title: Incidence and pattern of bear maul injuries in Kashmir.
abstract: BACKGROUND
  Injuries due to mauling by bears are rarely reported in the literature. The high incidence of such injuries in Kashmir, India, which is a valley surrounded by dense forests and is a habitat of Asiatic Black bears, urged us to undertake such a study in our department.
  
  
  METHODS
  The study was conducted both retrospectively (January 1990-July 2005) and prospectively (August 2005-December 2007).
  
  
  RESULTS
  A total of 417 cases were recorded and all the injuries were caused by black bears alone. Majority of the patients were young to middle-aged (96.8% of cases) and predominantly males (80.33%). The incidence was highest during July to November (76.82%), and most of the attacks (97%) occurred during daytime. Soft-tissue injury occurred in all 417 cases, bones were involved in 131 (31.41%) while the visceral organs were injured in four (12.94%) patients. The face (80.57%) was most common part of the body injured, followed by the head (54.67%), and all the patients had soft-tissue injury (100%). In spite of devastating injuries caused by bear maulings, the mortality rate was only 2.39%.
  
  
  CONCLUSIONS
  Injuries due to mauling by black bear occur mainly between July and November. The young and middle-aged men have a higher tendency to be wounded. The face and head were the most commonly affected sites, while visceral injuries were rare. Mortality was low, and reconstruction of many of the injuries was challenging, often necessitating a staged procedure. Those living in villages close to black bear habitats may benefit from education related to the risk and severity of the attacks in the hope of reducing the number of injuries seen.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190015, Kashmir, India. altafrsl@rediffmail.com
authors.forename: Altaf
authors.initials: A
authors.lastname: Rasool
authors.forename: Adil Hafeez
authors.initials: AH
authors.lastname: Wani
authors.forename: Mohammad Ashraf
authors.initials: MA
authors.lastname: Darzi
authors.forename: M Inam
authors.initials: MI
authors.lastname: Zaroo
authors.forename: Shabir
authors.initials: S
authors.lastname: Iqbal
authors.forename: Shiekh Adil
authors.initials: SA
authors.lastname: Bashir
authors.forename: Shafaq
authors.initials: S
authors.lastname: Rashid
authors.forename: Reyaz Ahmad
authors.initials: RA
authors.lastname: Lone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000209:etiology; D005151:Facial Injuries / Q000453:epidemiology* / Q000209:etiology; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012424:Rural Population; D012621:Seasons; D017695:Soft Tissue Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D001503:Ursidae; D014781:Viscera / Q000293:injuries; D055815:Young Adult