Patterns of Injuries in Road Traffic Accidents in a Rural Tertiary Hospital.

Road traffic injuries are a major but neglected global public health problem, requiring concerted efforts for effective and sustainable prevention. Of all the systems that people have to deal with on a daily basis, road transport is the most complex and the most dangerous. Objectives: To study the patterns of injuries in the road traffic accidents and days of hospitalization. Materials and Methodology: The study was retrospective record based study and included cases reported and recorded from October 2007 to March 2008. Results: The present study was designed to study the patterns of injuries in RTA (Road Traffic Accidents) in Anand district of Gujarat. The results showed that out of total 423 RTA cases, 327(77.3%) of the victims were males and the rest 96(22.7%) were females. Two wheeler riders and pedestrians form twothird of the total victims. Total 232 fractures were noticed and of these maximum numbers occurred in the lower limb region (53.86%) followed by fractures in the upper limb (24.54%) and 10.77% fractures were in the skull. Abrasions were seen most commonly on lower limbs (34.31%), lacerations were seen mostly on head (41.07%) and internal injuries were noticed more in the head region (31.48%). 74.2% of the victims were hospitalized and the rest 25.8% took treatment at the trauma centre. 51.1% of RTA victims were hospitalized for 1-5 days while patients who did not require hospitalization were 109(25.8%).

Road Traffic Accidents - Throwing Care and Caution to the Wind.

It was observed, for last ten years, that the Road Traffic Accidents causing morbidity and mortality has increased significantly in rural area. The economic growth in this area along with development of SHIRDI and SHANI- SHINGANAPUR was noted. Objectives: We were interested to know the incidence of trauma and any remediable factors that could be suggested and implemented. The aim was to document the predominant mechanism of injury and to determine temporal relationship between the final outcome, types of injury, and time taken since injury to hospitalization. Methods: The study, carried out in rural area, hospital based included 2,154 patients of polytrauma, who were admitted, diagnosed and treated out of a total number of 4,638 patients of polytrauma who visited the causality of the hospital. Proforma was designed and data recorded and analyzed. Results: Predominantly young male population was affected by trauma. There was a gross delay in arrival to the hospital in considerable number of patients. Mortality was 32.66% when patients reached hospital within two hours of injury. Mortality increased to 51.51% when patients reached the hospital after eight hours of injury! Conclusions: In majority of patients the mechanism of injury was the result of motor vehicle accident. The patients who have multi-system involvement have poorer outcome to our country due to accidents amounts to Rs.5000 crores annually2. In a developing country like India, public health facilities are scarce. Only 0.9% of GDP is spent on public medical services6. In higher income countries, RTA are already among the top ten leading causes of disease burden in 1998 as measured in DALY (Disability–Adjusted Life Years). According to a WHO / World Bank report, “The Global Burden of Disease’’, deaths from non communicable diseases are expected to climb from 28.1 million a year in 1990 to 49.7 million by 2020 and RTA being the main cause of this rise. On an average in the industrialized countries and also in many developing countries, one hospital bed in ten is occupied by trauma victim7. Member countries of South East Asia region, during the past two decades, are passing through significant Urbanization, Motorization, Industrialization and changes in the socio - economic values of societies. Injuries on roads, at homes and in the work place have increased due to lack of safety related policies and programmes. Children saved today from nutritional and infectious diseases are killed and/or maimed by injuries tomorrow. In fact RTA injuries are ranked as number one cause of burden of diseases among children in 2000. This heavy burden at such an early age has long – term implication on the qualities of life and economy of the nation8.

Pattern of Orthopaedic Injuries Among Patients Attending the Emergency Department in a Tertiary Care Hospital – An Analytical Study.

