Incidence Of Road Traffic Accidents Research Articles

Refractive error and abnormal stereopsis association with road traffic accidents in Saudi Arabian truck drivers

Abstract PURPOSE: To investigate the visual functions of truck drivers of the Kingdom of Saudi Arabia (KSA) in the region of Qassim and Dammam and to see if is there any association between these visual functions and self-reported road traffic accidents (RTA). METHODS: It is a cross-sectional, descriptive study. LogMAR visual acuity, refractive error, color vision, stereopsis, and confrontation visual fields were measured in 300 truck drivers in the Qassim and Dammam regions of KSA. Driving-related history and incidence of RTA from the past 3 years, systemic history, and general eye compliance history were collected through a self-reporting questionnaire. RESULTS: Among 300 truck drivers examined, 54 (18.4%) subjects have a refractive error, 14 (4.7%) subjects have color vision deficiency, 37 (12.2%) subjects have abnormal stereo acuity, and none of them have confrontation visual field defect. RTA was reported in 25 (8.3%) subjects. The current study has found RTA is significantly associated with refractive error (P = 0.01) and abnormal stereopsis (P < 0.01). Systemic history revealed that 11% of the subjects had diabetes mellitus. CONCLUSION: The current study is the first to report on the visual functions of KSA truck drivers. Hence, the current study has found a significant association between visual functions and RTA among truck drivers, we recommend a comprehensive examination need to be part of issuing driver’s licenses in KSA. More studies with larger samples from different regions of KSA are needed to extrapolate these findings.

Economic Burden of Accidents and Injuries in India: What Does 75th Round of National Sample Survey Imply?

Accidents and injuries constitute a sizable share of mortality and morbidity in low- and middle-income countries. This affects the most productive age group and increases disability-adjusted life years (DALYs). It results in a substantial financial burden on the households. To explore the economic burden of accidents and Injuries on Indian households and to find how the catastrophic health expenditure (CHE) from accidents and injuries affects the population. Another objective is to explore Catastrophic out-of-pocket expenditures (OOPE) patterns and distressed financing of households in India. The study used data from the 75th round of nationally representative surveys, that is, the National Sample Survey (NSS). Authors have analyzed the data using descriptive binary logistic regression analysis to estimate the rate and average days of hospitalization, average OOPE, and share of the population experiencing the catastrophic impact from the health expenditure separately from the public and private healthcare institutions. The study observed that hospitalization in the private sector imposes 72% of households incur CHE at more than 10% cut-off and 41% at more than 25% cut-off. In comparison, it is less in the public sector, with 22% of households incurring CHE at more than 10% of annual per capita household income and 9% at more than 25%. The increasing incidence of road traffic accidents (RTA) is a concern for the overstretched health system. The government should provide better healthcare facilities and universal health insurance coverage to ensure patients' speedy recovery and financial security.

Visual Functions, Seatbelt Usage, Speed, and Alcohol Consumption Standards for Driving and Their Impact on Road Traffic Accidents.

The incidence of road traffic accidents (RTAs) is dramatically increasing worldwide. Consequently, driving and licensing authorities have instituted strict rules and regulations, such as vision standards, restrictions on drunk driving, seat belt usage, and speeding, for driving safety. This study aimed to summarize the global visual standards for driving license issuing and renewal and investigate the effect of driving safety laws on RTA-related death rates in different countries. The study gathered data on visual standards for driving licenses from reliable sources and extracted enforcement scores (drunk driving, seat belt usage, and speeding) and RTA-related death rates from the World Health Organization status report on road safety. The Wilcoxon test explored the association between visual standards and RTA-related death rates, while the Kruskal-Wallis test analyzed the relationship between visual functions and death rates, as well as driving safety enforcement scores and RTA-related death rates. The analysis was conducted on 71 countries and 50 states within the United States out of the 193 countries listed by the United Nations. It was found that 116 countries and states required a minimum VA range of 6/6-6/18, while 91 countries and states mandated a similar range for one-eyed drivers. VF testing for driving licenses was necessary in 77 countries and states. No significant association was observed between VA or VF testing and RTA-related death rates. However, countries that conducted more visual function tests demonstrated lower rates of RTA-related fatalities. Furthermore, RTA-related death rates were significantly associated with speeding, drunk driving, and seat belt laws. Implementing clear policies regarding vision requirements, maintaining strict rules, and promoting law enforcement on speeding, drunk driving, and seat belt usage are crucial for improving road safety. These measures should be prioritized by driving and licensing authorities worldwide to mitigate the escalating incidence of RTAs.

