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Mahalingam S, Rajendran G, Rajaa S, Aazmi A, Maroju N, Purushothaman S, Gara M, Karn S, Rajendran A, Balassoundaram V. Clinico-Demographic Profile and Factors Affecting Duration of Hospital Stay Among Burn Patients in an Emergency Department of a Tertiary Care Center, South India: A Hospital-Based Cross-Sectional Study. Cureus 2023; 15:e43397. [PMID: 37706143 PMCID: PMC10495751 DOI: 10.7759/cureus.43397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 09/15/2023] Open
Abstract
Background Burns continue to be a serious public health problem in India. It persists as an endemic disease in spite of implementing various preventive measures at the individual and community levels. Etiology and factors influencing burns are varied. There is a paucity of data regarding the clinico-demographic profile of burns disease, especially from emergency tertiary care settings in India. Objective To assess the proportion of burn patients having longer hospital stays (>1 week) and the influence of clinico-demographic factors associated with it among the burn patients presenting to the emergency department of a tertiary care institute in south India. Methodology An institution-based cross-sectional analytical study was conducted among burns patients attending the Emergency Medicine Department (EMD) of a tertiary care center between January 2017 and December 2017. Information on clinico-demographic profile and duration of hospital stay were captured using semi-structured data collection proforma. Results All the 327 burns injury patients who presented to our EMD during the study period were included. Among the 327 patients, 259 (79%) were admitted to the EMD. Among 259 admitted patients, 142 (55%) patients were discharged home. Among these 142 patients, 106 (74.6%; 95%CI 66.8-81.2) had longer hospital stays (more than one week). Female gender and facial/inhalational burns were found to have an independent effect on the length of hospital stay even after adjusted analysis. Conclusion Length of hospital stay is independently influenced by female gender and facial/inhalational burns. This study also identified the need for better home safety, child-proofing, proper pre-hospital care, and dedicated burns units in the community.
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Affiliation(s)
- Sasikumar Mahalingam
- Emergency Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, IND
| | - Gunaseelan Rajendran
- Emergency Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, IND
| | - Sathish Rajaa
- Community Medicine, Employees State Insurance Postgraduate Institute of Medical Sciences and Research, Chennai, IND
| | - Arshiya Aazmi
- Emergency Medicine, Karpaga Vinayaga Institute of Medical Sciences and Research, Chengalpattu, IND
| | - Nanda Maroju
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Suruthi Purushothaman
- Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Mounika Gara
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Shivani Karn
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Ajithkumar Rajendran
- Emergency Medicine, Sri Ramaswamy Memorial (SRM) Medical College and Hospital, Trichy, IND
| | - Vishwanath Balassoundaram
- Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Sadeghian F, Saeedi Moghaddam S, Saadat S, Niloofar P, Rezaei N, Amirzade-Iranaq MH, Mehdipour P, Abbaszadeh Kasbi A, Ghodsi Z, Mansouri A, Sharif-Alhoseini M, Jazayeri SB, Aryannejad A, Ehyaee V, Naghdi K, Derakhshan P, Moradi-Lakeh M, Mokdad AH, O'Reilly G, Rahimi-Movaghar V. The trend of burn mortality in Iran - A study of fire, heat and hot substance-related fatal injuries from 1990 to 2015. Burns 2018; 45:228-240. [PMID: 30274812 DOI: 10.1016/j.burns.2018.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/30/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Burn injuries are a major cause of preventable mortality worldwide. To implement preventive strategies, a detailed understanding of the rate and trend of fatal burn injuries is needed. The aim of this study was to determine the rate and trend of burn mortality at national and province level in Iran from 1990 to 2015. MATERIALS AND METHODS The data were retrieved from various sources: the Death Registration System, cemetery databases, the Demographic and Health Survey and three national population and housing censuses. ICD-10 codes were converted to Global Burden of Disease (GBD) codes for comparability. After addressing the incompleteness of death data, statistical methods such as spatio-temporal modelling and Gaussian Process Regression (GPR) were applied to estimate the levels and trend of death and cause specific mortality. RESULTS The number of deaths due to burning across Iran was 80,625, with a male to female ratio of 0.88, 0.94 and 1.14 in 1990, 1995 and 2015, respectively. The annual percentage change of age-standardized death rate from 1990 to 2015 was -5.42% and -4.22% in women and men, respectively. The burn-related age-standardized mortality rate decreased considerably from 5.97 in 1990 to 1.74 per 100,000 in 2015. The mortality rate due to burns was highest among those aged more than 85 years, especially in Ilam province. CONCLUSION This study showed a decline in burn mortality in Iran from 1990 to 2015. Continued efforts to reduce the burden of burns are needed to accelerate this progress and prevent injuries.
