scholarly journals Face burns: A four-year experience

2021 ◽  
Author(s):  
Stephanie A Rasmussen ◽  
Kathleen S Romanowski ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
David G Greenhalgh
Keyword(s):  
Total Body Surface Area ◽  
Adult Patients ◽  
P Value ◽  
Chi Square ◽  
Lengths Of Stay ◽  
Degree Burn ◽  
The Face ◽  
The Mean ◽  
Total Body ◽  
Student’S T

Abstract Introduction Burns on the face pose unique management challenges because they are in a place that is constantly visible, so scars are hard to hide. The goal of this study was to review our experience of adult patients who had face burns. Methods We performed a retrospective review of adult patients (≥ 18 years old) who were admitted to a regional burn center from July 2015 – June 2019 with face burns. Sex, age, ethnicity, burn etiology, burn size, and discharge status were collected from electronic medical records of the patients who met study criteria. Descriptive statistics, student’s t-tests, and chi-square tests were performed in Stata/SE 16.1. Significance was defined as a p-value <0.05. Results In four years, 595/1705 patients (~35% of admissions) were admitted with face burns. The mean age was 44.9 ± 17.0 (mean ± SD) years, with the majority being men (475, 80%). The mean burn size was 19.8 ± 20.9% total body surface area (TBSA) with 10.1 ± 19.8% TBSA being third degree. The mean head burn size for any face burn was 2.8 ± 1.8% TBSA. The majority of burns were due to flames (478, 80%) and of those 122 (21%) were from accelerant use and 43 (7%) resulted from propane or butane use. Scalds caused 53 (9%), electric 25 (4%), hot tar 5 (1%), and chemical 5 (1%). Overall, 208 (35%) patients had grafting of some portion of their body, but only 31 patients (5.2%) had face grafting. The mean age of those with face grafting compared to patients who did not need grafting was 45.9 ± 13.8 and 44.9 ± 17.2 years, respectively. Patients who needed grafting had a mean third degree burn size of 31.7 ± 25.4% TBSA and a mean head (including face) burn size of 4.7 ± 2.0% TBSA, whereas patients who did not need grafting had a mean third degree burn size of 8.9 ± 18.7% TBSA and a mean head burn size of 2.7 ± 1.8% head TBSA. Patients requiring face grafts had longer lengths of stay, intensive unit stays, ventilator days, and mortality than those whose face burns healed spontaneously. Discussion Overall, head burns in adults were common within the four-year time span we studied, but only a small fraction (5%) had face grafts. The patients who needed grafting for their head burns had significantly larger total body and face burns, and had a 2.4-fold higher mortality rate compared to patients who did not need grafting. Most face burns were caused by flame, especially the use of accelerants or flammable gases. Prevention efforts should focus on avoiding the use of accelerants and being careful with flammable gases.

scholarly journals Effect of ondansetron on spinal induced hypotension in caesarean deliveries

2020 ◽  
Vol 8 (4) ◽  
pp. 193-199
Author(s):  
Pujan Balla ◽  
Anil Shrestha ◽  
Ninadini Shrestha ◽  
Navindra Bista ◽  
Moda Nath Marhatta
Keyword(s):  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
P Value ◽  
Chi Square ◽  
Induced Hypotension ◽  
Intergroup Comparison ◽  
Chi Square Test ◽  
The Mean ◽  
Student’S T ◽  
Student’S T Test

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.

