Grievous Injury Research Articles

Workplace Violence in a Large Urban Emergency Department

Workplace violence (WPV) against health care workers (HCWs) is common and likely underreported. Reliable data on the incidence of WPV and its impact on victims are lacking. To prospectively define the frequency of WPV against HCWs in the emergency department (ED), examine whether HCW demographics are associated with increased risk, and explore the impact of these events on HCWs. This cross-sectional study was conducted over 2 months in 2023 (August 28 to October 22, 2023) in the ED of a large, urban, academic safety net hospital in the US. Participants included ED physicians, nurses, and other HCWs, who were asked to complete a brief so-called shift sheet for every ED shift worked during the study period. WPV as recorded on shift sheets. The primary outcome was the number of events per shift. Events were coded for severity (types 1-5) and gender- or race and ethnicity-related bias. Shift sheets asked for the participant's demographics and whether they experienced verbal or physical abuse during the shift. If so, they were asked to provide a description; rate the impact the event had on them; and indicate whether they felt the event was sexist, racist, or otherwise biased. Perceived impact was recorded, and demographic characteristics associated with the likelihood of experiencing WPV were explored using multivariable logistic regression analysis. Among 72 HCWs who participated in the study, 52 were female (72%). A total of 575 shift sheets were returned of an estimated 1250 possible (46%), with 155 events, including 77 type 1 events (50%; shouting, yelling, or insults), 29 type 2 events (19%; threats of physical or sexual violence, death threats, or use of slurs), and 39 type 3 events (25%; physical violence); there was a mean (SD) of 3.7 (1.9) shifts per 1 event. No type 4 or 5 events, which involve physical violence causing grievous injuries requiring medical attention and, in the case of type 5 events, permanent disability or death, were recorded. Ten events could not be coded. Sexist or racist bias occurred in 38 events (25%) and 11 events (7%), respectively. Participants reported how the event impacted them in 133 events. Of those, moderate or severe impact was reported in 32 (24%) and mild to no effect in 101 (76%). There was no association between self-reported impact and coded severity of events. In a multivariable logistic regression analysis, a higher likelihood of experiencing WPV on any given shift was independently associated with being in the nursing role (odds ratio, 3.1; 95% CI, 1.9-5.0) and being age 40 years or younger (odds ratio, 2.0; 95% CI, 1.2-3.5). In this cross-sectional study of HCWs in the ED, participants experienced WPV once every 3.7 shifts. The nursing role and younger age were associated with increased risk. These results highlight an urgent need to identify interventions to support and protect HCWs.

Frequency, Causes and Medico-Legal Aspects of Grievous Injury to the Eye after Physical Assault

Aims: A medicolegal report is prepared by the medicolegal officer in conjunction with an ophthalmologist in cases of physical assault claiming vision loss. The objective was to report the frequency and cause of grievous injury to the eye after a physical assault. Methods: This was a descriptive cross-sectional study, conducted in the Department of Ophthalmology of a tertiary care hospital in Pakistan from October 2019 to August 2022. A total of 378 medicolegal cases were reported in the ophthalmology outpatient. Among them, 285 patients of physical assault were included with consecutive sampling technique. Results: The mean age of the patients was 33.93±12.96 years. The mean reporting time to an ophthalmologist was 4.1±8.2 days. Simple and grievous injuries were found in 278 (97.5%) and 7 (2.4%) cases, respectively. Among the grievous injuries, 4 (57.2%) were close globe injuries and 3 (42.8%) were open globe injuries. Thirteen (4.5%) were malingers. Domestic violence was observed in 82 (28.8%) study subjects. Conclusion: The frequency of grievous injury to the eye is very low (2.4%) in patients with physical assault. The patients of assault-related grievous injury were mostly males, young age, low level of education, and doing manual jobs. Vitrolage with corneal melting, and firearm injury caused the grievous injury in open globe patterns. Vitreous hemorrhage, retinal detachment, macular hole, and secondary glaucoma were seen among close globe patterns. J Bangladesh Coll Phys Surg 2024; 42: 336-341