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Affiliation(s)
- Farideh Sadeghian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parastoo Niloofar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Amirzade-Iranaq
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Universal Network of Interdisciplinary Research in Oral and Maxillofacial Surgery (UNIROMS), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anita Mansouri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behzad Jazayeri
- Department of Surgery, Kaiser Permanente, Fontana, CA, USA; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Armin Aryannejad
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vida Ehyaee
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Derakhshan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, WA, USA
| | - Gerard O'Reilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Honnegowda TM, Kumar P, Udupa P, Rao P. Epidemiological study of burn patients hospitalised at a burns centre, Manipal. Int Wound J 2018; 16:79-83. [PMID: 30240126 DOI: 10.1111/iwj.12995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/31/2018] [Indexed: 11/27/2022] Open
Abstract
Burn injuries constitute a major public health problem and account for a significant cause of mortality and morbidity amongst the Indian population. This 2-year prospective study was undertaken to find out the exact epidemiological determinants of 737 patients admitted with burn injuries and, thus, to try and formulate effective preventive strategies. This study was conducted in the department of plastic surgery and burns from September 2011 to June 2013. All consecutive patients with major burns admitted for in-hospital treatment during the study period were included in the study. The data collected included age, gender, cause and mode of burns, total burn surface area (TBSA), microbiological profile and outcome. More than 55% of the patients were female (58.61%). The mean age was 31.3 years ranging from 8 months to 89 years. A higher number of females (97.5%) sustained burn injuries at home compared with 36.11% males sustaining injuries outdoors. (P = 0.000). Almost one third of injuries (40.36%) occurred between 4 pm and 8 pm, followed by 28% between 7 am and 12 noon. Synthetic garments were worn by 70% of females at the time of injury, whereas 40% of males had worn mixed clothing (P = 0.000). Flame injuries contributed to 80.1% of burns in females (P = 0.006). The rate of electrical injuries (9.8%) was significantly higher in males (P = 0.005). In almost 40% of males, TBSA was <19%, whereas in 40% of females, TBSA was >68%. (P = 0.004). Microbial profile showed that pseudomonas aeruginosa (n = 260; 35.3%), Klebsiella pneumoniae (n = 209; 28.5%), and Escherichia coli (n = 145; 22.6%) were the most frequent types of Staphylococci bacterial growths. The cause for burn injury was ignition of clothes in 68.74% females, and in 35.48% males, it was because of an attempt to save other burn injury victims (P = 0.013) The case fatality rate was 29.3%. A majority of the males (60.7%) recovered, whereas 45.89% of females succumbed because of their burn injury. (P = 0.001). As the aetiological factors of burn injuries vary considerably in different communities, careful study of the pattern in every community is needed before a sound prevention programme can be planned and implemented. Hence, this study was conducted to assess epidemiological, modes, causes, and risk factors and the microbial profile of burn injuries and to study the outcomes.
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Affiliation(s)
| | - Pramod Kumar
- Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal University, Udupi, India
| | - Padmanabha Udupa
- Department of Biochemistry, Kasturba Medical College, Manipal University, Udupi, India
| | - Pragna Rao
- Department of Biochemistry, Kasturba Medical College, Manipal University, Udupi, India
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He S, Alonge O, Agrawal P, Sharmin S, Islam I, Mashreky SR, Arifeen SE. Epidemiology of Burns in Rural Bangladesh: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040381. [PMID: 28379160 PMCID: PMC5409582 DOI: 10.3390/ijerph14040381] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 12/23/2022]
Abstract
Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries.
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Affiliation(s)
- Siran He
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Olakunle Alonge
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Priyanka Agrawal
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Shumona Sharmin
- International Center for Diarrheal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Irteja Islam
- International Center for Diarrheal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Saidur Rahman Mashreky
- Center for Injury Prevention and Research, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Shams El Arifeen
- International Center for Diarrheal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
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Bhate-Deosthali P, Lingam L. Gendered pattern of burn injuries in India: a neglected health issue. REPRODUCTIVE HEALTH MATTERS 2016; 24:96-103. [PMID: 27578343 DOI: 10.1016/j.rhm.2016.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/09/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022] Open
Abstract
There are an estimated 7 million burn injuries in India annually, of which 700,000 require hospital admission and 140,000 are fatal. According to the National Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. This paper reviews the existing literature on burn injuries in India and raises pertinent issues about prevalence, causes and gaps in recognising the gendered factors leading to a high number of women dying due to burns. The work of various women's groups and health researchers with burns victims raises several questions about the categorisation of burn deaths as accident, suicide and homicide and the failure of the health system to recognise underlying violence. Despite compelling evidence, the health system has not recognised this as a priority. Considering the substantial cost of burns care, prevention is the key which requires health systems to recognise the linkages between burn injuries and domestic violence. Health systems need to integrate awareness programmes about domestic violence and train health professionals to identify signs and symptoms of violence. This would contribute to early identification of abuse so that survivors are able to access support services at an early stage.
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Affiliation(s)
- Padma Bhate-Deosthali
- Coordinator, CEHAT, Mumbai, India; PhD Scholar, Tata Institute of Social Sciences, Hyderabad, India.
