Pattern of burn injuries at King Fahad Hospital, Al-Baha: A study of 277 cases

Self-immolation in the Arab world: A systematic review

Self-immolation is the act of setting fire to oneself. Recent spikes in self-immolation events have been noticed in the Arab world, specifically in the aftermath of the Arab Spring in 2011. We aimed to examine the literature assessing the characteristics and patterns of suicide by self-immolation in the Arab world. We registered our systematic review in Prospero. We searched PubMed, Medline, PsycInfo, Embase, and Scopus databases from inception until 9 July 2022, along with other sources, following the PRISMA 2020 guidelines. We collected relevant articles tackling suicide by self-immolation in the Arab world via title and abstract screening followed by full-text screening. We then conducted a narrative synthesis of the results. Out of 326 records from databases and 17 additional records identified through other sources, 31 articles (27 quantitative and 4 qualitative) were included. The studies came from Iraq (n = 16), Tunisia (n = 6), Kingdom of Saudi Arabia (n = 3), Jordan (n = 2), Libya (n = 2), Bahrain (n = 1), and Egypt (n = 1). The quantitative studies had a sample size ranging from 22 to 600 self-inflicted burn victims. Studies showed that self-immolators were mostly married women with low educational level and low socioeconomic status. Self-immolation was more likely to happen at home, usually following marital conflicts. Kerosene was the accelerant used the most. Depression was the most comorbid mental health diagnosis. Studies highlighted that self-immolation was being increasignly used as a form of protest. Self-immolation is not uncommon in the Arab world. Specific interventions directed at the population at risk are warranted.

The Epidemiology of Burn Injuries in Saudi Arabia: A Systematic Review

Burns are potentially catastrophic injuries that disproportionately affect non-Western countries. We summarize results on the epidemiology of burn injuries in Saudi Arabia of all eligible papers through 2019, specifically evaluating the age and gender of patients, the location and mechanism of injury, burn size and severity, and outcomes. Between July 5 and July 10, 2019, a comprehensive literature review was performed on MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. For this search, "Saudi Arabia," coupled with the search terms "burn," "thermal burn," "flame burn," "chemical burn," "electrical burn," and "contact burn" to identify all abstracts potentially relating to the topic of interest. Eleven studies, encompassing 3308 patients, met eligibility criteria. Younger children (variably defined as ≤10-12) accounted for 52% of all burns. Males outnumbered females by an overall ratio of 1.42:1. About 83% of burns occurred at homes. Scald injuries accounted for 62.4% of injuries, followed by flame-induced burns (28.7%), electrical burns (3.3%), and chemical burns (2.8%). Pertaining to burn extent and severity, 80% to 100% of the burns were limited to <40% total body surface area, while roughly 60% were second-degree burns. Most patients remain in the hospital for 1 to 4 weeks. The overall mortality across studies including patients of all ages was 6.9%, while just 0.76% in the two studies restricted to pediatric patients. Scald injuries involving young children comprise the lion's share of burn injuries in Saudi Arabia. Increased public awareness is necessary to reduce the incidence and severity of these potentially catastrophic injuries.

Saudi parents awareness regarding burn, choking, and drowning first aid in children

Background:

Children are the most affected age group by home and traffic accidents. Parents, as the primary caregiver to their children, play an important role in saving their lives during an accident, therefore, more attention should be focused to assess and improve the parents' knowledge and skills of first aid (FA).

Aim:

Determining the parent's awareness level regarding choking, drowning, and burn FA, their readiness to attend an FA course and solutions from their perspective to improve the awareness level regarding FA for children.

Methodology:

Cross-sectional analysis was conducted by using a simple random sampling that includes 300 parents attending a well-baby clinic in Wazarat primary health care center in Riyadh through self-administered questionnaires. Multiple variables were evaluated to assess their effect on the outcome.

Results:

Only 6% of the parents have a high and acceptable awareness level regarding choking, drowning, and burn FA. A lot of myths and incorrect practices are prevalent among parents regarding these injuries' management. Fortunately, two-thirds of the participants (78%) are willing to attend an FA course and 79% of them think that adding FA to school subjects is the solution for awareness improvement.

Conclusions:

Parents' knowledge level regarding FA methods of major home injuries are insufficient, therefore, more attention should be focused to improve the parents' knowledge and skills of FA in order to reduce morbidity, mortality from these injuries.

Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza Strip: A Descriptive Study

BACKGROUND

Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza.

METHODS

This was a cross-sectional retrospective study of medical records of hospitalized patients from July 2013 to June 2014. Descriptive analysis for studied variables was applied and P ≤ 0.05 considered statistically significant.