Introduction: Th is study was aimed at analyzing the pattern of Orthopaedic injuries among patients attending the Emergency department in a tertiary care hospital. Retrospective study was conducted in the Department of Orthopaedics, Teerthanker Mahaveer Medical College & Research Centre. Methods: Th e record analysis of injured patients seen at the emergency department over a 12 months period from June 2012 to may 2013 was done. Th e data was analyzed with special reference tothepattern of Orthopaedic injuries. Results: A total of 1110 records of injured patients that attended the emergency department were analyzed. Study showed that themajority of victims were in the age group of 11-44 years (n=909, 81.89 percent). 71.09 percent (n=789) were males and 28.9 percent (n=321) were females. Road traffi c accident was the most common cause of injuries being responsible for 59.72 percent, (n=663) followed by fall from height (22.5 percent, n=247). Study revealed that the most common presentation of injuries was fracture (68.64 percent, n=762) and the most common site was lower limbs in 48.16 percent cases, (n=367). Next most common site was upper limbs (28.08 percent, n=214) followed by pelvic fracture (10.01 percent, n=77), spine fractures (8.26 percent, n=63), facial fracture (2.88 percent, n=22) & Ribs fracture (2.49 percent, n=19). Th ere were 71.65 percent cases (n=546) of simple fracture and 28.34 percent cases (n=216) ofthecompound fracture. Th ere were 3.87 percent cases (n=43), of various dislocations, shoulder dislocation being the most common. Crush injury was seen in 7.5 percent cases. Most commonly associated visceral injury wasthehead injury in 17.20 percent cases (n=191). Conclusion: Fractures were the most common pattern of Orthopaedic injuries, frequently associated with head injuries. Research in to appropriate strategies for prevention of injuries, especially RTA is required in tertiary care hospitals.

Pattern of road traffic accidents in Imphal.

In recent years the incidence of Road Traffic Accidents is increasing at an alarming rate throughout the world posing itself as a major epidemiological as well as medico-legal problem. In a study of 205 cases of Road Traffic Accidents brought to the mortuary of Regional Institute of Medical sciences, Imphal during September 2007 to August 2009, it was noted that males (75.13 %) outnumbered the females (24.87%). Majority of the victims were in the age group of 21 - 30 years (24.89%). It was also noted that majority of the accidents happened in the National Highways (59.51%) and pedestrians were the commonest victims (37.56%). Trucks were the most frequent offending vehicles (34.63%) followed by Buses (22.94%) The commonest cause of death was due to shock and haemorrhage (34.64%). large number of human lives can be saved if trauma centres are established along the National Highways equipped with well trained medical personnel and complete infrastructure of emergency care.

Profile of fatal road traffic accidents in Rajkot city.

Road traffic injuries are recognized as a major health problem in developing countries accounting for the maximum morbidity and mortality following trauma. The present prospective study was conducted at the Department of Forensic Medicine, P.D.U. Medical College and Associated Hospital, Rajkot from January 2008 to December 2008. The objective of this study was to analyze the trend of fatal road traffic accidents and to find out the measures for the prevention of their causative factors. During that period out of 2159 autopsies, 298 cases of Road Traffic Accidents were selected for the present study which accounts 13.8% deaths. Our study shows that 99(33.22%) victims were male of middle age group (21-30 years), male: female ratio was 10.5:1. 114(38.26%) cases were observed during working hours between 12.01 p.m. to 6.00 p.m. 101(33.89%) victims were pedestrians, followed by occupants of heavy four wheelers, two wheelers and three wheelers. Head injury in 161(54.03%) followed by hemorrhagic shock in 51(17.11%) were main causes of death. 141(47.32%) victims were died within one hour after accident.

Study of deaths in industrial areas around Aurangabad city.

We retrospectively studied the death cases brought for medico-legal post-mortem examination at mortuary, Government Medical College, Aurangabad in last one year i.e. 2010. All the cases from these areas (Police station MIDC Waluj, MIDC Cidco, MIDC Chikhalthana, and MIDC Paithan, etc.) were included in the study and the results are analyzed. Deaths from industrial areas accounted for 6.85% of total autopsies. It is observed that the most common cause of death in industrial area is road traffic accident probably due to higher frequency of transportation. Males outnumbered the females and they suffered injuries most in their fourth decade of life. Maximum incidences occurred in the month of October, that too on Friday between times 12:00 pm to 6:00 pm. Maximum cases were accidental in manner and brought dead to Government Medical College, Aurangabad. The most common cause of death was vehicular accidents involving head. This is the first time such a study has been carried out locally. The proportion of accidental deaths in industrial areas relative to that of non industrial area may be attributed to the poor enforcement of safety measures in these areas.

Victim profile and pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents.

