scholarly journals High Risk of Failed Skin Graft on Major Burn Patients with Complication of Hypernatremia

2021 ◽  
Vol 57 (2) ◽  
pp. 166
Author(s):  
Lynda Hariani ◽  
Agus Santoso Budi ◽  
Ephora Christina Wulandari
Keyword(s):  
Skin Graft ◽  
Healing Process ◽  
Cross Sectional Study ◽  
Electrolyte Imbalance ◽  
Wound Healing Process ◽  
Burn Patients ◽  
Sectional Study ◽  
Academic Hospital ◽  
Cross Sectional ◽  
Major Burn

The rate of failed skin graft in Dr. Soetomo General Academic Hospital Surabaya was around 26% of the cases, and it became a concern because skin graft was the main procedure to close large burn wounds. Many problems might affect this event; one of them was electrolyte imbalance. Hypernatremia was found in major burn patients. This condition disrupted the wound healing process of skin graft. This cross-sectional study evaluated patients with burns admitted to the Burn Centre of Dr. Soetomo Hospital between January 2014 and December 2018. 143 subjects participated in this study. Hypernatremia was found in 16% of all subjects (23 subjects), 19% with hypernatremia (28 subjects), and the majority of it, 65% with normonatremia (92 subjects). This study found that the risk of failed skin graft was higher on hypernatremia than normonatremia subjects. This risk was higher if the skin graft procedure took more than 10%.

scholarly journals Correlation of Hypernatremia to Success Rate of Skin Graft in Burn Patients Dr. Soetomo Hospital Burn Centre from 2014- 2018

2021 ◽  
Vol 4 (2) ◽  
pp. 44
Author(s):  
Ephora Wulandari ◽  
Lynda Hariani ◽  
Agus Santoso Budi
Keyword(s):  
Relative Risk ◽  
Skin Graft ◽  
Healing Process ◽  
Electrolyte Imbalance ◽  
Split Thickness Skin Graft ◽  
Wound Healing Process ◽  
Chemical Agent ◽  
Burn Patients ◽  
Burn Wound ◽  
Major Burn

Background : From collective data from 2014 – 2018 from Burn Centre in Dr. Soetomo Hospital, the rate of failed skin graft was 26%. This high number became a concerned because skin graft was the main procedure to close large burn wound. This event is affected by many problems, one of them is electrolyte imbalance. Hypernatremia was seen in major burn patients that causes the disruption of wound healing process of skin graft. Methods: A cross sectional study of patients with burns admitted to the Burn Centre of Dr. Soetomo Hospital between January 2014 and December 2018 were evaluated. Results : 143 subjects were involved in this study. 44 subjects are female (31%) and 99 subjects are male (69%). 66% of the burn injuries are caused by fire (93 subjects), 14% caused by electricity (20 subjects), 8% caused by scald (12 subjects), 6% caused by boiled oil (8 subjects), 4% caused by chemical agent (6 subjects) and 2% caused by blast injury (1 subject). 77% of all subjects (110 subjects) underwent split thickness skin graft less than 10% while 23% (33 subjects) underwent the procedure 10% or more than it. Hypernatremia is found in 16% of all subjects (23 subjects), 19% with hyponatremia (28 subjects) and majority of it, 65%, with normonatremia (92 subjects). From the study, it was found that the risk of failed skin graft was higher on hypernatremia subjects than normonatremia subjects, the relative risk was 6,06 to fail. This number was higher if the skin graft procedure took more than 10%. But, it was found the risk was higher on hyponatremia subjects than the rest of subjects, with the relative risk was 7,75 to fail. Conclusions: Hypernatremia caused high risk of failed skin graft on major burn patients

Maxillary Frenulum in Newborns: Association with Breastfeeding

2020 ◽  
Vol 162 (6) ◽  
pp. 954-958 ◽  
Author(s):  
Reena Razdan ◽  
Sarah Callaham ◽  
Renee Saggio ◽  
Mary Chafin ◽  
Michele M. Carr
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Academic Hospital ◽  
Birth Mothers ◽  
Cross Sectional ◽  
Breastfeeding Education ◽  
Biological Children ◽  
The Mean ◽  
First Time

Objective To relate maxillary and lingual frenulum configuration to breastfeeding success. Study Design Cross-sectional study. Setting Newborn nursery in tertiary care academic hospital. Subjects and Methods Newborns were observed between 24 and 72 hours after birth. Mothers were asked a series of questions relating to their breastfeeding experience. The maxillary and lingual frenula were examined and scored. Corresponding LATCH scores were recorded. Results A total of 161 mothers with newborns participated. The mean gestational age of newborns was 38.81 weeks (95% CI, 38.65-38.98); 82 (50.9%) male and 79 (49.1%) female newborns were included. In sum, 70.8% had the maxillary frenulum attached to the edge of the alveolar ridge; 28.6%, attached to the fixed gingiva; and 0.6%, attached to mobile gingiva. In addition, 3.7% had anterior ankyloglossia, and 96.3% had no obvious anterior ankyloglossia. There was no significant correlation between maxillary frenulum scores or lingual frenulum scores and LATCH scores ( P > .05). Of the mothers included in the study, 56.5% were first-time mothers. Overall, 43.5% of the mothers had other biological children, with 70.0% of those mothers having previously breastfed. Experienced mothers who had breastfed for >3 months had significantly higher LATCH scores. Those who had previously breastfed had a mean LATCH score of 9.16 (95% CI, 8.80-9.52), as compared with those who had not, with a mean of 8.14 (95% CI, 7.43-8.85). Conclusion We did not find that maxillary frenulum configuration correlated with LATCH scores. Mothers experienced with breastfeeding had better LATCH scores. Attention toward breastfeeding education, particularly in new mothers, should precede maxillary frenotomy in neonates with breastfeeding difficulties.

