ABSTRACT
To determine the frequency and causes of accidental upper limb amputations seeking rehabilitation [prosthesis] care in a tertiary care center. Observational Descriptive Study. This study was carried out at outpatients Department of Institute of Physical Medicine and Rehabilitation at Dow University of Health Sciences, Karachi from Jan 2007 to Dec 2010. The Sampling Technique was non Probability Purposive sampling. A study specific Performa was prepared which included patient age, stump complications, level of amputation and associated risk factors. The data was analyzed in SPSS version 15. The Mean+/-SD age of ULA was 28.56 +/- SD 11.97 [years]. Most ULA were reported from Karachi 65 [67.7%]. Labourers were the most commonly affected groups 33 [34.4%].Accidents leading to ULA were reported in 89 [92.70] and machine injury [chaff cutting] was responsible in one third of the ULA. Quarter of the ULA had leading cause electric injury. Only, 16 [16.7%] amputees had road traffic accidents. The study concluded that majority of upper limb amputation were caused by machine accidents affecting mostly labourers. Therefore, machine safety protocols for labourers, farmers and workers should be implemented in their local language and through pictoral messages and inbuilt safety measures machines should be sold by company representatives
Subject(s)
Humans , Male , Female , Upper Extremity , Tertiary Care Centers , Accidents , Accidents, Traffic , Accidents, Occupational , Electric InjuriesABSTRACT
To determine the determinants of lower extremity amputations in diabetics and non-diabetics in a tertiary care institute. Cross-sectional, analytical study. Outpatients Department of the Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, from January 2007 to December 2010. All patients with amputations reporting at the study centre for prosthesis fitting were included in the study. Patient's age, level of amputation, stump complications and associated risk factors of amputation were recorded on a structured proforma. Prosthesis and orthotic assessment were carried out. The frequency and determinants were collected to compare diabetic and non-diabetic amputees. The data was analyzed in SPSS windows version 16. A total of 1091 subjects were provided prosthesis, including 847 males [77.6%]. Mean age in diabetic and nondiabetics being 49.6 +/- 15.2 and 26.6 +/- 17.9 years respectively which is significant at [p < 0.001]. Socioeconomic status and educational levels were significantly associated with diabetic status [p < 0.001]. Amputation was more common in non-diabetic 858 [78.6%] compared to diabetics 233 [21.4%]. This study has identified that most common and significant predictors were gender, low social status and educational levels. Other significant predictors of amputation identified were type of lesion, [infections and ischaemia], initial diagnosis acute/chronic arterial insufficiency and diabetic foot
ABSTRACT
Amputation is stated to be a foremost but preventable community health problem causing intense financial, social and emotional effects on the patient and family particularly in developing countries where the prosthetic services are limited. The purpose of this study was to identify the causes and levels of amputation in low resource community, Sindh Pakistan. This was a retrospective chart review study that was carried out at first civilian Institute of physical medicine and rehabilitation-Dow University of health sciences from October 2007 to June 2012. After verbal informed consent all patients, who underwent major or minor amputation were enrolled for the study. Data was collected using a pre-tested, coded questionnaire and analysed using SPSS version 16. A total of 1115 patients were enrolled into the study. Their ages were ranged between 2-95 years [mean 38.40 +/- 17.38]. Among total population of amputees 83.58% were males. The most common cause for major limb amputation was road Traffic accident 38.38%, followed by Diabetes 15.42%, infection 14.26% and trauma 12.37%. Lower limbs [trans-tibial] amputations were in 47.35% of cases and transfemoral in 27.98% of cases. While for the upper limb trans-radial amputation [7.4%] were found to be more common than trans-humeral [5.56%]. Other amputations were for shoulder, hip and knee disarticulations. Road traffic accidents, complications of diabetic foot ulcers, infections and trauma were the most common causes for major limb amputations found in low resource community, Sindh Pakistan. The majority of these amputations are preventable by endowment of traffic rules, health education, early preventions and appropriate management of the common infections