European Journal of Cardiovascular Medicine

Mucormycosis is a fatal fungal infection predominantly occurring in a diabetic and in immunocompromised patients. Infection is acquired by inhalation, ingestion or traumatic inoculation in a susceptible host. Impairment of host defence mechanisms affecting innate immune system facilitates invasive fungal infection. Skin and soft tissue mucormycosis, necrotizing fasciitis has been described in victims of road traffic accidents, natural disasters (Tsunami, tornado) who had dirt contaminated wounds. Clinical presentation of such patient is non-specific for mucormycosis and represents bacterial necrotizing skin and soft tissue infection. Early clinical suspicion and appropriate microbiological work up allow early diagnosis and appropriate antifungal therapy. With this case report we are describing mucormycosis involving anterior abdominal wall in a diabetic patients and challenges faced in the treatment.

Background: Road traffic accidents are as war on the roads and it takes the lives of approx 1.2 million individuals around the world. It is direct effect of modern day urban civilization. Occupied time between the accident and reaching the hospital is life-threatening and that is a very important gap to provide medical first aid to the victims. In urban life, 75% of thoracic trauma follows blunt injury. Greatest difficulty is faced in their management and long time in diagnosis. Hence, objective of study is to get knowledge of the blunt chest injuries among accident victims travelling in different modes of road transportation. Material and Methods: Data was collected from 100 cases of death by road traffic accident that were brought for medico- legal autopsy at the mortuary of Forensic Medicine Department, Rajrajeshwari Medical College and Hospital Bengaluru, during the period from December 2013 to May 2015

Background: The most frequent injuries are lower limb fractures because road traffic accidents, which are the main cause of trauma, are occurring more frequently worldwide. Recent developments and the creation of newer fixation techniques have produced promising results in the treatment of complex lower limb fractures thanks to a better understanding of fracture healing. In our study, we treat lower limb fractures with a novel plate fixation method known as biological plate fixation-bridge plating. The two major fracture fragments are fixed by using the plate as an internal fixator. Without affecting the intricate fracture zone, length, alignment, and rotation are restored. In this case, as opposed to the traditional plating method, the fracture is healed by callus formation

Introduction: One of the most common types of fractures seen in orthopedic treatment is a crack or break in the shaft of the femur. In individuals who have sustained high intensity trauma, a fracture of the shaft of the femur is a major source of morbidity and mortality. Materials and methods: There were 20 people total who participated in the study. This study was a prospective research study that took place in Department of Orthopedics, Government Medical College, Ongole, Andhra Pradesh, India. There are roughly 8 men for every female. The time frame for the research was from May 2021 to April 2022. Results: The survey involved 20 people, with men making up 72% and women 28%. At least 88% of the population is under the age of 50. The majority of femur fractures occurred in the middle one-third of the thigh, and car accidents were the most prevalent cause of injury. Within 24 hours of injury, 76% of patients were seen. Fractures in most patients healed completely between 12–14 weeks clinically, and within 16–18 weeks radiologically. After 10 weeks, patients could begin light weight bearing, and by 16 weeks, they could handle their whole-body weight. Conclusion: In the fracture of the shaft of the femur that we saw, interlocking nailing had a very low complication rate and produced great results in terms of the patient's ability to function.

BACKGROUND: Motor vehicle accidents are one of the major causes of facial injuries. Midface is the common site to get involved. Midface fractures are frequently involved with head injury or associated with other facial fractures or in isolation.Mid face fracture patterns were first published by a French surgeon Rene Lefort in 1901.At present midfacefractures rarely fit into Lefort classification patterns.The changes in the lifestyle led to increased use of advanced motor vehicles which increased the road traffic accidents.The fractures are deviated from the Lefort patterns due to changes in the velocity,forces direction of impact on the skull. To emphasize the need for more comprehensive classificationto include variations in midface fractures patterns such as unilateral fractures, asymetricalLefort fractures,associated fractures etc., OBJECTIVE:A prospectiveobservational  cross sectional  study to assess various patterns of maxilla fractures in relation to age,sex and mode of injury. MATERIALS AND METHODS:Study includes patients presented to Plastic Surgery department in King George Hospital,Andhra Medical College from  June 2014  to May 2021.Patients were examined clinically and reviewed  with 3D CT facial bones .Injuries were classified using Lefort system and those fractures deviated from Leforts are noted. RESULTS: Evaluation of midfacial fractures done among facial bone fractures.Total number of patients in the study are 685 with 9.5 :1 male to female ratio.The peak incidence is in the age group of 21-30 years.The most common cause beingroad traffic accidents.Mid face fractures which are deviated fromlefort fractures aridentifie and evaluated.Different patterns in midface are observed with the help of radiological imaging.Among midface fractures majority doesnot fit into classical Leforts .Only 8.5%  constitutesLeforts patterns.

Background and objectives: Shoulder dislocations from automobile accidents are on the rise, making shoulder instability a widespread problem among young people today. to examine the association between these clinical and radiological results and arthroscopic findings, to compare the clinical outcome of arthroscopic treatment to open repair of anterior shoulder instability, and to treat these injuries arthroscopically. The essay aims to achieve these ends. Method: This study intends to investigate 25 cases of anterior shoulder instability by clinical, radiological, and arthroscopic methods in order to compare open repair versus arthroscopic therapy of these injuries. Result: We performed diagnostic shoulder arthroscopes on 25 people who had been diagnosed with anterior shoulder instability. According to the results of the procedure, all 25 patients had Bankart's lesions, and 16 additionally had Hillsach's lesions. Although bone loss in 14 of the 16 patients with Hillsach's lesion was less than 10%, they were candidates for arthroscopic Bankart's repair. The other two patients had bone loss of 13%-15%, making them surgical ineligible. In this procedure, the coracoid process was moved to the front of the glenoid using the Tasaki method and then set in place. Conclusion: "Arthroscopic Evaluation and Management of Anterior Shoulder Instability" is the best way to assess instability because of its higher specificity and sensitivity in recognising pathology compared to an MRI, its outstanding results when fixed with suture anchor points, and its outstanding range of motion

