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Purpose To explore the clinical and pathologi-cal features and the relationships between pathological features and drugs of patients with drug-induced liver injury(DILI)based on the hepatotoxicity injury patterns.Methods The clin-ical data,laboratory indicators,drugs,and liver biopsy of 50 cases of DILI were collected,the expression of CK19 was detec-ted by immunohistochemistry EnVision two-step method,and the reticular scaffold of liver tissue was displayed by Reticular fiber staining.Results Among the 50 patients with DILI,there were 29 cases of hepatocellular DILI,11 cases of cholestatic DILI,and 10 cases of mixed DILI,respectively,with the hepatocellu-lar DILI accounting for the highest proportion(58％).7 catego-ries of drugs induced DILI,with herbal ranking first(52％).Different types of drugs could cause different types of DILI,with herbal induced 17 cases hepatocellular DILI(58.62％)and an-ti-infectious and anticancer drugs induced all 3 cases cholestatic DILI(27.27％).Different types of DILI displayed various pathological characteristics.Hepatocellular congestion,feathery degeneration,and small bile duct thrombosis primarily occur in cholestasis and mixed DILI,while bridging necrosis,sub-large and large necrosis were mainly seen in hepatocellular DILI.Conclusion Based on hepatotoxicity injury patterns,DILI ex-hibits a variety of clinical and pathological characteristics,and there is some relationship between pathological characteristics and drugs.Liver puncture pathological biopsy plays an important role in improving the diagnosis and treatment of DILI.
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Background: Lockdown had hindered persons’ ability to engage in regular physical activity. Our study analysed bone trauma patients who visited the orthopedic department based on the mode of injury, kind of extremity involved, and the bone implicated. Methods: This was a retrospective cross-sectional study of patients visiting the orthopedic surgery department of a North Indian tertiary health care centre. Patient data was recorded from the case sheets. Results: A total of 792 patients’ data was collected, out of which 250 patients were those of during lockdown, and 542 patients were of non-lockdown phase. During the lockdown phase, the patients who have undergone RTA were 37 (14.8%), those admitted for domestic trauma were 128 (51.2%), and those for miscellaneous causes were 85 (34%). During the non-lockdown phase, RTA were 145 (26.739%), domestic were 318 (58.608%) and miscellaneous were 79 (14.652%). During lockdown, the site of injury was upper limb in 59 patients, lower limb in 154 patients, vertebrae in 37 patients. In the non-lockdown phase, the upper limb was injured in 95 patients, lower limb in 377 patients, vertebrae in 52 patients and hip bone in 17 patients. Femur was the most affected bone. Conclusions: There was a decrease in the number of instances during the lockdown. During both the periods, the majority of geriatric patients were from rural areas. Domestic trauma cases were most prevalent in the older age range, and the most common extremity implicated appeared to be the lower limb, with the femur being the most involved bone in both stages.
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INTRODUCTION@#With Singapore's ageing population, there are increasing numbers of elderly cyclists and motorcyclists. Compared to younger riders, this cohort sustains more injuries and has poorer outcomes. This study aimed to describe and compare patient demographics, injury patterns and outcomes among elderly cyclists and motorcyclists at a Level 1 trauma centre.@*METHODS@#Data of all cyclists, motorcyclists and pillion riders aged 65 years and above who presented to the emergency department after accidents from 1 January 2013 to 31 December 2017 was extracted from the hospital's trauma registry and reviewed.@*RESULTS@#Cyclists and motorcyclists formed 42.0% and 58.0%, respectively, of 157 recruited patients. At the time of the accident, 40.8% of the patients were employed. The mean age of the patients was 71.6 ± 5.8 years. Extremities and pelvic girdle injuries (61.1%) were the most frequent, followed by chest injuries (48.4%), and head and neck injuries (40.1%). Among severe injuries (defined as Abbreviated Injury Scale score ≥ 3), chest injuries (39.5%) were the most common, followed by head and neck injuries (36.3%). The overall mortality rate was 9.6%, with cyclists at nearly three times the risk compared to motorcyclists. More cyclists than motorcyclists (18.2% vs. 11.0%) required intensive care. There were no significant differences in the length of hospital stay between cyclists and motorcyclists.@*CONCLUSION@#Elderly riders have unique injury patterns and consume significant healthcare resources. Trauma systems need to acknowledge this changing injury epidemiology and equip trauma centres with the necessary resources targeted at elderly patients. Future work should focus on strategies to minimise extremity and chest injuries.