ABSTRACT
A mountain collapsed on National Highway-53(NH-53) on 6th July 2011 around 2:30 p.m. A minibus which was carrying Security Personnel of Manipur Rifles (MR) and Indian Reserved Battalion (IRB) was hit by the landslide. Six occupants died on the spot and seven were injured. The cases were registered under U.D. Case no. 5/2011/G-SPM-PS and were brought to the RIMS Morgue the next day for Post Mortem Examination (PME). On PME, the victims showed general features of blunt force injuries with gross deformation and one case showed clogging of the whole respiratory tract with soil debris of the landslide. The victims died almost immediately on the spot due to vital organs injuries except in one case where it was due to traumatic asphyxia. Landslides occur frequently in these National Highways due to the hilly terrain and the perpetual rains, such major fatalities have never occurred before. Therefore the cases are reported here to analyze the types of injuries sustained, the causes of death and to discuss precautionary measures for prevention of further mishaps. This will also serve as an eye-opener to the magnitude of severity such a natural disaster.
Subject(s)
Asphyxia/etiology , Asphyxia/mortality , Fatal Outcome , Humans , India/epidemiology , Landslides/epidemiology , Landslides/mortality , Landslides/statistics & numerical data , Thoracic Injuries/etiology , Thoracic Injuries/mortality , Wounds and Injuries/etiology , Wounds and Injuries/mortalityABSTRACT
Deaths in stampede accidents are not new in India. Majority of causalities occurred as a result of traumatic asphyxia in such cases. Traumatic asphyxia is a rare syndrome first described over 150 years ago by Olivier. It is caused by sudden compressive chest trauma and is associated with craniocervical cyanosis, facial edema and petechiae, sub-conjunctival hemorrhage, and neurological symptoms. Although minor incidents of jostling are common at railway stations, but deaths occurring consequent to stampede by an uncontrollable crowd is not very common. A stampede occurred at New Delhi railway station which results in death of two persons and injuring many. The autopsy findings along with circumstantial evidence, results in arriving of conclusion that these deaths occurs as a consequence of traumatic asphyxia. Various clinical features of this condition are described in the literature, a brief review of which is given in this article. In the conclusion few preventive measures are also suggested so that in future such tragedies can be averted.
Subject(s)
Adult , Asphyxia/etiology , Asphyxia/mortality , Autopsy , Crowding , Female , Cause of Death , Child , Humans , India , Male , Mass Behavior , Mass Casualty Incidents/epidemiology , Mass Casualty Incidents/mortality , Mass Casualty Incidents/prevention & control , Mortality , Railroads , Thoracic Injuries/complicationsABSTRACT
Retrobulbar hemorrhage and permanent visual loss are rare presentations following traumatic asphyxia. In this case, bilateral permanent visual disturbance developed in a woman after chest-crushing trauma without direct trauma to the orbits. A computed tomography scan confirmed bilateral retrobulbar hemorrhages. An ophthalmologic exam revealed bilateral subconjunctival hemorrhages and severe lid edema. Despite high-dose steroid therapy, visual recovery was limited, and optic nerve atrophy developed. Ischemia of the optic nerve associated with retrobulbar hemorrhage may be postulated as one of the causes of permanent visual impairment following traumatic asphyxia.
Subject(s)
Female , Humans , Middle Aged , Asphyxia/complications , Ischemia/complications , Optic Nerve/blood supply , Retrobulbar Hemorrhage/complications , Thoracic Injuries/complications , Tomography, X-Ray Computed , Vision Disorders/etiologyABSTRACT
PURPOSE: Traumatic asphyxia is a rare clinical syndrome characterized by cervicofacial cyanosis, edema, and multiple petechiae after a severe chest crush injury, and ophthalmic involvement includes violaceous discoloration of lid, lid edema, bulbar subconjunctival hemorrhage, exophthalmos and retinal hemorrhage. The authors experienced a case of traumatic asphyxia with typical ophthalmic manifestations after a crush chest injury, and we report this case with literature review. METHODS: A-54-year old man was consulted for bilateral proptosis after a crush chest injury. Ophthal-mologice valuation and intervention were performed. RESULT: Right eye was not checked due to previous corneal opacity, but visual acuity was 0.8 and IOP was 45 mmHg in left eye. There were bilateral proptosis and severe bulbar subconjunctival hemorrhage, and orbital computed tomography showed orbit fat interposed between globe and medial orbital wall. IOP was controlled with medications and other clinical signs including proptosis showed progressive improvement.
Subject(s)
Asphyxia , Corneal Opacity , Cyanosis , Edema , Exophthalmos , Hemorrhage , Orbit , Purpura , Retinal Hemorrhage , Thoracic Injuries , Thorax , Visual AcuityABSTRACT
Objective To investigate the change on monoamine neurotransmitter in cerebral cortex motor area of traumatic asphyxia canines and provide scientific basis for its therapy.Methods The model of canine traumatic asphyxia was established,the change on monoamine neurotransmitter in cerebral cortex (motor area) and the products of metabolism during different time were tested with HPLC DC method.Results At 2 h after damage in cerebral cortex 5 hydroxyindolecetic acid (5 HIAA) elevated remarkably; At 8 h after da mage 5 hydroxytryptamine (5 HT), homovanillic acid (HVA) elevated; but there was no obvious change on norepinephrine(NE) and 3,4 dihydroxyphenyl acetic acid (DOPAC).Conclusion The monoamine neurotransmitters might play an important role in the pathological course of secondary brain injury after traumatic asphyxia.The utilization of 5 HT antagonists or compound inhibitor at early stage was a reliable method for treating brain injury after traumatic asphyxia.