Black-Spot Identification from Ramol Cross Road to Kathwada Cross Road

Road accidents are a vital issue that is occurring all over the world. Accident severity is increasing with the exponential increase in vehicle population. Accident leads to disability, pain, suffering, grievous injuries, hospitalization expenditure, damage to health and property, social suffering, general degradation of the environment, and, in extreme cases, death. This study aims to identify black spots in the selected stretch involving four major intersections from Ramol crossroad to Kathwada crossroad of Ahmedabad. Data collection consists of collecting past accident data from traffic police station headquarters. The collected data are categorized into fatal accidents, grievous significant accidents, and minor accidents. The data is analyzed using the accident data collected, the Weighted Severity Index (WSI) method, and the PTV Visum software. WSI is estimated for the accident data for the year 2019-2023. By accident analysis, seven black spots were identified in this study. Inspecting the road stretch noted several issues and probable causes of accidents were identified. Poor road conditions, including cracks and potholes, affect road safety. Improper road markings and signs are one of the causes of accidents. The audited road stretch includes recommendations to prevent the number and severity of accidents.

Assessing functional, comfort and aesthetic needs of Indian male riders from motorcycle clothing

The number of motorcycle riders is growing at a phenomenal rate in India and so is the number of crashes involving them. The use of motorcycle protective clothing (PPE) is known to reduce the severity of soft tissue injuries to motorcyclists in the case of a crash. The PPE currently available in India is imported and not designed to meet the unique weather, road, and riding conditions prevalent in India. In this study, a conceptual framework based on Functional, Comfort and Aesthetic (FCA) requirements of motorcycle riders is proposed for the design of motorcycle PPE. Data regarding the FCA requirements of Indian riders was collected through a questionnaire. Riding habits, risk factors, factors affecting the buying decisions for motorcycle clothing, awareness regarding protection standards, satisfaction with currently owned motorcycling clothing and requirements of comfort and aesthetics from motorcycle clothing were studied. 217 Riders aged 18–45 years from 10 major Indian cities responded to the online survey questionnaire. Most riders reported facing heat stress, wet stress (dues to sweating), restricted mobility, and dissatisfaction with the fit of the currently available motorcycle clothing. Satisfaction with the available colours and styles was also reported to be low. The results of the survey show that currently available riders’ clothing is not as per requirements of Indian riders. It fails to provide adequate thermal comfort to users, which may compromise rider safety during long rides. Findings of this study can be used by motorcycle clothing designers and manufacturers to design clothing as per the requirements of Indian riders. Improved thermal and psychological comfort can improve rider focus, may contribute to crash prevention and protect the rider from grievous injuries during a crash.

Lactiplantibacillus plantarum JM113 alleviates deoxynivalenol induced intestinal damage by microbial modulation in broiler chickens

Deoxynivalenol (DON) contamination causes the grievous injury in public and animal health, poultry suffer from the greater toxin challenge. Probiotic have been considered as a potential way to mitigate the deleterious effects of DON. In this study, a total of 144 1-day-old Arbor Acres chickens were randomly assigned into 3 groups: control group, DON group (5 mg/kg DON diet), DJ group (1×109 cfu Lactiplantibacillus plantarum JM113/kg DON diet). The results showed that Lactiplantibacillus plantarum JM113 (L. plantarum JM113) increased the growth performance of 21-day-old broilers that challenged by the DON (P < 0.05), and the DON-induced disorder of jejunal morphology was recovered in DJ group (P < 0.05). Compared with the DON group, the mRNA and protein levels of Nrf2 and NQO-1 were upregulated in jejunum of DJ group broilers (P < 0.05). Meanwhile, administration of L. plantarum JM113 effectively increased the expression level of barrier-related genes, and the protein abundance of occludin and claudin1 (P < 0.05). L. plantarum JM113 restored the mRNA and protein abundance of PCNA, and proliferation-linked gene (Lgr5 and Bmi1) expression levels in jejunum of DON-insulted broilers (P < 0.05). Furthermore, administration of L. plantarum JM113 significantly enhanced the relative abundance of s_Limosilactobacillus_reuteri in jejuna of DON-challenged broilers (P < 0.05). Spearman correlation analysis showed that s_Limosilactobacillus_reuteri was positively associated with the jejunal barrier related genes (P < 0.05). In conclusion, L. plantarum JM113 alleviated the toxic effects of DON by regulating the jejunal function through microbial adjustment. Our findings proposed a viable approach to mitigating the adverse effects of deoxynivalenol exposure in broilers.

