impact of four wheel drives on road traffic disability and deaths compared to passenger cars

The aim of this study was to examine the pattern of injuries resulting from road traffic crashes involving four wheel drives [4WD] vehicles and passenger cars in the United Arab Emirates [UAE]. Descriptive study. Al-Ain and Tawam Hospital, UAE, during a period from 1st January to 31st December 2000. A questionnaire was created and filled out concerning: sociodemographic information; data about driving behavior and attitude which included driving experience, adherence to traffic laws [including speed limits and wearing seat belt], driving habits, and assessment of sustained injury was performed according to the Abbreviated Injury Score [AIS]. A total of 1157 motor vehicle crashes related casualty patients were hospitalized during the year 2000. Of these total patients, 495 victims [42.8%] were involved with 4WDs road traffic crashes related injuries and 72.9% of them required hospitalization. Of these, 76.8% were males, 60.7% were non-UAE nationals. The head injury was more common in those who had crashes from 4WD vehicles [45.6%] than those who had crashes from small cars [37.3%]. Abbreviated injury scare showed that four wheelers caused more severe [9.1%], serious [10.3%], critical [8.3%] and moderate injuries [13.9%]. A significant higher risk was observed for speed violations [OR=2.06; 95% CI=1.55-2.76, p<0.001]; property damage [OR=1.54; 95% CI=1.07-2.22, p<0.014] and pedestrian accident [OR=2.09; 95% CI=1.46-2.99, p<0.001]. The present study findings indicated that nearly half of the road traffic crashes were involved with 4WD vehicles and that most of the injured individuals were pedestrian and younger drivers. Reduction in motor vehicle injuries and deaths represents a major public health success

Clinical presentation and management of necrotic arachnidism

A case of necrotic arachnidism is described to alert the general practitioner and hospital emergency room physicians of the possible complications of spider bites. The range of presenting signs and symptoms and management strategies are discussed

Trigger digits treated by longitudinal incision of the tendon sheath

We reviewed 40 digits of the hand in 34 adult patients treated surgically for triggering between 1983 and 1989. Triggering was noted most commonly in the 40-50 year age group and was twice as common in females as in males. The dominant hand was involved in 70% of patients with the thumb most frequently affected, next the middle finger and then the ring finger; the index and the little fingers were spared. All were relieved of triggering after longitudinal release of the tendon sheath, except one who had a distal lesion which required a second operation. Subsequent to the transverse skin incision, the use of blunt dissection to expose the tendon sheath avoided injury to the digital nerves. Surgical release of the trigger digit is safe and simple, providing lasting relief of symptoms