Hydroureteronephrosis due to a misplaced suprapubic catheter.

Unintentional ureteral catheterisation, especially during the placement of suprapubic catheters, is extremely rare. We present a case of a suprapubic catheter misplaced in the left ureter leading to hydroureteronephrosis in a paediatric patient with history of complex pelvic fracture with urethral distraction defects after a motor vehicle accident. We highlight that emergent imaging evaluation and timely intervention saved us from the potential catastrophe.

A protocolised approach provides a favourable outcome in patients with severe pelvic trauma.

Background Pelvic fractures are often a result of injuries caused by a major force and lead to considerable morbidity and mortality. Despite advances in acute management protocols involving angioembolization as a prime intervention, mortality in complex pelvic fractures remains high. We analysed our experience with the outcomes of a pelvic trauma management protocol using surgical haemostatic techniques over 5 years.

Clinical determinants for survival following emergency thoracotomy in trauma patients: An 8-year experience from a level 1 trauma center.

Purpose: Emergency thoracotomy (ET) is a life-saving procedure performed during emergency resuscitation of patients in extremis. The controversy around such an invasive and resource-consuming procedure still lingers after so many years of its introduction. ET can serve as one of several indicators of trauma center efficiency and with information about the trauma system's overall preparedness, resources, and training.

Giant Parathyroid Adenomas: A 28-Year Experience at a Tertiary Super-Specialty Hospital.

Background: Giant parathyroid adenomas represent a distinct clinical entity forming a subset under primary hyperparathyroidism (PHPT). They comprise lesions weighing more than 3.5 g.

Impact of SARS-CoV-2 Infection on the Outcomes of Trauma Patients at a Level I Trauma Center: An Ambispective Observational Study.

Introduction: Trauma remained a leading cause of hospital admissions even during the COVID-19 pandemic. Trauma and surgical interventions are known to impair the patient's immune function. Clinically, some asymptomatic COVID-19 patients experienced rapid deterioration following surgery.

A pilot study on hemodynamically stable isolated chest trauma patients reveals dysregulation of oxidative metabolism.

Background: Metabolomic dysregulation precedes clinical deterioration following injury. However, despite receiving comparable treatment, patients with similar injury severity often follow different clinical trajectories and outcomes.

Methods: This prospective cohort study at a level 1 trauma centre screened 4541 acutely injured patients with chest trauma between September 2019 and February 2023.

Ionised calcium levels during trauma resuscitation in predicting outcomes-a prospective cohort study.

Background: Haemorrhage remains the leading cause of preventable mortality following trauma, often aggravated by the acidosis, hypothermia and coagulopathy-the lethal triad of trauma. However, the impact of trauma-induced hypocalcemia on the haemorrhage remains unclear. It is intuitive to consider perturbations of ionised calcium early during trauma resuscitation in acutely injured patients given its pathophysiological significance for an improved outcome.

Relevance of intra-abdominal pressure monitoring in non-operative management of patients with blunt liver and splenic injuries.

Purpose: Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury.

Role of low-pressure negative pleural suction in patients with thoracic trauma - a randomized controlled trial.

Background: Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to improve breathing and circulatory function. It is a simple and life-saving procedure; nevertheless, it carries morbidity, even after its removal. Efforts have been made continuously to shorten the duration of ICD, but mostly in non-trauma patients.

Benefits of Rib Fixation Utilizing Low-Cost Materials: A Randomized Pilot Trial.

Introduction: Surgical stabilization of rib fractures (SSRF) using standard rib plating systems has become a norm in developed countries. However, the procedure has not garnered much interest in low-middle-income countries, primarily because of the cost.

Methods: This was a single-center pilot randomized trial.

Revisiting the Role of Amniotic Membrane Dressing in Acute Large Traumatic Wounds: A Randomized Feasibility Study at a Level 1 Trauma Centre.

