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Hoveidamanesh S, Goharinezhad S, Bagheri T, Irilouzadian R, Fatemi MJ, Farokh Forghani S, Ghadimi T. Why do people get burned? Qualitative analysis of the causes of burns in a large survey of burn survivors. Burns 2024; 50:1286-1295. [PMID: 38472002 DOI: 10.1016/j.burns.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 01/21/2024] [Accepted: 02/08/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Understanding the national epidemiology of burns is necessary for effective planning of prevention and treatment services. However, epidemiological studies of burns have often focused on short-term and retrospective investigations of a specific group of burned patients in Iran. Therefore, we conduct a comprehensive study from August 2016 to October 2017, in the Burn Research Center of Iran University of Medical Sciences on approximately 1700 hospitalized burn patients at Motahari Hospital to identify the underlying causes of burns. In this study, an open-ended question was asked about how the burn occurred in the patients. The current study was designed and conducted for the qualitatively analyzing of the responses to this question, using the content analysis method, in order to maximize its use in policymaking and prevention. METHODS Content analysis of written responses to open-ended questions was done as a part of a large questionnaire survey. This survey was conducted by face-to-face interview at a national referral center for burn injuries. RESULTS Answers from 1595 patients were coded and the underlying causes of injury were categorized into three themes and 43 subthemes. These underlying causes were lack of knowledge and awareness, inappropriate equipment, and inevitable accidents. The underlying cause of lack of knowledge and awareness had the highest proportion in causing burns in both men and women. The most common subthemes in descending order included lack of skills, dangerous actions, improper location of hot liquids, individual mistakes, and improper use of flammable materials. The top five subthemes with the highest average percentage of burn in patients in descending order were deficiency of residential equipment, self-immolation, accidents, inappropriate location of flammable materials, and unsafe kitchen appliances. CONCLUSION The focus of prevention programs on educating and increasing awareness of individuals, preferably women, is suggested. Educational programs, tailored to occupational standards and workplace and household equipment, are recommended for men in work environments.
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Affiliation(s)
| | - Salime Goharinezhad
- Department of Healthcare Services Management, School of Health Management and Information Sciences, Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Tooran Bagheri
- Burn research center, Iran University of medical sciences, Tehran, Iran
| | - Rana Irilouzadian
- Burn research center, Iran University of medical sciences, Tehran, Iran
| | | | | | - Tayyeb Ghadimi
- Burn research center, Iran University of medical sciences, Tehran, Iran.
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Jafaryparvar Z, Adib M, Ghanbari A, Ali Yazdanipour M. Predictors of short-term outcomes of burn in a newly established burn centre in Iran. Nurs Open 2021; 8:2986-2995. [PMID: 34319015 PMCID: PMC8510761 DOI: 10.1002/nop2.1010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/06/2021] [Accepted: 05/27/2021] [Indexed: 12/03/2022] Open
Abstract
Aim This study aimed to determine the predictors of hospital stay and mortality in patients with burns. Design This is a cross‐sectional, retrospective study. Methods This study was performed on 626 medical records in Velayat Subspecialty Burn and Plastic Surgery Center in Rasht, Iran, during 2008–2013. Results Men comprised 78.4% of the study population. Overall, 50.2% of the participants lived in rural areas, and 72.5% were married. The majority of burns occurred at home (49.5%), and thermal factor (87.4%) was the major cause of burn injuries. Also, 6.9% of the patients died after burns. The mean length of hospital stay was 12.62 ± 13 days. Age (OR = 1.07), total body surface area (TBSA%) (OR = 1.12) and length of ICU stay (OR = 1.06) were the strongest predictors of mortality. Gender (IRR = 0.85), TBSA% (IRR = 1.01), location of burn (IRR = 1.1), skin graft (IRR = 2.12), length of ICU stay (IRR = 1.04), re‐hospitalization (IRR = 1.77) and burn degree (IRR = 1.09) were the predictors of the length of hospital stay. Conclusion BSA is still an important predictor of mortality and length of hospital stay, as the most important short‐term outcomes of burns.
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Affiliation(s)
- Zakiyeh Jafaryparvar
- Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoomeh Adib
- Department of Nursing (Medical-Surgical),School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Ghanbari
- Social Determinants of Health Research Center,School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Yazdanipour
- Bio-statistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Bevalian P, Pashaei F, Akbari R, Pooshang Bagheri K. Eradication of vancomycin-resistant Staphylococcus aureus on a mouse model of third-degree burn infection by melittin: An antimicrobial peptide from bee venom. Toxicon 2021; 199:49-59. [PMID: 34087287 DOI: 10.1016/j.toxicon.2021.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/18/2021] [Accepted: 05/29/2021] [Indexed: 01/10/2023]
Abstract
Third-degree burn infections caused by antibiotic-resistant bacteria are of high clinical concern. Chemical antibiotics are not promising in eradication of bacterial infections. In this challenging condition, antimicrobial peptides (AMPs) are recently introduced as novel promising agents to overcome the issue. Accordingly, our study aimed to evaluate the efficiency of 'melittin' as natural peptide in bee venom, in eradicating vancomycin resistant Staphylococcus aureus (VRSA) on a mouse model of third-degree burn infection. In vitro pharmacological value of melittin was determined by examining its inhibitory and killing activities on VRSA isolates at different doses and time periods. The action mechanism of 'melittin' was evaluated by fluorescent release assay and Field Emission Scanning Electron Microscopy (FE-SEM) analyses. In vivo activity and toxicity of melittin were also examined on a mouse model of third-degree burn infection. The Minimum Inhibitory Concentration (MIC) and the Minimum Bactericidal Concentration (MBC) of melittin on all isolates ranged from '0.125-2 μg/mL' and '0.125-4 μg/mL', respectively. Rapid antibacterial activity of melittin on VRSA isolates was demonstrated by killing kinetics assays. Fluorometric and FE-SEM analyses indicated the membranolytic effects of melittin on VRSA isolates. The colonized VRSA bacteria were eradicated by melittin at 16 μg, in a single dose. No dermal toxicity and in vivo hemolysis were observed in the examined mice. The lack of in vivo toxicity of melittin along with its potent antibacterial activity indicated its promising therapeutic value as a topical drug against S. aureus associated third-degree burn infections.
