Head injury and its consequences - a one year study in Karachi

Head injuries are a major cause of mortality or disability among the youth of the nation. This study was conducted to determine the causes of head injuries in Karachi and its implications on individuals. Prospective observational Study. This study was performed at the Emergency department of Jinnah Post Graduate Medical Centre [JPMC], Karachi from January 2013 to December 2013. The study included 1,59,600 cases of head injury [expired or alive] brought to the emergency department of JPMC. Major Head injuries accounted for 42% of the total injury cases. Majority of the head injury cases belonged to the male segment of the society [73%] with ages ranging from 20 years - 39 years [54%]. The leading cause of head injury was found to be Road traffic accidents [RTA] [43%]. While analysing the outcomes of head injuries, it was found that the death rate for head injuries was 40%. This encompasses the patients that expired during or after treatment as well as the dead brought to the hospital. The mortality rate due to head injuries is escalating day by day. Road traffic accidents account for majority of these cases. Steps need to be taken to control fatal head injuries by adopting effective preventive measures like traffic control and management, rapid response to accidents, effective and efficient handling of cases in hospital emergencies

Epidemiology and mortality of burns in Karachi

Despite being a serious hazard the causal factors and outcomes of burn injuries in Karachi remain an under researched area. The purpose of our study was to analyse the epidemiology and mortality of burn injury cases in Karachi in order to create awareness at mass level. Prospective Observational Study. This study was carried out from October 30[th], 2013 to April 30[th], 2014 in the Burns Centre, Civil Hospital Karachi. The study encompassed all the burn injury cases [expired or alive] reported to the Civil Hospital during the six months of the study period. The demographic information, cause and level of injury of all the reported cases were documented. 784 cases of thermal injuries were reported. Out of these, 441[56.25%] were males and 343[43.75%] were females. Most of the burn victims [60%] belonged to the age group of 15 - 44 years. Out of 784 cases, 565 cases [72%] were of serious dermo-epidermal and deep burns. The overall burn mortality rate was found to be 55.9%. This included burn victims who were brought dead or expired during treatment. Maximum burns were a result of fire/flame [48.1%]. The mortality rate of burn injuries in Karachi is alarming as compared to the international statistics. Fire incidents are the main cause of these injuries. Fatal burns can be prevented if necessary precautions are taken

Prevalence and proportion of anemia in pregnant women suffering from malaria

To find out the prevalence and proportion of anemia in pregnant women suffering from malaria. The aims and objectives of our study were to evaluate prevalence and proportion of anemia in pregnant women with malaria among the patients visiting the tertiary hospital PUMHS Hospital, Nawabshah, Shaheed Benazirabad so as to give awareness of these complications to doctors to ensure early diagnosis, prevention and prompt treatment of such cases. Descriptive observational study. This study was conducted at Outpatient Department of MMCH Hospital and Department of Pathology from April 2012 to February 2013. Study includes total 120 cases of malaria, diagnosed on the basis of clinical and laboratory findings. The hematological complications like anemia, leukocytosis and thrombocytopenia were studied in these patients. Out of 120, 64 patients were anemic. We divided pregnant women into 5 groups, 40 patients were in 16 - 20 years age group and amongst them 55% patients were anemic, 34 patients were in 21 - 25 years age group and amongst them 50% were suffering from anemia, 22 patients were in age group 26-30 and amongst them 22 % anemic, 15 cases were in age group 31 - 35 and out of them 46% were anemic and in age group 36-40 years 46 percent were anemic. Overall there were 53% anemic patients in total of 120. According to the occupation status majority were daily wages laborers and farmers and other were housewives. Out of 120 patients most of them were Multigravida. Most of the patients were suffering from anemia, 76% patients had Leucocytosis with Neutrophillia, 74 percent patients had complication of Lymphocytosis, 80 percent of patients had decreased level of monocytes and 60 percent had decreased level of platelets. All the patients were suffering from fever and associated symptoms of chills, sweating, feeling of hotness and coldness, 63 percent had back pain, 45 percent had headache and 23 percent had complication of Spleenomegaly. The diagnosis of malaria was made on clinical grounds and confirmed by laboratory findings. The problems of hematological complications as anemia, leukocytosis and thrombocytopenia were detected among the patient of malaria by determining hemoglobin concentration, complete blood picture and urine examination report. P.vivax malaria is most prevalent variety. Anemia, leukocytosis and thrombocytopenia are the most common hematological complications in these patients. It is suggested to ensure i. Effective malaria control program in country, specially interior Sindh. ii. Effective measures for prevention, diagnosis and treatment of patients. iii. effective health education through electronic and print media

Fatal road traffic accidents in Karachi

Fatalities due to road traffic accidents are a major cause of mortality all over the world. The aim of our study is to look at socio-demographic profile of such cases in order to find some remedial measures to minimize the brunt. Retrospective / observational study. This study was conducted at the Emergency Department, Sir Syed Hospital, Qayyumabad, Karachi from January to June, 2013. Study was based upon 56 victims of RTA. It includes all those who died during treatment or found dead on arrival in the emergency department. The demographic data of these cases was recorded. Males victims were 71% and maximum number of victims [37.5%] was in age group 30-39 years. Most of the accidents [38%] took place between 1200hrs and 1800hrs. Most of the injuries were found on the head [66%] and then chest 14%, lower extremities 21%, upper extremities 19%. The most common external injuries were abrasions, bruises and lacerations. Skull was the most common bone to be fractured [44%]. The head injury constituted major cause of death [53%] followed by hemorrhagic shock [35%]. Pedestrians and two wheeler riders were mostly affected individuals followed by cyclists, drivers of three wheeler, light and heavy motor vehicles. The incidence of traffic accidents is at rampant. The accidents risks can be minimized by enhancement of road visibility, good traffic control with properly working road traffic signals. Fatalities of Traffic accidents victims can be reduced by providing good pre-hospital care, establishment of well equipped emergency trauma centres in all big hospitals

