Motor Vehicle Accident Victims Research Articles

Epidemiology and Prevalence of Musculoskeletal Disabilities Following Motor Vehicle Accidents in Aljouf Region, Saudi Arabia

Background and Objectives: Motor vehicle accidents (MVAs) are the leading cause of disability, particularly among young adults in Saudi Arabia. Persistent disabilities account for around 7% of all injuries attributed to MVAs in Saudi Arabia in the last twenty years. Limited studies on musculoskeletal disabilities following MVAs have been carried out in Saudi Arabia. This study aims to explore the epidemiology and prevalence of musculoskeletal disabilities in motor vehicle accident (MVA) patients in the Aljouf region, Saudi Arabia. Materials and Methods: This retrospective cross-sectional study evaluated all MVA victims treated in the Aljouf region, Saudi Arabia, from January 2020 to December 2022. A total of 3252 medical records were collected, with 731, 1197, and 1324 musculoskeletal injury cases per year, of which 88, 168, and 153 records from 2020, 2021, and 2022 were analysed, respectively. Results: The study found that patients aged 25–34 and 35–44 years were the most likely to experience disability following MVAs. The difference between age groups during a single year was statistically significant (p < 0.001). Most patients were male (89.8%, 82.7%, and 79.7%) during 2020, 2021, and 2022, respectively. The majority of injuries involved the upper extremities (38.6%, 36.9%, and 40.5%), followed by lower extremities (36.4%, 35.7%, and 34.6%), head and neck (21.6%, 26.2%, and 34.6%), thoracic region (20.5%, 24.4%, and 17%), and finally lumbosacral spine (6.8%, 5.4%, and 6.5%) during 2020, 2021, and 2022, respectively, with a significant difference for each year (p < 0.001). The study found a link between the likelihood of developing high disability grades and injury severity scores. The patients with very severe ISS ≥ 25 (OR: ∞ CI 95%: 39.81–∞; p < 0.001), severe ISS = 16–24 (OR: ∞ CI 95%: 20.90–∞; p < 0.001), and moderate ISS = 9–15 (OR: ∞ CI 95%: 1.2–∞; p = 0.02) were at greater risk of developing high grades of disability. Conclusions: This study highlighted the musculoskeletal disabilities in the Aljouf region following MVAs. Severe musculoskeletal disabilities were rare, but fractures were the most common following MVAs. More efforts should be directed towards education on early transportation and transfer to the nearest medical centres, seeking assistance immediately after MVAs for patient safety, and disability prevention.

Investigating palatal rugae diversity – a comparative analysis of Bilaspur and Nagpur regions

Forensic odontology plays a key role in person identification in case of mass disasters, criminal investigations, and ethnicity studies, and in identifying decomposed and disfigured bodies, fire victims, and victims of motor vehicle accidents. Rugoscopy is an important specialty, which has been an area of interest for many forensic odontologists. As palatal Rugae are present in all victims and resistant to change (aging, trauma, and so forth) so they act as an ideal for identification. Palatal Rugae are also named Plicae Palatinae transverse or Rugae Palatine. The Palatal Rugae are generally transverse ridges placed in the anterior part of the palatine mucosa. Palatal Rugae are resistant to thermal effects (heat and burn) and decomposition changes because of their internal position in the head. They are used in cases where dental identification is not possible and in patients where other body parts are burnt or decomposed.: Aim of the study is to identify and analyze different patterns of palatal rugae and gender differences in Bilaspur and Nagpur populations. : This study will include a total of 80 dental casts — 40 males and 40 females.: The analysis of palatal rugae concerning the number of rugae, shape, length, and unification will be done.

Ocular injuries associated with motor vehicle accidents: long term effects on quality of life.

To describe the prevalence and outcome of motor vehicle accidents-associated ocular injuries. A survey of patients who presented to the emergency room at a level 1 trauma center with motor vehicle accidents-associated ocular injuries. A patient questionnaire and review of clinical notes were conducted for all patients. Of 274 motor vehicle accident victims with ocular injuries who presented to the emergency room, 40 (15%) responded to the survey. Over half of them were driving a vehicle, and most reported wearing a seat belt or a helmet. Most ocular injuries were mild. The most common injuries were bone fractures, subconjunctival hemorrhage, eyelid involvement and corneal injury. Most respondents had no change in vision and perceived their ocular involvement as a minor part of their injury. Most respondents returned to work and to driving within a year. Our study sheds light on the details and extent of ocular involvement and the visual ability to perform daily activities following motor vehicle accidents.

