Degree Of Burn Research Articles

Epidemiology of Burns in Pediatric and Adolescent Patients of Fars Province between 2017 and 2018.

According to the reports of the World Health Organization approximately 300,000 deaths occur yearly worldwide due to burns or burn-associated injuries. This study aims to review the epidemiology of burns in pediatrics and adolescents in Fars province between 2017 and 2018. This is a cross-sectional study that investigated all people ≤18 years old who suffered from burn injuries in Fars province between 2017 and 2018. We use data from the file of burn patients which was provided by pre-hospital emergency services of Fars province. This data comprises demographic information (age and gender), burn-related information (type, degree, and severity of burns), mode of transfer (outpatient surgery or transfer to hospital) and the outcome of the disease (death before arrival to the hospital or alive). The average age of the subjects of this study was 5.8±8.9. We also categorized the subjects into four age groups, 1-4, 5-8, 9-13 and 15-18 years. The number of boys who suffered from burn injuries is significantly more than the girls (p=0.011). Also, there is a remarkable correlation between burn with age (p<0.001) and burn with disease outcome (p=0.01). The Most common cause of burns in boys was nonchemical hot objects and liquids (28.5%). Likewise, the possibility of mortality in burn patients who faced an electric shock was 22.66%. ([95%CI=2.32-220.63], p<0.001 OR=22.66). This study shows that pediatrics and adolescents ≤ 4 have the most burn injuries, and boys have twice as many burn events as girls. More importantly, the most common cause of burns in both genders was burning with non-chemical hot objects and liquids, in particular, in the age group of 1-4 years, in which event happens at home.

Study of radiation-thermal damage in white rats

Currently, despite the improvement of radiation safety measures, there is a risk of increasing frequency of radiation accidents and various disasters accompanied by explosions, fires and emissions of radionuclides. Emergencies (emergencies) of peacetime and wartime, especially accidents at radiation-hazardous facilities, including nuclear power plants, carry the danger not only of irradiation of people, but also at the same time thermal burns, mechanical injuries, chemical poisoning by harmful gorenje products, as well as other lesions. Experimental modeling of acute radiation and burn disease was carried out both separately and in combination. It was found that external total gamma irradiation of white rats at a dose of 7.5 Gy causes severe radiation sickness with characteristic clinical signs and high mortality of irradiated animals. A heat stroke simulation was performed by applying a metal plate heated to 190°C with an exposure time of 5 and 8 seconds. It turned out that the degree of burn depends on the time of contact with the surface of the body: its application within 5 seconds caused a burn of the III-A degree, an 8-second exposure of the IIIB degree, which was confirmed by the timing of formation, rejection of eshar and complete healing of the thermal lesion. The aggravating effect of ionizing radiation on the course and outcome of combined radiation-thermal pathology is demonstrated.

Role of Apparels in Burns due to Domestic Violence – A tool for assessing Degree of Burns

Background: Human life is subject to certain environmental, cultural and ethnic origin factors. Based upon the above facts loose and tight variety of clothing/apparel are commonly used. Fire and flames are an integral part of human life on the other hand and accidents do occur in natural course of history. In such accidents type of apparel one might be wearing play a great role in degree or severity of burns. Association and assessments need to be established in this regard. Methods: The study has been conducted on 250 cases of dry flame burns in AED of Mayo Hospital Lahore/Medicolegal Clinic of King Edward Medical University Lahore for a period of nine months in 2017-18. The population of 250 cases were selected through convenient non-probability purposive sampling technique. The study descriptive cross-sectional study design was applied to the above population selected for the study. Results: Our study revealed1.6% females were involved more than males in the burn incident during the period of study. A wide majority up to 70% used Shalwar and Kameez of loose wearable category as per culture of the country in comparison to the relatively tight clothing of Trousers and Pantaloons variety. A grossly significant role has been established with a p value of 0.024 that loose variety of apparel are responsible for causing greater degree of damage in burns as compared to that of tight variety of apparel worn at the time of incidence. Conclusion: The study concludes that wearing relatively short apparels or of tight i.e. Trousers and Pantaloons variety can be safe, protective and a healthy habit during cooking, working in fire burning vicinity like that of industry, hotels, restaurants and winter outdoor activities. The loose variety hereafter referred as Shalwarand Kameezvariety of cultural apparels can be dangerous and even life threatening when it involves higher percentages of burns. Keywords: Burns, Apparel, Clothing, Degree of Burns

Enzymatic debridement for circumferential deep burns: the role of surgical escharotomy