RESULTS

One humdred eighty nime admissions, 60.8% were males and 63% were under 10 years old. Burn patients in the age range between 19-40 years represented 25.9%. Most common burn injuries were accidental (86.2%), located at home (88.9%), caused by scald (66.1%) and by fire flame (23.8%). On admission, the majority of cases presented with second degree burn (45.5%) or mixed burn (38.6%). The mean TBSA was 11.86 (SD ± 10.78) ranging from 1% to 75% whereas, the mean hospital length of stay was 11.45 (SD ± 12.60) ranging from 1 to 115 days. Total in hospital mortality rate was 2.1% and length of stay was significantly associated with TBSA (P < 0.001).

CONCLUSION

Young children below 10 years seem to be at a higher risk for burn injuries. A significant improvement in burn patients care is observed and practiced and in hospital mortality rate is better compared to neighbouring countries. Preventive programs focusing on safety measures, especially for mothers working in the home, should be implemented urgently to save our children.

Facial burns - our experience

Facial burns are generally considered severe. This is due to the possibility of respiratory complications. First responders check the nostrils for singed hairs. In severe cases there may be soot around the nose and mouth and coughing may produce phlegm that includes ash. Facial and inhalational burns compromise airways. They pose difficulties in pre-hospital resuscitation and are challenge to clinicians managing surviving burn victims in the intensive care setting. Management problems - resuscitation, airway maintenance and clinical treatment of facial injuries are compounded if the victim is child. Inhalational burns reduce survivability, certainly in adult victim. In our retrospective study we found that facial burns dominated in male gender, liquids and scalds are the most common causes of facial burns in children whereas the flame and electricity were the most common causes of facial burns in adults. We came to the conclusion in our study that surgical treatment minimizes complications and duration of recovery.

Burns in Sulaymaniyah province, Iraq: epidemiology and risk factors for death in patients admitted to hospital

This retrospective study was undertaken to describe the epidemiology of burns in the province of Sulaymaniyah in Iraqi Kurdistan and investigate factors associated with mortality. Hospital records of all patients admitted to the Burns and Plastic Surgery Centre of Sulaymaniyah for a burn incident during the calendar year of 2006 were reviewed retrospectively. A total of 947 acute burn patients were admitted over the year (females 53.5%, males 46.5%) of whom 41% were aged 0 to 14 years. Flame injuries were responsible for 59% and scalds for 37% of injuries. The median TBSA burnt was 19%, the median length of hospital stay was 5 days, and in-hospital mortality rate was 28%. Multivariable logistic regression showed that burn size, inhalation injury, older age, and female sex were significant risk factors for death. The adjusted odds ratios were 4.8 (95% confidence interval [CI] 1.3-20.0) for those aged 60 years or older compared with children aged 0 to 5 years; 2.2 (95% CI 1.2-4.1) for females compared with males; 9.8 (95% CI 4.8-20.0) for presence of inhalation injury; and 112.8 (95% CI 57.4-221.4) for ≥ 40% TBSA burnt compared with < 40% TBSA burnt. Burn injuries are an important public health problem in Iraq, and further studies are required to investigate circumstances surrounding burns and risk factors to inform planning of prevention programs.

Epidemiology of burn injuries in the East Mediterranean Region: a systematic review

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.

The use of silicon gel for treating children's burn scars in Saudi Arabia: a case study

This case study is presented to illustrate the effectiveness of silicon gel as an important option in burn scar treatment and to provide treatment guidelines that address cultural, clinical and patient compliance issues in Saudi Arabia. The case study involves an 18-month-old child whose burn scar was treated for a period of 15 months with silicon gel. The Vancouver Burn Scar Scale assessment (Baryza and Baryza, 1995), used to track progress across the duration of treatment, reflected an improvement in the scar as the composite score changed from 9 to 2. Strategies for problem solving and addressing needs unique to the environment of Saudi Arabia were also developed over the treatment period. The findings of this case study indicate that silicon gel may be a superior treatment option under certain circumstances. Further research with a wider sample is indicated, given the high incidence of childhood burn injuries in Saudi Arabia.

A comparison of the outcomes of two clinical audits of burn pressure garment satisfaction and compliance in Saudi Arabia

The treatment of burns is very important in Saudi Arabia given the high incidence of these injuries and the large proportion of children involved. Currently there are insufficient numbers of Saudi nationals to meet these and other health care needs, and consequently, a large investment in expatriate health care workers continues to be made. Expatriate workers have imported the use of the burn pressure garment (BPG), which is widely accepted as an effective intervention within western countries. However, evidence of effectiveness specific to the unique cultural context of Saudi Arabia is lacking. This paper compares the findings of two audits conducted regarding BPG treatments in two similar hospitals in Saudi Arabia. Although both hospitals were alike in structure, location and client population, Hospital A patient compliance rate was only 15.3% compared to Hospital B's 81.3%. Dissatisfaction was reported by 77% of the Hospital A group but by only 35% of the Hospital B patients. Hospital A lacked the clear guidelines for practice and follow-up procedures evidenced at the second facility and poorer outcomes could possibly be attributed to this short-coming. However, cross-cultural issues related to skill transfer, the auditing process and the impact of expatriate health care workers were also identified as warranting further exploration.