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Affiliation(s)
- Parvaneh Bevalian
- Venom and Biotherapeutics Molecules Lab., Biotechnology Dept., Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Fatemeh Pashaei
- Venom and Biotherapeutics Molecules Lab., Biotechnology Dept., Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Reza Akbari
- Venom and Biotherapeutics Molecules Lab., Biotechnology Dept., Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran; Department of Microbiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran
| | - Kamran Pooshang Bagheri
- Venom and Biotherapeutics Molecules Lab., Biotechnology Dept., Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.
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Correia-Sá I, Marques M, Horta R, Costa-Ferreira A, Rodrigues AG, Silva Á, Egipto P. Experience in Management of Burn Injury During Pregnancy in a Burn Unit. J Burn Care Res 2020; 42:232-235. [PMID: 32844994 DOI: 10.1093/jbcr/iraa141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Burns injuries during pregnancy are rarely reported in developed countries, but an increasing in mortality and morbidity has been observed. The authors describe their experience in the treatment of pregnant women in a burn unit. A 12-year retrospective study of burns in pregnant women hospitalized was conducted. Since 2008, two pregnant women were admitted in their unit. Patient 1, a 32-year-old pregnant woman on second trimester (27s6d), suffered a second-degree burn injury, 16% total body surface area (TBSA), caused by fire. She was admitted in their burn unit and submitted to medical treatment, wound dressing, and surgical treatment. Cerium nitrate and silver sulfadiazine were used in burn lesions and the patient was submitted to debridement and skin graft surgery. No uneventful events occurred with the fetus. Patient 2 was a 32-year-old pregnant woman on second trimester (26s), HVC positive, admitted with a second-degree flash burn, 8% TBSA. She was submitted to endotracheal intubation before arriving to the hospital due to risk of airway burn. Dexamethasone was administered for fetus lung maturation. No uneventful events were observed. The incidence of thermal injury in pregnancy in Portugal is low. Active medical treatment together with conservative wound care should be the standard in each trimester of pregnancy. Although there is limited safety information on cerium nitrate or silver sulfadiazine during pregnancy, those were used with no adverse effects on one of their patients. Obstetrical management should be individualized.
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Affiliation(s)
- Inês Correia-Sá
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal.,Faculty of Medicine, University of Porto, Portugal
| | - Marisa Marques
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal.,Faculty of Medicine, University of Porto, Portugal
| | - Ricardo Horta
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal.,Faculty of Medicine, University of Porto, Portugal
| | - António Costa-Ferreira
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal.,Faculty of Medicine, University of Porto, Portugal
| | - Acácio G Rodrigues
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal.,Faculty of Medicine, University of Porto, Portugal
| | - Álvaro Silva
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal
| | - Paula Egipto
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, Porto, Portugal
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Hubab M, Maab H, Hayat A, Ur Rehman M. Burn Wound Microbiology and the Antibiotic Susceptibility Patterns of Bacterial Isolates in Three Burn Units of Abbottabad, Pakistan. J Burn Care Res 2020; 41:1207-1211. [PMID: 32403126 DOI: 10.1093/jbcr/iraa073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Infection is the leading cause of morbidity and mortality among burn patients and is accentuated multifold by the emergence of antimicrobial resistance among the nosocomial isolates. It is vital to know the common organisms involved in infected burn wound etiology and their respective antibiotic susceptibility patterns. These crucial findings can help in formulating a better and more efficient antimicrobial therapy plan for controlling burn wound infections. The current study was conducted to identify the common bacteria involved in causing infections in wounds of burn patients and their respective antibiotic susceptibility patterns in three hospitals of Abbottabad, Pakistan. A total of 100 patients were included from the burn units of three hospitals in Abbottabad. Wound swabs were taken from the deepest portions of infected burns, and the organisms involved were isolated via standard microbiological techniques. The Kirby-Bauer disc diffusion technique was used to monitor antibiotic susceptibility. Gram-positive organisms were found readily in infected burn wounds. Staphylococcus aureus (46%) was the most common isolate followed by Staphylococcus epidermidis (17%), Escherichia coli (16%), Proteus spp. (12%), Klebsiella pneumoniae (10%), and Pseudomonas aeruginosa, which was only 7%. Gram-positive bacteria were sensitive to amikacin, gentamicin, cefotaxime, and norfloxacin. In contrast, the gram-negative isolates were sensitive to amikacin, chloramphenicol, and nalidixic acid. Pseudomonas was resistant to most of the antibiotics tested in the present study.
