Search

This study explores the prevalence and correlates of bone and joint diseases and its association with falls among older adults in India. Data from the Longitudinal Aging Study in India (2017-18) were utilized for analysis (n = 31,464). Bivariate and logistic regression was used to fulfill the study objectives. The findings revealed that 19.71% of older adults had bone and joint disease, which was higher among women (22.79%) than men (16.25%). The strongest predictors of such diseases included being currently employed, physically inactive, having difficulties in performing functional activities and higher economic status. The fall in the last two years was reported by 12.63% of older adults, and bone and joints diseases were significantly associated with falls (AOR = 1.287; 95% CI: 1.117-1.483) after adjusting for several socio-demographic and health covariates. These findings imply that policymakers and providers must implement interventions designed to reduce the risk of those diseases and associated falls., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The mining of manganese ore in India started in the year 1899, in Nagpur district of the Central Provinces. Almost six decades later, in 1957, Dr. T. P. Niyogi examined several young men involved in dry drilling of Manganese ore, who had symptoms of muscular pain, weakness, clumsy movements, asthenia, anorexia, insomnia, and gait difficulties. These patients were also emotionally disturbed and prone to falls and accidents. He concluded that these symptoms were due to chronic manganese toxicity with parkinsonian features and psychiatric manifestations which he published in 1958.[1] This lead to the formation of an Enquiry Committee by the Ministry of Labour and Employment, Government of India which instituted corrective measures in mining of manganese in India. Very few reports of chronic toxicity due to inhalation of manganese have been reported subsequently. This paper highlights the contributions of Dr. T.P. Niyogi who was the Civil Surgeon in Chhindwara, MP during that period. [ABSTRACT FROM AUTHOR]

Aim: The present paper aims to understand the fear of falling (FOF) and risk factors associated with FOF in community-dwelling individuals aged over 60 years in Pune, India. Subjects and methods: The study examined a random sample of 351 community-dwelling older adults. Data on demographic characteristics, health conditions, history of falls, and psychological factors were collected using a pre-tested, structured questionnaire. The Falls Efficacy Scale International (FES-I) was used to measure FOF. Univariate and bivariate logistic regression analyses were carried out to examine associations between various factors and FOF. Results: A high FES-I score was significantly associated with older age, females, unmarried status, education less than 6 years, living alone, unstable balance and gait, hypertension, arthritis, previous falls, self-reported loss of confidence, and depression. Adults older than 70 years of age (odds ratio, OR = 2.411), those with a history of falls (OR = 2.285), those reporting loss of confidence in the past 6 months (OR = 6.766), who had answered yes to the direct question of FOF (OR = 4.632), and had unstable balance (OR = 2.522) were also more likely to have higher FES-I values. Conclusion: A large number of older adults expressed concerns about falling and we also found several factors to be associated with developing FOF, supporting the need for screening. Thus, further research is needed in order to understand the relationship between severity of FOF and actual fall events for developing preventive measures which can be implemented before FOF becomes a problem. [ABSTRACT FROM AUTHOR]

The Asiatic Lion population has increased in the last three decades, which now occupies a large regional spread with six or more identified satellite populations in eight districts of Gujarat. An overlap of lion habitat with human-dominated landscape elements leads to an increase in lion-human interactions in these growing satellite populations. A high rate of lion mortality has been observed in the periphery of Gir in the last decade due to falls into open dug wells. These wells have been excavated for irrigation in the agricultural landscape of Gir. About 145 wild animals including lions have died due to accidental falls into open wells in past 10 years. It has been observed that construction of parapet walls around wells in some of the peripheral areas of Gir Sanctuary have prevented this accidental mortality at very low cost. To assess the efficiency of these measures we did a survey of 20 random villages in the Gir Lion Landscape to collect data on the types of wells that cause this uncalled-for mortality. The paper explores the reasons for the lions falling into wells in the agricultural areas outside the Gir Sanctuary. The survey has shown that the corridors used by lions and in the satellite population areas are high risk sites where more parapet walls should be built on a priority basis. From the year 2007 to 2018 more than 48,000 parapet walls have already been randomly built in the periphery of the Gir Sanctuary. Out of 130 identified wells, 90 were protected with parapet wall or iron net while, 32 were without parapet wall and rest eight were with unfinished parapet wall. Providing a scheme for building more parapet walls around prioritized open wells would be an effective step towards Asiatic Lion conservation in the Gir Lion Landscape. Our survey indicates that there has been no mortality of lions in those wells where parapet walls have been built. [ABSTRACT FROM AUTHOR]

