الفهرس 
Prevalence of firearm injuriesOnly 14 pages are availabe for public view
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Abstract
This study is a retrospective analysis of firearm injuries and deaths examined by Port Said Medico-legal Department of the medico-legal authority of the Egyptian Ministry of Justice in Port Said governorate, which lies at the north east of Egypt during the Egyptian revolution year, 2011.
The study aimed to outline the pattern and incidence rate of firearm injuries and deaths in Port Said governorate during the year of the Egyptian revolution 2011, investigate the firearm cases from the medico legal points of view, highlight the outcome of the firearm injured cases as disfigurement, disabilities, and permanent infirmities, and hence compensation needed. Moreover, to highlight if any new types of weapons or missiles were used in the field of wounding during the year 2011.
Data of cases was collected from the archives of the medico-legal reports written by the forensic pathologists who examined the cases in our study, and from the papers sent from the general prosecutor offices. The data collected were as follows:
The total number of cases with firearm injuries and fatalities.
Circumstances around the crime: (manner, season, time, site and motive of the crime and the type of the weapon alleged to be used).
Socio-demographic data of the victims and the assailants: (age, gender, job, relationship between the victim and the assailant and cross sex violence).
Characteristics of the inlet and exit wounds
The presence of associated other patterns of trauma and their types.
If x-ray was done or not, and its findings
If the clothes were examined or not, and their findings
Range of firing, direction of firingand direction of trajectory line
Types of the weapons used, types of missiles and calibers of the weapons usedand whether blood was found on weaponsor not
Outcome of the firearm injuries and cause of death in the deceased
Toxicological analysis
Possibility of the incidence according to the allegation
The results of this study shows that:
• There were 67 cases of firearm injuries and fatalities with a percentage of (11.59%) of the total cases presented to Port Said medico legal department in 2011, with an incidence rate of 11.08/100, 000 of population in Port Said.
• Homicidal cases (79.10%) were statistically significantly higher than accidental (8.96%)and suicidal cases (1.49%).
• Most of the crimes happened in the summer (32.84%), Followed by those in winter (28.36%). (20.90%) of the cases happened in the spring and (14.93%) happened in autumn.
• Most of the crimes happened in the streetswith a percentage of (58.21%).
• Most of the crimes (43.28%) happened due to previous enmity between the assailant and the victim, (96.55%) of which were homicidal in manner.
• In most of the homicidal and accidental caseswith percentages of (52.83%) and (50%), respectively, the weapon alleged to be used was a locally made shotgun. The second most used weapon in homicidal cases and in accidental cases were the automatic rifles in (22.64%) and (33.33%), respectively. Rifled handguns were used in (9.43%) of the homicides and were not used in the accidental cases. A handgun was used in the suicidal case in this study (100%).
• Most of the victims (34.33%) were in the 3rd decade,
• Most of the victims (95.52%) were males. Most of the assailants (85.51%) were males as well, the rest of the assailant’s sex was not mentionedin (8.96%) and unknown in (5.97%). No females were recorded as assailants in the present study.
• In most of the homicidal cases (98.11%) victims were males and one victim (1.89%) was a female. In the accidental cases, most of the victims were also males (83.33%). The suicidal case in this study (100%) was a male.
• Most of the cases (59.70%) had multiple inlets. (43.28%) of the cases were shot in multiple sitesof the body, (26.87%) were shot in the lower limbs, while (11.94%) were shot in the head. Inlets were rounded in most of the cases (65.67%). Most of the inlets were healed scars (47.76%), (23.88%) were fresh wounds with inversionof edges and loss of substances. Most of the inlets in this study were red in color (29.85%). Gunshot residues around or in the inlets was absent in most of the cases (94.03%). Absence of abrasion collar and bruises around the inlets was found in most of the cases (76.12%).
• In rifled weapons, most of the cases (56.25%) had a single exit, while (21.88%) had multiple exits and in (21.88%) there were no exits. While, in non-rifled weapons, all of the cases (100%) had no exit wounds. The exits in most of cases (13.43%) were in the lower limbs. (48%) of the exit wounds were irregular and (40%) were oval. (40%) of the exits were healed scars. Fresh wounds with eversion and loss of substances were present in (40%) of the exits.