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Affiliation(s)
- Muhammad Hubab
- Department of Microbiology, Abbottabad University of Science and Technology, Havelian, Pakistan
| | - Hira Maab
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Azam Hayat
- Department of Microbiology, Abbottabad University of Science and Technology, Havelian, Pakistan
| | - Mujaddad Ur Rehman
- Department of Microbiology, Abbottabad University of Science and Technology, Havelian, Pakistan
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Liu M, Zhu H, Yan R, Yang J, Zhan R, Yu X, Hu X, Zhang X, Luo G, Qian W. Epidemiology and Outcome Analysis of 470 Patients with Hand Burns: A Five-Year Retrospective Study in a Major Burn Center in Southwest China. Med Sci Monit 2020; 26:e918881. [PMID: 32417848 PMCID: PMC7222659 DOI: 10.12659/msm.918881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background This retrospective study aimed to investigate the epidemiology of burns to the hand, including the causes, demographic data, management, and outcome in a single center in Southwest China between 2012 and 2017. Material/Methods A retrospective study included 470 patients with hand burns who were treated at a single hospital in Southwest China between 2012 and 2017. Demographic, injury-related, and clinical data were obtained from the clinical electronic data collection system. Results In 470 patients, men were more commonly admitted to hospital with hand burns (73.62%). Children under 10 years (29.57%) were the main patient group. Hospital admissions occurred in the coldest months, from December to March (55.11%). In 60.21% of cases, hand burns occurred outside the workplace. Fire (40.42%), electricity (30.85%), and hot liquids (20.21%) were the main causes of hand burns. Data from 428 patients showed that burns with a larger total body surface area and deeper burns were associated with surgery and amputation. Burn depth was a risk factor for skin grafting, and lack of burn cooling before hospital admission increased the risk of amputation. Data from 117 patients with localized burns showed that full-thickness burns and lack of cooling before admission were associated with an increased hospital stay. Conclusions The findings suggest that in Southwest China, prevention programs for children aged 0–9 years, injuries occurring in winter and non-workplace sites, and fire burns were imperative.
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Affiliation(s)
- Mian Liu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Haijie Zhu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Rongshuai Yan
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Jiacai Yang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Rixing Zhan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Xunzhou Yu
- Department of Burn and Plastic Surgery, 80th Group Military Hospital, Weifang, Shandong, China (mainland)
| | - Xiaohong Hu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Xiaorong Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
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Single dose eradication of extensively drug resistant Acinetobacter spp. In a mouse model of burn infection by melittin antimicrobial peptide. Microb Pathog 2019; 127:60-69. [DOI: 10.1016/j.micpath.2018.11.055] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 11/23/2022]
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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: 7] [Impact Index Per Article: 1.2] [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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Mirza Aghazadeh A, Lotfi M, Ghahramanian A, Ahadi F. Lethal Area 50 in Patients with Burn Injuries in North West, Iran. J Caring Sci 2018; 7:53-58. [PMID: 29637058 PMCID: PMC5889799 DOI: 10.15171/jcs.2018.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/03/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction: In view of their considerably high rates of mortality and morbidity, burns are still viewed as one of the most important health-threatening environmental hazards imposing a significant burden on the health care system in low and middle-income countries. This study seeks to determine the lethal area fifty percent (LA50) in all burn patients admitted over a period of five years and the factors influencing mortality in burn injuries. Methods: This study was a cross-sectional carried out from 2010 to 2014 in Sina Hospital of Tabriz, 1226 participant including 319 women, 346 men, 272 girls, and 289 boys were selected through stratified sampling. The demographic and clinical data of patients ( their age, gender, burn type, TBSA, the season and consequences of burning) were all extracted and then analyzed, using descriptive statistics (measures of central tendency and variability) and inferential statistics(chi-square and linear regression)at a significance level of 0.05. The LA50 was calculated through determining the relationship between the total body surface area and mortality rate (The extent of the body burns measured and recorded based on Lando Chart in hospitals). Results: The highest (47.6%) and the lowest (3.8%) rates of burns were observed among those aged below 16 and above 65, respectively. The majority of the participants were residents of cities (55.4%), married (34.6%), illiterate (56.6%), and housewives (14.8%). Most burns were caused by accidents (98.4%) at home (90.6%). Most patients had suffered first- and second-degree burns (68.4%), with no inhalation damages (99.5%). Hot liquids were the main culprit in most of the burns (58.7%) and the upper extremities were the most frequently affected areas (34.8%). There was .99 rise in mortality for every percent increase in TBSA, and there seemed to be a significant relationship between the age level and the eventual outcome- the higher the age, the more likely for the incident to end in death.LA50 was also determined 43.73 percent for five years. Finally, the study findings showed that female gender, TBSA and age are associated with death from burn. Conclusion: Given the high LA50 index at this center, it is of high priority in our country to enhance the public knowledge and the quality of the care provided for the burn patients. Patients at risk including women, children, elderly and extensive burns should be considered.