Background. Dance as therapy is gaining attention as an adjuvant option for Parkinson's disease (PD). Assessing culturally popular dance forms is crucial for promoting the acceptance of dance therapy in a culturally sensitive context. Objectives. The pilot study evaluated the efficacy of Garba dance for alleviating motor symptoms, nonmotor symptoms, cognitive functions, and mood. Furthermore, this pilot study also assessed the tolerability and safety of this dance form using fatigue severity scale and assessing falls, respectively. Methods. Eligible participants with mild‐to‐moderate PD (H&Y stage 1 to 2.5) were sequentially randomized into the dance therapy, physical therapy, or control groups. Motor symptoms, nonmotor symptoms, cognitive functions, and mood were assessed using standard scales at baseline, week 6, and week 12. Tolerability was measured using the Fatigue Severity Scale, and safety was assessed by monitoring falls. Results. In the Garba dance group, significant improvements in UPDRS scores were observed at week 6 (p = 0.002) and week 12 (p < 0.001) compared to baseline. At week 12, UPDRS scores were better in the Garba dance group as compared to the control and physical therapy groups. Freezing of gait significantly improved at week 6 (p < 0.001) and week 12 (p < 0.001) in the Garba dance group. Garba dance also led to significant improvements in mood and sleep. Tolerability was favorable, with significantly better fatigue severity scores in the Garba dance group at week 12 compared to controls and physical therapy. About 6 patients in Garba dance group experienced near falls. Conclusion. Underscoring a cautious optimism, results of the current study indicate that Garba dance may be an effective, safe, and well‐tolerated intervention for Indian patients with mild‐to‐moderate PD (H&Y stage 1 to 2.5). [ABSTRACT FROM AUTHOR]

Background: Injuries have become a major public health concern. Recent data show that globally over 5 million people lose their life due to injury every year. Especially in low- and middle-income countries, people living below the poverty line are drastically scathed due to injuries. Objective: The objective of this paper is to find the magnitude and risk factors of fall among the elderly in India. Materials and Methods: A systematic search was done by using Google Scholar and PubMed. Results: The selected studies revealed that the prevalence of fall ranges from 26% to 37% across various regions, fall injuries are associated with poor vision, vertigo, imbalance, fear of falling, history of fall, presence of osteoarthritis, visual impairment, hearing impairment, and depression. This study has shown the risk of fall was higher among female elderly population. Conclusion: The major contributing factors for fall injuries are aging, visual impairment, previous history of fall, depression, and gait problem. Females have a higher risk of fall comparatively to males. [ABSTRACT FROM AUTHOR]

Considering the high burden of injuries, the Health Authority - Abu Dhabi developed a draft electronic and paper-based injury and poisoning notification system (IPNS) to generate better data on the nature and severity of injuries. The pilot testing and evaluation of IPNS was conducted with the specific objectives to (1) identify the characteristics of injury cases, (2) explore potential risk factors, (3) illustrate the nature and type of data, and (4) the working mechanism of data collection. Data were collected from selected hospitals on patient demographics, injury information and clinical assessment. Descriptive, bivariate and multivariate analyses were conducted. Of 4226 injury cases, nearly three-fourths were male, majority were non-UAE nationals, and the mean age was 21.9. Multivariate findings suggested that compared to UAE nationals, non-UAE nationals were 27% more likely to experience fatal, severe or moderate injuries (p= 0.01). Individuals with health insurance were 31% less likely to suffer a fatal, severe or moderate injury compared to those having no health insurance (p< 0.001). This is the first systematically standardised collection of injury data across three facilities in Abu Dhabi, and provides initial information on characteristics and injury risk factors that will help identify the need for evidence-based intervention for injury prevention and control. [ABSTRACT FROM PUBLISHER]

