Cases Of Head Injury Research Articles

Sex differences in Sport-related Concussion in Japan

ObjectiveTo evaluate the Sex differences in Sport-related Concussion in Japan.BackgroundWe dont't have the knowledge about the sex differences in SRC in Japan.Design/MethodsThe study design was retrospective study. Facility is Toho University Ohashi Medical Center Neurosurgery Sports-related head injury clinic. The search period is April 2017 to February 2018. Inclusion criteria were as follows: 1) Sports-related head injury cases, 2) Physician-diagnosed Sports-related concussion, 3) Underwent evaluation by the same neurosurgeon, 4) More than 28 days continued follow-up. The following items were compared male and female. The examination items were as follows: 1) Age/sex, 2) competition item, 3) prior concussion, 4) Migraine history, 5) persistent post concussive symptoms. Statistical analysis used t test.ResultsThe 140 selected cases were 114 male (Group M: GM) and 26 female (Group F: GF). The mean Age of both GM and GF was 20 years. The most majority competition item of GM was Rugby football. On the other hand, GF was lacrosse. 42 cases of GM and 9 cases of GF suffered prior concussion (p > 0.05, no significant). 19 cases of GM and 6 cases of GF had migraine history (p > 0.05, no significant). 37 cases of GM and 16 cases of GF had PPCS (p < 0.05).ConclusionsOur result suggests that female players explain the significant difference in the prevalence of PPCS in Japan.

Soccer-related head injuries-analysis of sentinel surveillance data collected by the electronic Canadian Hospitals Injury Reporting and Prevention Program.

Participating in sports is a great way to gain physical, psychological, and social benefits. However, it also carries the risk of injury. Soccer is one of the most popular sports worldwide, and in recent years, there have been concerns about potential vulnerabilities to head injuries. To investigate soccer-related head injuries (SRHIs), using data from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) surveillance system. Specifically, we aim to compare characteristics of SRHI cases to all head injury cases within the eCHIRPP database. Descriptive analyses of emergency department (ED) injury surveillance data (2011 to 2017) for individuals aged 5 to 29 years from all participating eCHIRPP sites. Computation of proportionate injury ratios (PIR) comparing SRHIs to all head injuries reported to eCHIRPP, and 95% confidence intervals (CI). A total of 3,970 SRHIs were reported to eCHIRPP. Injuries were from contact with another player, the ball, ground, goal-post, and other causes. Of the injuries caused by contact with the ball, 9% were from purposely directing the ball with the head (heading). A higher proportion of concussions (PIR=1.32, 95% confidence interval [CI]: 1.27 to 1.37) and minor closed head injuries (PIR=1.20, 95% CI: 1.15 to 1.26) were observed in soccer players. Higher proportions of head injuries occurred in organized soccer and soccer played outdoors. However, admission to the ED for a SRHI was rare (PIR=0.40, 95% CI: 0.30 to 0.55). Overall, elevated proportions of brain injuries were observed among soccer players, however, these injuries were unlikely to result in a hospital admission. Moreover, purposely heading the ball contributed to few ED visits.

An Epidemiological Study of Traumatic Head Injury in a Tertiary Care Center in Kancheepuram, Tamil Nadu, India

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury.
 Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients.
 Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21.
 Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM.
 Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.

