Pattern of firearm injuries managed at rural tertiary centre in Western Uttar Pradesh, North India

Background: Firearm injuries are associated with substantial emotional, physical and financial burden on community and hospital resources leads to profound morbidity. It is a global public health problem and pose therapeutic challenges to surgeons. Proper management of firearm wounds requires a working knowledge of physical factors involved in the creation of such injuries. Regional variations of the parameters of medico legal aspects of firearm injuries are still lacking. Objective is to analyse pattern of firearm injuries managed at rural tertiary hospital.Methods: All firearm injury cases brought to the emergency department of Hospital, from January 2016 to December 2016 were included in the study.Results: In this study 108 (83.7%) victims were males and 21 (16.3%) were female. Most common age group victimized was 20-29 year (33.3%). Most cases occurred in winter season.113 cases (87.3%) victim were unemployed.81 cases (62.8%) had below intermediate education. 110 (85.3%) cases were of homicidal motive. Shotgun/ ‘kattas’ outnumbered the rifled firearm injuries (109) cases (84.5%). Trunk was involved in 45 cases (34.8%) and lower extremity in (32.6%) 42 cases,) Exit wound found in 93(72.2%) cases only. The fatality rate was 3.9% (5 cases). . Wound debridement was performed for 48 cases (37.2%) of patients, while emergency exploration was done for 30 cases (23.3%). The hospital stay of 49 cases (37.9%) of patients was more than one week. 111 cases (86.1%) were discharged.Conclusions: Addressing the root causes of violence such as poverty, unemployment, substance abuse will reduce the incidence of firearm injuries in our environment. Establishment of efficient emergency health care services for pre-hospital care and effective ambulance system for rapid transport of injured victims to hospital will reduce morbidity and mortality. Management requires knowledge ATLS protocols, mode, presentation and ballistic of firearm. Authorities issuing license for possession of firearms need to be more strict and vigilant.

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Firearm Injuries in the Tribal Area of Pakistan. An Emerging Trend

10.53350/pjmhs211582240 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2240-2242

Author(s):

M Asghar Khattak ◽

Noreen Farid ◽

Urooj Husain ◽

Ghulam Muhayudin ◽

Amir Naveed ◽

...

Keyword(s):

District Hospital ◽

Financial Burden ◽

Easy Access ◽

Cross Sectional ◽

Firearm Injury ◽

Firearm Injuries ◽

Intentional Injuries ◽

Tribal Area ◽

The Family ◽

Tribal Areas

Background: Due to multiple conflicts among the society many countries are facing rise in the firearm causalities. Whether it may be due to unstable government or economic crises it leads to huge financial burden to the country and ultimately to the family. Easy access to firearm weapons is one of the leading cause. Material and Methods: It is a cross sectional descriptive study, conducted in the tribal areas of Pakistan. The study was conducted on intentional firearm injury cases which reported to hospital during the period from January 2010 to December 2010 in District Hospital Timergara after informed consent, history was recorded and examination was done. Study was focused on age, sex, site of injury, parameters causing injury, the person involved in causing this injury and management provided. Results: A total of 200 cases were reported during this study period. The cases included in the study were 150 (75%), of intentional injuries, out of which 143 (95.3%) cases were of homicidal firearm injuries and 7 (4.6%) cases were suicidal in nature. Majority of the cases were reported during the month of May (20.29%) and June (17.48%) and lowest figure was observed in the December (2.14%). Conclusion: Study concludes that not believing in the judicial system of the community added with multiple other factors leads intentional firearm injuries which is a dominant cause of fatal injuries observed in the society. Law should be enforced strictly on the use of illegal firearm weapons, as reported in this study that in majority of the cases weapon used was illegal. Keywords: Firearm injuries, Tribal Areas, Pakistan, homicidal, Firearm weapons

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Prevalence, Risk Factors and Awareness about HCV Infection in Pregnant Women in a Tertiary Care Center in North India

Global Journal of Medical Research ◽

10.34257/gjmrevol20is1pg25 ◽

2020 ◽

pp. 25-29

Author(s):

Dr. Renu Gupta ◽

Dr. Rashmi Kumari ◽

Dr. Shaily Agarwal ◽

Dr. Kiran Pandey ◽

Dr. Neena Gupta ◽

...