Background: Injuries are the leading cause of death and hospitalization among young people aged 15–24 years in India. While progress has been made in preventing injury deaths and disability in both older and younger age groups, young people remain at increased risk of injuries. The purpose of the study is to raise awareness and provide the national authorities and stakeholders with an insight into the size and impact of risk-taking behavior in accidents. The study was conducted with an aim to estimate the prevalence of risk-taking behavior and road traffic accidents and its association between them. Methodology: A cross-sectional study was conducted among 300 students aged 15-25 years of a medical and engineering colleges in Rajahmundry. A predetermined, semi-structured questionnaire was used to collect data. Data collected was entered and analyzed using Microsoft excels 2011 and Chi-square test was used to find the association between risk taking behaviour and road traffic accidents. Results: The prevalence of road traffic accidents in the study population was 46.7 per 1000 students/per year. Not taking personal safety measures (89%), over speeding (44%), using of mobile (46%) and thinking about something else (37%) were found to be the major factors causing road traffic accidents. There was a statistical significant association found between risk-taking behavior and a history of road traffic accidents (P<0.0001)

Tibial plateau fractures are one of the commonest periarticular fractures. These fractures include 1% of all fractures and 8% of fractures in elderly. Motor vehicle accidents account for the majority of these fractures in younger individuals with good bone stock, but in elderly individuals these fractures may result from simple fall due to osteopenic bone. These fractures are associated with high energy violence and extensive soft tissue injury. Each fracture type has its own morphology, treatment considerations and prognosis.  Materials And Methods: This is a prospective study was conducted in the Department of Orthopaedics, Surabhi Institute of Medical Sciences among 30 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. Patients with tibial plateau fractures with posterior column involvement, closed injury, and age >18 years were included in this study. Patients with fractures with zero columns (pure depression type), pure lateral or medial column involvement without posterior column involvement, open injury, and associated head/chest/abdomen/pelvis/spine injury, patient below 18 years of age, and patient not fit for surgery and not willing for surgery were excluded from the study. Results: In our study, the most of the patients were belongs to 21-30 years old 12 (40.0%). In our study, predominant were males 90% and females were of 10%. Single-column fractures (Schatzker Type IV and Hohl and Moore Type I coronal split fracture), Two-column fracture (Schatzker type IV and type V), Three-column fractures (Schatzker Type V).  In this study majority of patients were Three-column fractures, followed by Two-column fracture and Single-column fractures. Mean duration of surgery time of single column fractures were 61.49 minutes, two-column fracture 80.40 minutes and 103.38 minutes for Three-column fractures Conclusion: Based on this study, we would like to conclude that we were able to achieve acceptable clinical and radiological outcome while managing complex tibial plateau fractures with column specific approach.

Background -Children and young people are most often killed and disabled by accidents. Blunt trauma accounts for more than 90% of traumatic mechanisms of injury in children. Blunt abdominal trauma accounts for between 10 and 15% of all blunt mechanisms. The establishment of the present non- operative treatment for the majority of blunt solid organ injuries in the pediatric age group was prompted by observations that most blunt solid organ injuries will heal on their own and that surgical intervention would thwart this mechanism Aim: this is a prospective observational study done in department of pediatrics surgery in north india institute from January 2022 to July 2023. The aim of this study is to determine the management of solid organ injuries in blunt trauma abdomen (BTA) in children how to diagnose radiologically whether to conserve or operate at tertiary health care center in high patient load hospital in India.  Methodology: 116 patients with blunt abdominal trauma due to any cause, the medical records of all patients with trauma of any kind age up to 13 years were carefully reviewed. The injured organ, patient age, sex, injury grade, imaging findings, intervention, length of hospital stay, and complications were prospectively reviewed using medical records. Initial resuscitation was done according to ATLS protocol. Ultimate management decision was based on stability of patients after resuscitation. Data was entered and analyzed through SPSS-26. Chi- square test and student's t-test were applied and P value <0.05 was considered statistically significant. Results: The mean age was 5.34 years. Most of the patients suffered from road traffic accident, 50(86.2%). 104 (89.65%) patients showed free fluid in the abdomen. CT abdomen with intravenous contrast confirmed findings of ultra sonography. Despite resuscitation, 12 (10.6%) patients remained unstable and were operated. 104 [89.4%] patients were kept on conservative treatment. Hospital stays ranged from 5-19 days. Pancreatic injury patient has more hospital stay. Conclusion: BTA is common in boys under age of 10 years. Although non-operative management is the treatment of choice in blunt trauma abdomen with solid organ injury but stability of the injured child is the central pivot around which the whole management revolves. Delay in presentation and failure of timely resuscitation results into high operative intervention.

Introduction: Injury is defined as physiological damage to living tissue caused due to physical stress. It can be intentionally or unintentionally, caused by blunt and penetrating trauma, burning, toxic exposure, or overexertion. This injury can occur in any part of the body with different symptoms related to different injuries.  Computed tomography (CT) most commonly used diagnostic technique specifically used for organ and tissue damage, whole-body CT is used as a standard diagnostic technique. An autopsy is the final diagnostic examination and is considered a standard diagnostic methods in medicine. The study aimed to compare CT scan results, with autopsy results for forensic purposes. Material and method: The present study was retrospective–a prospective study carried out on 500 injured patients attending OPD of general medicine Patient's informed consent was taken. Their age, gender, cause of injury, different areas of injury, conciseness, unconciseness, death, and complication in conciseness patients were noted. Results: as per the study majority of the patients were male with the age group of 40 – 60 years. The majority of the patients were conscious having vertigo and bleeding, and were injured due to transport accidents. 84 patients having head injury among them brain death was observed in most of the patients having positive results over CT and autopsy technique. Conclusion: A CT scan compared to an autopsy is a good method for detecting gunshot injury of head and bone fractures. Were as the autopsy is better for detecting minor injuries to organs and soft tissues.CT and Autopsy are the best techniques for most injury cases.