| | - Lakshmi Lingam
- Professor, Tata Institute of Social Sciences, Hyderabad, India
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6
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Soltan Dallal MM, Safdari R, Emadi Koochak H, Sharifi-Yazdi S, Akhoondinasab MR, Pourmand MR, Hadayatpour A, Sharifi-Yazdi MK. A comparison between occlusive and exposure dressing in the management of burn wound. Burns 2016; 42:578-82. [PMID: 26970838 DOI: 10.1016/j.burns.2015.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 04/29/2015] [Accepted: 05/04/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIM Two types of dressing, occlusive and exposure dressing, are commonly used in burn units. A dressing is said to be occlusive if a moist wound surface is maintained when the dressing is in place. This study was designed to compare the effectiveness of occlusive and exposure dressing in controlling burn infections. PATIENTS AND METHODS Two hundred patients with second-degree burns admitted to Mottahari Hospital, Tehran, Iran, over a period of 12 months from May 2012 to May 2013 were studied. They were divided into two groups of 100 each, to receive either occlusive or exposure dressing. During the first week of treatment, wound specimens were obtained by sterile swab and cultured in selective media. Demographics (age and gender), burn areas, cause of burn, length of hospital stay (LOS), type of infections and time to total healing were compared between the two groups. RESULTS Occlusive dressing was more susceptible to microbial contamination and infections than exposure dressing. The mean duration of treatment based on epithelialization and healing in occlusive dressing was longer than for exposure dressing. The most common isolate was Pseudomonas spp., followed by Enterobacter, Escherichia coli, Staphylococcus aureus, Acinetobacter, and Klebsiella spp. CONCLUSIONS Exposure dressing was more suitable than occlusive dressing for treating partial-thickness at our center. Pseudomonas aeruginosa was the most common organism encountered in burn infection.
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Affiliation(s)
- M M Soltan Dallal
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran; Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - R Safdari
- Health Information Management Department, School of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - H Emadi Koochak
- Zoonosis Research Centre, Tehran University of Medical Sciences, Tehran, Iran; Infectious Diseases Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - S Sharifi-Yazdi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M R Akhoondinasab
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M R Pourmand
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A Hadayatpour
- Department of Anatomical Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M K Sharifi-Yazdi
- Zoonosis Research Centre, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Laboratory Sciences, School of Para Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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7
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Chamania S, Chouhan R, Awasthi A, Bendell R, Marsden N, Gibson J, Whitaker IS, Potokar TS. Pilot project in rural western Madhya Pradesh, India, to assess the feasibility of using LED and solar-powered lanterns to remove kerosene lamps and related hazards from homes. Burns 2014; 41:595-603. [PMID: 25441542 DOI: 10.1016/j.burns.2014.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/12/2014] [Accepted: 09/03/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Globally, 300,000 deaths are estimated to occur annually and the incidence is far greater as a large majority of burns are small and go unreported. Ninety-five percent of the global burden of burns is found in low- and middle-income countries; however, there is relatively little in the literature regarding effective primary prevention in these areas. Flame is the most common cause of burn in Madhya Pradesh, the central state of India. The most common demographic among the burn unit inpatient of Choithram hospital Indore, is young women from 21 to 40 years of age, whose burns are primarily caused by kerosene lamps. A non electrical source of illumination is essential for every household in rural areas due to the infrequent and poor power supply. At the baseline, 23 kerosene lamp burns were reported by villagers in the past 5 years among the study population of this pilot project. METHOD A pilot project to investigate the strategies for reducing the incidence of domestic burns in rural villages around the city of Indore was performed, by replacing kerosene lamps with safer and more sustainable alternatives, including solar-powered and light-emitting diode (LED) lamps. A total of 1042 households were randomly chosen from 18 villages within the Malwa region of Madhya Pradesh (population of 28,825) to receive the alternative light source (670 LED and 372 solar lamps). We investigated the efficacy of this strategy of reducing the incidence of burns, measured the social acceptance by villagers, and quantified the cost implications and availability of LED lamps in rural communities with a high incidence of burns. RESULTS Replacing kerosene lamps with LED and solar alternatives was deemed socially acceptable by 99.34% of the participants and reduced the cost of lighting for impoverished rural villagers by 85% over 1 year. We successfully demonstrated a significant decrease in the use of kerosene lamps (p<0.01). More evidence is required to investigate the efficacy of this strategy in reducing burns. CONCLUSION This pilot study highlights the viability of the approach of replacing kerosene lamps as an effective primary prevention strategy for reducing burns in rural areas. However, barriers remain to the wider adoption of these lamps, including accessibility and availability for the populations of rural India.
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Affiliation(s)
- S Chamania
- Interburns Training Centre at Choithram Hospital, Indore, Madhya Pradesh, India.
| | - R Chouhan
- Interburns Training Centre at Choithram Hospital, Indore, Madhya Pradesh, India
| | - A Awasthi
- Interburns Training Centre at Choithram Hospital, Indore, Madhya Pradesh, India
| | | | - N Marsden
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
| | - J Gibson
- University of Cardiff Medical School, Cardiff, UK
| | - I S Whitaker
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
| | - T S Potokar
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK
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Fekih Hassen A, Ben Khalifa S, Daiki M. Epidemiological and bacteriological profiles in children with burns. Burns 2014; 40:1040-5. [DOI: 10.1016/j.burns.2013.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/09/2013] [Accepted: 10/29/2013] [Indexed: 01/01/2023]
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Kumar S, Ali W, Verma AK, Pandey A, Rathore S. Epidemiology and mortality of burns in the Lucknow Region, India—A 5 year study. Burns 2013; 39:1599-605. [DOI: 10.1016/j.burns.2013.04.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 04/05/2013] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
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Abstract
This paper appraises the public health burden of mortality in India caused by the practice of dowry and examines the association of some demographic and socio-economic factors with dowry deaths and dowry-related suicides. The paper is based on the data available on the public domains of the National Crime Records Bureau (NCRB), third National Family Health and Survey-2005-06, Planning Commission of India and Census of India 2001. In 2007, the total number of dowry deaths and dowry-related suicides reported in India were 8093 and 3148, respectively. There was a 74% increase in dowry-related deaths from1995 to 2007, while there was a 31% increase in the reporting of dowry-related suicides. Occurrence of dowry deaths has significant association with some demographic and socio-economic variables. The data reveal that the status of women is undesirable, and the burden of mortality and related morbidity is enormous. There should be a national injury surveillance system and reliable estimates of dowry-related homicides. However, available information can be used to design and implement some counter-measures to prevent dowry-related violence and deaths. The study warrants the undertaking of research to give insights into circumstances and triggers of such violence, the healthcare seeking of these victims, bottlenecks in seeking health care and reporting to the police.