• Regarding the presence of accompanying other patterns of trauma, (25.37%) of the cases had associated other patterns of trauma, of which (41.18%) had cut wounds, (41.81%) had different types of blunt trauma as abrasions, bruises, contused wounds and fractures of bones, (17.68%) had cut wounds and wounds due to blunt trauma. All of which were homicidal in manner.
• This study shows that in most of the cases (62.69%), x- ray was done, (90.48%) of which showed positive findings. Also, it was found that clothes were not examined in most of the cases (65.67%), in (34.33%) the clothes were examined of which (82.61%) showed positive findings. There was a statistically significant difference regarding these parameters.
• Non-rifled weapons were used in most of the cases (52.24 %). While, in (47.76%), rifled weapons were used.
• In (55.07%) of the cases missiles were found, of which (52.63%) were lead shots. (18.42%) were metal jackets of bullets and in (7.89%) plastic wads were found. The study reveals that no unusual firearm weapons were used in Port Said in the field of wounding in 2011.
• Most of the calibers of weapons used could not be detected (76.10%). In (7.46%) it was a12 mm shotgun, in (5.97%) it was 7.62 x 39 mm automatic rifle, in (4.48%) it was a 9 mm rifled gun and in (2.99%) it was a 16 mm shotgun.
• Examination of the weapon in the suicidal case in the current study revealed that blood spatter was present on the weapon.
• It was found that in homicidal cases, most of the cases (84.90%) were far in range. (5.66%) were near in range and in (9.43%) the range could not be detected.In accidental cases, the range of firing was far in all of the cases (100%).In the suicidal case (100%), the range of firing was near. A statistically significant difference was present regarding that.
• Most of the homicidal cases (39.62%) were shot from front to back,in (28.30%) the direction couldn’t be detected. In accidental cases (50%) were shot from front to back, in (33.33%) the direction could not be detected. In the suicidal case, the direction was in the head from the left to the right (100%).
• Regarding the outcome of the crimes, most of the cases (31.34%) were injured but the permanent infirmity was not applicable. Second most outcome was death in (28.63%). (26.87%) were completely healed without permanent infirmities.The least of the cases (13.43%) had permanent infirmities. A statistically significant difference was found between the number of the injured and dead cases.
• Regarding the cause of death, most of the cases (73.68%)died from Hemorrhage and shock and (26.32%) died from head injuries.
• In (98.51%) of cases, no laboratory samples were taken for toxicological analysis. Toxicological analysis was done in one case (1.49%).
• (92.54%) of cases were possible to happen according to the allegation, while in (7.46%) it couldn’t be detected.
The current study has offered an evaluative perspective on a type violence which affects the whole world medically, legally, financially and emotionally. Moreover, it encountered such a huge problem at a period of political unrest in the region and it revealed an increase in the magnitude of the firearm violence because of the unusual circumstances in Egypt in that period of time. The study encountered a set of conclusions, which needs to be considered. Certain changes may minimize mortality, disability, and costs to the community due to firearm injuries. Those changes include: Law enforcement, security, political, economic and social stability which is very essential in minimizing the spread of firearm violence in the country. There is a need to decrease the number of firearms used and sold in Egypt. We need to eradicate illicit local community gun manufacturing units. There is a need for educational efforts, community and societal curriculum to reduce the number of firearm-related injuries, and specially addressing the youths by applying efficient programs to solve their problems and increase their awareness against violence and use of firearms by applying national programs for youths and organizing widespread media campaigns to increase the awareness against violence. Better training of police officers and policemen for dealing with protesters and crowds is essential. There is a need of better training for medical personnel for better diagnosis and documentation of injuries and possible complications, specially the serious ones. A detailed form should be sent to the forensic pathologist from the general prosecution members explaining all the circumstances of the crime available before autopsy or medico-legal examination of victims. There is an urgent need for using every possible and available mean during autopsy and examination in order not to miss any injury, finding, or information that will help to reach the final opinion in order to achieve the desired justice.