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Pork is one of the commodities that is widely consumed by people in East Nusa Tenggara Province (NTT), with se'i meat as one of its superior processed products. Se'i pork, which goes through a traditional smoking process, has a distinctive taste and aroma that makes it favored by many consumers. Based on data from the Kupang City BPS in 2021, the pig population in NTT reached 2.6 million heads, and pork production reached 26.81 million tons. This makes NTT one of the regions with the highest pork production in Indonesia. Along with the increase in the pig population, the consumption of processed pork products, especially se'i, has also increased, driving the growth of the pork se'i agroindustry in the region. The city of Kupang and its surroundings has many restaurant businesses that offer pork se'i, including Baun pork se'i restaurant, which is known for its location in the West Amarasi area. However, marketing factors such as price, location, product, and promotion in the marketing mix of pork products in Baun have not been analyzed in detail. Therefore, this study was conducted to understand consumer perception of the marketing mix of pork products in Baun and the factors that affect purchase decisions. This study aims to analyze consumer perception of the marketing mix of pork in baun, analyze factors that affect consumer decision-making. Price, location, product, and promotion are factors that affect the marketing mix of pork products in Baun. The sampling method uses an accidental sampling technique, while the data collection for primary data uses a list of questions that have been prepared and secondary data is taken from related agencies. Meanwhile, the data analysis method uses binary logistics analysis. The results of the study show that the consumer perception of pork sausage is included in the level of very fondness, and the factors that affect the marketing mix of pork sausage are price, location, and promotion while the product has no effect on the marketing mix of pork sausage in Baun. [ABSTRACT FROM AUTHOR]

AbstractLiterature reported drug poisoning as a major cause for visiting emergency departments, with various rates of occurrences across countries, regions, socioeconomic status, and cultures. Therefore, this study was conducted in Qassim to describe the sociodemographic patterns of acute drug poisoning as well as the most common drugs involved. A retrospective method of data collection was used employing medical record review for drug poisoning cases that occurred in the Qassim region during the 8 years from January 2008 to December 2015. Data was collected using a standardized, validated data collection sheet. The study failed to reveal any pattern (either decreasing or increasing) in the number of poisoning cases over time. Most cases (56.2%) of drug poisoning were accidental, caused by analgesics (35%), affected children younger than 5 years of age (41.4%), and occurred via ingestion (99.2%). It can be concluded that as most poisoning cases affected children, this highlights the importance of increasing awareness and educating families about the safe handling and storage of drugs out of reach of children. [ABSTRACT FROM AUTHOR]

The present retrospective study has been carried out to find the occurrence of deaths due to electrocution in Eastern part of Bengaluru with special emphasis on finding out the conditions along with pattern of injuries sustained by the victims. Medico legal autopsy cases with history of electrocution over period of three years between January 2019 to December 2021 were included in this study. A total of 799 cases were autopsied at our Institute during that period, out of which 51 deaths (6.38%) were deaths due to electrocution, in which male's outnumbered females. The highest number of cases were observed in the age group of 21-30 years (n=18, 35.3%). 27 victims (52.9%) were electrocuted by low tensions domestic supply. Majority of the victims (n=31, 60.8%) died on the spot. Most cases (n=38, 74.5%) were reported during the daytime between 7 am and 7 pm. The incidence of deaths during rainy season were typically higher (n=29, 56.9%). Limbs were the most common body parts affected by electrocution (n=27, 52.9%). 37 (72.5%) victims were electrocuted in dry conditions according to the surrounding places of incidence. As per police documents and history by relatives all cases of the electrocution deaths in the present series were accidental in nature. The hazard of getting electrocuted in domestic surroundings from the chaotically connected electric wires without correct maintenance is certainly a matter of worry. Implementation of correct insulation safety procedures are important factors required for prevention of fatal electrocution. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: This study aimed to investigate the clinical status, outcomes, and healthcare costs of older patients who presented at the emergency department (ED) with falls in the periods before and during the Coronavirus disease-2019 (COVID-19) pandemic. Findings: Though the number of fall-related presentations of older persons to the ED, comorbidity burden, consultations, and the length of stay in the ED was lower, direct costs were higher during the pandemic period than the pre-pandemic period, particularly for COVID-19 positive older patients admitted to the ED with falls, and those patients were with poorer outcomes. Message: As older patients with falls and multi-comorbidities might have experienced difficulties to reach the ED or avoided to apply during the pandemic period, strengthening community-based health services, and organizing EDs according to the needs of older patients are critical measures for crises situations. Purpose: This study aimed to investigate the clinical characteristics, outcomes and healthcare costs of older patients presented to the emergency department (ED) with falls in the periods before and during the Coronavirus disease-2019 (COVID-19) pandemic. Methods: Hospital records one year before and after the onset of the COVID-19 pandemic were retrospectively analyzed through "International Statistical Classification of Diseases-10th Revision" codes. Age, gender, falls, triage classification, length of stay (LOS) in the hospital and the ED, COVID-19 status, Glasgow Coma scale, consultations-comorbidities, injury status, outcomes in the ED, and costs were recorded. Results: The study comprised of 3187 patients aged ≥ 65 years admitted to the ED of a university hospital between March 2019 and 2021. In terms of pre-pandemic and pandemic periods; older patients presenting with falls to the ED, consultations, Charlson Comorbidity Index, and LOS in the ED were lower in the pandemic period, but costs were higher (p = 0.03, p = 0.01, p = 0.01, p = 0.01 and p = 0.02, respectively). Hospitalization/mortality rates were higher in COVID-19 positive patients (77.2%) than in COVID-19 negative patients (4.6%) within the pandemic period and the patients in the pre-pandemic period (22.8%), and the costs, as well (both p = 0.01). Conclusion: Though the number of fall-related presentations of older persons to the ED, comorbidity burden, consultations, and the LOS in the ED was lower, direct costs were higher during the pandemic period, particularly for COVID-19 positive older patients admitted to ED with falls than the pre-pandemic period, and those patients were with poorer outcomes. [ABSTRACT FROM AUTHOR]

Non-accidental injury (NAI) poses a complex problem to healthcare professionals around the world. There are no specific signs or symptoms that directly correlate with the inflicted injury, but diagnosis is based on high index of suspicion in cases where there is confounding history, disproportionate injury, radiological findings, together with social circumstances. The age of the child is a known risk factor, with the younger child being more likely to suffer recurrent and severe trauma, resulting in increased morbidity and mortality. Thus, timely investigation and management of a suspected NAI is critical to the safety and wellbeing of a child, alongside injury-specific management, and follows a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

The principle of Al-Zati La-Yo’allal (Self-evident essence does not need proof) is one of the important philosophical doctrines which falls into three philosophical rules. This paper intends to review Imam Khomeini’s analysis of this principle with a glance at the lexical connotation of the word Zati. In view of Imam Khomeini “an essence needless of proof”, the core concept of this principle, is an essence coming from logical reasoning rather than accidentality. Indeed, Imam Khomeini is of the opinion that “an essence needless of proof” is a truth inseparable from inherent essence whether it is imbedded in inherent essence (Isagoge essence) or detached but associated with it. Imam Khomeini continues with explaining about why self-evident essence does not need proof, i.e. he argues “an essence needless of proof” through logical reasoning. Therefore, paying attention to his precise opinion on this principle can help answering many philosophical, theological, etc. questions. Apparently, Imam Khomeini has underscored this point that since it is imperative to carry self-evident essences and attributes of essence on essence itself, and because any attribute affixed to its subject is needless of proof, the self-evident essences and attributes of essence do not need proof at all, hence any question on its proof shall be meaningless.

