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Facial Trauma Among Patients With Head Injuries

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Facial Trauma among patients with head injuries Dr. Shazia Yasir*, Dr. Faisal Moin, Dr. Muneer Sadiq ABSTRACT Introduction: Facial trauma is without a doubt a most challenging area for any emergency physician. Despite many researches and advances in the understanding of multiple techniques; initial assessment and management of facial injuries in emergency and early stages remained a complex area for patient care. Objective: The purpose of this study is to determine the prevalence of facial trauma among patients with head injuries that may help emergency department physicians to deliver accurate and quick diagnosis and decision. Trauma to this region is often associated with mortality and morbidity and varying degree of physical and functional damage. Study Design: Prospective Cross-sectional Descriptive Study. Place and Duration of Study: Department of Emergency Medicine, Ziauddin University Hospital, Karachi from four months from Feb 2014 to May 2014. Methodology: This study was conducted at Ziauddin university hospital emergence medicine department. It is a prospective cross sectional descriptive hospital based study. 115 patients who were diagnosed of having head injuries were included in this study. Information on age, sex and cause of injury was taken for each case. Each patient was then examined for the presence of facial trauma using the CT 3D face. Data was analyzed using the SPSS program. Result: Out of 115 patients, 85 (74%) were males and 30 (26%) were females. A total of 59 (51%) patients were between 15 – 30 years of age; 26 (23%) were aged between 31 – 50; and 30 (26%) were above 51 years of age. 76% patients had facial trauma where head injuries were evident. 63% female and 80% male had facial trauma where head injuries were found in patients. Out of these 115 patients majority were involved in road traffic accidents and are from the age group 15 – 30 and predominantly male. Conclusion: Based on the study conducted; it is safe to conclude that patients who have facial trauma associate with head injuries are young males and is mainly caused by road traffic accident. The result might vary by governmental, culture or social differences. Key words: Facial Trauma; Head Injuries; emergency department _____________________________________________________________________________________________ INTRODUCTION Trauma is a type of injury where external force is being applied suddenly and violently at the body which causes a serious injury [1]. A head injury in human body is any trauma that can cause injury of scalps, brain or skull. The injury could be a minor bruise or serious injury on the head and brain injury [2]. Some injuries can result in prolonged or unrecoverable brain damage. The injury can cause bleeding inside the brain or forces that damages the brain directly. The most common cause of head injuries are road traffic accidents, fall, physical assault or others. These accidents can occur at home, work, outdoors, sports or many other places. Head injuries are commonly associated with facial trauma; often result from high energy blunt force injury to facial skeleton. Typical mechanisms of trauma include motor vehicle accidents, altercation and fall [3]. ———————————————————————- PG Emergency Medicine, Department of Emergency Medicine, Ziauddin University Hospital, North Campus, Karachi * Correspondence Email: drshazia24@live.com The face is vital to human appearance and function. Facial injuries can impair a patient’s ability to eat, speak, interact with others, and perform other important functions. Facial injuries may be caused by a direct blow, penetrating injury, or fall. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury [11]. METHODOLOGY This study was carried out at the department of emergency medicine, Ziauddin University Hospital, Karachi, Pakistan. Patients of either gender with more than 15 years of age presenting to Ziauddin Hospital Karachi who were diagnosed of having head injuries were selected. Patients who gave the history of previous head trauma were not included in this study, this aimed at avoiding some ambiguity during examination as to whether the encountered trauma was the result of the recent head injury or previous underlying trauma. Each patient was then examined for the presence of facial trauma, using 3D CT scan. A 3D CT scan, or a three-dimensional computerized tomography scan, is a type of x-ray that allows high quality images of organs, blood vessels, and bones to be recorded in a very short amount of time. The individual CT images are then layered together to form a virtual model of the body. It is able to reveal the functionality of many of the anatomical structures in the body, in addition to structural defects, tumors, and lesions [12]. The obtained data was checked for completeness and clarity then entered into the computer and analysis was performed using Statistical package for social sciences program (SPSS). Chi –square test (X2) will be carried out and significant level p<0.05 will be used to draw out conclusion by the help of the statistician. RESULT A Total of 115 patients with head trauma were included in the study. The gender distribution of the study population is as shown in Table 1 below. Table 1:- There were 85 (74%) males and 30 (26%) females. Gender Total %Age Female 30 26% Male 85 74% Total 115 The age distribution of the study population is as shown in Table 2 below. Table 2:- There were 59 (51%) cases between ages 15 – 30, 26 (23%) cases with ages from 31 – 50 years males and 30 (26%) with age over 51 years old. Age Total %Age 15 – 30 59 51% 31 – 50 26 23% 51 30 26% Grand Total 115 The presence of facial trauma according to gender is shows in table 3. Out of 115 patients monitored, 19 female have facial trauma out of 30 which consist of 63% female, while 68 male patients have facial trauma with head injuries out of 85 which make 80% of male population. The total of 76% patients has facial injuries where head injuries were evident. Table 3:- Presence of facial trauma according to gender Presence of facial trauma according to gender Gender No Yes %Age Total F 11 19 63% 30 M 17 68 80% 85 Total 28 87 76% 115 The presence of facial trauma according to age is shows in table 4 along with graphical representation. Out of 115 patients monitored, 59 patients were between ages 15 – 30. From these 59 patients 51 have facial trauma where head injuries were evident, this make 86% of the population. The