A Prospective Clinical Study of the Effect of Recombinant Human Growth Hormone in Wound Healing of Severely Burned Children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salah Nasser Mohamed ◽  
Nahed Samir Boghdady ◽  
Mina Agaiby Estawrow ◽  
Mariam Loutfy Ahmed Mohamed
Keyword(s):  
Growth Hormone ◽  
Wound Healing ◽  
Recombinant Human Growth Hormone ◽  
Total Body Surface Area ◽  
Human Growth ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
The Mean ◽  
Total Body

Abstract Background A burn is a thermal injury caused by biological, chemical, electrical and physical agents with local and systemic repercussions. There are several ways of classifying burns: Classification by mechanism or cause, depth and extent of burn . Objectives The objective of this study was to determine the safety and efficacy of using recombinant human growth hormone (rhGH) in the treatment of pediatric burn victims and their probable effect on accelerating burn wound healing. Patients and Methods This study was an Interventional randomized controlled Double Blind Study in which Patients subdivided randomly into 2 groups: Group A received somatotropine hormone after their 3 days of resuscitation besides their conventional treatment during their stay in the Burn ICU. Group B received the conventional treatment only in the Burn ICU. Results The comparison between the GH group and the control group showed that that there was statistically significant difference found between the two studied groups regarding TBSA of burn at 3rd week. The mean TBSA in GH group was ( 9.06 ± 7.47 ) while in the control group (13.94 ± 11.96) with P value (0.041). There was highly statistically significant difference found between the two studied groups regarding Insulin like growth factor .the mean Insulin like growth factor in GH group was (16.48 ± 11.40) while in the control group(2.77 ± 0.64) with P value(0.000). Conclusion The use of recombinant Growth hormone with a dose of 0.2 mg/Kg SQ 2 days per week with 3 days time interval in pediatric burn patients after their primary resuscitation from the burn injury, shows a marvelous improvement concerning the total body surface area of burn(TBSA) as the patient received the growth hormone showed a decrease total body surface area of burn(TBSA) than the control group. This may be accounted for the faster wound healing and readiness for grafting .

scholarly journals A Descriptive Study of Length of Stay at an Intensive Care Unit

2015 ◽  
Vol 3 (1) ◽  
pp. 29-32
Author(s):  
Kasturi Shukla ◽  
Priyadarshini Chandrashekhar ◽  
Nirmal Kumar ◽  
Pradnya K Devade
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Descriptive Study ◽  
P Value ◽  
Chi Square ◽  
High Dependency ◽  
Chi Square Test ◽  
The Mean ◽  
Student’S T

ABSTRACT Background and aims As intensive care units (ICUs) are very resource intensive, length of stay (LOS) is of prime importance. This study was done to analyze the LOS in different ICUs and analyze it against a set benchmark. Materials and methods This retrospective study was conducted from April to June 2013 on patients admitted during January to March 2013 in the neurosurgery ICU (NICU), medical ICU (MICU), high dependency unit (HDU) and isolation ICU of a large multispecialty hospital in Pune (India). As per the quality manual of the hospital, benchmark LOS was considered as 3.08 days for ICU. Mean and median LOS was analyzed through Student's t and Chi-square test; proportion of short (<2 days) and long stay (>4 days) patients was also computed. Results Out of 835 patients admitted to the NICU, MICU, HDU and Isolation ICU, the overall mean LOS was 3.37 ± 5.54 days which was statistically significant at a p-value <0.001 (t = 17.58, 95% CI 3-3.75). The overall mean LOS was higher than the benchmarked 3.08 days but still within the optimal range of 2 to 4 days. Mean LOS was statistically significant when tested for department-wise variations with a Chi-value of 173.56 (p-value < 0.001, LR = 113.75). Highest mean LOS was observed for isolation ICU and lowest for MICU. 360 (43.1%) were short stay, 141(16.8%) were long stay and remaining were optimal stay patients. Conclusion The mean LOS for the ICUs varied significantly across the type of ICUs which needs to be continuously monitored. Mean LOS variation across ICU type indicates need for separate benchmarks. How to cite this article Shukla K, Chandrashekhar P, Kumar N, Devade PK. A Descriptive Study of Length of Stay at an Intensive Care Unit. Int J Res Foundation Hosp Healthc Adm 2015;3(1):29-32.

scholarly journals Fishery regulamentation or ethnoknowledge? The dilemma of the management of the mapará fisheries on the lower Tocantins river in northern Brazil