Traumatic optic neuropathy in head injury

Introduction: Head injury accounts for approximately 3.4% of all emergency presentations. The role of ocular injuries secondary to head trauma in the causation of blindness continues to be an immense public health problem. This study is aimed to estimate the incidence of traumatic optic neuropathy, to obtain demographic data and to document concurrent injuries in cases of head injury. Materials and Methods: A total of 510 patients presenting with head injury were examined for all the ocular injuries. Severity of head injury which was graded according to Glasgow Coma Scale (GCS). Computed tomography (CT) scan of head was done in all the patients. Visually evoked potential (VEP) was done in patients who had relative afferent pupillary defect (RAPD) and defective color vision. Diagnosis of traumatic optic neuropathy was confirmed on the basis of VEP. Results: Majority of the people affected were males (77.5%). Patients between 16-45 years were affected most. The most frequent site of injury was roadside (72.55%). Ophthalmic involvement was observed in 313 individuals (61.4%). Abnormal uni-ocular color vision was found in 21(4.11%) patients. RAPD was found in 24 (4.70%) patients. VEP was abnormal in 10 (1.96%) patients, of all the cases of head injury. Conclusion: There was a 1.96% incidence of traumatic optic neuropathy in patients of head injury. Among all the ocular findings, eyelid ecchymosis with edema was most common. Intracranial hemorrhage was the most common CT scan finding in head injury patients. Chances of ophthalmic manifestations are much more when there is intracranial bleeding and facial fractures. Keywords: Traumatic optic neuropathy, Head injury.

Baseline Performance of Real-World Clinical Practice Within a Statewide Emergency Medicine Quality Network: The Michigan Emergency Department Improvement Collaborative (MEDIC)

Large-scale quality and performance measurement across unaffiliated hospitals is an important strategy to drive practice change. The Michigan Emergency Department Improvement Collaborative (MEDIC), established in 2015, has baseline performance data to identify practice variation across 15 diverse emergency departments (EDs) on key emergency care quality indicators. MEDIC is a unique physician-led partnership supported by a major third-party payer. Member sites contribute electronic health record data and trained abstractors add supplementary data for eligible cases. Quality measures include computed tomography (CT) appropriateness for minor head injury, using the Canadian CT Head Rule for adults and Pediatric Emergency Care Applied Network rules for children; chest radiograph use for children with asthma, bronchiolitis, and croup; and diagnostic yield of CTs for suspected pulmonary embolism. Baseline performance was established with statistical process control charts. From June 1, 2016, to October 31, 2017, the MEDIC registry contained 1,124,227 ED visits, 23.2% for children (<18 years). Overall baseline performance included the following: 40.9% of adult patients with minor head injury (N=11,857) had appropriate CTs (site range 24.3% to 58.6%), 10.3% of pediatric minor head injury cases (N=11,183) exhibited CT overuse (range 5.8% to 16.8%), 38.1% of pediatric patients with a respiratory condition (N=18,190) received a chest radiograph (range 9.0% to 62.1%), and 8.7% of pulmonary embolism CT results (N=16,205) were positive (range 7.5% to 14.3%). Performance varied greatly, with demonstrated opportunity for improvement. MEDIC provides a robust platform for emergency physician engagement across ED practice settings to improve care and is a model for other states.

Do equestrian helmets prevent concussion? A retrospective analysis of head injuries and helmet damage from real-world equestrian accidents

ObjectivesTo collect and analyse helmets from real-world equestrian accidents. To record reported head injuries associated with those accidents. To compare damage to helmets certified to different standards and the injuries associated with them.MethodsTwo hundred sixteen equestrian helmets were collected in total. One hundred seventy-six helmets from amateur jockeys were collected via accident helmet return schemes in the UK and USA, while 40 helmets from professional jockeys were collected by The Irish Turf Club. All helmet damage was measured, and associated head injury was recorded.ResultsEighty-eight percent (189) of equestrian fall accidents returned an injury report of which 70% (139) reported a head injury. Fifty-four percent (75) of head injury cases had associated helmet damage while 46% had no helmet damage. Reported head injuries consisted of 91% (126) concussion, 4% (6) skull fractures, 1 (0.7%) subdural hematoma, 1 (0.7%) cerebral edema and 5 (3.6%) diffuse axonal injury (DAI). It is also shown that helmets certified to the most severe standard are overrepresented in this undamaged group (p <0.001).ConclusionsIt is clear that despite jockeys wearing a helmet, large proportions of concussion injuries still occur in the event of a jockey sustaining a fall. However, the data suggest it is likely that helmets reduce the severity of head injury as the occurrence of skull fracture is low. The proportion of undamaged helmets with an associated head injury suggests that many helmets may be too stiff relative to the surface they are impacting to reduce the risk of traumatic brain injury (TBI). It may be possible to improve helmet designs and certification tests to reduce the risk of head injury in low-severity impacts.

