Road Traffic Accident Coming to Hillah Teaching Hospital: Prospective and Retrospective Study
Salam Salah Flayyih, Imad Hadi Hameed*, Fakhir Daffa Fakhir
College of Nursing, University of Babylon, Iraq
*Corresponding Author E-mail: imad_dna@yahoo.com
ABSTRACT:
Study was planned to study the major causes/risk factors as well as nature, type and mode of occurrence of road traffic accidents in Hilla city and study demographic profile and injury pattern among RTA victims. Road traffic accidents are responsible for a substantial proportion of deaths &injuries and are responsible for more years of life lost than most human diseases. This study has been conducted prospectively. The WHO has defined road traffic accident (RTA) as when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other stationary obstruction. This prospective study was conducted at Hillah Teaching hospital, Hillah city from 1st October 2016 to 30th Mach 2017. The retrospective study group consisted of all the RTA victims reporting to Emergency Department of Hillah Teaching Hospital in the study period from 1st January 2010 to 30th December 2016. The data were summarized using percentages. There is a high percentage of RTA among males of younger age group (10-20) years those were using cars. Total of 210 injured patients were seen in the emergency department. Commonest injury was a simple injuries (81.9 percent, n=172), dangerous injuries (13.33 percent, n=28) and dead was (4.29 percent, n=9)
KEYWORDS: Road Traffic Accident, Injuries, Prospective, Retrospective, Mode of travel.
INTRODUCTION:
Accidents and injuries are rapidly on the increase and appear to emerge as the leading causes of morbidity and mortality in the age group of 15 to 34 years. Road Traffic Accident (RTA) is one of the varieties of transportation injuries (Road, Rail and Air)1-8. Road Traffic Accidents (RTA) accounts for 1.7% of global mortality and 91% of the world’s fatalities on the roads occur in the low-income and middle-income countries9-11. Accidents, tragically, are not often due to ignorance, but are due to carelessness, thoughtlessness and over confidence. Road traffic accidents are responsible for a substantial proportion of deaths and injuries and are responsible for more years of life lost than most human diseases11. The morbidity and mortality burden in developing countries is rising due to a combination of factors, including rapid motorization, poor road and traffic infrastructure as well as the behavior of road users.
This contrasts with technologically advanced countries where the indices are reducing. According to World Health Organization (WHO), road traffic injuries are the sixth leading cause of death in India with a greater share of hospitalization, deaths, disabilities and socio-economic losses in young and middle - age population12. This level of attention to road safety underscores the global burden of road traffic injuries and the need for public health concerned towards reducing this epidemic13, 14. This study was planned to understand the major causes/risk factors as well as nature, type and mode of occurrence of road traffic accidents in Hillah city-Iraq.
MATERIALS AND METHODS:
RTA was defined as an accident which took place on the road between two or more objects, one of which must be any kind of moving vehicle. This study was conducted at Hillah Teaching Hospital from 1st October 2016 to 30th Mach 2017. The study group consisted of all the RTA victims reporting to Emergency Department of Hillah Teaching Hospital in the study period. Data was collected for complete one month and all the cases in the month were included in the study, which thus constitute sample for the study. Using database, major accident prone areas have been identified and data pertaining to the time, Place, effectiveness of emergency medical services. The retrospective study group consisted of all the RTA victims reporting to Emergency Department of Hillah Teaching Hospital in the study period from 1st January 2010 to 30th December 2016. The data were summarized using percentages.
Statistical Analysis:
Data was analyzed via SPSS (Version 20). Interpretation of the collected data was done by using appropriate statistical methods like percentage and proportions.
RESULTS AND DISCUSSION:
In this study a total of 210 cases were included who admitted in the emergency department of Hillah Teaching Hospital from 1st October 2016 to 30th Mach 2017.
Figure 1 and Figure 2 shows that there were 177 (84.29%) male victims and 33 (15.71%) female RTA victims. The highest numbers of victims were in the age group of 11–20 years, that is, 62 (29.52%) followed by 21–30 years 47 (22.38%) Figure 3. Distribution of RTA according to educational status, that there were 127 (60.48%) educated victims and 30 (14.29%) uneducated RTA victims. The highest numbers of victims were in the age group of 11–20 years Figure 4. In Figure 5 shows distribution of road traffic accident cases according to type of injuries (no injury, simple injury, dangerous injury and dead) were 1 (0.477%), 172 (81.90%), 28 (13.33%) and 9 (4.28%), respectively RTA victims.
The highest numbers of victims were in the age group of 11–20 years, that is, 62 (29.52%) followed by 21–30 years 47 (22.38%). Distribution of road traffic accident according to mode of travel-vehicle used (bicycle, motor cycle, car and car with motor), were 2 (0.952%), 29 (13.81%), 159 (75.71%) and 20 (9.52%), respectively Figure 6. In Figure 7 shows distribution of road traffic accident cases according to responsibility of driver (speed, turn, cross the road and others) were 124 (59.04%), 16 (7.62%), 52 (24.76%) and 18 (8.57%), respectively.