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Affiliation(s)
- Gopalan Retheesh Babu
- Social and Behavioural Research Unit, Indian Council of Medical Research, New Delhi 110 029, India
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Golshan A, Patel C, Hyder AA. A systematic review of the epidemiology of unintentional burn injuries in South Asia. J Public Health (Oxf) 2013; 35:384-96. [DOI: 10.1093/pubmed/fds102] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Bayram Y, Parlak M, Aypak C, Bayram I. Three-year review of bacteriological profile and antibiogram of burn wound isolates in Van, Turkey. Int J Med Sci 2013; 10:19-23. [PMID: 23289001 PMCID: PMC3534873 DOI: 10.7150/ijms.4723] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 11/26/2012] [Indexed: 12/21/2022] Open
Abstract
The risk of infection in burns is well-known. In recent decades, the antimicrobial resistance of bacteria isolated from burn patients has increased. For this reason, a retrospective study was conducted at Van Training and Research Hospital to analyze the bacterial isolates from the wounds of patients admitted to the Burn Unit and to determine the susceptibility patterns of the commonly cultured organisms over a 3-year period, January 2009 to December 2011.A total of 250 microorganisms were isolated from burn wounds of 179 patients. Our results revealed that the most frequent isolate was Acinetobacter baumannii (23.6%), Pseudomonas aeruginosa (12%), Staphylococcus aureus (11.2%), Escherichia coli (10%) respectively. Multidrug-resistance has emerged as an important concern in our burn unit. Tigecycline, and colistin were found to be the most active drugs against Acinetobacter baumannii. Carbapenems and amikacin, were found to be the most active drugs against other gram negative bacteria. Vancomycin and linezolid were active against gram positive bacteria.Aggressive infection control measures should be applied to limit the emergence and spread of multidrug-resistant pathogens.
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Affiliation(s)
- Yasemin Bayram
- Microbiology Laboratory, Van Training And Research Hospital, Van, Turkey
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Afify MM, Mahmoud NF, Abd El Azzim GM, El Desouky NA. Fatal burn injuries: A five year retrospective autopsy study in Cairo city, Egypt. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2012. [DOI: 10.1016/j.ejfs.2012.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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14
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Burn mortality in Iraq. Burns 2012; 38:772-5. [DOI: 10.1016/j.burns.2011.12.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 11/11/2011] [Accepted: 12/21/2011] [Indexed: 11/23/2022]
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15
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Ahuja RB, Dash JK, Shrivastava P. A comparative analysis of liquefied petroleum gas (LPG) and kerosene related burns. Burns 2011; 37:1403-10. [DOI: 10.1016/j.burns.2011.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 03/04/2011] [Accepted: 03/21/2011] [Indexed: 10/18/2022]
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Shankar G, Naik VA, Powar R. Epidemiolgical study of burn injuries admitted in two hospitals of north karnataka. Indian J Community Med 2011; 35:509-12. [PMID: 21278873 PMCID: PMC3026131 DOI: 10.4103/0970-0218.74363] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Accepted: 06/16/2010] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gowri Shankar
- Department of Community Medicine, S N Medical College, Navanagar, Bagalkot, Karnataka, India
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Agbenorku P, Edusei A, Ankomah J. Epidemiological study of burns in Komfo Anokye Teaching Hospital, 2006-2009. Burns 2011; 37:1259-64. [PMID: 21726953 DOI: 10.1016/j.burns.2011.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 04/21/2011] [Accepted: 04/27/2011] [Indexed: 11/30/2022]
Abstract
AIM To identify and describe the patterns of burns reported at the Komfo Anokye Teaching Hospital (KATH) from 2006 to 2009 and their outcomes on the various age groups and genders. METHODS Patients' records from admission and discharge books of the Burns Intensive Care Unit, Polyclinic Casualty Consulting Rooms and from the Statistical Department of KATH were reviewed to obtain the necessary data for this retrospective study. Data entry and analysis were done by using SPSS version 17.0. RESULTS A total of 731 patients' records were reviewed, with male to female ratio of 1.2:1. The mean age was 15.83 years; range was 0-79 years. Children less than 10 years were the most frequently admitted group (53.5%). Most of the burns occurred in domestic settings (88.5%), whiles, majority of the burns were accidental (98.8%). Scalds (57.4%) were the most frequent cause of burns followed by open flame (38.2%). The mortality rate was 13.1% for the period under review. Majority (71.4%) of the patients spent less than 10 days on admission. The mean total body surface area (TBSA) was 24.79%, and there was significant correlation between TBSA, age group, outcome and duration of hospital admission. CONCLUSION Children less than 10 years were the most vulnerable victims to burns; males dominated the number of victims. The commonest aetiological factor was scalds, with most of them related to inattention from parents. More dedicated burn surgeons and properly trained nurses are needed at KATH. Ambulance and pre-hospital services should be increased with adequate number of paramedics. Coordination between district hospitals and tertiary burn centres should also be established, for the proper transfer of burn cases to the tertiary burn centres, especially KATH.
