jiafm, 2010-32(2) april-june. - forensic medicine

More documents

Recommendations

Info

ISSN 0971-0973 J Indian Acad Forensic Med, 32(2)Original research paperStudy Of Road Traffic Accidental Deaths (RTA) in and AroundBastar Region of Chhattisgarh*Dr.Dhaval J. Patel, **Gopinath AgnihotramAbstractTo analyze the magnitude of head injury in fatal RTA cases, present study was conducted in the departmentof Forensic Medicine Toxicology, Govt. Medical College, Jagdalpur (Chhattisgarh) in 2009 calendar year. Thepresent study was undertaken on 105 victims of RTA who died due to head injuries, which autopsied at GMC,Jagdalpur (C.G). Most of the accidents occurred in the afternoon hours (12: 01 - 18:00). There was a clear maledominance (88.57%). The most affected age was middle age (21-40 yrs) & most commonly affected age group is21-30 yrs. Vehicular occupants were commonly affected (63.80%) & amongst them two wheeler occupants mostcommonly involved. Fissure fracture of the skull was commonest (45.71%) & parietal region of head was mostlyinvolved region of the head (27.61%). Among the intracranial hemorrhages, subdural hemorrhage (SDH) wascommonest (31.42%). In relation duration of survival time 59.04% of victims died within 24 hrs of fatal accident.Key Words: Road Traffic Accident (RTA), Head injury, HemorrhageIntroduction:Accident constitutes a complex phenomenonof multiple causations. The causative factorsclassified into human & environmental (1). During1990 RTA was 9 th leading cause of death in the world.RTA may become 2 nd commonest cause around 2020(2). The total annual deaths due to road trafficaccidents has crossed 1.18 lakh, according to latestreport of National Crime Records Bureau, NCRB (3).Total no. of deaths were only 83,430 in 2003, itcrossed 1.18 lakh in 2008, an increase of nearly 40%.RTA had the maximum (37.10%) share ofunnatural causes of accidental deaths in country. In2009 rate of road deaths is 13 persons per hour.According to NCRB maximum cases reportedbetween 15:00 – 18: 00 hrs in Asian countries 60-80% road traffic accidents occurs in urban & semiurbanregions. In India rate of RTA is 7.5 accidentsper 1000 vehicles. [5]In developing countries like India, all theabove mentioned figures are due to lack of goodquality roads, increase number of vehicles, carelessdriving by young people, unsafe traffic environmentand lack of knowledge regarding traffic rules. So thepresent study is smallest attempt to understand themagnitude of problem.Corresponding Author:*Assistant Professor, Department of ForensicMedicine, Govt. Medical College, Jagdalpur(Bastar), Chhattisgarh -494 001M – 09617660480 / 09617660563E-mail: agn_bio@ yahoo.com**Demonstrator, Department of BiochemistryMaterials and Methods:The present study was conducted indepartment of Forensic Medicine & Toxicology,Govt. Medical College, Jagdalpur (C.G). It includesthe retrospective study & analysis of 105 cases inwhich cause of death was head injury due to RTA,over a period of one year from 01/01/2009 to31/12/2009. The epidemiological data such as age,sex, time of accident, survival time, type of victim,type of vehicular occupants & all pathologicalfeatures as type & site of skull fracture, type ofintracranial hemorrhage were noted at the actualautopsy examination with related history as well.Observations:Total 105 cases studied during one yearperiod. Male comprised (88.57%) and female(11.42%) makes M: F ratio almost 8:1. Age groupsdivided in to 10 years period ranging from 0 -70years. The youngest victim was 10 years old boy andoldest was 69 years male. Highest victims of RTAfound in 21 – 30 years group (32.38%) and least inboth extreme age group, 0 – 10 and 61 – 70, onevictim each. [Table No.1]Highest no. of RTA cases occurred during12:01 -18:00 hrs, (43.80%) and least no. of casesduring 00:01- 06:00 hrs (10.47%). [Table No.2]In present study pedestrians (36.19%) andvehicular occupants (63.80%) involved and make aratio of 1:1.75. [Table No. 3]Two wheeler occupants are mostly(65.67%), involved in RTA death, which is very highin comparison to deaths by LMV (14.92%) and HMV(19.40%). [Table No.4]The study shows fissure fracture wascommonest (45.71%), where as comminuted,110