Keyword(s):

Hepatitis C ◽

Pregnant Women ◽

Viral Infections ◽

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Developed Countries ◽

North India ◽

Global Public Health ◽

Female Population

Among the viral infections affecting the liver in pregnancy, Hepatitis C though uncommon now is recognized to be a serious global public health problem affecting 170 million people worldwide I .e. 3% of the population [1]. The prevalence of anti-HCV antibody in pregnant women in developed countries ranges from 0.14 to 4.4%, whereas the seroprevalence in Indian pregnant female population is 1.03% [2,3,4].Following the decreasing transmission of HCV by blood -transfusion, intravenous drug use has now become the primary route of new HCV infections in adults while mother to child transmission (MTCT) is the major route of new infections in young children in the developed as well as in developing countries.[5]Approximately 7–8% of hepatitis C virus-positive women transmit this virus to their offspring [6]mainly because they are ignorant about this infection and unaware of their status. The natural course of hepatitis C is a progression from acute hepatitis to chronic hepatitis, which occurs in 55%-85 % of patients.

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Firearm injury epidemiology in children and youth in Ontario, Canada: a population-based study

BMJ Open ◽

10.1136/bmjopen-2021-053859 ◽

2021 ◽

Vol 11 (11) ◽

pp. e053859

Author(s):

Natasha Ruth Saunders ◽

Charlotte Moore Hepburn ◽

Anjie Huang ◽

Claire de Oliveira ◽

Rachel Strauss ◽

...

Keyword(s):

Public Health Problem ◽

Population Based ◽

Children And Youth ◽

Unintentional Injuries ◽

Cross Sectional ◽

Firearm Injury ◽

Firearm Injuries ◽

Injury Epidemiology ◽

Self Injury ◽

Increased Risk

Background and objectiveDespite firearms contributing to significant morbidity and mortality globally, firearm injury epidemiology is seldom described outside of the USA. We examined firearm injuries among youth in Canada, including weapon type, and intent.DesignPopulation-based, pooled cross-sectional study using linked health administrative and demographic databases.SettingOntario, Canada.ParticipantsAll children and youth from birth to 24 years, residing in Ontario from 1 April 2003 to 31 March 2018.ExposureFirearm injury intent and weapon type using the International Classification of Disease-10 CM codes with Canadian enhancements. Secondary exposures were sociodemographics including age, sex, rurality and income.Main outcomesAny hospital or death record of a firearm injury with counts and rates of firearm injuries described overall and stratified by weapon type and injury intent. Multivariable Poisson regression stratified by injury intent was used to calculate rate ratios of firearm injuries by weapon type.ResultsOf 5486 children and youth with a firearm injury (annual rate: 8.8/100 000 population), 90.7% survived. Most injuries occurred in males (90.1%, 15.5/100 000 population). 62.3% (3416) of injuries were unintentional (5.5/100 000 population) of which 1.9% were deaths, whereas 26.5% (1452) were assault related (2.3/100 00 population) of which 18.7% were deaths. Self-injury accounted for 3.7% (204) of cases of which 72.0% were deaths. Across all intents, adjusted regression models showed males were at an increased risk of injury. Non-powdered firearms accounted for half (48.6%, 3.9/100 000 population) of all injuries. Compared with handguns, non-powdered firearms had a higher risk of causing unintentional injuries (adjusted rate ratio (aRR) 14.75, 95% CI 12.01 to 18.12) but not assault (aRR 0.84, 95% CI 0.70 to 1.00).ConclusionsFirearm injuries are a preventable public health problem among youth in Ontario, Canada. Unintentional injuries and those caused by non-powdered firearms were most common and assault and self-injury contributed to substantial firearm-related deaths and should be a focus of prevention efforts.

