scholarly journals Ocular morbidity following road traffic acccidents: a retrospective analysis

Author(s):  
Shubhra Das ◽  
Dipak Bhuyan ◽  
Sujit Addya

Background: Ocular trauma is a well-known cause of blindness and visual impairment and in industrialised nations it has become the reason for extended hospitalization of ophthalmologic patients. Anually, there are in excess of 2 million cases of ocular trauma, with more than 40,000 individuals sustaining significant visual impairment on a permanent basis. The aim of the present study was to study the pattern of ocular involvement in variety of road traffic accidents, attending the emergency department of Gauhati Medical College and Hospitals; analyse and correlate various factors playing roles in etiology and evaluate the final visual outcome. Methods: The study was conducted at a tertiary care centre in which retrospective analysis of 500 cases, who sustained injury involving any part of eye due to road traffic accidents attending emergency department from 1st January 2014 to 31st December 2016, was performed. Results: The predominant age group was between 21-30 years of age with males (75.2%) dominating over female (24.8%). Lid injury in the form of abrasions, lacerations, oedema to full thickness tear, is the commonest presentation in majority of the studies. RTA is more common in rainy and winter months and during the daytime. Two (2) wheelers is the common type of vehicle involved. Final visual outcome in the present study is good and comparable to other studies. Conclusions: Driving under the influence of alcohol is an important etiology in Northeast India. A significant section of the patients were driving two-wheelers and not following the safety precautions as advised, which calls for rigorous implementation of traffic rules. Last but not the least, it is often said that the prevention is the best way to minimise such unwanted events. Public sensitisation, strict adherence to traffic rules and improved roads are some of the few steps that can go a long way to reduce such events. 

Author(s):  
Arun Kumar Singh

Majority of the world's fatalities on the roads occur in low-income and middle-income countries, even though these countries have approximately half of the world's vehicles. India is no exception and data showed that more than 1.3 lakh people died on Indian roads, giving India the dubious honour of topping the global list of fatalities from road crashes. Road traffic injuries have been neglected from the global health agenda for many years, despite being predictable and largely preventable. Evidence from many countries shows that dramatic successes in preventing road traffic crashes can be achieved through concerted efforts that involve, but are not limited to, the health sector. Hence based on above findings the present study was planned for Assessment of Injuries in Road Traffic Accidents Admitted to Emergency Department of GMCH, Bettiah, West Champaran, Bihar. The present study was planned in Department of Forensic Medicine, Government Medical College, Bettiah, West Champaran, Bihar, India from jan 2018 to Dec 2018.In the present study 20 cases suffered from the road traffic accidents were evaluated for the pattern of injury. A predesigned and pretested questionnaire especially designed for this purpose was used for interviewing the accident victims, either in the emergency itself or in the wards. In India, there are ample risk factors for RTAs to occur because of lack of proper infrastructural facilities, poor designs of roads, improper implementation of traffic rules and a high load of variety of vehicles on the roads.  Road traffic accidents with head injuries are much more common in young working males as compared to females and that to in those who were pedestrians and motor cyclists. The rate of incidence is higher in India because of bad traffic patterns and possibly the lack of awareness about traffic rules and also lack of good hospital services to our victims of RTAs. Keywords: Injuries, Road Traffic Accidents, Emergency Department, GMCH, Bettiah, West Champaran, Bihar, etc.  


2021 ◽  
Vol 8 (03) ◽  
pp. 141-145
Author(s):  
Vinay Kumar Dawson ◽  
Manasvi Dawson

BACKGROUND Ocular injuries due to road traffic accidents (RTA) is one of the important causes of ophthalmological morbidity and cause of unilateral blindness. Some of the injuries also result in cosmetic disfigurement. Increased usage of vehicles for transport in recent times has increased the incidence of cases. The primary objective of this study was to understand the epidemiology and pattern of ocular trauma in RTA cases and their visual outcome. METHODS A total of 75 cases was included in the study following the inclusion and exclusion criteria. A detailed history was taken which included information regarding time, location, type and mechanism of injury, use of spectacles, car safety belts, and helmets. The time interval between injury and reporting was recorded. Test of visual acuity was done, ophthalmic examination included the examination of all patients with the slit lamp, 90 D examination, and indirect ophthalmoscopy were done. Ultrasound B scan was done in cases where unclear media prevented fundus examination. RESULTS Ecchymosis of the lids was the commonest type of ocular injury. Out of 15 eyelid laceration cases, 10 cases were with mild partial-thickness tears present and 5 had severe lid tears which required suturing. Most of the patients recovered with good vision in 6 months post-treatment and a few fair results. Analysis of variance (ANOVA) comparison between conservative management and surgical management at the end of 4 months post treatment was done. The P-values were > 0.05 hence, not significant. It indicated that the outcomes were independent of the method of management adopted. CONCLUSIONS The incidence of RTAs is increasing due to an increase in the number of vehicles used by the public. Ocular injuries are more often seen in young men especially those driving two-wheelers without safety devices like helmets. Open globe injuries and cases with previous ocular problems have poor outcomes. KEYWORDS Ocular Trauma, Road Traffic Accidents [RTA], Visual Outcome


