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Rehan M, Iqbal T, Khawar Khokhar O, Aziz Khan A, Ain QU, Waheed U. Domestic Cylinder Blasts: A Neglected Torpedo. J Burn Care Res 2024; 45:398-403. [PMID: 37879628 DOI: 10.1093/jbcr/irad160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Indexed: 10/27/2023]
Abstract
High-pressure cylinders are used to store liquefied petroleum gas (LPG). An instant and swift explosion of these cylinders can result in serious burn injuries. This current research was conducted to study the epidemiological characteristics of LPG-related burns to highlight a major public health issue. Analysis was conducted on patients with LPG-related burns over a span of 10 years admitted to our center between January 2011 and December 2020. The data recorded included demographic features, site of burn, %TBSA, associated injuries, and outcomes. The variable data were documented for every patient in a Microsoft Excel file and analyzed by IBM SPSS version 25.0. Over the span of 10 years, 678 patients were affected by LPG-related accidents. The peak incidence was seen in 2019 when there was a surge to 18.03%. The patient's age ranged from 1 to 79 years, with a median of 40.86 ± 15.27 years. Of the 678 patients, 52.50% were males and 47.50% were females. The majority (57.96%) of patients had a total BSA of >60% and 86.72% were diagnosed with inhalation injury. The majority of burns (84.66%) occurred at home. The mean hospital stay was 24.5 days. The total mortality rate was 59.58%. This study concludes that LPG cylinder blast is a preventable cause that can be minimized by making people aware of its safe use and by arranging awareness programs at every national level.
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Affiliation(s)
- Muhammad Rehan
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 04403, Pakistan
| | - Tariq Iqbal
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 04403, Pakistan
| | - Omar Khawar Khokhar
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 04403, Pakistan
| | - Amna Aziz Khan
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 04403, Pakistan
| | - Qurrat Ul Ain
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 04403, Pakistan
| | - Usman Waheed
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 04403, Pakistan
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Kaur N, Byard RW. Bride burning: A unique and ongoing form of gender-based violence. J Forensic Leg Med 2020; 75:102035. [PMID: 32871350 DOI: 10.1016/j.jflm.2020.102035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
Despite legislation, dowry is still widespread in many parts of India and adjacent countries. It refers to the transfer of goods, money, and property to a bridegroom, his parents, or his relatives from a bride's family as a condition of the marriage. One of the consequences of the dowry system has been the murder or abetted suicide of young wives, either because more dowry goods were not provided to her husband or his family, or to secure the goods after marriage. In 2015 7634 women died due to dowry harassment, representing approximately 21 cases per day in India. The majority of dowry deaths occur within the first three years of marriage. Common types of dowry death homicides involve fire ('bride burning', drowning, poisoning and hanging/strangulation. In addition to legislation, an organized and multipronged approach is need by investigating police officers, women's' welfare organizations, responsible public servants, and the judiciary with consistent applications of deterrent penalties. Full and properly conducted medicolegal investigation is mandatory which must include scene examinations, full autopsies with photographic documentation and ancillary investigations such as headspace analyses. Significant burns in young Indian women living in traditional circumstances should raise the possibility of dowry-related crime.