patients between 31 – 50 years of ages were 26, where only 14 were found to have facial trauma which makes 54% of the population. The patients over 51 years of age were 30 where 22 were found to have facial trauma which makes 73% of the population. Table 4:- Presence of facial trauma according to age Presence of facial trauma according to age Age No Yes Total %Age 15 – 30 8 51 59 86% 31 – 50 12 14 26 54% 51 8 22 30 73% Total 28 87 115 76% Table 5 shows prevalence of facial trauma by gender according to the causes of injuries. Out of 87 patients where facial trauma was also observed 11% female had it because of road traffic accident comparing to 39% male. Fall in female was 9% comparing to 17% male; no assault in female was observed while 14% male had facial trauma during assault. Prevalence of facial trauma by gender according to Cause of injury Gender RTA Fall Assaults Others Total F 10 8 0 1 19 M 34 15 12 7 68 Total 44 23 12 8 87 Table 6 below shows the details of prevalence of facial trauma by age according to cause of injury. The detail shows higher number of road traffic accident, followed by fall, assault and other causes of injuries. Prevalence of facial trauma by age according to Cause of injury Age RTA Fall Assaults Others Total 15 – 30 29 12 7 3 51 31 – 50 6 3 5 0 14 51 9 8 0 5 22 Total 44 23 12 8 87 DISCUSSION Head injuries causes hospitalization of 200 – 300 patients per 100,000 population per year worldwide. A head injury associated with facial trauma comprises a number of complications, such as sequestrum formation, sinusitis, nasolacrimal duct injuries, facial deformity and injury to or entrapment of the globe. Trauma is very well known to be the main cause of death in first forty years of life. Facial trauma can be very dangerous as this could impact the essential parts of the body like speech, respiration, vision or smell so special attentions and importance should be given to facial trauma patients [13]. An international study was done in France to determine the types of facial injuries; 25.4% of the injuries were aged between 21 – 30 years. Sex ratio was 2.7M/1F. The most frequent cause was sports injuries (25.8%); followed in decreased order by traffic injuries (23.1%); home injuries (17.6%); fight injuries (3.4%); work injuries (3.4%) and dog bite (3.2%) [4]. Multiple studies conducted that amongst facial trauma the most common sites are nose (50%) [6] and maxillofacial trauma (5%) [5]. In this study 115 patients with head trauma were included with sex ration of 2.8M / 1F which seems to be consistent with previous studies done in different part of the globe [8, 10, 7]. The findings in this study also revealed the most common involving age group was 15 – 30 years of age; which constituted 51% as compared to other age groups. This finding is the same as that done in Nigeria and others in 2010 [42]. The reason for high prevalence of head and facial trauma to this age group (15 – 30 years) as compared to other age group could be related to activities of this age group in economic and social activities which lead to increase in accidents and violence. In this study it was also found that male are slightly more involved as compared to females where by 74% were male patients and 26% were female patients. The most common cause of facial trauma is to be road traffic accidents which involve motor cycle; car and pedestrian while the second most is fall from height. This was similar to previous findings in other studies which shows most common etiologies of injuries were car crash (39%); followed by assaults (28%) with majority are male with age group 15 – 30 years [9]. Observations from multiple studies of different part of the world shows that leading cause of facial trauma associated with head injuries is road traffic accident followed by fall and assault. Based on the study design and area; each study has its precise section of dominance. CONCLUSION This study concludes the prevalence of facial trauma associated with head injuries was 76% and higher age group is 15 – 30 years with 51% than other age group and prevalence of male 59% than female 16% had facial trauma where head injuries were eminent. The common cause is road traffic accident 50% followed by fall 26%, assault 13.7% and others were 9%. CONSENT FOR THE STUDY All patients or relatives were given a necessary explanation about the study before they asked to participate. For those patients who were unconscious, consents were obtained from their relatives. For patients under ages 18 years, informed consents were obtained from their parents/ guardians. ACKNOWLEDGEMENT We would like to acknowledge faculty of Ziauddin Hospital, North Campus for helping us during the study, staff for helping in data collection and all others who have given their input. The study was self funded. REFERENCE Anderson T ,Heitger M, and Macleod AD (2006). “Concussion and Mild Head Injury”. Practical Neurology : 342–357. Heegaard WG, Biros MH. Head. In: Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. St. Louis, Mo: Mosby; 2009:chap. 38 Aksoy E, Unlu E, Sensoz O. A retrospective study on epidemiology and treatment of maxillofacial fractures. J Craniofac Surg. 2002:772-5 Lebeau J, Kanku V, Duroure F, Morand B, Sadek H, Raphaël B. Facial injuries treated in the Grenoble University Hospital. 2006;107:23-9 Goodisson, D, MacFarlane, M, Snape, L. Darwish, B, Head injury and associated maxillofacial injuries New Zealand Med J 2004,vol.117 Khan, A. R.,Arif, S., ,J Ayub Med Coll Abbottabad 2005 Vol.17 Hashim H, Iqbal S. Motorcycle accident is the main cause of maxillofacial injuries in the Penang Mainland, Malaysia. 2011;27:19-22. Madubueze CC, Chukwu CO, Omoke NI, Oyakhilome OP. Head and neck injuries as seen in a Nigerian teaching hospital. Ozo CInt Orthop. 2010. Bouguila J, Zairi I, Khonsari RH, Jablaoui Y, Hellali M, Adouani A.Epidemiology of maxillofacial traumatology in Tunis. Rev Stomatol Chir Maxillofac. 2008 Khan AA. A retrospective study of injuries to the maxillofacial skeleton in Harare, Zimbabwe. Br J Oral Maxillofac Surg 1988; 26:435-439. Rankin M, Borah GL. Perceived functional impact of abnormal facial appearance. Plast Reconstr Surg 2003; 111:2140. Saigal K, Winokur RS, Finden S, et al. Use of three-dimensional computerized tomography reconstruction in complex facial trauma. Facial Plast Surg 2005; 21:214. Motamedi MH: An assessment of maxillofacial fractures: a 5-year study of 237 patients. J Oral Maxillofac Surg 2003, 61(1):61–64 Share this: Facebook Twitter Reddit LinkedIn WhatsApp
MGT 322 SEU Lean Thinking in Production Management Discussion.

