Strong evidence showed that fever after traumatic brain injury TBI is associated with increased mortality. In this study, we tried to evaluate the role of Bromocriptine in central hyperthermia in patients with severe TBI. This prospective controlled study was conducted on 50 severe TBI patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and GCS of less than 9 at admission. Then, they were randomly assigned into 2 groups. Bromocriptine group (25) received bromocriptine 7.5 mg/day during 24 hours from admission through a naso-gastric (NG) feeding tube. Control group (25) received conventional treatment only. Temperature was measured every 2 hours. The antipyretic measures used were the same across all patients enrolled. The primary outcome was number of patients diagnosed with central hyperthermia. After the discharge of all patients, there was a statistically significant difference between the 2 groups in number of patients diagnosed with central hyperthermia (6 (24%) in bromocriptine group Vs 18 (72%) in control, p = 0.002). There were no differences in hospital length of stay (p = 0.904) or mortality (p = 0.393). Early administration of bromocriptine in severe TBI may be associated with lower incidence of central hyperthermia with no effect on length of stay or mortality.
Background: Chest trauma is a catastrophic event that affects large number of population and leads to morbidity, disability and mortality. The definition of an occult pneumothorax is uncontested. It is a pneumothorax that was not suspected on the basis of clinical examination or plain radiography, but was ultimately detected with CT and usually treated conservatively. We evaluated the success of selective conservative management of small pneumothorax following stab chest injuries, in Emergency Department patients. Methods: This prospective study was conducted on 30 adult patients admitted to the emergency department with small traumatic pneumothorax following stab injury. All enrolled patients (n = 30) were assessed for the following, demographic data, laboratory investigations, chest x-ray and CT scan. The outcomes measured were discharge safely after successful conservative management, Initial conservative then invasive measurement. Results: There was a statistically significant difference between conservative and non-conservative types of management in the incidence of complications after 1 week follow up (p = 0.001). Conclusion: The majority of asymptomatic small pneumothorax patients following a stab injury can be managed conservatively. Haphazard chest tube insertion and aging may lead to complications in such patients.
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