Bu çalışma İbn Sînâ (ö. 428/1037) felsefesinde mantıkî tümelin tümel olmak bakımından değerine ve Gazzâlî’nin (ö. 505/1111) mantıkî tümel bağlamında İbn Sînâ’ya yönelttiği eleştirilere odaklanmaktadır. Bu iki düşünürün tümel ve tümel türlerini nasıl açıkladıklarına değinip, onların düşünce sisteminde tümelin tekabül ettiği manayı ortaya koyarak Gazzâlî’nin İbn Sînâ’ya yönelttiği eleştirilerinin felsefi analizi yapılmaktadır. Buna göre İbn Sînâ tümelin üç türünden bahsetmektedir. Bu tümeller tabiî, aklî ve mantıkî olarak üç türe ayrılır. Bu tümeller arasındaki ilişkiyse zâtî bir ilişkiye dayanır. Bu türden ilişkiyi belirleyen ve ilke veren ise tümellerin dışında olmak zorundadır. Ona göre tümellerin anlamını ve tümel türleri arasındaki zâtî ilişkiyi varlık kavramı belirlemektedir. Bu bakımdan aklî tümel tabiî tümelin makulü; aklî tümel mantıkî tümelin lazımı olabilir. Öyleyse İbn Sînâ’da tümel kavramı varlığa ilişkindir. Gazzâlî’de ise tümelin üç türünden bahsedebiliriz. O tümelin türlerini isimlendirmez ama onları betimleyerek birbirinden ayırır. Onun ayrımında ise ortaklık kavramı bilfiil ve bilkuvve olmak bakımından ele alınır ve bu kavramsal ayrımlardan hareketle varlık taksim edilir. Bu bakımdan İbn Sînâ’nın tümellere yüklediği anlam ile Gazzâlî’nin tümellere yüklediği anlam arasında arızî bir ayrımdan söz edemeyiz. Bunun tam aksine iki düşünürünün tümellere yüklediği anlam arasında zâtî bir farklılık vardır. Bu ayrılıktan hareketle Gazzâlî’nin İbn Sînâ’ya yönelttiği eleştiriler de zâtî bir nitelik arz etmektedir. Gazzâlî’nin İbn Sînâ’ya yönelttiği eleştirilerin en açık göstergelerinden biri onun mantıkî tümele yüklediği anlam ve mantıkî tümel bağlamında verdiği örnekte yatmaktadır. Gazzâlî mantıkî tümeli bilkuvve ve bilfiil olmak bakımından ortaklığı kabul etmeyen mana olarak ele alarak ondaki ortaklığı ise tasdiğe konu olan şeyin dışında bir nedene bağlamaktadır. İbn Sînâ, Gazzâlî’nin mantıkî tümele yüklediği anlamın, söylenmenin tasdikin dışında olması hususuna katılmakla beraber tasavvura konu olmayı açıkça vurgulamaktadır. Gazzâlî ise İbn Sînâ’nın bu gönderimini göz ardı etmiş ve mantıkî tümel bağlamında verdiği “İlah” örneğinden hareketle İbn Sînâ’nın bunu kabul edeceğini vurgulamıştır. Halbuki İbn Sînâ’nın felsefi sisteminde “İlah” lafzının tasavvura konu olması mümkün değildir. Çünkü “İlah” tasavvur edilmez ama idrak edilir. Ona göre tasavvura konu olanlar bilkuvve çokluk barındırır. Ama “İlah” lafzı ancak zorunlu varlık olması bakımından tasavvurun konusu olmaya elverişli değildir. Bu bakımdan Gazzâlî’nin eleştirilerinin beş sanat bakımından cedelî mi yoksa safsata mı olduğu analiz edilebilir. Gazzâlî’nin hem mantıkî tümele yüklediği anlam hem de bu anlam için verdiği örnekler onun eleştirilerinin safsata türünden olduğunun zâtî niteliğini teşkil etmektedir.

Introduction: Civilian gun violence is a public health crisis in the USA that will be an economic burden reported to be as high as $17.7 billion with over half coming from US taxpayers dollars through Medicaid-related costs. The purpose of this study is to review the epidemiology of upper extremity firearm injuries in the USA and the associated injury burden. Methods: The Inter-university Consortium for Political and Social Research's Firearm Injury Surveillance Study database, collected from the National Electronic Injury Surveillance System, was queried from 1993 to 2015. The following variables were reviewed: patient demographics, date of injury, diagnosis, injury location, firearm type (if provided), incident classification, and a descriptive narrative of the incident. We performed chi-square testing and complex descriptive statistics, and binomial logistic regression model to predict factors associated with hospital admission. Results: From 1993 to 2015, an estimated 314,369 (95% CI: 291,528–337,750; 16,883 unweighted) nonfatal firearm upper extremity injuries with an average incidence rate of 4.76 per 100,000 persons (SD: 0.9; 03.77–7.49) occurred. The demographics most afflicted with nonfatal gunshot wound injuries were black adolescent and young adult males (ages 15–24 years). Young adults aged 25–34 were the second largest estimate of injuries by age group. Hands were the most commonly injured upper extremity, (55,014; 95% CI: 75,973–89,667) followed by the shoulder, forearm, and upper arm. Patients who underwent amputation (OR: 28.65; 95% CI: 24.85–33.03) or with fractures (OR: 26.20; 95% CI: 23.27–29.50) experienced an increased likelihood for hospitalization. Patients with a shoulder injury were 5.5× more likely to be hospitalized than those with a finger injury (OR:5.57; 95% CI:5.35-5.80). Summary points: The incidence of upper extremity firearm injuries has remained steady over the last decade ranging between 4 and 5 injuries per 100,000 persons. Patients with proximal injuries or injuries involving the bone were more likely to require hospital admission. This study should bring new information to the forefront for policy makers regarding gun violence. [ABSTRACT FROM AUTHOR]