The present research aims to highlight the pattern of thoraco-abdominal injuries sustained by the victims of fatal road traffic accidents (RTA) in Manipal, South India. The study is an autopsy based observation of thoraco-abdominal injuries in victims of fatal road traffic accidents during 1999 – 2003. Road traffic accidents accounted for most of the injury related deaths (77%) during the study period. A male preponderance (86%) was observed with a male-female ratio of 6:1. Individuals in the age group of 21 to 50 years formed the most vulnerable (83%) group. External thoracic injuries were more common than internal thoracic injuries in the thoracic region. In the abdominal region, internal injuries were more common than external injuries. Lungs (61%) and kidneys (23%) were the most commonly involved organs in the thoracic and abdominal regions respectively. Majority of the victims were two wheeler occupants (35%) followed by pedestrians (23%). The study indicates the pattern of thoraco-abdominal injuries sustained along with the trend of road traffic accidents in the region.

Trends of Maxillofacial Trauma at Adesh Institute of Medical Sciences and Research, Bathinda, Punjab.

A four years retrospective study from April 1, 2007 to March 31, 2011, was conducted to analyze the pattern and magnitude of maxillofacial trauma in medico-legal cases coming to the casualty of Adesh Institute of Medical Sciences and Research, Bathinda, a rural area of Punjab. The study revealed that out of 1237 medico-legal cases 130 (10.5%) suffered maxillofacial trauma. The commonest age group prone to maxillofacial injury was between 16-30 years. Male preponderance was quiet evident (6: 1). The commonest cause of such injuries was road traffic accident including 83.1% of the total cases. Soft tissue was the most common type of maxillofacial trauma (52.3%). Most common bones involved were nasal bone and mandible (18.5% each) and the commonest associated injury was involvement of limbs (30.0%). Most common weapon involved was blunt (90.8%). Drawing public attention and awareness towards the traffic rules especially use of helmets by the motorcyclists and separation of pedestrians from motor vehicles could possibly reduce the number of maxillofacial trauma cases.

An epidemiological survey of fatal road traffic accidents and their relationship with head injuries.

Death from road traffic accidents (RTA) and in particular Motor vehicle Traffic Accidents have been characterized worldwide as a hidden epidemic which affects all sectors of society. It account for 2.1% of global mortality. A retrospective study of fatal cases of RTA was conducted at Department of Forensic Medicine and Toxicology, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India between 1-1-2004 to 31-12-2009. The majority of victims belonged to the age group 31-40 years (145 cases; 28.7%). Female were less involved than men with ratio of 1: 3.3. In our present study total vehicular accident fatalities comprised 506 (48.7 %) out of total 1039 medico legal cases autopsied during five years (2005 to 2009). Our study shows the overwhelming majority of the deceased (76.9%) were males. This study shows that most of the deaths in road traffic accidents, take place either within 24 hours or on the spot of injury which is very alarming and highlights the need for taking urgent steps for establishing good pre-hospital care and provision of trauma services at site in India.

Pattern of non-fatal head injury in adult cases reported at J.N.M.C. Hospital, A.M U, Aligarh.

Head injury is one of the major public health problems and has already attained epidemic proportions in India. The incidence of head injuries is growing with greater mechanization in industry and an increase in high velocity mode of transport. The injuries could be caused by a penetrating or blunt force either by direct violence or indirectly. The Present study was conducted in cases admitted to Emergency section of J.N. Medical College Hospital, A.M.U. Aligarh. All the cases (2850) of head injury reported from 01/01/2008 to 31/12/2009 for treatment were included in the study. Most of the cases of head injury belong to younger age group (15-34 yrs) comprising of 56.61% with male preponderance of 85.68% with majority of the cases belonging to road traffic accident (55.02%).Scalp injury in 2365 cases where as 969 were cases of skull fractures and extradural hemorrhage(17.36%) was most common intracranial injury followed by subdural hemorrhage(7.6%).

Fatal road traffic accidents among young children.

