Roadside Accident Research Articles

A Five Year Retrospective Epidemiological Study of Burn Deaths

Burn injury cases are one of the common medical emergencies admitted to any hospital in India. There are several factors, which play role in the treatment, management, autopsy and investigations of burns death cases. This study is conducted with the aim to study the epidemiology of the burn deaths. All the records of the autopsies which were performed between January 2008 and December 2012 were analyzed with respect to burn death, the age-gender distribution of burn death and manner of death. It was observed that total 7606 cases of unnatural death occurred at PGIMS Rohtak and brought to mortuary of Forensic Medicine Department between January 2008 and December 2012. It was analysed that most common cause of death was road side accident (32.78%) followed by burns (22.13%), poisoning (21.54%), murder (4.67%), railway accident (3.02%), drowning and other asphyxial deaths (2.59%), fall from height (1.42%), electrocution (1.36%), excess of alcohol (1%), snake bite (0.24%) and 9.23% of the deaths were described as miscellaneous deaths.

Medicolegal aspects of road side accident victims

Medical professionals are often unsure of the course of action in medico-legal cases. Thus they are rather reluctant to attend to cases of accident for fear of being involved in unnecessary litigation later on. Even in cases of serious accidents, medical professionals hesitate to offer help, sometimes resulting in patient's death. This paper highlights some important legal precautions to be taken care of in cases of road side vehicular accidents. These simple steps, if observed by medical practitioners, will prevent unnecessary litigation.

Chronic Bilateral Subdural Hematoma Complicating Decompressive Craniectomy

Problems Considered A case of road side accident developed acute subdural hematoma and cerebral contusion with progressive edema and rise intracranial pressure as revealed on serial computed tomographic scan of the head. Methods Decompressive craniectomy performed for progressive hemorrhagic contusion producing mass effect. Results Patient improved unconsciousness and remained stationary because of the development of subdural hematoma further improvement occurred after drainage of subdural hematoma. Conclusion Development of chronic subdural hematoma is extremely uncommon following decompressive craniectomy and could be responsible for arrest of neurological recovery.

A rare cause of upper gastrointestinal bleeding: Posttraumatic pseudoaneurysm

Introduction: Hemobilia is a rare cause of upper gastrointestinal bleeding. It needs prompt diagnosis and immediate management to safe the life. Posttraumatic pseudoaneurysm of hepatic artery is seen mostly after abdominal trauma causing liver injury or interventions on hepatobiliary system. On esophagogastroduodenoscopy active bleeding without apparent source is clue to the diagnosis. case report: A 27-year-old male presented with history of one episode of hematemesis and melena. there was history of roadside accident one and a half months before and he had liver injury which was revealed on computed tomography of the abdomen. Patient was managed conservatively and discharged. On examination, patients was anemic and had postural fall in blood pressure. Emergency esophagogastroduodenoscopy revealed blood coming from ampulla. computed tomography angiography (ctA) revealed pseudoaneurysm in segmental branches of right hepatic artery with active bleeding. conclusion: Hemobilia is defined as bleeding into the biliary tree from abnormal communication between blood vessel and bile duct. the most common cause of posttraumatic hemobilia is pseudoaneurysm. the classic triad of hemobilia is absent in 70% of cases and in such cases clinical diagnosis is difficult. the ctA is the investigation of choice and embolization is the treatment option. surgery should be done in cases refractory to embolization.

Pediatric maxillofacial injuries – If a new look is required?

ObjectiveMaxillofacial injuries in children always present a challenge in respect of their diagnosis and management. The phenomenal increase in automotives on the road has led to a tremendous rise in the number of road traffic accidents leading to facial injuries, of which children are the most unfortunate victims. The purpose of this retrospective study was to evaluate the epidemiology, etiology and pattern of facial injuries and also to access the most feasible method for the management of facial injuries in children without hampering the facial growth. MethodsThe records and radiographs of 110 patients within the age range of 0–16 years were retrospectively reviewed who have presented with maxillofacial injuries to our department from October 2008 to June 2012. The information extracted from patient's case records included patient's gender (male/female), age, etiology, fracture type (single fractures and multiple fractures), occlusal status, fracture site and treatment performed. ResultsPatient's age at the time of accident ranged from 0 to 16 years, with a mean of 6.1 years. 54.54% (n=60) of the patients were under 6 years (infants and preschool), 31.82% (n=35) were between 6 and 11 (school age), and 13.64% (n=15) were between 12 and 16 years (adolescents). Road side accident was the most frequent cause of injury. Most fractures occurred in the mandible (54.54%; n=60). The fractures with minimal or no occlusal disturbance were managed by liquid diet alone. ConclusionWe believe that even after so much advancement in surgical techniques and armamentarium, conservative treatment is still the most reliable approach in managing maxillofacial injuries in children.