2021 ◽  
Vol 10 (11) ◽  
pp. e131101118963
Author(s):  
Esther Mirian Cardoso ◽  
Paulo Allison Costa da Mata ◽  
Matheus dos Santos Souza ◽  
Maria Clara Pinheiro de Souza ◽  
Victoria Isaac
Keyword(s):  
Socioeconomic Development ◽  
Economic Importance ◽  
Chi Square ◽  
Great Economic Importance ◽  
Chi Square Test ◽  
Northern Brazil ◽  
The Mean ◽  
Tocantins River ◽  
Student’S T ◽  
Student’S T Test

The fishery of mapará (Hypophthalmus marginatus) is of great economic importance in the Amazon region. Despite this, it is observed that the current norms of management disagree with the ethnoknowledge of fishermen of the Tocantins river. Therefore, there are many seizures and fines in the Tocantins Low region. This work appeared as a demand of the fishermen of the region and had as purpose to test the pertinence of the fishing legislation on the capture of the species and to provide subsidies for the adaptation of the norms to the local reality. For this, a mapará fishery was taken on the Pindobal Grande river, in the municipality of Igarapé-Miri, in the state of Pará. A sample of the captured individuals was collected, and identification, sexing and biometry were done. Fishing was described, and the sex ratio tested with the Chi-Square test and the mean length differences between the sexes with the Student's t-test. The results were compared with current legislation and literature data. The captured mapará individuals were mostly above 30 cm, as determined by legislation. It is concluded that, despite using a network that is prohibited, the capture of the species in the region acts selectively, due to the ethno-cognition and the fisherman's action ("taleiro"). Therefore, it is necessary that the legislation be revised, seeking the reconciliation between the conservation of ecosystems, the traditional knowledge and the socioeconomic development of the region.

scholarly journals A Comparative Study between C-Reactive Protein and Procalcitonin in Iraqi Burn Patients

2017 ◽  
Vol 28 (1) ◽  
pp. 41
Author(s):  
Alia E. Al-Ubadi
Keyword(s):  
Burn Injury ◽  
Total Body Surface Area ◽  
Latex Agglutination ◽  
Burn Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Survivor Group ◽  
Significant Difference ◽  
The Mean ◽  
Total Body

Association between Procalcitonin (PCT) and C-reactive protein (CRP) and burn injury was evaluated in 80 burned patients from Al-Kindy and Imam Ali hospitals in Baghdad-Iraq. Patients were divided into two groups, survivor group 56 (70%) and non-survivor group 24 (30%). PCT was estimated using (Human Procalcitonin ELISA kit) provided by RayBio/USA while CRP was performed using a latex agglutination kit from Chromatest (Spain). Our results declared that the mean of Total Body Surface Area (TBSA %) affected were 63.5% range (36%–95%) in non-survivor patients, while 26.5% range (10%–70%) in survivor patients. There is a significant difference between the two groups (P = 0.00), the higher mean percentage of TBSA has a significant association with mortality. Serum PCT and CRP were measured at the three times of sampling (within the first 48hr following admission, after 5thdays and after 10th days). The mean of PCT serum concentrations in non-survivor group (2638 ± 3013pg/ml) were higher than that of survivor group (588 ± 364pg/ml). Significantly high levels of CRP were found between the survivor and non-survivor groups especially in the 10th day of admission P=0.000, present study show that significant differences is found within the non-survivor group through the three times P= 0.01, while results were near to significant differences within survivor group through the three times (P= 0.05).

scholarly journals A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients

2009 ◽  
Vol 42 (02) ◽  
pp. 176-181
Author(s):  
P. S. Baghel ◽  
S. Shukla ◽  
R. K. Mathur ◽  
R. Randa
Keyword(s):  
Wound Healing ◽  
Average Duration ◽  
Total Body Surface Area ◽  
Burn Patients ◽  
The Mean ◽  
Total Body ◽  
Time Of Admission ◽  
And Control ◽  
Burn Contractures

ABSTRACTTo compare the effect of honey dressing and silver-sulfadiazene (SSD) dressing on wound healing in burn patients. Patients (n=78) of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area) were included in the study, over a period of 2 years (2006-08). After stabilization, patients were randomly attributed into two groups: ‘honey group’ and ‘SSD group’. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37) and SSD cream over the wounds of patients in SSD group (n=41), everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group) and control (SSD group) was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100%) who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound healing, makes the wound sterile in lesser time, has a better outcome in terms of prevention of hypertrophic scarring and post-burn contractures, and decreases the need of debridement irrespective of time of admission, when compared to SSD dressing.