Fatal road traffic accidents in childhood constitute a significant public health problem. Young children are extremely vulnerable to such injuries which are vastly preventable. 59 cases of fatal road traffic accidents in children aged below 16 years, autopsied during 1 year period were studied. Males accounted for 83.1% cases with male-female ratio of 4.9. The most common age group involved was 13-16 years. The most frequent victims of road traffic accidents were pedestrians (61%) followed by cyclists (13.6%). More than half of the cases occurred in winter season and majority occurred at 12-4 PM. Children themselves were at fault in majority of cases. Head injury alone was fatal in 72.9% cases. None of the victim received any treatment or first-aid at the site of accident. 72.9% of victims died with in 6 hrs of accident. The study highlights the pattern of fatalities due to road accidents in children and suggests suitable preventive measures to reduce burden of childhood mortality due to road accidents.

Study of road traffic accidental deaths (RTA) in and around Bastar Region of Chhattisgarh.

To analyze the magnitude of head injury in fatal RTA cases, present study was conducted in the department of Forensic Medicine Toxicology, Govt. Medical College, Jagdalpur (Chhattisgarh) in 2009 calendar year. The present study was undertaken on 105 victims of RTA who died due to head injuries, which autopsied at GMC, Jagdalpur (C.G). Most of the accidents occurred in the afternoon hours (12: 01 - 18:00). There was a clear male dominance (88.57%). The most affected age was middle age (21-40 yrs) & most commonly affected age group is 21-30 yrs. Vehicular occupants were commonly affected (63.80%) & amongst them two wheeler occupants most commonly involved. Fissure fracture of the skull was commonest (45.71%) & parietal region of head was mostly involved region of the head (27.61%). Among the intracranial hemorrhages, subdural hemorrhage (SDH) was commonest (31.42%). In relation duration of survival time 59.04% of victims died within 24 hrs of fatal accident.

Pattern of motorcyclist's mortality in Mazandran province, northern Iran

Road traffic accidents [RTA] is recognized internationally as the major threat to human health and, motorcycle collision victims form a high proportion of those killed or injured in RTA.This study was performed to evaluate the patterns of motorcyclist's mortalities. All motorcyclists' corpses that were presented to the legal medicine center of Mazandaran Province during January 2002 to January 2004 were enrolled and the patterns of motorcyclist's mortalities were determined. Of the 89 bodies, 93.3% were male and 84.2% were riders. About 60% sustained injuries from collision with a car. Two third of the deaths occurred in the first half of the year. Three fourth of the death occurred in heavy traffic volume time of a day [7 am to 10 pm] peaking at 9 pm [21%]. Fifty seven percent died on the rural roads collisions and 47% on the urban road collisions. Head injury was the main cause of death [50.6%]. Motorcyclist's mortalities were prevalent in young motorcycle riders [males], collision with a car, first half of the year, heavy traffic volume time, riding on rural roads, and head injury was the main cause of death

Profile of road traffic accidents & head injury in Jaipur (Rajasthan).

The injuries and death due to head trauma are inescapable in the modern way of life and their correct interpretation is vital to the reconstruction of the events of Forensic Medicine and their proper management for treatment of the injured. The present study was conducted in the department of forensic medicine, SMS medical college, Jaipur in year 2003-2004 to analyze the quantity of the magnitude of deaths due to Road Traffic Accidents (RTAs) and to provide epidemiological data, so the preventive measures can be undertaken. Our study shows that majority of the victims of RTA were male of middle age group (20-40 years), when they were going on two wheelers with out wearing helmets.

An epidemiological study of road traffic accident victims in medicolegal autopsies.

Unnatural deaths of any kind i.e. suicidal, homicidal, accidental can cause severe emotional reactions to the near relative of the victim immediately after the event and later. Of all types of unnatural deaths road-traffic accidental death probably has the highest incidence worldwide.