Assignment 2Deadline: 02/12/2020 @ 23:59Course Name: Logistics Management Student’s Name:Course Code: MGT-322Student’s ID Number:Semester: ICRN:Academic Year: 1441/1442 HFor Instructor’s Use onlyInstructor’s Name: Dr. Farhat AnjumStudents’ Grade: Marks Obtained/Out ofLevel of Marks: High/Middle/LowInstructions – PLEASE READ THEM CAREFULLY • The Assignment must be submitted on Blackboard (WORD format only) via allocatedfolder.• Assignments submitted through email will not be accepted.• Students are advised to make their work clear and well presented, marks may be reduced for poor presentation. This includes filling your information on the cover page.• Students must mention question number clearly in their answer.• Late submission will NOT be accepted.• Avoid plagiarism, the work should be in your own words, copying from students or other resources without proper referencing will result in ZERO marks. No exceptions. • All answered must be typed using Times New Roman (size 12, double-spaced) font. No pictures containing text will be accepted and will be considered plagiarism).• Submissions without this cover page will NOT be accepted. ASSIGNMENT -2Submission Date by students: Before the end of Week- 14thPlace of Submission: Students Grade Centre Weight: 10 Marks Learning Outcome: 1. Apply essential elements of core logistic and supply chain management principles.2. Analyze and identify challenges and issues pertaining to logistical processes.3. The capacity to write coherent project about actual logistic case studies.Assignment Workload:This assignment is an individual assignment.Critical ThinkingUse Saudi digital Library (SDL) search engineSearch Title: THE BENEFITS OF LEAN MANUFACTURING what lean thinking offers the process IndustriesAuthors Name: Melton,TSource: In 7th World Congress of Chemical Engineering, Chemical Engineering Research and Design June 2005 83(6):662-673Read out the research paper carefully and based on your understanding you should answer the following questions. Questions:1. Define why Manufacturing Companies emphases on lean thinking? Justify your answer with suitable example. (3 Marks)2. What do you understand by the term overproduction? Why do you think overproduction waste described as the biggest waste while comparing to all other type of waste? (3 Marks)3. What are the benefits from Suppliers to end users by using lean thinking? (3 Marks)4. Use APA referencing style (1 Mark) Note: You can assume any manufacturing company of your choice while answering questions.
MGT 322 SEU Lean Thinking in Production Management Discussion

