Introduction: Maxillofacial injuries are one of the most frequently encountered entities accounting for a large proportion of patients in emergency department. Present study was performed to assess the role of multidetector computed tomography (MDCT) in patients of maxillofacial trauma and to describe the spectrum of various patterns of injuries in maxillofacial region in this part of Nepal. Methods: The study was carried out on a prospective basis over a period of one year. All the patients referred for evaluation of maxillofacial trauma were included in the study. MDCT was done in patients of maxillofacial injury and the data was recorded and analyzed. Volumetric MDCT scan of the maxillofacial region was performed in axial plane with multiplanar reconstruction in coronal and sagittal planes were obtained wherever required. Results: Out of 60 patients of maxillofacial trauma 42 (70%) were males and 18 (30%) were females and age ranges from 12 to 70 years. The 11?30 years age group has the highest percentage (55%) of maxillofacial trauma, followed by 31?40 (20%). The common cause of injuries in our study was road traffic accidents (58.33%), fall from height (20%), physical assault (16.66%) and sport injuries (5%). Out of 60 patients there was total of 115 fractures. The frequency and types of fracture was as follows: orbital floor fracture in 21 (35%), maxillary sinus wall fracture in 18 (30%), nasal bone fracture in 17 (28.33%), jaw fracture in 15 (25%), zygomatic bone fracture in 13 (21.66%), orbital wall fracture in 11 (18.33%), naso?ethmoidal fractures in 9 (15%), frontal sinus fracture in 7 (11.66%), Lefort fracture in 1 (1.66%) and others 3 (5%). The highest percentage of fracture was of orbital floor (35%) followed by fracture of wall of maxillary sinus (30%) and nasal bone fracture (28.33%). Three cases had simultaneous injury of the globe and cervical spine; they underwent computed tomography/magnetic resonance imaging for the assessment of spine. Conclusion: Injuries to maxillofacial region is one of the most common emergency requiring accurate and early diagnosis for preventing unnecessary investigations and proper management. MDCT has high sensitivity and specificity and has high accuracy for detection of fracture. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9561 Asian Journal of Medical Sciences 2014 Vol.5(4); 39-43
Background: Sleep disturbance negatively affects recovery and survival of patients in intensive care units (ICUs).Aims and Objectives: This study aimed to measure the noise levels and evaluate the impact of a white noise app on the sleep quality of critically ill patients.Design: A quasi-experimental time series pre-test-post-test control group design with repeated measures was adopted. Methods:The study was conducted in the high dependency unit (HDU) of a selected tertiary care hospital in Mangalore, Karnataka State, India. Conscious oriented patients with systolic blood pressure ranging from 100/70 to 140/90 mm Hg and hearing acuity of at most 20 dB in both ears were included in the study. Noise levels in the HDU were measured using calibrated sound level meter on weekdays/ weekends in three different shifts and an average of 24 readings was obtained per shift. A 4-point Likert scale was used to assess the sleep quality. The intervention included administration of white noise app twice a day, for three consecutive days by using different masking sounds such as white noise on day 1 which resembles to a humming AC conditioner, pink noise on day 2 which resembles to the sound of ocean waves and brown noise on day 3 which resembles a steady rainfall. The app was used with the help of JBL earphones C10SI an excellent noise cancellation and noise isolating earphone.Results: Among the 54 subjects, the mean age of the patients was 40.28 years, majority 34 (63%) were males. The noise level in the ICU was more than 60 dB. There was a significant difference in the sleep quality after the application of the white noise app in the experimental group on Day 1 (Z = À3.996; P = .001), Day 2 (Z = À3.302; P = .001), and Day 3 (À2.822; P = .005) compared to the control group. Conclusion: Adoption of technology driven noise reduction applications wouldenhance the quality of sleep among the ICU patients.Relevance to clinical practice: The use of a technology-driven application helps control noise levels which promotes improved sleep quality among critically ill patients in the intensive care units.
Introduction: Vitiligo, a pigmentary disorder, may influence considerably patients health-related quality of life (QoL) and psychological wellbeing. Previous reports indicated that the patients' illness understandings influence adherence behaviors and actions in various chronic dermatological conditions. Objectives:To know the understanding of Nepalese patients with vitiligo about their disease by using illness perception questionnaire and also to investigate the potential factors that might influence it. Material and Methods:The illness perception questionnaire consisting of 25 questions about causes, timeline, consequences and control of disease were given to 154 patients with vitiligo of 13 years or more age attending the dermatology OPD.Results: A total of 146 patients completed the questionnaire. The belief about the causes of vitiligo was considered as germs or virus by 64.4% patients while half of the patients believed that vitiligo was due to chance or fate. Vitiligo was considered to be a serious condition (83.6%) and have had serious consequences on their life (63%). Approximately half of the patients believed that their disease had serious economic and financial consequences more so in female patients and in those with generalized disease. Although 43.8% patients believed that their illness was likely to be permanent rather than temporary, 75% patients believed that vitiligo would improve with the time and their treatments were effective (75.3%). However, females felt that there were very little that could be done to improve their vitiligo. Conclusion:The knowledge about vitiligo is unsatisfactory and needs accessible, accurate, community based education about the natural history of vitiligo and the effectiveness of treatment.
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