Pattern of Injury in Lightning Deaths- A Post Mortem Study in Southern Odisha

Abstract

Lightning is one of the most powerful natural phenomena resulting in high-voltage electrical injury. This study attempts to analyze the  different patterns of injury, epidemiological profile, trend and circumstances of lightning deaths in one of the southern region of Odisha.  This cross-sectional retrospective study was conducted on the 58 fatal cases of lightning strike autopsied in the department of Forensic  Medicine and Toxicology of M.K.C.G. Medical College, Berhampur, Odisha during a period of 5 years (2016 - 2020). Lightning deaths  constituted 0.89% of total post mortem cases with a male to female ratio, 3.46:1. Majority of victims (27.59%) were between 41-50 years,  from rural background and agricultural workers. A fluctuating trend in lightning deaths is seen. 2016 and 2017 had highest incidence of  lightning i.e. 31.03% each. Maximum deaths (29.31%) occurred in the month of June and between 3-5 PM (62.7%). The incidences  occurred mostly (94.82%) open areas and 37.93% were working in agricultural land. Only 5.17% victims had taken shelter under trees.  Burn injuries (mostly linear) were dominant (84.48%) and involved mostly the chest in 39.66% cases followed by abdomen (36.2%).  Arborescent marks were detected in 8.62% cases, other injuries in 22.41% and burning and singeing of hairs in 53.45%. Clothing was torn  in 13.79% of victims and ear bleeding in 15.51%. No gross internal injury was seen except SAH in 2 cases. All the victims were brought  dead and cause of death was mostly due to cardiac arrest. This study will provide expertise and ideas to medical personnel and various  stakeholders for prompt management, prevention of fatalities, solve medicolegal issues and policy making.