Morbidity Andmortality Research Articles

POS-522 EARLY VERSUS LATE DIALYSIS: TIMING AND MORTALITY

Chronic kidney disease remains one of the diseases with a high cardiovascular morbidity andmortality, especially when approaching the end stage. The correct timing of dialysis initiation remains a controversial issue until now. The aim of this study is to compare early and late dialysis andtheir impact on mortality. This is a retrospective study. We collected sociodemographic, clinical and biological data from the medical records of patients who reached the end stage, divided into two groups : early HDP hemodialysis with a glomerular filtration rate (GFR > 7 ml/min) and late HDT hemodialysis (GFR ≤ 7ml/min). Our study included 149 patients of whom 66 were in the HDT group. The mean age was 59.38 yearsand 64.27 years in the HDT and HDP groups respectively. The mean GFR in the HDT and HDP group was 5.4 ml/min and 9.8 ml/min. The percentages of hypertension, diabetes and coronaryi nsufficiency were respectively in HDT and HDP : 41.35%, 36.47%, 41.38% and 58.65%, 63.53%,58.62%. The main etiologies of CKD were : diabetes (26.56% HDT ; 20.73% HDP), chronic interstitial nephropathy (18.75% HDT ; 23.17% HDP), vascular nephropathy (7.8% HDT ; 4.88% HDP), chronic glomerular nephropathy (9.37% HDT ; 12.19% HDP) and indeterminate (37.5% HDT ; 30.49% HDP) Mortality in the HDT group was 34.85% (n=23) and in the HDP group 48.19% (n=40). There was no significant difference in mortality between the 2 groups (p=0.1014). In our study, mortality was slightly higher in HDP group than among HDT group, but was not significant, which requires larger studies spread over time to confirm or disprove this result.

Protective Effect of Trimetazidine on Kidney Dysfunction: A Review of Experimental Evidence

Background and Objectives Acute kidney injury is the main cause of morbidity and mortality in the worldwide that is accompanied by short-term and long-term complications, including chronic kidney disease, end-stage renal disease, and ultimately death. Various mechanisms are involved in renal dysfunction, including oxidative stress, inflammatory responses, apoptosis, fibrosis, and mitochondrial dysfunction. Trimetazidine as a drug with free radical oxygen scavenging property represents to be more invaluable against acute kidney injury. Trimetazidine is considered as an anti-ischemic drug in the treatment of cardiac diseases which has been documented pharmacologic effects such as antioxidant, anti-apoptotic, and anti-inflammatory properties in renal ischemia-reperfusion injury, diabetic nephropathy, and nephrotoxicity models. Subjects and Methods This review underlines the nephroprotective effect of trimetazidine on kidney injury models. For this review, the articles have been searched in the databases, including PubMed, Scopus, Web of science, and Google Scholar. The search process was provided using these keywords: “Trimetazidine”, “kidney”, “nephrotoxicity”, “renal ischemia – reperfusion injury”, and “Protective.” Results Present study validates which trimetazidine as a potential agent alleviates kidney dysfunction in experimental models through several mechanisms. Conclusion Trimetazidine could be considered as promising candidate to treat a variety of kidney diseases in the future.

Candidemia in pediatric cancer patients contributes to significant morbidity andmortality: A single centre experience from India

candidemia in pediatric cancer patients contributes to significant morbidity andmortality: A single centre experience from India

COVID-19 vaccination rates in hospitalized mentally ill patients compared to the general population in Germany: Results from the COVID Ψ Vac study.