2020 ◽  
Vol 7 (11) ◽  
pp. 5063-5069
Author(s):  
Sandeep Jawade ◽  
Rahul Dagwar ◽  
Ravi Chauhan

Introduction: Ocular trauma is a major cause of visual morbidity and Visual impairment leading to injury of the globe, optic nerve and adnexa ranging from superficial to vision-threatening complications. Objective: To study the factors leading to blunt ocular trauma, its characteristics, presentation and Outcome. Methods: Hospital-based prospective study conducted at the tertiary care centre of central India. The patient was assessed and if required, admitted. They were followed up on 1st week,1st month,6th month and were assessed for visual outcome and complications. Results: Male constituted 66% and female 34% of all patients. This study had patients of age ranging from 3 to 90 years. Most of the patients were found in the age group of 31-40 years(20.3%). In our study which included 103 cases, there were 20% cases of RTA and 80% cases of non-RTA. 85(82.5%) had lid oedema with chemosis of conjunctiva.87(84.4%) patients had a sub-conjunctival haemorrhage.16 patients (15.5%) presented with a corneal abrasion.32 patients(31.06%) presented with traumatic hyphaema.2 patients(1.9%) had traumatic optic neuropathy.7 patients(6.7%) presented with Berlin’s oedema and 8(8.1%) presented with angle recession glaucoma. Final visual outcome of patients was,1 patient(0.97%)had no perception of light,4 patients(3.8%) had visual acuity of perception of light and projection of rays inaccurate. 7 patients(6.7%) had vision perception of light and projection of rays accurate.45(43.68%) patients regained visual acuity of 6/6 Conclusion: Blunt trauma was more common in males. Most common age group was 4th decade. Road traffic accidents constituted a large number of blunt injuries. Road traffic accidents had a high rate of visual loss due to optic nerve injury.                                                                                                            


2015 ◽  
Vol 30 (6) ◽  
pp. 599-605 ◽  
Author(s):  
Adam R. Aluisio ◽  
Annelies De Wulf ◽  
Ambert Louis ◽  
Christina Bloem

AbstractIntroductionMore than 90% of traumatic morbidity and mortality occurs in low- and middle-income countries (LMIC). Haiti is the poorest country in the Western Hemisphere and lacks contemporary statistics on the epidemiology of traumatic injuries. This study aimed to characterize the burden of traumatic injuries among emergency department patients in the Northeast region of Haiti.MethodsData were collected from the emergency departments of all public hospitals in the Northeast region of Haiti, which included the Fort Liberté, Ouanaminthe, and Trou du Nord sites. All patients presenting for emergent care of traumatic injuries were included. Data were obtained via review of emergency department registries and patient records from October 1, 2013 through November 30, 2013. Data on demographics, mechanisms of trauma, and anatomical regions of injury were gathered using a standardized tool and analyzed using descriptive statistics. Temporal analysis of injury frequency was explored using regression modeling.ResultsData from 383 patient encounters were accrued. Ouanaminthe Hospital treated the majority of emergent injuries (59.3%), followed by Fort Liberté (30.3%) and Trou du Nord (10.4%). The median age in years was 23 with 23.1% of patients being less than 15 years of age. Road traffic accidents (RTAs) and interpersonal violence accounted for 65.8% and 30.1% of all traumatic mechanisms, respectively. Extremity trauma was the most frequently observed anatomical region of injury (38.9%), followed by head and neck (30.3%) and facial (19.1%) injuries. Trauma due to RTA resulted in a single injury (83.8%) to either an extremity or the head and neck regions most frequently. A minority of patients had medical record documentation (37.9%). Blood pressure, respiratory rate, and mental status were documented in 19.3%, 4.1%, and 0.0% of records, respectively. There were 6.3 injuries/day during the data collection period with no correlation between the frequency of emergent trauma cases and day of the week (R^2=0.01).ConclusionsTraumatic injuries are a common emergent presentation in the Northeast region of Haiti with characteristics similar to other LMIC. Documentation and associated data to adequately characterize the burden of disease in this region are lacking. Road traffic accidents are the predominate mechanism of injury, suggesting that interventions addressing prevention and treatment of this common occurrence may provide public health benefits in this setting.AluisioAR,De WulfA,LouisA,BloemC.Epidemiology of traumatic injuries in the Northeast region of Haiti: a cross-sectional study.Prehosp Disaster Med.2015;30(6):599–605.


Author(s):  
Rashmi A. ◽  
Shrinivasa B. M. ◽  
Shrinivasa B. M. ◽  
Shrinivasa B. M. ◽  
Narayanamurthy M. R. ◽  
...  