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Affiliation(s)
- Ahmad Mirza Aghazadeh
- Department of Basic Sciences, Paramedical Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Mojgan Lotfi
- Department of Medical-Surgical, Nursing and Midwifery Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Akram Ghahramanian
- Department of Medical-Surgical, Nursing and Midwifery Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Farideh Ahadi
- Department of Medical-Surgical, Nursing and Midwifery Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
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Knowlin L, Strassle PD, Williams FN, Thompson R, Jones S, Weber DJ, van Duin D, Cairns BA, Charles A. Burn injury outcomes in patients with pre-existing diabetic mellitus: Risk of hospital-acquired infections and inpatient mortality. Burns 2017; 44:272-279. [PMID: 29029861 DOI: 10.1016/j.burns.2017.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is a major cause of illness and death in the United States, and diabetic patients are at increased risk for burn injury. We therefore sought to examine the impact of pre-existing DM on the risk of inpatient mortality and hospital acquired infections (HAI) among burn patients. METHODS Adult patients (≥18 years old) admitted from 2004 to 2013 were analyzed. Weighted Kaplan-Meier survival curves - adjusting for patient demographics, burn mechanism, presence of inhalation injury, total body surface area, additional comorbidities, and differential lengths of stay - were used to estimate the 30-day and 60-day risk of mortality and HAIs. RESULTS A total of 5539 adult patients were admitted and included in this study during the study period. 655 (11.8%) had a pre-existing DM. The crude incidence of HAIs and in-hospital mortality for the whole burn cohort was 8.5% (n=378) and 4.4% (n=243), respectively. Diabetic patients were more likely to be older, female, have additional comorbidities, inhalational injury, and contact burns. After adjusting for patient and burn characteristics, the 60-day risk of HAI among patients with DM was significantly higher, compared to non-diabetic patients (RR 2.07, 95% CI 1.28, 6.79). However, no significant difference was seen in the 60-day risk of mortality (RR 1.34, 95% CI 0.44, 3.10). CONCLUSIONS Pre-existing DM significantly increases the risk of developing an HAI in patients following burn injury, but does not significantly impact the risk of inpatient mortality. Further understanding of the immune modulatory mechanism of burn injury and DM is imperative to better attenuate the acquisition of HAIs.
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Affiliation(s)
- Laquanda Knowlin
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; North Carolina Jaycee Burn Center, Chapel Hill, NC, United States
| | - Paula D Strassle
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Felicia N Williams
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; North Carolina Jaycee Burn Center, Chapel Hill, NC, United States
| | - Richard Thompson
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; North Carolina Jaycee Burn Center, Chapel Hill, NC, United States
| | - Samuel Jones
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; North Carolina Jaycee Burn Center, Chapel Hill, NC, United States
| | - David J Weber
- Division of Adult Infectious Diseases, University of North Carolina, Chapel Hill, NC, United States
| | - David van Duin
- Division of Adult Infectious Diseases, University of North Carolina, Chapel Hill, NC, United States
| | - Bruce A Cairns
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; North Carolina Jaycee Burn Center, Chapel Hill, NC, United States
| | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; North Carolina Jaycee Burn Center, Chapel Hill, NC, United States.
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Tripathee S, Basnet SJ. Epidemiology of burn injuries in Nepal: a systemic review. BURNS & TRAUMA 2017; 5:10. [PMID: 28413803 PMCID: PMC5389177 DOI: 10.1186/s41038-017-0075-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/08/2017] [Indexed: 11/30/2022]
Abstract
Burn is a global public health problem associated with significant morbidity and mortality, mostly in low- and middle-income countries. Southeast-Asian countries share a big burden of burn injuries, and Nepal is not an exception. We performed a systemic review to examine the epidemiological characteristics of burn injures in Nepal. Relevant epidemiological studies were identified through systemic search in PubMed, EMBASE, and Google Scholar. Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Eight studies were included in our systemic review. Most of the burn victims belong to the working age group between 15–60 years old. Flame burns were found to be the most common cause of burn injury followed by scald burns, whereas scald burns were the most common cause of burn injury among the pediatric population. Most patients sustained less severe burn injuries, with home being the most common place of burn injury. The average hospital stay among the burn victims ranged from 13 to 60 days. Mortality among the burn victims ranged from 4.5 to 23.5%, with highest mortality among the flame burn patients. Developed nations have significantly reduced the burn incidence through effective intervention program. Although, burn injuries are the leading cause of morbidity and mortality in Nepal, effective intervention programs are lacking due to the limited epidemiological data related to burn injuries. Further large scale research is imperative to investigate the problem and assess the effectiveness of an intervention program.
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Hashemi SS, Sharhani A, Lotfi B, Ahmadi-Juibari T, Shaahmadi Z, Aghaei A. A Systematic Review on the Epidemiology of Pediatric Burn in Iran. J Burn Care Res 2017; 38:e944-e951. [DOI: 10.1097/bcr.0000000000000524] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Khongwar D, Hajong R, Saikia J, Topno N, Baruah AJ, Komut O. Clinical study of burn patients requiring admission: A single center experience at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences. J Family Med Prim Care 2016; 5:444-448. [PMID: 27843858 PMCID: PMC5084578 DOI: 10.4103/2249-4863.192337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Although burns are a major problem in health care, a lot of the variation in risk factors exists from region to region which if uncovered correctly could help take effective prevention measures. Aims and Objectives: To assess the 3-year (January 2012 to January 2015) epidemiology of burn injuries admitted to our hospital (primary objective) and to find areas of improvement in burn care (secondary objective). Materials and Methods: After obtaining ethical approval data were obtained from the medical record section regarding age, sex, residence, occupation, marital status, socioeconomic status, dates of admission and discharge, circumstances regarding the place, intent, cause, and source of heat. Clinical assessment was done using Wallace's “Rule of Nine” in adult and “Lund and Browder” chart in the pediatric age groups. The interrelationships between clinical and epidemiological variables with burn injury were studied. Results: An increasing trend in the admission rates of burn victims noted in last 3 years males (55.47%) outnumbered females (44.52%). The most common age group affected is older children, adolescents, and young adults (between 11 and 30 years). Flame (38.3%) and scald (25.3%) burns contributed to most of the injuries. Females (52.30%) are the major victim of flame burns. Electrical and chemical burns affected only the males suggesting work-related injuries. Trunk (30.8%) is the most severely affected site in all cases. Depression (6.8%) and power line workers (4.7%) seem to be important risk factors in our study. Inability to complete treatment (26.7%) was a major concern in our study. Conclusions: This study highlights the need for proper burn care that could be provided at the primary health-care level. The majority of burns were accidental in nature in school going children, young adults, and females. Flame and scald burns were the most common cause. Preventive measures directed toward burn safety and first aid measures may improve the outcome in burn injuries.