Genocide in Ukraine: problems of proof

The article emphasizes that genocide was first criminalized immediately after the Second World War, precisely in 1948 when the UN General Assembly unanimously adopted the Convention on the Prevention of Genocide. In terms of severity, it is undoubtedly the most serious crime for both peacetime and wartime, and it is also the most difficult to prove. First of all, it is argued that in order to establish the very fact of genocide, it is necessary to have the intention to destroy, in whole or in part, any national, ethnic, racial or religious group, as well as for this destruction to be carried out by killing, inflicting grievous injuries, creating intolerable conditions life, prevention of childbirth or forced transfer of children to another group. The main focus of the article is on the fact that crimes against humanity most often occur during war. In order for the underlying crimes—such as murder, torture, extermination, sexual violence, and other acts—to qualify as crimes against humanity, they must be part of a widespread or systematic attack on civilians. Unfortunately, trials for genocide and crimes against humanity take forever. An example is the events in Srebrenica, proceedings in several genocide cases are still ongoing. Genocide, as well as crimes against humanity, are most clearly defined in legal terms in the Rome Statute of 1998, which became the foundational document of the International Criminal Court. Both crimes were also included in the criminal codes of many countries, the Criminal Code of Ukraine (Articles 442, 437) was not an exception. However, until now, there is no responsibility for crimes against humanity in national legislation. Therefore, currently the criminal actions of the combatants can only be qualified as war crimes. Many states have integrated the crime of genocide into national legislation, but not all have used the UN definition. Many states have also included crimes against humanity in their criminal codes. It is quite clear that both genocide and crimes against humanity are systematic crimes, to prove which it is not enough to confirm with evidence the commission of individual acts. Both crimes are committed within a system, often wide-ranging, and both contain elements that require proof of relevant intent or awareness on the part of the perpetrators, for example, in the case of genocide, by proving that the perpetrators knew of an express or implied plan.

Analyzing the factors affecting the crash severity level at urban roundabouts in non-lane-based heterogeneous traffic

Pivotal crash factors are investigated, and crash-severity model for the safety assessment at roundabouts and its vicinity in non-lane based heterogenous traffic is developed. An ordered-probit model was developed using crash-data collected between 2015–2019 for 20 roundabouts in India. The analysis revealed critical influencing parameters for determining the severity-level of crash outcomes at roundabouts, namely, inscribed-circle diameter, height of central island, number of circulatory lanes, presence of splitter island and median, posted-speed limit, type of collision, type of violation behaviour, collision partner, the pattern of collision, presence of road lane-marking, presence of street-light and age of victims. To precisely quantify the impact of each significant factor, marginal effects analysis was also carried out. The results show that the probability of fatal-injuries increased by 14.28% due to angle-collision, 15% for hit-pedestrians, 20.6% due to the pattern of collision and 15.60% due to the collision-partner, Whereas the probability of occurrence of grievous injury was the highest for rear-end with 17%, followed by sideswipe collision with 16% respectively. This study’s findings can aid in developing effective remedies to reduce the crash severity for roundabouts road-users and updating the roundabout design standards, considering the safety perceptive.

Forensic analysis of fabricated long bone fractures for gain.