Mental illness is known to come along with a large mortality gap compared to thegeneral population and it is a risk for COVID-19 related morbidity andmortality. Achieving high vaccination rates in people with mental illness is therefore important. Reports are conflicting on whether vaccination rates comparable to those of the general population can be achieved and which variables represent risk factors for nonvaccination in people with mental illness. The COVID Ψ Vac study collected routine data on vaccination status, diagnostic groups, sociodemographics, and setting characteristics from in- and day-clinic patients of 10 psychiatric hospitals in Germany in August 2021. Logistic regression modeling was used to determine risk factors for nonvaccination. Complete vaccination rates were 59% (n = 776) for the hospitalized patients with mental illness versus 64% for the regionally and age-matched general population. Partial vaccination rates were 68% (n = 893) for the hospitalised patients with mental illness versus 67% for the respective general population and six percentage (n = 74) of this hospitalized population were vaccinated during the hospital stay. Rates showed a large variation between hospital sites. An ICD-10 group F1, F2, or F4 main diagnosis, younger age, and coercive accommodation were further risk factors for nonvaccination in the model. Vaccination rates were lower in hospitalized people with mental illness than in the general population. By targeting at-risk groups with low-threshold vaccination programs in all health institutions they get in contact with, vaccination rates comparable to those in the general population can be achieved.

Injury Pattern of Victims in Fatal Motor Bike Accident

Background: Road traffic accidents (RTA) are a major health problem worldwide, responsible for significant morbidity andmortality. The increase in the number of motorcycles circulating over the years is a consequence of the low cost, ease oflocomotion and fuel efficiency of this vehicle. Objective: To find out the injury pattern of victims in fatal motor bike accident in addition to socio-demographiccharacteristics of victims. Methods and Materials: The cross-sectional study was conducted inSylhet M. A. G. Osmani Medical College Hopital,Sylhet. Data were collected from the emergency unit and hospital ward registers. Information from the different unit & wardregisters was entered into a standardized questionnaire. Data were collected by the study principal investigator, during studyperiod from January 2021 to June 2021. Results: More than two third (68.0%) victims belonged to age group 21-40 years. Male was found 49(98.0%) and 40(80.0%)were employer. Half (50.0%) of the victims were driver followed by 16(32.0%) were passenger and 9(18.0%) were pedestrian.Every victim has been injured in different parts of the body at the same time. Out of 50 patients, head injuries accounted for 49(98 percent), thorax (chest) injuries for 44 (88%), abdominal injuries for 100%, and limb injuries for 27 (54%). Majority47(94.0%) victims were alive and 3(6.0%) were death. In died patients, 1(33.3%) had severe haemorrhage and 2(66.7%) hadcraniocerebral injury. Conclusion: Male was predominating, half of the victims were driver, and more common type of injury was Head, Thorax (chest), Abdomen and Limbs. Mortality rate was found 6% and most of them were craniocerebral injury.

Innovative Therapeutic Methods for the Treatment of Liver Diseases

The article investigates innovative therapeutic methods for the treatment of liver diseases. The author notes that liver diseases represent a serious burden on health worldwide and they are recognized as the leading cause of mortality and morbidity in the world. In this regard, specialists are constantly searching for innovative methods in the field of treatment and maintenance therapy for liver diseases. Such methods include, for example, mass medical examination of patients at risk, early diagnosis of liver diseases on ultra-precise medical equipment, gene therapy, etc.

Vitamin D Affects the Warburg Effect and Stemness Maintenance of Non- Small-Cell Lung Cancer Cells by Regulating the PI3K/AKT/mTOR Signaling Pathway.

Non-Small-Cell Lung Cancer (NSCLC) is the most prevalent form of lung cancer, accounting for approximately 85% of all lung cancer cases and resulting in high morbidity and mortality. Previous studies have demonstrated that 1,25-dihydroxy-vitamin-D3 (vitamin D) exhibited anti-cancer activity against breast and prostate cancer. The aim of the current study is to investigate the effect of vitamin D on NSCLC and its underlying mechanism. The effects of vitamin D on stemness maintenance and the Warburg effect in NSCLC cells were investigated both in vitro and in vivo. In vitro experiments revealed that vitamin D inhibited glycolysis and stemness maintenance in A549 and NCI-H1975 cells. Both in vitro and in vivo experiments indicated that vitamin D attenuated the expression of metabolism-related enzymes associated with the Warburg effect (GLUT1, LDHA, HK2, and PKM2). In addition, vitamin D down-regulated the expression of stemness-related genes (Oct-4, SOX-2, and Nanog) and the expression of PI3K, AKT, and mTOR. Overall, these findings suggest that vitamin D suppresses the Warburg effect and stemness maintenance in NSCLC cells via the inactivation of PI3K/AKT/mTOR signaling, thereby inhibiting the progression of NSCLC. The current study indicates that vitamin D is a potential candidate in therapeutic strategies against NSCLC.