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Affiliation(s)
- Donkupar Khongwar
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Ranendra Hajong
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Jyoutishman Saikia
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Noor Topno
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Arup J Baruah
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Ojing Komut
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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Siadat AH, Iraji F, Bahrami R, Nilfroushzadeh MA, Asilian A, Shariat S, Nikyar Z, Bokaie S. The comparison between modified kligman formulation versus kligman formulation and intense pulsed light in the treatment of the post-burn hyperpigmentation. Adv Biomed Res 2016; 5:125. [PMID: 27563635 PMCID: PMC4976535 DOI: 10.4103/2277-9175.186997] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/26/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic diseases and medical interventions. Different modalities including topical agents, lasers and intense pulsed light (IPL) are suggested for treatment of the post-burn PIH. In the current study, we evaluated the efficacy of IPL plus modified Kligman cream (MODIFIED KLIGMAN CREAM) versus MODIFIED KLIGMAN CREAM alone in the treatment of the post-burn PIH. MATERIALS AND METHODS This was a randomized, non-blinded clinical trial. A total of 53 patches of post-burn PIP in 14 patients were randomized to receive either two sessions of IPL plus modified Kligman formula or kligman formula for 2 months. The patients were recommended to apply MODIFIED KLIGMAN CREAM cream for 12 h at night. RESULTS According to our results, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). In addition, according to physician evaluation, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). No side effects except a little irritation, erythema and exfoliation due to MODIFIED KLIGMAN CREAM cream were seen in the patients. CONCLUSIONS The results of our study showed the better efficacy and faster response of the IPL plus modified Kligman formula versus modified Kligman formula in the treatment of the post-burn PIH. To better determine the efficacy of IPL in treatment of the post-burn PIP, more extensive studies as randomized, double-blinded clinical trial are recommended.
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Affiliation(s)
- Amir Hossein Siadat
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Iraji
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Bahrami
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ali Asilian
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sheila Shariat
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Nikyar
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Safura Bokaie
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
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Severity of burn and its related factors: A study from the developing country Pakistan. Burns 2016; 42:901-5. [PMID: 26831723 DOI: 10.1016/j.burns.2016.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 11/19/2015] [Accepted: 01/03/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Burns are leading cause of fatal injuries and major cause of morbidity and mortality in developing countries. The major obstacle in controlling severity is factors related to burn. This study determines frequency of burns and the factors related to it in Karachi, Pakistan. METHODS A cross-sectional study was conducted and 384 hospitalized adult patients with burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile, intent of burn, severity of burn, health hazards, physical and psychological characteristics. TBSA burn of >15% was considered as higher severity of burn. RESULTS Higher severity of burns was found in 76.3% patients. Multivariate analysis showed that higher severity of burns were significantly associated with age less than 25 years (OR 2.7, 95% CI 1.5-4.9), never had been to school (OR 3.1, 95% CI 1.7-5.9) and intentional burn (OR 20.6, 95% CI 5.0-84.9). CONCLUSION Majority of patients had higher severity of burn. The intent of injury was intentional, age less than 25 years and no schooling were found significantly associated with higher severity of burns.
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Effect of current pathway on mortality and morbidity in electrical burn patients. Burns 2015; 41:172-6. [DOI: 10.1016/j.burns.2014.06.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/20/2014] [Accepted: 06/07/2014] [Indexed: 11/23/2022]
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Ahmadi M, Alipour J, Mohammadi A, Khorami F. Development a minimum data set of the information management system for burns. Burns 2015; 41:1092-9. [PMID: 25561018 DOI: 10.1016/j.burns.2014.12.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/05/2014] [Accepted: 12/10/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Burns are the most common and destructive injuries in across of the world and especially in developing countries. Nevertheless, a standard tool for collecting the data of burn injury has not been developed yet. The purpose of this study was to develop a minimum data set (MDS) of the information management system for burns in Iran. MATERIALS AND METHODS This descriptive and cross-sectional study was performed in 2014. Data were collected from hospitals affiliated with Hormozgan and Iran University of Medical Sciences and medical documents centers, emergency centers and legal medicine centers located in Bandar Abbas city, in addition to internet access and library. Investigated documents were burn injury records in 2013, and documents that retrieved from the internet, and printed materials. Records were selected randomly based on T20-T29 categories from ICD-10. Data were collected using a checklist. In order to make a consensus about the data elements the decision Delphi technique was applied using a questionnaire. The content validity and reliability of questionnaire were assessed by expert's opinions and test-retest method, respectively. RESULTS An MDS of burns was developed. This MDS divided into two categories: administrative and clinical with six and 17 section and 161 and 311 data elements respectively. CONCLUSIONS This study showed that comprehensive and uniform data elements about burns do not exist in Iran. Therefore a MDS was developed for burns in Iran. Development of an MDS will result in standardization and effective management of the data through providing uniform and comprehensive data elements for burns. Thus, comparability of the extracted information from different analyses and researches will be possible in various levels. In addition, establishment of policies and prevention and control of burns will be possible, which results in the improvement of the quality of care and containment of costs.
