 631 patients followed by inter personal violence (IPV) in 147
patients. Mandibular fracture was the most frequently encountered fracture. The
seasonal variation showed the peak incidence of cases in the months of January and
December with 23.4 % of total patients. 15.13 % of the cases were managed
conservatively, 7.29% patients with debridement and soft tissue repair, while closed
reduction was used in 60.54 % of patients and 17.04 % were treated with surgical open
reduction and internal fixation. There was no serious complication in any of our patient
in the average follow up span of 6 months.
Conclusion: This study verified a young male predominance involved in maxillofacial
trauma. RTAs contributed as the major etiological factor. Thus, similar long-span multi
centric epidemiologic studies may help government and authorities to plan periodic
review of driving skills & strict implementation of traffic rules policies.