Clinical and Diagnostic (CT scan) Case Profile of Traumatic Brain Injury (TBI) Patients in a Teritiary Care Center, Visakhapatnam - A Retrospective Observational Study

Introduction: India experiences increase in incidence of Road Traffic Accidents (RTA). During 1970 to 2011, there is 7.3 times increase in road accident injuries. Head injury is the commonest due to RTA injury which accounts for 60% of cases in Visakhapatnam which is situated along the 9National Highway. Aim: The aim is to study the clinical and CT scan diagnostic case profile of Traumatic brain injury (TBI) in Visakhapatnam region. Material &amp; Methods: It is a retrospective observational study of cases of TBI reported at the trauma care center at the tetitiary care King George Hospital (KGH), Visakhapatnam, for the period 2011 – 2018. Proper permission and clearance for the present study is duly obtained. Results &amp; Discussion: Head injury is the commonest among traumatic injuries. CT scan is performed as the gold standard diagnostic test for head injury cases. Contusions followed by Sub arachnoid hemorrhage (SAH) and Sub dural hemorrhage (SDH) are the most common CT findings. About 25% needed ventilator support. Most common cause of death is CNS injuries (42%) followed by blood loss in 39% of cases. Conclusions: Regulated traffic control, wearing helmet and seat belt, limiting speed and avoiding L &amp; U bends at road corners can prevent and minimise the incidence of fatal injuries.

ANALYSIS OF CLINICAL DIAGNOSES IN FATAL HEAD INJURY CASES

Aim. In this research, we compare the antemortem and postmortem diagnosis in fatal head injury cases with the purpose of establishing the structure and causes of incorrect diagnoses.Material and methods. 1223 cases of fatal outcomes with the clinical diagnosis of death from head trauma were examined. In each case, we carried out a comparison of the clinical and autopsy diagnosis in terms of all report headings in order to establish reasons for divergence in the antemortem and postmortem diagnoses and the role of incorrect clinical diagnostics in the onset of death.Results. In 35% of cases, the clinical head trauma diagnoses were incorrectly categorized. In 22.6% cases, the antemortem diagnoses were formulated not in correspondence with the modern classifi cation and terms of ICD-10. In 11.7% cases, the violation of the etiopathogenesis principle was observed. Clinical diagnoses were not supported by objective data and examination results in 4.5% cases. The discrepancy between the clinical and autopsy diagnoses in terms of the ‘underlying disease’, ‘complications’ and ‘concomitant’ headings was 15.6%, 10.1% and 14.0% from all the studied cases, respectively. Subjective reasons are found to statistically predominate among the identifi ed reasons for the divergence of diagnoses.Conclusion. It is established that fi nal clinical diagnoses in fatal head injury cases fail to fully meet the criteria of structure, nosology, etiopathogenesis and reliability. Erroneous diagnoses are found to result from underestimation of clinical data, insuffi cient observation and instrumental examination of patients, incorrect formulation of the fi nal clinical diagnosis.

Co-relation of initial Computed tomography findings with prognosis in head injury cases, mainly based on basal cistern status and mid-line shift parameters

Co-relation of initial Computed tomography findings with prognosis in head injury cases, mainly based on basal cistern status and mid-line shift parameters - IJASHNB- Print ISSN No: - 2581-5210 Online ISSN No:- 2581-5229 Article DOI No:- 10.18231/j.ijashnb.2019.004, IP Indian Journal of Anatomy and Surgery of Head, Nec

Concentration of microtubule associated protein tau (MAPT) in urine and saliva as a potential biomarker of traumatic brain injury in relationship with blood–brain barrier disruption in postmortem examination