Self-inflicting injury is a recognised psychiatric disorder. Such cases are regularly seen in the emergency department, with a false history of assault. Most of these are easily detected by a forensic medicine expert as they present as described in literature but are difficult to explain if altered by professionals for nefarious reasons. This was a prospective study carried out at a tertiary centre. The data was collected and analysed from the office records of medico-legal reports prepared at our institute between 25 February 2022 and 25 February 2023. 21 cases were recorded, that met with our criteria. Most involved males (90.5%). Minimum age was 27 years and maximum age 66 years with a mean of 48.6 years and a standard deviation of ±11 years. Most offenders were unemployed (38.1%). Most fractured bone was tibia (47.6%). Left-sided fractures were more common (61.9%). Injuries corresponded with the findings on clothes in three cases (14.3%). Fabricated wounds will reflect the intentions of the fabricator and may range from superficial wounds to grievous injury. Only a critical analysis of all medico-legal cases will identify them, and they will have similarities of presentation. Such findings have rarely been reported in other parts of India. A diligently prepared medico-legal report and profiling of all cases can help establish patterns of such injuries.

Social Box: A New Housing System Increases Social Interactions among Stallions.

In domestic conditions, adult stallions are mostly housed individually in internal stables to reduce the risk of injuries during social interactions. Social deprivation in horses results in physiological stress and behavioural problems. The aim of this study was to test the "social box" (SB), which allows closer physical contact between neighbouring horses. Eight pairs of stallions (n = 16) were filmed over a 24 h period in the SB and in their usual box stables, "conventional boxes" (CB), which strongly restrict tactile contact. The effect of housing in the SB on behaviour and the occurrence and characteristics of injuries was investigated. The total duration of active social interactions was significantly higher in the SB than in the CB (51.1 vs. 4.9 min, p < 0.0001). Positive interactions accounted for about 71% of the total duration of interactions in SB and CB stabling. The stallions interacted significantly more often in the SB than in the CB (113.5 vs. 23.8 social interaction sequences over 24 h, p < 0.0001). No grievous injuries were recorded. The social box appears to be a suitable solution to give adult stallions the possibility of having physical interactions. Therefore, it can be considered a substantial environmental enrichment for singly housed horses.

Forensic characteristics of 4866 violent injury cases in Sichuan Province, China

To evaluate the characteristics of violent injury cases in Sichuan Province, China. Overall, 4866 violent injury cases in Sichuan province, China from 2014 to 2017 were included. The injury evaluation report was used to classify and summarize the injury information, case and injury characteristics, and to describe the characteristics for each risk factor. The majority of cases were males (n = 3851, 79.14%), aged 20–60 (n = 3867, 79.47%), and living in rural areas (n = 3094, 65.55%). Many cases occurred in public areas (n = 3351, 74.19%) and in the evening (n = 1005, 29.49%). Passion was the main motive for the violent injuries (n = 2098, 82.11%) and the main types of injuries were those to the brain, face, and auricula (n = 3075, 63.21%). Blunt instruments (n = 2951, 64.86%) were most commonly used to inflict injury, and the injury evaluation determined that the majority of injuries were simple (n = 2669, 54.85%) and slight (n = 1685, 34.63%). For cases resulting from passion and money, blunt instruments were more commonly used, while sharp instruments were more commonly used for injuries resulting from emotion and revenge (p < 0.05). Compared with grievous injuries, public and entertainment areas and the use of blunt instruments were risk factors for slight injuries. The use of blunt instruments was a risk factor for simple injuries. The cases of violent injury in the Sichuan Province of China have certain characteristics and causes. In order to reduce the frequency of such cases, corresponding intervention measures should be actively conducted at the identified high risk places, times, and populations.

Modeling of crashworthy foam mounted braced unreinforced brick masonry wall and prediction of anti-blast performance