Antibiotic Resistance Pattern in Respiratory Tract Infection during COVID-19 Era

Background: Respiratory Tract Infection (RTI) is a very common disease in our country. Bacterial infections in the respiratory tract causing significant morbidity andmortality in hospitalized patients. Information on the prevalence of bacterial infection in RTI in our health care settings is lacking. Moreover, the injudicious use of antibiotics often leads to antibiotic resistance which is an emerging problem. The objective of this study was to determine the prevalence of bacterial infections and antibiotic resistance patterns in pathogens isolated from the sputum samples of admitted patients suffering from RTI in a tertiary care teaching hospital in the Coronavirus Disease (COVID-19) era. Materials and methods: In this cross-sectional study 104 patients who were admitted to the Medicine Department of Chittagong Medical College Hospital with a diagnosis of RTI from February 2021 to June 2021 were included. Bacterial isolates from the sputum culture were confirmed by the standard microbiological methods. Antibiotic resistance was determined by using the disk diffusion method. Results: Out of 104 processed sputum samples 92 (88.5%) cases had established bacterial etiology. Klebsiella (45.2%) was the most common organism followed by Pseudomonas (17.2%) and Acinetobacter (14.4%). In antimicrobial susceptibility testing, Imipenem and meropenem were sensitive against Klebsiella. Ciprofloxacin, levofloxacin, imipenem, meropenem and piperacillin were sensitive against Pseudomonas. Acinetobacter was highly resistant to ceftriaxone. Conclusions: The resistance pattern varied for different organisms. Therefore, appropriate identification of the causative organisms and their antibiotic resistance is crucial for the right choice of antibiotic therapy in LRTIs. JCMCTA 2021 ; 32 (2) : 8-13

Development of Tool for Case Submission and Review as Foundation for Department Patient Safety / Quality Improvement Program

Objective: Describe creation and implementation of secure case collection tool for the foundation of otolaryngology department Patient Safety/Quality Improvement (PSQI) program. Describe how tool decreased burden while fulfilling stakeholders’ reporting requirements. Methods: Incorporation of elements of required reports into online tool, facilitating improved case submission for Morbidity and Mortality conference (M&M) review. Reviewer commentary and conference discussion notes are recorded within the project. Regular reports tailored to each stakeholder were designed. Results: During first 8 months of implementation, 83 cases were submitted–5250 surgical procedures were performed by our department in that period—compared to 75 cases submitted via prior system in a same time period the year before (6930 surgical procedures performed). Elements of routine reports for interdepartmental use and external stakeholder requirements determined and reported. Discussion: Preliminary description of secure online tool with a single platform serving multiple stakeholders with unique reporting elements. This presents an opportunity to reduce the burden of essential administrative tasks while providing a reliable PSQI repository. Future metrics for ongoing evaluation will be identified and incorporated. Case submissions were maintained through a period of altered clinical activity (SARS-CoV-2 pandemic). Implications for Practice: This tool will allow our department to review cases for our required M&M with improved efficiency and efficacy, while supporting our PSQI program and generate necessary reports to stakeholders. Reduction of electronic task burden may reduce risk of physician burnout. Facilitating implementation of essential and required PSQI efforts will strengthen our curriculum and clinical work.

