Non-fatal limb injuries in motorbike accidents

To determine frequency and pattern of non-fatal limb injuries in motorbike accidents victims. Cross-sectional observational study. Study was conducted at Jinnah Postgraduate Medical Centre [JPMC], Karachi, from October 2006 to March 2007. Trained data collectors prospectively collected data from the emergency department of JPMC, Karachi using structured pre-tested questionnaires. All motorbike accident victims presented to Emergency department with single or multiple bone injury in body extremities were included. Head injury patients who had first presented to neuro-surgery department were excluded. Motorbike accident victims with soft tissue injuries were also excluded from this study. Chi-square test was applied to find out statistical significance at 95% confidence level. P-value <0.05 was considered as significant. A total of 137 [39%] patients presented with tibial injury among the study sample of 348 patients, which was significantly higher than the bone injuries of the body part [p<0.001]. Out of those, in 26% of patients, fibula was also involved along with tibia fracture. Other bone injuries included femur [16%], radius [9.2%], humerus [8.3%] and others. Radius was the commonest injured bone and in highest proportion among upper limb injuries [p<0.001]. Overall, 66% of the injuries in motorbike involved lower limb fractures. The highest proportion of motorbike accidents were observed on Saturdays [31%]. Majority of the accident victims were in the age group between 16 and 30 years [41% accident cases], 27% in age group 30 to 45 years, 15% in 45 to 60 years and 5% in >60 years. Those with less than 15 years accounted for 12% of cases. Tibial bone is at the greatest risk in motorbike accidents probably due to its superficiality and exposed position while riding motorbike. Protective measures need to be taken for the prevention of disability associated with lower limb involvement in motorbike accidents

Cleaning methods for ultrasound probes

To determine the effectiveness of three different methods of ultrasound probe cleaning for the prevention of nosocomial infections. Experimental study. Radiology Department, the Aga Khan University Hospital, Karachi and Microbiology Department, JPMC, Karachi, from December 2006 to April 2007. A total of 75 culture swabs from ultrasound probes used for sonographic examinations of different body parts of patients were included in the study. Probes were prospectively randomized into three equal groups with 25 probes in each group. Culture was sent before and after using three different techniques of cleaning ultrasound probe, which included sterilized paper towel, 0.9% saline and swipe over with standard bath soap applied on group A [n = 25], group B [n = 25] and group C [n = 25] respectively. Number of Colony Forming Unit [CFU] of bacteria were calculated on standard agar plate to find out the effectiveness of cleaning methods in reducing bacterial count from the ultrasound probe after the procedures. All samples were tested in single microbiology lab by using same bacterial growth media provided by same manufacturer. Kruskall Wallis, Jonchkheere-Terpstra and Wilcoxon sign rank tests were applied to find out statistical significance. There was a significant reduction in bacterial count after applying either of all three cleaning methods for ultrasound probe compared to count on the probes before cleaning [p < 0.001], however, soap cleaning method was the most effective in decreasing bacterial count to the minimum level in comparison to other two methods [p < 0.001]. The overall reduction in pathogenic bacterial count after performing each cleaning method was 45%, 76% and 98% for paper cleaning, normal saline and soap cleaning method respectively. Cleaning ultrasound probe after performing each procedure is a cost-effective practice with potential of reducing nosocomial infections. Soap cleaning technique is the most effective method for reducing bacterial count acquired due to patients' body contact with the ultrasound probes