Analysis of EU Countries’ Capabilities to Achieve Ambitious “Zero Victim” Vision in 2050

The objective of this research paper is to examine and assess the correlation between the economic expansion of European Union member states and the escalating rate of motorization, which subsequently leads to road accidents resulting in significant loss of life and injury. A statistical analysis of economic growth, the rate of motorization, and road incidents in EU member states from 2010 to 2020 constitutes the research methodology. The research paper employs a quantitative approach to analysis and comparison. The research paper demonstrates how an increase in the number of motor vehicles in EU member states contributes to road accidents and human mortality. Varying degrees of economic development are associated with disparities between the rate of motorization expansion and the decline in fatalities. Because the rate of increase in motor vehicle usage surpasses the decline in fatalities per motor vehicle at low-income levels. At increased levels of income, the opposite occurs. Practical Implications: This research paper illustrates the importance for road traffic safety authorities to be aware of safety performance indicators and to incorporate them into legislative deliberations in order to bolster the European Union’s “zero victims” objective and provide enhanced protection for motor vehicle accident victims. Originality – This paper examines the correlation between motorization rates and fatalities in various EU member states with varying degrees of economic development over the past few decades.

Motor-Vehicle Accidents Victims in Khartoum-Sudan; Identification and Analysis of Related Risk Factors, Safety Measures, and Injury Severity

Motor-Vehicle Accidents Victims in Khartoum-Sudan; Identification and Analysis of Related Risk Factors, Safety Measures, and Injury Severity

Abstract #1399280: Not Just an Accident: Early Diagnosis and Treatment of Insulinoma in a Motor Vehicle Accident Victim

Abstract #1399280: Not Just an Accident: Early Diagnosis and Treatment of Insulinoma in a Motor Vehicle Accident Victim

Roles and Responsibilities while Rethinking the Movement to Get Moving: Archives and Records in the Road Accident Fund

This paper reports on the findings of a Master of Information Science dissertation. The purpose of the study was to determine the Road Accident Fund’s readiness for electronic records. The study was qualitative, and a case study was used as the design for the investigation. Data were collected through document analysis. The findings revealed that two business units in the organisation have similar record-keeping mandates, which is confusing. Records Management forms part of the Information Governance unit at head office, while Correspondence and Document Management Services are responsible for performing records management functions in the regional offices. These business units do not form part of Information Governance, as is the case at head office, but are stand-alone regional units entrusted with records management. There is one such unit in every regional office across the country. The organisation has a central records manager who operates from the head office in Centurion. However, these regional records management business units exist and operate in isolation. As a result, there is dis-integration between paper records and the electronic processing of claims, which hinders the institution from providing timely services to motor vehicle accident victims. To improve its records management practices, the study recommended developing and implementing a records management programme, which will facilitate records management policy implementation and the development of standard processes and procedures within the organisation for managing paper and electronic records in an integrated manner.

Economic Reliable Arthroscopic Technique for Reduction and Fixation of Acute Acromioclavicular Joint Dislocation

Separation of the acromioclavicular joint (ACJ) is a common orthopaedic injury among athletes involved in contact sports and victims of motor vehicle accidents. ACJ disruptions are common in athletes. Treatment is guided by the level of injury; grade 1 and 2 injuries are managed nonoperatively. Grades 4-6 are managed operatively, whereas grade 3 is an area of controversy. Several operative techniques have been described to restore anatomy and function. We present a technique that’s safe, economic, and reliable in the management of acute ACJ dislocation. It allows intra-articular glenohumeral assessment and relies on a coracoclavicular sling. This is an arthroscopic-assisted technique. It entails a small transverse or vertical incision over distal clavicle 2 cm away from ACJ, which enables us to reduce the ACJ and maintain reduction with a k-wire, checked by the C-arm. Diagnostic shoulder arthroscopy is then performed to assess the glenohumeral joint. The rotator interval is liberated and the coracoid base is exposed, and PROLENE sutures are then passed anterior to the clavicle medial and lateral to the coracoid. It is the used to shuttle polyester tape and ultrabraid as a sling under the coracoid. A tunnel is then made in the clavicle, then one end of suture is passed through the tunnel whereas the other end remains anterior. Several knots are made to ensure it is secured, then the deltotrapezial fascia is closed as a separate layer.