Global impact of foodborne diseases on health

The occurrence of foodborne diseases (FBD) has increased in the last decade as a result of negligence for hygiene. Prevalence of FBD due to lack of education, insufficient health services result in the spread of disease on a larger scale. Personal hygiene, as well as local cleanliness, is the most important aspect of the overall health community. Pandemic like COVID is due to lack of personal hygiene as well as health education. The data published by global bodies like World Health Organization (WHO) indicates that the FBD should be controlled by increasing awareness related to personal hygiene and health education. This article reviewed the global occurrence of FBD, preventive measures and solutions for an overall healthy community. The aim of this review is to analyse reports related to foodborne diseases over the globe and suggest guidelines for community health. The scope of this review is in food safety and quality – microbiological and chemical in Food research Journal. Reviews, reports, research data related to foodborne diseases have been analysed and future solutions for building a better health community have been suggested. A total of 74 references including research articles, reviews, press notes, government sites related to foodborne diseases over the globe have been reviewed and data collection has been analysed to suggest better health community guidelines. All the references showed that the occurrence of foodborne diseases are increasing day by day and thus control measure policies have to be implemented worldwide. These include strict government policies, education of food vendors, strict action against those who are not following it, educating the importance of personal as well as community hygiene. These results will surely help to build a better healthy community in future. The data showed that foodborne disease is affecting many populations at any age each year leading to morbidity and mortality. The disease is caused by bacteria, viruses, parasites and fungi. The common symptoms are diarrhoea, vomiting, fever and abdominal pain. Awareness and education related to community health should be spread using advertisements, social media, newspapers, news channels to lower the incidence of foodborne diseases.

P.121 Leading the Way to the Future: Implementing Novel Therapeutics for Rare Pediatric Neurological Disorders

Background: Children and Adolescents with rare neurogenetic disorders often have no known cure or disease modifying treatments. Recent advancements in treatments are offering much needed hope to these patients and families. However, these treatments are extremely costly, have complex administration requirements and have many unknown long-term risks and outcomes. Methods: In this presentation, we will discuss our experiences with the implementation process, including developing intricate care pathways, collaborating with multiple disciplines and services, supporting and advocating for our patients and families, and interacting with government agencies and pharmaceutical companies. Case studies will highlight the positive impact these treatments are making on the lives of children and adolescents with rare neurological disorders. Results: Spinal muscular atrophy and Neuronal Ceroid Lipofuscinosis Type 2 are both rare and devastating neurodegenerative conditions with significant morbidity and mortality. Health Canada and government funding agencies recently approved Nusinersen, Onasemnogene abeparvovec for the treatment of SMA and Cerliponase alfa for the treatment of CLN2, leading us to swiftly integrate these treatments into our standard of care. Conclusions: While implementing these novel therapies into clinical practice can be both challenging and rewarding, neuroscience nurses are positioned at the forefront to be leaders in this process at both organizational, national, and international levels.

Postoperative Complication and Depression: A Literature Review

Surgical procedure is a significant factor for patients and is associated withdepression. The literature review aims to identify depressive conditions inpatients with a history of postoperative hospitalization. Depressive conditions,anesthesia and surgery can lead to a high increase in patient morbidity andmortality. Major depressive disorder is a common complication, which can leadto increased morbidity and mortality. Depressive disorders can cause patients todevelop certain diseases that occur postoperatively, especially in patients whohave malignant tumors or carcinomas that will undergo surgery. Depression isassociated with cognitive impairment, which is exacerbated by postoperativeevents. There is evidence that postoperative pain is seriously depressing anddepression causes pain to worsen. Depression is also said to be a strong predictorand correlates with persistent postoperative pain. Some studies say depressionis an objective risk factor that can lead to a long recovery after surgery.Depression can also occur in patients admitted to the intensive care unit, whichis associated with high morbidity and mortality rates, thereby increasing thepossibility of additional hospitalization costs.