Rasmussen College Art in The World and Workplace Request for Funding Proposal Summary

Rasmussen College Art in The World and Workplace Request for Funding Proposal Summary.

CompetencyIdentify the role of music, poetry, prose, and visual art in the modern world and workplace.ScenarioYou have been asked to be on the town’s board of Cultural Affairs. When you step into your new role, you quickly realize that the organization is in trouble; the other board members have been on the board for a long time and haven’t done much in recent years. They explain that there is no money in the budget.You hear about a grant opportunity. Every year, a wealthy resident of your town, Mr. Brown, offers a grant of $10,000 to one local organization. In the past, he has never given this grant to an arts organization because, in the words of another board member, “Mr. Brown does not think the arts are important.”If you can change Mr. Brown’s mind about the importance of the arts in your community, you might just get the grant and be able to revitalize the town’s cultural arts scene!Write the grant proposal summary for review by a few board members to be sure you are on the right track for the grant.InstructionsCompose this document in the format of a letter to Mr. Brown. Your letter should include:two to three paragraphs using persuasive language.concisely written paragraphs using bullet-points if possible.a beginning paragraph that immediately captures the reader’s attention, using a story, surprising fact, or insightful quote.a complete but brief synopsis of the details in the proposal.the reason for the proposal and how the grant money will be used.NOTE – Be sure the documents display proper grammar, spelling, punctuation, and sentence structure.
Rasmussen College Art in The World and Workplace Request for Funding Proposal Summary

9 and 10 word problem

assignment helper 9 and 10 word problem. I’m trying to study for my Physics course and I need some help to understand this question.

Question 37

Explain the concept of frames of reference.

Question 38

Explain length and time dilation and give an example of when each is observed.

Question 39

A train is moving with a speed of 50 miles per hour. A man standing in the rear of a train car throws a ball toward the front of the train with a speed of 10 miles per hour. If a stationary observer outside the train sees this happen, what speed is the ball moving with? Explain your answer.

Question 40

Explain any one situation in which light behaves like a particle and one situation in which light behaves like a wave.

Question 43

What is nuclear fission? How do you account for the release of a large amount of energy in a nuclear fission process?

Question 44

Two events that are simultaneous in one inertial frame of reference will not necessarily be simultaneous in any other inertial frame of reference. Explain.

Question 45

Consider a situation where immediately after birth, twins are separated. One continues to live on earth, while the other is whisked away in a space ship at 90% of the speed of light. After 65 years they are reunited. Will they look the same? Show proof of your answer through mathematics.

