Dr. V. Chandra Sekhar

Over the last few years there is a rise in use of button batteries in various toys and other electronic gadgets. Easy availability and small size of these batteries pose a significant risk of ingestion in small children. Button battery ingestion can lead to serious health hazards very rapidly. A 2-year-old girl presented to the emergency room of a community hospital complaining of hematemesis. X-ray showed a coin lithium battery located in the esophagus, and she was transferred to a referral hospital and succumbed to death after 4 hours survival in king george hospital. Postmortem examination revealed massive blood clots in stomach.

Background: Trauma is one of the leading causes of disability and death all over world and also in the Indian population. According to United State's Centre for Disease Control and Prevention (CDC), 74 per cent of deaths in USA, is due to trauma and it occurs in the age group of 10 to 24 years. A comparative data reported by National Crime Record Bureau (NRCB) in India is 62 per cent of all deaths and it occurred in the age group of 15 to 44 years 11. Craniocerebral injury is any trauma that leads to injury of the skull and/or brain. Traumatic Brain Injury (TBI) is one of the most devastating types of injury. It affects all age groups and associated with significant socioeconomic loss to India and other developing countries. Road Traffic accidents remain the main cause of TBI followed by falls, assault and collapse of heavy objects. Aim: To estimate various demographic variables among the individuals who died due to head injuries. To estimate the pattern of distribution in the factors associated with incident viz., time of accident, place of accident, manner of accident, type of accident in deaths due to head injuries. Material and methods: Descriptive (Observational) study-Quantitative analysis. Study period one year from 01 st January 2018 to 31 st December 2018. Deaths due to Cranio-cerebral injuries in Visakhapatnam, for which post mortem is conducted in Modern Mortuary, King George hospital Visakhapatnam. Results: A total of 1702 medico legal autopsies were conducted during the study period (2018). Of that Head injury cases alone accounted for 35.66% (n=605) of all autopsied cases. Among them 163 case autopsies performed by Dr. V. Chandra Sekhar, were taken up for the study, so as to eliminate any variations in autopsy technique. Male preponderance observed in our study with ratio of 9:1 compared to female. This gender bias could be due to more males being involved in outdoor works and commonly exposed to accidents. All age groups are equally prone to Head injuries; however, majority of victims are between 41-50 years age group accounting for 19.63% followed by 21-30 age group 19.01%, and 51-60 age group 17.79% remaining are rest of the age groups. Maximum cases are reported during rainy season accounting for 34%, the reason could be slippery nature of road for both pedestrians and vehicles. Most of the accidents occurred between 12Noon and 6PM leading to 39% (n=64) cases followed by 6PM to 12 Mid night, 6AM to 12 Noon and least is seen from 12Mid night to 6AM. Place of death: Majority of cases were found dead in KGH (Government Hospital) 48% (n=78) followed by other hospitals 20% (n=33) both combinedly accounting for 68%, rest of the cases died during transport to hospital or spot dead. Manner of death most of the cases are of accidental accounting for 96% and only 4% cases are homicidal and there are no suicidal cases. Head injuries are more common in Road Traffic Accidents and among RTAs making about 67% of cases, pedestrian 24% rest of the cases are other than RTA.