Traumatic brain injury (TBI) is the leading cause of death and disability in children. Data regarding mode of traumatic brain injury and severity which is vital for prognostication and epidemiology is limited. The aim of this study is to correlate findings in neuroimaging with mode of injury and to study the outcome in relation to mode of injury. It is a prospective observational study in children between 1month to 18years of age who presented to the emergency department with head injury. 131 children out of a total of 5435 children seen in the emergency department over 6months presented with head injury. 51 children warranted neuroimaging and were included in the study. CT brain was abnormal in 40% (n=20) of a total of 51 patients. 11 (22%) children who fell from a height and 9 (18%) who sustained road traffic accident had CT evidence of intracranial bleed. 57%(N=29) with significant mode of injury had normal CT cervical spine and 55%(n=18) did not have skull fracture. CT brain was normal in 60% (n=31). About 13 % with fall at ground level, 15% with fall from a height had minimal disability. In this study we conclude that fall from a height is a serious cause of head injury with abnormalities in neuroimaging and mode of injury with abnormalties in neuroimaging do not correlate with the outcome. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is commonly regarded as a healthy time of life, with apeak in strength, speed, fitness, and many cognitive abilities. However, major shifts in health take placearound puberty as new health risks with potentially life threatening consequences become prominent. Unnatural deaths are the leading killer of today's teenage and adolescent generation, as the patterns have changed from infections to social aetiologies during the lastdecades. The unnatural deaths may be due to unintentional or intentional injuries.Unintentional injuries are mainly accidents. Intentional injuries are mainly suicidesand homicide. Aims and Objectives: To know the type, incidence, and sex wise distribution of unintentional deaths of adolescents in the age group of 10 -- 19 years. Material Methods: Department of Forensic Medicine, BMC & RI (Victoria & Bowring and Lady Curzon Hospitals) is a postgraduate institute that conducts autopsies of all sudden, suspicious, unnatural deaths which occur in and around Bengaluru. The present study is a descriptive study of unintentional unnatural death cases of Adolescents (10 to 19 years) which were autopsied at BMC & RI, Bengaluru for a period of 18 months from Dec. 2014 to May 2016. Results: Out of 148 cases of unintentional injury, 109 cases were males (73.64%) and 39 cases were females (26.36%). Among unintentional deaths majority were due to RTA 58 cases (39.19%), Accidental Scalds/Burninjuries 30 cases (20.27%), Accidental drowning 18 cases (12.16%), Electrocution 14 cases (9.45%), Accidental railway injury sustained 15 cases (10.13%), Accidental fall 11 cases (7.43%), Snakebite 1 case (0.67%), Blast explosion 1 case (0.67%). Conclusion: Adolescent age is an important stage in development. Death in adolescentage is a potential life loss to family and society to some extent and reflects socioeconomic and Medical Health Carestatus at the National and Regional levels. Accurate legal investigations is essential increating awareness among National policymakers and educators/caregivers, to prevent adolescent deaths. To conclude useful and informative determinants of adolescent death were identified in this study. Since there is very little information regarding adolescent death in developing countries like ours. This suggests that each and every center conducting autopsies should come up with such studies to reflect the magnitude of the occurrence of unnatural adolescent deaths. [ABSTRACT FROM AUTHOR]

Cardiac laceration in child abuse cases is uncommon. Very few case studies are available illustrating the left ventricular rupture following blunt chest injuries. This article presents a case of sudden death of a two and a half year-old female child brought with history of fall on level ground while playing. The autopsy revealed multiple types of injuries over the whole body with duration varying from less than a day to more than 6 months old. Left ventricular rupture and liver laceration were the primary injuries contributing to death. Child abuse cases should never be examined with a preconception of finding the classical features of intracranial hematomas. [ABSTRACT FROM AUTHOR]