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Child access prevention legislative language and pediatric firearm injury rates

World Journal of Pediatric Surgery ◽

10.1136/wjps-2020-000223 ◽

2021 ◽

Vol 4 (4) ◽

pp. e000223

Author(s):

Bradford James ◽

Bertha Ben Khallouq ◽

Hubert Swana

Keyword(s):

Public Health Problem ◽

Injury Rates ◽

Firearm Injury ◽

Firearm Injuries ◽

Significant Public Health ◽

The Usa ◽

Per Capita ◽

Legislative Language ◽

A Minor ◽

The Impact

BackgroudFirearm injuries are a significant public health problem facing young people in the USA. In 2015, a total of 16 878 people under 19 years old were injured or killed by firearms. To reduce firearm injuries, 29 states and Washington, DC have enacted child access prevention (CAP) legislation. CAP legislation is intended to reduce the likelihood of a minor obtaining a weapon and subsequent injury or death. This study evaluates the impact of CAP legislation based on language of the legislation, specifically it evaluates a relationship of the legal threshold of liability and the number of firearm injuries per capita of minors.MethodsData were collected from the Web-based Injury Statistics Query and Reporting System for patients less than 19 years of age who presented to emergency departments with firearm injuries in 2016. The Giffords Law Center classification was used to group states into three categories (strong/weak/no CAP) based on CAP language. Differences of firearm-related injury rates per capita were assessed.ResultsWhen controlling for population, states with CAP legislation had a 22% decrease in firearm injuries per capita compared with states without CAP legislation. States with ‘strong’ CAP legislation had a 41% decrease in firearm injuries per capita compared with states with ‘weak’ or no CAP legislation when controlling for population.ConclusionsStates with ‘strong’ CAP legislation had lower pediatric firearm injury rates per capita, but more complete data and further studies are needed to evaluate this relationship as well as other factors that may impact firearm injury rates.

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Varied presentations of leptospirosis: experience from a tertiary care hospital in north India

Tropical Doctor ◽

10.1177/0049475516687431 ◽

2017 ◽

Vol 47 (2) ◽

pp. 128-132 ◽

Cited By ~ 1

Author(s):

Rama Chaudhry ◽

Karnika Saigal ◽

Tej Bahadur ◽

Kamla Kant ◽

Bishwanath Chourasia ◽

...

Keyword(s):

Tertiary Care ◽

Public Health Problem ◽

Central India ◽

Febrile Illness ◽

North India ◽

Care Hospital ◽

Global Public Health ◽

Disease Occurrence ◽

Igm Elisa ◽

Curative Action

Leptospirosis has been recognised as an emerging global public health problem. The aim of our study was to explore the epidemiological and clinical pattern of disease occurrence in suspected cases and to search for any existing co-infections. Ours was a retrospective study in patients with acute febrile illness in north India over a period of three years (April 2011 to June 2014). Serological diagnosis of leptospirosis was made using the PanBio IgM ELISA kit. Using modified Faine’s criteria, presumptive and possible diagnosis was made in 57% and 34% cases, respectively. Most of the affected population was resident in north and central India. Nineteen patients showed co-infection with other common pathogens prevailing locally. There is a need to increase awareness and understand the local sero-epidemiological pattern of leptospirosis so that timely preventive and curative action may be taken by healthcare authorities.

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Neighborhood disadvantage and firearm injury: does shooting location matter?

Injury Epidemiology ◽

10.1186/s40621-021-00304-2 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Kimberly Dalve ◽

Emma Gause ◽

Brianna Mills ◽

Anthony S. Floyd ◽

Frederick P. Rivara ◽

...