Background: managing blunt trauma requires prompt resuscitation of the unstable patient in parallel with physical examination and diagnostic testing to determine the presence or absence of hemoperitoneum and organ injury.  Materials and methods: 60 patients with blunt abdominal trauma who underwent laparotomy in the Department of Surgery, at Government General Hospital, Guntur, from November 2021 to October 2023 were included in the study. Results: Males are most commonly involved than females. Spleen is the most commonly involved solid organ. Jejunum and ileum are the most commonly involved hollow visceral organs. Conclusion: Increase in the sales of vehicles has also increased the incidence of road traffic accidents and thus increasing BAT cases. Measures must be taken to curb the rise in such accidents.

Background: Clavicle fractures, particularly midshaft fractures, are common orthopedic injuries. Traditional treatment approaches have included conservative management, but surgical intervention is increasingly utilized for displaced fractures. Among surgical techniques, intramedullary nailing with Titanium Elastic Nails (TENs) has emerged as a promising alternative to plate fixation due to its potential advantages such as minimal scarring, reduced risk of nonunion, and ease of application and removal. Methods: This hospital-based prospective study conducted in a tertiary care hospital in Central India aimed to assess the efficacy of Titanium Elastic Nail (TEN) fixation in midshaft clavicle fractures. A total of 50 patients meeting inclusion criteria underwent surgery and were followed up for a minimum of 6 to 12 months. Data collection involved comprehensive medical history, clinical examination, and radiographic assessments. Surgical techniques, complications, and postoperative outcomes were analyzed. Results: The study population primarily consisted of young adults aged 19-29 years, with a male predominance. Road traffic accidents were the leading cause of injury, affecting 80% of patients. Most fractures were classified as Robinson type B and OTA type 15b1. The majority of patients underwent surgery within 2-7 days, with closed reduction being the preferred technique. Postoperatively, 96.67% of patients exhibited no shortening, and excellent DASH scores were achieved by 80% of patients. Complications were minimal, with entry site irritation being the most common. Fracture union was achieved in 90% of cases by the 12th week post-operation. Conclusion: Intramedullary nailing with Titanium Elastic Nails (TENs) proves to be an effective and safe method for stabilizing displaced midshaft clavicle fractures. It offers rapid functional recovery, excellent cosmetic outcomes, and minimal risk of complications compared to conservative treatment and plate fixation. The findings support the use of this minimally invasive technique as a preferred option for managing midshaft clavicle fractures, particularly in young, active individuals seeking early return to function

Introduction: Cerebrovascular accidents (CVAs), commonly known as strokes, represent a significant public health concern worldwide due to their high morbidity and mortality rates. They result from the sudden interruption of blood flow to a part of the brain, leading to neurological deficits that can range from mild to severe. Ischemic strokes, caused by the blockage of blood vessels supplying the brain, account for the majority of cases, while hemorrhagic strokes, caused by the rupture of blood vessels, constitute a smaller but equally critical subset. Among the various biomarkers studied in the context of strokes, plasma fibrinogen levels have garnered considerable attention. Elevated levels of fibrinogen are associated with increased thrombotic potential, potentially contributing to the pathophysiology of ischemic strokes. Materials And Methods: This is a hospital based Prospective analytical study was conducted in Department of General Medicine at Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka over a period of 1 year. Total 50 adult patients who are getting admitted in medical wards and acute medical care with first episode of stroke and full filling the Inclusion and exclusion criteria. Plasma Fibrinogen level estimation will be carried between 24-72 hours after onset of Cerebro Vascular accidents. After completion of selection of patients, written consent is taken from the patients or their attender’s, detailed history was taken, Physical examination was done, subjects are investigated with routine blood tests like CBC, Blood Urea, Serum creatinine, Random blood sugar, CRP, urine Routine Microscopy, ECG, carotid doppler, Lipid profile, CT BRAIN, MRI BRAIN done in selected cases. Results: In the present study, Ischemic stroke is seen in 68% of patients and Hemorrhagic stroke in 32% of patients. It shows that ischemic stroke is more common than hemorrhagic stroke. Out of 34 patients of ischemic stroke,22(65%) showed their plasma fibrinogen levels ≥350 mg/dl4. Of them, 2 patients showed higher plasma fibrinogen levels between 450-549 mg/dl. Normal plasma fibrinogen levels are seen in 12 patients (35%). Higher fibrinogen levels are seen in 9 out of 16 patients (56%) in haemorrhagic stroke group. 7 patients showed normal fibrinogen level. Out of 50 patients, 7 patients expired and 43 patients survived. Among deceased 7 patients, 4 patients had ischemic stroke and 3 patients had hemorrhagic stroke. Conclusions: Stroke due to ischemia (68%) is more common than stroke due to haemorrhage (32%). Elevated fibrinogen level is one of the independent risk factors for stroke. Fibrinogen levels are slightly higher in ischemic stroke individuals compared to hemorrhagic stroke but not statistically significant. All non survivors have higher fibrinogen levels.

Background: Hypertension is a leading contributor to the disease burden worldwide. Hypertension, has an incidence of 3-6% among the adult population, with affected individuals at a higher risk of cerebrovascular accidents, ischaemic heart disease and renal failure.  Objective: To determine the prevalence of hypertension in School children aged 9-16 years in Bagalkot. Method: This cross-sectional study was conducted among School Children aged between 9-16 years from schools in Bagalkot. Study period: 1.5 years, Jan 2020- June 2021. Result: The prevalence of prehypertension and hypertension was found to be 11.9% (n=149) and 6.3%(n=79). Prevalence of hypertension increased with increase in age from 5.2% in 13-14 years children to 6.7% in children of 15-16 years age group. This was statistically significant P=0.002 Prevalence of hypertension in male children (6.9%) was more than in female children (5.5%). However, this was not statistically significant. Prevalence of hypertension in the children with positive family history of hypertension was more than in children with no hypertensives in the family. This correlation was statistically significant P=0.002 Prevalence of hypertension had significant correlation with increased daily screen time P=0.02. Conclusion: The current study evaluated school children aged 9-16 years and found that the prevalence of hypertension and prehypertension to be 6.3% and 11.9% respectively. Amount of daily screen time significantly correlated with Obesity. Hypertension correlated significantly with age, amount of daily screen time, positive family history of hypertension

