RESUMO
Background: Septic complications in traumatic brain injury causes short- and long-term cerebral dysregulation by disruption of blood brain barrier, reduced brain perfusion, neuroinflammation and deposition of amyloid. Materials and methods: The present study attempted to observe patients of traumatic brain injury for the development of septic complications during the hospital stay. 89 patients were included in the study with different grades of brain injury (Injury Severity Score (ISS) range, 9-72). The patients were managed according to the trauma protocol and classified into 3 groups based on the severity of trauma (ISS 9-17 (moderate), 18-30 (severe), and >32 (most severe)). The patients were observed for the development of major septic complications during the course of their hospital stay, which impacted on the morbidity and mortality while determining the clinical and functional outcome at the end. Results: Mean age of the study population was 33.5 years. TBI was more common in younger age groups with severe grades of injury, those with multiplicity of head injuries, sepsis with a pulmonary focus, prolonged ICU and in-hospital stay together with high mortality. Septic complications were also more common in cases with higher grades of TBI and more prolonged hospital stay. Patients requiring intubation had a higher risk of developing infectious complications. 69 patients (77.5%) required intubation and mechanical ventilation. Pneumonia was the most common source of sepsis leading to the respiratory failure while the most common cause being aspiration at the time of injury Genitourinary complications were also common leading to urosepsis. Most common organisms isolated were Staphylococcus aureus, Acinetobacter, klebsiella and Pseudomonas. Conclusion: Traumatic brain injury (TBI) when complicated by sepsis and multi organ failure increases the mortality and morbidity with less favorable clinical and functional outcome together with increased duration of ICU and hospital stay.
RESUMO
Introduction: Organophosphorus compounds are widelyused as insecticides. Organophosphorus poisoning hasa significant morbidity and mortality and is a commonoccurrence due to their easy accessibility. Study aimed toassess clinicoepidemiological profile of organophosphoruspoisoning.Material and methods: Our study was a hospital basedprospective study conducted over a period of two yearsinvolving all the patients of organophosphorus (OP)poisoning, admitted in the medical emergency of the hospital.These patients were evaluated for demographic and clinicalprofile and followed till the time of discharge or death.Results: 102 cases of OP poisoning were admitted, majoritybelonged to the age group of 15-25 years (54.9%) and were ofrural origin (84.3%). Females (67.64%) outnumbered males.97 cases had taken it with suicidal intent. Miosis was themost consistent clinical feature (93.13%). 64 patients (62.7%)needed admission in ICU. Respiratory failure was the mostcommon complication. Mortality rate of 14.7% was observed.Conclusion: OP compounds are ingested mostly with suicidalintent due to their easy availability mostly by young andproductive population. Initial management and resuscitationin periphery is invaluable