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Affiliation(s)
- Maryam Ahmadi
- Professor of Health Information Management Department, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran; Health management and economics research center, Iran University of medical sciences, Tehran, Iran
| | - Jahanpour Alipour
- PhD student of Health Information Management, Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Mohammadi
- PhD student of Health Information Management, Health management and economics research center, Iran University of medical sciences, Tehran, Iran
| | - Farid Khorami
- MSc of Health Information Technology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Al Ibran E, Mirza FH, Memon AA, Farooq MZ, Hassan M. Mortality associated with burn injury - a cross sectional study from Karachi, Pakistan. BMC Res Notes 2013; 6:545. [PMID: 24354896 PMCID: PMC3878253 DOI: 10.1186/1756-0500-6-545] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 12/13/2013] [Indexed: 11/10/2022] Open
Abstract
Background Burn injuries are a major cause of medico legal deaths in Pakistan. The present study was conducted with the aim to assess the mortality rate related to different types of burns injuries. Findings This was an observational prospective cross sectional study conducted in Burns Ward of Civil Hospital, Karachi during a period of two years from January 1st 2010 to December 31st, 2011. Data was collected over a questionnaire containing demographic variables as well as date of burn, date of the death (if patient expired), total body surface area involved, cause and manner of burn. The data was statistically analyzed by SPSS v. 16. A total of 1979 patients were admitted to the department during the study period. Out of them, 715 died, hence a mortality rate of 36.12%. Out of the 715 patients, 380 (53.1%) were males and 335 (46.9%) were females. Mortality was highest in age-group 16–30 years (n = 395, 55.2%). Majority of the deaths were accidental (n = 685, 95.8%). Fire burns was found to be the most common cause of death (n = 639, 89.3%). 35% (n = 252) of the patients who died had more than 60% of total body surface area involved in burns. Conclusion Measures must be taken to inform the general population of the possible causes of these injuries, and to enable the people to be prepared to face any such circumstances.
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Affiliation(s)
| | | | - Akhtar Amin Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
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Epidemiological profile of minor and moderate burn victims at the University Hospital San José, Popayán, Colombia, 2000–2010. Burns 2013; 39:1012-7. [DOI: 10.1016/j.burns.2012.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 11/02/2012] [Accepted: 11/13/2012] [Indexed: 11/23/2022]
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21
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Ahmadijouybari T, Najafi F, Moradinazar M, Karami-matin B, Karami-matin R, Ataie M, Hatami M, Purghorbani S, Amee V. Two-year hospital records of burns from a referral center in Western Iran: March 2010-March 2012. J Inj Violence Res 2013; 6:31-6. [PMID: 23831739 PMCID: PMC3865453 DOI: 10.5249/jivr.v6i1.276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 01/23/2013] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Burns are among the most common injuries affecting a great number of people worldwide annually. In Iran, especially in its western region and in Kermanshah province, burns have a relatively high incidence. The present study was aimed at investigating epidemiological characteristics in Western Iran. METHODS Within a cross-sectional study, the data on all patients attending the Burns Center at Imam Khomeini Hospital (Kermanshah, Iran) during 2010-2011 and 2011-2012 (24 months) were collected. Then, age, gender, cause of burns, total body surface area, and time of the occurrence were extracted from the hospital records. The data were analyzed using the SPSS statistical package (Version 19, for Windows). We used chi-squared test when we compared the categorical responses between two or more groups. For comparing means between two groups we used t-test. In addition, trends were investigated using linear regression. RESULTS Overall 13,248 people were referred to the Burns Center at Imam Khomeini Hospital (Kermanshah, Iran) during the period of study, including 328 cases of self-immolation. The mean age of the patients was 27±19 years and 29±13 years for unintentional burns and self-immolation respectively. Out of the total number of unintentional cases, 6,519 (50.5%) were men, while the corresponding percentage of men among the self-immolation cases was 16.6% (p less than 0.001). Trends in the number of cases were cyclic, with the highest and lowest number of burns cases being in March and May. Overall, hot liquids and flammable materials were the two most important causes of unintentional burns. However, flammable materials were the main cause of burns among self-immolation cases. During hospital admission, 168 (51%) self-immolation victims and 43 (0.33%) unintentional burn victims died. CONCLUSIONS While major preventive measures are not adequately used in developing countries, burns and their burden can be significantly reduced by increasing public awareness and by applying simple preventive measures.