Background: Electrocardiographic (ECG) changes are reported frequently after acute strokes. It seems that cardiovascular effects of strokes are modulated by concomitant or pre-existent cardiac diseases, and are also related to the type of cerebrovascular disease and its localization. We aimed to determine the pattern of ECG changes associated with pathophysiologic categories of acute stroke among patients with/ without cardiovascular disease and to determine if specific ECG changes are related to the location of the lesion. Every year, more than half a million people in the world suffer from acute cerebrovascular events, including ischemic stroke, intracerebral and subarachnoid hemorrhage.  Materials and methods: This is a Prospective and observational study conducted in the Department of Medicine, Tertiary Care Teaching Hospital over a period of 1.5 years. Selection of study subjects - After admission, based on clinical history and Physical Examination, a presumptive diagnosis is made and later the patient will be subjected to Serial ECGs after informed consent. Patients admitted in the NICU and various medical wards within 24 hours after the onset of neurological deficit. Patients who developed stroke during their stay in hospital. Result: We have recruited 90 stroke patients, most of them were males. Major type was ischemic stroke. In total 62 (68.89%) stroke patients had some form of ECG change. Majority i.e. 35 (38.89%) patients had QTc prolongation followed by 32 (35.56%) patients had T wave changes. QTc prolongation and Atrial fibrillation were significantly more among hemorrhagic stroke patients (p<0.05) and T wave changes and ST changes (elevation or depression) were significantly more among ischemic stroke patients (p<0.05). Conclusion: PWDis and PTFV1 are independent predictors of PAF in patients with acute ischemic stroke. These simple and easily accessible predictors that can be detected via surface ECG may be used as a guide to identify patients who require longer rhythm monitoring to better detect occult PAF, thereby preventing recurrent strokes.

Background:  Road traffic accidents have become a significant public health concern in the recent times. This issue has resulted in a rising rate of death and illness, largely due to changes in lifestyle and advancements in the automobile sector ^[1]. Trauma to eye remains a leading cause of visual morbidity and blindness, constituting approximately 75% of ocular emergencies, road traffic accidents (RTA) being one of the most common risk factors ^[2].

Objectives:

1. To study the incidence of ocular injuries in road traffic injuries.
2. To determine the pattern of clinical presentation of ocular injuries due to road traffic injuries.
3. Effective management and final visual prognosis in vehicular ocular injuries.

Material & Methods: Study Design: A prospective hospital-based cross-sectional study. Study area: Department of Ophthalmology, East Point College of Medical Sciences and Research Centre, Bengaluru, Karnataka.  Study Period: 1 year. Study population:  All patients with a history of ocular injuries following road traffic accidents presenting to the casualty and outpatient ophthalmology department. Sample size: The study consisted of 60 subjects.Results: The most common ocular manifestation of road traffic accidents was subconjunctival haemorrhage 32 (53.33%), followed by ecchymosis 29 (48. 33%). Majority of the ocular injuries (35%) occurred in the age group of 31- 40 years and the least number of cases (13.33%) were seen in patients over the age of 50 years. Ocular injuries were more common in males 43 (71.67%). Road traffic accidents with ocular injuries were more commonly seen with two wheelers 34 (56.67%).  Conclusion:  Ocular injuries resulting from road traffic accidents are among the primary contributors to eye-related health issues and loss of vision in developing nations such as India, where the number of two-wheeler vehicles is increasing and public awareness regarding eye protection gear is lacking. The most impacted demographic group consists of working-class male.

Background: Trauma is a leading cause of morbidity and mortality among children worldwide. Understanding the patterns and outcomes of pediatric trauma is crucial for improving emergency care and preventive strategies. This study aims to describe the epidemiology, clinical characteristics, and outcomes of pediatric trauma cases presenting to the emergency department (ED) of a tertiary care hospital in East India. Methods: A retrospective observational study was conducted over a period of 12 months, from January to December 2022, in the ED of a tertiary care hospital in East India. Data were collected from medical records of 90 pediatric trauma patients aged 0-18 years. Variables included demographic details, mechanism of injury, injury severity, clinical management, and outcomes. Descriptive statistics were used to analyze the data. Results: The mean age of the patients was 8.5 years (SD ± 4.2), with a male predominance (65.6%). The most common mechanism of injury was falls (48.9%), followed by road traffic accidents (RTAs) (32.2%), and burns (10%). Head injuries were the most frequent (42.2%), followed by fractures (30%) and soft tissue injuries (20%). The majority of patients (75.6%) were discharged with full recovery, while 15.6% required hospitalization, and 8.8% were referred to higher centers for specialized care. Mortality was observed in 2.2% of cases, primarily due to severe head injuries. Conclusion: Pediatric trauma in East India predominantly results from falls and RTAs, with head injuries being the most common. Most patients achieve full recovery, but severe cases require specialized care and have higher mortality rates. Preventive measures and improved emergency care protocols are essential to reduce the burden of pediatric trauma.

Background: Alcohol consumption is a significant public health concern, contributing to various forms of injuries and medico-legal cases. Blood Alcohol Concentration (BAC) is commonly measured to assess the influence of alcohol on injury severity and clinical outcomes. Breath alcohol analyzers provide a non-invasive, rapid method for estimating BAC. This study aimed to assess alcohol levels using a breath alcohol analyzer in medico-legal cases reporting to the casualty of a tertiary care hospital and to evaluate its association with injury severity and socio-demographic factors. Materials and Methods: A cross-sectional analytical study was conducted in the Emergency Department of a tertiary care hospital over two years. A total of 246 medico-legal cases were analyzed, and breath alcohol levels were measured using a handheld breath alcohol analyzer (AlcoMate Premium Model AL 7000). Data on age, gender, occupation, smoking status, time of incident, nature, and severity of injuries were collected and statistically analyzed using SPSS software. Results: Among the 246 medico-legal cases, 205 (83.3%) were males, and 41 (16.7%) were females. A total of 49 (19.92%) cases tested positive for breath alcohol, with a higher proportion among males (22.0%) than females (9.8%). The majority of alcohol-positive cases (46.93%) were aged 21–30 years. The most common injury type among alcohol-positive cases was road traffic accidents (75.5%), followed by accidental injuries (10.2%). Breath alcohol positivity was significantly associated with smoking (OR = 3.31, 95% CI: 1.73–6.31, p = 0.0003). Of the alcohol-positive cases, 57.14% sustained simple injuries, while 42.8% had grievous injuries. The highest proportion of cases (63.5%) occurred between 6 PM and 6 AM. Conclusion: The study found a significant association between alcohol consumption and injury severity, particularly in road traffic accidents and assault cases. Young adults and service-class individuals were the most affected groups. Breath alcohol analysis is an effective, non-invasive tool for rapid alcohol estimation in medico-legal cases. The findings highlight the need for stricter regulations on alcohol use, especially in high-risk populations, and the integration of alcohol screening into emergency department protocols.