Magnetic Resonance Imaging in Traumatic Brachial Plexus Injuries: A 6-Year Experience.

Background and Purpose: There is limited information in the literature on epidemiology of high-energy brachial plexus injuries evaluated with MR neurography (MRN). The aim of the present study is to describe the demographic characteristics of brachial plexus injuries secondary to motorcycle accident patients in the city of Fortaleza-Ceara, Brazil, and analyze the association of those data with the features of the brachial plexus lesions observed on MRN findings. Materials and Methods: A review of sixty medical charts and MRN findings of victims of motor vehicle accidents (MVA) in northeast, from November 2011 to November 2017. Demographic and imaging data collected included age, sex, laterality and level of the lesion and time interval between trauma and MRN examination. The MRN examinations were carried out on a GE 1.5T MR unit (Signa HDxT- General Electric, Milwaukee, USA) or on a Phillips 3T MR unit (Philips Achieva X-series - Philips Medical Systems, Best, The Netherlands). Dedicated multichannel phased-array coils. Results: The longest time interval from trauma to imaging was 330 days and between trauma and surgery was 692 days. Preganglionic lesions (avulsion) predominated, consisting of 52 patients (86.6%) reflecting the high energy trauma with upper limb traction from the neck. The lesions were most prevalent at the C6-C8 levels. Pseudomeningocele was identified in 62.9% of the preganglionic lesions and in only 1.6% of the postganglionic lesions. Regional muscle denervation changes were seen in all pre-ganglionic injuries and most of post-ganglionic injuries. Conclusions: MRN of the brachial plexus provides important insights into the distribution of neuromuscular lesions in high energy MVA trauma and these findings enrich the literature for researchers and clinicians focused on managing such patients and/or defining prognostic strategies.

Psychiatric symptoms and pain in maxillofacial injury following motor vehicle accidents: A comparative study.

Post-traumatic stress disorders, depression, and pain are rarely discussed in the literature on maxillofacial injuries, and psychiatric symptoms and pain are not identified and managed in such patients. The aim of this study was to determine the symptoms of post-traumatic stress disorders, depression, and pain in people with maxillofacial injuries following motor vehicle accidents. In this cross-sectional study, people injured in motor vehicle accidents from March to September 2015 who were referred to a medical educational center in the northern part of Iran for treatment follow-up were sampled. The existing symptoms of post-traumatic stress disorder by PSS, depression by BDI-II, and pain by NRS were assessed. SPSS software version 21 was used for analysis. Maxillofacial injured patients had significant differences in terms of post-traumatic stress disorder (p= .006), depression (p= .001), pain (p= .001), and length of hospital stay (p= .002) than patients without maxillofacial injuries. Motor vehicle accident victims with maxillofacial injuries suffered significantly more from post-traumatic stress disorders and depression, pain and length of hospital stay than patients with other injuries.

Pattern of associated brain injury in maxillofacial trauma: a retrospective study from a high-volume centre

The incidence of head injury in maxillofacial trauma patients varies widely in the literature. A good understanding of the patterns of association between these injuries would aid in efficient multidisciplinary treatment. The aim of this study therefore was to understand the associations between head injury and facial trauma by retrospectively analysing the records of patients seen at a tertiary care trauma centre. Demographic data were also described. Records of 4350 facial trauma patients over a five-year period were reviewed. A total of 3564 (81.9%) patients were victims of motor vehicle accidents (MVA). Male patients predominated, comprising 3711 (85.3%), and 36.6% were in the third decade of life. Facial fractures were seen in 2120 (48.7%), the most common being zygomatic fractures (60%). At the time of trauma, 2383 (57.3%) patients were under the influence of alcohol, and 2821 (87.8%) victims of two-wheeler MVAs were not using their helmet. Of all patients, 29.75% sustained a traumatic brain injury (TBI). Midface fractures were strongly associated with TBI. Maxillofacial injury may be considered a risk factor for TBI, and as such should immediately be suspected and investigated in all patients. Prompt recognition and management can improve outcomes in these patients.

