How multimorbidity relates to road traffic accident among older adults and elderly population: insights from longitudinal aging study in India (1st wave)

Background: Multimorbidity and road traffic accidents increase with increasing age. Supplemented with increasing life expectancy at birth, both multimorbidity and RTAs will contribute significantly to the growing disease burden of the country. The objective of the study was to determine the association between multimorbidity and RTAs among older adults (above 45 years) and the elderly (above 60 years) population in India. Methods: A secondary data analysis was conducted using the Longitudinal Ageing Study in India (LASI)-1st wave data (April 2017 to December 2018). Participants having at least two chronic health conditions were described as multimorbidity. Road traffic accidents (RTAs) was taken as the outcome variable. Univariate followed by multivariable logistic regression was conducted between the outcome variable and each explanatory variable. Results: Data extracted consisted of 34704 (51.1%) older adults and 31902 (47.9%) elderly. Multimorbidity was present in 25054 (37.6%) individuals. Among the RTA group, 325 (26.5%) individuals had multimorbidity. The elderly with multimorbidity (at least two) were associated with the RTA with an adjusted odds ratio (CI) of 0.55 (0.45-0.67) and p value of <0.001 in comparison to older adults. Clerical and skilled individuals with multimorbidity were associated with RTA in comparison to unemployed individuals with multimorbidity with an adjusted odds ratio (CI) of 1.40 (1.10-1.79) and p value of 0.007. Conclusions: The RTA was evident among males aged 45-60 years with multimorbidity. Clerical and skilled individuals with multimorbidity were more prone to RTA. These individuals should be encouraged to take necessary measures to promote healthy living and adhere to them.

Frequency of high risk behaviour in patients with alcohol dependence syndrome: a cross sectional study

Background: Alcohol use and high-risk behaviour has been shown to have an association. Severity of alcohol dependence has an association with frequency of risk-taking behaviour. Objectives were to evaluate the frequency of high risk behaviour in alcohol dependence syndrome and to find any correlation between psychosocial variables and high risk behaviour. Methods: 100 individuals with ICD 10 diagnosis of alcohol dependence syndrome were studied using semi structured interview. High risk behaviour was assessed using violent risk appraisal guide and deliberate self-harm inventory. The age of onset of initiation of alcohol use and dependence and severity of alcohol dependence syndrome were assessed and analyzed by frequency and Chi square test. Results: In 100 subjects with alcohol dependence syndrome, 4 (17.4%) and 7 (30.4%) of subjects with severe dependence had road traffic accidents and risky sexual and violent behaviour respectively. There was a statistically significant association between age of onset, age of dependence and high-risk behaviour. Conclusions: The present study concluded that most individuals with alcohol dependence syndrome had high risk behaviour. Road traffic accident was the most common followed by risky sexual and violent behaviour. There was a significant association between severity of alcohol dependence and high risk behaviour.

Road traffic injuries and their associated risk factors in Dibrugarh district, Assam: a cross-sectional study

Background: Road traffic injuries (RTIs) are a leading cause of mortality and morbidity throughout the world and especially in developing countries like India, out of which many goes unreported. As such, this study was conducted to estimate the prevalence of RTIs and their associated risk factors in Dibrugarh district of Assam. Methods: This was a cross-sectional study conducted among 820 samples taken from both urban and rural areas of Dibrugarh district. Data was collected by personal interview using a pre-designed, pre-tested structured questionnaire. Data is presented in percentages and association was tested using logistic regression analysis. Results: The overall prevalence of RTIs was found to be 4.4%. Prevalence of RTI was higher amongst males (6.85%), people belonging to age group of 18-30 yrs and people who were unemployed (26.2%). Also, most of the accidents were found to occur during night time (47.2%), amongst two wheelers (52.8%) and more in the rural areas than the urbans. A high prevalence of alcohol consumption (58.3%) and usage of mobile phones (16.7%) while driving was seen with the RTIs. Also only 25% and 13% of the RTI victims were using helmets and seatbelts respectively while riding their bikes/cars. Conclusions: Prevalence of RTIs was quite high amongst the population of Dibrugarh district along with high prevalence of risky behaviour while driving. As such, awareness regarding this hazardous problem amongst people and how to take proper preventive measures is of utmost importance.

