Patterns of Injuries in Road Traffic Accidents in a Rural Tertiary Hospital.

Road traffic injuries are a major but neglected global public health problem, requiring concerted efforts for effective and sustainable prevention. Of all the systems that people have to deal with on a daily basis, road transport is the most complex and the most dangerous. Objectives: To study the patterns of injuries in the road traffic accidents and days of hospitalization. Materials and Methodology: The study was retrospective record based study and included cases reported and recorded from October 2007 to March 2008. Results: The present study was designed to study the patterns of injuries in RTA (Road Traffic Accidents) in Anand district of Gujarat. The results showed that out of total 423 RTA cases, 327(77.3%) of the victims were males and the rest 96(22.7%) were females. Two wheeler riders and pedestrians form twothird of the total victims. Total 232 fractures were noticed and of these maximum numbers occurred in the lower limb region (53.86%) followed by fractures in the upper limb (24.54%) and 10.77% fractures were in the skull. Abrasions were seen most commonly on lower limbs (34.31%), lacerations were seen mostly on head (41.07%) and internal injuries were noticed more in the head region (31.48%). 74.2% of the victims were hospitalized and the rest 25.8% took treatment at the trauma centre. 51.1% of RTA victims were hospitalized for 1-5 days while patients who did not require hospitalization were 109(25.8%).

Study of Socio-Demographic Factors among Injured Persons in a District of Western Uttar Pradesh – A Cross Sectional Study.

Background: Injuries are becoming major public health problem worldwide and since India is also passing through a major socio-demographic, epidemiological and technological transition; injuries are coming up as an emerging health problem. Objectives: To fi nd out prevalence of “Injuries” and role of socio demographic factors related with injuries. Material & Methods: It is a type of observational study in rural & urban area of Agra district. Th e area to be surveyed was selected by multistage stratifi ed random sampling technique. A recall period of three months for minor injuries & one year for major injuries or deaths due to injury was used. A total of 4 villages covering 2439 population and in urban area 2 mohalla & 2 slums covering 2410 population were surveyed. Data collected was entered on Fox. Pro (vs. 2.6) and analyzed by SPSS (vs. 10). Results: A total of 93 persons in rural and 142 persons in urban had major while 147 peoples in rural and 200 peoples in urban had minor injuries during the recall period. It was found that as the age increases the number of minor injuries increased from 0-35 yrs while decreased after that and maximum major & minor injuries were found in 16-35 yr age group. Regarding socio-economic class maximum injuries both major & minor were found in class IV (lower middle). Conclusions: Considering the high morbidities due to injuries focusing health education eff orts based on local epidemiology and behavioral practices is needed.

A comparative study of clinical and autopsy findings (clinical audit) in 100 cases died of trauma.

Clinical audit is the systematic analysis of quality of any aspect of patient care with the aim of identifying possible improvements. In the present study one aspect of clinical audit - a comparison of clinical findings and autopsy findings was done in 100 cases died of trauma and brought for autopsy to Medical College, Trivandrum. This Study was conducted to find out the frequency of discrepancy and the type of co-existing injuries along with the missed injury. The discrepancies were classified according to the classification by Battle et al and Andersen et al. No discrepancy was observed in 62%, class I discrepancy (Major) in 25%, class II (Major) in 3%, and class III & IV (Minor) in 5% each. The injuries very rarely over looked were head injuries (11.4%) and spinal injuries (16.7%). The most frequent missed ones were abdominal injuries (64.3%) and chest injuries (63.9%). In majority of missed injuries head injury was a common occurrence i.e. 88.8% of missed abdominal injury, 78.1% of missed chest injuries, and all cases of missed spinal injuries.

A study of homicidal deaths by mechanical injuries in Surat, Gujarat.

Violence has been always an integral part of the human civilization since its inception. Human beings have been progressively become expert in producing various type of weapons both for offensive and defensive purposes. This study was aimed to evaluate the mechanical injuries in homicidal cases of different motives and also to find out the most vulnerable portion of the body so as to minimize the loss of human life and common weapon used in such cases. The present study was carried out on 166 cases of homicidal deaths due to mechanical injuries during the year 2004 -05. Incidence of homicidal death due to mechanical injuries was averagely 83 cases per year. Mechanical injuries were quite common in homicidal deaths involving 130 males and 36 female victims. Majority of victims were in the age group of 21-40 years include 104 cases (62.65%). Stab injuries were commonly seen on the abdomen and chest due to sharp cutting weapons. Blunt force was the most commonly employed method in 80 cases (48.19%). Incidence of firearm was quite rare. Lungs were commonly involved internal organ. Male group was dominant over female group in defensive mechanism.

Evaluation of mechanical injuries in homicidal deaths: (A retrospective study of 5 years).

Jamnagar region, Gujarat state, enjoys a relatively low incidence of homicide in India. The following study examined 120 cases, (67.04%) of homicides where death was produced by inflicting various mechanical injuries on the body, reported during the years 2000 to 2004. Incidence of homicidal deaths due to mechanical injuries was 24 cases per year. It formed about 2.89% of all the total medico legal autopsies conducted during the period. Mechanical injuries were quite common in homicidal deaths involving as many as 92 male and 27 female victims. Majority of the victims were in the age group of 21 to 40 years with 77 cases, (64.17%). Blunt force was the most commonly employed method seen in 58 cases, (48.33%). It was followed by sharp force seen in 38 cases, (31.67%) and sharp and blunt combine forces seen in 23 cases, (19.17%). Incidence of fire arm injuries was quite rare in the present study. Head injury was quite common in homicide. Maximum external injuries were seen on the head and mostly they were produced by hard, blunt and heavy weapons. Stab injuries were commonly seen on the chest and abdomen. In the present study 35 cases, (29.17%) showed presence of defence wounds. Defence wounds were commonly seen in the male victims.

Fatal road traffic accidents, study of distribution, nature and type of injury.

During one year study period medico legal autopsies were conducted on 950 cases of fatal road traffic accidents at the mortuary of SRN Hospital, MLN Medical College, Allahabad. M/F ratio 3:1. 33.68% of cases were in the age group of 25-44 years. Pedestrians were most vulnerable accounting for 35.79% of total fatalities followed by motorized two wheelers 30.53%. Heavy Vehicles were found to be mostly involved 58.52% of cases and most accidents 83.05% occurred on highways. Majority of cases sustained multiple injuries. Primary impact injuries were recorded in 455 cases and pedestrians 36.26% were mostly affected followed by pedal cyclists 20.88%. 505 cases sustained secondary impact injuries and pedestrians and motor cyclists were primarily involved. Of 697 secondary injuries, 29.99% were sustained by motorcyclists followed by pediastrians 22.67%. Mostly lower extremities 27.39% and pelvis 25.99% received the primary impacts; the head and neck 55.62% the secondary impacts, while secondary injuries were mostly located in the lower extremities 28.38%. Largest number of injuries were recorded in lower extremities 804 number, followed by head & neck 748 number. Vehicle occupants mostly sustained thoracic injuries. In majority of cases, the site of initial impact of the responsible vehicle was frontal (45.14%) followed by rear (25.83%) and side (7.01%). In 179 cases (22.02%) site of responsible vehicle were not known.