CYP3A4 *1B Gene Polymorphism in Coronary Artery Disease Patients with Obesity Undergoing Statin Treatment

Objective: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide and statins are frequently prescribed in the treatment of CAD to help lower blood cholesterol levels. Since the main enzyme involved in the metabolism of statins is CYP3A4, we aimed to investigate the effect of CYP3A4 * 1B genotypes on plasma lipid profile in Turkish cardiovascular disease subjects with and without obesity taking statin. Materials and Methods: The study group consisted of 85 cardiovascular disease patients who were prescribed statins and had routine biochemical analysis data. Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) assay was performed for genotyping of CYP3A4 *1B (rs2740574) polymorphism. Results: Genotype distribution of CYP3A4 *1B polymorphism was found for homozygous wild (AA) and homozygous polymorphic (GG) genotypes as 94.1% and 5.9%, respectively. We did not detect patients with heterozygous genotype in our study group. We found that the mean LDL-c, TG and TC levels were higher in patients with CYP3A4 *1B GG compared to the AA genotype. The frequency of CYP3A4 *1B GG genotype frequency (9.5%) was detected higher in the obese patients compared to the non-obese patients (7.7%) (χ2=0.037, p=0.85). Conclusions: Our results demonstrate that CYP3A4 *1B homozygous polymorphic genotype distribution tends to be higher in obese patients compared to non-obese patients with cardiovascular disease which may point to *1B allele having a slight effect on serum lipids during statin therapy. Additional studies with higher samples are needed for evaluating the role of CYP3A4 *1B on lipids in patients under statin therapy.

Sustained decrease in pediatric asthma emergency visits during the first year of the COVID-19 pandemic.

Background: On January 20, 2020, the first documented case of novel severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) was reported in the United States. The U.S. Centers for Disease Control and Prevention continues to report more morbidity and mortality in adults than in children. Early in Pandemic, there was a concern that patients with asthma would be affected disproportionately from COVID-19, but this was not manifested. It is now recognized that angiotensin-converting enzyme 2 receptors that are used by the coronavirus for infection have low expression in children with atopy that may contribute to decreased infectivity in children who are atopic. There are several early reports of decreased emergency department (ED) visits for children with asthma. The authors previously reported a decrease in pediatric ED visits in the spring of 2020, which correlated with school closure. Objective: To determine if this trend of decreased ED visits for pediatric asthma was sustained throughout the first COVID-19 pandemic year. Methods: ED data from one inner city children's hospital were collected by using standard medical claims codes. Conclusion: We reported a sustained year of decreased ED visits for children with asthma in one pediatric ED in an inner-city hospital; this seemed to be secondary to school closure and decreased exposure to upper respiratory infections.

Measurement of Some non-routine Markers in Patients with Chronic Kidney Disease

Chronic kidney disease has an indirect effect on global disorder and death by raising the risks of morbidityand mortality . This study included (60) patient diagnosed chronic renal failure; it also included (25)healthy subjects as control . In study population age ranged from (14-65 years) old who visited Al-BasrahTeaching Hospital in Basrah throughout the period from October 2020 to February 2021. Enzyme-LinkedImmunosorbent Assay (ELISA) was used to measure human serum soluble alpha klotho proteins , irisin andcystatin C . The results showed that there is a high significant difference (P value < 0.01) in the levels betweenCKD patients and control for the following : Soluble-a-klotho protein; Irisin (ng/ml) ; Cystatin-C (ng/ml).There was also a high significant decrease in the levels of irisin (ng/ml)among different stages of chronickidney . The same table revealed a high significant increase (P value <0.01) in the levels of Cystatin-C (ng/ml) and Soluble-a-klotho protein (ng/ml) among different stages of chronic kidney and respectively) . Thestudy concluded that there is a remarkable decrease in the level of serum soluble alpha klotho proteins andirisin and increase in serum cystatin C in patients with chronic kidney disease ; and these differences arepositively correlated with the glomerular filtration rate .