Trauma abdominal en pacientes del Hospital Universitario General Calixto García / Abdominal Trauma in patients at Hospital Universitario General Calixto García

Introducción: El trauma abdominal se considera un problema de salud significativo, debido a que su cinemática ocasiona lesiones tanto anatómicas como funcionales de los órganos del abdomen. Objetivo: Caracterizar el trauma abdominal en un grupo de pacientes lesionados del Hospital Universitario General Calixto García. Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, de corte transversal en los pacientes con trauma abdominal atendidos en el Servicio de Cirugía General desde enero de 2017 hasta diciembre de 2019. La muestra fue de 879 pacientes. Resultados: Existió un mayor número de pacientes con trauma abdominal en el grupo etario de 19-29 años, con una prevalencia del sexo masculino. Predominaron los accidentes de tránsito como la principal causa de trauma abdominal con el 52 por ciento. Prevalecieron las lesiones sobre órganos macizos, con mayor frecuencia en el hígado con un 33 por ciento. El tratamiento que con mayor asiduidad se empleó fue el quirúrgico, lo que representa el 83 por ciento con respecto al manejo conservador. Conclusiones: Por su ubicación y funcionalidad, las lesiones asociadas a trauma abdominal se convierten en un factor que representa gran riesgo para la vida del paciente. Los accidentes de tránsito continúan estando dentro de las primeras causas de trauma abdominal. Aunque la conducta conservadora ha ganado adeptos, existe un predominio en el tratamiento quirúrgico apoyado fundamentalmente en la sintomatología de los pacientes y en los medios diagnósticos(AU)

Introduction: Abdominal trauma is considered a significant health problem due to the fact that its kinematics causes both anatomical and functional injuries to the abdominal organs. Objective: To characterize abdominal trauma in a group of injured patients from Hospital Universitario General Calixto García. Methods: An observational, descriptive, prospective and cross-sectional study was conducted in patients with abdominal trauma attended at the general surgery service from January 2017 to December 2019. The sample was 879 patients. Results: There was a higher number of patients with abdominal trauma within the age group 19-29 years, with a prevalence of the male sex. Road traffic accidents predominated as the main cause of abdominal trauma, accounting for 52 percent. Injuries to solid organs prevailed, most frequently to the liver, accounting for 33 percent. The most frequently used treatment was surgical, which represents 83 percent with reference to conservative management. Conclusions: Due to their location and functionality, injuries associated with abdominal trauma become a factor that represents a great risk for the patient's life. Road traffic accidents continue to be among the first causes of abdominal trauma. Although the conservative approach has gained followers, there is a predominance of surgical treatment supported mainly by the patients' symptomatology and diagnostic means(AU)

Association Of Socio-Demographic Determinants with Economic Burden Among Road Traffic Accident Victims: A Longitudinal Study

Background: RTA are the sixth leading cause of death in India with a greater share of hospitalization, disabili-ties, deaths and socio-economic losses. The study was conducted to assess the socio-demographic determi-nants associated with households’ economic burden among RTA victims. Methods: A longitudinal study was conducted for 2 years in Puducherry employing simple random sampling to include 169 accident victims. Baseline data was collected with a semi-structured questionnaire on socio-demographic details, direct and indirect costs towards road traffic injuries. Follow up was at 6th and 12thmonth from the day of accident. Data entry and analysis were performed using Epi-data. Written informed consent from each participant was sought. Ethical clearance received. Results: Mean age of the accident victims was 36.2 (11.4) years. The median (IQR) for direct, indirect and to-tal expenses were INR 1500 (1000-22100), 18000 (2400-46500) and 3000 (1037-47125) respectively. Asso-ciation between the median (IQR) indirect expenses and marital status as well as socio-economic status of vic-tims were found to be statistically significant. Conclusion: Accident victims and their family faced financial burden, as a large proportion of victims were from productive age group belonging to lower- and middle-class income group

Refractive errors, road traffic accidents and long-term spectacle compliance amongst commercial taxi drivers in a major North-East Indian city