24 h mortality and its predictors among road traffic accident victims in a resource limited setting; a multicenter cohort study

IntroductionThe incidence of road traffic accidents (RTAs) is on the rise contributing to the global burden of mortality as a major global health threat. It has been estimated that 93% of RTAs and more than 90% of the resulting deaths occur in low and middle income countries. Though death due to RTAs has been occurring at an alarming rate, there is paucity of data relating to incidence and predictors of early mortality. This study was aimed at determining the 24 h mortality and its predictors among RTA patients attending selected hospitals in western Uganda.MethodsThis was a prospective cohort that consecutively enrolled 211 RTA victims admitted and managed in emergency units of 6 hospitals in western Uganda. All patients who presented with a history of trauma were managed according to the advanced trauma life support protocol (ATLS). The outcome regarding death was documented at 24 h from injury. Data was analyzed using SPSS version 22 for windows.ResultsMajority of the participants were male (85.8%) aged 15–45 years (76.3%). The most common road user category was motorcyclists (48.8%). The 24 h mortality was 14.69%. At multivariate analysis, it was observed that a motorcyclist was 5.917 times more likely to die compared to a pedestrian (P = 0.016). It was also observed that a patient with severe injury was 15.625 times more likely to die compared to one with a moderate injury (P < 0.001).ConclusionThe incidence of 24 h mortality among road traffic accident victims was high. Being motorcycle rider and severity of injury according to Kampala trauma score II predicted mortality. Motorcyclists should be reminded to be more careful while using the road. Trauma patients should be assessed for severity, and the findings used to guide management since severity predicted mortality.

Outcome of Depressed Cranial Fracture: A single centre Experience of 490 Cases with short literature Review

Introduction: Depressed cranial fractures (DCFs) are one of the serious head injuries where road traffic accident (RTA) is the most common cause. So, we have assessed the outcome in surgically managed cases of depressed cranial fracture following head injury and study the factors which may affect the surgical outcome of patients. Materials and methods: A retrospective assessment of 490 consecutive cases was undertaken who went surgery for depressed cranial fracture (DCF) in Department of Neurosurgery, Neuro-Cardio and Multispecialty Hospital, Biratnagar, Nepal, from January 2011 to December 2021. All age groups (except&lt; 1 year) were included in this study and diagnosis confirmed by CT scan of brain with bone window. Outcome was assessed by Glasgow outcome scale. Results: The incidence of depressed cranial fracture was highest in road traffic accident (RTA) and in the age group of 20-40 years. There was predominance of male over female with ratio 5.53:1. There was a significant correlation between age, mode of injury, fracture site, GCS at admission and intracranial bleed with outcome. Similarly, the complications such as CSF leakage, seizure were significant association with outcome. Of all 490 cases, most of them were operated within 5 hour with overall mortality rate of 0.40%. Conclusions: Our study concluded that patient who underwent surgery for DCFs, with GCS &gt;13 at the time of admission, age &lt;40 year and no hospital delay (&lt;5hour) had better outcomes. Incidence of RTAs was noted comparatively higher rate in age 20-40 year, which can help us to find out best strategic management option.

