Mechanical Injury among Medicolegal Cases in the Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: A medico-legal issue arises whenever an injured person visits a hospital. Therefore, all physicians who treat such patients have a legal duty to accurately document injuries as part of medical treatment. The study aimed to find out the prevalence of mechanical injury among medicolegal cases in the Department of Emergency in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Emergency Department of a tertiary centre from May 2018 to April 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number: 356). Convenience sampling method was used among patients who met the eligibility criteria. All relevant data were extracted using hospital records. Point estimate and 95% Confidence Interval were calculated. Results: Out of 3486 medicolegal cases registered in the Department of Emergency, 856 (24.55%) (28.37-29.96 at 95% Confidence interval) were cases of mechanical injuries. Males 616 (71.96%) outnumbered females for all types of mechanical injuries. Road Traffic Accident 527 (61.56%) was the leading cause of injury and lacerations 351 (29.52%) were the most common pattern of injury. The majority 628 (73.36%) of the injuries were simple in nature. Conclusions: The prevalence of mechanical injuries among medicolegal cases was similar in our study compared to other studies done in similar settings. The majority of the injuries were caused by traffic accidents, which could have been prevented if a safe system approach to road safety was followed. Keywords: accidents; documentation; forensic medicine; injuries; Nepal.

Pesticide Poisoning among All Poisoning Cases Presenting to the Emergency Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Acute pesticide poisoning is a significant global public health issue that contributes to one of the leading causes of emergency department visits. There is no national data on the incidence of acute pesticide poisoning or the pesticides that cause deaths. The purpose of this study is to find the prevalence of pesticide poisoning among patients who presented to the emergency department with acute poisoning. METHODS: This was a descriptive cross-sectional study undertaken in a tertiary care hospital from April to September 2021 among patients who presented to the emergency department with acute poisoning. Ethical clearance was obtained from (reference number: 123/2077-78). Convenient sampling was done. Sociodemographic factors, types of poison consumed, route of consumption, reason, motive, and place of poison intake, time elapse in the presentation to the hospital were studied along with psychological factors associated with poisoning. Statistical analysis was done using Statistical Package for the Social Sciences version 23. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 85 cases studied, the prevalence of pesticide poisoning was 60 (70.58%) (61.28-79.88 at 90% Confidence Interval). Insecticides 41 (68.33%) was mainly responsible for poisoning with organophosphate compounds 33 (42.30%), being the commonest chemical constituent. Fifty-three (88.33 %) incidents occurred at home. Domestic disputes 26 (43.33%) were the main reason behind poison consumption and suicide 43 (71.66%) was the main motive. CONCLUSIONS: The prevalence of pesticide poisoning among all cases of poisoning presenting to the emergency department was slightly higher than studies done earlier in similar settings.