Purpose: To assess the prevalence of refractive error (RE) and its association with road traffic accidents (RTAs) and the subsequent long?term spectacle compliance and adherence to suggested appropriate strategies In Shillong, India. Methods: This prospective study was conducted between July and October 2019 among commercial taxi drivers (CTDs), with follow?up interviews conducted with a subset of respondents to assess long?term spectacle compliance after a year. Gross ophthalmologic examination was performed, including visual acuity and refraction. Descriptive statistics and Chi?square tests were conducted to assess the association between the type of REs, spectacle compliance, and selected sociodemographic and clinical variables. Multiple logistic regression was performed for analysis of the association between RTAs and sociodemographic, clinical, and work characteristics variables. Results: A total of 382 (95.5%) CTDs completed interviews and gross eye examination. The prevalence of any RE in the worst eye was 28.8% (95% CI: 24.3–33.6). Presbyopia with or without distance vision was the commonest type of RE with 21.7% (95% CI: 17.7%–26.2). Among those who were prescribed spectacles, 70.5% needed near correction. Drivers with RE were nearly two times (OR: 2.6; 95% CI: 1.4–5.1) more likely to be involved in RTAs compared to those without any RE. Long?term spectacle compliance was at 40.9%. The predominant barrier reported for spectacle compliance was “can manage well without spectacles.” Conclusion: This survey has demonstrated a significant relationship between poor vision and occurrence of RTAs. There is an urgent need for tailor?made targeted interventions to address the eye health needs of CTDs in India

Traumatic avulsion of the eyeball: a case report

Ocular trauma is very common, but globe avulsion along with optic nerve avulsion is a rare clinical event. Blunt trauma during a road traffic accident can cause rupture or avulsion of the globe and the outcome can range from complete recovery on repositioning to visual loss because of globe perforation or optic nerve injury. Here, authors report a case of a 20-year-old male who presented with history of a road traffic accident causing severe facial injuries. The physical examination revealed oedema and ecchymoses over the right side of the face with avulsion of the right eyeball anteriorly outside the orbit along with avulsion of the optic nerve. The visual acuity in the injured eye was no perception of light and the direct pupillary response was absent. Computed tomography revealed fracture of the roof and lateral wall of the right orbit. As the eye was not salvageable, enucleation surgery was done. Insertion of an ocular prosthesis for rehabilitation was planned. The presentation, investigations, surgery and follow-ups are described.

Outcomes of Surgical Management of Floating Knee Injuries

Introduction: Floating knee, referred to as ipsilateralfractures of the femur and tibia, is usually associated withseveral complications and mortality. This study was designedto present our experience with treatment of this injury.Demographic parameters like age, sex, mechanism of injury,associated injuries, method and results of treatment, andcomplications of floating knee are discussedMaterial and Methods: This Prospective study wasperformed between January 2014-July 2016. All patientswith floating knee injuries who were admitted to the PMCHfulfilling the inclusion and exclusion criteria were included.The information about the 20 cases of floating knee injurieswere gathered, particularly the demographic parameters, modeof injury, bones involved, condition of skin, other associatedinjuries and their neurovascular status. The patients werefollowed for a minimum of one year duration and functionaloutcome was assessed.Result: Most of the patients were between 21-30years of age(45%). The floating knee injuries were more common in males(85%). FraserType I fracture was observed in 70% of cases.Roadtraffic accidents(RTA) was the most common cause ofsuch injuries. 18 out of 20(90%) cases were having associatedinjuries while only 10%were cases of isolated floating knee.The most common early and late complications were infectionand knee stiffness respectively. The final outcome as perKarlstrom criteria was excellent and good in 11 out of 14 casesof Fraser type I fracture and in 3 out of 6 cases of Fraser type IIfracture, and this was statistically significant (P=0.05).Conclusion: This study revealed that the complication rateassociated with floating knee injuries remain high and theprognosis mostly depends on type of injury and associatedinjuries. This study also advocates early aggressive approachfor management of these injuries.

