ABSTRACT
This study assessed the characteristics and emergency care outcomes of fall-related injuries in Pakistan. This study included all fall-related injury cases presenting to emergency departments [EDs] of the three teaching hospitals in Rawalpindi city from July 2007 to June 2008. Out of 62,530 injury cases, 43.4% [N = 27,109] were due to falls. Children [0-15 years] accounted for about two out of five of all fall-related injuries. Compared with women aged 16-45 years, more men of the same age group presented with fall-related injuries [50% vs. 42%]; however, compared with men aged 45 years or more, about twice as many women of the same age group presented with fall-related injuries [16% vs. 9%, P < 0.001]. For each reported death due to falls [n = 57], 43 more were admitted [n = 2443, 9%], and another 423 were discharged from the EDs [n = 24,142, 91%]. Factors associated with death or inpatient admission were: aged 0-15 years [adjusted odds ratio [aOR] = 1.35], aged 45 years or more [aOR = 1.94], male gender [aOR = 1.15], falls occurring at home [aOR = 3.38], in markets [aOR = 1.43], on work sites [aOR = 4.80], and during playing activities [aOR = 1.68]. This ED-based surveillance study indicated that fall prevention interventions in Pakistan should target children, older adult women, homes, and work sites
ABSTRACT
Violence in a public health problem in low and middle income countries. Our study attempted to define the circumstances, risk groups, extent and severity of firearm-related injuries in patients coming to the Aga Khan University Hospital [AKUH] Karachi, Pakistan. This was a retrospective study conducted in the department of Emergency Medicine [EM] at AKUH Karachi, Pakistan. Past medical records of all patients who were injured by firearms and were presented to the AKIH Emergency Department [ED] from June 2002 till May 2007 were reviewed. Data were recorded on the basic demographics of injured, length of hospital stay, body parts injured and the outcome [alive vs. dead]. Total of 286 patients with firearm injuries were identified. Majority of them were males [92%, n=264]. More than half of them patients [63%] were in the age group of 21-40 years. Upon arrival to the hospital 85% [n=243] of patients had Glasgow Coma Scale [GCS] >/= 13. The mean injury severity score [ISS] was found to be 6 [SD +/- 4]. The length of hospital stay of patients ranged from 0 to 54 days with a mean of 7 days. Lower limb were the most affected body parts [30%, n=86] followed by abdomen pelvis [27%, n=77]. Seven percent [n=21] of the patient who were brought to the hospital were labeled as 'deceased on arrival]. Most of the injuries were caused during the act of robbery [40%, = 103] in the city. Robbery was the most common cause of firearm injures. Lower limb, abdomen and pelvis were the most affected body regions. Educational efforts, and individual, community and societal approaches are needed to alleviate firearm-related injuries
Subject(s)
Humans , Male , Female , Firearms , Hospitals, University , Retrospective Studies , ViolenceABSTRACT
To review the incidence, clinical presentation and outcome of Non traumatic Aortic emergencies in a tertiary care hospital and its evaluation in the Emergency department [ED]. We conducted a retrospective review of cases presented to the ED at Aga Khan University Hospital during 15 year period [1988 - 2002] who had final diagnosis of Aortic Dissection or Ruptured Aortic Aneurysm. Patients without confirmatory investigations were excluded. We aimed at looking for the incidence, clinical presentation, evaluation in the ED and final outcome. Of the 12 cases, 7 had aortic dissection while the remaining 5 had ruptured aortic aneurysm. For Aortic dissection, mean age of presentation was 53 years with male predominance. Most of these patients had chest pain. Most common comorbid condition was hypertension. Pulse deficit was found in 2 cases, murmur in 4 cases, and focal neurologic deficit in 2 cases. Electrocardiogram revealed ischemic changes in 3 cases. Widened mediastinum on chest x-ray was present in all cases. The only initial misdiagnosis was cardiac ischemia. One patient survived to discharge. For patients presenting with ruptured aortic aneurysm, mean age of presentation was 52 yrs with a male predominance. The associated comorbid condition was hypertension. Almost all patients presented classically with abdominal pain, hypotension and palpable mass. No patient survived to discharge. Aortic emergencies although rare, are associated with significant mortality. High index of suspicion and prompt recognition by the emergency physician is of key importance