Background: Alcohol consumption is a significant public health concern, contributing to injuries and fatalities worldwide. In medico-legal cases, assessing alcohol intoxication is crucial for forensic and clinical decision-making. Breath alcohol analyzers offer a rapid, non-invasive method for estimating blood alcohol concentration (BAC), potentially replacing traditional blood alcohol testing. This study compares the effectiveness of breath alcohol analysis with blood alcohol testing in emergency department medico-legal investigations and explores the association of alcohol levels with the severity and nature of injuries. Materials and Methods: A cross-sectional analytical study was conducted in the Emergency Department of a tertiary care hospital over two years. A total of 246 medico-legal cases were included. Breath alcohol levels were assessed using the AlcoMate Premium (Model AL 7000) breathalyzer. The study recorded socio-demographic data, injury characteristics, and alcohol levels. Statistical analysis was performed using SPSS software to determine correlations between alcohol consumption, injury severity, and other risk factors. Results: Among 246 medico-legal cases, 205 (83.3%) were males and 41 (16.7%) were females. Breath alcohol analysis was positive in 49 cases (19.92%), with a higher prevalence among males (22.0%) compared to females (9.8%). Road traffic accidents (RTA) were the most common type of injury (71.1%), followed by accidental injuries (16.3%) and burns (4.1%). Breath alcohol positivity was significantly associated with RTAs (75.5%) and assault cases (4.1%). The majority of alcohol-positive cases (73.46%) had a BAC of <0.3%, while 26.53% had levels >0.3%. Breath alcohol positivity was more frequent in the 21-30 age group (46.9%). Smokers had a significantly higher likelihood of being alcohol-positive (OR = 3.31, 95% CI: 1.73-6.31, p = 0.0003). Most alcohol-related medico-legal cases occurred between 6 PM and 6 AM (63.5%). Conclusion: Breath alcohol analysis is a rapid and effective screening tool for detecting alcohol intoxication in emergency department medico-legal cases. Its non-invasive nature and ease of use make it preferable to blood alcohol testing. The study highlights a strong association between alcohol consumption and RTAs, particularly among young males and smokers. Implementing routine breath alcohol screening in emergency settings could aid in injury prevention and medico-legal documentation.

Background: Cerebrovascular accidents (CVAs), also called as strokes, considered as second leading cause of death and disability globally. The pathological mechanism of stroke may be either ischemic and hemorrhagic disturbances of the cerebral blood circulation. Hypercholesterolemia is also a known risk factor for stroke. Aim: This study aimed to assess the lipid profile of stroke patients and to compare the lipid profile of hemorrhagic stroke and ischemic stroke in patients admitted to Akash hospital, Devanahalli, Bengaluru rural, Karnataka, India. Materials and methods: This cross-sectional observational study conducted in Department of General Medicine, Akash Institute of Medical Sciences and Research Centre (AIMSRC), Karnataka, India. In this, a total of 112 patients with new onset ischemic and hemorrhagic stroke, confirmed by CT/MRI and presented within 24 hours of onset of stroke admitted in Akash hospital. Blood samples were collected, centrifuged to obtain serum sample. The obtained serum was used for biochemical analysis of total cholesterol (cholesterol oxidase/peroxidase), triglycerides (glycerol phosphate oxidase/peroxidase), HDL-C (HDL-C- Direct) were estimated by using Cobas C111 Biochemistry fully auto analyzer. LDL-C and VLDL-C were calculated by Frieldwald’s formula. Detailed history, physical and clinical examination was done for all the study subjects. Results: In this study, males were 63 (56.2%) and females were 49 (43.8%). 68 (60.7%) cases were above 60 years of age, 28 (25%) were 51-60 years of age, Among the comorbidities, hypertension 42 (37.5%) emerges as the most prevalent. In this study, 88 (78.6%) cases were with infarcts and 24 (21.4%) cases were hemorrhagic. Majority of subjects were non-smokers 58 (51.8%) and smokers were 54 (48.2%). In this study, lipid profile parameters were compared between hemorrhage and infarcts. Serum cholesterol (196.88±21.40) levels were significantly increased in haemorrhagic stroke compared with infarcts. Lipid profile parameters were compared between smokers and non-smokers, significant differences were observed in LDL (smokers 94.4±20.3 mg/dL vs non-smoker 104.96±22.9 mg/dL). Similarly, lipid profile parameters were compared between diabetic and non-diabetic subjects, significant increase was observed in total cholesterol (diabetic 192.8±31.4 mg/dL vs non-diabetic 178.8±30.0 mg/dL), Triglycerides (diabetics 132.6±18.6 mg/dL vs non-diabetic 121.9±36.0 mg/dL). Conclusion: In a comparison of lipid profiles between patients with hemorrhagic stroke and ischemic stroke, statistically significant differences were observed as raised total cholesterol levels. In comparison of lipid profiles between smokers and non-smoker significant differences were observed in increased LDL among non-smokers. Decreased HDL was seen in all the stroke patients. In the comparison of lipid profiles between Diabetic and non-diabetic stroke patients, increased total cholesterol and triglyceride levels among the diabetic group.