A prospective and retrospective study on conservative management of hepatic and splenic injury following blunt abdominal trauma

Background: worldwide road traffic accidents accounts as the leading cause of death of young people. For a very long time most of the intra-abdominal injuries following blunt abdominal trauma were managed operatively. Conservative management is becoming more acceptable and effective management option for blunt abdominal trauma during the last few decades.Methods: This study was conducted in Government Medical College, Kottayam during September 2007 to December 2008. All conservatively managed blunt abdominal trauma patients during the study period were included in the study.Results: Out of 22 patients, 4 patients failed conservative management. Success rate was 81%. Most commonly injured solid organ in the study group was liver (77%). Maximum cases were of age group 10 to 20 (31.81%) years. 81% of patients were males. Motor vehicle accident was the most common cause of trauma (77%). Mean stay in intensive care unit was 4.2 days and mean hospital stay was 15.7 days. Mean systolic blood pressure was 110 mmHg ranging from 70 to 130 mmHg. 50% of patients had moderate hemoperitoneum and non-had massive hemoperitoneum.Conclusions: Non operative management is safe and effective approach in blunt spleen and liver injuries. Non operative management should be treatment of choice for all hemodynamically stable patients with blunt liver and splenic trauma.

A Clinical Study of Blunt Trauma Abdomen in a Tertiary Care Hospital of Uttarakhand

Background: Blunt abdominal injuries are met more often nowadays due to increased industrialization and a greater numberof vehicles, and is the third most common form of injury in road traffic accidents (RTAs) after orthopedic injuries and headinjuries. Blunt injury to the abdomen can also occur as a result of fall from height, assault with blunt object and sports injuries,etc. Blunt trauma abdomen is seen in increasing number in the emergency department and therefore, the early diagnosis andtreatment are very important and crucial for patients.Methods: The study was carried out from January 2018 to December 2019. A total of 100 patients were studied. After detailedclinical history, physical examination various investigations such as complete blood count, X-rays, ultrasound of the abdomen,and computed tomography scan of the abdomen were done to complete the diagnosis. Then, data were statically analyzed.Results: In our study, male patients were commonly affected (73%). The younger population between the age group of 18 and40 years was predominantly affected (73%). The common mode of injury was RTAs (62%). The organ that was found to bemost commonly injured in our study was the liver (27%) than spleen (22%). About 59% patients were managed conservativelywhile 41% were operated. The most common cause of death was cardiorespiratory failure followed by septicemia.Conclusions: This research article shows that blunt injury abdomen is a major cause of morbidity and mortality in young agepatients with RTA being the most common cause. Patients that are received in the emergency department should be givenimmediate attention and a quick and thorough evaluation of the patient must be done. Early diagnosis reduces the mortalityrates and plays a major role in good outcome and lead to successful treatment in these patients.

Comprehensive study of blunt injury abdomen in single center

Background: Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining. Focused assessment with sonography for trauma (FAST) and computed tomography (CT) abdomen are very beneficial to detect those patients with minimal and clinically undetectable signs of abdominal injury. Objective of the study was to evaluate the incidence of blunt injury abdomen, mode of injury, organs involved in patients.Methods: A retrospective study was done on blunt injury abdomen. 48 patients were enrolled in this study.Results: Out of 48, 35 (72.9%) male patients more commonly encountered blunt injury to the abdomen. 28 (58.3%) was the highest incidence for age group 21-40 years. The most common mode of injury was road traffic accidents 36 (75.0%). Grade III splenic injuries were encountered in majority 19 cases and 13 cases involved laceration of parenchyma >3 cm depth and 6 cases were subcapsular hematoma (>50%). Spleen was the most common injured organ accounting for 25 (52.0%) and second most common injury was Ileal perforation 6 (12.5%), liver injury 6 (12.5%) of the cases.Conclusions: Blunt injury abdomen mainly affected male and the younger population between the age group 21-40 years. The most common mode of injury is road traffic accidents. In this study the spleen was found to be the most common organ injured in blunt injury abdomen.