Introduction: Acute large traumatic wounds require temporary dressing prior to the definitive soft tissue reconstruction, as the physiological derangement during the immediate postinjury period delays the definitive surgical intervention. Selecting an ideal dressing material from numerous available synthetic dressings and skin substitutes poses a challenge. Although amniotic membrane (AM) scaffold has a definitive role in promoting wound healing in burns and chronic wounds, however, its efficacy in acute large traumatic wound is lacking.

Use of super-thin anterolateral thigh flap in intra-oral reconstruction of soft tissue defects.

Background: Traditional sub-fascial anterolateral thigh (ALT) flaps are bulky and often give unsatisfactory outcomes in several head and neck reconstructions where thin pliable flaps are required. As a result, despite high incidence of donor site complications, radial forearm flap is still commonly used for tongue, buccal mucosa and lip defects where a traditional ALT flap would be too bulky. The objective of this report was to evaluate the usefulness of super-thin ALT flap as an alternative to radial forearm flap for intra-oral reconstruction.

No role of antibiotics in patients with chest trauma requiring inter-costal drain: a pilot randomized controlled trial.

Purpose: To study the role of prolonged prophylactic antibiotic therapy (PAT) in the prevention of Inter-costal drain (ICD) related infectious complications in patients with Blunt Trauma Chest (BTC).

Methods: Patients of age 15 years and above with BTC requiring ICD were included. Patients with penetrating chest injuries, associated injuries/illnesses requiring antibiotic administration, need for mechanical ventilation, known pulmonary disease or immuno-compromised status and need for open thoracotomy were excluded.

Contrast-enhanced computed tomography abdomen versus diagnostic laparoscopy-based management in patients with penetrating abdominal trauma: a randomised controlled trial.

Purpose: Penetrating abdominal trauma was traditionally managed by mandatory exploration, which led to high rates of non-therapeutic surgery and prolonged hospital stay. Diagnostic laparoscopy (DL) is a less-invasive alternative; however, it requires general anaesthesia and carries a potential risk of iatrogenic injuries. Contrast-enhanced computed tomography (CECT)-guided selective non-operative management (SNOM) may avoid surgery altogether, but there is apprehension of missed injury.

Traumatic chylothorax: a dilemma to surgeons and interventionists.

Chylothorax is generally seen due to iatrogenic injury to the thoracic duct during thoracic or neck surgery. It can also be encountered secondary to chest trauma either blunt or penetrating. Percutaneous thoracic duct embolisation is an alternative to surgical treatment and is considered an effective and safe minimally invasive treatment option for chylothorax with a success rate of about 80%.

Down a wrong path - A nasogastric tube in the lung.

Nasogastric tube insertion is a common bedside procedure. In an awake patient, unexpected passage into airway is easily noticeable due to the gag reflex; however, in the case of ventilated patients false cannulation is liable to be missed, unless insertion is carried out under direct visualization. We present a case of passage of nasogastric tube into peripheral bronchiole of the right lung, which was initially missed on chest radiography.

Early hospital discharge following non-operative management of blunt liver and splenic trauma: A pilot randomized controlled trial.

Background: Despite the acceptance of non-operative management (NOM), there is no consensus on the optimal length of hospital stay in patients with blunt liver and splenic injury (BLSI). Recent studies on pediatric patients have demonstrated the safety of early discharge following NOM for BLSI. We aimed at evaluating the feasibility and safety of early discharge in adult patients with BLSI following NOM in a randomized controlled trial.

Train-Associated Injuries Pose a Significant Burden on Trauma Care Systems of Emerging Economies.

Background: The Indian railway system is the fourth largest in the world and causes about 15 deaths every day, due to intentional or unintentional reasons. This study presents a 5-year retrospective analysis of patients injured due to train-associated events, managed at a level-1 trauma center in India.

Materials And Methods: Hospital-based trauma registry data of train-associated injuries presenting between 2012 and 2016 were analyzed.