Estimation of blood alcohol concentration in deaths due to roadside accidents

Like any other disease, accidents too are caused by interaction between agent, host, and environment. Human factors include age, (accidents most common between 10 and 24 years), sex, education, medical conditions (heart attack, impaired vision), fatigue, influence of alcohol and other drugs, lack of bodily protection (like helmets, seat belts) and psychosocial factors like lack of experience, impulsiveness, aggressiveness, defective judgment and delay in decisions. Drunken driving is an important risk factor in causing accidents. This study was focused on the status of alcohol consumption in relation with roadside accidents in northern India in the region of Amritsar. The present study was carried out in 100 cases alleged to have died of roadside accident and brought to the mortuary attached to the Department of Forensic Medicine and Toxicology, Government Medical College, Amritsar for autopsy examination. Blood samples were collected from the femoral vein and were tested for the presence of alcohol with steam distillation and titration method using potassium dichromate and sulfuric acid. In the present study, 23% of the fatal driver/pedestrian victims of roadside accidents were found to have consumed alcohol before accident. Most of the victims of road accident were from the age group 21–30 and 31–40 years. Most of the accidents occurred on straight roads instead of bends or intersections, more during daytime and weekends. 57% of the blood alcohol positives were between 100 mg% and 149 mg%. Majority of the victims of roadside accidents were motorcyclists and the striking vehicles were trucks and buses causing head & neck injuries in most of the victims. Death occurred within a few minutes in most of the cases.

2012 Focused Update of the ESC Guidelines for the Management of Atrial Fibrillation: An Update of the 2010 ESC Guidelines for the Management of Atrial Fibrillation

Maxillofacial injuries in children always present a challenge in respect of their diagnosis and management. The phenomenal increase in automotives on the road has led to a tremendous rise in the number of road traffic accidents leading to facial injuries, of which children are the most unfortunate victims. The purpose of this retrospective study was to evaluate the epidemiology, etiology and pattern of facial injuries and also to access the most feasible method for the management of facial injuries in children without hampering the facial growth.The records and radiographs of 110 patients within the age range of 0–16 years were retrospectively reviewed who have presented with maxillofacial injuries to our department from October 2008 to June 2012. The information extracted from patient's case records included patient's gender (male/female), age, etiology, fracture type (single fractures and multiple fractures), occlusal status, fracture site and treatment performed.Patient's age at the time of accident ranged from 0 to 16 years, with a mean of 6.1 years. 54.54% (n = 60) of the patients were under 6 years (infants and preschool), 31.82% (n = 35) were between 6 and 11 (school age), and 13.64% (n = 15) were between 12 and 16 years (adolescents). Road side accident was the most frequent cause of injury. Most fractures occurred in the mandible (54.54%; n = 60). The fractures with minimal or no occlusal disturbance were managed by liquid diet alone.We believe that even after so much advancement in surgical techniques and armamentarium, conservative treatment is still the most reliable approach in managing maxillofacial injuries in children.

Restoration of anterior missing teeth using computer-aided manufacturing CAD/CAM zirconia restoration: A multidisciplinary report

Recent advances in all ceramic restorative materials have made it possible to restore a patient with high esthetics and comfort. This article brings about the case report in which a young male patient lost his maxillary anterior teeth in a road side accident; and, because of combined efforts of endodontics, periodontics and prosthodontics' departments, the patient's dentition was restored achieving high levels of esthetics and comfort.

Sociodemographic Profile of Road Traffic Accident Victims admitted at Emergency Surgical OPD of a Tertiary Care Hospital

ABSTRACT Objective To assess sociodemographic profile of roadside accident victims. Materials and methods Using purposive sampling technique 100 patients were enrolled in the study. A questionnaire consisting of personal identification data, personal habits and details related to occurrence of accident was used to collect the data. Results More than half subjects (59%) were in age group of 20 to 40 years with mean age being 36.5 years ± 14.2. Majority of the accident victims (84%) were male. More than half (67%) belonged to Hindu religion, educated up to secondary level (65%), were married (54%) and were rural habitants (54%). Twenty-six percent of subjects had the history of drinking alcohol. Out of these 15 subjects (57.7%) had consumed alcohol at the time of accident. Sixty-eight percent were driving two wheeler; only 27% were wearing protective equipment (helmet/seat belt) at the time of accident. Approximately one-third (39%) had 6 to 15 years of driving experience. Half (51%) of the accidents occurred in evening hours and on Saturday and Sunday. Conclusion The present study reflects that there is need to plan strategies to decrease risk of accidents and inculcate healthy driving habits in the vulnerable citizens. How to cite this article Aggarwal A, Kaur S, Dhillon MS. Sociodemographic Profile of Road Traffic Accident Victims Admitted at Emergency Surgical OPD of a Tertiary Care Hospital. J Postgrad Med Edu Res 2012;46(1):15-18.