Demographics in trauma: a prospective observational study in a tertiary care zonal hospital

Background: Trauma represents a major challenge worldwide and is the leading cause of morbidity and mortality in young population. There is significant change in trauma related injuries due to urbanization, motorization, industrialization and the socioeconomic changes in India. Road traffic accidents (RTA) pose the largest threat to human lives and have become the number one public hazard all across the world causing morbidity and mortality. The aim of this study is to find out the demographics and to determine the injury pattern of surgical trauma cases presenting to this tertiary care zonal hospital.Methods: A prospective observational study was conducted in a tertiary care zonal hospital from June 2018 to December 2018. Data was collected for 105 patients presented with trauma in surgical emergency centre of this hospital were included in the study which excluded only orthopaedic trauma cases. The data collected was analysed.Results: Out of 105, 76 (72.38%) were male and 29 (27.61%) were female with 21 (20%) in the 31-40 age group. The average age of cases was 40.2 years.  RTA was the major cause of trauma i.e. (77.14%) followed by accidental fall and slips (18.09%) and assaults (4.76%). Contusion was the common injury sustained (45.71%) followed by laceration (38.09%), abrasion (35.23%) and fracture (17.14%).Conclusions: There is a need for trauma registries which can help to formulate strategies towards decreasing the burden of trauma and improved outcomes at hospital as well as in public health.

Analysis of the current situation of road traffic accidents in the 31 provinces/municipalities of China and the projection for achieving the SDGs target of halving the numbers of death and injury / 中华疾病控制杂志

Objective To analyze the data of road traffic accidents, deaths and injuries in 31 provinces and municipalities in China from 2010 to 2017, and to predict that the number of deaths and injuries caused by road accidents set in the sustainable development goals (SDGs) will be halved by 2020 compared with the target set in 2015. Methods Describing and analyzing the current situation of road traffic accidents in 31 provinces and municipalities in China, and using the trend extrapolation method to predict whether the SDGs target can be achieved by 2020. Results The numbers of traffic accidents, deaths and injuries in Guangdong, Jiangsu, Zhejiang and Shandong Provinces showed a downward trend from 2010 to 2017, but still ranked the front in China. In 2017, Beijing had the highest death rate followed by Guizhou as the second, and Guizhou had the highest injury rate followed by Tianjin as the second. The projected results showed that the numbers of deaths and injuries caused by road traffic accidents in China would be increased by 17% and 1.3% respectively in 2020 indicating that SDGs target could not be met. Among the 31 provinces/municipalities, it was predicted that the numbers of deaths and injuries in Hunan would be reduced to 50.7% and 65.3% in 2015, respectively by 2020, and the target could be achieved; the number of injuries in Shanghai was decreased by 83.3%, but the deaths was only decreased by 34.5%, and there was still a gap with the target; the rest 29 provinces/municipalities could not meet SDGs target. It was expected that the deaths in 11 provinces and municipalities would increase by 2020, with Beijing, Jilin, Jiangxi, Hubei and Guizhou Provinces showing the most significant growth. The number of injured people in 8 provinces and municipalities shows an increasing trend, with Jilin, Jiangxi, Hubei and Guizhou provinces showing significant growth. Conclusions Except for Hunan Province, it was difficult for the whole country and the rest provinces and municipalities to reach the SDGs target. According to the forecast results and the actual situation, a targeted scientific prevention and control strategy can be formulated. The measures taken by Hunan and Shanghai in traffic accident prevention and control were effective and worth learning.

Analysis of risk factors contributing to road traffic accidents in a tertiary care hospital. A hospital based cross-sectional study / 中华创伤杂志(英文版)

PURPOSE@#Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them.@*METHODS@#During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward.@*RESULTS@#In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motorcyclists (54.2%) followed by pedestrian (25.1%).@*CONCLUSION@#There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.

Causes of head injury in Dr. Hasan Sadikin General Hospital Bandung in 2015

Background: The study aimed to describe the causes of head injury (HI) in Rumah Sakit Hasan Sadikin Bandung with the considerations of gender, age and the severity of HI.Methods: This was a descriptive retrospective study. The study subjects were HI patients in Department of Neurosurgery of Dr. Hasan Sadikin General Hospital Bandung in 2015. Consecutive sampling was used with minimum sample size of 97 patients. The variables of the study were patients’ characteristics, causes of head injury, and types of road traffic accidents in HI patients. The data were collected from medical records.Results: Road traffic accidents (RTAs) contributed to 70.3% mild HI, 77.2% moderate HI, and 100% severe HI and it was the highest cause of HI (73%). Two-wheelers motor vehicle contributed to 62.5% mild HI, 75% moderate HI, and 66.7 severe HI and it was the highest cause of RTAs (68%). Majority of the HI patients were male (57%). The highest number of HI was 18-45 years old.Conclusions: RTAs is the main mechanism of HI, while two-wheelers motor vehicle is the main cause of RTAs.