Background: In India, Road safety is an issue of national concern. Road accidents create negative impact on the economy, public health and the general welfare of the people. Every year the lives of approximately 1.25 million people are cut short as a result of road traffic accidents. Between 20 and 50 million more people suffer non-fatal injuries, with many incurring a disability as a result of their injury. Reliable road traffic injury surveillance is an important component of evidence based road safety policy making. Methods: A cross sectional study was conducted for the period of 3 months in Mysuru city. The present study included all the 5 Traffic Police stations coming under Mysuru city. Before conducting the study, permission to collect all the relevant information is obtained from the in charge of the stations. Retrospective data regarding the traffic rules violations, fatal and non-fatal injuries are obtained in the fixed format prescribed by the government which is maintained uniformly by all the police stations. Data collected was entered in MS office excel sheet and analyzed using statistical package for social sciences (SPSS) software version 22.0. Results: From the study we can observe that there is a drastic increase in the total number of traffic crimes in 2015 compared to 2014. Case fatality of road traffic accident showed decreasing trend from the year 2013. It was evident from the study that there was no significant correlation between total number of accidents every year with violation of traffic rules (r = -0.86 p =0.338). Similarly  There was no significant correlation between the number of persons killed every year with violation of rules by riding two wheeler without helmet(r = -0.380 p =0.752). Conclusions: With massive investment in roads and the exponential growth in the number of vehicles it has become necessary to have a system, which integrates all disciplines that influence road safety. In depth evaluation of the road traffic accidents to build infrastructures and to reinforce the regulations specific to local needs is required. 


Author(s):  
Angli Manhas ◽  
Rameshwar S. Manhas ◽  
Gaurav S. Manhas ◽  
Rishabh Sharma ◽  
Dinesh Gupta

Background: One of the delicate structure in the human body is eye and trauma to the eye is essentially a very grave matter. Major cause of preventable monocular blindness and visual impairment in the world is ocular trauma. So any injury to the eye must be deemed to be an ocular emergency and should be handled with utmost care. Despite its public health importance, there is relatively less population based data on the magnitude and risk factors for ocular trauma specially from developing countries. The objective of the study was to find out the epidemiological pattern of ocular trauma.Methods: The present study was 5 year retrospective study of all the patients who reported directly with ocular injury or referred from the casualty to the department of ophthalmology from January 2013 to January 2018. Various parameters like age, sex, mode of injury, type of injury etc. of all patients seen during this period were analyzed.Results: Total of 4192 ocular trauma patients were seen during study period. Maximum number of ocular trauma patients i.e. 1146 were seen in age group of 21-30 years. Males i.e. 3490 outnumbered females in the present study. Road traffic accidents were the most common cause of ocular trauma and accounts for 1760 cases. Most common reported ocular trauma was periorbital oedema/ecchymosis followed by laceration. Surgical intervention was done in 1660 cases whereas 2532 were managed medically.Conclusions: From present study, we may conclude that the maximum number of ocular trauma patients were seen in the age group of 21-30 years with more preponderance in males. Road traffic accidents were the most common cause of ocular trauma. The fact that the lifetime prevalence of ocular trauma is higher than that of eye diseases, which can be decreased by implementing the traffic rules with strict force and imposing heavy fine and license cancellation for drunken driving.


2021 ◽  
Vol 59 (243) ◽  
pp. 1081-1085
Author(s):  
Rohan Jha ◽  
Priya Pathak ◽  
Pallavi Koirala ◽  
Bishwash Maharjan ◽  
Srijana Panthi

Introduction: Road Traffic Accidents have emerged as the leading cause of mortality and morbidity globally. The burden of road traffic accidents has escalated gradually in Nepal and is a common cause of injury and trauma. The study aims to identify the prevalence of road traffic accidents in the emergency department. Methods: This descriptive cross-sectional study was conducted among hospital records of cases admitted to the emergency department of tertiary care hospital between March to August, 2020. Ethical approval was taken from the ethical review board of College of Medical Sciences (reference number: 2020-035). Information was collected through pro-forma and hospital records. Convenience sampling was done. The data were entered in the Statistical Package for the Social Sciences version 24 and analysed using descriptive statistics. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 4050 cases presenting to the emergency department, 228 (5.6%) (4.9-6.3 at 95% Confidence Interval) cases of road traffic accidents were seen. The most common injuries involved were soft tissue injury 90 (39.47%) and head injury 77 (33.77%). Most patients admitted to the hospital were male 178 (78.07%) aged 21 to 30 years 79 (41.38%). The vehicles mostly involved in the accidents were motorized two-wheelers 120 (50.6%) and pedestrians 51 (22.4%). Conclusions: The prevalence of road traffic accidents was similar to the findings from similar studies. Strengthening the capacities of the pre-hospital care and emergency department is necessary along with preventive intervention in public to reduce such health burden.


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