Background: Electrical Fatality is not Uncommon in Low voltage and High voltage despite rapid advances in its Transmission and usage. It is essential to understand the Injuries and the manner of Death in all Electric Fatalities. Aims & Objectives: To Understand the Manner of Death, Pattern of injuries, Site of Injuries and Cause of Death in Fatal Electrocution, retrospectively in Chengalpattu region. This retrospective study was conducted in the Department of Forensic Medicine and Toxicology of government Chengalpattu medical college & hospital, Chengalpattu, Tamilnadu, India. Total 3886 autopsies were conducted from January 1, 2020 to December 31, 2022. Materials and Methods: All the cases Electrical Fatalities Referred by the Police for Autopsies were Analyzed & Examined. Results: Electric Fatalities Contributed to 1.5% of the Autopsies. Major Age Group Affected was 21-40 years in 75% of cases. Males to Females Ratio 8.1:1. Accidental Deaths were the Major Number of Fatalities in 96.6% of cases. Low Voltage Electrical Current contributed to 81.3% of Fatalities. Right Hand was involved in contact injury in 64.4% of Deaths and in 13.5% of Fatal Electrocution No Contact or Exit Injuries were Present. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the causes of human fatalities in cases autopsied at Chengalpattu government medical college from 2018 to 2022 that were caused by venomous animal encounters. Methods: Retrospective study of data collected from the police requests for autopsy and history of the cases from department of forensic medicine and toxicology in Chengalpattu government medical college. Results: From 2018-2022, 144 dead bodies were autopsied at Chengalpattu government medical college after venomous animal encounters. An average of 30 fatalities per year were recorded. Males appear to be the group most likely to die from an encounter. Conclusions: A significant loss of human lives are happening due to envenomation from venomous animals especially in the working age group in rural population. Rural population has a disproportionate impact on rural population. [ABSTRACT FROM AUTHOR]

Background: Fire, since ancient times have kept amusing mankind in various ways. Perhaps it is one of the greatest inventions in the history of all times. It has helped humans to evolve but if mishandled can lead to serious consequences. It is commonly encountered as medical emergencies in any hospital in India. It has continuously effected population resulting in form of prolonged morbidity, disability and even as death of the individual ultimately leading to loss to individual's family, society and to the state. Materials And Methods The present retrospective study was carried out in the Department of Forensic Medicine & Toxicology Chengalpattu Medical College and Hospital, Chengalpattu, during the period from 1st January 2021 to 31st December 2021 which includes a total of 24 cases of death due to burn injuries, brought to the mortuary of the hospital for medico-legal postmortem examination. Results: During the study period burn in female victims was more evident with accounting 18 (75%) cases as compared to males 6 (25%). 21-30 years age group i.e. 8 (33.3%) was most effected and minimum in the age group of 0-10 years i.e. 1 (4.2%).Accidental deaths were 19 in number (79.2%) Various other demographic aspects of deaths due to burns were included as objective in the study and ultimately provided some remedial measures in order to cope up with current scenario. [ABSTRACT FROM AUTHOR]

Background: Severe hypothermia (core body temperature < 28°C) is life‐threatening and predisposes to cardiac arrest. The comparative effectiveness of different active internal rewarming methods in an urban U.S. population is unknown. We aim to compare outcomes between hypothermic emergency department (ED) patients rewarmed conventionally using an intravascular rewarming catheter or warm fluid lavage versus those rewarmed using extracorporeal membrane oxygenation (ECMO). Methods: We performed a retrospective cohort analysis of adults with severe hypothermia due to outdoor exposure presenting to an urban ED in Minnesota, 2007–2021. The primary outcome was hospital survival. We also calculated the rewarming rate in the 4 h after ED arrival and compared these data between patients rewarmed with ECMO (the extracorporeal rewarming group) versus without ECMO (the conventional rewarming group). We repeated these analyses in the subgroup of patients with cardiac arrest. Results: We analyzed 44 hypothermic ED patients: 25 patients in the extracorporeal rewarming group (median temperature 24.1°C, 84% with cardiac arrest) and 19 patients in the conventional rewarming group (median temperature 26.3°C, 37% with cardiac arrest; 89% received an intravascular rewarming catheter). The median rewarming rate was greater in the extracorporeal versus conventional group (2.3°C/h vs. 1.5°C/h, absolute difference 0.8°C/h, 95% confidence interval [CI] 0.3–1.2°C/h) yet hospital survival was similar (68% vs. 74%). Among patients with cardiac arrest, hospital survival was greater in the extracorporeal versus conventional group (71% vs. 29%, absolute difference 42%, 95% CI 4%–82%). Conclusions: Among ED patients with severe hypothermia and cardiac arrest, survival was significantly higher with ECMO versus conventional rewarming. Among all hypothermic patients, ECMO use was associated with faster rewarming than conventional methods. [ABSTRACT FROM AUTHOR]

This study focuses on the value of the logical universal in terms of being universal in the philosophy of Avicenna, and al-Ghazālī’s criticisms of Avicenna in the context of the logical universal. A philosophical analysis of al-Ghazālī’s criticisms of Avicenna is made by mentioning how these two thinkers explained the universal and its types, and by revealing the meaning that the universal corresponds to in their thought system. Accordingly, Avicenna talks about three types of universal. The intercourse between these universals is based on an intrinsic relation. The one that determines this kind of relationship and gives a principle has to be an outsider of the universals. According to Avicenna the concept of being determines the meaning of universals and the personal relationship between universal types. In this respect, the rational universal is the reasonable of the universal; the rational universal may be necessary for the logical universal. Therefore, the concept of universal in Avicenna is related to existence. In al-Ghazālī’s thought, we can talk about three types of the universal. He does not name the types of the universal, but distinguishes them by describing them. In his distinction, the concept of partnership is considered in terms of being actual and potential, and being is divided based on these conceptual distinctions. In this respect, we cannot talk about a random distinction between the meaning attributed to universals by Avicenna and by al-Ghazālī but an inherent difference. Based on this separation, al-Ghazālī’s criticisms of Avicenna are also of a essential nature. One of the clearest signs of al-Ghazālī’s criticism of Avicenna lies in the meaning he attributes to the logical universal and the example he gives in the context of the logical universal. al-Ghazālī considers the logical universal as a meaning that does not accept commonality in terms of potential and actual, and attributes the commonality in it to a reason other than what it is. While Avicenna agrees that the meaning that al-Ghazālī’s attributes to the logical universal, saying that it is outside of approval, clearly emphasizes being the subject of conceptualization. al-Ghazālī, on the other hand, ignored this reference of Avicenna and emphasized that Avicenna would accept this, based on the example of “divine/dieu” he gave in the context of the logical universal. However, in Avicenna's philosophical system, it is not possible for the word "divine" to be the subject of imagination, because the “god” is not conceived, but perceived. According to him, the things which are the subjects of imagination potentially contain multiplicity. But the word "god” is not suitable to be the subject of imagination as it is a necessary being. In this respect, it can be analyzed whether al-Ghazālī’s criticisms are austere or nonsense in terms of the five arts (sophistry). The meaning that al-Ghazālī attributed to the logical universal and the examples he gave for this meaning constitute the inherent quality of his criticisms being of the kind of fallacy. [ABSTRACT FROM AUTHOR]