Single-center evaluation of prognostic factors of moderate and severe closed head injuries

Background Traumatic brain injury is a frequent cause of mortality and lifelong disability. Despite the very high incidence of trauma, especially owing to motor vehicle accidents in Egypt, there is dearth of evidence related to head trauma statistics. Aim The aim of this study was to evaluate and analyze some of the factors affecting the prognosis of closed head injury to provide better application of medical care. Patients and methods This observational study was conducted on 269 patients with closed head injuries at a level 1 trauma center for a period of 1 year. Various factors were assessed such as patient demographics, injury and early clinical course, and outcome parameters, mainly hospital length of stay and Glasgow outcome scale extended. Results Factors related to worse outcome were age more than 40 years, female sex, rural residence, victims of motor vehicle accidents and falls, lower initial Glasgow coma scale, and computed tomography findings of diffuse brain injuries. Surprisingly, time from injury to admission had no statistically significant relation to outcome, and also pretrauma comorbidities were associated with longer hospital length of stay but not with worse outcome. Conclusion The initial Glasgow coma scale on presentation and diagnosis based on clinical assessment and computed tomography brain findings are both the most correlated and the best predictors when it comes to outcomes measured such as Glasgow outcome scale extended and also predictors of length of hospital stay. Estimating prognosis can be useful in guiding patient counseling, management decisions, and allocation of limited hospital resources.

The Impact of Skin Color on the Recognition of Blunt Force Injuries.

Dark skin may obscure injuries. This is reflected in the illustrations in textbooks, which generally depict blunt force injuries in victims with light skin tones. We explored whether forensic pathologists can reliably recognize blunt force injuries in dark-toned skin by comparing the average number of contusions and abrasions of motor vehicle accident victims with dark- and light-toned skin. We also investigated whether the race of the forensic pathologist observer mattered. We found a significant difference in the number of injuries recorded in autopsies of motor vehicle accident victims based upon skin tone; there was also a difference in the race of the observer.

Bold policy changes are needed to meet the need for organ transplantation in India

Twenty-five years after India passed legislation to legalize brain death, deceased donor transplantation remains underdeveloped while the country has established formidable capacity for living donor transplantation. Because of a large number of potential deceased donors, there is hope that deceased donation could help meet India's enormous need for organ transplantation. However, significant policy and practical barriers limit progress. The vast majority of potential deceased donors are poor motor vehicle accident victims who present for care in hospitals without the necessary infrastructure or expertise to support deceased donation. In contrast, transplant infrastructure and expertise are concentrated in private hospitals and are only accessible to those with the ability to pay. Given these realities, the potential of deceased donor transplantation can only be recognized if Indians who are likely to donate organs are also provided access to transplantation. In this viewpoint, we review the current status of organ transplantation in India and propose new policies to establish a national organization to oversee deceased donor services in all states, to fund resources needed to support deceased donation, to leverage the existing living donor infrastructure to advance deceased donor transplantation, and call for establishment of government policy on funding for posttransplant care and immunosuppression.

Whiplash-Associated Disorders. Biopsychosocial Profiles of Pain Perception in Forensic Cases of Victims of Motor Vehicle Accidents.

