Setting: Study was performed in mortuary of B P Koirala Institute of Health Sciences (BPKIHS), Dharan. Objectives: 1. To know the various epidemiological factors related to road traffic accident cases. 2. To know the relationship of head injury in road traffic accidents with the factors like helmet use, type of vehicle involved in accident. Study design: longitudinal descriptive study. Study unit: 77 Dead bodies with fatal head injury from RTA coming to BPKIHS mortuary, a focal point in eastern Nepal Study variables: Demographic characteristics of the victims, time, day and month of accidents, type of accidents, vehicle involved in accidents etc. Statistical analysis: Proportion. Results: There were approximately 78% male and 22% female road traffic accident victims with head injury. Students were the highest (20.7%) among the victims. The highest number of accidents took place in the month of June (11.7%) and on Saturdays (24.6%). The pedestrians were the largest (45%) group of the victims. Among the motorized vehicles, two wheeler drivers were more (34%) victims in accidents. Out of 77 fatalities, 22% were found to have consumed alcohol. Conclusion: Due to bad and mismanaged roads and poor road traffic knowledge to the citizens, road traffic accidents are the most common cause of unnatural deaths in this region. Minimal use of helmet is the main cause of fatal head injury in two wheeler occupants.

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Traumatic asphyxia is a condition presenting with cervicofacial cyanosis and edema, subconjunctival hemorrhage, and petechial hemorrhages of the face, neck, and upper chest that occurs due to a compressive force to the thoracoabdominal region.In this case report a 52 years old lady who was brought to the mortuary because of death due to traumatic asphyxia as a result of being stampeded by her own cows upon her chest was discussed. Congestion on both the conjunctiva, cyanosis on chin and adjacent upper left side of neck found with a well demarcated area observed between the cyanosed area over face and the normal area of neck. Hematoma was present in the chin and the adjacent neck region.Apart from quickly eliminating organ pathologies and initiation of supportive therapy in a case of traumatic asphyxia, possibility of formation of hematoma in neck after few hours of getting injured should also be considered, as this type of hematoma may contribute to the cause of death.Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 51-55

In forensic casework, investigation of injury severity is important in evaluating the mortality, occasionally in terms of the adequacy of clinical management. The study was conducted with an objective to study the relationship of severity of the injuries using Abbreviated Injury Scale and Injury Severity Score (ISS) with survival period and place of death among fatal cases with abdominopelvic trauma.The total number of cases studied was 80. The injuries in all the body parts were allotted using the Abbreviated Injury Scale 2005, Update 2008, and the ISS was calculated. The male/female ratio was 4:1, and the mean (SD) age was 30.76 (15.2) years. The cause of trauma was road traffic accidents in 82.5% of the cases. The median duration of survival was 2 hours. The mean (SD) ISS was 38.90 (14.89). Abbreviated Injury Scale scores of 5 and 4 were the most common in the region. With increase in the ISS, the survival period was decreased. There was a highly significant difference between the mean ISS of the victims who died prehospital and that of who died in the emergency department (P < 0.005). The mean ISS of the victims who died in the emergency department and of those who died in the ward, intensive care unit, or after discharge was also significantly different (P < 0.05).Although the cases with more severe injuries died sooner, there should be provision of treatment on the spot without delay. More time taken to start the treatment increases the fatalities.