Presentation and Management of Staphylococcal Scalded Skin Syndrome in a Child After a Burn Injury: A Case Report

2019 ◽  
Author(s):  
Thomas Edward Pidgeon ◽  
Federica D’Asta ◽  
Malobi Ogboli ◽  
Yvonne Wilson
Keyword(s):  
Case Report ◽  
Burn Injury ◽  
Wound Care ◽  
Total Body Surface Area ◽  
Granular Cell ◽  
Burn Wound ◽  
Staphylococcal Scalded Skin Syndrome ◽  
The Face ◽  
Total Body ◽  
Learning Points

Abstract This case report describes the clinical course of a child who developed staphylococcal scalded skin syndrome (SSSS) after a burn injury. The intent is to aid other units in recognizing the presentation of SSSS after a pediatric burn and to optimize subsequent management. The main clinical finding was of rapid, progressive, superficial epidermal loss at sites separate from the original burn, involving 55% of the total body surface area, 13 days after a 6% scald burn to the face, neck, and chest. Diagnosis was confirmed by multidisciplinary team clinical assessment and histopathology of an intraoperative skin biopsy. This confirmed epidermal cleavage at the granular cell layer. These findings were later supported by Staphylococcus aureus cultured from the burn wound, and a positive epidermolytic toxin A assay. Management was with general medical supportive care, clindamycin and flucloxacillin intravenous antibiotic therapy, and cleansing and dressing of the areas of epidermal loss. Key learning points from this case were that SSSS presented after a burn injury and that 13 days elapsed between the burn and SSSS. Factors differentiating it from toxic epidermal necrolysis are described, including the value of histopathology in confirming the diagnosis. The prompt use of antibiotics and attentive wound care are advocated as an effective management strategy.

212 EFFECT OF CONSECUTIVE SUPERSTIMULATORY TREATMENT-INDUCED FOLLICULAR WAVE SYNCHRONIZATION TO OPTIMIZE OOCYTE RETRIEVAL AND EMBRYO PRODUCTION BY OVUM PICKUP AND IN VITRO FERTILIZATION IN COWS

2011 ◽  
Vol 23 (1) ◽  
pp. 205
Author(s):  
K. Imai ◽  
M. Ohtake ◽  
Y. Aikawa ◽  
S. Sugimura ◽  
M. Hirayama ◽  
...  
Keyword(s):  
Development Program ◽  
Oocyte Retrieval ◽  
Embryo Production ◽  
Chi Square ◽  
Vitro Fertilization ◽  
Follicular Wave ◽  
The Third ◽  
The Mean ◽  
Student’S T

