Falls from Trees in Coastal Karnataka: A Neglected Cause of Polytrauma in Lower-Middle-Income Countries of Similar Agroforestry.

INTRODUCTION: Falls are the second most common cause of injury associated with mortality worldwide and an important type of blunt trauma, which forms a significant percentage of traumatic accidents and emergency department admissions. Falling from a tree is an important problem because of its effect on one's health owing to infirmity caused by injuries, most commonly spinal injuries, and the economic burden that accompanies it. METHODS: A retrospective chart analysis was performed including all the patients with falls from heights who presented to a tertiary care hospital in South India during the summer months of 2018, 2019, and 2020. A structured case record form was used to capture information such as basic demographics, tree species, reason for climbing the tree, and mode of fall, along with the clinical profile, and outcomes from the cases selected from the emergency department registers and cross verified using ICD codes. RESULTS: Despite the existing lockdown due to COVID, an unusual increase in the number of patients getting admitted to the triage with a fall from tree was noted in the year 2020 compared to 2019 and 2018. The most common type of injuries sustained were spinal injuries. Burst fractures were leading types of fractures in the patients with spinal injury. The second most common type of injuries involved were of extremities, with lower extremities more than upper extremities. Two patients had inhospital mortality within 30 days. CONCLUSIONS: Falls from a tree are a neglected and preventable mechanism of trauma with a significant socio-economic impact, as most of the patients are young or middle aged earning members of their families. The burden of this mode of injury is primarily on rural and agricultural communities. Pre-hospital services in areas with vast agroforestry cultivation require dedicated first response clinics. Lockdowns and geographic isolation during disasters or disease outbreaks must also factor in a supply of essential commodities and warrant treatment on an urgent basis to reduce the need and risk of injury from forestry and agricultural activities.

Telemedicine and Telehealth in Urology-What Do the 'Patients' Think About It?

Telemedicine is the delivery of healthcare to patients who are not in the same location as the physician. The practice of telemedicine has a large number of advantages, including cost savings, low chances of nosocomial infection, and fewer hospital visits. Teleclinics have been reported to be successful in the post-surgery and post-cancer therapy follow-up, and in offering consulting services for urolithiasis patients. This review focuses on identifying the outcomes of the recent studies related to the usage of video consulting in urology centers for hematuria referrals and follow-up appointments for a variety of illnesses, including benign prostatic hyperplasia (BPH), kidney stone disease (KSD), and urinary tract infections (UTIs) and found that they are highly acceptable and satisfied. Certain medical disorders can cause embarrassment, social exclusion, and also poor self-esteem, all of which can negatively impair health-related quality-of-life. Telemedicine has proven beneficial in such patients and is a reliable, cost-effective patient-care tool, and it has been successfully implemented in various healthcare settings and specialties.