Background:Though, traumatic brain injury (TBI) has been documented as the single most common cause of morbidity and mortality in infancy and childhood, the exact incidence is unavailable in India. Moreover, modes of injury, mechanisms of damage, and management differ significantly from that of an adult.Aims and Objectives:To analyze the epidemiological factors, the spectrum of TBI, modes of injury, types of injury, and the outcome in the children <15 years with TBI.Materials and Methods:This is a retrospective study from August 2012 to May 2013 at Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India. All the pertinent details from case records of hundred and forty-seven children <15 years with TBI were analyzed. Follow-up was done for 6 months at outpatients department.Results:Age wise, incidence and severity of TBI is more common in 10–15 years. Males outnumber females with a male: female ratio 2.19:1. Overall, road traffic accident (RTA) is the commonest mode of injury. Assault is not uncommon (7.48% cases). Falls is common in <5 years while RTA is common in 5–15 years. The extradural hematoma was the most common injury pattern; however, surgical consideration was maximal for fracture skull. Overall mortality was 7.48%. Diffuse axonal injury has the maximum individual potential for mortality. We noticed excellent recovery in 68.7%, disabilities in 17.68%, and persistent vegetative state in 5.45% cases.Conclusion:TBI in children carries good outcome, if resuscitated and referred early to a neurotrauma center, and managed subsequently on an individualized basis with a well-organized team approach. Severe TBI in children has a poor outcome.

Background:Subacute subdural hematoma (SASDH) is an entity which is yet to capture the popular imagination among the neurosurgeons. Its management is often equated clinically to that of the chronic subdural hematoma (CSDH). However, their neurological deterioration is usually rapid, which seems to align them with acute subdural hematoma (ASDH). We proceed for their epidemiological evaluation. The advantages of a novel “double barrel technique (DbT)” over the conventional burrhole drainage are also presented.Methods:This retrospective study was conducted on all the patients having clinical and radiological evidence of SASDH, admitted to a tertiary care referral institute, during the period August 2013 to December 2015. Postoperatively, patients were followed-up for 3–24 months.Results:46.87% of the patients belonged to the 35–54 year age group with a male predominance (3.6:1); 68.7% had a history of alcohol abuse, whereas aspirin users were 25%. 87.5% cases were unilateral, 18.75% were hemispheric, and 46.87% were present on the left side. Altered consciousness (100%) followed by headache (37.5%) were the most common presenting clinical features.Conclusion:SASDH is an uncommon neurosurgical entity (0.89% of traumatic brain injury cases in our study) and mimics both CSDH as well as ASDH. The true incidence of SASDH may have been underestimated due to its clinical imitation with CSDH. This study in a South Asian nation also provides the epidemiological data of this rare neurosurgical entity. Outcome of surgery is good; our retrospective study confirms that “DbT” is an adequate and safe treatment. However, a better designed, randomized control trial will be needed to reinforce our findings.

No abstract

Background: India, has an estimated annual incidence of 6-7 million burn cases. In the state of Odisha, there are very few epidemiological studies of Burn injuries. Therefore a hospital based descriptive study among the admitted burn cases was conducted. Methods: The study was conducted among the burn cases admitted to the burn unit of Surgery Department of SCB Medical College and Hospital, Cuttack during the time period from 1st January 2014 to 31st May 2015.A total of 145 patients were included for the study. Results: Socio-demographic profile of burn cases showed 83 (57.2%) were females and rest 62 (42.8%) were males. Regarding residence, 109 (75.1%) of the burn victims were from rural area and the rest 36 (24.9%) were from urban area. Also 140 cases (96.5%) belonged to low socio-economic status and were having BPL card. Regarding the nature of burn, 108 (74.5%) cases had it accidentally while 33 (22.7%) had burn due to suicidal attempt and the rest 4 (2.8%) had homicidal burn and all these 4 cases were married females. 104 (71.7%) cases were affected by flame, 12 (8.2%) cases were due to scald while 29 (20%) were due to electric burn. Among the burn cases due to flame, kerosene was the most common cause. Conclusions: The study revealed that thermal burn was the most common type of burn and the victims were in their active productive period of life (21-40 years), married, illiterate and were from rural areas. Among the thermal burn victims, use of kerosene was the most common cause of burns in both the sexes.

No abstract