Explosions are continually occurring in many parts of the world endangering human lives and seriously affecting the health of infrastructures and facilities. Low-rise buildings having a height of fewer than 13 m are load-bearing structures generally made of unreinforced masonry (URM), particularly in semi-urban areas, villages, and war-prone border areas. Many structures of importance including buildings constructed in the pre- and post-independence era of courts, monuments, etc., are masonry load-bearing structures. URM is also used as non–load-bearing partition walls and compound/boundary walls. Such walls are susceptible to out-of-plane blast loading. Under such loadings, these walls fail to survive and thus either get severely damaged or collapsed, jeopardizing the stability of the entire structure. Resistance of masonry walls against blast loading is vital for the safety of the building and its users as injuries sustained and casualties are generally not caused due to explosion, but by the brittle dynamic fracture and fragments of masonry walls, window glass panes shattering, and other secondary objects propelled as missiles by the blasts. In general, buildings are not designed for blast loading. For the safety of the building users, it is imperative that the walls must withstand such short-duration high-magnitude extreme loadings without not only undergoing catastrophic collapse but also not producing deadly fragments which could cause grievous injuries to the users. To protect URM walls from high-intensity blast waves, an out-of-box wall protecting technique using foams of polymer (e.g., polyurethane) and metals namely; aluminum and titanium, is considered on the face of the wall exposed to the blast pressure. This study describes a numerical technique implemented in ABAQUS/Explicit software to predict the overall anti-blast performance of URM wall strengthened externally with the above three different crashworthy foams. For this purpose, a braced URM wall made of clay bricks, with two transverse bracing walls one at each end on the same side, tested experimentally by Badshah et al. in the year 2021 under the chemical explosive loads of 4.34 kg and 7.39 kg-TNT, respectively, at scaled distances 2.19 m/kg1/3 and 1.83 m/kg1/3 is considered as the reference model and is validated against the test observations. Explosion load is modeled with ABAQUS built-in ConWep simulation program to simulate the wall-explosion wave interactions in the free field. Material nonlinearities of the brickwork have been attributed to bricks, joint-mortar, and brick-mortar interfaces through constitutive laws considering strain-rate effects. The foams are modeled using ABAQUS’s inbuilt Crushable Foam Plasticity Hardening model considering foam hardening and rate-dependent schemes. Results show that the higher Young’s modulus and inelastic stiffness of the foams contribute to dissipating more explosion energy and improve the resistance of the walls from savage explosions.

Epileptic Psychosis-Endangering Human Life: Case Series and Review of Literature

Epileptic psychosis is a cerebral dysfunction that occurs or is further classified in temporal relation to the occurrence of a seizure. These phenomena, also called ‘epileptic mania’, can last for days to months, not only increase the caregiver's burden, but also statistically add to the morbidity and mortality of an epileptic patient. Its symptoms can vary and fluctuate from a mild degree of confusion and delirium to a serious thought and perceptual disorder. The prevalence of psychosis increases drastically in patient with temporal lobe epilepsy or refractory epilepsy. Here we report seven such cases that have endangered human life in the form of self-harm or grievous injury to others.

Diagnostic and Management Challenges and Medico-legal Impacts of Multiple Dento-Alveolar Injuries: A Case Report

Dento-Alveolar Injuries (DAI) usually present with multiple trauma to many teeth and alveolar bones. Treatment protocols vary according to the type of injury. The prognosis is determined by the type of injury and adherence to the recommended treatment protocol. A pedestrian who has been knocked down by a motorcycle presented with an alveolar bone fracture where the plain radiographs implied to have root fractures. Meticulous clinical assessment together with confirmative investigation using Cone Beam Computerized Tomogram (CBCT) revealed the absence of root fractures. This enabled the implementation of a proper treatment protocol and a better prognosis for the affected teeth. It had a significant impact from a Medico-legal point of view as it determined the absence of root fractures and the presence of only alveolar bone fractures. Therefore, reduced the number of grievous injuries. Thus, it can affect the amount of punishment given to the motorcycle rider and the compensation given to the victim by the court.

Untargeted lipidomics and metagenomics reveal the mechanism of aspirin eugenol ester relieving hyperlipidemia in ApoE-/- mice.