Background: Injuries constitute around 16% of the total disease burden in India with respect to Disability-Adjusted Life Years. More than two third of these injuries are unintentional and occur at household level. Domestic accidents are preventive and can be drastically reduced by effective measures and safety consciousness. This study aims to find the prevalence of domestic accidents, the household safety practices and their association with socio demographic factors in selected urban wards of Puducherry. Methods: A population-based cross sectional analytical study was conducted in the service area of Jawaharlal Institute of Postgraduate Medical Education and Research Urban Health Centre, Puducherry, in June 2018. Data regarding self-reported domestic accidents in the last one year were collected using a structured questionnaire and assessment of household hazards was done after examining the houses. Results: Among the 578 randomly selected households, 393(68%) belonged to nuclear families, 486(84%) had pucca houses and in 339(59%) overcrowding was present. 59(10.2%) households reported domestic accidents -- of which 25(42%) had adult victims, 22(37%) were due to falls, 27(45%) had upper limb injuries and 25(43%) occurred in kitchen. On assessment of safety practices, 121(21%) houses had doors with stoppers, 394(68%) had items scattered on living room floor while 128(24%) and 160(30%) had grab bars and doormat in bathrooms respectively. Domestic accidents were more prevalent among overcrowded households Prevalence Ratio: 1.74 ([95% CI: 1.02 - 2.98], p = 0.04). Conclusion: The prevalence of domestic accidents was 10.2% in the present study. It was reported mostly among the adults and in the kitchen, with falls being the most common cause and upper limbs injury being commonest. Most of the houses had objects lying scattered on the floor hindering movement; and stoppers and grab bars were missing from the doors and bathrooms respectively. Overcrowding was significantly associated with domestic accidents. [ABSTRACT FROM AUTHOR]

Background: Falls in older adults can cause severe physical injuries leading to activity restriction and subsequently adding to financial burden. Objectives: The objectives of our study were to assess the fear of falling in older adults living in old-age home, to implement cost-effective environmental modifications in old-age home, and to assess the relationship of fear of falling with activity level and activity restriction in older adults. Study Design: A one-arm interventional study design was chosen for the research. Methods: In this one-arm interventional study, 32 older adults, both males and females, were recruited from an old-age home, after their written informed consent. All the 32 older adults were assessed on the Survey of Activities and Fear of Falling in the Elderly (SAFFE) at baseline (preintervention), postintervention at 2 months, and at follow-up of 12 months. The architectural barriers in the old-age home were identified, and cost-effective environmental modifications were implemented. Statistical analyses of the SAFFE scores from baseline to follow-up were done. Results: The results revealed that fear of falling significantly reduced with the implementation of environmental modifications at postintervention at 2 months and at follow-up of 12 months. Fear of falling was positively correlated with the activity restriction (P = 0.0001, 95% confidence interval [CI] = 0.88-0.97) and fear of falling was negatively correlated with activity level (P = 0.0001, 95% CI = -0.97-0.88) at baseline, postintervention, and follow-up. Conclusion: Our study showed that with the implementation of cost-effective environmental modifications, there was a significant reduction of fear of falling among older adults. [ABSTRACT FROM AUTHOR]

Background: Injuries are considered as an emerging public health problem in India. Globally every year, injuries kill more than 5 million people, and by 2020, injuries will be the third-leading cause of death and disability worldwide. The study aimed to assess the prevalence and characteristics of nonfatal home injuries among the elderly in Tamil Nadu. Methodology: A cross-sectional analytical study was conducted among 1139 elderly (60 years and above), sampled from three districts of Tamil Nadu, India. Probability proportional to size sampling technique was used for sampling; a pretested questionnaire was used to collect the data. Results: Prevalence of nonfatal home injuries among elderly within the past 1 year was 14.6% (12.5–16.7 at 95% confidence interval), (n = 1003), among those injured, 94.5% were unintentionally injured and 5.5% were of intentional nature. When classified according to the types of injuries, majority of them had fall injuries (6.7%) followed by minor domestic injuries (5.4%), animal-related injury (0.2%), burn injuries (1.1%), road traffic injury (0.4%), and suicide attempt (0.8%). Majority of the respondents were in the age group of young-old, 60–69 years of age (84%), and there was more number of males (55%) in the study. Conclusion: The study reveals that nonfatal home injuries among elderly are an emerging public health problem, unintentional injuries contribute to the majority of the injuries, fall was the single largest contributor for all injuries among elderly. [ABSTRACT FROM AUTHOR]