Traumatic brain injury (TBI) constitutes a frequent finding in medico-legal practice, including forensic autopsy and neuropathological examination. Despite clinico-scientific advances there is a need for identification of novel biomarkers considered for TBI diagnostics in ante- and postmortem cases. The role of MAPT protein as a biomarker in case of TBI was investigated in previous studies by examination of blood and cerebrospinal fluid obtained during forensic autopsies whereas less is known concerning its liberation and occurrence in other biofluids. The aim of this study was to elucidate and identify if elevated MAPT levels in other biofluids, such as urine, saliva, and vitreous body are also seen in TBI cases in population-based autopsy screening. The study was carried out using cases (n = 14) of severe head injury suspected as the cause of death and control cases (n = 13) of sudden death in the mechanism of cardiopulmonary failure. The biofluids, such as urine, saliva, and vitreous body were collected within ∼24 h after death and compared using ELISA test. Tissue specimens including brain and kidney were similarly collected during forensic autopsies. Brain specimens were stained immunohistologically with anti-Vimentin (V9) antibody and histologically using Mallory’s trichrome method (to assess structural damage to blood–brain barrier elements) whereas kidney specimens were stained immunohistologically with anti-MAPT antibody (to assess the suitability of such a study in the diagnosis of TBI). In our study, we observed the elevated concentration levels of MAPT in saliva and urine. These changes were accompanied by damage to the structural elements of the blood–brain barrier (damage to the vascular endothelium and vascular basement membrane). According to this elevated cencentration levels of MAPT in this biofluids should be considered as TBI marker in postmortem examination even in cases where the head injury was not supposed to consist the direct cause of death.

Analysis of early treatment of multiple injuries combined with severe pelvic fracture

PurposeTo summarize and analyze the early treatment of multiple injuries combined with severe pelvic fractures, especially focus on the hemostasis methods for severe pelvic fractures, so as to improve the successful rate of rescue for the fatal hemorrhagic shock caused by pelvic fractures. MethodsA retrospective analysis was conducted in 68 cases of multiple trauma combined with severe pelvic fractures in recent 10 years (from Jan. 2006 to Dec. 2015). There were 57 males and 11 females. Their age ranged from 19 to 75 years, averaging 42 years. Causes of injury included traffic accidents in 34 cases (2 cases of truck rolling), high falling injuries in 17 cases, crashing injuries in 15 cases, steel cable wound in 1 case, and seat belt traction injury in 1 case. There were 31 cases of head injury, 11 cases of chest injury, 56 cases of abdominal and pelvic injuries, and 37 cases of spinal and limb injuries. Therapeutic methods included early anti-shock measures, surgical hemostasis based on internal iliac artery devasculization for pelvic hemorrhage, and early treatment for combined organ damage and complications included embolization and repair of the liver, spleen and kidney, splenectomy, nephrectomy, intestinal resection, colostomy, bladder ostomy, and urethral repair, etc. Patients in this series received blood transfusion volume of 1200–10,000 mL, with an average volume of 2850 mL. Postoperative follow-up ranged from 6 months to 1.5 years. ResultsThe average score of ISS in this series was 38.6 points. 49 cases were successfully treated and the total survival rate was 72.1%. Totally 19 patients died (average ISS score 42.4), including 6 cases of hemorrhagic shock, 8 cases of brain injury, 1 case of cardiac injury, 2 cases of pulmonary infection, 1 case of pulmonary embolism, and 1 case of multiple organ failure. Postoperative complications included 1 case of urethral stricture (after secondary repair), 1 case of sexual dysfunction (combined with urethral rupture), 1 case of lower limb amputation (femoral artery thrombosis), and 18 cases of consumptive coagulopathy. ConclusionThe early treatment of multiple injuries combined with severe pelvic fractures should focus on pelvic hemostasis. Massive bleeding-induced hemorrhagic shock is one of the main causes of poor prognosis. The technique of internal iliac artery devasculization including ligation and embolization can be used as an effective measure to stop or reduce bleeding. Consumptive coagulopathy is difficult to deal with, which should be detected and treated as soon as possible after surgical measures have been performed. The effect of using recombinant factor VII in treating consumptive coagulopathy is satisfactory.