Hyperlipidemia is induced by abnormal lipid metabolism, which can cause the occurrence of cardiovascular diseases and lead to grievous injury to health. Studies showed that AEE had a significant therapeutic effect on hyperlipidemia and is likely to be associated with the up-regulation of cholesterol 7-alpha hydroxylase (CYP7A1), the key enzyme for cholesterol conversion to bile acids, but no research confirmed whether the effect of AEE on hyperlipidemia was related to the gut microbiota and liver lipids. At the same time, more and more studies have shown that gut microbiota and lipids are closely related to hyperlipidemia. Hence, in this study, we investigated the effects of AEE on liver lipids through LC-MS-based untargeted lipidomics and the effects of AEE on gut microbiota based on cecal contents metagenomics by Illumina sequencing in HFD-induced hyperlipidemia ApoE-/- mice at the overall level. The results of lipidomics showed that AEE relieved hyperlipidemia by decreasing the concentration of 10 PEs and 12 SMs in the liver and regulating the pathways of glycerophospholipid metabolic pathway, sphingolipid signaling pathway, and NF-kB signaling pathway. The results of metagenomics concluded that AEE treatment changed the composition of gut microbiota and regulated the functions of lipid transport and metabolism, as well as the metabolism of bile acids and secondary bile acids. The results of the joint analysis between lipidomics and metagenomics showed that the abundance of Verrucomicrobia, Verrucomicrobiales, Candidatus_Gastranaerophilales, and Candidatus_Melainabacteria was significantly positively correlated with the concentration of SM (d18:1/18:0) and PE (16:0/18:1) in the process of AEE alleviating hyperlipidemia in mice. In conclusion, these results suggested that the effect of AEE on hyperlipidemia was closely related to the gut microbiota by the change of bile acids and liver lipids.

Assess the knowledge, awareness and practice of wearing seatbelts and helmet among the drivers of private vehicle who are visiting Moodbidri municipality

Main aim of the research is to assess the knowledge of wearing Seatbelt and Helmets among the drivers of private vehicle who are visiting Moodbidri Municipality. To assess the knowledge of traffic rules among the adult population. Also to assess whether the peoples are practicing the traffic rules. And the riders are aware about the government action if they are not obeyed the rules. Also having the aim of educating the people about Road-Traffic safety measures. By this research work finding out the cause of not wearing helmet and seatbelt or to know any particular reason behind refusing to wear Helmet and seatbelt while travelling in vehicle. Trying to find out the solution for reducing the fatal and grievous injury in Road-accident because of non-usage of seatbelt and helmet while riding the four-wheeler and two-wheeler vehicle.Also Aiming at Improvement of Hospital Set up and Arrangement of proper Emergency care unit in the hospital for the patient who are coming to hospital after RTA. Surgery and Medicine Department of the Medical Health Centers have to be improved to provide emergency-health care with all the equipments and all the setup for any procedures. A questionnaire was prepared regarding the knowledge of wearing seatbelt and helmet .Collected data was evaluated. The collected data was analyzed. Inference was obtained from the data obtained. By this study it was assessed that people are aware of most of rules and regulation of road safety meassures and their importance in preventing RTA but at the same time it was even noted that most of the people have paid fine for not following the Safety measures rules and regulations. From this it can be inferred that though people were aware about wearing seat belt and helmet it has not been practiced properly. Based on this further study can be made and reason for this can be assessed so as to implement the traffic rules properly.

Kite String Vascular Injuries

Introduction and Objectives: Vascular injuries due to kite string are uncommon but are associated with significant morbidities and mortality. With the increase in the sharpness of the string, the incidence of these injuries is on the rise not only to flyer but also to the innocent other people. We present our experience as there is a relative paucity of data and literature on this subject and suggest measures to control. Methods: Between January 2016 and January 2022, six patients suffered vascular injuries due to kite string (manja) and were admitted to the vascular unit of tertiary care center. The medical histories of the patients were reviewed retrospectively and analyzed. Initial treatment included hemorrhage control by direct pressure or packing and fluid resuscitation and airway establishment by intubation (if required). Neck injuries were divided into three zones. All patients were subjected to computed tomography angiography followed by emergency exploration and repair. Results: Males are most commonly affected. The most common age group affected was 3050 years. Majority of these patients were travelling on a two wheeler. The neck was most commonly involved with primarily venous injuries. Four patients had injuries in Zone II and one patient in Zone I. One patient had a deep laceration around the ankle with vascular and significant soft-tissue injuries. The injuries were of the jugular veins, external carotid artery, trachea and tibial artery, nerve, and tendoachilles (complete tear). All the major vascular injuries were either repaired or ligated. There was no major morbidity or mortality. Conclusion: Kite flying is a popular sport in the Indian subcontinent. Vascular injuries due to sharp string can lead to grievous injuries or may be fatal. This study attempted to enlighten these dangers and emphasize that potential threats have to be understood and addressed adequately.

