Jabeen Nazish, Malik Sajid
Nazish Jabeen, Human Genetics Program, Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, 45320 Islamabad.
Sajid Malik, Human Genetics Program, Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, 45320 Islamabad.
Pak J Med Sci. 2015 Jan-Feb;31(1):54-9. doi: 10.12669/pjms.311.6423.
Traumatic limb amputations (TLA) are structural defects that cause mild-to-severe disabilities and have significant impact on the quality of life of subjects. A recent epidemiological study in Bhimber District, AJK, Pakistan, revealed that TLA had a very high incidence among the young/adult females. The present study aimed at determining the prevalence, pattern, causes and risk factors associated with TLA in that female sample.
In a prospective door-to-door survey, 1731 females were randomly enrolled, and clinico-etiological investigations on 19 subjects with TLA were carried out in a follow-up study. Affected subjects were physically examined and phenotypic detail and restriction to normal function were documented.
There were 19 subjects with TLA, hence the prevalence was estimated to be 10.98/1,000 (0.011%; CI=0.0061-0.0159). TLA mostly involved the upper limbs and right hand. Transphalangeal amputations were most frequent, followed by involvements of middle/upper arm and leg segments. These analyses further revealed that agriculture tools were the leading cause of trauma. TLA were witnessed to be higher in subjects originating from Samahni tehsil (OR:2.71), rural areas (OR:3.33), those who were illiterate (OR:2.65), married, spoke Pahari language (OR:1.73), those who fall in higher age category (OR:16.74), and had certain professions.
Limb amputations had heavy bearings on the lives of subjects. Curiously, majority of these traumas could be avoided by adopting certain safety measures. Prevalence and risk estimate of TLA across various socio-demographic variables of Bhimber population would be useful in guiding further studies and the public health policy to mitigate the impact of these anomalies.
创伤性肢体截肢（TLA）是一种导致轻度至重度残疾的结构缺陷，对患者的生活质量有重大影响。最近在巴基斯坦阿扎德克什米尔地区比姆伯县进行的一项流行病学研究显示，TLA在年轻/成年女性中发病率极高。本研究旨在确定该女性样本中TLA的患病率、模式、原因及相关危险因素。
在一项前瞻性挨家挨户调查中，随机纳入1731名女性，并在后续研究中对19例TLA患者进行临床病因学调查。对受影响的患者进行体格检查，并记录表型细节和对正常功能的限制。
有19例TLA患者，因此患病率估计为10.98/1000（0.011%；可信区间=0.0061 - 0.0159）。TLA大多累及上肢和右手。经指骨截肢最为常见，其次是上臂中部/上部和腿部节段受累。这些分析进一步表明，农具是创伤的主要原因。来自萨马尼乡（比值比：2.71）、农村地区（比值比：3.33）、文盲（比值比：2.65）、已婚、说帕哈里语（比值比：1.73）、年龄较大（比值比：16.74）以及从事某些职业的患者中TLA更为常见。
肢体截肢对患者的生活影响重大。奇怪的是，通过采取某些安全措施，这些创伤大多可以避免。比姆伯人群中不同社会人口学变量的TLA患病率和风险估计，将有助于指导进一步的研究以及公共卫生政策，以减轻这些异常情况的影响。