Prevalence of Anxiety and Depression among Orthopedic Trauma Inpatients

Background and aim: Orthopedic trauma patients experience anxiety and depression, both of which are undesirable psychological issues. The present study aimed was to determine the prevalence of anxiety and depression. Material and Methods: This cross-sectional study was conducted on 188 orthopedic trauma patients in Orthopaedics Department of Federal Govt. Polyclinic Hospital (FGPC) Islamabad and Wah Medical College / POF hospital Wah Cantt from October 2020 to September 2022. Prior to study conduction, ethical approval from research and ethical committee was taken. Informed written consent was obtained from each individual. Social characteristics, demographic details, and clinical examination were recorded. Hospital anxiety and depression scale (HADS) was used for the assessment of patient’s anxiety and depression. SPSS version 26 was used for data analysis. Results: Of the total 188 patients, there were 112 (60%) male and 76 (40%) females. The overall mean age was 46.82 ± 12.94 years with an age range (15-75 years). Age-wise distribution of patients was as follows: 56 (29.8%) in 15-30 years, 44 (23.4%) in 31-45 years, 38 (20.2%) in 46-60 year, and 50 (26.6%) in 61-75 years. Out of 188 orthopedic trauma patients, the incidence of road traffic accident (RTA) and ground fall was 96 (51.1%) and 92 (48.9%) respectively. The incidence of anxiety and depression before and after orthopedic surgery was 22 (11.7%) and 32 (17%) and 36 (19.1%) and 46 (24.5%) respectively. Anxiety and depression on HADS was 4.12 and 5.21 before surgery and increased substantially to 4.62 and 5.81 after surgery. The incidence of single, double, and triple fracture was 162 (85.2%), 24 (12.8%), and 2 (1.1%) respectively. Conclusion: The present study found that orthopedic trauma in the elderly often leads to emotional disorders. Anxiety and depression levels were low before surgery and increased after surgery in orthopedic trauma patients. However, age, poverty, and gender are directly related to anxiety and depression. Patients with geriatric disorders should be monitored closely by clinicians. Keywords: Orthopedic trauma, Psychological problems, anxiety, depression

Treatment of Diaphyseal Fractures of the Femur in Paediatric Age Group: A Comparative Study of Locking Compression Plate Versus Titanium Elastic Nailing System (TENS).

Background: Diaphyseal femur fractures are commonly seen in the paediatric age group as there is an increase in the incidence of road traffic accidents. Titanium elastic nailing system (TENS) and plating are the common methods used for paediatric long bone fracture fixation. The purpose of our study was to evaluate and compare functional and radiological outcomes of paediatric femur diaphyseal fractures treated with locking compression plates and with TENS.Methods: Our study included 59 patients diagnosed with femur shaft fracture. Twenty-eight patients included in group one underwent open reduction and internal fixation with locking compression plates and 31 patients in group two underwent open reduction/closed reduction with intramedullary TENS. All post-operation patients were evaluated at four, eight, 10, 12, 16, 20, 24, and 36 weeks. The functional outcome was assessed based on the Flynn scoring system and radiological union based on fracture union on X-ray.Results: We analyzed our data using the Flynn scoring system. In group one, out of 28 cases treated with locking compression plates, 25 (89%) were excellent, two (7.5%) were satisfactory, and one (3.5%) was poor. In group two, out of 31 cases treated with intramedullary TENS, 26 (83.8%) were excellent and five (16.2%) were satisfactory. In our study, the average union time in group one was 11.4 weeks and in group two was 14.41 weeks. Fracture union was 100% in both groups.Conclusion: In our study, we noted that the union of the femur shaft was early with the use of locking compression plates. In TENS, there was less intraoperative blood loss, very minimal postoperative scar, and less soft tissue damage. Also, implant removal was easier compared to locking compression plates.

Electroconvulsive Therapy and Risk of Road Traffic Accidents: A Danish Register-Based Cohort Study.

The aim of the study is to examine whether electroconvulsive therapy (ECT) was associated with the subsequent risk of being involved in a road traffic accident. A cohort of all 375,435 patients older than 18 years with their first psychiatric hospital contact between 2003 and 2017 in the Danish National Patient Registry was followed for road traffic accidents until December 2018. Associations between ECT and road traffic accidents were examined using Cox regression analyses with multiple adjustments and using propensity score matching on sociodemographic and clinical variables. A total of 8486 patients (0.2%) were treated with ECT. During the median follow-up of 5.9 years, 778 of these patients (12.5%) were involved in a road traffic accident and the unadjusted incidence of road traffic accidents was lower among these patients (incidence rate, 15.5 per 1000 patient-years; 95% confidence interval [CI], 14.5-16.7) compared with patients not treated with ECT (incidence rate, 20.0 per 1000 patient-years; 95% CI, 20.0-20.3). Electroconvulsive therapy was not associated with road traffic accidents in the Cox regression models after adjustment for all covariables (hazard ratio, 1.00; 95% CI, 0.92-1.08) or in the propensity score-matched sample (hazard ratio, 0.91; 95% CI, 0.83-1.08). The HRs did not vary materially with follow-up time or when analyses were stratified on sex, age, or type of hospital contact. The analysis of Danish National registry data indicates that ECT is not associated with the risk of being involved in major road traffic accidents.