Motorization Rate Resulting in a Road Traffic Accident an Epidemiological Audit of Injuries and Factors in the Medium-Scaled Cities of Punjab, Pakistan

Background: Motor vehicles are increasing exponentially day by day all over the world with a global increasing prevalence of road traffic accidents. This situation of mass motorization has affected developing countries like Pakistan as well. Due to a lack of popper legislation and implementation of the law, the RTA situation is worse and requires proper research of epidemiological factors and medico-legal evaluation of injuries. Purpose: To see the pattern of RTA injuries and various epidemiological factors influencing them in the medium-scaled city like Sargodha, Gujranwala, Sialkot, and Gujarat Punjab, Pakistan. Study design: It is a retrospective study to evaluate and assess the pattern, severity, and epidemiological factors concerning RTA injuries and their medico-legal relationship during four years period from 2016 to 2019 in the medium-scaled cities of Punjab, Pakistan. Nearly 300 cases were selected to get information on predesigned Performa from Hospital records of DHQ Teaching Hospitals of Sargodha, Gujranwala, Sialkot, and Gujarat. Method and materials: After collecting data on designed Performa, the information was collected about epidemiological factors, type of injuries, the pattern of injury, outcome of injury, and medico-legal outcome for furthering justice. A descriptive statistical method was applied for the analysis and evaluation of collected data. Furthermore, standard deviation, F-statistics, and Chitest p-value were also applied to see the association of epidemiological factors with RTA injuries. Results: In a total of 300 cases of road traffic accidents, the average age was found 28.5years of age with gender male in most of the cases (86%). The 15-35 years age group was identified in more than 70 % of cases with the majority of accidents being motorcyclists with pillion riders and pedestrians. The majority of victims suffered RTA injuries while crossing the roads and constituted 30.66 % of all the cases followed by the victims passing by the side of roads with 24 %. The head and neck injuries were the most affected in most of these cases followed by extremities injuries. Conclusion: Motorcyclists with pillion riders were mostly involved in road traffic accidents. Males in the age group 20-30 years were the most affected victims being the socially active age group involved in motoring. The grievous and life-threatening injuries are increasing resulting in a very high rate of mortality and morbidity in society. The study suggests strict legislation and proper implementation of health and safety measures to avoid high RTA rates. Keywords: Motorization, RTA, automobile accidents, grievous injuries, health &amp; safety measures.

“…It is impossible to endure the above mentioned serious matters and grievous injuries…” Misunderstandings between István II. Koháry, General-Captain of Fiľakovo and the Nobility (1667-1682)

In the 17th century Fiľakovo was not only the base for the royal garrison, but at the same time the fort was the seat of three counties: Novohrad, Pest-Pilis-Solt and Heves and Külső-Szolnok earlier fleeing before the Ottomans. By the common sense and the practical reason, we could believe that the dependency on each other, the mutual national interest and the patriotic solidarity would bring about cooperation between the border soldiers and the nobility. The stark reality was, however, that they could not agree: mutual accusations, disagreements, atrocities, severe debates — occasionally with the intention to kill — characterised the relationship of the Fiľakovo troops and the nobility residing or temporarily staying in the border castle. The main problem was the lack of supplies for the army. As the border soldiers did not receive their dues, they procured food and goods needed for their living and clothing from the nearby settlements in the county, which was ever so often violent. The county nobility was deeply harmed by the attacks of the soldiers that not only hindered their living, but they saw it as the derogation of their ancient noble rights and their sanctity, which they could not tolerate. As a result the nobility had to limit the privileges of the Fiľakovo border soldiers that the other party could not stand, either. The war between the two social strata both regarding themselves privileged precipitated in legal debates: who is to accuse and punish the guilty and captured border soldiers? who has the right to call to account and punish the guilty captured soldiers? whose jurisdiction is stronger and in what case? Heves and Külső-Szolnok County sent their representatives either together with other counties or on its own to Pál Esterházy, Ferenc Nádasdy, then from 1670 to Ádám Forgách, Chief Judge of Hungary, but they could have even presented their grievances to the Emperor. The other frontline of the confrontation between the two parties manifested in the use of violence. People were treated roughly by the soldiers due to the mutual conflict, but the village inhabitants instigated by the County Magistrate did not hold themselves back when capturing a soldier. This way, there were often human casualties. When a person of noble origin committed an atrocity, no matter how significant it was he was treated carefully and judgement was very slow. This is shown in the study through the case of Menyhért Ebeczky, the Deputy-Lord-Lieutenant of Novohrad County and Noble Judge of Heves and Külső-Szolnok County from 1678.

