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1.
Chinese Journal of Traumatology ; (6): 243-248, 2020.
Article in English | WPRIM | ID: wpr-827836

ABSTRACT

PURPOSE@#To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster.@*METHODS@#A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated.@*RESULTS@#Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure.@*CONCLUSION@#In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.


Subject(s)
Adolescent , Adult , Child , Cyclonic Storms , Disaster Planning , Disaster Victims , Emergency Service, Hospital , Female , Humans , Male , Middle Aged , Multiple Trauma , Epidemiology , Retrospective Studies , Tertiary Care Centers , Trauma Centers , Trauma Severity Indices , Young Adult
2.
Article in English | WPRIM | ID: wpr-917854

ABSTRACT

PURPOSE@#The spotter's (objectively structured practical examination) is an assessment tool which is widely used to test the practical knowledge of anatomy extensively. In Indian context it is used as an inclusive model in the gross anatomy practical examination and the marks allotted to it varies. The traditional spotter examination often has been blamed for only incorporating the initial levels of revised Bloom's taxonomy. This study retrospectively analysed the pre-professional spotter's examination score and tested its efficacy in terms of reliability, internal consistency, validity, educational impact, and resource intensiveness.@*METHODS@#The summative data of student's score on four different days of unrepeated spotter's examination and final theory examination score was collected and tabulated. These four group of students acted as independent cohorts. The difficulty index (DI), point biserial correlation (PBC), Cronbach α (CA) and descriptive statistics of each cohort were calculated. Revised bloom taxonomy rating was applied to spotter's.@*RESULTS@#We found heterogenous distribution of spotter's in each cohort according to DI. The PBCs and CA of each cohort were acceptable. The majority of spotter's tested the cognitive and comprehension domain of revised bloom's taxonomy. There was nonsignificant difference between mean scores of cohorts but we found low positive significant correlation between theory and spotter's score.@*CONCLUSION@#We concluded that the construct of spotter's was reliable, internally consistent, had fair validity, variable educational impact, and sustainable resource intensiveness. We propose urgent redesigning of spotter's to include higher level of taxonomy to comply with emerging curricular changes.

3.
Article in English | WPRIM | ID: wpr-771640

ABSTRACT

PURPOSE@#Reduction and fixation in femoral neck fracture in young patients have a problem of nonunion requiring additional procedure like valgus osteotomy but fixation devices are technically difficult for inexperienced surgeons. We aims to assess the results of valgus osteotomy in femoral neck fracture in our setup.@*METHODS@#We report a series of 20 patients of higher Pauwel's angled fracture of femoral neck fracture presenting late wherein for valgus osteotomy was added to reduction fixation secured with a commonly available 135° dynamic hip screw and plate.@*RESULTS@#Femoral neck fractures united in 16 patients (80%). Excellent to good results (Harris hip score >80) were seen in 70% patients. Angle of correction of preoperative Pauwels has been changed from 68.3 to 34.3.@*CONCLUSION@#135° dynamic hip screw and plate provides rigid internal fixation after valgus osteotomy and being a more familiar fixation device simplifies the procedure with good results.


Subject(s)
Adult , Bone Plates , Bone Screws , Female , Femoral Neck Fractures , General Surgery , Femur Neck , General Surgery , Follow-Up Studies , Fracture Fixation, Internal , Methods , Humans , Male , Middle Aged , Osteotomy , Methods , Pelvic Bones , General Surgery
4.
Article in English | WPRIM | ID: wpr-759885

ABSTRACT

PURPOSE: The spotter's (objectively structured practical examination) is an assessment tool which is widely used to test the practical knowledge of anatomy extensively. In Indian context it is used as an inclusive model in the gross anatomy practical examination and the marks allotted to it varies. The traditional spotter examination often has been blamed for only incorporating the initial levels of revised Bloom's taxonomy. This study retrospectively analysed the pre-professional spotter's examination score and tested its efficacy in terms of reliability, internal consistency, validity, educational impact, and resource intensiveness. METHODS: The summative data of student's score on four different days of unrepeated spotter's examination and final theory examination score was collected and tabulated. These four group of students acted as independent cohorts. The difficulty index (DI), point biserial correlation (PBC), Cronbach α (CA) and descriptive statistics of each cohort were calculated. Revised bloom taxonomy rating was applied to spotter's. RESULTS: We found heterogenous distribution of spotter's in each cohort according to DI. The PBCs and CA of each cohort were acceptable. The majority of spotter's tested the cognitive and comprehension domain of revised bloom's taxonomy. There was nonsignificant difference between mean scores of cohorts but we found low positive significant correlation between theory and spotter's score. CONCLUSION: We concluded that the construct of spotter's was reliable, internally consistent, had fair validity, variable educational impact, and sustainable resource intensiveness. We propose urgent redesigning of spotter's to include higher level of taxonomy to comply with emerging curricular changes.