Psychosocial Impact of Brain Injury: A Review

AbstractTraumatic brain injury (TBI) is known as “silent epidemic” because of lack of knowledge about it and its delayed symptoms of memory and cognitive problems. The incidence is approximately 1.4 million per year in the United States, and in the developing countries, it is approximately 341 per 100,000. In the United States, the annual productivity loss due to TBI and its delayed effects is more than $56 billion. TBIs occur mainly due to traffic accidents and falls. All the age groups are affected, but the rates are higher in men than in women. The causes vary as per the age groups as traumas affect mainly children and elderly, and traffic accidents and violence affect more of adolescents and young adults. Data from various studies indicate wide variation in the incidence and prevalence of psychiatric disorders after TBI, but they are definitely higher as compared with general population. We also noted different psychiatric disorders in post head injury cases during follow-up at our university hospital, which included depression, behavioral disorders, cognitive disorders, memory impairment, anxiety disorders, stress-related headache, vertigo, irritability and sleep disorders, etc. Therefore, this review was undertaken to assess the psychosocial impact of brain injury on an individual.

DISTRIBUTION AND CHARACTERISTICS OF HEAD INJURY AND REFERRAL NUMBER AT DR H. ANDI ABDURRAHMAN NOOR GENERAL HOSPITAL, TANAH BUMBU, SOUTH BORNEO, INDONESIA

Background: Head injury (HI) has been one among leading causes of morbidity and mortality worldwide especially in the peripheries area. In South Borneo, 9.4% of trauma cases was a head injury. Especially, Tanah Bumbu Regency, one of peripheries area in South Borneo ranks third for head injuries after Tabalong and Tanah Laut Regency in 2007.Objective: The aim of this study was to describe the characteristics of head injury patient and referral number at Dr. H. Andi Abdurrahman Noor general hospital.Methods: All head injury patients admitted to the emergency department (ED) of Dr. H. Andi Abdurrahman Noor general Hospital in a one-year period (2017) were registered in this retrospective study. Using the total population sampling method, 413 cases of head injury during the period were included as a subject of study.Result: This study showed that mild head injury was the most cases of head injury with 325 cases (78.2%). 61 patients were referred to a higher trauma center in 2017. Head injury was most common in 11-20 years old age group. Men also had higher incident rate compared to women (2:1). Most of the patients were a nonstate employee. Head injury is commonly caused by traffic accident.Conclusion: This study shows that characteristics of HI in the peripheries area such Tanah Bumbu regency are no different from other countries. Our findings suggest that several prevention steps should be taken to reduce the number of head injury based on the distribution and characteristics of head injury sustainers.

Evaluation of cases of head injury in pa-tients admitted to emergency using CT scan

Background: Traumatic brain injury (TBI) is one of the most devastating types of injury. The present study was conducted to evaluate cases of head injury with CT scan. Materials & Methods: The present study was conducted on 225 patients of head injury of both genders. All patients underwent CT scan using Toshiba Aquillion CT scanner (16 slice). Both the bone and soft tissue windows were viewed, and images were reformatted into sagittal, coronal, and oblique planes. Results: Out of 225 patients, males were 125 and females were 100. Reason of head injury was road traffic accident in 170, fall in 38, assault in 12 and gun shot in 5. The difference was significant (P< 0.05). Common CT findings were fracture in 120, subdural hemorrhage in 65, epidural hemorrhage in 32, subarachnoid hemorrhage in 46, contusion in 24, hematoma in 72, cerebral odema in 35, sinus collection in 44 and pneumocranium in 26. The difference was significant (P< 0.05).Conclusion: Maximum cases were due to road traffic accidents and common CT finding was cranium fracture.

