scholarly journals Present Condition of Road Traffic Accident: A Case Study of Rajshahi City, Bangladesh

2015 ◽  
Vol 111 (7) ◽  
pp. 36-41
Author(s):  
Md. MahmudHasanMamun ◽  
Md. Mintu Miah ◽  
Muhammad Iftiarul Islam
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Present Condition ◽  
Rajshahi City

Primary care community engagement – delivery of an enhanced and brief homogeneous group TF-CBT intervention for trauma from a single-incident road traffic accident: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Lilian Skilbeck ◽  
Christopher Spanton
Keyword(s):  
Primary Care ◽  
Community Engagement ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Treatment Protocol ◽  
List Type ◽  
Ptsd Symptoms ◽  
Improve Access

Abstract The main current intervention for post-traumatic stress disorder (PTSD) in adult primary care is individual trauma-focused cognitive behavioural therapy (TF-CBT). Group TF-CBT for PTSD has been advocated in order to improve access and cost. Barriers to the development of group TF-CBT include the need for a large number of sessions and therapist input in order to manage high levels of affect, possible dissociation and secondary traumatisation. This case study was prompted via our community engagement project when local women who had been involved in a single road traffic accident requested group therapy. The aim was to develop a NICE guideline-compliant brief 8-session group TF-CBT intervention that circumvented the above-mentioned barriers and is described in detail. In order to improve access, the group was delivered in the community. Standard and PTSD-specific measures were administered pre-therapy and post-therapy. Eight clients were offered treatment: two dropped out and six completed treatment. At the end of treatment, 3/6 clients attained reliable improvement in their PTSD symptoms. Two of these three clients also reached recovery. This change was maintained at 3-month follow-up where 4/6 clients attained reliable improvement, with three maintaining recovery. The remaining two clients showed minimal change in their PTSD symptoms. Overall, clients reported high-level satisfaction with the treatment protocol. This case study demonstrates a potentially clinically effective and cost-effective group TF-CBT intervention for non-complex single-incident PTSD. Key learning aims It is hoped that the reader of this case study will increase their understanding of the following: (1) Use of a brief group TF-CBT protocol to treat homogeneous single incident trauma in adults. (2) Adaptations to overcome barriers to group TF-CBT in adults. (3) Implementation of individualised reliving based on written-narrative rather than spoken-narrative. (4) Focus on the processes of PTSD, whilst using content as a theme to contextualise the symptoms. (5) Emphasis on the use of homework in order to enhance group affect-modulation and individual learning.

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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