Road Traffic Accidents among Patients Visiting Department of Emergency of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Road Traffic Accidents, are one of the major neglected global health burdens which are predicted to be the 7th leading cause of global deaths by 2030 as per the World Health Organization hence, seem to be one of the major global threats in near future. Most road traffic accidents affect the most vulnerable age groups in developing countries. The aim of this study was to find out the prevalence of road traffic accidents among patients visiting the Department of Emergency of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the department of emergency of a tertiary care centre from 16 September 2022 to 15 October 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC-DMCRI: 307/079/080). All the road traffic accidents cases recorded in the Emergency Department from 14 April 2021 to 13 April 2022 were taken. Convenience sampling was used. Point estimate and 95% confidence interval were calculated. Results: Among 29735 patients, the prevalence of road traffic accidents was 1340 (4.50%) (4.26-4.74, 95% Confidence Interval). Among these, 1037 (77.4%) were male and 303 (22.6%) were female. Road traffic accidents among two-wheelers were 1065 (79.48%) followed by pedestrian 703 (52.46%). Mangsir witness the higher number of cases, 137 (13.90%) followed by Kartik, 170 (12.69%). Conclusions: The prevalence of road traffic accidents was similar to other studies done in similar settings. In our study, young people of highly productive and active age groups were the most common victims. Keywords: emergencies; prevalence; traffic accidents.

Complications among Mothers and New Born Due to Delivery Process in Rupandehi District Nepal.

BACKGROUND: Child birth is a universally celebrated occasion, yet everyday for thousands of women child birth is experienced not as a joyful event as it should be, but as a private hell that may even end in death. The objective of this study is to determine the complications of normal delivery and cesarean section on the mothers and new born. METHODS: A descriptive study was conducted in two selected hospitals of Rupandehi district, Nepal. Data was collected as per pretested structured proforma from 550 respondents who were the mothers and new born delivered normally and through cesarean section randomly till the completion of sample size and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables. RESULTS: In a total of 550 deliveries,25.8% were cesarean delivery, 42.7% motherssuffered from delivery related complications, common were PPH (21.1%), prolonged labour (8.5%) and wound infection (7.6%). 35.5% of newborn had complications, common were respiratory distress (6.3%) and neonatal jaundice (4.2%). CONCLUSIONS: Delivery related complications were higher among Lower segment cesarean section compared to vaginal delivery in mothers and newborn.

Cesarean vs Vaginal Delivery : An Institutional Experience.

INTRODUCTION: According to the WHO, 15% of deliveries have precise indication for cesarean section where it is mandatory for the preservation of maternal and/or fetal health. Increasing rates of Lower Segment Caesarean Sections puts foreword various question that, whether a LSCS need to be reflected as a normal delivery in this twenty first century. There are conflicting reports regarding the safety of caesarean sections. While a significant number of cesarean delivery are performed for obstetrical indications, some are simply due to maternal request and may incur several risks for the child. Not much study has compared the complications of caesarean section with those of vaginal birth. Objective of this study is to find out and compare the common complications of cesarean section with vaginal deliveries on mothers. METHODS: A descriptive study was conducted in two selected hospitals of Rupandehi district, Nepal. Data was collected as per pretested structured proforma from 550 respondents randomly and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables. RESULTS: In total of 550 mothers, 408 (74.2%) had vaginal delivery and 142 (25.8%) had cesarean delivery.The common maternal complications were postpartum hemorrhage 116 (21.1%), prolonged labor 47 (8.5%) and wound infection 42 (7.6%). CONCLUSIONS: The result of the study shows that the maternal complications were higher among LSCS compared to vaginal delivery.

Operative Management of Late Presented Displaced Lateral Condyle Fracture of Humerus in Children.

INTRODUCTION: Management of late presented displaced fracture of lateral condyle of humerus in children is controversial, many recommend conservative management due to fear of complications like avascular necrosis but recently many are advocating for operative management with good results hence we studied the outcome of operative management in late presented displaced lateral condyle fracture of humerus in children. METHODS: We studied 22 children aged between 4 to 11 years, presenting 3 to 16 weeks from injury. All underwent open reduction and internal fixation with Kirschner wires with or without additional screw and followed up for average 18.05 months. Elbow range of motion, angular or local deformity, premature fusion of physis, avascular necrosis and fracture union were noted and analyzed using modified Aggarwal et al criteria. RESULTS: We had 9 (40.91%) excellent, 5 (22.73%) good, 5 (22.73%) fair, 3 (13.63%) poor result. Overall satisfactory results were seen in 19 (86.37%); 3 (13.63%) had poor result , one due to AVN, two due to premature fusion of physis and visible local deformity. All poor result were seen among delay of operation 6 weeks or later. There was significant improvement of elbow range of motion and all fracture united. CONCLUSIONS: Outcome of operation without bone grafting on lateral condyle fracture of humerus in children who presents late up to 5 weeks are excellent; whereas outcome of delayed operation up to 16 weeks also gives good functional recovery and union.