Comparitive Analysis of Computed Tomography Scan and Post Mortem Findings in Cases of Head Injury at a Tertiary Health Centre

Background- Head injury is the leading cause of morbidity and mortality among young adults in developing economies like India and the incidences in elderly population is increasing. Computed tomography serves as the primary modality of choice in detecting fatal legions in the head. In spite of this, the fallacies of CT scan in finding these legions can’t be ignored. The present study tries to evaluate the pattern of head injury and fallacies of CT scan. Material & Method: Total 300 cases of head injury were selected for the study based on the inclusion criteria during period of December 2014 to November 2016. Results: CT scan could not detect 22.22% cases of occipital bone fracture, 21.95 % cases of temporal bone, 10.76% cases of frontal bone & 7.36% cases of parietal bone fracture. In case of fractures of base of skull, CT could not detect 71.42 % fractures of anterior & middle cranial fossa and 42.85% of the posterior fossa. Autopsy detected 20%, 71%, 10% & 100% more depressed fractures of frontal, temporal, parietal & occipital than that of CT scan respectively. CT missed linear fracture of frontal bone, parietal bone, temporal bone & occipital bone in 0%, 17%, 3%, 22% cases respectively. Considering the intracranial haemorrhages, the disparity between CT scan and autopsy in detecting extradural haemorrhage, subarachnoid haemorrhage, subdural hematoma, intracerebral haemorrhage and intraventricular hemorrhage was 7.01%, 15.21%, 15.65%, 5.40% and 11.76% respectively. With respect to traumatic brain injuries the CT could not detect cerebral oedema, brain contusions and brain lacerations in 2.45%, 2.12% and 70% cases. Conclusions: To improve the sensitivity of CT scan the use of multi detector CT with sagittal & coronal reformation should be implemented in a routine interpretation of a CT head so that forensically important fractures will not get missed.

A case of severe head injury with repeated contralateral hematomas in a young patient — Study of surgical strategy

A case of severe head injury with repeated contralateral hematomas in a young patient — Study of surgical strategy

Immunolocalization of dynein, dynactin, and kinesin in the cerebral tissue as apossible supplemental diagnostic tool for traumatic brain injury in postmortem examination.

Traumatic brain injury (TBI) is characterized by various micro- and macrostructural neuropathological changes which can be identified in the light microscope examination. The most common pathophenotype of TBI visualized in postmortem neuropathological assessment includes neuron injury with involvement of all of its structural regions followed by its progressive degeneration defined as traumatic axonal injury (TAI). This is directly related with disruption of the axolemmal cytoskeletal network architecture resulting in breakdown, dissolution and accumulation of anumber of neuronal proteins. Regarding the availability and progress in the development of specific antibodies against neuronal proteins, their usage is restricted due to low specificity for injured axons in the pathomechanism of TBI followed by TAI. Taking this into account with relation to expanding the role of axonal cytoskeleton and its based biomarkers we have presented astudy documenting neuropathological features concerning the expression of dynein (DNAH9), dynactin (DCTN1) and kinesin (KIF5B) in the brain specimens obtained during forensic autopsies from TBI victims. The study was carried out using cases (n = 21) of severe head injury suspected to be the cause of death and control cases (n = 17) of sudden death in the mechanism of cardiopulmonary failure along with apositive control case which died after suicidal gunshot injury. In our study, we documented that DNAH9, DCTN1, and KIF5B staining should be considered as asupplemental diagnostic tool for TBI in postmortem neuropathological examination and forensic autopsy. This additional motor protein immunohistochemical staining procedure could be useful in the evaluation of lesions that may remain undiagnosed during aroutine examination and aid in more accurate identification of TBI followed by TAI.

Detecting heart tissue injury in electrocution human cases using heart-type fatty acid-binding protein 3

