Epidemiology of Blindness From Facial Trauma: A Multi-Centre Nigerian Study

Study Design This is a multi-centre retrospective study. Objective To determine the prevalence of blindness and pattern of facial trauma associated with blindness among Nigerians. Methods A multi-centre retrospective study of all patients with facial trauma resulting in blindness, that were co-managed by maxillofacial surgeons and ophthalmologists in 4 Nigerian public tertiary hospitals between January 2010 and December 2019 was undertaken. Data was analysed by IBM SPSS Statistics (version 21.0 for windows, IBM© Inc, Chicago, IL). Results Of 2070 patients who presented with major facial injuries during the study period, 61 eyes of 56 (2.7%) patients were blind. Blindness was bilateral and unilateral in 5 (8.9%) and 51 (92.1%) patients, respectively. The mean age (SD) at presentation was 36.2 (16.6) years, and 47 (83.9%) of these patients were males. Road traffic accident (n = 27; 48%) was the commonest mechanism of facial trauma, the cheek (n = 18; 40.9%) was the commonest site of associated soft tissue injury and zygomatic complex fracture (n = 19; 24.1%) was the commonest related fracture. Globe rupture (n = 34; 55.7%) was the leading cause of blindness. Enucleation (n = 7; 13.2%) and evisceration (n = 22; 41.5%) were performed on 29 eyes of which 12 (41.4%) patients had ocular prosthesis post-operatively. Conclusion Blindness was recorded in 2.7% of Nigerians with facial trauma. The commonest mechanism of trauma and cause of blindness in at least one eye were road traffic accident and globe rupture, respectively. Eye removal surgery was necessary in about half of the blind eyes.

Epidemiological Study of Road Traffic Accidents in Japan during 2010-2019

The study aimed to determine epidemiological characteristics of road traffic accidents in Japan during the year 2010-2019. A cross-sectional descriptive study depended on a retrospective analysis of road traffic accident data that were obtained from the National Police Agency (NPA) for the years 2010 – 2019 in Japan. The relationship of road traffic accident consequences as dependent variables with age, road user type, helmet, and seatbelt use as independent variables during the studied years was analyzed with Chi-square test. The case fatality rate has been declining every year from 3.88 in 2010 to 2.54 per 100,000 persons. More than half of fatality cases have occurred among the elderly. There was a statistically significant relationship between road user type and accident severities. 36.21% fatality occurred in pedestrians. Otherwise, 27.61% of motor vehicle occupants were dominant in serious injury cases and 66.87% in slight injury cases. Most of the casualties revealed for fatality cases were in the head, whereas the leg part was dominant in serious injury cases and the neck region was raised in slight injuries. There was a significant relationship between the use of helmets and seat belt use with casualties of road traffic accidents. There was a declined trend of road traffic accidents in Japan during 10 years of study. The result of the epidemiological study could be a valid consideration for the design of road safety policy in the future.

Pattern of isolated mandibular symphysis fracture and trends in management at a tertiary care hospital of Karachi, Pakistan.

Objective: To find the pattern of isolated mandibular symphysis fracture and trends in management at a tertiary care hospital of Karachi, Pakistan. Study Design: Crossectional study. Setting: Department of Oral Surgery, Sir Syed Medical & Dental Hospital-Karachi, Pakistan. Period: January 2018 to December 2019. Material & Methods: Eighty one patients were selected on the basis of inclusion and exclusion criteria. They were diagnosed with isolated anterior mandibular fracture on basis of detailed history, thorough clinical examination and a radiologic investigation (OPG). Etiology of fracture and gender distribution was observed, fracture pattern was observed on basis of helmet wearing. Results: There was a male predilection with a male to female ratio of 4.3:1. Road traffic accident was the commonest cause. 82.7 % of patients were not wearing helmet at time of incidence and 69% from all patients had displaced mandibular fracture which resulted in derranged occlusion. Conclusion: Isolated anterior mandibular fractures is common in younger age group, with a male predilection. Most common etiologic factor is road traffic accident. Displaced fracture pattern is prevalent among patients who were not wearing helmet at time of incidence.

Tear-drop Fracture of the Axis: Non-operative Treatment of Two Cases : Case Report

Tear-drop fracture of the axis are rare. It is characterized by a fracture of the anterior-inferior corner of the C2 body. The mechanism is usually in extension which is different from the tear-drop of lower cervical spine. We report two cases of adults who sustained a road traffic accident. They did not have any neurological deficit. The diagnosis was made on radiological examination. They both were treated conservatively with rigid immobilization and recovered well. Tear-drop fracture of the axis are usually stable. Imagery is the key of the diagnosis. Neurological deficit is rare. Conservative management usually give good outcome for non-complicated cases.

