Correlation of thermal burn hepatic dysfunction with outcomes

INTRODUCTION

Organ dysfunction and failure increase the morbidity and mortality following major burn. Alteration of liver morphology and function is common following major burns; however, it has not received much attention. In this study we have assessed the impact of thermal burn on liver in relation with mortality.

MATERIAL AND METHODS

55 patients (33 female and 22 males) with TBSA 10-90% and age ranged from 18 to 75 years were included. A bed side serial ultrasonography to assess the volume of liver and liver function tests was done on the 2nd, 9th and 16th day following burn. Baseline demographic and clinical information such as age, gender, burn size and outcome of patient were also collected.

RESULTS -

8 patients died during 2nd week following burn and 47 survived. The mean TBSA for survivors was 37% and for non survivors 80%. Mean liver volume in survivors steadily decreased from 1693.70 cm3 to 1631.31 cm3 over 3 weeks. Mean liver volume in non- survivors steadily increased from 1855.88 cm3 to 2028.50 cm3 over 2 weeks. Liver function test in survivors steadily improved while in non survivors it deteriorated over 2 weeks.

CONCLUSION

There is a correlation between altered liver morphology and function with mortality among severely burnt patients however liver volume did not show statistical significance. A decreasing trend of liver dysfunction parameters and hepatomegaly following burn is associated with good prognosis.

Seventh Cervical Nerve (C7) Transection for Spastic Arm Paralysis After Cerebral Injury

BACKGROUND

Spastic limb paralysis because of cerebral injury can cause long-term disability. Its treatment varies from conservative to operative; however, the optimum treatment is yet to be found.

OBJECTIVE

To test the hypothesis that patients with spastic arm paralysis who receive C7 nerve transection to their paralyzed side might have reduction in spasticity, pain, and improvement in arm function.

METHODS

Four patients with spastic hemiparesis that had ceased to improve after 1 year of rehabilitation, having pain and poor function, were included. All 4 patients underwent C7 nerve transection plus rehabilitation. The outcome was assessed at 1, 3, and 6 months by the Fugl-Meyer upper extremity scale for motor recovery, by the Modified Ashworth Scale score for spasticity, and by the visual analogue score for pain. Functional use of the limb was also assessed by performance of activities such as dressing, tying shoe laces, wringing a towel, and operating a mobile phone.

RESULTS

At the end of 6 months, there was a significant improvement in mean Fugl Meyer score, reduction in Modified Ashworth score, and Visual Analogue scale for pain. At the beginning of the study, none of the patients could perform any day-to-day activities; however, at the end of 6 months, 3/4 of the patients could perform at least 1 activity.

CONCLUSION

C7 neurectomy leads to improved motor function, reduction of spasticity and pain, and improvement in function in patients with spastic arm paralysis because of cerebral injury.

Assessment of prevalence and morphology of plantaris tendon in Indian population by ultrasound

Background

There is wide racial difference in the prevalence of the absence of the plantaris tendon. This study was conducted to determine the prevalence of plantaris tendon in Indian population.

Materials and methods

The presence of the plantaris tendon was determined by ultrasound in 250 healthy volunteers using the standard technique.

Results

Out of 250 individuals 28 (11.2%) had absence of plantaris tendon either unilaterally or bilaterally. Unilateral absence of plantaris tendon was in 3.2%, bilateral absence in 4.8% and overall absence was in 8%. According to the hand and foot dominance the probability of finding right plantaris tendon in right dominant person was 92.3% and in left dominant is 89.7%. Height of the person also correlated significantly with tendon length.

Conclusions

Plantaris tendon was absent in ∼11%, either unilaterally or bilaterally, in this cohort of Indian population.

Psychological well-being among college students: A study from Central India

Background: Psychological well-being (PWB) is affected by age, physical health, personality, life experiences, socioeconomic status, and culture. Age is an important social determinant of health and age-based analysis is necessary to rectify one’s health and health care. Aims and Objectives: This study aims to assess the PWB of college students and to determine the correlation between age and PWB aspects. Materials and Methods: This cross-sectional study was conducted among 210 college students selected by simple random sampling. Ryff’s PWB scale, a 42-item version used for the assessment of PWB, and data were collected by self-administering questionnaires. Statistical Analysis: Internal consistency of the scale was estimated and descriptive statistics, independent samples t-test, and regression analysis were applied. Results: The mean age of the participants was 19.41±1.69 years and 61% were male. Cronbach’s alpha coefficient for internal consistency of Ryff’s PWB scale was 0.814 in this study. The mean of PWB was 205.42±11.04 and ≥20 years scored higher in all the parameters of PWB than <20 years, differences were (t=3.62, P=0.001) significant. Simple linear regression showed that age was a highly significant (P=0.002) predictor of PWB. Conclusion: The study illustrated that students of 20 years or more had better PWB in terms of all dimensions than <20 years-, and also suggested the need for future research, like, to deepen on the conceptual and relations between age and PWB, and to analyze the impact that social changes have toward age group on PWB.

Awareness and utilization of Geriatric Welfare Schemes among urban elderly population of District Gautam Budh Nagar

Background: India has 8.6% elderly population which is going to increase to 12% by 2025. Government of India is providing for the elderly through various social security and welfare schemes as well as legislations. But various studies, mostly in rural areas have shown that the awareness regarding these schemes was poor and incomplete. Utilization of schemes by the beneficiaries was even poorer. Very few studies have assessed the same in urban areas. Aims & Objectives: To assess the awareness and utilization of geriatric welfare schemes and factors associated with them among urban elderly. Material & Methods: The study was conducted in urban field practice area of Dept of Community Medicine, SMS&R, Greater Noida. 402 elderly living in slums of Bhangel, Noida, were interviewed using semi structured questionnaire assuming 50% awareness levels in the urban area with 10% relative precision and 95% confidence interval. Results: Awareness regarding any one scheme was 31.6%, of whom only one fourth subjects knew about more than one scheme. Among those who knew about the schemes, only 40% were utilizing them. The awareness as well as utilization was found to be significantly associated with religion, caste and educational status of the subject. Conclusion: The study shows poor awareness and even poorer utilization of geriatric welfare schemes among elderly people of urban slums. Further studies are required for judging the influencing factors.