This study was done on blunt chest trauma related deaths in the city of Bangalore, which focused on deaths due to Road traffic accidents among two-wheelers. Study includes 64 deaths, 49 deaths being because of RTA, apart from fall from height and assaults. 40% of people who died because of RTA were in the age limits of 21-30 years. 24.5% in the age of 31-40 years. Males predominated with rate of 83.7%. All the deaths were accidental, detected by autopsy and by investigation. 61% of deaths were among riders. Most accidents occurred on city roads i.e., 79.6% and on highways 14.2%. 62% of people survived till 6 hours after the accident. Maximum cases were brought dead to the hospital. Death was mostly due to blunt trauma to the trunk and combined regions. This study mainly aims at determining the survival period, two wheeler chest injuries and possible preventions for it. [ABSTRACT FROM AUTHOR]

Background: Unintentional injuries are an important cause of death in India. However, no reliable nationally representative estimates of unintentional injury deaths are available. Thus, we examined unintentional injury deaths in a nationally representative mortality survey. Methods: Trained field staff interviewed a living relative of those who had died during 2001-03. The verbal autopsy reports were sent to two of the130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and adjudication. Proportionate cause specific mortality was used to produce national unintentional injury mortality estimates based on United Nations population and death estimates. Results: In 2005, unintentional injury caused 648 000 deaths (7% of all deaths; 58/100 000 population). Unintentional injury mortality rates were higher among males than females, and in rural versus urban areas. Road traffic injuries (185 000 deaths; 29% of all unintentional injury deaths), falls (160 000 deaths, 25%) and drowning (73 000 deaths, 11%) were the three leading causes of unintentional injury mortality, with fire-related injury causing 5% of these deaths. The highest unintentional mortality rates were in those aged 70years or older (410/100 000). Conclusions: These direct estimates of unintentional injury deaths in India (0.6 million) are lower than WHO indirect estimates (0.8 million), but double the estimates which rely on police reports (0.3 million). Importantly, they revise upward the mortality due to falls, particularly in the elderly, and revise downward mortality due to fires. Ongoing monitoring of injury mortality will enable development of evidence based injury prevention programs. [ABSTRACT FROM AUTHOR]

Background Little is known about the context, risk factors and severity of non-fatal fall-related injury in India. Objective To report these data for a rural population in the East and West Godavari districts of the Indian state of Andhra Pradesh. Methods In a cross-sectional population-based survey, 3686 participants aged ≥30 years (83.6% participation) selected by stratified random sampling were interviewed in 44 villages. Participants recalled injuries in the preceding 12 months that required them to stay away from their usual daily duties for at least 1 day irrespective of whether medical attention was sought for that injury. Results The annual incidence of non-fatal fall-related injury based on a 3-month recall period was 3.30% (95% CI 2.54% to 4.05%) and 9.22% (95% CI 7.74% to 10.69%) for men and women, respectively, with the incidence increasing with age. For the most recent non-fatal fall-related injury, the home was the most common place of injury for women, and the farm for men, with the former more likely to fall while climbing up/down (20.9%) compared with the latter (10.3%). Most falls were at the same level (71.7%) and slipping was the most common cause of fall (40%). Limbs (legs, 55%; hand/arm, 33.3%) were the most commonly injured body part. Fifty-six per cent reported seeking treatment outside home for injury, of whom 74.6% were women; and 8.4% reported being admitted to a hospital. Conclusion Falls are a significant public health problem facing women in rural India. Fall prevention strategies should be explored and implemented within the Indian context. [ABSTRACT FROM AUTHOR]