Background: Tibial shaft fractures are among the most frequent long bone injuries and pose a significant challenge in surgical orthopedics due to their subcutaneous location and limited soft tissue coverage. While plating and intramedullary nailing are standard treatments, they are often associated with wound complications and longer recovery times. Minimally Invasive Reduction and Osteosynthesis System (MIROS) offers an innovative alternative, aiming to achieve stable fixation while minimizing soft tissue trauma. Materials and Methods: A prospective observational study was conducted over one year in which forty adult patients with closed tibial shaft fractures (proximal, middle, or distal third) underwent MIROS fixation. Clinical and radiological outcomes were assessed at 3rd, 6th, 12th, and 24th weeks. Functional recovery was measured using Johner and Wruhs criteria. Union rates, complications, hospital stay, and return to weight bearing were also evaluated. Results: Among the 40 patients included in the study, the majority were males (65%), and road traffic accidents were the leading cause of injury (70%). The distal third of the tibial shaft was the most commonly fractured site (55%). The average operative time was 26.4 ± 3.1 minutes, and the mean hospital stay was 6.9 ± 1.3 days. Radiological union was achieved at a mean of 15.8 ± 1.7 weeks. Functionally, 62.5% of patients had excellent outcomes, 27.5% good, and 10% fair as per Johner and Wruhs criteria. Early full weight bearing was achieved in 45% of patients by the 8th week. Complications were minimal, with only 12.5% experiencing mild pin tract infections and no cases of nonunion or deep infection. Conclusion: MIROS offers a minimally invasive and cost-effective alternative for tibial shaft fracture fixation, demonstrating early mobilization, fewer complications, and high patient satisfaction. It is particularly beneficial in patients with comorbidities or in distal fractures where soft tissue coverage is poor.

Background: Head injuries are a major global healthcare issue. Traumatic brain injury (TBI), commonly known as craniocerebral trauma, is a major cause of death and disability among young adults, with half of the cases resulting in unfavourable outcomes. This study aimed to identify the correlation between non-contrast computed tomography (CT) findings and the Glasgow Coma Scale (GCS) in assessing craniocerebral trauma. Materials and Methods: This observational prospective study included 50 patients with acute (less than 24 hours) craniocerebral trauma over a period of one year at the Government Erode Medical College. The patient’s level of consciousness was determined using the Glasgow Coma Scale (GCS), and a brain CT scan without contrast media was performed. Result: The majority of the population belonged to males, accounting for 76% (n = 38), and females accounted for 24% (n = 12). It has been found that the major causes of head injuries are road traffic accidents, followed by fall injuries. The distribution of patients according to consciousness level was 54% with mild TBI (GCS score 12–14), 28% with moderate TBI (GCS score 11–8), and 18% with severe TBI (GCS score less than 7). Conclusion: This study found that the prevalence of road traffic accidents was higher than that of other causes of cerebral injury. Using the GCS and CT together increases the chances of assessing the severity of the risk for the patients, which helps in making clinical decisions about their treatment plan.

Background: The Circle of Willis (CoW) is a critical arterial anastomotic system at the base of the brain that ensures collateral circulation. Anatomical variations in the CoW can significantly influence the pathophysiology and prognosis of cerebrovascular diseases. This study aimed to examine the morphological variations of the Circle of Willis in cadaveric brains and assess their clinical relevance. Objectives: To determine the prevalence of anatomical variations in the Circle of Willis among human cadavers and evaluate the potential implications for cerebral collateral circulation. Materials and Methods: A cross-sectional study was conducted over a period of 16 months using 50 formalin-fixed human cadaveric brains obtained from a medical college anatomy department. Standard dissection techniques were employed to expose and examine the components of the Circle of Willis. Observations were recorded regarding completeness, component integrity, variation types, and laterality. Results: A complete Circle of Willis was observed in 60% of specimens, while 40% showed incomplete configurations. Posterior communicating arteries exhibited the highest variability (44% hypoplastic or absent). The most common variation type was Type II (hypoplastic/absent PCoA, 20%). Unilateral variations were noted in 28% of cases, and bilateral variations in 12%. These findings suggest that a significant proportion of individuals may possess anatomical patterns that compromise collateral circulation. Conclusion: Anatomical variations of the Circle of Willis are common and may have important clinical implications in the context of cerebrovascular accidents and neurosurgical planning. Preoperative vascular imaging is recommended for optimal management.

Background: Distal femur fractures are complex injuries with significant functional implications. The Swashbuckler’s approach provides an extensible anterior exposure facilitating anatomical reduction. This study aimed to evaluate the functional outcomes and complication profile of distal femur fractures managed with the modified Swashbuckler’s approach. Methods: This prospective observational study was conducted at a tertiary care centre over 18 months. Fifty adult patients with closed distal femur fractures were included. All patients underwent open reduction and internal fixation via the modified Swashbuckler’s approach. Fractures were classified according to the AO/OTA system. Functional outcomes were assessed using the Neer’s scoring system at 6 months postoperatively. Data on operative time, blood loss, union time, and complications were also recorded. Results: The mean age of the study population was 46.8 ± 13.5 years, with 72% being male. Road traffic accidents were the predominant cause (68%). The most common fracture type was AO 33-C1 (36%). The average operative time was 112 ± 18 minutes and mean blood loss was 310 ± 70 mL. Radiological union occurred at a mean of 17.3 ± 2.4 weeks. Delayed union occurred in 6% of cases. Complications included superficial infection (8%), knee stiffness (12%), and implant irritation (4%). At 6-month follow-up, 48% had excellent, 34% good, 14% fair, and 4% poor outcomes per Neer’s score. Conclusion: The modified Swashbuckler’s approach offers adequate visualization and yields favorable functional outcomes with minimal complications in the management of distal femur fractures.

Background: Tibial plateau fractures, particularly Schatzker Type V and VI, are complex intra-articular injuries resulting from high-energy trauma such as road traffic accidents and falls from height. These fractures often involve significant comminution and soft tissue damage, posing challenges in management. Immediate internal fixation may increase the risk of wound complications, necessitating a staged approach for optimal outcomes. Aim and objectives: The aim of this study was to evaluate the functional outcomes of complex proximal tibial plateau fractures managed with an initial spanning external fixator followed by internal fixation using locking compression plates, with a focus on joint function and soft tissue recovery. Methods This retrospective observational study was conducted at Dr. B. R. Ambedkar Medical College and Hospital between June 2022 to January 2024. A total of 30 patients aged 18–65 years with Schatzker Type V and VI fractures were included in the study. Initial management involved temporary external fixation, followed by internal fixation with locking plates once soft tissue conditions allowed. Patients were evaluated clinically and radiologically, with follow up at 3, 6 and 9 months. Functional outcomes were assessed using the Modified Rasmussen Criteria. Results: Most patients were males (76.67%) in the 31–50-year age group. Road traffic accidents accounted for 60% of cases, and right-sided injuries predominated (63.33%). Type VI fractures were more frequent (56.67%). Partial and full weight bearing were initiated by 8 and 12 weeks respectively. Radiological scores showed 33.33% excellent and 60% good outcomes, with no poor results. Conclusion: Staged surgical management using external and internal fixation produced favorable functional outcomes and minimized complications in complex tibial plateau fractures.