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Affiliation(s)
- Pius Agbenorku
- Reconstructive Plastic Surgery & Burns Unit, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
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Contribution of bacterial and viral infections to attributable mortality in patients with severe burns: an autopsy series. Burns 2010; 36:773-9. [PMID: 20074860 DOI: 10.1016/j.burns.2009.11.007] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 10/02/2009] [Accepted: 11/11/2009] [Indexed: 11/20/2022]
Abstract
Bacterial infections are a common cause of mortality in burn patients and viral infections, notably herpes simplex virus (HSV) and cytomegalovirus (CMV) have also been associated with mortality. This study is a retrospective review of all autopsy reports from patients with severe thermal burns treated at the US Army Institute of Research (USAISR) burn unit over 12 years. The review focused on those patients with death attributed to a bacterial or viral cause by autopsy report. Of 3751 admissions, 228 patients died with 97 undergoing autopsy. Death was attributed to bacteria for 27 patients and to virus for 5 patients. Bacterial pathogens associated with mortality included Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. This association with mortality was independent of % total body surface area burn, % full-thickness burn, inhalation injury, and day of death post-burn. Bloodstream infection was the most common cause of bacteria related death (50%), followed by pneumonia (44%) and wound infection (6%). Time to death following burn was < or =7 days in 30%, < or =14 days in 59% and < or =21 days in 67%. All of the viral infections associated with mortality involved the lower respiratory tract, HSV for 4 and CMV for 1. Four of these 5 patients had evidence of inhalation injury by bronchoscopy, all had facial and neck burns, and 2 had concomitant Staphylococcus pneumonia. Time to death following burn ranged from 14 to 42 days for the 5 patients. Despite advances in care, gram negative bacterial infections and infection with S. aureus remain the most common cause of bacteria related mortality early in the hospital course. Viral infections are also associated with mortality and numbers have remained stable when compared to data from prior years.
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Keen EF, Robinson BJ, Hospenthal DR, Aldous WK, Wolf SE, Chung KK, Murray CK. Incidence and bacteriology of burn infections at a military burn center. Burns 2009; 36:461-8. [PMID: 20045259 DOI: 10.1016/j.burns.2009.10.012] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 09/28/2009] [Accepted: 10/14/2009] [Indexed: 11/28/2022]
Abstract
Considerable advancements in shock resuscitation and wound management have extended the survival of burned patients, increasing the risk of serious infection. We performed a 6-year review of bacteria identification and antibiotic susceptibility records at the US Army Institute of Surgical Research Burn Center between January 2003 and December 2008. The primary goal was to identify the bacteria recovered from patients with severe burns and determine how the bacteriology changes during extended hospitalization as influenced by population and burn severity. A total of 460 patients were admitted to the burn ICU with 3507 bacteria recovered from 13,727 bacteriology cultures performed. The most prevalent organisms recovered were Acinetobacter baumannii (780), Pseudomonas aeruginosa (703), Klebsiella pneumoniae (695) and Staphylococcus aureus (469). A. baumannii was most often recovered from combat-injured (58%) and S. aureus the most frequent isolate from local (46%) burn patients. Culture recovery rate of A. baumannii and S. aureus was highest during the first 15 hospital days (73% and 71%); while a majority of P. aeruginosa and K. pneumoniae were recovered after day 15 (63% and 53%). All 4 pathogens were recovered throughout the course of hospitalization. A. baumannii was the most prevalent pathogen recovered from patients with total body surface area (TBSA) burns less than 30% (203) and 30-60% (338) while P. aeruginosa was most prevalent in patients with burns greater than 60% TBSA (292). Shifting epidemiology of bacteria recovered during extended hospitalization, bacteriology differences between combat-injured and local burn patients, and impact of % TBSA may affect patient management decisions during the course of therapy.
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Affiliation(s)
- Edward F Keen
- San Antonio Military Medical Center, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA
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Dissanaike S, Rahimi M. Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects. Int Rev Psychiatry 2009; 21:505-11. [PMID: 19919203 DOI: 10.3109/09540260903340865] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Burns are devastating injuries that disproportionately affect people in developing countries, including children. In addition to a high mortality rate, survivors are burdened with life-long physical and emotional scars. The etiology and nature of burn injuries varies significantly by country, and this chapter explores the predominant causes and patterns of burn injury in both the developing and industrialized worlds. Gender differences play a significant role in the risk of burn injuries, across a spectrum with a predominance of women injured in fires from cooking and heating fuels in the developing world and industrial accidents primarily affecting men in developed nations. Children are particularly vulnerable to burn injuries, accounting for almost 50% of all burn patients in some studies. A majority of pediatric burns are scald injuries usually affecting very young children below the age of 5 years, and we discuss the behavioral patterns underlying this finding. Finally, the elderly form a rapidly increasing proportion of the population in many countries, and are often burdened with comorbidities that are likely to pose significant challenges in burn care.