We previously reported that superstimulatory (SS) treatment-induced follicular wave synchronization after ovum pickup (OPU) was effective in enhancing the quality of obtained oocytes and blastocysts derived from in vitro maturation (IVM) and fertilization (IVF; Imai et al. 2010 Reprod. Fertil. Dev. 22, 296). The present study was designed to examine the efficiency of embryo production by 4 sessions of OPU-IVF using a series of the SS treatment-induced follicular wave synchronizations. For the SS protocols, 3 consecutive SS (3CSS) and 2 separated SS (2SSS) were used. In the 3CSS group, the first OPU was performed on random days of the oestrous cycle (Day 0) and all follicles larger than 2 mm in diameter were aspirated. On Day 5, follicles larger than 8 mm in diameter were aspirated and a CIDR (InterAg, Hamilton, New Zealand) was inserted. The cows then received 20 armour units of FSH (Kawasaki-Seiyaku, Kawasaki, Japan) in twice-daily decreasing doses by IM injection from Day 7 to 10. Cloprostenol (PGF; 0.75 mg, Fujita-Pharm, Tokyo, Japan) was administered on the morning of Day 9. The second OPU was performed 48 h after PGF administration on Day 11; the CIDR was removed from the cows just before OPU. After the second OPU, donors were treated consecutively with the SS protocol mentioned above for the third and fourth OPU sessions. In the 2SSS group, donors received 2 sets of the SS treatment mentioned above, with an interval of 11 days between the second and the third OPU session. Four OPU sessions were performed every 11 days on all cows. In this study, 8 Japanese Black cows were divided into the 3CSS and 2SSS groups, and the treatment for each group was reversed after a 65-day interval as crossover trials. After OPU, Grade 1 and 2 oocytes were used for IVM and IVF, and putative zygotes were cultured as described by (Imai et al. 2006 J. Reprod. Dev. 52, S19–S29 suppl.). A part of the zygotes were cultured in a micro-well system. Data were analysed by Student’s t-test and chi-square test. There were differences (P < 0.05) in the mean (±SD) number of follicles, collected oocytes, and cultured oocytes in the 3CSS (35.0 ± 8.6 and 24.4 ± 11.2, respectively) and 2SSS (30.8 ± 10.5 and 20.2 ± 9.0, respectively) groups. There were no differences in mean percentage of blastocyst formation and Grade 1 blastocyst rates between the 3CSS (38.5 and 55.8%, respectively) and 2SSS (34.8 and 54.8%, respectively) groups. However, the mean number of blastocysts produced per OPU session was significantly (P < 0.05) higher in the 3CSS group (8.1 ± 6.3) compared with the 2SSS group (5.8 ± 4.4). These results indicate that a series of 3 consecutive SS treatments had greater efficiency in producing OPU-IVF embryos. This work was supported in part by the Research and Development Program for New Bio-industry Initiatives.

A Retrospective Multicenter Study of 1898 Liquefied Petroleum Gas-Related Burn Patients in Eastern China From 2011 to 2015

2020 ◽  
Vol 41 (6) ◽  
pp. 1188-1197
Author(s):  
Ronghua Jin ◽  
Jiaming Shao ◽  
Jon Kee Ho ◽  
Meirong Yu ◽  
Chunmao Han
Keyword(s):  
Eastern China ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Liquefied Petroleum Gas ◽  
Chi Square ◽  
Burn Prevention ◽  
Chi Square Test ◽  
The Mean ◽  
The One

Abstract Liquefied petroleum gas (LPG) is a widely used environment-friendly fuel. Previous studies have shown an increasing number of LPG-related burns. Our study was designed to evaluate the epidemiologic pattern of these injuries and provide recommendations for burn prevention. This retrospective study included all patients with LPG-related burns from eight burn centers in Zhejiang Province, China between 2011 and 2015. Database variables included patient demographics, accident characteristics, and injury characteristics. The association between different categorical variables was identified using the chi-square test. And the association between two or more means of quantitative variables was analyzed by the one-way analysis of variance or t-test. A total of 1898 patients were included, 47.31% were males and 52.69% were females. The predominant age group was 31 to 70 years (74.50%), and the majority were poorly educated and the incidence peaked from June to September. The most common place of occurrence was home (74.08%) and gas leak (96.52%) was the most common cause. The four limbs (43.33%) were the most frequently affected areas; the mean burn area was 25.19 ± 20.97% of the total body surface area and most patients (46.89%) suffered from moderate burns. The mean length of hospital stay was 17.66 ± 16.55 days and the majority of patients (89.36%) recovered with a 0.84% mortality rate. Our findings reflected that the increase in incidence rate was alarming, and the causes resulting in LPG-related burns have not gained much attention yet. Therefore, this calls for simple but strict measures aiming at each hazardous step during the use of LPG to prevent these burn injuries.

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