Acidentes de tráfego, um problema de saúde pública: análise de 160 pacientes acidentados e internados em hospital de pronto-socorro / Trafic accidents, a public health problem: analysis of 160 accident victims admitted to an enaergency hospital

Os autores apresentam estudo baseado na análise de 160 pacientes internados por acidentes de tráfego, no mês de novembro de 1986, em um hospital em Curitiba. A maioria das vítimas era do sexo masculino, entre os 18 e 30 anos. No caso de acidentes envolvendo motocicletas, a incidência foi maior na faixa etária dos 18-19 anos (35%). A causa principal foi o atropelamento (45,6%) e a colisäo (31,2%). A regiäo da cabeça foi a mais atingida, ocorrendo em 81,8% das vítimas. Houve, em média, 2,6 diagnósticos por pacientes e as fraturas foram mais freqüentes nos membros inferiores, com 44,53%, sendo a mais comum a dos ossos da perna e coxa, com 21 e 15%, respectivametne. Houve necessidade de tratamento cirúrgico em 76% dos pacientes. A maioria dos óbitos ocorreu a nível dos atropelamentos. O estudo realizado demonstrou a necessidade urgente de campanha de prevençäo, no mínimo com uso do cinto de segurança e do capacete. Há necessidade urgente de sistema de atendimento no local e de transporte adequado para hospital capacitado, pois a análise da literatura demonstrou que, quando isso é efetivado, o índice de mortalidade é sensivelmente reduzido. o que estamos esperando

Prevalencia del uso del cinturón de seguridad en tres sectores del área oriente de Santiago / Prevalence of the use of seat belts in 3 sectors of the eastern area of Santiago

Se estudia el uso del cinturón de seguridad por parte de pilotos y copilotos en automóviles particulares, en 3 sectores del área oriente de Santiago. Se registran 5.136 vehículos particulares y se entrevistan a 963 pilotos y 569 copilotos. El porcentaje de uso general encontrado fué de 23,2% para el piloto y de un 16,8% para el copiloto. Destaca la baja para el piloto en comparación a lo encontrado en un estudio similar hace un año que era de 35,4%, diferencia que es estadísticamente significativa. El porcentaje de uso sube en relación a la escolaridad, de un 8,3% con educación básica a un 18,1% con educación media y un 27,3% con escolaridad superior. Se estudia el uso del cinturón por parte del piloto al ir sólo que es de un 20,1%, con copiloto de 23,7%, con copiloto y acompañantes 28,7% y acompañante solamente de un 39,3% Se estudian otras relaciones según edad, sexo, día hábil o festivo, no encontrándose diferencias significativas

Accidentes de transito: problema de salud en paises en desarrollo de las Americas / Traffic accidents: a health problem in developing countries of the Americas

Los accidentes de tránsito han dejado de ser dominio exclusivo de los países desarrollados y se han convertido en una de las principales causas de lesiones, invalidez y muerte en algunos países en desarrollo. La organización Panamericana de la Salud inició recientemente una evaluación epidemiológica sistemática del problema en los países de América Latina y el Caribe. Se elaboró un cuestionario para las investigaciones y se han llevado a cabo talleres con el propósito de recomendar planes de acción. Varios países americanos en desarrollo han suministrado datos actualizados sobre la magnitud del problema y la infraestructura existente en relación con el control del tránsito, la prevención de accidentes, la atención de la salud y la información estadística. En este artículo se examina esa información y se señalan las condiciones que es preciso considerar, entre las cuales se incluyen el estado de los caminos, las actudes de conductores y peatones, los tipos de vehículos y otros factores. se comparan las tasas de defunciones y lesiones por accidentes de tránsito en un grupo de países de América latina y el Caribe con las de los Estados Unidos y Canadá. Se presenta también la información obtenida en dos talleres sobre el problema, uno en el Caribe y otro en Colombia, y se mencionan algunas de las recomendaciones que se propusieron en ellos

Las muertes violentas: aspectos epidemiológicos / Violent deaths: epidemiologic aspects

El autor hace un análisis de las muertes violentas en Venezuela. En el año 1984 hubo. 10.493 muertes debidas a accidentes, homicidios y suicidios esto representa el 13.3% y el segundo lugar de la mortalidad total del país en ese año. En el trienio 1982-84 las tasas de accidentes de tránsito, homicidio y suicidios fueron de 28.4, 11.4 y 4.7 respectivamente. En relación fueron: Accidentes de tránsito: Hombres 46.0, Mujeres 1.04, Homicidios: Hombres 21.0. Mujeres 1.8, Suicidios Hombres 7.4, Mujeres 2.0. En general la zona Andina y el Estado Mérida en particular tienen la mayor frecuencia de muertes violentas y la zona oriental, en especial el Estado Sucre la menor incidencia