Copyright of Art-E is the property of Suleyman Demirel University, Faculty of Fine Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Ingestion of dental instruments is rare during dental surgery but can result in serious complications. Here we describe a case in which an endodontic hand file was accidentally misplaced in situ during endodontic (root canal) therapy. Plain radiographs were used to identify its location, and serial imaging was used to monitor passage of the endodontic file through the gastrointestinal tract, and it ultimately passed without intervention. We conclude by describing methods for surveillance and management of ingested dental instruments. Case report A 62-year-old Caucasian male presented to the Emergency Department approximately 2 hours after suspected ingestion or inhalation of an endodontic hand file. He had experienced two episodes of excessive coughing and dyspnea while undergoing endodontic therapy, and was promptly referred by his dentist for further investigation. On admission, plain abdominal radiographs confirmed the position of the file in the duodenum, and serial radiographs were used to monitor its transition and clearance through the gastrointestinal tract. During this time, the patient did not demonstrate any clinical signs of bowel perforation, nor was there any radiographic evidence of pneumoperitonium. The patient was discharged after a final radiograph confirmed the absence of the foreign body. Conclusion Ingestion and inhalation of dental instruments can be life threatening and should be managed cautiously, with early input from general surgeons, gastroenterologists, or respiratory physicians for possible endoscopic retrieval, emergent laparotomy, or surgical intervention. Imaging studies are useful for discerning the position of the foreign body and to determine whether retrieval is possible, and the management will ultimately depend on the position and characteristics of the foreign body, as well as risk factors from the patient which may increase the likelihood of perforation, obstruction, or impaction.

The aim of this study was to present a causal model of factors affecting the formation of organizational forgetfulness in government organizations using structural equations. The method of the present study is descriptive (non-experimental) and the correlational research design is structural equations with the least squares method. Participants in the present study included managers and experts of government organizations in Tehran. According to Cochran's formula, 234 managers and experts of government organizations in Tehran were selected as a statistical sample using simple random sampling. The standard questionnaire of Huang et al. (2018) and Yeh et al. (2020) were used to measure the research variables. This questionnaire consists of 24 items. Questions were measured based on a five-point Likert scale (strongly disagree = 1 to strongly agree = 5). The internal consistency coefficient of this questionnaire was 0.85 using Cronbach's alpha. Findings indicate that the impact factor of knowledge management and experienced manpower on promoting organizational resilience and interpersonal communication is significant at the level of (0.01). Also, promoting organizational resilience and interpersonal communication have a significant effect on random and targeted organizational forgetfulness, and meritocracy plays a moderating role in the organizational forgetfulness model. The results showed that 29% of the variance of organizational resilience promotion, 78% of interpersonal communication, 69% of random organizational forgetfulness and 55% of targeted organizational forgetfulness are explained by the research model.

Manar M Ellaban,1 Eman Afifi,2 Moustafa El Houssinie,1 Jon Mark Hirshon,3,4 Mohamed El-Shinawi,3,5,6 Maged El-Setouhy1,3,7 1Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 3Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 4Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA; 5General Surgery Department, Ain Shams University, Cairo, Egypt; 6Galala University, Cairo, Egypt; 7Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi ArabiaCorrespondence: Manar M EllabanCommunity, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, EgyptTel +201550690740Fax +2024346041Email manarellaban@med.asu.edu.egPurpose: For knife-related injuries (KRI), a comprehensive understanding of the incidence, mechanism, and pattern of injury is required for the development of prevention strategies. Unfortunately, reliable data on knife-related injuries are difficult to obtain. In Egypt, there is no national routine surveillance system for all knife injuries. The aim was to examine the epidemiologic characteristics of knife-related injuries at the Ain Shams University Hospital (ASUH) emergency department (ED).Patients and Methods: A cross-sectional study was conducted on 140 patients who presented with knife injuries at the ASUH ED. Data collection was done during a randomly selected period of seven days each month from October 2018 to September 2019. The sociodemographic characteristics, injury-related variables, and outcomes of the injury were recorded on a structured worksheet.Results: Knife-related injuries represented 22.9% of all injury cases that presented to the ED. Majority of the knife-related injuries (87.86%) were accidental, 7.9% were assault, and 4.3% were self-inflicted. Home was the most reported place of injury. Most of the victims were discharged from the ED (87.1%), and 84.3% recovered completely. The mean hospital stay was 3.6 ± 1.3 days.Conclusion: Majority of the knife-related injuries were accidental, and the most common pattern was isolated chest injury with contusions. Cases that were not severe and had favorable prognosis (ie, complete recovery) comprised the largest proportion. Recommendations include development of a surveillance system may result in the effective control and prevention of this growing problem of knife-related injuries.Keywords: epidemiology, knife injuries, accidental, emergency department, ASUH

Objective: To determine the commonest site of non-suicidal self-inflicted firearm wound in comparison with accidental firearm wounds. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospitals Jhelum, Bannu & Kharian, from Nov 2014 to Nov 2018. Methodology: Sixty-four patients with firearm injuries were observed. All the participants were males between the ages of 18- 60 years. The injuries were determined to be either self-inflicted or accidental by an independent committee. The participants’ replies and responses were assessed by dividing them into five main domains by using quantitative software SPSS version 20. Variables involving demographic characteristics of participants such as age, occupation, marital and socioeconomic status, were associated with mental health variables such as psychological stress, previous history of self-harm and clinical psychiatric illness. Result: Fifteen subjects were found to have self-inflicted injuries and 50 had accidental injuries. There was a marked preference for left foot and left lower limb as a site for non-suicidal self-inflicted injuries (94.6%) as compared to other sites (left upper extremity 1.8%, chest 1.8% and right lower extremity 1.8%). Conclusions: Left lower limb and left foot was a more common site for self-injury as compared to the other sites.