IntroductionCircumferential deep burns carry a high risk for a burn induced compartment syndrome. It was recently shown that an enzymatic bromelain-based debridement with Nexobrid® is a safe and efficient procedure to release pressure in deep circumferential extremity burns reducing the need for surgical escharotomy. We therefore herein aimed to analyze the conceptual relation between Nexobrid® and surgical escharotomy. Patients and methodsWe conducted a retrospective study on all patients with circumferential deep partial-thickness or full-thickness burns requiring immediate escharotomy that was either performed by surgical incision or Nexobrid®. Medical records of 792 patients that were treated at the burn center of the University Hospital Zurich between 2016 and 2021 were analyzed. ResultsOverall, 62 patients with circumferential deep partial-thickness or full-thickness burns who received preventive decompression either by Nexobrid® (N = 29) or surgical escharotomy (N = 33), were included. Whilst distribution of age, sex, BMI and type of injury showed no difference between the groups, the ABSI score, TBSA, percentage of third degree burns and mortality were significantly higher in patients who received a surgical escharotomy. ConclusionWhile the use of Nexobrid® to prevent burn induced compartment syndrome has steadily increased, surgical escharotomies were predominantly performed in severely burned patients with a high degree of full-thickness burns. Thus, higher mortality in this patient group needs to be considered with caution and is mainly attributed to the higher TBSA. Although evidence is lacking for the use of Nexobrid® for larger body areas exceeding 15%, escharotomy is also the more reliable and faster approach in such critically burned patients.

Investigation of Anxiety and Depression Predictors in Burn Patients Hospitalized at Velayat Hospital, a Newly Established Burn Center.

Burns are a leading cause of global mortality and disability. Burns have the mental, psychological and physical impact on the sufferers. Burn patients need special care, both physical and mental, and majority of them are suffering from symptom of difficulty, such as depression, anxiety, post-traumatic stress disorder, and isolation. Finding the predictors of post-burn anxiety and depression can accelerate the treatment and recovery process and maintain the mental health of the patients. The present study investigated the depression and anxiety predictors in burn patients admitted to a medical facility in northern Iran. The present study is a descriptive-analytical study with a cross-sectional methodology on all the burn patients (n = 611) admitted to the Velayat Subspecialty Burn and Reconstructive Surgery Center, Rasht, Iran during 2013-2019. The study tools included the demographic and clinical questionnaire and the Symptom Checklist-90-Revised (SCL-90-R) for anxiety and depression. Data were collected using interviews. Data analysis was performed using the SPSS version 19 and the statistical tests of Chi-square and logistic regression test. The present study included 611 patients, with 61% males and 39% females. The mean age of the participants was 38.86 ± 18.39, while most participants were in the age group of 20-40 years. The most common cause of admission was burning by flames (36.7%), and most patients had third-degree burns (67%). Five hundred forty three patients showed mental symptoms, of which 343 (52.6%) had anxiety disorder symptoms, and 309 (47.4%) had symptoms suggestive of depression. The independent predictors of depression were found to be the gender (OR = 0.253), age group (OR = 0.706), and the degree of burn (OR = 0.406), while the independent predictors of anxiety disorder included the gender (OR = 1.669), age group (OR = 1.58), the classified burn area (OR = 0.653), marital status (OR = 0.532), and education level (OR = 0.773). It is important to identify predictors of depression and anxiety after burn. The predictors can serve as indicators that these patients may benefit from mental health evaluations and treatment.

Evaluation of the factors that influence surgical outcome in conjunctival-limbal allograft transplantation.

To evaluate the surgical results and the variables affecting the outcomes in conjunctival-limbal allograft transplantation (CLAL). Patients who underwent CLAL for limbal stem cell deficiency (LSCD) between 2007 and 2019 were included in the study. LSCD staging was performed according to the staging system developed by the 'Limbal Stem Cell Working Group'. Stage 1C and higher stage LSCD patients were included in the study. 'Successful surgical outcome' was defined as improvement in LSCD stage at 1 year postoperatively. A total of 19 eyes of 19 LSCD patients were included. The mean age of the patients was 40.21 ± 14.65 (6-65) years, and the male/female ratio was 12/7. CLAL was performed in 9 (47.3%) patients with Stage 2B, 9 (47.3%) patients with Stage 3 and 1 (5.4%) with Stage 1C. LSCD aetiology; chemical injury (12), vernal keratoconjunctivitis (2), aniridia (1), corneal degeneration (1), and unknown (3). Surgery was successful in 52.6% of cases. Surgical success was associated with lower LSCD stage (p = 0.04). Lower grades of chemical injury at presentation and a longer time interval between injury and CLAL were associated with higher surgical success (p = 0.001; p = 0.001). The mean postoperative follow-up time was 50.77 ± 29.46 (6-98) months. Despite graft rejection and long-term use of immunosuppressants, CLAL is still one of the most preferred techniques in the treatment of bilateral LSCD. Preoperative LSCD stage and degree of chemical burn are important factors affecting the surgical outcome. Also, CLAL surgery should not be rushed and should be performed when inflammation has subsided.

