Background: Children are vulnerable to musculoskeletal injuries both at home and on the street for various reasons. Morbidity and disabilities resulting from these, mostly preventable, injuries, make them a burden to their families and society. The role of various factors associated with injuries is often not documented. Methods: This prospective, cross sectional study was done on 80 children aged below 16 years with musculoskeletal trauma, data were collected and analysis was done using Microsoft excel and frequency table. The various modes of injuries, place of injuries, pattern of injuries and regional distribution of injuries were analyzed. Results: One in every four to five patient was a child below 16 years of age. Boys were injured more than girls. Injuries, especially fractures, were most common in the extremities, the upper limb more commonly injured than the lower limb. Most of the injuries occurred at home. The most common mode of injuries was falls that happened while playing both within and outside the home, followed by road traffic accidents. Most injuries occurred during daytime. Conclusions: Many injuries in children were found to be preventable. Small interventions and modification while constructing homes and surroundings can contribute tremendously to injury prevention and control in children. Parental awareness about the various modes of injury, role of supervised playing and their responsibility towards injury prevention can play a key role in reducing the morbidity associated with childhood fractures.
Introduction: Poisoning is a common cause of morbidity and mortality in the Nepal. The objective of our study is to evaluate the incidence and pattern of acute poisoning cases admitted to the Gandaki Medical Teaching Hospital. Methods: This is cross-sectional observational study carried out among acute poisoning cases attending emergency department from January 2015 to December 2017. Results: A total of 156 poisoning cases were treated of which female patients were 71% and the highest numbers (36.5%) of patients were in the age group 21 to 30 years. Organophosphates poisoning was the commonest poison diagnosed among 28.8%, followed by rodenticide poisoning found among 27.5%. Psychiatric illnesses were present among 94.8% of our patients. The most common diagnosis were Anxiety and depression 46.6% followed by family dispute among 30.4%. Above fifty percent of our patients attended our emergency department within 2 hours our ingestion of poisons. Conclusion: Female and young people are at greater risk of acute poisoning. Pesticides were the most common agent. The reasons for the poisoning need to be carefully evaluated and proper support and advice must be given in poisoning cases.
Introduction: Tension band wiring is the most commonly used treatment method for transverse patella fracture. Tension band construct can be achieved by various modifications. Percutaneous cannulated screw with tension band is a minimally invasive technique with stiffer fixation that follows tension band principle. This study aims to assess the clinical and radiological outcome using percutaneous cannulated screw with tension band for the management of transverse patella fracture. Methods: This was a prospective study among 30 adult patients who had closed displaced transverse patella fracture. Patients with polytrauma, comminuted fracture, neurovascular injury and prior injury to the limb were excluded from the study. Each patient was followed up at 2 weeks, 4 weeks, 3 months and 6 months postoperatively. Results: Among all surgically treated patients using this technique, Pain gradually decreased over time and was less than VAS score of 1 in all patients at 6 months follow-up with an average score of 0.3. The final range of motion at 6 months was: flexion ranging from 122 to 145 degrees and extension lag from of 0 to 8 degrees. There was significant improvement in range of motion of knee in each follow up. The mean duration for fracture union was 11.4±2.3 weeks. There were no cases of nonunion and hardware failure. The mean Lyshom score was 82.5 at final follow up. Conclusions: The percutaneous fixation of transverse patella fracture with cannulated screw and SS wire is safe and effective method which gives good functional outcome.
Introduction: On April, 2015, at 11:56 Nepal Standard Time (06:11:26 UTC), a catastrophic earthquake with a magnitude of 7.8 - 8.1 on Richter scale and lasted approximately fifty seconds with Mercalli intensity of IX (Violent) hit the North West of Kathmandu, Nepal. Its epicenter was East of Gorkha District at Barpak, Gorkha, and its hypocenter was at a depth of approximately 8.2 km. It was the worst natural disaster to strike Nepal since the 1934 earthquake. The earthquake caused nearly 9,000 individuals death, injured 22,000 people and 3.5 million people were homeless.Objectives: The main objective of this investigation was to study the demography profile, morbidity pattern, duration of hospital stay and mortality incidence among the 2015 earthquake injured patients visiting Emergency Department of Gandaki Medical College Teaching Hospital.Methods: A retrospective analysis of the earthquake injured patients attending through the Emergency Department. All the earthquake injured patients attending the Emergency Department from 25th April to 24th May, 2015 were enrolled in our study. The collected data has been complied and analyzed using Statistical Package for the Social Science software package 16 version.Results: Hundred and seventy patients were triage and 63% were females. Majority (44.2%) of patients were of age group of 15 - 34 years. Eighty one percent of patients were from Gorkha district, the epicenter site of the earthquake. The three most common diagnoses were trauma and orthopedic injuries (52.4%), mental health issues and psychological problems (21.2%) and reproductive health issues (16%). Among the 83% of patients who had been hospitalized, almost 34% were discharged within one week. Mortality rate was 1.2%.Conclusions: Since 1993, earthquakes of more than or equal to 5.0 on the Richter scale have occurred in Nepal every year and this makes Nepal 11th most vulnerable country in world. Therefore, every hospital should have well functioning Earthquake Disaster Management Plan to handle this high intensity emergency situation in our country. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 11-15
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