An Epidemiological Study of Road Traffic Accident Cases Attending a Tertiary Care Hospital

Introduction: Road traffic accidents are a major global health problem. Incidence of road traffic accidents can be minimized by applying safety measures and following strict traffic rules and regulations.&#x0D; Aims: The main purpose of our study was to find out the socio-demographic profile of the victims involved in road traffic accidents and to provide epidemiological data.&#x0D; Methods: This is a hospital based, cross sectional study with victims of road traffic accidents attending to Nepalgunj Medical College, Kohalpur,a tertiary care center. Consecutive patients of road traffic accidents attending emergency department or admitted in wards (surgery, orthopedic or neurosurgery) were taken and information of injury pertaining to epidemiological factors and demographic profile along with time of occurrence of accident, type of vehicle involved, the pattern of injury, site of accident and part of body involved was collected on a pre-designed proforma.&#x0D; Results: Total patients enrolled in the study were 410.Majority of victims were young with age group of 10-19 years(18.5%). By gender male were more affected than female (67.8% versus 32.2%).Incident was more among married couple (61%). Majority belongs to Hindu by religion (96.1%). Regarding educational level majority have attained school level education (46.8%). By occupation majority were students (36.1%) followed by private employee (16.6%). Most of road traffic accidents were happened during summer season (65.4%). Regarding time most accidents were in between 6 PM10PM. Major site of accident was highway (63.4%). Among vehicle involved 4 wheelers were more common (65.4%).Head, neck and face region was found mostly injured in this study (33.2%). Most common type of injury was abrasion (30.7%) then followed by laceration (26.3%).&#x0D; Conclusion: Road traffic accidents can be minimized and it’s fatal consequences also preventable by strict enforcement of traffic rules and applying safety measures.

Spatio-temporal modeling of traffic accidents incidence on urban road networks based on an explicit network triangulation

ABSTRACT Traffic deaths and injuries are one of the major global public health concerns. The present study considers accident records in an urban environment to explore and analyze spatial and temporal in the incidence of road traffic accidents. We propose a spatio-temporal model to provide predictions of the number of traffic collisions on any given road segment, to further generate a risk map of the entire road network. A Bayesian methodology using Integrated nested Laplace approximations with stochastic partial differential equations (SPDE) has been applied in the modeling process. As a novelty, we have introduced SPDE network triangulation to estimate the spatial autocorrelation restricted to the linear network. The resulting risk maps provide information to identify safe routes between source and destination points, and can be useful for accident prevention and multi-disciplinary road safety measures.

Intensive Care Unit Management of Traumatic Brain Injury Patients

Head injury or traumatic brain injury (TBI) is considered an instant epidemic in the developed world. Head injuries account for one quarter to a third of all trauma-related deaths. According to the Global Status Report on Road Safety 2018, more than 1.35 million people were killed in a single year. Out of these, 90% of the casualties occurred in developing countries, and India contributes about 11% of the total share. Until the last decade, cardiac disease, cancer, and road traffic accidents were considered the leading causes of death in our country. It is predicted that if the incidence of Road Traffic Accidents continues at the present rate, then by the end of 2025, the head injury will become the most common cause of death worldwide. The head injury patients pose a unique challenge to the treating physicians in the early period of hospitalization and the later duration of follow-up. The primary role of intensive care management is preventing and treating intracranial hypertension, which causes derangement in cerebral perfusion pressure (CPP), thereby preventing secondary brain injury. In the present review, we discuss the effective management of TBI in the critical care unit.

A prospective observational study of functional outcome of pott’s fracture managed with operative modalities

