Maxillofacial trauma and associated brain injuries

The aim of this study is to find out the distribution of brain injuries in patients with craniofacial trauma. Retrospective study. This study was conducted at the Departments of Oral and Maxillofacial Surgery and Neurosurgery of Liaquat National Hospital from Jan. 2010 to Dec. 2010 History form and radiographs of 112 patients who visited the Departments of Oral and Maxillofacial Surgery and Neurosurgery of Liaquat National Hospital were reviewed. Mean age of the sample was 31.7 years [+/- 8.8], minimum 18 years and maximum 65 years. The most common cause of cranio-facial trauma was road traffic accidents accounting for 94.6% followed by gunshot 2.7% fall 1.8% and assault 0.9%. Young adult males were most frequently affected. The most common site of trauma was midface 49.5% followed by mandible 26.8%, orbit 16.1% and panfacial 8%.Brain injury was recorded in 37.8 % of patients. Contusion, concussion and direct trauma to the brain was most common in mid face fractures hemorrhage was most common in Panfacial fracture. Mean GCS score was 14.77 in Mandibular trauma, 13.17 in isolated orbital fractures 12.98 in Midface trauma and 9.18 in Panfacial trauma. There is a strong correlation noticed between the craniofacial trauma and brain injury in this study. Young adult males sustained most craniofacial fractures as a result of road traffic accidents. A clearer understanding of risk factors associated with road traffic accidents and strict implantation of road traffic safety measures should be emphasized to avoid serious complications. Education of oral and maxillofacial surgeons regarding brain injury and its significance in terms of neurological outcomes should be emphasized

Chest radiographs in acute pulmonary embolism

Pulmonary embolism [PE] is a serious clinical entity carrying significant morbidity and mortality. Clinically, it is a difficult condition to diagnose and remains under treated condition in Pakistan due to non-availability of objective tests and lack of awareness among physicians. This study was conducted to determine the chest radiographic presentation in known cases of acute PE presenting to a tertiary care hospital. hospital records of patients with a diagnosis of acute PE were reviewed from June 2000 until June 2004. fifty diagnosed cases of defect were selected. Two chest physicians reviewed the chest demonstrating an intraluminal-filling hospitalization. In case of discrepancy, a radiologist made final interpretation. The chest radiograph was interpreted as normal in only 18% of patients with acute PE. The most common chest radiographic abnormalities were cardiac enlargement [38%], pulmonary parenchymal infiltrates [34%], atelectasis [26%], pleural effusion [24%], and pulmonary congestion [24%]. Other rare findings were elevated hemi diaphragm [14%], pulmonary artery enlargement [14%], and focal oligemia [8%]. Cardiomegaly is the most common chest radiographic abnormality associated with acute pulmonary embolism. Its major role is in identification of alternative disease processes that can mimic thrombo-embolism