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Affiliation(s)
- Sharmila Dissanaike
- Division of Trauma and Burn Care, Department of Surgery, and Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA.
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Abstract
BACKGROUND Hospital-based studies have suggested that fire-related deaths might be a neglected public-health issue in India. However, no national estimates of these deaths exist and the only numbers reported in published literature come from the Indian police. We combined multiple health datasets to assess the extent of the problem. METHODS We computed age-sex-specific fire-related mortality fractions nationally using a death registration system based on medically certified causes of death in urban areas and a verbal autopsy based sample survey for rural populations. We combined these data with all-cause mortality estimates based on the sample registration system and the population census. We adjusted for ill-defined injury categories that might contain misclassified fire-related deaths, and estimated the proportion of suicides due to self-immolation when deaths were reported by external causes. FINDINGS We estimated over 163 000 fire-related deaths in 2001 in India, which is about 2% of all deaths. This number was six times that reported by police. About 106 000 of these deaths occurred in women, mostly between 15 and 34 years of age. This age-sex pattern was consistent across multiple local studies, and the average ratio of fire-related deaths of young women to young men was 3:1. INTERPRETATION The high frequency of fire-related deaths in young women suggests that these deaths share common causes, including kitchen accidents, self-immolation, and different forms of domestic violence. Identification of populations at risk and description of structural determinants from existing data sources are urgently needed so that interventions can be rapidly implemented.
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Gomez R, Murray CK, Hospenthal DR, Cancio LC, Renz EM, Holcomb JB, Wade CE, Wolf SE. Causes of mortality by autopsy findings of combat casualties and civilian patients admitted to a burn unit. J Am Coll Surg 2009; 208:348-54. [PMID: 19317995 DOI: 10.1016/j.jamcollsurg.2008.11.012] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2008] [Revised: 11/14/2008] [Accepted: 11/20/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND Approximately 5% of combat-related injuries include burns. Previous studies have shown similar mortality rates between military and civilian burn casualties; but causes of death were not detailed. STUDY DESIGN We retrospectively reviewed autopsy reports of patients with burns treated at the US Army Institute of Surgical Research Burn Center from 2004 to 2007. RESULTS Of 1,255 admissions, 100 (8%) died, with autopsies performed on 74 (36 burned during military operations). Causes of death included infection (61%); disorders of the pulmonary (55%), cardiac (36%), renal (27%), gastrointestinal (27%), and central nervous (11%) systems; and multiorgan dysfunction (15%). Patients burned as a result of military operations were younger men with more associated inhalation injuries, greater severity of injury, and longer time from injury to admission and to death. They died more frequently of infection (notably fungus, Pseudomonas, and Klebsiella) and gastrointestinal complications; and those not burned in military operations had greater numbers of cardiac and renal causes of death. CONCLUSION Casualties of military operations are clinically different and die from different causes than patients not burned during military operations. The differences are likely reflective of a younger population, with greater severity of illness and longer times from injury to admission. Therapeutic interventions should focus on prevention of infection and gastrointestinal catastrophes in military burn casualties, which are similar to younger burn patients in the US, and minimizing cardiac complications in civilian burn casualties, who are typically older patients and possibly reflective of patients with more comorbidities.
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Affiliation(s)
- Ruben Gomez
- Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
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Arslan MM, Berber G, Özdeş T. Childhood Deaths Resulted from Burn Injuries in Diyarbakır. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2009. [DOI: 10.29333/ejgm/82632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kumar V, Mohanty MK, Kanth S. Fatal burns in Manipal area: A 10year study. J Forensic Leg Med 2007; 14:3-6. [PMID: 17046310 DOI: 10.1016/j.jcfm.2005.09.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2005] [Revised: 09/13/2005] [Accepted: 09/28/2005] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burn injuries retrospectively. An analysis of autopsy records revealed 19.4% cases of burn injuries amongst the total autopsies done over 10years period (1993-2002) in the mortuary of the department of Forensic Medicine of Kasturba medical College, Manipal. The majority of deaths (78.5%) occurred between 11 and 40years of age group with preponderance of females (74.8%). The flame burns were seen in 94.1% of the victims followed by scalds and electrical burns in 2.8% and 2.5% cases, respectively. The majority of burn incidents were accidental (75.8%) in nature followed by suicidal (11.5%) and homicidal (3.1%) deaths. The percentage of burn (TBSA) over 40% were observed in most of the cases (92.5%). The majority of deaths occurred within a week (69.87%) and most the victims died because of septicemia (50.9%).
