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Open access

Amit Agrawal, Ashok Munivenkatappa, B.V. Subrahmanyam, S. Satish Kumar and P. Ramamohan


Introduction. Traumatic brain injury (TBI) is affected by multiple factors. Patient’s education, manifesting symptoms and surgical management play a significant role on discharge outcome. The literature of same from developing country is limited. The present pilot study aims to describe patient characteristics, presenting symptom and management aspects of TBI patients from a tertiary hospital.

Methods. The present study is a prospective study, where TBI patients were selected and data of injury was entered on standard proforma on electronic data base. The study was approved by institute ethical board. The data was analyzed using Stats Direct version 3.0.150 software.

Results. Three hundred and thirty three patients were evaluated. Eighty percent of patients were from rural areas. About 75% of patients were illiterates and married. Patient employment was significant with discharge outcome. All the patients manifested with symptoms loss of consciousness (LOC) was higher (73%) followed by vomiting (44%). LOC and oral bleed was significant with outcome. Associated injuries was higher in extremities (22.5%) followed by chest (4.4%). About 15% of patients require intracranial surgery that was significant with discharge outcome.

Conclusion. The present pilot study finding is similar to available literature data and adds knowledge to TBI data of a developing country like India.

Open access

Amit Agrawal, M. Veera Prasad, S. Satish Kumar, B. V. Subrahmanyan, P. N. Harisha and G. Malleswara Rao


Aim: The aim of present article is to share our experiences and lessons learned from a pilot study which was conducted to collect data to serve as a model in establishing a multi-center registry on traumatic brain injury patients.

Methods: The present study was conducted from December 2013 to June 2014 in the Department of Neurosurgery and Department of Accident and Emergency Medicine. All patients with the diagnosis of traumatic brain injury (as per the criteria laid by International Classification of Disease injury codes ICD 10) were enrolled in the study. Variables were identified as per the international norms and the data points were selected which included demographic details, pre-hospital characteristics, clinical details in emergency room, injury details, course during hospital stay, treatment and disposition. The data were categorized into master data, data related to pre-hospital events including pre-hospital care, data related to emergency room care offered in the emergency department, data related to hospital stay and patient course, outcome and follow up.

Results: A total of 231 patients were admitted with the diagnosis of traumatic brain injury. There were 79.1% male and 20.5% female patients. Mean age was 37.19 years (SD±17.02 years, range 4-87 years). Mean hospital stay was 3.66 days (SD±4.46 days, range-1-21 days). Data were collected daily for all the admitted patients on previous day fulfilling the inclusion criteria. The Proforma was easy to comprehend and it was easy to fill.

Conclusion: We found that a well-designed Proforma based under supervision data collection in a relatively low volume trauma center. We found that a well-designed Proforma based under supervision data collection in a relatively low volume trauma center and at regular intervals can be costeffective which can be managed by personnel with basic training.

Open access

K. Aswani Kumar, B.V. Subrahmanyam, S.V. Phanidra, S. Satish Kumar, P.N. Harish, P. Ramamohan and Amit Agrawal


Background: Traumatic spinal cord injury (SCI) is recognized as a serious public health problem resulting in significant morbidity, mortality and permanent disability. The present study is aimed to describe the epidemiological characteristics and outcome of patients with traumatic spinal cord injury in rural tertiary referral care center form South India.

Material and methods: The present study was conducted at Narayana Medical College and Hospital, Nellore. All patients admitted and managed for traumatic spinal cord injury were retrieved and data collected in a pre-designed proforma. Patient characteristics, details of etiology, mechanism of injury, level of injury, extent of neurological deficits, details of investigations, details of management and immediate outcome were recorded.

Results: A total 152 patients were included in the present study. The mean age was 38.45 years and majority the patients were young adult males. The mean hospital stay was 19.12 days. 71.7% percent patients were non-agriculture workers (mainly involved in construction work) and 28.3% patients were farmers. 61.2% of the patients sustained injuries due to fall from height and 34.2% patients sustained injuries due road traffic accidents. Cervical spine injuries were most common (44.1%), followed by thoraco-lumbar region (36.8%) and dorsal spinal region (19.1%). 9 patients expired in post-injury during hospital stay and all of them had complete cervical spinal cord injury. All patients received aggressive rehabilitation care.

Conclusion: In accordance with the literature our results reflect that traumatic spinal cord injuries affect young population and can leave these persons with significant functional and physical morbidity. The major limitation of the study is that it is a single institution based and may not reflect the true spectrum of traumatic spinal cord injuries in the population.

Open access

Niharika, B.P. Agrawal, Iqbal A. Khan and Zahid A. Khan


Titanium alloy (Ti-6Al-4V) has been extensively used in aircraft turbine-engine components, aircraft structural components, aerospace fasteners, high performance automotive parts, marine applications, medical devices and sports equipment. However, wide-spread use of this alloy has limits because of difficulty to machine it. One of the major difficulties found during machining is development of poor quality of surface in the form of higher surface roughness. The present investigation has been concentrated on studying the effects of cutting parameters of cutting speed, feed rate and depth of cut on surface roughness of the product during turning of titanium alloy. Box-Behnken experimental design was used to collect data for surface roughness. ANOVA was used to determine the significance of the cutting parameters. The model equation is also formulated to predict surface roughness. Optimal values of cutting parameters were determined through response surface methodology. A 100% desirability level in the turning process for economy was indicated by the optimized model. Also, the predicted values that were obtained through regression equation were found to be in close agreement to the experimental values.