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.

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.

Outbreak of methanol fatalities in Jordan

To investigate methanol poisoning from a national forensic perspective in Jordan. From 1st January 2006 to 31st December 2006 a total number of 1388 autopsies were carried out at the National Institute of Forensic Medicine; the medico legal and toxicology reports were probed for methanol related deaths. Variables abstracted included age, sex, circumstances of death, admission to hospital, principle cause of death, and blood methanol concentration. Seventeen cases of fatal methanol intoxication were reported, representing a mortality rate of 0.3 per 100,000. All deaths occurred in the last quarter of the year 2006, and all victims were males. The major outbreak of 11 cases [64.7%] occurred in October. The victims mean age was 36 years [24-56 years], the age group 21 -30 years accounted for 35.3% of the total cases. Eleven cases were found dead, 4 were admitted to hospital before death and 2 cases were brought to the forensic medicine institution due to fatal road traffic accident. Methanol concentration ranged from 46 to 645 mg/dl [mean 306 mg/100ml], no ethanol or drugs of abuse were detected. As alcohol intake propagates within Jordanian community, a significant increase in the number of fatal alcohol poisoning is expected. Jordanian society lacks the public awareness regarding the grave consequences of methanol intoxication. A prompt medical, legal and education plan should be implemented as soon as possible to save lives, and eradicate poisoning outbreaks

Color blindness: forensic perspective.

Color vision deficiency is a condition in which certain colors can not be distinguished, and is most commonly due to an inherited condition. Being color blind does keep one from performing certain jobs and makes other difficult. Compared to persons with normal color vision, they have some trouble differentiating between certain colors, but the severity of the color deficiency is variable. Color blindness is normally diagnosed through clinical testing- Ishihara color test is one of the most common tests used. It is mainly useful for quick screening. From a practical stand point though, many protanomalous and deteranomalous people breeze through life with very little difficulty doing tasks that require normal color vision but in some professions a normal color vision is a necessary requisite. This article focuses on the forensic perspective of abnormal color vision and future research and guidelines for assessing an individual for colour vision.