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Affiliation(s)
- Virendra Kumar
- Department of Pathology (Forensic Unit), Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
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Joshi R, Cardona M, Iyengar S, Sukumar A, Raju CR, Raju KR, Raju K, Reddy KS, Lopez A, Neal B. Chronic diseases now a leading cause of death in rural India—mortality data from the Andhra Pradesh Rural Health Initiative. Int J Epidemiol 2006; 35:1522-9. [PMID: 16997852 DOI: 10.1093/ije/dyl168] [Citation(s) in RCA: 183] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas. METHODS Deaths occurring in 45 villages (population 180 162) were documented during a 12-month period in 2003-04 by multipurpose primary healthcare workers trained in the use of a verbal autopsy tool. Algorithms were used to define causes of death according to a limited list derived from the international classification of disease version 10. Causes were assigned by two independent physicians with disagreements resolved by a third. RESULTS A total of 1354 deaths were recorded with verbal autopsies completed for 98%. A specific underlying cause of death was assigned for 82% of all verbal autopsies done. The crude death rate was 7.5/1000 (95% confidence interval, 7.1-7.9). Diseases of the circulatory system were the leading causes of mortality (32%), with similar proportions of deaths attributable to ischaemic heart disease and stroke. Second was injury and external causes of mortality (13%) with one-third of these deaths attributable to deliberate self harm. Third were infectious and parasitic diseases (12%). Tuberculosis and intestinal conditions each caused one-third of deaths within this category. HIV was assigned as the cause for 2% of all deaths. The fourth and fifth leading causes of death were neoplasms (7%) and diseases of the respiratory system (5%). CONCLUSION Non-communicable and chronic diseases are the leading causes of death in this part of rural India. The observed pattern of death is unlikely to be unique to these villages and provides new insight into the rapid progression of epidemiological transition in rural India.
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Affiliation(s)
- Rohina Joshi
- The George Institute for International Health, PO Box M201, Missenden Road, Sydney NSW 2050, Australia.
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Xifró-Collsamata A, Pujol-Robinat A, Medalla-Muñiz J, Arimany-Manso J. [Impact of data used in forensic medicine on public health]. Med Clin (Barc) 2006; 126:389-96. [PMID: 16750131 DOI: 10.1157/13086051] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Alexandre Xifró-Collsamata
- Institut de Medicina Legal de Catalunya, Departament de Justícia, Generalitat de Catalunya, Barcelona, Spain.
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Abstract
Burning incidents amongst women are a major concern in India as it has become pervasive throughout all social strata and geographical areas. They may be homicidal, suicidal or accidental in nature. Here, in the study, the main objective is to present the different epidemiological and medicolegal aspects of accidental burns in the married women. In a cohort of 152 burned wives, 70 (46%) were accidental victims and these cases were analyzed accordingly for their different medicolegal and epidemiological aspects. Data were collected from personal interview and from examining the different documents related to death. In this series, most of the women were illiterate Hindu housewives hailing from joint families (i.e. multigenerational groups of related individuals living under a single roof) of rural community. The majority (60%) of the affected wives were 16-25 years of age at the time of the accident and sustained less than 90% total body surface area burn injury. Most had the survival period more than 1 day, and more than half of them died of septicaemia.
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Affiliation(s)
- Virendra Kumar
- Department of Forensic Medicine, KMC, Manipal, 576119 Karnataka, India.
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Avşaroğullari L, Sözüer E, Ikizceli I, Kekeç Z, Yürümez Y, Ozkan S. Adult burn injuries in an Emergency Department in Central Anatolia, Turkey: a 5-year analysis. Burns 2003; 29:571-7. [PMID: 12927982 DOI: 10.1016/s0305-4179(03)00140-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Burn injuries require a multidisciplinary approach. Emergency Departments can play vital roles in the treatment of burns. The purpose of this study is to investigate the epidemiological and clinical characteristics of the adult burn patients admitted to our Emergency Department and to determine the frequency of the patients who were treated on an outpatient basis and discharged from the Emergency Department. PROCEDURE A retrospective review of 314 adult burn patients who presented to the Emergency Medicine Department of Erciyes University Hospital from January 1996 to December 2000. FINDINGS Sixty-four percent of the patients were male. Mean age was 32.9+/-14.7. Ninety-nine patients (32%) had moderate to major burns. The highest numbers of patients were in the 21-30 age group. Flame burns comprised the majority of presentations and admissions (48 and 69%, respectively). Thirteen patients had associated injuries (4%). Eighty-seven patients (28%) were hospitalized, 21 of these died. Death occurred mostly from respiratory failure and sepsis. Domestic accidents were the leading mechanism (63%). CONCLUSION Burns were mostly due to accidents arising from carelessness, ignorance, hazardous traditions and improperly manufactured products. These can be prevented through mass education programs countrywide. Because almost all burn patients present to Emergency Departments first and not all hospitals can employ burn specialists, the patients with minor burns can be treated on an outpatient basis and the treatment of severe burns can be effectively initiated by emergency physicians.
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Affiliation(s)
- Levent Avşaroğullari
- Department of Emergency Medicine, Medical School of Erciyes University, Kayseri, Turkey.