Evaluation of critical damage location of contact blast on conventionally reinforced one-way square concrete slab applying CEL-FEM blast modeling technique

Nowadays, accidental explosions in residential and factory buildings are common owing to poor maintenance and mishandling of fuel gas and chemical explosive appliances leading to grievous injuries and infrastructure damages. Contact blast on slabs using explosives is noticed as a simpler act of subversion as compared to other components of the building and is more damaging than a close-in blast. In general, damage caused by contact blast is localized in the form of concrete cratering, scabbing, and rupture of the reinforcement. A recently published state-of-the-art review on the performance of reinforced concrete (RC) slabs under contact and close-in explosion loading scenario by the authors (Anas et al., 2021b) reveals the common perception for the location of contact blast to cause maximum damage is the centroid of the slab. It develops a curiosity with sufficient interest to investigate the effect of the location of contact explosive charge on the damage response of the slab. Several numerical techniques such as empirical, ConWEP (semi-empirical), Smooth Particle Hydrodynamics (mesh-free method), and Coupled-Eulerian-Lagrangian (CEL) are in use for simulation of blast loading on structures. Current literature reveals that the CEL is the most advanced and realistic blast modeling technique. This study applies Coupled-Eulerian–Lagrangian (CEL) formulation with finite element method (FEM) using the dynamic computer code ABAQUS/Explicit-v.6.15 to investigate the performance of singly reinforced one-way spanning concrete slab subjected to concentric contact blast loading. The numerical model is validated with the experiment results in the open literature. The validated model is then employed to investigate whether or not the maximum damage is really caused by the central location of the contact blast. For this purpose, one-quarter of the slab with nine symmetrical points (or locations) of contact blast of explosive charge, which reflect the coverage of the entire slab, in contact with the top face of the slab is considered in the study. Two constitutive material models, Concrete Damage Plasticity and Johnson–Cook, with strain rate effects are used to simulate the non-linear behavior of the concrete and steel, respectively. The results reveal that the most critical location of maximum damage to the slab is along the line of symmetry parallel to the supports at an eccentricity of B/4 from the centroid of the slab, where “B” is the width of the one-way slab.

Profile of Accidental Fall Cases Presented at Casualty of a Tertiary Healthcare Center from Central India

Fall from height or accidental fall are the common injury which are reported to a casualty/emergency department of a tertiary care hospital. Injury pattern ranges from simple injury like abrasion to grievous injury or sometimes life threatening injury. Present study includes examination of 163 such cases which have been reported to casualty of medical college. These cases are analyzed on the basis of various parameters like age, sex, residential pattern, type of injury, causative agent, and medicolegal formalities done on them by the duty doctor. Aims and objective: To know the profile of accidental fall cases reporting to the casualty of medical college. Material and methods: Study done on 163 cases which were reported to the casualty/ emergency department of medical college. Data is collected from directly examining the patient and history was taken by interviewing the patient and their relative or accompanying person. The collected data then analyzed on various parameters as described in the study. Cases involve only accidental fall cases as per history given by patient or accompanying person. Result: The study shows more involvement of adult population, rural predominance, more involvement of upper limb injury, and hard and blunt object is most commonly involved and in very few cases injury report was asked by investigating agency for the investigation. Conclusion: Data of accidental fall should be maintained properly at casualty department by the medical officer because sometimes these case may have medicolegal issue and the investigating agency may ask the injury reports to the treating doctor.