Introduction: The movement around the ankle joint is very important because of the cultural practices, which involve squatting and sitting cross-legged. Bimalleolar Pott’s fractures are very common in ankle joint injuries because of the increased incidence of road traffic accidents and industrial trauma. Accurate reduction of fractures around the ankle joint is important for a painless ankle joint. AIM: To study the functional outcome of surgically managed closed bimalleolar fractures of the ankle in adults; to evaluate the restoration of the anatomy of malleoli and ankle perfectly by operative treatment with internal fixation; to assess the union of fractures after surgical management; and to achieve stable fixation and early mobilization of the ankle. Materials and Methods: We have evaluated clinical, radiological and functional outcomes of 50 patients treated with different treatment modalities, which include - tension band wiring (TBW), Kirschner (K)-wire, malleolar screw (MS) and cannulated cancellous screws (CCS) for medial malleolus fracture and rush nail, one-third tubular plate, fibular locking plate for lateral malleolus fracture. Results: The present study of 50 patients with ankle fractures treated by open reduction and internal fixation. Excellent results were achieved in 27 (54%) patients, good in 14 (28%), Fair in 5 (10%) and Poor in 4 (8%) patients. The patient with poor results had mild pain with activities of daily living, diminution in the abilities to run and to do work, the reduced motion of the ankle and narrowing of joint space.Conclusion: Closed treatment is often inadequate for restoring the proper biomechanics and anatomical structure of an injured ankle joint, internal fixation is an excellent method. Treating malleolar fractures with the use of anatomic fixation and open reduction was found to be very effective.

Basic life support, a necessary inclusion in the medical curriculum: a cross-sectional survey of knowledge and attitude in Uganda

BackgroundUganda continues to depend on a health system without a well-defined emergency response system. This is in the face of the rising cases of out-of-hospital cardiac arrest contributed largely to the high incidence of road traffic accidents. Non-communicable diseases are also on the rise further increasing the incidence of cardiac arrest. Medical students are key players in the bid to strengthen the health system which warrants an assessment of their knowledge and attitude towards BLS inclusion in their study curriculum.MethodsA descriptive cross-sectional study was conducted in 2021 among undergraduate medical students across eight public and private universities in Uganda. An online-based questionnaire was developed using Google forms and distributed via identified WhatsApp groups. Chi-square or Fisher’s exact test and logistic regression were performed in STATA 15 to assess the association between knowledge of BLS and demographics. P < 0.05 was considered statistically significant.ResultsOut of the total 354 entries obtained, 351 were analyzed after eligibility screening. Of these, (n = 250, 71.2%) were male less than 25 years (n = 273, 77.8%). Less than half (n = 150, 42.7%) participants had undergone formal BLS training.Less than a third of participants (n = 103, 29.3%) had good knowledge (≥ 50%) with an overall score of 42.3 ± 12.4%. Age (p = 0.045), level of academic progress (p = 0.001), and prior BLS training (p = 0.033) were associated with good knowledge. Participants with prior training were more likely to have more BLS knowledge (aOR: 1.7, 95% CI: 1.1–2.7, p = 0.009).The majority (n = 348, 99.1%) believed that BLS was necessary and would wish (n = 343, 97.7%) to have it included in their curriculum.ConclusionsUndergraduate medical students have poor BLS knowledge but understand its importance. Institutions need to adopt practical teaching methods such as clinical exposures, field experience in collaboration with local implementers, and participating in community health promotion campaigns.

PATTERNS AND SEVERITY OF MAXILLOFACIAL INJURIES IN VICTIMS OF MOTORBIKE ACCIDENTS AND THEIR RELATIONSHIP TO ALCOHOL CONSUMPTION

Abstract Introduction Trauma is a leading cause of morbidity and mortality worldwide. Motorbike riders have the highest incidence of road traffic accidents. The maxillofacial region is highly vulnerable to such incidents. Injuries to this region can lead to severe bleeding and airway compromise. Not wearing a helmet and drug intoxication can increase the risk of accidents and their complications. Patterns and severity of these injuries vary with road conditions, speed and type of impact. Aims and Objectives: The current study intends to assess the patterns and severity of maxillofacial injuries among intoxicated and non-intoxicated victims of motorbike accidents. Materials and Methods: The present study was a single-centre, Prospective Observational study conducted on patients admitted into the emergency medicine department with suspected maxillofacial injuries to motorbike accidents at PESIMSR Hospital, Kuppam, from October 2018 to July 2020. Results There was a clear male preponderance with 11 males for every female. Two-thirds of patients were aged between 25-and 50 years. Skid and fall and head-on-collision were common mechanisms of injury. Soft-tissue injuries like abrasions and lacerations were common injuries. Ninety-one patients had facial fractures, mostly involving the midface. Nasal bone fractures were most frequent. Of the 149 patients, 54 had an A.I.S. score of 1, 43 had 2, 21 had 3, 18 had 4 and 13 had 5. There was no significant difference in the severity or patterns of injuries in intoxicated patients. Conclusion Midface injuries are more common. Intoxication increases the risk of injuries. But it does not seem to alter the patterns and severity of injuries.