scholarly journals The Effect of Early Tangential Excision and Split Thickness Skin Graft in Reducing Length of Stay in Burns Patients in Jakarta Islamic Hospital Cempaka Putih

2021 ◽  
Vol 8 (1) ◽  
pp. 15-20
Author(s):  
Gammaditya Adhibarata Winarno ◽  
Aditya Wardhana ◽  
Sanjaya Faisal Tanjunga ◽  
A. S Augiani ◽  
An’umillah Arini Zidna
Keyword(s):  
Length Of Stay ◽  
Skin Graft ◽  
Burn Injury ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Burn Injuries ◽  
Split Thickness Skin Graft ◽  
Burn Patients ◽  
Cross Sectional ◽  
Thickness Skin

Introduction: Early tangential excision (TE) and split-thickness skin graft (STSG) have increased the outcome in burn patients treated at specialized burn centers. This study was conducted to compare the length of stay (LOS) in burn patients undergoing early TE & STSG and delayed TE & STSG. Method: This is a retrospective cross-sectional study including 42 patients with varied burn degrees, and TBSA admitted to Jakarta Islamic Hospital Cempaka Putih (JIHCP) Burn Unit. Patients were assigned to two study groups, the early TE & STSG group including 32 patients and the delayed TE & STSG group including 10 patients. All data were collected from the medical record and compared between two study groups. Result: The mean of LOS in a group with early TE & STSG was shorter (9.81±6.41 days) than LOS in the delayed TE & STSG group (15.80±5.67 days). The data of LOS between these groups were compared using an independent T-test. The LOS in the early TE & STSG group was significantly shorter than the delayed TE & STSG group (p=0.012). Conclusion: In patients with burn injuries, early TE & STSG is associated with a shorter length of stay than the delayed TE & STSG. Our study indicates that early excision within five days after burn injury is optimal to reduce the length of stay in burn patients.

scholarly journals Healthcare distrust among hospitalised black patients during the COVID-19 pandemic

2021 ◽  
pp. postgradmedj-2021-140824
Author(s):  
Thang Cong Nguyen ◽  
Evelyn Gathecha ◽  
Regina Kauffman ◽  
Scott Wright ◽  
Ché Matthew Harris
Keyword(s):  
Tertiary Care ◽  
Healthcare Systems ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Academic Hospital ◽  
Cross Sectional ◽  
The People ◽  
Black Patients ◽  
History Of ◽  
Meaningful Relationships

Study purposeDistrust of the healthcare system is longstanding in the black community. This may especially threaten the health of the population when a highly contagious infection strikes. This study aims to compare COVID-19-related perspectives and behaviours between hospitalised black patients who trust versus distrust doctors and healthcare systems.Study designCross-sectional study at a tertiary care academic hospital in Baltimore, Maryland. Hospitalised adult black patients without a history of COVID-19 infection were surveyed between November 2020 and March 2021 using an instrument that assessed COVID-19-related matters. Analyses compared those who trusted versus mistrusted doctors and healthcare systems.Results37 distrusting hospitalised black patients were compared with 103 black patients who trusted doctors and healthcare systems. Groups had similar sociodemographics (all p>0.05). Distrustful patients were less likely to think that they were at high risk of contracting COVID-19 (54.0% vs 75.7%; p=0.05), less likely to believe that people with underlying medical conditions were at higher risk of dying from the virus (86.4% vs 98.0%; p=0.01) and less likely to be willing to accept COVID-19 vaccination (when available) (51.3% vs 77.6%; p<0.01) compared with those who were trusting.ConclusionHealthcare distrustful hospitalised black patients were doubtful of COVID-19 risk and hesitant about vaccination. Hospitalisations are concentrated exposures to the people and processes within healthcare systems; at these times, seizing the opportunity to establish meaningful relationships with patients may serve to gain their trust.

scholarly journals Validity and Reliability of WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) Type 12 Questions Indonesian Version on Back Pain

2021 ◽  
Vol 57 (3) ◽  
pp. 220
Author(s):  
Kusumawardhany Airlangga Rijanti ◽  
Imam Subadi ◽  
Patricia Maria Kurniawati
Keyword(s):  
Back Pain ◽  
Oswestry Disability Index ◽  
Cross Sectional Study ◽  
Disability Assessment ◽  
Sectional Study ◽  
Validity And Reliability ◽  
Academic Hospital ◽  
Internal Reliability ◽  
Cross Sectional ◽  
Whodas 2.0