Figure 8-13 show distribution of persons injured during period 2010–2015. Road Traffic Accident are considered part of the “diseases of development” and occur as a result of third world development components that include the increase in the number of motor vehicles, environmental changes, increased population densities and pollution15, 16. Road traffic injuries are ranked ninth among global causes of disability-adjusted life years lost and developing countries account for over 80% of deaths globally due to road traffic accidents17-19. Approximately 20% of all unintentional deaths worldwide occur in children under 15 years old and are among 10 leading causes of death. Road accidents account for 21% of all death in this age group20 0-14 year children constitute 30.4% of total population in our country. Accidental death of children accounts for 6.7% of total such death out of which 36.3% are due to road accidents21.
Road Traffic injuries are a leading cause of death in children. Pedestrian are 30 times more in involved in accidents as compare to cyclists and car occupants. Road accidents accounted for 55% of all accidental death in children and in almost all of these, the unsafe behavior of child was considered to be at fault. These road accident deaths occur in healthy children who might have been expected to have had productive lives and cause immeasurable distress and guilt to the parents and other parties involved. So the prevention of accidents in children is being increasingly recognized as an important public health issue. The increasing use of traditional medicines and therapies demands more scientifically sound evidence for the principles behind therapies and for effectiveness of medicines22-34.
Recent advancements in the analytical and biological sciences, along with innovations in genomics and proteomics can play an important role in the validation of these therapies. Pharmaceutically as well as biologically, the herbal extracts promote fast wound healing than control and non-medicated group in different in vivo studies. The process of wound healing is promoted by several herbal extracts, which are composed of active agents like triterpenes, alkaloids, flavonoids, tannins, saponins, anthraquinones, and other biomolecules35-57.
A number of secondary metabolites /compounds isolated from plants have been demonstrated in animal models as active principles responsible for facilitating healing of wounds. The enhanced wound healing potency of various herbal extracts may be attributed to free radical-scavenging action and the antimicrobial property of the phyto-constituents present in the extract, and the quicker process of wound healing could be a function of either the individual or the synergistic effects of bioactive molecules58-65. These active constituents promote the process of wound healing by increasing the viability of collagen fibrils, by increasing the strength of collagen fibers either by increasing the circulation or by preventing the cell damage or by promoting the DNA synthesis66-70.
Figure 1. Distribution of road traffic accident cases according to age and gender
Figure 2. Distribution of road traffic accident cases according to gender (Male and Female)
Figure 3. Distribution of road traffic accident cases according to marital status.
Figure 4. Distribution of road traffic accident cases according to educational status.
Figure 5. Distribution of road traffic accident cases according to type of injuries (no injury, simple injury, dangerous injury and dead).
Figure 6. Distribution of road traffic accident cases according to mode of travel-vehicle used (bicycle, motor cycle, car and car with motor).
Figure 7. Distribution of road traffic accident cases according to responsibility of driver (speed, turn, cross the road and others).
Figure 8. Distribution of persons injured (road traffic accident) during 2010.
Figure 9. Distribution of persons injured (road traffic accident) during 2011.
Figure 10. Distribution of persons injured (road traffic accident) during 2012.
Figure 11. Distribution of persons injured (road traffic accident) during 2013.
Figure 12. Distribution of persons injured (road traffic accident) during 2014.
Figure 13. Distribution of persons injured (road traffic accident) during 2015.
CONCLUSION:
Reducing the risk of road traffic systems requires commitment and informed decision-making by government, industry, NGOs, professionals and communities, through a broad range of cooperative activities and interventions including enforcement of legislation to control speed and alcohol consumption, mandating the use of seat-belts and crash helmets, safer design and use of roads and vehicles, and public education on road safety. To prevent these early childhood deaths, children should be educated about traffic rules. They should be separated from high-speed highways and safe playgrounds should be developed for their recreation. The cyclists should have proper training and should be encouraged to obey traffic rules. Wearing of safety helmets should be made compulsory even for the cyclists. Smaller children should not be left unattended by parents near the roads. Special restraining devices should be installed in cars and buses. Walking should be encouraged in children rather than cycling for good health and safe journey.
RECOMMENDATIONS:
1- Setting and enforcing speed limits appropriate to the function of specific roads.
2- Setting and enforcing laws requiring seat-belts and child restraints for all motor vehicle occupants.
3- Setting and enforcing laws requiring riders of bicycles and motorized two-wheelers to wear helmets.
4- Restrictions on speed and engine performance of motorized two-wheelers.
5- Increasing the legal age for use of motorized two-wheelers.
6- Graduated driver licensing systems.
7- The role of education, information and publicity.
8- Use of new therapeutic ways to improve wounds healing in the management of RTA victims at the hospital.
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Received on 12.05.2017 Modified on 28.05.2017
Accepted on 10.06.2017 © RJPT All right reserved
Research J. Pharm. and Tech 2017; 10(11):3819-3825.
DOI: 10.5958/0974-360X.2017.00693.X