Profile of Medicolegal Cases in the Casualty Department of Government Medical College, Badaun, Uttar Pradesh

Medicolegal cases constitute a significant proportion of the emergencies brought to the casualty department of the hospital. Profiling of these medicolegal cases is an excellent strategy to speculate the kind of case load in a specific region and to strengthen the health care services of the concerned hospital accordingly. With this insight a hospital based study was conducted in the Government medical college of Badaun to determine the common causes of the medicolegal cases in the inhabitants of this region. Aprospective study was conducted in the casualty department of the hospital and all the medicolegal cases which presented from 15 September 2019 to 15 January 2022 were studied thoroughly. Gender analysis revealed preponderance of male cases (72.01% ) over female cases (27.9%). Majority of the patients were in the age group of 21-30 years (35.57%). Maximum medicolegal cases were of RTA(51.89%), followed by Poisoning(15.45%) and assault (13.41%). Maximum cases were reported between 12 p.m. to 6 p.m. (44.6%). The present study highlights the profile of medicolegal cases in Badaun region which clearly shows a very high incidence of road traffic accidents. In all trauma cases whether they are due to RTA, farm related injuries, thermal injuries, etc. the outcome can be improved firstly by injury prevention education, secondly by providing appropriate emergency medical care in well-equipped trauma centres associated with the hospital.

Impact of Eyes and Visual Functions in Safe Driving

Driving is a high level of visual functions demanding occupation. The relationship of good visual function and driving safety are innately and unarguably linked and have a direct bearing on the incidence of road traffic accidents. A more practical approach to improve the efficacy of vision screening at licensure is to examine visual acuity screening test supplemented by other types of screening tests like contrast sensitivity, visual field, binocularity, color vision, processing speed, light and dark adaptation etc. These clinical tests have a large evidence basis for their relevance to driver safety and should be mandatory for obtaining and renewing the driving license. The individual who failed the initial screening should undergo a protocol based comprehensive evaluation by an Ophthalmologist or Optometrist if fit to drive in future. Visual acuity and other visual functions requirements for driving vary from country to country though most countries mandate visual acuity of 20/40 in the better eye with horizontal visual field of 120 degrees. But there is variation regarding provision of color vision, binocularity, contrast sensitivity and night vision tests. Nepal yet , has not strict rules regarding evaluation of visual functions for safe driving. But indeed, a local expert review board should determine the suitability to issue a normal driving license or a restricted driving license, a temporary or a permanent denial for those who partially or completely failed the vision specific requirements. Moreover appropriate modification of the existing laws and expedited implementation are mandatory to minimize visual functions related road traffic accidents which is an avoidable cause of mortality and morbidity.

A Multicentric Prospective Study on Maxillofacial Trauma Due to Road Traffic Accidents: The World Oral and Maxillofacial Trauma Project

Abstract The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide. Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis. Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P &lt; 0.001). This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.

TRENDS AND CHARACTERISTICS OF ROAD TRAFFIC ACCIDENTS IN OSUN STATE, SOUTH WEST NIGERIA

Road traffic accident (RTA) is a growing critical issue globally, resulting in high casualties and fatalities, especially in developing countries. This study examines the magnitude and trend of RTA and the effectiveness of road traffic safety measures in Osun State, South West Nigeria. Data on road traffic accidents from 1992 to 2016 was obtained from Nigeria's Federal Road Safety Commission (FRSC) coupled with primary data acquired from 2,209 sampled households in six hierarchically selected cities through a multi-stage stratified random procedure. The study reveals a very high positive correlation (r = 0.97; p = 0.001) between road traffic accidents and the size of the cities. Trend analysis shows a gradual decline in accident and mortality rates but increasing injury rates. The study observed a relatively higher male involvement than females in RTA at the ratio of 3:1 and a relatively higher occurrence among civil servants (38.2%) and traders (27.6%) than other occupational groups. The study concludes that the incidence of road traffic accidents varies spatially, temporally, across gender and occupational divide and that safety measures employed do not have a significant impact in preventing its occurrence in the study area. It is recommended that safety culture should be encouraged among road users apart from strengthening the institutional framework responsible for transport safety.