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To find out incidence, prevalence, various modes and pattern of cutthroat injury during COVID-19 pandemic and compare with prior non pandemic period. To find out the various factor influencing the suicidal cutthroat and establish the temporal association of suicidal cutthroat with COVID-19 pandemic. It is a retrospective study of cutthroat patients who were managed in ENT Dept. VIMSAR, Burla, Sambalur, Odisha, India from 1st September 2019 to 31st August 2020. Source of information are casualty, IPD and OT registers and online data. Total cases were divided into group-A (prior to COVID-19 pandemic) and group-B (during COVID-19 pandemic) and analysed. Total 24 cutthroat injury cases were treated over 1 year in department of ENT, VIMSAR, Burla, which was 0.054% of total cases attended at casualty and 2.371% of total IPD patients treated. In GROUP-A, total 10 cases with M:F = 9:1,suicidal 4 cases (40%), homicidal 6 cases (60%), and no accidental cases were recorded. While in GROUP-B, total 14 case with M:F = 14:0, suicidal 9 cases (64.28%), homicidal 3 cases (21.42%) and accidental 2 (14.28%) cases were recorded. In our study majority of cases were male with M:F = 23:1. Common age group belongs to 20–30 years with LSES and farmer by occupation. Zone II injury had incidence of 70.83%. Homicide cases proportionally high during non-COVID period while suicide cases high during COVID-19 pandemic. Association of COVID-19 pandemic with suicidal cut throat injury is seems to be significant. Among predisposing risk factors for suicidal, depression during COVID-19 pandemic had seen in 53.84% of total suicidal cases. Incidence and prevalence of Cut throat injury is comparatively high in western odisha which again increases during months of July and August parallel to COVID-19 pandemic. The common mode of cutthroat injury is homicidal, which suddenly changes to suicidal during COVID-19 pandemic. More vulnerable groups were young unemployed male, farmers and labours. Cutthroat injury cases definitely increases during COVID-19 pandemic with most common mode of injury being suicidal attempt, which may be due to economical and psychological imbalances, due to loss of job and fear and social stigma for COVID-19 diseases. [ABSTRACT FROM AUTHOR]

Carbon monoxide (CO) is an odourless and tasteless gas which can be produced by the incomplete combustion of carbon-containing fuels. Compared to vehicular CO suicides, unintentional cases (excluding those related to fires) are much less common. Increased education surrounding the risks associated with the accumulation of CO in enclosed spaces has contributed to a reduced incidence of unintentional CO poisonings. However, such cases may remain undetected, particularly in domestic and recreational settings where scene findings are often non-specific. The current study of unintentional CO poisonings in South Australia and the Northern Territory, each with a unique climate (Mediterranean and tropical respectively), demonstrated differences in the circumstances of death. Several cases where individuals used carbon-producing fuel sources for heat, both in domestic and vehicular settings and without adequate ventilation, resulted in fatal outcomes. Less common scenarios involved faults in equipment (e.g. a hot water heater), vehicle faults resulting in the accumulation of fatal levels of CO in enclosed spaces, and inadvertent introduction of CO into a diving oxygen supply in a recreational aquatic setting. In ascertaining the cause of death, other considerations include the potential role of underlying chronic cardiovascular and respiratory disease and age which may increase an individual's susceptibility to CO toxicity. Understanding the wide variety of presentations and contributing factors in cases of fatal CO poisoning including consideration of climate-specific differences in domestic and extra-domestic settings may enable improved detection at autopsy., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: The ingestion of small, strong, rare-earth magnets, also termed 'ball magnets', can rapidly result in life-threatening bowel injuries. The objective of this study was to report the incidence and management of 'ball magnet' ingestion in children across the UK and to discuss the potential implications for policy-makers and public awareness campaigns.Methods: In this multi-centre survey of UK major trauma centres (MTCs), paediatric patients admitted to hospital following 'ball magnet' ingestion from 1 January 2020 to 31 December 2020 were included.Results: Responses were received from 11 MTCs (52%) reporting a total of 53 children admitted with 'ball magnet' ingestion over the 1-year study period. Most patients (n=51) presented following unintentional ingestion. 36 (68%) patients presented asymptomatically following witnessed or reported ingestion. In symptomatic patients, abdominal pain and vomiting were the the most common symptoms. The median number of 'ball magnets' ingested was 5.0 (IQR 3.0-7.8), range 1 to 63. 27 (51%) patients underwent operative intervention; laparotomy being the the most common (n=24, 89%). There were no deaths reported during the study period.Conclusion: This multi-centre survey from the UK demonstrates the serious impact of 'ball magnet' ingestion in children. Clinicians, regulators and caregivers must work symbiotically in order to prevent, recognise and reduce life-threatening bowel injuries. [ABSTRACT FROM AUTHOR]

Amaç: Çocukluk çağında sindirim sistemine ağız yoluyla kazara alınan yabancı cisimler önemli bir sağlık sorunudur. Çalışmamızda, tek merkezde kazara yabancı cisim yutma nedeni ile başvuran çocukları retrospektif olarak değerlendirip, karşılaşılan vakalarda durumu yönetme deneyimini göstermeyi amaçladık. Hastalar ve Yöntem: Karaman Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi Kliniği’nce Mart 2016 ile Şubat 2021 tarihleri arasında yabancı cisim yutma nedeni ile hastalar yaş, cinsiyet, yabancı cismin cinsi, lokalizasyonu, radyolojik, ve klinik bulgular ile uygulanan tedavi açısından retrospektif olarak değerlendirildi. Hastaların parametreleri bilgisayar veri tabanından alındı. Eksik verilere sahip hastalar çalışma dışında tutuldu. Bulgular: Hastanemizde çalışma kriterlerine uygun kazara yabancı cisim yuttuğu tespit edilen 72 olgu incelendi. Eksik veriler nedeniyle biri dışlandı. Hastaların yaşları 6 ay ile 14 yaş arasında değişmekte olup 37 (% 51,4)’si 3 yaş ve altındadır. En sık yutulan yabancı cisim madeni paradır 35/72 (% 48,6), onu kalem pil 11/72 (%15,3), mıknatıs 6/72 (%8.3%) ve disk şeklinde pil 5/72 (% 7), 3 (%4.2) kırık cam, 3(%4.2) bilye, 2 (%2.8) kürdan,2 (%2.8) oyuncak parçası olduğu düşünülen plastik, 2 (%2.8) toplu iğne, 2(%2.8) vida, 1(%1.4) saç tokası izlemektedir. Sadece 10 (%13.9) hastada yutulan materyal radyografide görülmeyen radyolüsentti. Bunların büyük çoğunluğu 57/72(%79,1) gastrointestinal sistem ile dışarı atıldı. Kaza ile yutulan yabancı cisimlerden geriye kalan 9 (%12.5)’u Magill forseps,6(%8.3)’sı endoskopik olarak alındı. Hiçbir hasta eksploratif laparotomiye ihtiyacı olmadı. Sonuç: Madeni paranın yanlışlıkla yutulması, çocuklarda hala en yaygın yabancı cisimlerdir. Elektronik bir cihazda yaygın olarak kullanılan düğme pil giderek yaygınlaşmaktadır. Yabancı cisimlerin çoğu radyografi ile görselleştirilebilir ve vakaların çoğunda materyal herhangi bir müdahale olmaksızın kendiliğinden dışarı atılır. Hastaların erken teşhisi ve tedavisi, olası komplikasyon riskini azaltmak için önemlidir.