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Affiliation(s)
| | - Roger W Byard
- Adelaide School of Medicine, The University of Adelaide, Adelaide, Australia
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3
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Vidhate SG, Pathak H. A study of medico-legal aspects of death due to burns at a tertiary care centre in Mumbai, India. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2017. [DOI: 10.1186/s41935-017-0018-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dasari M, David SD, Miller E, Puyana JC, Roy N. Comparative analysis of gender differences in outcomes after trauma in India and the USA: case for standardised coding of injury mechanisms in trauma registries. BMJ Glob Health 2017; 2:e000322. [PMID: 29225936 PMCID: PMC5717963 DOI: 10.1136/bmjgh-2017-000322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/30/2017] [Accepted: 06/06/2017] [Indexed: 11/05/2022] Open
Abstract
Introduction While females generally have better outcomes than males after traumatic injury, higher mortality has been shown to occur in females after intentional trauma in lower-income countries. However, gender differences in trauma outcomes in different countries have not been previously compared. We conducted a two-country comparative analysis to characterise gender differences in mortality for different mechanisms of injury. Methods Two urban trauma databases were analysed from India and the USA for fall, motor vehicle collision (MVC) and assault patients between 2013 and 2015. Coarsened exact matching was used to match the two groups based on gender, age, injury severity score, Glasgow Coma Score and type of injury (blunt vs penetrating). The primary outcome of mortality was studied by using logistic regression to calculate the odds of death in the four country/gender subgroups. Results A total of 10 089 and 14 144 patients were included from the Indian and US databases, respectively. After matching on covariates, 7505 and 9448 patients were included in the logistic regression. Indian males had the highest odds of death compared with US males, US females and Indian females for falls, MVC and assaults. Indian females had over 7 times the odds of dying after falls, 5 times the odds of dying for MVC and 40 times the odds of dying after assaults when compared with US females. Conclusion The high odds of death for Indian females compared with US females suggests that there are other injury and systemic factors that contribute to this discrepancy in mortality odds. This same mortality pattern and implication is seen for Indian males compared with all subgroups. Standardised coding of injury mechanism in trauma registries, in addition to intentionality of injury, can help further characterise discrepancies in outcomes by gender and country, to guide targeted injury prevention and care.
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Affiliation(s)
- Mohini Dasari
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Siddarth D David
- School of Habitat Studies, Tata Institute of Social Sciences, Deonar, India
| | - Elizabeth Miller
- Division of Young Adult and Adolescent Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Juan Carlos Puyana
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Nobhojit Roy
- Department of Public Health Sciences, School of Habitat Studies, Tata Institute of Social Sciences Karolinska Institutet, Stockholm, Sweden
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Jin R, Wu P, Ho JK, Wang X, Han C. Five-year epidemiology of liquefied petroleum gas-related burns. Burns 2017; 44:210-217. [PMID: 28781135 DOI: 10.1016/j.burns.2017.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies. METHODS A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015. Information obtained for each patient included age, gender, education status, occupation, medical insurance, average hospital cost, length of hospital stay, monthly distribution of incidence, place of burns, mechanism of burns, extent of burns, site of burns, accompanying injuries, and treatment outcomes. RESULTS For the first 4 years (2011-2014), the yearly incidence of LPG-related burns was at approximately 10% of all burns; however, in the fifth year (2015) alone, there was a surge to 26.94%. A total of 1337 burn patients were admitted during this period. Of these, 195 patients were admitted because of 169 LPG-related accidents; there were 11 accidents involving more than one victim. LPG-related burns occurred most frequently in patients aged 21-60 years (73.85%). The majority of injuries occurred from May to August (56.41%), and the most common place was home (83.08%, 162 patients). Gas leak (81.03%) was the main cause of LPG-related burns, followed by inappropriate operation (7.69%) and cooking negligence (2.05%). The mean burn area was 31.32±25.40% of TBSA. The most common sites of burns were the upper extremities (37.47%), followed by the head/face and neck (24.80%) and lower extremities (19.95%). The most common accompanying injuries included inhalation injury (23.59%), shock (8.71%), and external injury (7.18%). The average hospital stay was 22.90±19.47days (range 2-84 days). Only 48 patients (24.62%) had medical insurance, while 124 patients (63.59%) had no medical insurance. The average hospital cost of the no medical insurance group was significantly higher (p<0.0001) than that of the medical insurance group. In addition, 72.73% of patients who left against medical advice (LAMA) were uninsured. The number of patients who recovered at our hospital was 165 (84.62%), while 22 patients (11.28%) LAMA. The overall mortality rate was 4.10% (8 patients). CONCLUSION Our study shows that the exponential increase in LPG-related burns is alarming. This calls for rigorous precautions. Because gas leak was the main cause of LPG-related burns, any part of LPG stove system that shows signs of weathering should be replaced regularly. In addition, we also found that most of the LAMA patients were uninsured. Thus, comprehensive medical insurance should be involved early in the recovery process to assure a safe and adequate discharge.