Road traffic accidents attending casualty in a tertiary care hospital : a 03 year study from South Western India

Background: Road Traffic Accident (RTA) is any vehicular accident occurring on the roadway i.e. originating on, terminating on, or involving a vehicle partially on the roadway. Road traffic accidents are a human tragedy which has an immeasurable impact on the families affected. The WHO estimates that over 1.2 million people pass away every year on the world’s roads, and between 20 and 50 million fall victims to non-fatal injuries.  The incidence of RTA remains poorly measured in India.Methods: The present study is conducted at casualty department of a tertiary care hospital in South Western India among victims of road traffic accident. This cross sectional study was conducted to elucidate the role of various factors involved in road traffic accidents and to study demographic profile and injury pattern among RTA victims. All the reported RTA cases from 1st January 2016 to 31st December 2018 were included in the study.Results: A total of 875 cases of RTA were studied. There were 83.77%(n=733) male and 16.23%(n=142) female accident victims. Most of the patients were aged between 21 and 30 years. Monsoons witnessed 46.63%(n=408) cases. Most cases occurred between 6 and 12pm (54.4%, n=476). Commonest injury was a simple injury (72.91%, n=638), dangerous injuries (27.09% percent, n=237) and dead was (7.43%, n=65). The highest number of accidents took place in the month of June (19.09%, n=167) and on Sundays (22.17%). Among the motorized vehicles, two-wheeler drivers were more (76.91%, n=673) involved in accidents. In this study 17.60% (n=154) were under influence of alcohol while driving.Conclusions: This study shows there are multiple factors associated with road traffic accidents. Most of the factors responsible for RTA and its fatal consequences are preventable. India, as a signatory to the Brasilia declaration, intends to reduce road accidents and traffic fatalities by 50% by 2022. A comprehensive multipronged approach can mitigate most of them.

Head Injury in Road Traffic Accidents - A Study from North East India.

Introduction: India is undergoing major economic anddemographic transition with increased urbanization,industrialization, construction projects and motorization. Headinjury is the result of variety of mechanisms including motorvehicle and motor cycle accidents, pedestrians being struckby motor vehicles, falls from heights, occupational hazards,assaults, riots and bomb blasts. India has second highestreported mortality rate of 29.2 per 100000 people from roadtraffic injuries. Injuries are reported to be the seventh leadingcause of death (11% of all deaths) in India, with road trafficinjuries making up to 78% of them (WHO, 1999). Currentresearch aimed to study pattern of Head Injury in Road TrafficAccidents from North East India.Material and Methods: This study was conducted on medicolegal cases coming for autopsy in Department of ForensicMedicine, Guwahati Medical College and Hospital, Guwahatiduring the period of 1st August, 2009 to 31st July 2010. Duringthis period a total 2474 autopsies were performed in ourdepartment with 815 cases had head injuries. After obtainingthe necessary and relevant information about the victim, athorough and complete autopsy was performed on the deadbody, recording the findings on the proforma.Result: Our findings are similar to above studies and also tothe studies of Sevitt S (1973), Chandra J et al (1979), TyagiAK (1986), Motto L (1988) and Basu R et al (1992), Dandonaand Mishra (2004), Menon A and Nagesh KR (2005). Mostcommon cause of head injury is Road side accident (21.26%),most commonly occurring during office hours (6-9am)(25.45%) with 4 wheelers being most common offendingvehicle(49.39%).Conclusion: Road are like arteries of country. Vehicles mustrun for development of country and necessities of life. Injurieson head and other parts of body due to road traffic incidentsare unavoidable but with scientific data, we can minimize theloss of life and misery due to death and injury. We shoulddesign our interventions based on these data and studies.