Introduction: In the medicolegal daily practice, electrocution is a traumatic cause of death owing to wide use of electricity and electrical devices in different activities of modern life at home and workplaces. Electrical current passage through tissues elaborates different types of energy (the electrical, thermal, and mechanical energies) which can cause skin lesions, multiorgan damage, and even death. The severity and extent of tissue injuries depend on the current type (alternating current [AC] or direct current), its strength (amperage), voltage (low or high), frequency, tissue resistance, duration of exposure, and its pathway through the body. Microscopic examination of tissue samples from the heart may show nonspecific findings to electrocution, but sometimes none is detected by conventional hematoxylin and eosin stains (H and E). Therefore, immunohistochemical studies could help the forensic pathologists in their diagnosis, especially cases with less typical findings or obscure circumstances. Heart-type fatty acid-binding protein 3 (H-FABP3) is a small cytoplasmic protein of (15 kDa), composes of 133 amino acids, involves in active fatty acid metabolism, and transports fatty acids from the cell membrane to mitochondria for oxidation. Due to its cytoplasmic location and small molecular weight, it released from cardiac myocytes into the circulation following an ischemic episode. Objective: This study was conducted to evaluate the effect of electric current on the expression of H-FABP3 in human heart tissue autopsy samples. Methods: Human heart tissue samples were collected during the period from January 1 2016 to June 30, 2016, through autopsy of 30 medicolegal cases of electrocution as well as 30 cases of fatal head injuries which were used as control. They were examined by conventional histopathological H and E stain and immunohistochemical technique so that H-FABP3 was detected using FABP3 polyclonal antibody and demonstrated by ready to use biotin-free, one-step horseradish peroxidase polymer anti-mouse, rat, and rabbit immunoglobulin G with 3,3'-diaminobenzidine to achieve the aim of this study. Results: This study shows that electric shock was the fifth cause of traumatic death, being responsible for death of only 4.5% of cases referred to the medicolegal directorate in Baghdad during the period of study. It is almost accidental death in Iraqi society with higher incidence to be due to contact with low-voltage household AC sources with young males at the age of (15–20 years old) are being more vulnerable to fatal electrical injury than females during their early productive life (with male:female ratio = 6:1). Heart tissue ischemia is a major cause of death following electrocution, especially when victim being in contact with household low-voltage AC in the presence of transthoracic pathway to the ground and low body resistance due to skin wet which can cause death within a minute in association with mild if any electrical skin burns. Electrocution has a significant effect on H-FABP3 stain total index as it causes depletion of FABP3 total stain index with mean of 0.28 ± 0.149177SD for tissue sections of the heart muscle in the affected areas of human cases. Conclusions: Immunohistochemical heart tissue samples' examination which shows dramatic depletion in H-FABP3 total stain index in affected area(s) is of value in detecting heart tissue injury caused by electrocution during the early period after death even in the absence of grossly and microscopically visible lesion(s).

Nanowired delivery of DL-3-n-butylphthalide induces superior neuroprotection in concussive head injury.

Concussive head injury (CHI) is quite prevalent in military personnel leading to lifetime disability in more than 85% of cases. Other reasons of CHI include motor vehicle accident, fall or blunt trauma under various conditions. In United States of America (USA) alone more than 150k cases of head injury are added every year for which no suitable therapeutic strategies are still available. Thus, there is a need to expand our knowledge in treating CHI cases with novel therapeutic measures to enhance the quality of life of head injury victims. With recent advancements in nanodelivery of drugs for superior neuroprotective effects in neurological diseases, our laboratory is engaged in understanding the role of nanowired delivery of suitable drugs in treating CHI and other neurodegenerative diseases. DL-3-n-butylphthalide (NBP) is an extract of Chinese celery and is able to induce profound neuroprotection following ischemic stroke and other related neurological dysfunction. Thus, it is quite likely that synthetic NBP could have pronounced neuroprotective effects in CHI as well. We believe that nanodelivery of NBP have superior neuroprotection in CHI. In this review neuroprotective effects of nanowired delivery of NBP in CHI induced brain pathology is described. Our experimental observations show that nanowired delivery of NBP results in superior neuroprotection than the regular NBP in CHI. The probable mechanisms and functional significance of our finding in relation to military medicine is discussed based on our own investigations.

Analysis and Outcome of Head Injury Cases due to RTA in Tertiary Hospital in North West Uttar Pradesh

Head injuries and road traffic accidents have been seen to occur in maximum number in the state of Uttar Pradesh. The present study details the pattern of head injuries arising out of road traffic accidents admitted to a hospital in North West Uttar Pradesh and aims to provide an idea of the similarities and differences in the pattern and outcome of head injury cases in comparison to other studies around the country