Clinical Profile of Blunt Trauma Chest: A Hospital based Study

Introduction: Blunt trauma to the chest is a very commonoccurrence in setting of traumatic incidents occurring withhighest frequency in young adults between 15-35 years ofage. Traumatic chest injuries lead to significant burden ofmortality and morbidity in the young population. The mostcommon modes of injury in such patients is motor vehicleaccidents followed by other high energy traumatic scenarioslike falls from height, contact sports, violence etc. This studywas aimed at the evaluation and management of BCT with ribfractures and associated injuries.Material and Methods: The present study was a retrospectivecum prospective hospital based study done in SKIMS MedicalCollege Hospital, Srinagar, J & K, India. Sixty four patientswho attended the Emergency Department with history of bluntchest injury were included in the study. Patients of all gendersbetween 18 and 65 years of age were included in the study.The data regarding age, gender, mode of injury, presence ofthoracic injuries, abdominal injuries, skeletal injuries wasgathered and tabulated.Results: We observed a strong male preponderance with45 out of 64 patients being male. Most common mode ofinjury was traffic accidents followed by falls from height,fall of heavy objects, hit by animals, violence and contactsports. Associated injuries were seen in both thoracic andextra-thoracic organs. Musculoskeletal injuries were alsocommonly seen. Patients were managed according to ATLSprotocol; fifteen patients were managed with intercostal tubedrainage four of which required thoracotomy, four patientsrequired laparotomy for visceral injuries, four patientsrequired fixation of vertebral fractures and musculoskeletalinjuries were managed according to the orthopaedic protocols.In the present study four (6.25%) died as a result of massivethoracic injuries.Conclusion: Blunt chest injury is a serious injury whichcan result in life threatening complications which need to beanticipated, identified and adequately managed to reduce therates of poor outcome. Integrated management employingthe general surgeon, anesthetist, orthopaedician, internistand relevant paramedics is essential. Strict adherence toATLS protocol is imperative. Adequate fluid resuscitation,ventilatory support, O2 inhalation, pulmonary physical therapyand efficient analgesia can lead to quick recovery and reducedrates of surgical intervention

Evaluation of hospital management system at combined military hospital Peshawar

Objective: To evaluate HMS in terms of its user's satisfaction, time management, data retrieval, record keeping and confidentiality of medical records

Study Design: Cross sectional study

Place and Duration of Study: Combined Military Hospital [CMH] Peshawar, from 1[st] Nov 2013 to 30[th] Apr 2014

Material and Methods: All doctors using hospital management system [HMS] for more than six months in CMH Peshawar were included in this study by means of non probability convenient sampling. This made a total sample size of 71. A questionnaire was filled regarding satisfaction, time management, data retrieval, record keeping and confidentiality of medical records and results analyzed

Results: Out of total 71 participants, 25 [35.25%] were satisfied and 46 [64.75%] were not satisfied with the use of HMS. Increase in time per patient was observed in 60 [84%]. Out of total respondents, 57 [80%] found HMS as useful tool for data retrieval and 25 [35%] stated that manual record should be retained along with electronic records. Concerns regarding confidentiality of record was shown by 21 [30%] of the participants

Conclusion: A significant percentage of doctors were not satisfied with the use of HMS. Its use leads to increase in time spent per patient. However, most of the participants of the study found HMS efficient tool for data retrieval, record keeping and confidentiality of medical records

Early onset neonatal sepsis in preterm premature rupture of membranes

To determine the frequency of early onset neonatal sepsis in newborn with various duration of preterm premature rupture of membranes [PPROM]. Cross sectional study. Neonatal Intensive Care Unit Combined Military Hospital, Lahore from November 2009 to November 2010. Neonates of singleton pregnancies complicanted by pretern premature rupture of the membranes [PPROM] with delivery between 30 and 36 weeks gestation were included in the study. The overall frequency of neonatal sepsis was calculated on clinical and serological basis. Comparison of the frequency of sepsis among groups with varying duration of rupture of membranes was done. Out of 164 babies, 84 [51.2%] were female and 80 [48.8%] were male. Mean maternal age was 23 year [range: 18-36 years] .Mean gestational age was 33 weeks [range: 30-36 weeks]. Sepsis was suspected in 41 [25%] babies on clinical grounds. C-reactive protein was raised in 36 [22%] neonates. There was statistically insignificant difference between clinical versus serological diagnosis [p=0.515]. Frequency of neonatal sepsis was significantly higher in mothers with longer duration of rupture of membrane [p< 0.001]. Frequency of neonatal sepsis was observed to be 22%. PPROM is an important risk factor for early onset neonatal sepsis

effect of aircraft engine noise on the hearing of army aviation personnel

To determine the frequency and severity of noise induced hearing loss [NIHL] and its audiometric configurations among Pakistan Army Aviation personnel. Cross sectional descriptive study. From June 2009 to May 2010 at ENT department of CMH Gujranwala. A total of 100 individuals who were exposed to turbo-propeller aircraft's engine noise for more than two years were recruited and assessed for hearing impairment. All the subjects were evaluated through detailed history and clinical examination. Pure tone audiometry was carried out and pathological audiograms with sensorineural hearing loss were segregated. Hearing thresholds and audiometric configurations were recorded. Out of the 100 subjects enrolled NIHL was found in 32% individuals. Among them, 20 [62.5%] patients suffered from bilateral pathology. It was mild in 13 [40.62%], moderate in 14 [43.75], and severe in 5 [15.62%] cases. The most common audiometric configuration was the notched audiogram with a dip at 4 kHz occurring in 14 patients followed by slope configuration found in 13 patients. Aviation workers are exposed to exceptionally intense noise which can render them physically and socially handicapped at times. The intricate nature of such impact entails a prompt recognition and adoption of necessary prophylactic measures to minimize the risk of developing a rather irreversible sensory handicap