Spectrum of medico-legal deaths in metropolis of Karachi: an autopsy based study

Background: The number and variety of medico-Iegal deaths has inflated tremendously in the recent years in relation to acts of terrorism using explosive material and street crimes which often result in tragic death

Objectives: To determine the frequency, causes and manners of medico-legal autopsies at three major mortuaries in Karachi

Methods: A case study, involving the medico legal deaths autopsied at three major mortuaries in Abbasi Shaheed Hospital, Jinnah Postgraduate medical center and Civil Hospital, from March 01, 2008 to February 28, 2009. A detailed autopsy was conducted in each case to determine the cause of death. The bodies were first examined externally followed by dissection of body cavities in accordance with Robert Virchow's technique. The results were collected from the respective institutions on a structured performa and were statistically analyzed using SPSS version 15. The Mean +/- SD was calculated for age

Results: Out of total 2,090 autopsies c0nducted during the period of study, 98.7% of the deaths were found to be due to unnatural causes. Homicides accounted for 54% of the deaths where as 39.3% were accidental deaths. Firearms were the most common cause of deaths [44.6%], followed by road traffic accidents [27.7%]. Male to female ratio was 9:1 with 88.8% of the victims being males. Majority of the victims belonged to age group 19-32 years [47.3%]

Conclusion: Homicides were the most common manner of death [54%], followed by accidents [39.3%]. Frequency in relation to cause of death revealed firearm injuries accounting for 446% deaths followed by road traffic accidents [278%]

Lethality of suicidal organophosphorous poisoning in Karachi in 2010

The study was aimed to evaluate the cases of suicide using organophosphorous compounds as intoxicant with the objective to bring up possible preventive measures based upon modifiable factors associated with lethality. Cross-sectional analytical Study. This retrospective study was based upon 66 patients of poisoning treated at intensive care unit of Ward No.5, JPMC Karachi during a period of one year from January 2010 to December 2010. Out of total 66 cases of poisoning 38 were of organophosphorous compounds [OPC] poisoning, 20 males and 18 females. Most of the cases [63%] of OPC poisoning were in age range of 20-40 years, 33 [86.84%] were of suicidal poisoning while 5 [13.16%] had accidental poisoning and 57% reported to treatment facility within 6 hours. All the cases of OPC poisoning had severe symptoms with fatal out come. Suicidal ratio was quite high. The period between the ingestion of poison and initiation of treatment plays vital role. In order to reduce fatality rate urgent intervention is required by government by improving the treatment facilities at local level hospitals i.e. primary health care centres and banning of highly toxic organophosphorous compounds. Additional measures which can help include improving the public awareness regarding recognition of toxic symptoms and importance of prompt referral to an appropriate facility

break up of autopsies conducted at district head quarter hospital Kasur

This is the first time study to find out the cause and manner of death through medico-legal autopsies in a small district comprising municipal boundaries and rural setup [District Kasur] and comparing it with urban studies conducted by the Forensic Medicine Departments of various medical colleges. This study is also aimed to assess the criminal behavior in this segment of society. Observational Study. This study was conducted at District Head Quarter Hospital Kasur from 2008 to 2010. This study was carried out on 451 medico legal autopsies performed at District Head Quarter Hospital Kasur. The findings were extracted from autopsy reports, chemical examiner reports, relevant hospital record and police documents. The cases were examined for various characteristics like cause and manner of manner of death, age and sex of victim and condition of body at the time of autopsy. The results revealed that homicide was the most common manner [82.26%] among unnatural deaths and males became three times more victims than females. The most vulnerable age group in unnatural deaths were from 15 to 45 years [77.39%]. In 44.12% cases firearm is the weapon responsible for death. Regarding condition of body at autopsy, 364 [80.71%] bodies were in fresh condition. Medico legal autopsy rate reflects the incidence of crime and criminal behavior of that segment of society. Compared with more civilized societies the crime incidence in our society is very high. In order to control it, we need to change the behavior of society through improvement in literacy rate, socioeconomic status and law and order situation. In order to improve the quality of medico-legal reporting there is need to strengthen the expertise in forensic medicine both at urban and rural level

epidemiologic profile of homicidal deaths in Karachi

The study was planned to review the epidemiologic profile of homicidal deaths in Karachi. Observational study. Since Jan. 2009 to June 2009 and place of study was the Department of Forensic Medicine and Toxicology of Jinnah Postgraduate Medical Centre [JPMC], Karachi. 1'wo hundred and ninety seven cases were included in the study. The data was collected by reviewing the police papers and autopsy repons. The parameters recorded were age, sex, manner of death, type of weapon used, part of the body involved, time of death and location of fatal wound. During the study period there were 297 cases of homicides, out of which 259 [87.2%] were firearms related homicides and majority of victims were males [75.4%] and most of them were between 21 to 30 years of age [39.5%] Most of the crimes occurred during night hours [59, 5%] and head injuries were most common [49.8%]. The firearms related homicides are highest in number, the reason being easy access to firearm weapons. Further studies and effective intervention strategies are needed to be employed to reduce the occurrence of homicides. The situation demands a strict control on firearms by government