9 and 10 word problem

SWK 3320 Troy University Conflict Resolution Essay

SWK 3320 Troy University Conflict Resolution Essay.

Look at this from asocial workers view. Also, Please make sure to use the book pages where instructed.Answer the questions in the form she has them in. I will send book pages over when question is accepted. Attributes are uploaded in a file for you.* Do not use contractions in this course. Contractions will be counted as grammatical errors.Clear and professional writing is expected.Correct = “Do not”, “will not” etc…Incorrect = “Don’t”, won’t”, etc….5 deduction for every 3 grammatical errors.*All reading assignments are located in the “Course Schedule” in the Syllabus. If you have questions or concerns please do e-mail me well before an assignment is due. Week 5Did you know that… Labeling Theory – Page 549According to the Labeling theory, and the Interactionist perspective, labels can become self-fulfilling. If a person is labeled with negative attributes, they risk believing that these attributes are true, and may face an undesirable declining trajectory. In the case scenario below, you will meet a young girl named Pia. You will see that Pia’s parents are approaching a tough situation in a negative manner. This negative approach is cultivating Pia’s self-concept and beliefs.After reading the case scenario provided below, address “a” and “b”.Case ScenarioYou are a social worker and Pia, an eighteen-year-old senior, has been referred to see you. Pia is scheduled to graduate in two months, however, Pia’s instructors have reported a drop in her grades, and a sudden change in her demeanor. You are aware that if Pia’s grades continue to decline she runs the risk of not meeting graduation requirements. Historically, Pia excelled in high school and was a star athlete. She was known to be a reliable motivated hard worker. She was a determined leader and had goals of attending college.During meeting #1, Pia reports that she is 6 weeks pregnant, and plans to marry her 19-year-old boyfriend. Pia reports that she has been forbidden to see her boyfriend, and her parents are not interested in what he or his parents have to say. Pia reports that her parents are furious, disgraced, embarrassed and have told her numerous times that she has been selfish, disrespectful, a failure, and has tarnished the family name. Pia reports that she understands that she is a failure and is ready to drop out of school.According to the labeling theory, Pia’s parents have the ability to negatively impact Pia due to the consequences that are associated with labeling, as well as self-fulfilling prophecies.You are preparing for meeting #2 with Pia and her parents. a). You are to select and explain at least 3 positive attributes that Pia has in order to point out her strengths and build her self-esteem. (1.50)Why is this important? (.50 points)(Examples of positive attributes are in module 5.) b). Meeting #2 has been scheduled and Pia’s parents will be joining this meeting.After reading “Conflict Resolution Strategies”, beginning on page 559, select 3 strategies that you plan to utilize with this family. You are to explain your goals and why you have selected these approaches. (2.25 pts.)Did you know…“Conflicts produce lively discussions. When constructively handled, conflicts motivate the people involved to define issues more sharply, to search harder for resolution strategies, and to work harder in implementing solutions. Conflict, when handled effectively, can also lead to greater commitment to the relationship of people involved, raise morale, and increase communication and cooperation. Successful resolution of conflict can lead to: personal growth and facilitate innovation and creativity.Ineffective management of conflict can lead to deterioration of rapport between the people involved, distrust, and perhaps alienation and burnout.” (Pg. 559)
SWK 3320 Troy University Conflict Resolution Essay

essay question

essay question. I’m trying to study for my Film course and I need some help to understand this question.

“Essay,” asks you to respond in essayform (i.e., with a well-developed argument including an introduction, analysis and conclusion) to a question about a broad concept from the class that connects issues from across lecture, readings and screenings. There will be one essay question on the exam. (50 points for Essay)
Essay question:
According to Lynn Spigel and class lecture/screenings, the introduction of television as a new technology was both “utopian” and “dystopian,” unifying and disruptive to the family and to gender roles in the home. Discuss examples from Spigel’s article of TV’s hopeful and frightful potential. Using specific examples, discuss how The Honeymooners episode, “TV or Not TV?” supports or refutes these arguments.
There is book from Lynn Spigel I upload.
And for the The Honeymooners, please search by yourself. Thank you~
You don’t need to write too much, the most important thing is follow the requirements. please write at lease 1 page. Thank you again.
essay question

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