Objective: To report trauma outcome from a developing country based on the Trauma and Injury Severity Scoring (TRISS) method and compare the outcome with the registry data from Major Trauma Outcome Study (MTOS). Design: Registry based audit of all trauma patients over two years. Setting: Emergency room of a teaching university hospital. Subjects: 279 injured patients meeting trauma team activation criteria including all deaths in the emergency room. Outcome measures: TRISS methodology to compare expected and observed outcome. Statistical analysis: W, M, and Z statistics and comparison with MTOS data. Results: 279 patients meeting the trauma triage criteria presented to the emergency room, 235 (84.2%) were men and 44 (15.8%) women. Blunt injury accounted for 204 (73.1%) and penetrating for 75 (26.9%) patients. Seventy two patients had injury severity score of more than 15. Only 18 (6.4%) patients were transported in an ambulance. A total of 142 (50.9%) patients were transferred from other hospitals with a mean prehospital delay of 7.1 hours. M statistic of our study subset was 0.97, indicating a good match between our patients and MTOS cohort. There were 18 deaths with only one unexpected survivor. The expected number of deaths based on MTOS dataset should have been 12. Conclusions: Present injury severity instruments using MTOS coefficients do not accurately correlate with observed survival rates in a developing country.

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Periodic collection of field data, analysis and interpretation of data are key to a good healthcare service. This data is used by the subsequent decision makers to recognize preventive measures, provide timely support to the affected and to help measure the effects of their interventions. While the resources required for good disease surveillance and proactive healthcare are available more readily in developed countries, the lack of these in developing countries may compromise the quality of service provided. This combined with the critical nature of some diseases makes this an essential issue to be addressed. Taking advantage of the rapid growth of cell phone usage and related infrastructure in developed as well as developing countries, several systems have been established to address the gaps in data collection. Android, being an open sourced platform, has gained considerable popularity in this aspect. Open data kit is one such tool developed to aid in data collection. The aim of this paper is to present a prototype framework built using few such existing tools and technologies to address data collection for seasonal influenza, commonly referred to as the flu.

Surgeons, trainees, and patients may be uncomfortable with the secrecy that surrounds the process of teaching and learning surgical procedures. Well structured training programs use a system of graded responsibility, supervision, and evaluation to ensure skill development and patient safety. Patient outcomes are generally excellent in training institutions. Disclosure of the role of trainees and their contribution to care enhances trust.

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