Adolescent Riding Behavior During the COVID-19 Pandemic in Urban Area, Indonesia: A Cross-sectional Study.

According to police reported crash, in 2020 there have been 510 road traffic accidents among adolescents aged 16-25 years. The problem is that although restrictions on social activities have been implemented, 9.80% of accidents have caused deaths in Semarang City. There were many factors that influence the occurrence of road traffic accidents; one of those is the poor knowledge about safe riding behavior. The aim of this study is to determine the factors that contribute to the occurrence of road traffic accidents in adolescents during the pandemic. This was a cross-sectional study, collected data using an online questionnaire distributed to adolescents aged 15-20 years in Semarang City, Indonesia. It was distributed during February-April 2021. The data included participant's demographic information, riding behavior, and knowledge about safe riding. We analyzed using chi-square and logistic regression to determine the most influential factors. The sample included 725 participants with a mean age of 17.4 years (SD=0.97); 260 (35.9%) males. We have found that gender was associated with the incidence of road traffic accidents (AOR=1.455, 95% CI [1.048-2.020], P=0.025) after adjusting for experience road safety education, vehicle type, and knowledge of safe riding. It is necessary to carry out Road Safety Education efforts to male students during the pandemic to reduce the incidence of traffic accidents.

English

BACKGROUND One of the most common emergency diseases is traumatic vascular injury. The damage mechanism is linked to the environment and the time frame. The treatment of vascular injury is evolving in tandem with the passage of time. In short, vascular injury treatment ranges from simple to complex, and from simple to diverse. Patients suffering from vascular injury can now benefit from advanced medical equipment. Traditional treatments, on the other hand, continue to play an important role. It remains to be seen which treatment method will be adopted as the standard. Traumatic vascular injury is an emergency in surgery, mainly characterized by damage to veins and arteries. Haemorrhage (commonly from truncal vascular injuries) and ischemia (typical of peripheral arterial injuries) are the main clinical manifestations of vascular injuries. If vascular trauma has not been treated in time, it may cause disability or even death, especially for limb vascular surgery. There are many difficulties in diagnosis and treatment of vascular injuries, which have brought many challenges to the surgeons since the 20th century. Vascular trauma accounts for 3 % of all traumatic injuries. Vascular injury may lead to severe complications, so early diagnosis and timely treatment are critical. The purpose of this study was to assess the clinical profile of emergency extremity vascular cases at Trivandrum medical college. METHODS The demographic details, aetiology, mode of injury, limb and structures involved, concomitant injuries, clinical finding, delay in reaching trauma centre and surgical intervention done were recorded in a planned proforma and analysis was done. In this retrospective cross-sectional study, a total of 67 patients with extremity vascular emergencies referred to and called for intraoperative assistance in cardiovascular and thoracic surgery, Trivandrum Medical College over a period of 2 years from January 2018 to December 2019were included. RESULTS The mean age was 44 (SD 16.2) years with male to female ratio being 10.1 : 1.0. Trauma was the most common aetiology of vascular emergency (76.1 %). Out of the total study population, lower extremity emergencies (82 %) were high compared to upper extremity emergencies (18 %). Popliteal and superficial femoral arteries were the most common sites of injury in lower extremity, whereas radial and brachial arteries were the most common arteries involved in the upper extremity. Vessels were seen contused in majority of patients (46.3 %) followed by thrombosis, transection and rupture. No patients presented with venous injuries. But tendon and nerve injuries were present in 36 patients (53.7 %). Average time delay in reaching trauma center was 3 hours. Simple injuries to arteries were repaired with simple stitches as direct repair in 2 patients (2.99 %) and end to end anastomosis was done in 19 patients after resecting the injured segment. CONCLUSIONS Majority of the affected patients belonged to younger age group with trauma being the predominant aetiology. This may be due to the increase in incidence of road traffic accidents and other industrial accidents. Road safety measures are needed and awareness among public should be increased to reduce these types of injuries. All patients presented to our centre could be managed by performing emergency vascular surgeries, owing to timely reporting to hospital and by better use of imaging modalities. KEY WORDS Extremity Vascular Surgery, Anastomosis, Embolectomy