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Affiliation(s)
- Ronghua Jin
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
| | - Pan Wu
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
| | - Jon Kee Ho
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
| | - Xingang Wang
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
| | - Chunmao Han
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China.
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Dissanaike S, Ha D, Mitchell D, Larumbe E. Socioeconomic status, gender, and burn injury: A retrospective review. Am J Surg 2017; 214:677-681. [PMID: 28693838 DOI: 10.1016/j.amjsurg.2017.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/26/2017] [Accepted: 06/20/2017] [Indexed: 11/25/2022]
Abstract
Burn injury rates appear to be influenced by socioeconomic status (SES) and gender globally, but the impact of poverty and gender on burn injury has not been studied in a developed country. This study was a retrospective chart review conducted at a regional burn center in the Southwest US that included 340 patients with TBSA burns >15%. SES was determined using zip code and US census data. The distribution of mechanism of injury was significantly different by gender (χ2(6) = 36.14, p < 0001), but not significantly different by SES (χ2(12) = 19.68, p = 0.073). Burn rates in women was found to have a significant and linear increase (χ2 = 13.8513, p = 0.001) with increasing poverty. Women had higher frequencies of being burned at home, and men had higher frequencies of being burned at work. While poverty did not appear to increase the risk of burn injury overall in a mixed population, it was associated with a significant increase in the risk of burn injury in women. Thus, strategies for decreasing risk factors should be targeted toward low SES females and the working male.
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Affiliation(s)
- Sharmila Dissanaike
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Daniel Ha
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Diana Mitchell
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Eneko Larumbe
- Clinical Research Institute, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Audit of burn deaths among older adults in North India – An autopsy-based study. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2016. [DOI: 10.1016/j.ejfs.2016.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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8
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Adil SO, Ibran EA, Nisar N, Shafique K. Pattern of unintentional burns: A hospital based study from Pakistan. Burns 2016; 42:1345-9. [DOI: 10.1016/j.burns.2016.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 03/17/2016] [Accepted: 03/28/2016] [Indexed: 10/21/2022]
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Bhate-Deosthali P, Lingam L. Gendered pattern of burn injuries in India: a neglected health issue. REPRODUCTIVE HEALTH MATTERS 2016; 24:96-103. [PMID: 27578343 DOI: 10.1016/j.rhm.2016.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/09/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022] Open
Abstract
There are an estimated 7 million burn injuries in India annually, of which 700,000 require hospital admission and 140,000 are fatal. According to the National Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. This paper reviews the existing literature on burn injuries in India and raises pertinent issues about prevalence, causes and gaps in recognising the gendered factors leading to a high number of women dying due to burns. The work of various women's groups and health researchers with burns victims raises several questions about the categorisation of burn deaths as accident, suicide and homicide and the failure of the health system to recognise underlying violence. Despite compelling evidence, the health system has not recognised this as a priority. Considering the substantial cost of burns care, prevention is the key which requires health systems to recognise the linkages between burn injuries and domestic violence. Health systems need to integrate awareness programmes about domestic violence and train health professionals to identify signs and symptoms of violence. This would contribute to early identification of abuse so that survivors are able to access support services at an early stage.
