BACKGROUND:Road traffic accidents (RTA) are responsible for 1.2 million deaths worldwide each year. RTA willbecome the 3rd largest contributor to the global burden of diseases after ischemic heart diseases (IHD) and depression. We conducted a retrospective study on RTA in a tertiary center in the hilly district of Uttarakhand in India. METHODS:The number of RTA, pattern of RTA, the number of patients killed and injured, the pattern of injury causing death and disability, the severity of accidents, and the type of disability were noted from December 2009 to November 2011. The accident severity was calculated as the number of patients killed per 100 accidents. The methods for reducing the incidence of RTA were observed, and the role of policy makers was studied. RESULTS:The majority of deaths and disabilities in Uttarakhand were due to road traffic accidents in the hilly districts of the states. The most common cause of RTA was driving fault followed by defective roads. CONCLUSION:Proper designing of roads and minimizing the fault of drivers are essential to prevent road traffic accidents in hilly regions.

BACKGROUND: Penetrating injuries of the perineum are rare but very dangerous. Since the genitourinary and colorectal organs may be injured, how to evaluate surgical management of the injury is very important. METHODS: The present report presents a case of penetrating injury of the perineum by a wooden stick when the patient fell on the upright wooden stick from a tree. The three feet long stick entered the perineal region just left lateral to the anal opening. Upon reaching the thoracic cavity, it broke and only a foot stick was left in the subcutaneous plane. These injuries are potentially serious with risk of damage to multiple organs. Exploratory laprotomy was done, and bladder injury was repaired. The entry wound and the track of stick was thoroughly washed and allowed for secondary intention healing. RESULTS: The post operative period was uneventful and the patient recovered fully. CONCLUSION: Meticulous evaluation and surgical management of perineal injuries are the key to prevent devastating complications.