A 5 year retrospective study on epidemiological pattern of ocular trauma

Background: One of the delicate structure in the human body is eye and trauma to the eye is essentially a very grave matter. Major cause of preventable monocular blindness and visual impairment in the world is ocular trauma. So any injury to the eye must be deemed to be an ocular emergency and should be handled with utmost care. Despite its public health importance, there is relatively less population based data on the magnitude and risk factors for ocular trauma specially from developing countries. The objective of the study was to find out the epidemiological pattern of ocular trauma.Methods: The present study was 5 year retrospective study of all the patients who reported directly with ocular injury or referred from the casualty to the department of ophthalmology from January 2013 to January 2018. Various parameters like age, sex, mode of injury, type of injury etc. of all patients seen during this period were analyzed.Results: Total of 4192 ocular trauma patients were seen during study period. Maximum number of ocular trauma patients i.e. 1146 were seen in age group of 21-30 years. Males i.e. 3490 outnumbered females in the present study. Road traffic accidents were the most common cause of ocular trauma and accounts for 1760 cases. Most common reported ocular trauma was periorbital oedema/ecchymosis followed by laceration. Surgical intervention was done in 1660 cases whereas 2532 were managed medically.Conclusions: From present study, we may conclude that the maximum number of ocular trauma patients were seen in the age group of 21-30 years with more preponderance in males. Road traffic accidents were the most common cause of ocular trauma. The fact that the lifetime prevalence of ocular trauma is higher than that of eye diseases, which can be decreased by implementing the traffic rules with strict force and imposing heavy fine and license cancellation for drunken driving.

Study of Clinical Presentation of Tibial Plateau Fractures Presenting to a Tertiary Healthcare Institute: A Cross Sectional Study

Introduction: Tibial plateau are a diverse group of fractureswhich includes a wide spectrum of clinical presentation andseverity which was previously known as car bumper fractures.Clinically tibial plateau fractures ranges from simple injuriesmost commonly to the complex fracture often offers challengesfor successful management even to the most experiencedsurgeons globally. The present study was conducted to studythe clinical presentation of tibial plateau fractures presentingto a tertiary care center.Material and methods: It was a cross sectional studyconducted among 13 patients with tibial plateau fracturesduring January 2016 to December 2016 admitted underdepartment of orthopedics in a tertiary healthcare institute innorthern Maharashtra.Results: The majority of fracture (69%) was the consequenceof road traffic accidents. This clearly explains the synonymfor tibial condylar fractures as “bump fractures”, caused by hitby bumper f vehicle. Fall from height was the second majorcause.Conclusions: Tibial plateau fractures were observed to bemore common among males, in 30-40 years of age group.Road traffic accident being the most common cause.

Patterns and characteristics of injuries encountered in road traffic accidents and effect of pre-hospital care on their outcome: a tertiary-hospital study in Lahore, Pakistan

Background: Road traffic accidents are the eighth leading cause of death worldwide, contributing significantly to the global disease burden. As there is a paucity of published data on RTAs in Lahore, this study was carried out to highlight injuries encountered in RTA victims and provide baseline data for the establishment of prevention strategies in our locality.Methods: This is a descriptive cross-sectional study of RTA victims admitted in Mayo Hospital, Lahore to determine factors associated with RTAs, characteristics, and outcomes of injuries sustained and effect of Pre-hospital care in determining the outcome.Results: Out of total 100 subjects recruited, 89 were males and 11 females. Ages of patients ranged from 5 to 70 years with the most injured age group ranging between 11-30 years (59%). Motorcyclists were found as the most vulnerable road user group (61%). Most of the accidents occurred because of a collision with another vehicle (45%). 65 victims received pre-hospital care en route to Mayo Hospital, which was found effective in preventing major disabilities in 81% of cases (53 out of 65). Incidence of Musculoskeletal injuries was highest (55%). Most patients (86%) were discharged without permanent disabilities. No patient died during our study.Conclusions: This study shows road traffic accident is a major public health problem in our setting and contribute markedly to high morbidity. Urgent preventive measures should be established to reduce the risk of their occurrence. Early recognition and prompt treatment are important for the survival of the victims.