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Affiliation(s)
- Padma Bhate-Deosthali
- Coordinator, CEHAT, Mumbai, India; PhD Scholar, Tata Institute of Social Sciences, Hyderabad, India.
| | - Lakshmi Lingam
- Professor, Tata Institute of Social Sciences, Hyderabad, India
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10
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Sharma NP, Duke JM, Lama BB, Thapa B, Dahal P, Bariya ND, Marston W, Wallace HJ. Descriptive Epidemiology of Unintentional Burn Injuries Admitted to a Tertiary-Level Government Hospital in Nepal. Asia Pac J Public Health 2015; 27:551-60. [DOI: 10.1177/1010539515585386] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study describes the epidemiology of unintentional adult burn injury admissions in a tertiary hospital in Nepal, from 2002 to 2013, focusing on gender-specific patterns. Chi-square tests and Wilcoxon Rank Sum tests were performed. There were 819 unintentional burn admissions: 52% were male and 58% younger than 35 years. The median percentage total body surface area burned (interquartile range) was greater in females than in males ( P < .001): 28% (17-40) versus 20% (12-35), and female mortality was higher (32% vs 11%). A higher proportion females were illiterate than males (48% vs 17%). Burns occurred at home (67%), work (28%), and public places (5%); gender-specific patterns were observed. Flame burns accounted for 77%, electricity 13%, and scalds 8%. Kerosene (31%) and biomass (27%) were the major fuels. Cooking, heating, and lighting were the main activities associated with burn injury. Results support interventions to reduce the use of open fires and kerosene and to promote electrical safety.
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Affiliation(s)
| | - Janine M. Duke
- The University of Western Australia, Crawley, Western Australia, Australia
| | | | | | | | | | | | - Hilary J. Wallace
- The University of Western Australia, Crawley, Western Australia, Australia
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Daruwalla N, Belur J, Kumar M, Tiwari V, Sarabahi S, Tilley N, Osrin D. A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India. BMC WOMENS HEALTH 2014; 14:142. [PMID: 25433681 PMCID: PMC4260258 DOI: 10.1186/s12905-014-0142-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 10/28/2014] [Indexed: 11/23/2022]
Abstract
Background Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause – accidental or non-accidental, suicidal or homicidal – is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. Methods We conducted semi-structured interviews with 33 women admitted to two major burns units, their families, and 26 key informant doctors, nurses, and police officers. We used framework analysis to examine the context in which burns occurred and the sequence of medicolegal action after admission to hospital. Results Interviewees described accidents, attempted suicide, and attempted homicide. Distinguishing between these was difficult because the underlying combination of poverty and cultural precedent was common to all and action was contingent on potentially conflicting narratives. Space constraint, problems with cooking equipment, and inflammable clothing increased the risk of accidental burns, but coexisted with household conflict, gender-based violence, and alcohol use. Most burns were initially ascribed to accidents. Clinicians adhered to medicolegal procedures, the police carried out their investigative requirements relatively rapidly, but both groups felt vulnerable in the face of the legal process. Women’s understandable reticence to describe burns as non-accidental, the contested nature of statements, their perceived history of changeability, the limited quality and validity of forensic evidence, and the requirement for resilience on the part of clients underlay a general pessimism. Conclusions The similarities between accident and intention cluster so tightly as to make them challenging to distinguish, especially given women’s understandable reticence to describe burns as non-accidental. The contested status of forensic evidence and a reliance on testimony means that only a minority of cases lead to conviction. The emphasis should be on improving documentation, communication between service providers, and public understanding of the risks of burns.
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Belur J, Tilley N, Daruwalla N, Kumar M, Tiwari V, Osrin D. The social construction of 'dowry deaths'. Soc Sci Med 2014; 119:1-9. [PMID: 25129569 PMCID: PMC4394358 DOI: 10.1016/j.socscimed.2014.07.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/03/2014] [Accepted: 07/17/2014] [Indexed: 11/22/2022]
Abstract
The classification of cause of death is real in its consequences: for the reputation of the deceased, for her family, for those who may be implicated, and for epidemiological and social research and policies and practices that may follow from it. The study reported here refers specifically to the processes involved in classifying deaths of women from burns in India. In particular, it examines the determination of ‘dowry death’, a class used in India, but not in other jurisdictions. Classification of death is situated within a framework of special legal provisions intended to protect vulnerable women from dowry-related violence and abuse. The findings are based on 33 case studies tracked in hospital in real time, and interviews with 14 physicians and 14 police officers with experience of dealing with burns cases. The formal class into which any given death is allocated is shown to result from motivated accounting processes representing the interests and resources available to the doctors, victims, victim families, the victim’s husband and his family, and ultimately, the police. These processes may lead to biases in research and to injustice in the treatment of victims and alleged offenders. Suggestions are made for methods of ameliorating the risks.