Epidemiological and Clinical Profile of Pediatric Burns in the COVID-19 Era: The Experience of a Reference Center.

Pediatric burns represent a significant public health problem. We analyzed the characteristics of pediatric burns in a reference center, in order to identify better strategies for prevention and care. Burn patients admitted to the pediatric departments of our hospital from January 2020 to June 2022 were retrospectively evaluated. Age, gender, the etiology of injuries, the total burn surface area (TBSA), the degree of burns, the length of hospital stay (LOS), concomitant SARS-CoV-2 infection, and burn surface microbial colonization were analyzed. Forty-seven patients were included in the analysis (M:F = 1:0.67). Most of the cases involved patients between 0 and 4 years of age (83%). Hot liquid burns accounted for 79% of cases, flame burns for 9%, thermal burns for 6%, scald burns for 4% and chemical burns for 2%. Mean TBSA was 14 ± 11%. A second-degree lesion was detected in 79% of patients and third-degree in 21%. Mean LOS was 17 days. No additional infection risks or major sequelae were reported in patients with SARS-CoV-2 infection. Fifteen different species of bacteria plus C. parapsilosis were isolated, while no anaerobic microorganisms were detected. In the light of our experience, we recommend a carefully planned and proactive management strategy, always multidisciplinary, to ensure the best care for the burned child.

Burns in children and relation with some variables in Al Diwaniya city

Afield study aimed to identify the burns in children and relation with some variables such as Age , sex , order of child in the family , education level of motherThe sample of the study involved (50) case of burn from Al-Diwaniya educational hospital for the period 1 / 6 / 2008 – 30 / 11 / 2008 Data were collected by special questionnaire designed for purpose of the study and analyzed by using frequency distribution and relative frequency. The result of the study revealed that 34% of children were Toddlers, male more than female (54%) , (58%) of children were intermediate order in family. 50% of mothers were illiterate 70% of burns were fires, 50% the degree of burn of 20% , 48% of mothers were removed the clothes of burn child and put ointment. The study recommends about follow the toddlers children and health education of mothers about true first aids of burns.

Infections in Pediatric Patients With Burn Injury: 6 Years of Experience.

This study aimed to determine the frequency of bloodstream and wound infections and their possible risk factors in hospitalized children with burn injury. We performed this retrospective descriptive study from 2015 to 2021. The study subjects consisted of all the pediatric patients hospitalized in the burn unit, from whom microorganisms were isolated either from blood or wound culture samples. We detected a total of 142 microorganisms from 97 blood culture samples and 45 wound culture samples. Among the 115 patients, 44 (38.3%) were females and 71 (61.7%) were males, with a median age of 21 months (interquartile range: 14-39 months). Gram-positive bacteria were the most common causative agents of bloodstream infections in patients with burns (54.6%), followed by Gram-negative bacteria (32.9%) and fungi (12.3%). Gram-negative bacteria were the most common causative agent of wound infections (86.7%). Prolonged hospitalization positively correlated with the extent of the burn surface area (P: 0.031), degree of burn (P: 0.001), use of central venous catheter (P: 0.028), and intensive care unit stay (P: 0.044). Independent risk factors for Gram-negative bacteremia and Gram-negative wound infections were the extent of the burn surface area (P: 0.018), degree of burn (P: 0.024) and intensive care unit stay (P: 0.023). The independent risk factor for fungemia was prolonged hospitalization (P: 0.026). To reduce infections, minimizing invasive procedures using a multidisciplinary approach would be beneficial, especially in patients who have a large burn surface area and are expected to have a long hospital stay.

Sociodemographic characteristics and fate of hospitalized burned patients in Al-Hilla city

Background: A burn is defined as a damage to the tissues due to high temperatures or heat, cold, electrical, chemical, friction, or irradiation. In developing countries such as Iraq, burn injuries are widespread, particularly in low-income and rural regions. Burns are considered the fourth most prevalent type of injuries worldwide. Objectives: The aim of this study is to assess the sociodemographic characteristics of hospitalized burned patients, as well as patients’ fate and related risk factors. Materials and Methods: This was a cross-sectional study. The data were collected by interviewing patients who admitted in the burns ward center of Al-Imam Al-Sadiq Teaching Hospital or their companions, for a 3-month period from February 1, 2022 to May 1, 2022. Statistical analysis was done by SPSS version 27. Results: We collected data from 73 burned patients, which showed that most of them were males 53.4%, the mean age ± standard deviation was 18.76 ± 16.81 years, 65.8% living in rural areas, most patients had scald burn 43.9%, with second degree of burns and total body surface area (TBSA) &lt;50%. About the outcome, 38.3% died. We found a significant (P-value &gt;0.05) association between the fate of burned patients and the age, gender, place of burn, degree of burns, TBSA involved, and the presence of inhalational injury. Conclusion: The majority of the burned patients were male children, with scald burns, second-degree burns, and TBSA more than 50%. The mean age was 18.67 ± 16.81 years. The mortality rate was 38.3% and increased with age, female gender, flame burn, TBSA more than 50%, and with inhalation injuries.