Remarks on patients with traumatic brain injury due to traffic accident related to alcohol comsumption treated in Vietduc hospital after implementing the decree 100

Purpose: Traumatic Brain Injury (TBI) is still considered as a leading cause of morbidity and mortality of victims by traffic accident. Despite a fact that many measurements and preventions have been applied, the rate of TBI is remained high. Aim of this study was to investigate treatment process of TBI caused by road traffic accident at Viet Duc Hospital after the Decree 100 which has been issued in Vietnam in early 2020. Materials and method: A retrospective and prospective study has been conducted in Viet Duc Hospital from Dec, 2020 to March, 2021. All the patients with TBI by road traffic accident were enrolled. Severity of TBI was identified by Glasgow Scale (GCS) and BAC (Blood Alcohol Concentration) test taken on arrival. The data was collected from medical record as well as autopsy report and analysed by SPSS.20.0 Results: A total of 150 patients with TBI by road traffic accidents were enrolled, age group from 21 to 60 years old accounted for 64%, male accounted for 86.7%. Associated injuries were maxillofacial lesions 48%, extremities 24.7%, chest accounted for 20%. Severity of TBI with GCS 6 - 8 was the highest rate 52%, from 3 - 5 GCS accounted for 30%. 40% were operated on emergency; BAC was positive 46.7%, of which over from 50 mg/L accounted for 32.6%. The patients with GCS from 6 to 8 were BAC positive accounted for a higher rate than groups with GCS above 9 or below 5. The most common TBI lesions were subarachnoid hemorrhage, subdural hematoma and cerebral edema accounted for 67.3%, 60% and 58% respectively. Overall mortality was 26% including in-hospital death and discharged to die. Conclusions and recommendations: Data from the study has shown that many young men with severe TBI by road traffic accident were BAC positive which can results in the high risk of death and disability. Thus, we highly recommend counterparts should constantly strengthen the propaganda and enforcement measures in order to reduce traffic accidents and TBI patients. Keywords: traffic accidents; injury; brain trauma severity.

Assessment of Mortality Pattern Based on Autopsy in Victims of Road Traffic Accident

Background: The Trauma and road accident is considered as major cause mortality in the young adults’ populations around the world. The understanding the importance of forensic investigation of un-natural deaths, accidental injuries and suicidal cases is required by medical staff and patients’ family members. Objective: To asses of mortality pattern based on autopsy in victims of road traffic accident Study Design: Retrospective study Place and Duration of the Study: Medicolegal Section of Liaquat University Hospital Hyderabad, Pakistan from 1st January 2018 to 31st December 2019. Methodology: Six hundred and twenty nine autopsies were included. Deaths due to road traffic accident were included. Results: There were 472 males and 157 females between 31 to 50 years. Two hundred and forty nine patients were admitted in ICU. Two hundred and fourteen patients had affected head region followed by face 104 injuries. While 74 had affected neck, 67 affected thorax, 63 affected abdominal region, 52 affected spine and 55 had affected lower extremities.173 were died due to damage of central nervous system. The damages were due to car accident was 62, motorbike 73, rickshaw 22 and other reasons 14. One hundred and forty patients were died due to fracture of skull. Conclusion: The mortalities rates are under reported in majority of accidental cases due to lacking of autopsies procedures. Keywords: Autopsy, Assessment, Mortality pattern, Road traffic accident

OUTCOME AND ASSOCIATED FACTORS AMONG ROAD TRAFFIC ACCIDENT VICTIMS AT WOLAITA SODDO CHRISTIAN HOSPITAL, WOLAITA SODDO, SOUTH ETHIOPIA 2020, INSTITUTION-BASED CROSS-SECTIONAL STUDY.

ABSTRACT Background In today's world road traffic accident victims is treated as a major epidemic of non-communicable disease. Road traffic accidents caused numerous family tragedies such as serious economic loss to the community and the death of young people. The problem is more severe in low and middle-income countries. In Ethiopia, the largest proportion of series injuries comes from road traffic accidents and become major causes of death in the emergency room. Despite this, only a little is known about treatment outcomes of road traffic accident victims and its associated factors in Ethiopia. Method An institution-based Cross-sectional study design was conducted at Wolaita Soddo Christian hospital with a sample of 400 road traffic accidents. The medical record was selected using a systematic sampling method. Data was entered using Epi-data version 4.1 and was exported to and analyzed using SPSS version 23. A multivariable logistic regression model was used to assess the association between the independent variables and dependent variables. RESULT The overall death rate was 9.5%. Being out of hospital catchment area [AOR= 2.16, 95% CI= (1.01-4.70)] presence of co-morbid condition [AOR= 6.77 95% CI= (2.44-18.81)] lack of first aid help [AOR= 2.77 95% CI= (1.17-6.52)] and severity of the injury [AOR= 3.85 95% CI= (1.50-9.89)] were found to be significantly associated with outcome of road traffic accident victims. Conclusion The study shows that the death rate from road traffic accidents was high. Therefore, designing strategies to decrease death from road traffic accidents by giving great emphasis to road traffic accident victims with co-morbid conditions and severe injury and focusing on the availability and accessibility of pre-hospital care service. Keywords: Outcome, road traffic accident, Wolaita Soddo Christian hospital, Ethiopia