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Affiliation(s)
- Jyoti Belur
- Department of Security and Crime Science, UCL, 35 Tavistock Square, London WC1H 9EZ, UK.
| | - Nick Tilley
- Department of Security and Crime Science, UCL, 35 Tavistock Square, London WC1H 9EZ, UK.
| | - Nayreen Daruwalla
- Society for Nutrition, Education and Health Action, Urban Health Centre, Room No. 110, Dharavi, Mumbai 400 017, India.
| | - Meena Kumar
- Lokmanya Tilak Municipal Medical College and General Hospital, Dr. Babasaheb Ambedkar Road, Sion West, Mumbai 400 022, India.
| | - Vinay Tiwari
- Burns, Plastic and Maxillofacial Surgery, VM Medical College and Safdarjang Hospital, New Delhi 110 029, India.
| | - David Osrin
- UCL Institute for Global Health, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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Belur J, Tilley N, Osrin D, Daruwalla N, Kumar M, Tiwari V. Police investigations: discretion denied yet undeniably exercised. POLICING & SOCIETY 2014; 25:439-462. [PMID: 26376482 PMCID: PMC4338498 DOI: 10.1080/10439463.2013.878343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Police investigations involve determining whether a crime has been committed, and if so what type of crime, who has committed it and whether there is the evidence to charge the perpetrators. Drawing on fieldwork in Delhi and Mumbai, this paper explores how police investigations unfolded in the specific context of women's deaths by burning in India. In particular, it focuses on the use of discretion despite its denial by those exercising it. In India, there are distinctive statutes relating to women's suspicious deaths, reflecting the widespread expectation that the bride's family will pay a dowry to the groom's family and the tensions to which this may on occasion give rise in the early years of a marriage. Often, there are conflicting claims influencing how the woman's death is classified. These in turn affect police investigation. The nature and direction of police discretion in investigating women's deaths by burning reflect in part the unique nature of the legislation and the particular sensitivities in relation to these types of death. They also highlight processes that are liable to be at work in any crime investigation. It was found that police officers exercised unacknowledged discretion at seven specific points in the investigative process, with potentially significant consequences for the achievement of just outcomes: first response, recording the victim's 'dying declaration', inquest, registering of the 'First Information Report', collecting evidence, arrest and framing of the charges.
