PurposeMaxillofacial injuries are commonly encountered in the practice of emergency medicine. More than 50% of patients with these injuries have multisystem trauma that requires coordinated management between emergency physicians and surgical specialists in oral and maxillofacial surgery, otolaryngology, plastic surgery, ophthalmology, and trauma surgery. The aim of this study is to identify the patterns of brain injuries associated with maxillofacial trauma and its outcome.MethodsThis descriptive study (cross-sectional) was carried out among 90 polytrauma patients with maxillofacial fractures attending the Emergency Department at Suez Canal university Hospital and fulfilling our inclusion and exclusion criteria.ResultsThis study demonstrates the relation between type of maxillofacial fracture and type of traumatic brain injuries in which the majority of patients with epidural hemorrhage presented with mid face fractures (60%), while the minority of them presented with upper and lower face fractures (20% for each of them). The majority of patients with subdural hemorrhage were associated with mid face fractures (75%), the majority of patients with brain contusions associated with mid face fractures (75%), and all of the patients presented by pneumocephalus were associated with mid face fractures (100%).ConclusionThe results of this study confirm the value of quick diagnosis and early intervention, which is fundamental to prevent morbidity as well as mortality especially with regards to prevention of traumatic brain injury as even a short duration of hypoxia and edema will lead to significant permanent neurological deficits.

Background: Acute appendicitis occurs through bacterial invasion in appendix leads to transmigration of bacteria and release of tumour necrosis factor (TNF)-alpha, Interleukin-6 (IL6) and cytokines. These reach the liver through a superior mesenteric vein and may produce inflammation or dysfunction of liver either directly or indirectly by altering hepatic blood flow with rising of total serum bilirubin. Objective: To evaluate the validity of elevated serum total bilirubin as a diagnostic marker for acute appendicitis and if elevated serum total bilirubin levels have a predictive potential for the diagnosis of complicated appendicitis. Methods: This is a prospective cross-section study including ninety-four (94) of adult patients have right iliac fossa pain attending to the Emergency Department (ED) at Suez Canal University Hospital. All 94 patients undergo total serum bilirubin measuring and postoperative histopathological examination of the removed appendix. Results: Amongst the patients diagnosed with acute appendicitis post-operatively, 57 patients (70.4%) were found to have elevated serum total bilirubin (>1.2mg/dL) while 24 patients (29.6%) had normal serum total bilirubin levels (≤ 1.2 mg/dL). Conclusion: Serum total bilirubin level appears to be a promising new laboratory marker for diagnosing acute appendicitis and have a predictive potential for the diagnosis of complicated appendicitis.

Introduction: CT is the gold standard diagnostic test for evaluating children with head trauma, however, this procedure has disadvantages, including exposure to ionizing radiation, transport of the child away from the direct supervision of emergency physicians, the frequent requirement for pharmacologic sedation, additional health care costs, and increased time for completing Emergency Department (ED) evaluation. The Pediatric Emergency Care Applied Research Network (PECARN) is a clinical decision rule that aims to determine which children are at very low risk of developing clinically significant traumatic brain injury (ci TBI) * and who therefore do not require a CT scan of the head.* (ci TBI) defined by death from TBI, need for Neurosurgery, intubation more than 24 hours for TBI, or Hospital admission more than two nights for TBI. The aim of the study: This study aimed to improve the quality of management of children with mild Traumatic Brain Injury (mTBI) at the Emergency Department (ED) by evaluating CT scan ordering in comparison to the PECARN clinical decision rule (CDR). Methodology: The present study was a cross-sectional observational study that was conducted at the Emergency Department (ED) of Suez Canal University (SCU) Hospital. It included 97 children, 18 years old or younger with a history of blunt head trauma within the last 24 hours with Glasgow Coma Score (GCS) between 13-15 who presented to ED at SCU Hospital. Results: The present study revealed that 20.6% of patients were classified as High Risk, 45.3% as Intermediate Risk, and 35% as the Low risk of developing (ci TBI) according to PECARN CDR. CT scan was ordered in all patients classified as High Risk, 90.9% of patients classified as Intermediate Risk, and 51.5% of patients classified as Low Risk. Conclusions:The present study revealed that most of the patients were adherent to PECARN CDR. Also, most of the patients younger than two years old followed the CDR. Most of the patients older than two years old followed the CDR.

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Background: Among kids older than a year old, trauma is the primary cause of illness and death. Injuries to two or more organ systems that could prove fatal or disabling are unfortunately not out of the ordinary in pediatric patients who have sustained multiple severe injuries. Objective: To improve the circulatory management in pediatric polytrauma by detection of pitfalls according to international guidelines in Suez Canal University Hospital. Patients and Methods: All children with polytrauma who were brought to the Emergency Department (ED) at Suez Canal University Hospital were included in a cross-sectional study. Patients were evaluated and cared for with an emphasis on circulatory management in accordance with Advanced Trauma Life Support (ATLS) standards. Next, the patient's outcome was documented. Results: Obstruction of the airway, breathing difficulties, bradycardia, and extended capillary refill were substantially linked with the 9.5% death rate among pediatric polytrauma patients who presented to ED at Suez Canal University Hospital. Survival of the studied patients was statistically significant associated with higher frequency of performing chest X-ray (p < 0.001), pelvis X-ray (p < 0.012) and Focused Assessment with Sonography for Trauma (FAST) study (p=0.024). Conclusion: Adherence to the international guidelines in evaluation and management of pediatric polytrauma patients is a cornerstone in improving outcomes and decreasing mortality.