Background: Poisoning is one of the most common causes for emergency hospitalization and mortality in children. Mostly it is accidental in nature and can be prevented by awareness in caregivers. Recently due to increased use of many new chemicals in homes and agriculture clinic etiological profile of poisoning is also changed. Aims and Objectives: To study clinic-epidemiological pattern of acute poisoning in hospitalized children and To evaluate association of clinicodemographic factors to age of intoxicated children to evaluate association of clinicodemographic factors to age of intoxicated children. Material and Methods: A cross sectional study was conducted from October 2019 to February 2020 in pediatric department of a tertiary care center. Child admitted with alleged history of poisoning included in study. Type and amount of poison, clinical presentation, outcome and demographic profile were recorded from medical records of patients. Results: Study was conducted among 50 patients of poisoning. 74% patients were under 5 year of age while 56% were boys and 44% were girls. Patients admitted due to ingestion of Insecticides and pesticides (18%), hydrocarbons (14%), medicines (12%) and agricultural products (8%), plant products ((16%) and others. Maximum number of patients intoxicated with household products (56%). Age was significantly associated with residence (p = 0.02) and place of exposure (p = 0.01) and nature of poisoning (p = 0.05). Conclusion: In children below 5 year of age incidences of poisoning are more frequent, most of the cases are accidental in nature and easily preventable. Proper care in this tender age is very important in order to prevent morbidity and mortality due to poisoning.

Introduction: Accidental ingestion of needle pin has been reported among tailors and women using hijabs or headscarves. Sharp objects when swallowed, have the potential to cause harm to various areas within the digestive system such as oesophageal, gastric, and intestinal perforation. Case description: We report a case of recurrent accidental ingestion of a needle pin by a nursing student. It was found to be lodged in the gastroduodenal junction about two hours after ingestion. She was observed in the hospital for four days and was conservatively managed with laxative. At the time of discharge, abdominal Xray showed the needle was in the large bowel, but her general condition was stable. This is her second accidental ingestion of a needle pin within two years. During this latest episode, she accidentally swallowed a needle pin after putting it in between her lips while adjusting her headscarf. She had no history of medical and mental illness. She was discharged home on day-4 with syrup Lactulose (15 ml TDS). She was advised to continue with faeces observation and to return to the hospital immediately if there is any spike in temperature or increased in abdominal pain which may indicate peritonitis. A repeat Xray a month later showed no needle in her body. Discussion: Like other reported cases, our patient accidentally swallowed her headscarf pin due to the practice of holding needles between the teeth while putting on the wearing headscarves. She was fortunate because the needle was able to pass through her gastrointestinal tract and exit the body though the faeces. Surgical interventions have been reported in other cases. Thus, it is crucial to raise awareness about the risks of accidental needle swallowing and emphasize the importance of seeking prompt medical attention in cases of ingestion. [ABSTRACT FROM AUTHOR]

Aims: The end-tidal carbon dioxide (ETCO2) is frequently measured in cardiac arrest (CA) patients, for management and for predicting survival. Our goal was to study the PaCO2 and ETCO2 in hypothermic cardiac arrest patients.Methods: We included patients with refractory CA assessed for extracorporeal cardiopulmonary resuscitation. Hypothermic patients were identified from previously prospectively collected data from Poland, France and Switzerland. The non-hypothermic CA patients were identified from two French cohort studies. The primary parameters of interest were ETCO2 and PaCO2 at hospital admission. We analysed the data according to both alpha-stat and pH-stat strategies.Results: We included 131 CA patients (39 hypothermic and 92 non-hypothermic). Both ETCO2 (p < 0.001) and pH-stat PaCO2 (p < 0.001) were significantly lower in hypothermic compared to non-hypothermic patients, which was not the case for alpha-stat PaCO2 (p = 0.15). The median PaCO2-ETCO2 gradient was greater for hypothermic compared to non-hypothermic patients when using the alpha-stat method (46 mmHg vs 30 mmHg, p = 0.007), but not when using the pH-stat method (p = 0.10). Temperature was positively correlated with ETCO2 (p < 0.01) and pH-stat PaCO2 (p < 0.01) but not with alpha-stat PaCO2 (p = 0.5). The ETCO2 decreased by 0.5 mmHg and the pH-stat PaCO2 by 1.1 mmHg for every decrease of 1° C of the temperature. The proportion of survivors with an ETCO2 ≤ 10 mmHg at hospital admission was 45% (9/25) for hypothermic and 12% (2/17) for non-hypothermic CA patients.Conclusions: Hypothermic CA is associated with a decrease of the ETCO2 and pH-stat PaCO2 compared with non-hypothermic CA. ETCO2 should not be used in hypothermic CA for predicting outcome. [ABSTRACT FROM AUTHOR]

Background: Ingestion of dental instruments is rare during dental surgery but can result in serious complications. Here we describe a case in which an endodontic hand file was accidentally misplaced in situ during endodontic (root canal) therapy. Plain radiographs were used to identify its location, and serial imaging was used to monitor passage of the endodontic file through the gastrointestinal tract, and it ultimately passed without intervention. We conclude by describing methods for surveillance and management of ingested dental instruments.Case Report: A 62-year-old Caucasian male presented to the Emergency Department approximately 2 hours after suspected ingestion or inhalation of an endodontic hand file. He had experienced two episodes of excessive coughing and dyspnea while undergoing endodontic therapy, and was promptly referred by his dentist for further investigation. On admission, plain abdominal radiographs confirmed the position of the file in the duodenum, and serial radiographs were used to monitor its transition and clearance through the gastrointestinal tract. During this time, the patient did not demonstrate any clinical signs of bowel perforation, nor was there any radiographic evidence of pneumoperitonium. The patient was discharged after a final radiograph confirmed the absence of the foreign body.Conclusion: Ingestion and inhalation of dental instruments can be life threatening and should be managed cautiously, with early input from general surgeons, gastroenterologists, or respiratory physicians for possible endoscopic retrieval, emergent laparotomy, or surgical intervention. Imaging studies are useful for discerning the position of the foreign body and to determine whether retrieval is possible, and the management will ultimately depend on the position and characteristics of the foreign body, as well as risk factors from the patient which may increase the likelihood of perforation, obstruction, or impaction. [ABSTRACT FROM AUTHOR]

Objective: To test with the Rasch analysis the psychometric properties of the Falls Efficacy Scale International, a questionnaire for measuring concern about falling. Design: Longitudinal observational study, before–after rehabilitation. Setting: Inpatient rehabilitation. Subjects: A total of 251 neurological patients with balance impairment. Interventions: Physiotherapy and occupational therapy aimed at reducing the risk of falling. Main measures: Participants (median age, first–third quartile: 74.0, 65.5–80.5 years; stroke and polyneuropathy: 43% and 21% of the sample, respectively) received a balance assessment (Falls Efficacy Scale International included) pre- and post-rehabilitation. Rasch analysis was used to evaluate the Falls Efficacy Scale International. Differential item functioning, which assesses the measures' stability in different conditions (e.g. before vs. after treatment) and in different groups of individuals, was tested for several variables. Results: Patients suffered a moderate balance impairment (Mini-BESTest median score; first–third quartile: 15; 11–19), mild–moderate concern about falling (Falls Efficacy Scale International: 28; 21–37) and motor disability (Functional Independence Measure, motor domain: 70.0; 57.0–76.5). Falls Efficacy Scale International items fitted the Rasch model (range of infit and outfit mean square statistics: 0.8–1.32 and 0.71–1.45, respectively) and the questionnaire's reliability was satisfactory (0.87). No differential item functioning was found for treatment, gender, age and balance impairment. Differential item functioning was found for diagnosis and disability severity, but it is shown that it is not such as to bias measures. Conclusions: Falls Efficacy Scale International ordinal scores can be turned into interval measures, i.e. measures of the type of temperature. Being differential item functioning-free for treatment, these measures can be safely used to compare concern about falling before and after rehabilitation, such as when interested in assessing the rehabilitation effectiveness. [ABSTRACT FROM AUTHOR]