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Affiliation(s)
| | - Farid Najafi
- School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Epidemiology and outcome of burns: Early experience at the country's first national burns Centre. Burns 2013; 39:358-62. [DOI: 10.1016/j.burns.2012.07.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 07/02/2012] [Accepted: 07/12/2012] [Indexed: 11/16/2022]
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Sadeghi-Bazargani H, Mohammadi R. Epidemiology of burns in Iran during the last decade (2000-2010): review of literature and methodological considerations. Burns 2011; 38:319-29. [PMID: 22119445 DOI: 10.1016/j.burns.2011.09.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Revised: 08/07/2011] [Accepted: 09/21/2011] [Indexed: 11/15/2022]
Abstract
The approach to burn prevention, to be effective in a particular area, should be based on sound knowledge of etiological patterns of burns injuries and must take into account the geographical variations and socioeconomic differences in burn epidemiology. Although many articles are published on burns epidemiology in Iran, a holistic view of burn epidemiology in Iran is not well presented in literature. In this study, a wide literature review was made on articles published regarding burns injuries in Iran. Pubmed, Embase, Scopus, and Iranian scientific information (SID) databases were searched for information on epidemiology of burns in Iran during the years 2000-2010. During the investigation we found that few Farsi journals were not indexed in SID during the earlier years of the decade, so to increase the chance of capturing necessary information these were checked by hand. As the second source, available data from the Iranian National Home Injury Registry Database (INHIRD) during two Iranian calendar years in the period 2001-2003 were used to extract necessary information. The results of this review helped in defining the magnitude of the burns problem, exploring the role of gender and age in burns, defining the agents causing burns, burn extent, burn mortality and place of injury occurrence. Some areas with paucity of information as well as methodological pitfalls in published research were identified and discussed.
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Affiliation(s)
- Homayoun Sadeghi-Bazargani
- Injury Epidemiology & Prevention Research Center, Statistics and Epidemiology Department, School of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
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Abstract
CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical analysis software SPSS 10.05. Differences between the two groups were evaluated using Student's t-test and the chi square test. P < 0.05 was considered as significant. RESULTS: The major mechanism of injury for the diabetic patients was scalding and flame burns, as was also the case in the nondiabetic burn patients. The diabetic burn patients were significantly older, with a lower percentage of total burn surface area (TBSA) than the nondiabetic burn population. There was significant difference between the diabetic and nondiabetic patients in terms of frequency of infection. No difference in mortality rate between diabetic and nondiabetic burn patients was observed. The most common organism in diabetic and nondiabetic burn patients was methicillin-resistant staphylococcus. Increasing %TBSA burn and the presence of inhalation injury are significantly associated with increased mortality following burn injury. CONCLUSIONS: Diabetics have a higher propensity for infection. Education for diabetic patients must include caution about potential burn mishaps and the complications that may ensue from burns.
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Affiliation(s)
- Hemmat Maghsoudi
- Department of Surgery, Faculty of Medicine, University of Medical Sciences of Tabriz, Iran
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Sadeghi-Bazargani H, Maghsoudi H, Soudmand-Niri M, Ranjbar F, Mashadi-Abdollahi H. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran. Neuropsychiatr Dis Treat 2011; 7:425-9. [PMID: 21857783 PMCID: PMC3157486 DOI: 10.2147/ndt.s23041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD) and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran. METHODS This prospective study examined adult patients aged 16-65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD. RESULTS Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01). Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned. CONCLUSION PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury.
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Othman N, Kendrick D. Epidemiology of burn injuries in the East Mediterranean Region: a systematic review. BMC Public Health 2010; 10:83. [PMID: 20170527 PMCID: PMC2841676 DOI: 10.1186/1471-2458-10-83] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 02/20/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burn injuries remain one of the leading causes of injury morbidity and mortality in the World Health Organization's East Mediterranean Region. To provide an overview on the epidemiology of burn injuries in this region, a systematic review was undertaken. METHODS Medline, Embase and CINAHL were searched for publications on burns in this region published between 01/01/1997 and 16/4/2007. Data were extracted to a standard spreadsheet and synthesised using a narrative synthesis. No attempt has been made to quantitatively synthesise the data due to the large degree of clinical heterogeneity between study populations. RESULTS Seventy one studies were included in the review, from 12 countries. Burn injuries were found to be one of the leading causes of injury morbidity and mortality. The reported incidence of burns ranged from 112 to 518 per 100,000 per year. Burn victims were more frequently young and approximately one third of the victims were children aged 0-5 years. Hospital mortality ranged from 5 to 37%, but was commonly above 20%. Intentional self-harm burns particularly involving women were common in some countries of the region and were associated with a very high mortality of up to 79%. CONCLUSION Burn injuries remain an important public health issue in the East Mediterranean Region therefore further research is required to investigate the problem and assess the effectiveness of intervention programmes.