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Affiliation(s)
- J. Belur
- Department of Security and Crime Science, University College London, London, UK
| | - N. Tilley
- Department of Security and Crime Science, University College London, London, UK
| | - D. Osrin
- Institute of Child Health, University College London, London, UK
| | - N. Daruwalla
- Society for Nutrition, Education and Health Action, Urban Health Centre, Mumbai, India
| | - M. Kumar
- Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - V. Tiwari
- Department of Burns, Plastic and Maxillofacial Surgery, VM Medical College and Safdarjung Hospital, New Delhi, India
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Kumar S, Ali W, Verma AK, Pandey A, Rathore S. Epidemiology and mortality of burns in the Lucknow Region, India—A 5 year study. Burns 2013; 39:1599-605. [DOI: 10.1016/j.burns.2013.04.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 04/05/2013] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
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Golshan A, Patel C, Hyder AA. A systematic review of the epidemiology of unintentional burn injuries in South Asia. J Public Health (Oxf) 2013; 35:384-96. [DOI: 10.1093/pubmed/fds102] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Afify MM, Mahmoud NF, Abd El Azzim GM, El Desouky NA. Fatal burn injuries: A five year retrospective autopsy study in Cairo city, Egypt. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2012. [DOI: 10.1016/j.ejfs.2012.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Incidence and treatment of burns: a twenty-year experience from a single center in Germany. Burns 2012; 39:49-54. [PMID: 22673118 DOI: 10.1016/j.burns.2012.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 05/04/2012] [Accepted: 05/06/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To analyze trends in incidence and treatment of thermal injuries over the last two decades. METHODS We retrospectively reviewed our local single center database of patients with thermal injuries admitted to the burn intensive care unit (BICU) of the Cologne-Merheim Medical Center (University Hospital of Witten/Herdecke). The cohort was divided into two groups according to the decade of admission and the epidemiology and clinical course of the patient sample admitted during the period 1991-2000 (n=911) was compared to that of 2001-2010 (n=695). RESULTS The following variables were significantly different in the bivariate analysis: mean age (39.8 years vs. 44.0 years), burn size of total body surface area (23.2% vs. 18.0%) and size of 3rd degree burns (9.6% vs. 14.9%). The incidence of inhalation injury was significantly lower in the last decade (33.3% vs. 13.7%) and was associated with a shorter duration of mechanical ventilation (10.8 days vs. 8.5 days). The ABSI-score as an indicator of burn severity declined in the second period (6.3 vs. 6.0) contributing partially to the decline of BICU length of stay (19.1 days vs. 18.8 days) and to the mortality rate decrease (18.6% vs. 15.0%). CONCLUSION The severity of burn injuries during the last two decades declined, probably reflecting the success of prevention campaigns. Concerning mortality, the chance of dying for a given severity of injury has decreased.
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Clinico-Epidemiological Profile of Burn Patients Admitted in a Tertiary Care Hospital in Coastal South India. J Burn Care Res 2012; 33:660-7. [DOI: 10.1097/bcr.0b013e31824795b7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ahuja RB, Dash JK, Shrivastava P. A comparative analysis of liquefied petroleum gas (LPG) and kerosene related burns. Burns 2011; 37:1403-10. [DOI: 10.1016/j.burns.2011.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 03/04/2011] [Accepted: 03/21/2011] [Indexed: 10/18/2022]
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Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet 2009; 374:881-92. [PMID: 19748397 DOI: 10.1016/s0140-6736(09)60741-8] [Citation(s) in RCA: 682] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pronounced changes in patterns of health take place in adolescence and young adulthood, but the effects on mortality patterns worldwide have not been reported. We analysed worldwide rates and patterns of mortality between early adolescence and young adulthood. METHODS We obtained data from the 2004 Global Burden of Disease Study, and used all-cause mortality estimates developed for the 2006 World Health Report, with adjustments for revisions in death from HIV/AIDS and from war and natural disasters. Data for cause of death were derived from national vital registration when available; for other countries we used sample registration data, verbal autopsy, and disease surveillance data to model causes of death. Worldwide rates and patterns of mortality were investigated by WHO region, income status, and cause in age-groups of 10-14 years, 15-19 years, and 20-24 years. FINDINGS 2.6 million deaths occurred in people aged 10-24 years in 2004. 2.56 million (97%) of these deaths were in low-income and middle-income countries, and almost two thirds (1.67 million) were in sub-Saharan Africa and southeast Asia. Pronounced rises in mortality rates were recorded from early adolescence (10-14 years) to young adulthood (20-24 years), but reasons varied by region and sex. Maternal conditions were a leading cause of female deaths at 15%. HIV/AIDS and tuberculosis contributed to 11% of deaths. Traffic accidents were the largest cause and accounted for 14% of male and 5% of female deaths. Other prominent causes included violence (12% of male deaths) and suicide (6% of all deaths). INTERPRETATION Present global priorities for adolescent health policy, which focus on HIV/AIDS and maternal mortality, are an important but insufficient response to prevent mortality in an age-group in which more than two in five deaths are due to intentional and unintentional injuries. FUNDING WHO and National Health and Medical Research Council.