Background: Thoracic injury represents a leading indication for emergency surgical admission and is responsible for a significant proportion of morbidity and mortality related to trauma. Early diagnosis and the delivery of appropriate interventions are critical to optimizing patient results, especially within the context of a resource-limited environment. Objective: The objective of the current research was to assess the clinical presentation, management, and outcome of chest trauma patients who were admitted to a tertiary care facility. Method: We had a one-year prospective observational study on all patients with thoracic injury admitted under the general surgery, cardiothoracic, and orthopedic services. We had emergency procedures, radiological investigations, and complete clinical assessment whenever required. Descriptive statistics were used to compare data on mode of treatment, nature of trauma, complications, and outcomes, and demographics. Result: A total of 70 patients were studied with a significant predominance of males (91.4%) and a mean age of 31.3 years. Blunt trauma was the most frequent (80%), mainly due to road traffic accidents (60%), and followed by assaults and falls. The most frequent injury was rib fractures (68.6%). Intercostal chest tube drainage was the primary management in 77.1% of the cases, and 10% needed thoracotomy. Complication was 19.3%, and the most frequent infection was. Mortality occurred in 5.7% of the cases, mostly due to related head injuries. The mean hospital stay was 8.9 days, and the majority of the patients had complete recovery in follow-up. Conclusion: In summary, blunt chest trauma due to road traffic accidents is the most frequent cause of thoracic injuries. Early diagnosis and timely surgical repair are crucial in minimizing complications and maximizing patient survival.

Introduction: Every year more than 10 million people are affected by traumatic brain injuries (TBIs). Despite efforts being made to improve TBI care, it remains a public health problem, continuing to cause high mortality and morbidity in a young population. Aims: To determine the Incidenceof TBI following RTAs in the rural population served by PCS Govt Medical College and Hospital.To identify the causes and risk factors associated with TBI following RTAs in the rural population.To assess the outcomes of TBI following RTAs in terms of mortality, morbidity, and disability. Materials & methods: This is a prospective observational study study place PCS Govt Medical College & Hospital, Arambagh, Hooghly, West Bengal. The study was conducted over a period of one year, from 1st August to 31st July. And total number of patient was 216. Result: In our study of 216 TBI patients, two-wheeler accidents were the leading cause (50.0%), followed by four-wheelers (22.2%), pedestrian hits (16.7%), and others like falls or animal hits (11.1%). The mean age was 36.9 years, patient of two-wheeler group are younger than the four wheeler group showing a significant age variation (p = 0.002). Most patients were male (75.0%), with no significant gender distribution difference across injury mechanisms (p = 0.981). Conclusion: We concluded that this study shows that one of the major public health concerns in rural areas is traumatic brain injury (TBI) after road traffic accidents (RTAs). The most common cause, which primarily affected younger boys, was two-wheeler accidents. The most common presentation was mild TBI, although four-wheeler and pedestrian collisions were more likely to result in severe TBI and negative outcomes such neurological impairments and death

Background: Extra-articular distal tibial fractures are difficult to manage due to poor soft tissue coverage, precarious blood supply, and a high risk of complications such as malunion and non-union. Among the available fixation options, intramedullary nailing (IMN) and minimally invasive plating are commonly used, but their relative superiority remains debated. This study compared the radiological and functional outcomes of these two techniques. Methodology: A hospital-based prospective observational study was conducted in the Department of Orthopaedics, MKCG Medical College and Hospital, Berhampur, Odisha, from March 2023 to February 2025. Forty adult patients (>18 years) with extra-articular distal third tibial fractures (closed or Type I open) were randomly allocated into two groups: Group A – plating (n=20) and Group B – intramedullary nailing (n=20). Patients were followed for 9 months. Radiological union time, time to weight bearing, perioperative parameters, complications, and functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Data were analyzed using R software, with p<0.05 considered significant. Results:
The mean age of patients was 38.25 years, and 82.5% were males. Road traffic accidents were the most common cause of injury (87.5%). Mean operative time and hospital stay were comparable between groups (p>0.05). Mean union time was significantly shorter in the nailing group (19.2 ± 2.88 weeks) than in the plating group (23.8 ± 3.43 weeks) (p<0.01). Partial weight bearing was initiated by 8–10 weeks in most cases. Complication rates were low and statistically similar between the two groups. Functional outcome assessment showed excellent to good results in 90% of IMN and 85% of plating cases (p=0.59). Discussion: Both IMN and plating achieved satisfactory union and function, though IMN demonstrated faster union, earlier rehabilitation, and fewer superficial infections. These findings align with previous studies suggesting that IMN provides a biological advantage by preserving periosteal circulation and promoting secondary bone healing, while plating offers superior control in metaphyseal comminution. Hence, the choice of fixation should be individualized based on fracture pattern and soft tissue condition. Conclusion: Intramedullary nailing and minimally invasive plating are effective for extra-articular distal tibial fractures. However, IMN offers earlier union and recovery with comparable functional outcomes and complication rates, making it a preferable option in suitable patients.

