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Biomedical subjects

A J Raja

Publications and source records attributed to A J Raja.

5 recordsLinked to original sources
PubMed2002

Registry based trauma outcome: perspective of a developing country.

OBJECTIVE: To report trauma outcome from a developing country based on the Trauma and Injury Severity Scoring (TRISS) method and compare the outcome with the registry data from Major Trauma Outcome Study (MTOS). DESIGN: Registry based audit of all trauma patients over two years. SETTING: Emergency room of a teaching university hospital. SUBJECTS: 279 injured patients meeting trauma team activation criteria including all deaths in the emergency room. OUTCOME MEASURES: TRISS methodology to compare expected and observed outcome. STATISTICAL ANALYSIS: W, M, and Z statistics and comparison with MTOS data. RESULTS: 279 patients meeting the trauma triage criteria presented to the emergency room, 235 (84.2%) were men and 44 (15.8%) women. Blunt injury accounted for 204 (73.1%) and penetrating for 75 (26.9%) patients. Seventy two patients had injury severity score of more than 15. Only 18 (6.4%) patients were transported in an ambulance. A total of 142 (50.9%) patients were transferred from other hospitals with a mean prehospital delay of 7.1 hours. M statistic of our study subset was 0.97, indicating a good match between our patients and MTOS cohort. There were 18 deaths with only one unexpected survivor. The expected number of deaths based on MTOS dataset should have been 12. CONCLUSIONS: Present injury severity instruments using MTOS coefficients do not accurately correlate with observed survival rates in a developing country.

Adolescent↗
PubMed2001

Day care surgery at a university hospital--who is responsible after discharge.

OBJECTIVE: To computer the rate of morbidity and unplanned hospitalization amongst patients undergoing Day Care Surgery at this institute. METHODS: Retrospective study of all adult general surgical patients undergoing planned day care surgical procedures between November 1996 and December 1997. RESULTS: Six hundred and seventy four patients underwent ambulatory operations over one year. The morbidity rate was 6.2% and the rate of unplanned hospitalization was 13.6%. CONCLUSION: We conclude that timing of surgery and short duration operation on carefully selected patients is likely to reduce hospitalization. There is great scope of Day Care Surgery in developing countries and a major effort will be required to popularize it in Pakistan, which include development of infrastructure and patient education.

Adult↗
PubMed2000

Age-related changes in muscle fatigue resistance in humans.

OBJECTIVE: The goal of this study was to compare the relative contributions from the muscle and the central nervous system to muscle fatigue resistance in aging. METHODS: Each subject carried out 90 s of sustained maximal voluntary isometric contraction (MVC) of the thumb using the thenar and forearm thumb muscles. Contractile capacity of the thenar muscles was assessed through tetanic stimulation of the median nerve. Interpolated doublets delivered during an MVC represented the overall voluntary activation level while transcranial cortical stimulation with an electromagnetic stimulator was used to assess motor output upstream from the corticomotoneuronal pathway. RESULTS: Nine elderly subjects [four females and five males, 70+/-9 years old (mean+/-SD)] and 10 younger subjects (five females and five males, 30+/-6 years old) were tested. After the fatiguing exercise, the elderly group's MVC declined by 29% as opposed to 47% in the younger group (p<0.01). The elderly group's greater fatigue resistance was accounted for by increased fatigue resistance at the muscle level as well as in the central nervous system. At least some of the decline in the central motor drive was upstream from the corticomotoneuronal pathway. CONCLUSION: The higher muscle fatigue resistance in the elderly group was attributable to differences in both the peripheral and central nervous systems.

Adult↗