Incidence and pattern of bear maul injuries in Kashmir.

BACKGROUND: Injuries due to mauling by bears are rarely reported in the literature. The high incidence of such injuries in Kashmir, India, which is a valley surrounded by dense forests and is a habitat of Asiatic Black bears, urged us to undertake such a study in our department. MATERIALS AND METHODS: The study was conducted both retrospectively (January 1990-July 2005) and prospectively (August 2005-December 2007). RESULTS: A total of 417 cases were recorded and all the injuries were caused by black bears alone. Majority of the patients were young to middle-aged (96.8% of cases) and predominantly males (80.33%). The incidence was highest during July to November (76.82%), and most of the attacks (97%) occurred during daytime. Soft-tissue injury occurred in all 417 cases, bones were involved in 131 (31.41%) while the visceral organs were injured in four (12.94%) patients. The face (80.57%) was most common part of the body injured, followed by the head (54.67%), and all the patients had soft-tissue injury (100%). In spite of devastating injuries caused by bear maulings, the mortality rate was only 2.39%. CONCLUSION: Injuries due to mauling by black bear occur mainly between July and November. The young and middle-aged men have a higher tendency to be wounded. The face and head were the most commonly affected sites, while visceral injuries were rare. Mortality was low, and reconstruction of many of the injuries was challenging, often necessitating a staged procedure. Those living in villages close to black bear habitats may benefit from education related to the risk and severity of the attacks in the hope of reducing the number of injuries seen.

Isolated aglossia in a six year old child presenting with impaired speech: a case report.

INTRODUCTION: The most mobile organ of the body, the tongue is associated with various congenital anomalies; most of which are in association with many other systemic abnormalities. Rarely do they occur in isolation. Isolated aglossia, that we presented, is one of the more rare presentations. CASE PRESENTATION: Our patient is a 6-year-old male child of Asiatic origin from Kashmir (India), who was physically well built and mentally sound and presented with history of impaired speech. The patient had normal velopharangeal competence but absence of tongue which was replaced by a small mucus membrane projection near the floor of oropharangeal isthmus. The patient had no difficulty in feeding or taste sensation but he was unable to pronounce lingual consonants. CONCLUSION: Isolated aglossia is very rare condition explained on the basis of growth failure of lateral lingual swellings and tubercular impar. Such patients do not usually need reconstruction of tongue; as feeding, swallowing and taste sensations are usually intact and speech cannot be improved by reconstruction. However, malocclusion of teeth needs to be taken care of.