Removal of a bent tibial intramedullary nail: a rare case report and review of the literature

Intramedullary interlocking nailing is a gold standard for treatment of tibial shaft fractures. Bending of a nail secondary to trauma is a rare complication, which may be encountered in healed or unhealed tibial shaft fractures. Removal of such bent nail is always a challenge. We reported this case to discuss various techniques for removal of bent nails and to share our experience in removing a bent tibial intramedullary nail in a 30-year-old man, who was admitted in our department with re-fracture of the right tibial shaft due to a roadside accident two years after the initial surgical treatment. The intramedullary nail, bent by 30 degrees and visible on anterioposterior as well as on lateral radiographs, was firstly weakened by partially cutting the convex wall, then straightened by applying external force, and finally removed by using the standard nail removal method.

Post-traumatic biliobronchial fistula demonstrated on hepatobiliary scintigraphy with SPECT/CT

A 22-year-old male patient suffered a grade IV liver injurywith haemoperitoneum in a roadside accident 2 monthsearlier, for which laparotomy and biliary stenting weredone. However, after a few days, the stent was passedduring defecation. A week later, the patient developedintractable cough with copious expectoration of greensputum. Chest X-ray showed right-sided pleural effusionwith consolidation in the right lower lobe. Sputumexamination confirmed the presence of bile, which raisedthe suspicion of a biliobronchial communication.[

Traumatic Splenic Rupture in Pregnancy

Abstract Background: Splenic rupture in pregnancy is a rare and frequently misdiagnosed occurrence. Failure to recognize it is common and can be fatal for both mother and child. Case: A 20-year-old primigravida was admitted at 35 weeks of gestation with pain in the abdomen after a roadside accident. Ultrasonography was done to exclude a ruptured uterus. Labor was induced and the patient's condition deteriorated after 6 hours of admission. An urgent laparotomy was performed and the spleen was found to be lacerated. The patient underwent a splenectomy along with a lower segment cesarean section. Conclusion: This case illustrates the need to consider the rupture of the spleen as part of the differential diagnosis in pregnant women after trauma. Immediate surgical intervention is needed to ensure the survival of both mother and fetus. (J GYNECOL SURG 25:33)

Carotico-cavernous sinus fistula

We present a rare case of carotico-cavernous sinus fistula who presented with proptosis with gradual diminision of vision following a roadside accident. Contrast enhanced CT scan and angiography confiruned the diagnosis and it was managed by transfemoral embolisation of right ICCF.

Jimi Hendrix, Bluegrass Star

In front of the Pompidou Center, a pretty girl with a violin case took a position about fifteen yards to my left. She wore tight jeans and a black cowboy shirt with pearly buttons, and I kept one eye on her as she took out her instrument and applied rosin to the bow in brisk, short strokes. I finished up "All Along the Watchtower," nodded to the family from Peoria who had stopped to stare at me as if I were a roadside accident, lay down my Strat and went over.

An unusual penetrating shoulder injury: a case report

A 32-year-old male sustained penetrating injury of the right shoulder with an angled iron rod in a road side accident. He presented with the rod in situ in his shoulder. Fortunately there was no neurovascular deficit. The metal rod was carefully removed with success, after cutting the rod with hacksaw to avoid neurovascular damage during removal.

Reactive Airway Dysfunction Syndrome in Three Police Officers following a Roadside Chemical Spill

The reactive airway dysfunction syndrome (RADS) is a recently described syndrome in which bronchial hyperreactivity and asthmatic symptoms develop in previously healthy individuals after a single large exposure to an irritating gas, fume, or vapor. We report a cluster of three Philadelphia police officers who developed RADS after a common exposure to toxic fumes from a roadside truck accident. Results of initial pulmonary function testing were normal in all three, and methacholine challenge was required for diagnosis in two out of the three. This syndrome needs to be recognized by physicians dealing with environmental or industrial medicine as a potential cause of loss of work or inability to perform on the job. Also, there is a potential for multiple individuals to develop this syndrome from a single incident.