Background: E-scooters have emerged as a frequently used vehicle in German cities due to their high availability and easy access. However, investigations about the causes and mechanisms of E-scooter incidents and their trauma-specific consequences are rare.Methods: We analysed all patients involved in E-scooter incidents from June to December 2019 who presented to four inner-city EDs in Berlin. The prospective data included patient-related and incident-related data, information on injury patterns and therapy, responses in a voluntary questionnaire concerning E-scooter use and general traffic experience.Results: 248 patients (129 males; median age 29 years (5-81)) were included: 41% were tourists and 4% were children. Most incidents (71%) occurred between July and September 2019, the majority occurring at weekends (58%). The injury pattern was mostly multifocal, affecting the lower (42%) and upper limbs (37%) and the head (40%). Traumatic brain injury was associated with alcohol consumption. Inpatient admission was recorded in 25%, surgery in 23%.Conclusion: This study has defined the incidence of injury related to E-scooter use in a major European city. Stricter laws governing the use of E-scooters, the wearing of helmets and technical modifications to the E-scooter platforms might decrease E-scooter-associated incidents and resulting injuries in the future.Trial Registration Number: German Clinical Trials Registry (DRKS00018061). [ABSTRACT FROM AUTHOR]

Objective: To determine the commonest site of non-suicidal self-inflicted firearm wound in comparison with accidental firearm wounds. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospitals Jhelum, Bannu & Kharian, from Nov 2014 to Nov 2018. Methodology: Sixty-four patients with firearm injuries were observed. All the participants were males between the ages of 18- 60 years. The injuries were determined to be either self-inflicted or accidental by an independent committee. The participants’ replies and responses were assessed by dividing them into five main domains by using quantitative software SPSS version 20. Variables involving demographic characteristics of participants such as age, occupation, marital and socioeconomic status, were associated with mental health variables such as psychological stress, previous history of self-harm and clinical psychiatric illness. Result: Fifteen subjects were found to have self-inflicted injuries and 50 had accidental injuries. There was a marked preference for left foot and left lower limb as a site for non-suicidal self-inflicted injuries (94.6%) as compared to other sites (left upper extremity 1.8%, chest 1.8% and right lower extremity 1.8%). Conclusions: Left lower limb and left foot was a more common site for self-injury as compared to the other sites. [ABSTRACT FROM AUTHOR]

Background: Pediatric (especially preadolescent) asphyxiation secondary to near hanging is a seldom reported entity and tends to be predominantly accidental in nature. Objective: The objective of the study was to assess and report the course during the intensive care unit (ICU) stay and the unique problems that are pertinent to pediatric near-hanging injuries. Methodology: A 10-year retrospective analysis (2009–2019) was conducted after obtaining ethical approval. Results: Eleven patients presented to our pediatric ICU over the past 10 years, with pediatric asphyxiation secondary to near hanging. Among these children, most of them had saree swing as the mode of hanging; this subgroup had a higher morbidity and mortality. They tend to have higher markers of myocardial ischemia (high troponin T and creatine kinase). About half of the patients required fluid boluses, inotropic requirement, and ventilation at admission. Patients with pulmonary edema tended to have low oxygen saturation (SpO2), even without respiratory distress at admission, and higher ventilator and inotropic requirement. Only half of the patient population admitted were discharged with good neurological outcome (Glasgow Coma Scale: 15/15 at discharge). Conclusion: The nature of complications secondary to hanging necessitates ICU monitoring, with pediatric ENT and anesthesia backup. The presence of low SpO2at admission in this setting should alert the clinician to possibility of pulmonary edema. Parents should be made aware that saree swing can lead to accidental asphyxiation. It is important to raise awareness to prevent this entity as it is associated with poor outcome.

Background: Suicide and attempted suicide are on a rise in India. Suicide attempt is an area which is well researched. However, there is a dearth of studies that focus on any other/absence of suicidal intent in “suspected suicidal attempters” (SSA). The present study aimed at identifying the presence or absence of intent in SSA to gain insight into the preventive methods. Methods: This study was based on cross-sectional baseline data of an ongoing prospective study of suicide attempters undertaken in General Hospital Psychiatry Unit. Convenient sampling was done; data were collected using semi-structured pro forma. Consenting medically stable SSA referred for psychiatric evaluation were included, and grouped based on variations in intent. Using SPSS software version 20.0, descriptive and inferential statistics were done. Results: Two hundred and forty-two participants were included in the study. Majority of participants (73.55%) with suicide intent were impulsive and 15.29% were planned. About 11.16% of participants had no intent (accidental incidents). Participants in accidental group were significantly older and more often diagnosed with alcohol use disorder (AUD) than the other two groups. Significantly, more number of agriculturists attempted impulsively/accidentally. Planned attempters significantly had less social support, higher suicide intent, and were more depressed. Conclusions: A tetrad of rural background, agriculturist, poisoning with pesticides, and AUD was seen in accidental and impulsive attempters, a noteworthy finding requiring imposing restrictions on the availability of alcohol and pesticides to prevent such occurrences. Accidental incidents as a group need further research and classification for its clinical and legal impact.

Background: Scald burns result from exposure to high-temperature fluids and are more common in the pediatric age group. They occur mainly by two mechanisms: (i) spill and (ii) immersion (hot cauldron) burns. These two patterns differ in clinical characteristics and outcomes. Scalds cause significant morbidity and mortality in children. The objective of this study was to compare accidental spill burns and hot cauldron burns in a hospital setting. Methods: An analytical cross-sectional study was conducted by reviewing the secondary data of scald cases admitted during the years 2019 and 2020 in a burn-dedicated tertiary care center. Total population sampling was adopted. Data analysis was done partly using SPSS, version-23, and Stata-15. Mann Whitney U-test and Chi-square/Fisher's exact test were done appropriately to find associations between different variables. Binary regression analysis was performed taking mortality events as the outcome of interest. Results: Out of 108 scald cases, 43 (39.8%) had hot cauldron burns and 65 (60.2%) had accidental spill burns. Overall mortality was 16 (14.8%), out of which hot cauldron burns and accidental spill burns comprised 12 (75.0%) and 4 (25.0%), respectively. Binary logistic regression analysis showed the type of scald, age, and Baux score found to be associated with mortality. Every one-year increment in age had a 29% lower odds of occurrence of mortality event (adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.50-0.99, p=0.042). Likewise, every one-point increment in Baux score was associated with 19% higher odds of mortality (adjusted OR, 1.190; 95% CI, 1.08-1.32; p