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Singh D, Dewan I, Pandey AN, Tyagi S. Spectrum of unnatural fatalities in the Chandigarh zone of north-west India – a 25 year autopsy study from a tertiary care hospital. ACTA ACUST UNITED AC 2003; 10:145-52. [PMID: 15275009 DOI: 10.1016/s1353-1131(03)00073-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 25 year (1977-2002) autopsy study of 5933 unnatural fatalities from a tertiary care hospital of north-west India revealed an abrupt rise in unnatural deaths (3050; 51.4%) since 1997. 84.2% subjects were between the age group of 16 and 45. Accidental deaths (79.3%) constituted the majority of unnatural fatalities followed by suicidal (13.9%) and homicidal (6%) deaths. Road traffic accidents (RTAs), burn, poisoning, accidental falls from height and firearm injury were responsible for 94.5% of the total unnatural deaths. A male preponderance (73.4%) was seen in all causes of deaths except for burns where females (61%) outnumbered males (39%). The incidence of fatalities due to poisoning and burns had increased from 5.7% and 22.6% to 12% and 24.3%, respectively, whereas due to fire arms and machinery accidents decreased from 4.5% and 1.2% to 1.2% and 0.4%, respectively. The proportion of mortality due to road traffic accidents (50.3%) and accidental fall from height (6.9%) remained almost static. Two-wheeler occupants (motor cycles, etc. 33.3%) were the main victims in road traffic accidents. Pouring of kerosene oil (36% dowry death), malfunctioning and bursting of kerosene oil stove (43.5%) were the most common factors in burn deaths. Between 1977 and 1987 barbiturates (33.3%), organophosphates (23.8%) and copper sulphate (14.3%) and in 1987-1997 organophosphates (45%) and aluminium phosphide (26.5%) were the major fatal poisons. Since 1992 aluminium phosphide (80%), a fumigant pesticide used for wheat preservation was the most common poison. The incidence of suicidal deaths increased from 10.9% (1987-1992) to 15.7% (1997-2002) with a peak incidence of 18.2% in 1992-1997, when this pesticide with no effective antidote was made freely available in the market.
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Affiliation(s)
- Dalbir Singh
- Department of Forensic Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Abstract
Ritual self-immolation has long been practiced in India. Although in the past the practice has been related to the act of sati, it is currently more commonly associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 32 (21%) were immolation suicides and these cases were analyzed from both epidemiological and medicolegal aspects. Suicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from joint families (i.e. multigenerational groups of related individuals living under a single roof) and the suicides occurred 2-5 years after marriage. The majority of the affected wives were 21-25 years of age (69%) at the time of the suicide and sustained more than a 50% TBSA burn injury after dousing themselves with kerosene. Most died at the time of the incident or within the subsequent 24h, most commonly from shock.
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Affiliation(s)
- Virendra Kumar
- Department of Forensic Medicine, KMC, 576119, Karnataka, Manipal, India.
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De-Souza DA, Manço ARX, Marchesan WG, Greene LJ. Epidemiological data of patients hospitalized with burns and other traumas in some cities in the southeast of Brazil from 1991 to 1997. Burns 2002; 28:107-14. [PMID: 11900932 DOI: 10.1016/s0305-4179(01)00101-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This retrospective analysis of burn patients and victims of other forms of trauma from Ribeirão Preto and nearby cities admitted to hospitals in the city of Ribeirão Preto, São Paulo, Brazil, was carried out to determine the frequency of injuries of all types in order to identify the extent of the problem of burns relative to other forms of trauma. Data concerning 921 patients with burns and 60,344 patients with other traumatic injuries hospitalized during the period from 1991 to 1997 are described. Burns corresponded to 1.5% of the total number of traumatic injuries. When data are reported as absolute numbers or as incidence rate of hospitalized burn patients, burns were two times more frequent among men in most age groups. The case fatality ratio due to burns was 8.4% (77 deaths among 921 patients), with a rate of 6.4% for men and 12.2% for women. The case fatality ratio was higher among women than men regardless of the city of residence. The case fatality ratio was 3.2 and 4.4 times greater for men and women burn victims from other towns than for burn victims from Ribeirão Preto, indicating the need for additional equipment and training of medical and paramedical personnel in the initial measures to be taken with burn patients.
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Affiliation(s)
- D A De-Souza
- Centro de Química de Proteínas, Universidade de São Paulo, Ribeirão Preto, Brazil
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Leistikow BN, Martin DC, Milano CE. Fire injuries, disasters, and costs from cigarettes and cigarette lights: a global overview. Prev Med 2000; 31:91-9. [PMID: 10938207 DOI: 10.1006/pmed.2000.0680] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Fires cause 1% of the global burden of disease. Fire (includes explosion) disasters have immense health, social, and environmental costs. We will provide initial estimates of overall U. S. and global fire tolls from smoking. METHODS We tabulated and summarized smoking-related fire and disaster tolls from published documents. We compared those tolls to U.S. fire, burn, and fire death rates per billion cigarettes extrapolated globally. Smoking-attributable percentages of adult and child access to cigarette lighter and match ignitions (lights), and resultant fires, burns, and deaths ignited by young children, were estimated from likely smoking-attributable lights usage. Cigarette plus cigarette lights fire tolls were multiplied times published and estimated fire costs. RESULTS Smoking is the leading cause of residential or total fire death in all eight countries with available statistics. Smoking is a leading cause of fires in many more countries. Cigarettes cause numerous fire disasters. Cigarette lights cause an estimated 100,000 U.S. and one million global, child-playing fires per year. Cigarette lights fire injuries likely rival U.S., and possibly global, cigarette fire injury numbers. Smoking causes an estimated 30% of U. S. and 10% of global fire death burdens. Smoking's estimated U.S. and global fire costs were $6.95 (sensitivity range $5.34-22.8) and $27.2 (sensitivity range $8.2-89.2) billion, respectively, in 1998 U. S. dollars. CONCLUSIONS Smoking likely causes large global fire tolls. U.S. fire tolls have fallen when smoking decreased. Further reducing smoking can substantially reduce fire and disaster tolls.
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Affiliation(s)
- B N Leistikow
- Department of Epidemiology and Preventive Medicine, University of California, Davis, California 95616-8638, USA.
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