“Study of Estimation of Cerebrospinal Fluid C-Reactive Protein in Diagnosis of Acute Meningitis.”

Objectives:To assess the diagnostic role of CSF C-reactive protein quantitatively in acute meningitisand to evaluate the efficacy of CSF C-reactive protein in differentiating pyogenic meningitis fromnon-pyogenic meningitis.Material and Methods: It is a prospective observational study of total 102children with suspected meningitis allocated into three groups based on initial investigations; group-I Pyogenic meningitis, group-II Non-Pyogenic meningitis and group-III No meningitis (Controlgroup). Quantitative CSF C-reactive protein was detected by the latex agglutination method. Datawere analyzed to establish the diagnostic role of CSF-CRP and to evaluate the efficacy of CSF-CRP indifferentiating pyogenic meningitis from non-pyogenic meningitis.Results: A total of 102 clinicallysuspected meningitis patients were studied. Based on CSF findings, the study population (102cases) was categorized into 3 groups. Group I was pyogenic meningitis consist 53 cases (51.96%).Group II was Non-Pyogenic meningitis consists 27 cases (26.47%). Group III was normal CSFfindings consist 22 (21.56%). 98.1% cases of pyogenic meningitis had elevated CSF-CRP level >1.1μg/ml of CSF. In the case of Non-Pyogenic meningitis, 96.2% were found to have CSF- CRP in therange of 0.05-0.10 μg/ml. The mean value of CSF-CRP in groups I,II and III were 5.57±1.48,0.09±0.042 and 0.01±0.010 respectively. Conclusion: Detection of CSF-CRP provides a newdimension to establish the diagnosis of pyogenic meningitis. It is a rapid, reliable and sensitivediagnostic test. From this study it is concluded that CSF-CRP can be used to differentiate pyogenicfrom non-pyogenic meningitis. Early, accurate and appropriate therapy can ameliorate the morbidityand mortality rates in such cases.

Artificial Neural Network Models for Coronary Artery Disease

Background: Coronary artery disease (CAD) is an important cause of mortality and morbidity globally. Objective : The early prediction of the CAD would be valuable in identifying individuals at risk, and in focusing resources on its prevention. In this paper, we aimed to establish a diagnostic model to predict CAD by using three approaches of ANN (pattern recognition-ANN, LVQ-ANN, and competitive ANN). Methods: One promising method for early prediction of disease based on risk factors is machine learning. Among different machine learning algorithms, the artificial neural network (ANN) algorithms have been applied widely in medicine and a variety of real-world classifications. ANN is a non-linear computational model that is inspired by the human brain to analyze and process complex datasets. Results: Different methods of ANN that are investigated in this paper indicate in both pattern recognition ANN and LVQ-ANN methods, the predictions of Angiography+ class have high accuracy. Moreover, in CNN, the correlations between the individuals in cluster ”c” with the class of Angiography+ are strongly high. This accuracy indicates the significant difference among some of the input features in Angiography+ class and the other two output classes. A comparison among the chosen weights in these three methods in separating control class and Angiography+ shows that hs-CRP, FSG, and WBC are the most substantial excitatory weights in recognizing the Angiography+ individuals although, HDL-C and MCH are determined as inhibitory weights. Furthermore, the effect of decomposition of a multi-class problem to a set of binary classes and random sampling on the accuracy of the diagnostic model is investigated. Conclusion: This study confirms that pattern recognition-ANN had the most accuracy of performance among different methods of ANN. This is due to the back-propagation procedure in which the network classifies input variables based on labeled classes. The results of binarization show that decomposition of the multi-class set to binary sets could achieve higher accuracy.