Background: Many risk factors have been implicated in causation of Cerebro-Vascular accidents. Serum Homocysteine is speculated as one of the risk factor for the same in many epidemiological studies. This study is aimed to investigate whether Homocysteine is an independent risk factor for Cerebro-Vascular accidents. Methods: A cross sectional study in which 96 Stroke patients between 18-80 years have been studied from one and a half year, in Shri Chamarajendra hospital HIMS Hassan, Karnataka. SPSS software was used for statistical analysis of the data and P value less than 0.05 was considered significant. Results: Out of 96 cases participated in the study, 66 were male, with mean age of 51.9848 ± 13.93887.30 were Females with mean age 64.7333 ± 16.29879. Among males 40(60.7%) had elevated levels of Homocysteine,26(39.3%)had values within normal range. Among Females 18(60%) subjects had normal levels and 12(40%) had elevated Homocysteine levels. Out of 96 subjects,52 had raised levels of Homocysteine,44 subjects had normal levels.8 out 9 patients with CVT had raised levels of  S.Homocysteine. Out 70 subjects with Ischemic stroke,36 had raised levels of  S.Homocysteine. Only 5 out of 14 subjects with Haemorrhage had raised levels of  S.Homocysteine.Male preponderance is noted with respect to Hyperhomocysteinemia. There is  no significant difference with respect to Hyperhomocysteinemia in patients with and without comorbidities. Significant association is found between Hyperhomocysteinemia and stroke. Conclusion: The current study revealed that Hyperhomocysteinemia appears to be an important risk factor for Cerebrovascular accidents. Therefore it becomes pertinent to investigate serum homocysteine in all cases of Cerebrovascualar Accidents

Background: Zygomaticomaxillary complex (ZMC) fractures are common midfacial injuries that can compromise facial aesthetics, ocular function, and masticatory efficiency. Open reduction and internal fixation (ORIF) with titanium miniplates is widely used; however, postoperative complications and fixation stability remain clinically relevant outcomes. Objectives: To evaluate postoperative complications and early stability of rigid internal fixation in patients with ZMC fractures treated with ORIF. Materials and Methods: A single-center observational cohort was structured including adult patients with unilateral displaced ZMC fractures managed by ORIF using titanium miniplates. Clinical and radiographic assessments were performed preoperatively and at postoperative week 1, week 6, and month 3. Outcomes included postoperative complications (infection, neurosensory deficit, ocular symptoms, hardware-related issues) and fixation stability assessed clinically and radiographically. Data were summarized descriptively, and associations between fixation strategy and outcomes were explored. Results: The cohort predominantly comprised young adult males, with road traffic accidents as the most common etiology. Two-point fixation was the most frequently employed technique. Early postoperative morbidity was mainly transient infraorbital sensory disturbance and trismus, which showed marked improvement over follow-up. Infection, plate exposure, and persistent ocular complications were infrequent. Fixation stability was high, with secondary displacement observed in a small minority, more commonly associated with single-point fixation. Conclusion: Rigid internal fixation with titanium miniplates provides reliable early stability in ZMC fractures with an acceptable complication profile. Individualized selection of fixation points based on fracture severity enhances outcomes.

Introduction: Road traffic injuries (RTIs) are a major public health concern worldwide, particularly in low- and middle-income countries. Understanding the epidemiological patterns and risk factors associated with RTIs is essential for developing effective prevention and trauma care strategies. Objectives: To assess the pattern of road traffic injuries and identify socio-demographic and injury-related factors associated with hospital admission among victims presenting to the emergency department of a tertiary care hospital. Methods: A hospital-based cross-sectional study was conducted among 120 road traffic accident victims attending the emergency department. Data regarding socio-demographic characteristics, injury mechanisms, use of protective devices, and clinical injury patterns were collected using a structured proforma. Statistical analysis was performed using descriptive statistics and inferential tests including chi-square test and Welch’s t-test, with a p-value <0.05 considered statistically significant.  Results: The mean age of the victims was 34.7 ± 12.8 years, with males constituting 65.8% of cases. Hospital admission was significantly associated with older age, male gender, urban residence, alcohol consumption, nighttime accidents, and non-use of protective devices. Two-wheeler riders and victims involved in high-velocity collisions had significantly higher odds of severe injury and hospitalization. Head injuries were the most common anatomical injury and were strongly associated with hospital admission.  Conclusion: Road traffic injuries predominantly affect young, economically productive males and are strongly associated with modifiable risk factors such as alcohol use, non-compliance with safety measures, and high-speed travel. Strengthening road safety enforcement, improving public awareness, and enhancing trauma care services are essential to reduce the burden of road traffic injuries.

The global and Indian demographic trend shows that, with passage of time, countries have experienced ageing of population with increase in proportion of older persons, thus creating a burden on the working age group. Census 2011, Sample Registration System, and other studies, have shown following demographic changes in India. Objective of The Study: 1. To assess morbidities amongst the elderly in the study area. 2. To determine the nutritional status by the elderly in the rural areas. 3. To study the socio demographic factors influencing the health care seeking behaviour amongst the elderly. Material and Methods: Study Type: Community-based, Cross-sectional study. Study Population: Elderly Population above 60 years of age. Study Area: Villages under Titaguri,Dotma & Balajan, kokrajhar Study Duration: November 2024 to January 2025. Sample Size calculation: Sample size was calculated based on study named Barua K, Borah M, Deka C, Kakati R. Morbidity pattern and health-seeking behavior of elderly in urban slums: A cross-sectional study in Assam, India. J Fam Med Prim Care. 2017;6(2):345–50 ,Taking the prevalence of diabetes mellitus (24%), among the elderly in urban settlements from a study in Assam in 2017, 95% confidence interval, and absolute error as 5%, the sample size is calculated to be 291.84. The sample size was rounded off to300. This community-based cross-sectional study was conducted among persons aged 60 years and above, in rural areas in the Kokrajhar district, Assam. Consent: Informed consent will be taken from all the participants before data collection and confidentiality will be maintained. Results and Observations: On the basis of their history, clinical assessment, laboratory test reports, and doctors' prescriptions, it had been noted that out of 300 elderly people, 37% had hypertension, 32.33% had diabetes mellitus, 40.33% had musculoskeletal disorders, 36.67% had dental problems, 12.33% had urogenital disorders, 11% had sleep disorders, 10.33% had geriatric depression,8.33%had accidents and injuries and 6.66%had dementia. Ocular disorders(83.67%) were observed to be the most frequent morbidity followed by musculoskeletal disorders (40.33%) and hypertension (37%). Conclusion; A significant association with increasing age was seen with different morbidities including ocular disorders, hearing disorders, musculoskeletal disorders, urinary system disorders, dementia, dental problems, sleep disorders, and multimorbidity.