In order to make a complete diagnosis of all the factors influencing whiplash associated disorders (WAD), the evidence suggests that the condition evaluation should follow an integrated biopsychosocial model. This perspective would offer a fuller view of it, recognizing the interplay between the medical, biomechanical, social, and psychological factors. Despite the progress made in the subject, evidence of which psychosocial factors influence the experience of pain in litigant WAD patients is limited. A cross-sectional design and a cluster analysis was used to study the experience of pain and the psychosocial factors included therein in 249 patients with WAD assessed after suffering a motor vehicle accident. Three clusters were obtained: C1, with low scores of pain and a slight-moderate alteration of the Health-Related Quality of Life (HRQoL); C2, with medium scores of pain, alteration of HRQoL and a perception of moderate disability; and C3, with medium-high scores of pain, alteration of the HQoL, perception of moderate disability, presence of anxious-depressive symptomatology, poorer comprehension of the condition suffered, and the belief that it will extend over a long period of time. The results show a heterogeneous experience of pain in WAD, compatible with the biopsychosocial model of disease and the multidimensional approach to pain. The role of the psychologist in the evaluation of the condition could be useful to obtain a complete view of the condition, thus ensuring that the treatment is adapted to the needs of the patient.

Motor Vehicle Injury and Kidney Damage: Trauma, Rhabdomyolysis, Acute Kidney Injury and Beyond.

Clinical Background: Automobile accidents constitute one of the main causes of morbidity and mortality worldwide. Kidney injury related to automobile accidents occurs through several mechanisms. Among the mechanisms are direct traumatic injury, rhabdomyolysis, acute renal failure, hypovolemic shock, and others. Kidney injuries after traffic accidents can have different forms of clinical presentation, which can include morphological and functional changes of the organ. Epidemiology: Annually, approximately 1.35 million individuals are fatal victims of motor vehicle accidents. Challenges: It is of the utmost importance to recognize and adequately manage kidney injuries secondary to automobile events, since their timely identification can prevent permanent damage to the organ and, at times, save lives. Prevention and Treatment: An approach with a focus on traffic safety is ideal for all users. The cornerstones of this approach are safe roads and road shoulders, adequate speeds, safe vehicles, and trained drivers. Kidney injury and death due to this condition can be prevented by effective and integrated traffic legislation. After the occurrence of traffic accidents, effective emergency care is vital. Thus, a series of urgent actions are essential to provide assistance to the injured individual. In patients who are victims of car accidents and develop acute kidney injury and rhabdomyolysis, a timely diagnosis is extremely important to be able to offer assistance to the patient still in the early stages.

Abusive head trauma: experience improves diagnosis

PurposeThe diagnosis of abusive head trauma (AHT) is complex and neuroimaging plays a crucial role. Our goal was to determine whether non-neuroradiologists with standard neuroradiology knowledge perform as well as neuroradiologists with experience in pediatric neuroimaging in interpreting MRI in cases of presumptive AHT (pAHT).MethodsTwenty children were retrospectively evaluated. Patients had been diagnosed with pAHT (6 patients), non-abusive head trauma-NAHT (5 patients), metabolic diseases (3 patients), and benign enlargement of the subarachnoid spaces (BESS) (6 patients). The MRI was assessed blindly, i.e., no clinical history was given to the 3 non-neuroradiologists and 3 neuroradiologists from 2 different institutions.ResultsBlindly, neuroradiologists demonstrated higher levels of sensitivity and positive predictive value in the diagnosis of pAHT (89%) than non-neuroradiologists (50%). Neuroradiologists chose correctly pAHT as the most probable diagnosis 16 out of 18 times; in contrast, non-neuroradiologists only chose 9 out of 18 times. In our series, the foremost important misdiagnosis for pAHT was NAHT (neuroradiologists twice and non-neuroradiologists 5 times). Only victims of motor vehicle accidents were blindly misdiagnosed as pAHT. No usual household NAHT was not misdiagnosed as pAHT. Neuroradiologists correctly ruled out pAHT in all cases of metabolic diseases and BESS.ConclusionMRI in cases of suspected AHT should be evaluated by neuroradiologists with experience in pediatric neuroimaging. Neuroradiologists looked beyond the subdural hemorrhage (SDH) and were more precise in the assessment of pAHT and its differential diagnosis than non-neuroradiologists were. It seems that non-neuroradiologists mainly assess whether or not a pAHT is present depending on the presence or absence of SDH.