A simple effective method for frailty in Heart Failure with impact on clinical outcomes in north Indian population

Introduction and objectivesFrailty has been studied extensively in elderly population as a predictor and prognostic marker for morbidity and mortality. Frailty is being increasingly recognized as a distinct pathophysiological condition which plays a major role in outcomes of various disease states including heart failure. Our aim was to study the prevalence of frailty in heart failure and see its prognostic significance in such patients.MethodsThis was a prospective study conducted in an out-patient HF clinic. All consecutive patients with HF, ≥25 years age, with LVEF<40% were included. All patients were asked a simple frailty questionnaire. Hand-dynamometer was used to assess handgrip strength in kilograms and were classified as frail, pre-frail or non-frail. The primary end point was cardiovascular mortality and hospitalization, and secondary end-point was composite of all cause mortality, hospitalization, device implantation and documented arrythmia.Results210 patients were studied for clinical outcomes. Mean age was 60.59 ± 11.55 years with 15% patients aged less than 50 years. Mean LVEF was 30.24 ± 6.8%. Handgrip strength was poor in the frail vs non/pre-frail patients (p = 0.001) with a strength >16.95 kg having sensitivity of 72% and specificity of 63% for the prediction of survival. Frailty was an independent predictor of mortality with higher mortality and re-hospitalization in frail population (p = 0.001). Hazard for mortality or hospitalization was 4.7 fold in frail population.ConclusionFrailty is associated with a significant morbidity and mortality in heart failure. A simple bedside hand-dynamometer may aid as a frailty screening tool in these patients and help in planning treatment strategies.

Endoscopic treatment of intracranial cysts in infants: personal experience and review of literature.

A wide variety of intracranial cysts is known to occur in infants. If symptomatic, they require treatment; the ideal surgical treatment andindications of surgery are yet a matter of discussion. Traditional treatment is either by cystoperitoneal shunting, or microsurgical fenestration. Endoscopictreatment is an alternative procedure that avoids the invasiveness of open craniotomy and the complications caused by shunting. This articlereviews the endoscopic treatment of intracranial cysts in infants. The author presents personal experience by reviewing the results of endoscopic treatmentin different subgroups among his series of pediatric patients extending over 20 years. Different types of intracranial cysts in infants were discussedand the role of endoscopy in the management of these patients was reviewed. The author also presented the results of endoscopic treatment of a personalseries including 87 infants with intracranial cysts operated by the endoscopic procedure. It has been recommended to use the endoscopicprocedure in the treatment of intracranial cysts in infants, because it is effective, simple, minimally invasive, and associated with low morbidity andmortality rates. However, an important prerequisite is the presence of an area of contiguity with the subarachnoid cisterns and/or the ventricular system.

Characteristics of Calvaria Depression Fractures Patients in Dr. Kariadi General Hospital, Semarang

Introduction. Head injury is one of trauma cases with high morbidity and mortality, with an incidence of 7.3 to 811 cases per 100.000 individuals per year and mortality ratio varying from 5.2 to 80.73 cases per 100.000 cases. Calvaria fractures that result from head injuries are often associated with risk of post-traumatic morbidity and mortality, where the incidence of post-trauma calvaria fractures is about 25% of all cases and around 10% of calvaria fractures are depressed calvaria fractures. This study was aimed to identify the characteristics of patients with depressed calvaria fractures at Dr. Kariadi General Hospital in 2020. Methods. This research is a descriptive study using secondary data from medical records. There were 30 patients with depressed calvaria fractures in January - December 2020 at Dr. Kariadi Hospital. The data is then presented in tabular form. Results. Depressed calvaria fractures in the period 2020 at Dr. Kariadi General Hospital was dominated by male (76.7%), mainly age 12-45 years old with a mean of 25.73 years old. The most common cause of depressed calvaria fractures is high velocity trauma. Minor head injury is the most common type of head injury. Depressed calvaria fractures of the frontal bone predominate in 80% of cases, with fracture depth &gt; 1 tabula. Conclusion: There were no cases of posttraumatic infection. There were 16.7% of cases with neurological deficits at the time of discharge. There were 73.3% cases with other intracranial disorders associated with depressed calvaria fractures. Operative management is the main choice of management with most cases length of stay are 5-10 days.