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Affiliation(s)
- George C Patton
- Centre for Adolescent Health and Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
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Abstract
BACKGROUND Hospital-based studies have suggested that fire-related deaths might be a neglected public-health issue in India. However, no national estimates of these deaths exist and the only numbers reported in published literature come from the Indian police. We combined multiple health datasets to assess the extent of the problem. METHODS We computed age-sex-specific fire-related mortality fractions nationally using a death registration system based on medically certified causes of death in urban areas and a verbal autopsy based sample survey for rural populations. We combined these data with all-cause mortality estimates based on the sample registration system and the population census. We adjusted for ill-defined injury categories that might contain misclassified fire-related deaths, and estimated the proportion of suicides due to self-immolation when deaths were reported by external causes. FINDINGS We estimated over 163 000 fire-related deaths in 2001 in India, which is about 2% of all deaths. This number was six times that reported by police. About 106 000 of these deaths occurred in women, mostly between 15 and 34 years of age. This age-sex pattern was consistent across multiple local studies, and the average ratio of fire-related deaths of young women to young men was 3:1. INTERPRETATION The high frequency of fire-related deaths in young women suggests that these deaths share common causes, including kitchen accidents, self-immolation, and different forms of domestic violence. Identification of populations at risk and description of structural determinants from existing data sources are urgently needed so that interventions can be rapidly implemented.
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Burton KR, Sharma VK, Harrop R, Lindsay R. A population-based study of the epidemiology of acute adult burn injuries in the Calgary Health Region and factors associated with mortality and hospital length of stay from 1995 to 2004. Burns 2009; 35:572-9. [PMID: 19203840 DOI: 10.1016/j.burns.2008.10.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Accepted: 10/13/2008] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Trauma resulting from acute burns is relatively common and we wished to study the incidence, outcomes and factors related to mortality and hospital length of stay to identify potential areas of prevention and improve the care of burn-injured patients. To do so, we studied a population of adult burn injury patients from a large area of Canada (the Calgary Health Region (CHR) over a 10-year period. Burn data from this population-based sample has never been published and is not currently included in the American Burn Association Repository report. METHODS We extracted data on all adult (>or=18 years) residents of the CHR who suffered a burn injury requiring hospital admission between January 1995 and December 2004. Of particular interest were patient demographics, incidence and mortality rates of the victims as well as any factors that were associated with mortality or increased length of hospital stay. RESULTS A total of 928 burn-injured patients were identified. The highest incidence of burn injury admissions in the CHR occurred in 1996 (12.2 burn injury admissions per 100,000 population) and 2004 (12.3 admissions per 100,000 population). The largest number of burn injury admissions occurred during the months of July and August (23.3%), while the fewest occurred during the winter months of February and December (11.9%). Mean patient age was 45.2 years (range 18-97) and 658 (70.9%) were male. The majority of our patients were admitted with second-degree burns (48.7%) and burns of the head and neck were the most prevalent (22.2%). The mean length of hospital stay for burn patients was 20.4 days (range 1-312). Over the course of the 10 years of the study, 9 (1.0%) burn patients died during their hospital stay. In univariate analyses, burn survivors differed significantly from non-survivors with respect to mean age, burn degree, body part burned and year of admission. In adjusted analyses, survivors and non-survivors differed significantly with respect to year and month of admission, degree of burn, patient age and length of stay. Factors significantly associated with increase length of hospital stay included degree of burn, older patient age and hospital site. CONCLUSIONS In this Canadian health region, patients who die from burns tend to be older, present to the hospital during the winter months, and suffer more acute burns to the torso or multiple body regions. Additionally, patient length of stay is influenced by older patient age and greater burn thickness.
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Affiliation(s)
- Kirsteen R Burton
- University of Toronto, Department of Medical Imaging, c/o 22B Birch Avenue, Toronto, Ontario, Canada.
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