Fraudulent records – Grave forensic consequences

Natural disasters, fatal accidents, and violent criminal offences are part of everyday life. All of these may result in fatalities that shatter the lives of the victim’s families and friends. Their trauma is compounded by the fact that all unnatural deaths have to be investigated, and the bodies of the deceased positively identified before they can be released to the families for burial. Bodies of victims of violent crimes, fires, drowning, motor vehicle or aviation accidents, work place fatalities or situations where some time has elapsed since death may be so disfigured that “identification by a family member is neither possible or desirable”. Often the nature or degree of the injury may be so extensive that fingerprinting is also not a viable option. DNA analysis may be considered, however it takes time and is a costly procedure. There are also concerns with maintaining strict control over the chain of evidence during all additional procedures and tests. Thus, in these situations the forensic odontologist may be called in as part of the investigative team.

Neuroprotective Effects and Treatment Potential of Incretin Mimetics in a Murine Model of Mild Traumatic Brain Injury.

Traumatic brain injury (TBI) is a commonly occurring injury in sports, victims of motor vehicle accidents, and falls. TBI has become a pressing public health concern with no specific therapeutic treatment. Mild TBI (mTBI), which accounts for approximately 90% of all TBI cases, may frequently lead to long-lasting cognitive, behavioral, and emotional impairments. The incretins glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are gastrointestinal hormones that induce glucose-dependent insulin secretion, promote β-cell proliferation, and enhance resistance to apoptosis. GLP-1 mimetics are marketed as treatments for type 2 diabetes mellitus (T2DM) and are well tolerated. Both GLP-1 and GIP mimetics have shown neuroprotective properties in animal models of Parkinson’s and Alzheimer’s disease. The aim of this study is to evaluate the potential neuroprotective effects of liraglutide, a GLP-1 analog, and twincretin, a dual GLP-1R/GIPR agonist, in a murine mTBI model. First, we subjected mice to mTBI using a weight-drop device and, thereafter, administered liraglutide or twincretin as a 7-day regimen of subcutaneous (s.c.) injections. We then investigated the effects of these drugs on mTBI-induced cognitive impairments, neurodegeneration, and neuroinflammation. Finally, we assessed their effects on neuroprotective proteins expression that are downstream to GLP-1R/GIPR activation; specifically, PI3K and PKA phosphorylation. Both drugs ameliorated mTBI-induced cognitive impairments evaluated by the novel object recognition (NOR) and the Y-maze paradigms in which neither anxiety nor locomotor activity were confounds, as the latter were unaffected by either mTBI or drugs. Additionally, both drugs significantly mitigated mTBI-induced neurodegeneration and neuroinflammation, as quantified by immunohistochemical staining with Fluoro-Jade/anti-NeuN and anti-Iba-1 antibodies, respectively. mTBI challenge significantly decreased PKA phosphorylation levels in ipsilateral cortex, which was mitigated by both drugs. However, PI3K phosphorylation was not affected by mTBI. These findings offer a new potential therapeutic approach to treat mTBI, and support further investigation of the neuroprotective effects and mechanism of action of incretin-based therapies for neurological disorders.

Security issues and challenges in V2X: A Survey

In its latest report, the United States National Highway Traffic Safety Administration (NHTSA) registered some 37,300 fatalities for the yearly victims of motor vehicle accidents in 2017. Vehicle-to-everything (V2X) is playing an important role in improving road safety, traffic efficiency and infotainment systems. With the growth of the connected vehicle technology, V2X is emerging as a key component in the rapid rise of this technology. Therefore, researchers think that development of robust wireless communication through efficient V2X technologies can significantly improve the vehicular environment. The highly dynamic environment and the mobility factor appear to be challenging for implementation of V2X technology. Similar to other wireless technology, the security issues are also key concerns in V2X.In this survey, we highlight and discuss the main security issues of V2X. Particularly, the main objective of this survey is providing for a comprehensive and structured outline of different research directions and approaches, mostly emphasizing on the security issues and challenges in V2X communication technologies. At first, we discuss the key features of V2X and focus on the standardization techniques used for communication technologies. Then, we introduce the security challenges and requirements of V2X. We also classify present state-of-the-art works dealing with implementing different secured techniques in V2X. We further discuss the project implementation that concentrated on the various applications in V2X. Finally, we identify possible future research directions of V2X, particularly in the area of security.