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Affiliation(s)
- Nasih Othman
- School of Community Health Sciences, University of Nottingham, Nottingham, UK
| | - Denise Kendrick
- School of Community Health Sciences, University of Nottingham, Nottingham, UK
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Taghavi M, Rasouli MR, Boddouhi N, Zarei MR, Khaji A, Abdollahi M. Epidemiology of outpatient burns in Tehran: an analysis of 4813 cases. Burns 2010; 36:109-13. [PMID: 19818561 DOI: 10.1016/j.burns.2009.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Revised: 02/05/2009] [Accepted: 02/16/2009] [Indexed: 02/08/2023]
Abstract
This study aims to demonstrate the epidemiologic characteristics of outpatient burn injuries in Tehran. This cross-sectional study was performed over a 1-year period in a referral burn centre in Tehran and included all outpatient burns. The required data were recorded by two trained physicians. Of the 4813 studied patients, including 293 infants, 2901 patients (60%) were male (P<0.001). The mean age of the adult patients was 31.3+/-18.3 years, while for infants it was 10.68+/-2.27 months. In all age groups and both genders, scalding was the most common aetiology. Majority of the burns were non-intentional (n=4808) and 70.5% of the injuries occurred at home. Housewives consisted of 24% of the burn patients. With respect to the site of burn, multiple injuries were the most frequent (53%) followed by upper extremities (37%). Most of the burns (96%) were partial thickness. Significant association was present between the aetiology and depth of burn (P<0.001). The mean affected total body surface area (TBSA) was 3.16+/-2.92% and there was significant association between burnt TBSA and the mechanism of injury (P<0.001). In conclusion, it seems that women aged 21-30 years and children younger than 10 years are at greater risk of these injuries and therefore should be the target for preventive strategies.
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Affiliation(s)
- Morteza Taghavi
- Division of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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28
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Papp A. The first 1000 patients treated in Kuopio University Hospital Burn Unit in Finland. Burns 2009; 35:565-71. [DOI: 10.1016/j.burns.2008.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Accepted: 03/10/2008] [Indexed: 11/28/2022]
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29
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Frans F, Keli S, Maduro A. The epidemiology of burns in a medical center in the Caribbean. Burns 2008; 34:1142-8. [DOI: 10.1016/j.burns.2008.05.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 05/12/2008] [Indexed: 11/15/2022]
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30
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Burn injuries during pregnancy in Iran. Int J Gynaecol Obstet 2008; 104:132-4. [DOI: 10.1016/j.ijgo.2008.10.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Revised: 09/21/2008] [Accepted: 10/03/2008] [Indexed: 11/23/2022]
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Abstract
The aim of this study was to explore the mechanisms, complications, morbidity, and mortality associated with electrical injuries. Of 5053 acute burn admissions during a 5-year period, 202 patients (4%) had electrical burn injuries. Their mean age was 27.5 years (range, 3-71 years). Ninety-eight percent were male, and the extent of burn ranged from 1% to 70% TBSA (mean, 10.5 +/- 10.7% TBSA). High-voltage electricity caused 54% of the electrical injuries. Forty-two percent were caused by low-voltage currents and 4% by lightning. A total of 217 surgical procedures were performed on 202 patients Fifteen patients (7.4%) required amputation. All patients who had abnormal electrocardiograms underwent cardiac monitoring. Four had cardiac complications. Mean hospital stay was 13.9 +/- 14.6 days (range, 1-90). Four patients (2%) died. Electrical burn injuries continue to be a serious problem of modern society. Climbing power poles is the most common mechanism for high-voltage injury. Special consideration is required to prevent this type of injury in our region.
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Affiliation(s)
- Hemmat Maghsoudi
- Department of Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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32
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Franco MAH, Gonzáles NCJ, Díaz MEM, Pardo SV, Ospina S. Epidemiological and clinical profile of burn victims. Burns 2006; 32:1044-51. [PMID: 17045748 DOI: 10.1016/j.burns.2006.03.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2006] [Accepted: 03/31/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To describe the clinical and epidemiological profile of the patients in the Burn Unit of the Hospital Universitario San Vicente de Paúl (HUSVP) de Medellín, Colombia, from 1994-2004. METHODS Retrospective descriptive study of all pediatric and adult burn patients. The following were recorded: age, gender, cause, extent and severity of the burns, time in the hospital, operations, complications and death rate. Statistica 6.0 (Stafsoft Inc.) was used. RESULTS Two thousand three hundred and nineteen patients were admitted, 66.8% were males and 62.9% were less than 15 years old. Burns caused by scalding were the most frequent (45.9%) followed by flames (38.5%) The average burn area was 26.9%. Average hospital stay was 26.9 days. In 2004, 40.4% of the patients required surgery; 13.4% of the patients had complications. 7.4% of the patients died, with an average burn area of 62%; burns caused by flames accounted for 63% of the deaths. CONCLUSIONS There is a continuing improvement in hospital stay, survives burn sizes, with figures comparable to others without access to a tissue bank or skin cultivation.
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Abstract
A 9-year prospective study of burns in pregnant women hospitalized at the Sina hospital burn center was conducted to determine the etiology and outcome of pregnant patients. Fifty-one patients (27.45% self-inflicted, 72.55% unintentional) were identified and stratified by age, burn size, presence or absence of inhalation injury, trimester of pregnancy, maternal and fetal mortality, and cause of burn. The mean patient age was 24.2 years. There were 20 maternal deaths and 23 fetal deaths. The majority of which (maternal: 13 and fetal: 13) were among self-inflicted burned pregnant women. The mean burn size was 37.7%, and was significantly larger for nonsurvivors of mother than survivors (68.8% versus 17.6%; p<0.001). In the 51 pregnant women, as the total burned body surface area exceeds 40%, both maternal and fetal mortality reaches 100%. Inhalation injuries were strongly associated with large burns, and were presents in all suicide patients. Kerosene ignition (68.6% of all patients, 100% of self-inflicted patients) was the most common type of burn. Large burn size was the strongest predictor of mortality of mother and fetus followed by the presence of inhalation injury.
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Affiliation(s)
- Hemmat Maghsoudi
- Department of Surgery, Faculty of Medicine, University of Medical Sciences of Tabriz, Iran.
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