Keyword(s):

Census Tract ◽

Social Deprivation ◽

Public Health Problem ◽

Credible Interval ◽

Neighborhood Disadvantage ◽

Future Research ◽

Census Tracts ◽

Firearm Injury ◽

Firearm Injuries ◽

Census Tract Level

Abstract Background Firearm violence is a public health problem that disparately impacts areas of economic and social deprivation. Despite a growing literature on neighborhood characteristics and injury, few studies have examined the association between neighborhood disadvantage and fatal and nonfatal firearm assault using data on injury location. We conducted an ecological Bayesian spatial analysis examining neighborhood disadvantage as a social determinant of firearm injury in Seattle, Washington. Methods Neighborhood disadvantage was measured using the National Neighborhood Data Archive disadvantage index. The index includes proportion of female-headed households with children, proportion of households with public assistance income, proportion of people with income below poverty in the past 12 months, and proportion of the civilian labor force aged 16 and older that are unemployed at the census tract level. Firearm injury counts included individuals with a documented assault-related gunshot wound identified from medical records and supplemented with the Gun Violence Archive between March 20, 2016 and December 31, 2018. Available addresses were geocoded to identify their point locations and then aggregated to the census tract level. Besag-York-Mollie (BYM2) Bayesian Poisson models were fit to the data to estimate the association between the index of neighborhood disadvantage and firearm injury count with a population offset within each census tract. Results Neighborhood disadvantage was significantly associated with the count of firearm injury in both non-spatial and spatial models. For two census tracts that differed by 1 decile of neighborhood disadvantage, the number of firearm injuries was higher by 21.0% (95% credible interval: 10.5, 32.8%) in the group with higher neighborhood disadvantage. After accounting for spatial structure, there was still considerable residual spatial dependence with 53.3% (95% credible interval: 17.0, 87.3%) of the model variance being spatial. Additionally, we observed census tracts with higher disadvantage and lower count of firearm injury in communities with proximity to employment opportunities and targeted redevelopment, suggesting other contextual protective factors. Conclusions Even after adjusting for socioeconomic factors, firearm injury research should investigate spatial clustering as independence cannot be able to be assumed. Future research should continue to examine potential contextual and environmental neighborhood determinants that could impact firearm injuries in urban communities.

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Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽

10.33883/jms.v23i1.747 ◽

2020 ◽

Vol 23 (1) ◽

pp. 48-49

Author(s):

Javaid Ahmad Bhat ◽

Shariq Rashid Masoodi

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Tertiary Care ◽

Resistance Mechanisms ◽

North India ◽

Global Public Health ◽

Care Centre ◽

Tertiary Care Centre ◽

Effective Prevention ◽

Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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Modulation of the drug resistance by Platonia insignis Mart. extract, ethyl acetate fraction and Morelloflavone/Volkensiflavone (biflavonoids) in Staphylococcus aureus strains overexpressing efflux pump genes

Current Drug Metabolism ◽

10.2174/1389200221666200523155617 ◽

2020 ◽

Vol 21 ◽

Author(s):

Andressa Kelly Ferreira e Silva ◽

Antonielly Campinho dos Reis ◽

Emanuelly Elanny Andrade Pinheiroc ◽

Jonas Nascimento de Sousa ◽

Felipe Araújo de Alcântara Oliveira ◽

...

Keyword(s):