Subject(s)
Classification , Cognition , Cohort Studies , Comprehension , Curriculum , Educational Measurement , Humans , Retrospective Studies
5.
Asian Spine Journal ; : 388-389, 2018.
Article in English | WPRIM | ID: wpr-739246

ABSTRACT

No abstract available.


Subject(s)
Ligamentum Flavum
6.
Asian Spine Journal ; : 422-429, 2016.
Article in English | WPRIM | ID: wpr-131717

ABSTRACT

STUDY DESIGN: Data of 22 patients with congenital scoliosis who underwent single stage posterior hemivertebrectomies and short segment fixation with a minimum follow-up of 2 years in our centre were studied retrospectively. PURPOSE: To report the efficacy of posterior hemivertebrectomy in single vs multiple level hemivertebra and compare their results. OVERVIEW OF LITERATURE: Single stage hemivertebrectomy is a standard procedure for single level hemivertebra. Results of multiple level hemivertebrectomies have not been reported. METHODS: Twenty-two patients (9 male and 13 female) with the mean age of 11.2 years (range, 2 years 4 months to 24 years 10 months) and a mean follow up of 32 months (range, 4 to 73 months) were studied retrospectively and their results were compared. RESULTS: Average number of hemivertebrae removed was 1.46 (range, 1 to 3). Mean preoperative and postoperative coronal cob angle was 48.7° (range, 22° to 80°) and 24.2° (range, 7° to 41°), respectively (p<0.001). Mean preoperative and postoperative sagittal cobb angle was 32.1° (range, 7° to 76°) and 13.6° (range, 0° to 23°), respectively (p<0.005). Mean coronal and sagittal cob correction percentage achieved was 50.2% and 51.8% respectively. Mean follow-up was 49 months (range, 30 to 84 months). Mean loss of coronal and sagittal correction at final follow-up was 4% (0% to 13.6%) degrees and 3.5% (0% to 20%), respectively. CONCLUSIONS: Posterior hemivertebrectomy in congenital scoliosis is a safe treatment option for up to 3-level hemivertebrae. Excision of thoracolumbar hemivertebrae results in better correction than thoracic and lumbar hemivertebrae.


Subject(s)
Congenital Abnormalities , Follow-Up Studies , Humans , Kyphosis , Male , Retrospective Studies , Scoliosis , Spinal Curvatures , Spine
7.
Asian Spine Journal ; : 422-429, 2016.
Article in English | WPRIM | ID: wpr-131716

ABSTRACT

STUDY DESIGN: Data of 22 patients with congenital scoliosis who underwent single stage posterior hemivertebrectomies and short segment fixation with a minimum follow-up of 2 years in our centre were studied retrospectively. PURPOSE: To report the efficacy of posterior hemivertebrectomy in single vs multiple level hemivertebra and compare their results. OVERVIEW OF LITERATURE: Single stage hemivertebrectomy is a standard procedure for single level hemivertebra. Results of multiple level hemivertebrectomies have not been reported. METHODS: Twenty-two patients (9 male and 13 female) with the mean age of 11.2 years (range, 2 years 4 months to 24 years 10 months) and a mean follow up of 32 months (range, 4 to 73 months) were studied retrospectively and their results were compared. RESULTS: Average number of hemivertebrae removed was 1.46 (range, 1 to 3). Mean preoperative and postoperative coronal cob angle was 48.7° (range, 22° to 80°) and 24.2° (range, 7° to 41°), respectively (p<0.001). Mean preoperative and postoperative sagittal cobb angle was 32.1° (range, 7° to 76°) and 13.6° (range, 0° to 23°), respectively (p<0.005). Mean coronal and sagittal cob correction percentage achieved was 50.2% and 51.8% respectively. Mean follow-up was 49 months (range, 30 to 84 months). Mean loss of coronal and sagittal correction at final follow-up was 4% (0% to 13.6%) degrees and 3.5% (0% to 20%), respectively. CONCLUSIONS: Posterior hemivertebrectomy in congenital scoliosis is a safe treatment option for up to 3-level hemivertebrae. Excision of thoracolumbar hemivertebrae results in better correction than thoracic and lumbar hemivertebrae.


Subject(s)
Congenital Abnormalities , Follow-Up Studies , Humans , Kyphosis , Male , Retrospective Studies , Scoliosis , Spinal Curvatures , Spine
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