The study was to prove the validity and reliability of the WHODAS 2.0 Indonesian version questionnaire in patients with back pain. This study was an observational cross-sectional study conducted in 2018. The study included the filling of WHODAS 2.0 Indonesian version, Indonesian version of Oswestry Disability Index (ODI) questionnaire, Wong-Baker Scale, conducted at Department of Rehabilitative Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, against 82 respondents with back pain. Each respondent was given informed consent. The validity of the WHODAS 2.0 Indonesian version questionnaire was measured using Pearson's test on the correlation of WHODAS 2.0 Indonesian version questionnaire and Oswestry Disability Index questionnaire with r >0.3 (0.862). WHODAS 2.0 Indonesian version questionnaire and Wong-Baker Scale had r >0.3 (0.449–0.785). The reliability of the WHODAS 2.0 Indonesian version questionnaire was measured using Pearson's correlation test with r >0.3 (0.764–0.866). WHODAS 2.0 Indonesian version's internal reliability was tested using Cronbach-Alfa Test with alpha >0.6 (0.634–, 853). In conclusion, the WHODAS 2.0 - Indonesian version is a valid and reliable questionnaire for patients with back pain. 

scholarly journals Characteristics of Heat Illness during Hajj: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Doaa A. Abdelmoety ◽  
Nahid K. El-Bakri ◽  
Wedian O. Almowalld ◽  
Zyad A. Turkistani ◽  
Bassam H. Bugis ◽  
...  
Keyword(s):  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Interdisciplinary Teams ◽  
Electrolyte Imbalance ◽  
Heat Illness ◽  
Sectional Study ◽  
Cross Sectional ◽  
Heat Exhaustion ◽  
The Mean ◽  
Elevated Creatinine

Introduction. Data regarding the characteristics and outcomes of heat illness are lacking in the literature. The present study aimed to identify the clinical characteristics, morbidity, management, and mortality associated with heat illness among Hajj participants. Methods. A cross-sectional study was conducted during the Hajj in 2016 on patients who presented to emergency departments and were diagnosed with heat exhaustion or heatstroke. Data were collected using a structured collection sheet developed based on the literature. Results. A total of 267 patients were recruited. Of these, 80 (29%) and 187 (67.75%) were diagnosed with heatstroke and heat exhaustion, with 6.3% and 0.0% mortality, respectively. The mean age of the patients was 54.0±16 years. Diabetes mellitus was the most common comorbidity among both heatstroke and heat exhaustion patients. The majority of patients had hyperthermia and electrolyte imbalance. Most of the heat illness cases were treated per heat illness guidelines. Conclusions. Although authorities are working on research and forming interdisciplinary teams to prevent health problems during the Hajj, the mortality rate from heatstroke is high and the majority of the patients had hyperthermia, varied signs and symptoms, elevated creatinine levels, and electrolyte imbalances.

scholarly journals Pneumococcus nasopharyngeal carriage in children attending an academic hospital in Pretoria, South Africa, after the introduction of pneumococcal vaccine

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Charity Newton ◽  
Harry Maake ◽  
Caroline Maluleka ◽  
Siyazi Mda
Keyword(s):  
South Africa ◽  
Cross Sectional Study ◽  
Nasopharyngeal Carriage ◽  
Common Condition ◽  
Sectional Study ◽  
Academic Hospital ◽  
Cross Sectional ◽  
Serotype Replacement ◽  
Younger Age ◽  
Immunisation Status

Background: In 2009, pneumococcal conjugate vaccine was introduced in South Africa. However, there are concerns that this could lead to an increase in colonisation of non-vaccine serotypes (serotype replacement).Methods: In a cross-sectional study, 350 children aged 1 month to 14 years were enrolled at Dr George Mukhari Academic Hospital from December 2015 to April 2016. We assessed the prevalence of nasopharyngeal colonisation with pneumococcus and characterised the serotypes found.Results: The median age of the cohort was 33.7 months (interquartile range 16.27–69.5 months), with 20% being 1 year. A total of 21% of the children were diagnosed with pneumococcal-related conditions; among these, pneumonia was the most common condition. Less than half (43%) of the participants were fully immunised. Forty-six (13%) of the children were colonised with pneumococcus. Younger age was significantly associated with pneumococcal colonisation. Among those colonised with pneumococcus, 35% were fully immunised, 30% were partially immunised, 30% had an unknown immunisation status and 4% were unimmunised. Eight (17%) of the children who were colonised with pneumococcus had pneumococcal-related conditions. The commonest serotype identified was 6A/B. Overall, 2% of the cohort were colonised with vaccine-serotype pneumococcus.Conclusion: As a minority of children had evidence of nasopharyngeal colonisation with vaccine-serotype pneumococci, serotype replacement may be emerging in our population.

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