Background: Scald burns result from exposure to high-temperature fluids and are more common in the pediatric age group. They occur mainly by two mechanisms: (i) spill and (ii) immersion (hot cauldron) burns. These two patterns differ in clinical characteristics and outcomes. Scalds cause significant morbidity and mortality in children. The objective of this study was to compare accidental spill burns and hot cauldron burns in a hospital setting. Methods: An analytical cross-sectional study was conducted by reviewing the secondary data of scald cases admitted during the years 2019 and 2020 in a burn-dedicated tertiary care center. Total population sampling was adopted. Data analysis was done partly using SPSS, version-23, and Stata-15. Mann Whitney U-test and Chi-square/Fisher's exact test were done appropriately to find associations between different variables. Regression analysis was performed taking mortality events as the outcome of interest. Results: Out of 108 scald cases, 43 (39.8%) had hot cauldron burns and 65 (60.2%) had accidental spill burns. Overall mortality was 16 (14.8%), out of which hot cauldron burns and accidental spill burns comprised 12 (75.0%) and 4 (25.0%), respectively. Multinomial logistic regression analysis showed the type of scald, age, and Baux score found to be associated with mortality. Every one-year increment in age had a 29% lower odds of occurrence of mortality event (adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.50-0.99, p=0.042). Likewise, every one-point increment in Baux score was associated with 19% higher odds of mortality (adjusted OR, 1.190; 95% CI, 1.08-1.32; p Conclusions: Accidental spill burns were more common but mortality was significantly higher for hot cauldron burns. The majority of burn injuries occurred inside the kitchen emphasizing appropriate parental precautions. The risk of mortality was significantly higher in burn events occurring outside the house, and burns involving back, buttocks, perineum, and lower extremities.

Olanzapine long-acting injection is a commonly used antipsychotic drug formulation in the treatment of schizophrenia. Postinjection delirium/sedation syndrome (PDSS) is a potential side effect of this intramuscular depot, for which patients are often presented at the ED. In this article, we give an overview of the current literature outlining the key aspects of managing this syndrome in a critical care setting, illustrated by a typical fictional clinical case. We discuss several useful and practical aspects of PDSS for emergency physicians and critical care physicians, including pharmacological background, common symptoms, diagnostic criteria and therapeutic options., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: The International Hypothermia Registry (IHR) was created to increase knowledge of accidental hypothermia, particularly to develop evidence-based guidelines and find reliable outcome predictors. The present study compares hypothermic patients with and without cardiac arrest included in the IHR.Methods: Demographic, pre-hospital and in-hospital data, method of rewarming and outcome data were collected anonymously in the IHR between 2010 and 2020.Results: Two hundred and one non-consecutive cases were included. The major causeof hypothermia was mountain accidents, predominantly in young men. Hypothermic Cardiac Arrest (HCA) occurred in 73 of 201 patients. Core temperature was significantly lower in the patients in cardiac arrest (25.0 vs. 30.0 °C, p < 0.001). One hundred and fifteen patients were rewarmed externally (93% with ROSC), 53 by extra-corporeal life support (ECLS) (40% with ROSC) and 21 with invasive internal techniques (71% with ROSC). The overall survival rate was 95% for patients with preserved circulation and 36% for those in cardiac arrest. Witnessed cardiac arrest and ROSC before rewarming were positive outcome predictors, asphyxia, coagulopathy, high potassium and lactate negative outcome predictors.Conclusions: This first analysis of 201 IHR patients with moderate to severe accidental hypothermia shows an excellent 95% survival rate for patients with preserved circulation and 36% for HCA patients. Witnessed cardiac arrest, restoration of spontaneous circulation, low potassium and lactate and absence of asphyxia were positive survival predictors despite hypothermia in young, healthy adults after mountaineering accidents. However, accidental hypothermia is a heterogenous entity that should be considered in both treatment strategies and prognostication. [ABSTRACT FROM AUTHOR]

Introduction: Multiple skull fractures, including bilateral parietal skull fractures (BPSFs) in infants are considered to be suspicious for abusive head trauma (AHT). The aim of this report is to describe a series of BPSF cases in infants which occurred due to accidental falls. Methods: We searched our neuroradiology database for BPSF in infants (<1 year old) diagnosed between 2006 and 2019; we reviewed initial presentation, mechanisms of injury, clinical course, head imaging, skeletal survey X-rays, ophthalmology, social work and child abuse physicians (CAP) assessments, and long-term follow-up. "Confirmed accidental BPSF" were strictly defined as having negative skeletal survey and ophthalmology evaluation and a CAP conclusion of accidental injury. Results: Twelve cases of BPSF were found; 3 were confirmed to be accidental, with a mean age at presentation of 3 months. Two infants had single-impact falls, and 1 had a compression injury; all 3 had small intracranial hemorrhages. None had bruises or other injuries, and all remained clinically well. A literature search found 10 similar cases and further biomechanical evidence that these fractures can occur from accidental falls. Conclusion: While AHT should be kept in the differential diagnosis whenever BPSFs are seen, these injuries can occur as a result of accidental falls. [ABSTRACT FROM AUTHOR]

Background: The survival of completely buried victims in an avalanche mainly depends on burial duration. Knowledge is limited about survival probability after 60 min of complete burial.Aim: We aimed to study the survival probability and prehospital characteristics of avalanche victims with long burial durations.Methods: We retrospectively included all completely buried avalanche victims with a burial duration of ≥60 min between 1997 and 2018 in Switzerland. Data were extracted from the registry of the Swiss Institute for Snow and Avalanche Research and the prehospital medical records of the physician-staffed helicopter emergency medical services. Avalanche victims buried for ≥24 h or with an unknown survival status were excluded. Survival probability was estimated by using the non-parametric Ayer-Turnbull method and logistic regression. The primary outcome was survival probability.Results: We identified 140 avalanche victims with a burial duration of ≥60 min, of whom 27 (19%) survived. Survival probability shows a slight decrease with increasing burial duration (23% after 60 min, to <6% after 1400 min, p = 0.13). Burial depth was deeper for those who died (100 cm vs 70 cm, p = 0.008). None of the survivors sustained CA during the prehospital phase.Conclusions: The overall survival rate of 19% for completely buried avalanche victims with a long burial duration illustrates the importance of continuing rescue efforts. Avalanche victims in CA after long burial duration without obstructed airway, frozen body or obvious lethal trauma should be considered to be in hypothermic CA, with initiation of cardiopulmonary resuscitation and an evaluation for rewarming with extracorporeal life support. [ABSTRACT FROM AUTHOR]