Management and outcome of posterior fossa extradural hematoma and management outcome

Presentation of patients with CT proven extra dural hematoma their management and out come. 12 patients of posterior fossa extradural hematoma were included in the study. Excellent recovery was found in 50% good in 25% and poor in 16.6% and 8.33% was died

Conservative and surgical management of depressed, skull fractures

The aim of the study is to examine the efficacy of a conservative and surgical management of depressed fractures skull. A prospective study of 120 patients with depressed skull fractures treated at Bolan Medical Complex Hospital from December 2003 -2007. There were 108 males and 12 females, age range was 12 month to 80 years, and the mean age was 40 years. All patients underwent X-ray and cranial CT scan. Depressed fractures due to missile injuries were excluded from the study. Object fall on the head was the cause of depressed fracture in 30% of our patients, fall from a height in 19%, road traffic accident in 20%, sports injury in 10%, assault in 19.8% and suicidal attempt in 1.2%. Parietal bone was injured in 44%, frontal bone in 32%, temporal bone in 18% and occipital bone in 6%. Seventy-two percent were compound depressed fractures and 28% were simple depressed fractures. Eighty-four patients were managed conservatively, 56 patients with compound fractures [66.7%] and 28 patients [33.3%] with simple fractures. Significant extra-axial haematoma was the indication for elevation of the fracture in 40% of the surgical group, significant wound contamination, brain tissue and CSF in the wound in 5%, frontal sinus involved in 15%, cosmetic deformity in 25%, fracture on the superior sagittal sinus in 10% and right sided hemiplegia in 5%. Our study demonstrates that 70% of patients with depressed skull fractures can be safely managed conservatively without major surgical intervention

Role of advanced CT Scan and management of maxillofacial trauma at tertiary care hospital in Taif Kingdom of Saudi Arabia

Find out the role of advanced CT-Scan information at early stage for optimal care and early recovery of polytrauma patients and to compare causes and pattern of maxillofacial injuries to similar studies. A retrospective study was carried out at King Abdul Aziz Specialist Hospital-Taif, Kingdom of Saudi Arabia by reviewing files, radiographs and CT- scans of 78 patients treated during two years [Jan.2003- Jan.2005]. Data regarding age, cause of fracture, anatomic site, treatment modalities and clinical results were reviewed Male to female ratio was 77% and 23% respectively and age group of 21y to 30y [69%] were predominantly involved in maxillofacial injuries. Cause of trauma in all patients was road traffic accidents and no one was alcoholic. Majority of patients [66.6%] were drivers and 61% had polytrauma with severe facial injuries. Surgical interventions were needed in 97.5% of patients and were managed by open reduction and internal fixation [ORIF] with plates and screws. Mean delay between admission to hospital and surgery was 6 days. There were 14% complications in total, 6.4% as plate removal, 5% enophthalmoses and 2.5% Malocclusion.. Severely injured patients had more complications. Causes and incidence of maxillofacial injuries vary from one country to another. ORIF by screws and plates is a standard of care for maxillofacial fractures. Advanced CT-scan and 3-D information at early stage facilitate team work by neurosurgeons, plastic surgeons and maxillofacial surgeons and play an important role in optimal care and early recovery of poly trauma patients

Knowledge, attitude and practice regarding tooth loss among adult patients in Quetta, Balochistan

To assess the relationship between KAP of patients about dental treatment and tooth extraction status in tooth extraction and non-extraction case. Cross sectional study. Study was carried out at out patient department Sandeman teaching Hospital Quetta from January to February 1999. The source of the population were the patients aged 25-65 years attending out patient department at Sandeman teaching Hospital Quetta, The non-probability sampling was used, a total 205subjects were included in the study. Descriptive statistics, Chi-Square test and mean t-test was used. The behavior of the patients was determined by a questionnaire. There was 205 patients, among them 134 were tooth extracted cases and 71 were non-tooth extracted. Age was 25-65, and mean age was 37.38 +/- 11.09. Male were 63.9 percent and 36.1 percent were female. The K score is higher in non-extraction cases [mean 2.90+1.87] as compare to extraction case [mean 1.81+1.5], [p =.001].The mean of A score is higher in non-extraction cases [mean 21.69 +/- 6.1] compare to extracted cases [0.89 +/- 0.82], [p=.001]. The mean of P score is higher in non-extraction cases [1.59+1.112] than extraction cases [0.89+0.82], [p=0.001]. As a whole the KAP of non-extracted cases [mean 26.1 +/- 8.22] is better than extracted cases [mean 19.44+6.64], [p=.001]. The proportion of extracted group has low KAP score, [p = .001]. The findings suggested that the extracted cases were less educated, having low KAP and less number of teeth present in the oral cavity. In this regard preventive programs are to be initiated to change the patient perception towards dental treatment

Diagnosis of oral squamous cell carcinoma of fine needle aspiration cytology

The purpose of this study was to determine the possibility of using fine needle aspiration cytology [FNAC] as a primary diagnostic test in oral squamous cell carcinoma. The sample consisted of twenty cases of white and red lesions and forty cases of squamous cell carcinoma. FNAC and conventional incision biopsy was done on all the cases. A cytological and histopathological correlation was made. The result showed that both true positive and false negative result were obtained. In oral squamous cell carcinomas, 88.3% were true positive. 10% of false negative results were obtained in the white and red lesions. The overall positive correlation was 50%. The present study indicates that FNAC can be used as a reliable diagnostic test for oral squamous cell carcinoma