Natural Products ◽

Ethyl Acetate ◽

Native Species ◽

Efflux Pump ◽

Public Health Problem ◽

Ethyl Acetate Fraction ◽

Multidrug Resistant ◽

Global Public Health ◽

Minimal Inhibitory Concentrations ◽

Subinhibitory Concentrations

Background: Microbial resistance to antibiotics is a global public health problem, which requires urgent attention. Platonia insignis is a native species from the eastern Brazilian Amazon, used in the treatment of burns and wounds. Objectives: To evaluate the antimicrobial activity of the hydroalcoholic extract of P. insignis (PIHA), the ethyl acetate fraction (PIAE), and its subfraction containing a mixture of biflavonoids (BF). Moreover, the effect of these natural products on the antibiotic activity against S. aureus strains overexpressing efflux pump genes was also evaluated. Methods: Minimal inhibitory concentrations were determined against different species of microorganisms. To evaluate the modulatory effect on the Norfloxacin-resistance, the MIC of this antibiotic was determined in the absence and presence of the natural products at subinhibitory concentrations. Inhibition of the EtBr efflux assays were conducted in the absence or presence of the natural products. Results: PIHA showed a microbicidal effect against S. aureus and C. albicans, while PIAE was bacteriosctatic for S. aureus. PIAE and BF at subinhibitory concentrations were able to reduce the MIC of Norfloxacin acting as modulating agents. BF was able to inhibit the efflux of EtBr efflux in S. aureus strains overexpressing specific efflux pump genes. Conclusion: P. inignisis a source of efflux pump inhibitors, including volkensiflavone and morelloflavone which were able to potentiate the Norfloxacin activity by NorA inhibition, being also able to inhibit QacA/B, TetK and MsrA. Volkensiflavone and morelloflavone could be used as adjuvant in the antibiotic therapy of multidrug resistant S. aureus strains overexpressing efflux pumps.

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4H-1,3-Benzothiazin-4-one a Promising Class Against MDR/XDR-TB

Current Topics in Medicinal Chemistry ◽

10.2174/1568026619666190305130809 ◽

2019 ◽

Vol 19 (8) ◽

pp. 567-578 ◽

Cited By ~ 1

Author(s):

Marcus Vinicius Nora de Souza ◽

Thais Cristina Mendonça Nogueira

Keyword(s):

Treatment Time ◽

Public Health Problem ◽

New Drugs ◽

Global Public Health ◽

Synthesis Mechanism ◽

Highly Active ◽

Latent Disease ◽

Resistant Strains ◽

Chemical Class ◽

Global Public Health Problem

Nowadays, tuberculosis (TB) is an important global public health problem, being responsible for millions of TB-related deaths worldwide. Due to the increased number of cases and resistance of Mycobacterium tuberculosis to all drugs used for the treatment of this disease, we desperately need new drugs and strategies that could reduce treatment time with fewer side effects, reduced cost and highly active drugs against resistant strains and latent disease. Considering that, 4H-1,3-benzothiazin-4-one is a promising class of antimycobacterial agents in special against TB-resistant strains being the aim of this review the discussion of different aspects of this chemical class such as synthesis, mechanism of action, medicinal chemistry and combination with other drugs.

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Application of Inherent Risk of Contagion (IRC) framework & modelling to aid local Covid-19 response & mitigation: Viewpoint (Preprint)

10.2196/preprints.19814 ◽

2020 ◽

Author(s):

Helmi Zakariah ◽

Fadzilah bt Kamaluddin ◽

Choo-Yee Ting ◽

Hui-Jia Yee ◽

Shereen Allaham ◽

...

Keyword(s):

Public Health ◽

Public Health Problem ◽

Analytical Framework ◽

Vulnerable Population ◽

Contact Tracing ◽

Global Public Health ◽

Inherent Risk ◽

Transmission Area ◽

Current Outbreak ◽

Novel Coronavirus

UNSTRUCTURED The current outbreak of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus named SARS-CoV-2 has been a major global public health problem threatening many countries and territories. Mathematical modelling is one of the non-pharmaceutical public health measures that plays a crucial role for mitigating the risk and impact of the pandemic. A group of researchers and epidemiologists have developed a machine learning-powered inherent risk of contagion (IRC) analytical framework to georeference the COVID-19 with an operational platform to plan response & execute mitigation activities. This framework dataset provides a coherent picture to track and predict the COVID-19 epidemic post lockdown by piecing together preliminary data on publicly available health statistic metrics alongside the area of reported cases, drivers, vulnerable population, and number of premises that are suspected to become a transmission area between drivers and vulnerable population. The main aim of this new analytical framework is to measure the IRC and provide georeferenced data to protect the health system, aid contact tracing, and prioritise the vulnerable.

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