J Indian Acad Forensic Med, 32(2) ISSN 0971-0973depressed and multiple type (>1) were seen in19.04%, 14.28% and 20.95% respectively. [TableNo.5]Most commonly affected site is parietalregion (27.61%), which is followed by multiple site>1 involvement (23.80%). The least affected site isoccipital region (7.61%). [Table No.6]Ours study shows SDH was commonest typeof intra cranial hemorrhage (31.42&), which isfollowed by multiple type (23.80%). The leastobserved hemorrhage was intraventricular (3.80%).[Table No.7]Most of the RTA victims died within 24hrs(59.04%) and only 7.61% can survive for more than aweek. [Table No.8]Discussion:Head injury is still the major cause of deathin RTA cases. The reason behind this may beurbanization, more industrial growth in smaller townsas well as population growth & increasing number oftwo wheelers. These factors causes tremendous overcrowding of vehicles on roads which eventually leadsto more accidents.In present study, male dominance with M: Fratio 8:1, because males are more mobile due togoing to work, studies etc. and so more prone toaccident. [6, 7, 12] In present study, third and fourthdecades were commonly affected. This correspondswith other studies. [7, 9, 11] This age group mainlyconsists of working people and students, who usuallytraveled by own vehicles or other publictransportation. This leads to involvement of this agegroup more commonly in RTA.Vehicular occupants were more involvedthan pedestrians. This corresponds with other studies.[10, 12] It is due to careless driving mainly byyounger age group. Some of the studies also showedthe more involvement of pedestrians than vehicularoccupants. [8, 9, 10]In our study most of the accidents were inafternoon hours (12:01-18:00hrs) followed bymorning hours (06:00-12:00hrs). It may be due toheavy traffic during peak hours.Most common type of intra cranial hemorrhage wassubdural hemorrhage (31.42%). This correspondswith other study. [6] This is followed by multipletype of hemorrhage (>1 type), where as in otherstudies second most common type of hemorrhagewas subarachnoid hemorrhage. [10]Extra dural, intra cerebral and intraventricular hemorrhages found in very less number ofcases, which corresponds with other studies. [9, 10]In present study, 62% of RTA victims diedon the spot or within 24 hours of accident. Thiscorresponds with other studies. [13, 14]Conclusion:From present study males of middle agegroup (21- 40yrs) are involved in accidents duringafternoon hours (12:01-18:00). More accidents in twowheeler occupants than other vehicles and subduralhemorrhage (SDH) were commonest. The almostsame type of conclusion observed in so many otherstudies due to using the same parameters for thestudy. It‟s necessary to do much more studies onRTAs and strict implementation of the alreadyexisting rules.References:1. Norman LG. Road Traffic Accidents Epidemiology,Control & Prevention. World Health Org. Geneva,1962; 7-18.2. WHO, The world Health Report 1995, Report of theDirector General WHO.3. NCRB, Annual Report on Road Accidents.4. WHO (2002), Injuries in South East Asia Region,Priorities for Policy & Action. SEA/ Injuries.5. The Government of India, Ministry of Home Affairs,National Crime Record Bureau, Accidental Deaths &Suicides in India 1999.6. Menon A et al: Pattern of Fatal Head Injuries due toVehicular Accidents in Manipal, JIAFM. 2005; 27(1),19-22.7. Pathak et al : Profile of Road Traffic Accidents &Head Injury in Jaipur (Rajasthan), JIAFM. 2007. 30(1),6-9.8. Patel NS. Traffic fatalities in Lusaka, Zambia. Med.Sci. Law 1979; 19(1): 61-65.9. Chandra J et al: Pattern of Cranio-cerebral injuries inFatal Vehicular Accidents in Delhi 1966-76. Med. Sci.Law 1979; 19(3): 186-194.10. Akang et al: Pattern of Fatal Head Injuries in Ibadan-A10 year Review. Med. Sci Law 2002; 42(2): 160-166.11. Gautam Biswas et al. Pattern of Road TrafficAccidents in North-East Delhi.JFMT 2003; 20(1): 27-32.12. Nilambar Jha et al. Epidemiological study of RoadTraffic Accident cases: Study from South India. IndianJournal of Community Medicine 2004; 29(1):20-24.13. Singh H. Pattern & Distribution of Injuries in FatalRoad Traffic Accidents in Rohtak. JIAFM. 2004; 26(1):20-23.14. Singh YN et al. An Epidemiological Study of RoadTraffic Accident victims in Medico legal Autopsies.JIAFM. 2005; 27(3): 166 – 169.Table No. 1Age and Sex distributionAge (years)No. of casesMale Female Total0 – 10 01 00 0111 – 20 16 02 1821 -30 30 04 3431 – 40 28 02 3041 – 50 13 03 1651 – 60 04 01 0561 – 70 01 00 01Total 93 12 105111
Page 2 and 3: ISSN 0971-0973 J Indian Acad Forens
Page 68 and 69:
ISSN 0971-0973 J Indian Acad Forens
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
Page 94 and 95:
Page 96:
show all

jiafm, 2010-32(2) april-june. - forensic medicine

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?