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.

Fatal gastro-duodenal perforation following electrocution: A case report.

A 45 yrs old male was accidentally electrocuted, while cooking on a locally made heater in his home. He was immediately brought to the hospital in unconscious state by the family members. After first aid he was referred to a tertiary care hospital, where he was admitted about two hrs after the incident. On admission he was unconscious, abdomen was distended, with fluid in peritoneal cavity. There was tachycardia and hypotension. Bowel sounds were absent. Electrocution burn marks were present over the right hand. Arterial blood analysis showed severe metabolic acidosis. He was immediately shifted to the ICU. His condition continued to be critical with persistent metabolic acidosis despite repeated sodium bicarbonate infusion. An exploratory laprotomy was planned to rule out abdominal visceral injuries. However the patient expired six hrs after admission to the hospital before being taken to the operation theatre. Autopsy examination showed perforated anterior wall of stomach antrum and first part of duodenum.

Fatal unintentional carbon monoxide poisoning inside a garage A case report.

A young female aged 18 years was found unresponsive in the car by her boyfriend. Both were inside the car, which was parked inside a closed garage. The engine and air conditioner of the car was switched on. The girl had complained of giddiness earlier and the boyfriend too was feeling drowsy. The boy had been going out of the car to attend to phone calls and upon returning after one such call, found that his friend was not responding. She was immediately brought to the casualty dept of a tertiary care hospital by him where she was declared dead on arrival. A police complaint was lodged by the relatives of the girl, accusing the boy of homicide due to the presence of some minor injuries on the body of girl. Medico Legal autopsy on the girl revealed, death due to carbon monoxide poisoning.

Sudden death due to aortic rupture while swimming: A case report.

An eleven year old, healthy boy with no past history of illness suddenly felt acute excruciating chest pain which was radiating to back, while he was swimming in a private swimming pool. He was immediately transferred to a hospital where he was declared dead on arrival. Autopsy and histopathological findings were suggestive of death was due to extensive advential haemorrhge due to inherent weakness in aortic wall.