A Clinico-Epidemiological Study among Burn Injury Patients in a Tertiary Care Hospital of Eastern India

Background: Every year in India about 7 million people suffer from burn injury, which is a leading cause of not only mortality, but morbidity and disability among the burn patients, leading to emotional trauma and stigma. Objectives: The present study was conducted in a peripheral medical college of West Bengal to describe the epidemiology, clinical presentation, and outcome in burn patients and also to identify contributing factors influencing the outcome in burn patients. Methodology: In this descriptive cross-sectional study, all consecutive burn patients admitted in Dept of surgery in 2018 were included. Data was collected regarding socio demographic profile, mechanism, type and degree of burn, total body surface area involved, time taken to reach health facility and outcome. Results: Out of 514 burn patients, majority were 20 to 60 years age group, females, Muslim in religion, from rural background, completed primary education, homemaker and having monthly income of the family below Rs 5000. Most of the burns were accidental, thermal in nature occurred at household level. About one third had burns involving dangerous areas of body. Average length of stay in hospital was 6.104 days with 20% case fatality and directly proportional with body surface area involved. Conclusion: Safety measures and building awareness can prevent burn injury at household level. Early initiation of treatment, infection control and following standard management protocol can avert mortality in tertiary setting. Rehabilitation and psychosocial care are urgently needed to combat disability. Keywords: Burn, Clinico-epidemiology, Length of stay, Outcome

Managing Burn Scar with a Combination Therapy of Long Pulsed 1064 Nm Nd: YAG (LPND) Laser, Topical Tretinoin and Hydroquinone

Background: Burn scars are associated with significant morbidity ranging from pigmentation, pruritus, pain, contractures and disfigurement to psychosocial impairment. Newer and advanced therapies for the treatment of burn scars have been developed, including lasers, and other topical treatments Case Illustration: An asian woman with history of having hypertrophic scar arising from the edges of previous skin graft for her second degree of burns. We performed contact-mode long pulsed 1064 nm Nd:YAG laser treatment in combination with topical tretinoin and hydroquinone. Ten months after initial combination treatment, the scar showed improvement in term of colour, contour, and consistency. Discussion. Burn scars have tendency to enlarge, hypertrophic and become keloids. Long pulsed 1064 nm Nd:YAG laser helps to reduce hypervascularization that usually found in hypertrophic scars or even keloid. Tretinoin is a derivate of vitamin A which has many different mechanisms in wound healing enhancement. Hydroquinone inhibits melanogenesis and plays role in maintaining pH level in wound healing process. Conclusions: Burn scar responded well to long pulsed 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser treatment. A combination therapy with topical tretinoin and hydroquinone improved the burn scar in term of better color, contour and consistency.

Preliminary Analysis of Burn Degree Using Non-invasive Microwave Spiral Resonator Sensor for Clinical Applications.

The European “Senseburn” project aims to develop a smart, portable, non-invasive microwave early effective diagnostic tool to assess the depth(d) and degree of burn. The objective of the work is to design and develop a convenient non-invasive microwave sensor for the analysis of the burn degree on burnt human skin. The flexible and biocompatible microwave sensor is developed using a magnetically coupled loop probe with a spiral resonator (SR). The sensor is realized with precise knowledge of the lumped element characteristics (resistor (R), an inductor (L), and a capacitor (C) RLC parameters). The estimated electrical equivalent circuit technique relies on a rigorous method enabling a comprehensive characterization of the sensor (loop probe and SR). The microwave resonator sensor with high quality factor (Q) is simulated using a CST studio suite, AWR microwave office, and fabricated on the RO 3003 substrate with a standard thickness of 0.13 mm. The sensor is prepared based on the change in dielectric property variation in the burnt skin. The sensor can detect a range of permittivity variations (εr 3–38). The sensor is showing a good response in changing resonance frequency between 1.5 and 1.71 GHz for (εr 3 to 38). The sensor is encapsulated with PDMS for the biocompatible property. The dimension of the sensor element is length (L) = 39 mm, width (W) = 34 mm, and thickness (T) = 1.4 mm. The software algorithm is prepared to automate the process of burn analysis. The proposed electromagnetic (EM) resonator based sensor provides a non-invasive technique to assess burn degree by monitoring the changes in resonance frequency. Most of the results are based on numerical simulation. We propose the unique circuit set up and the sensor device based on the information generated from the simulation in this article. The clinical validation of the sensor will be in our future work, where we will understand closely the practical functioning of the sensor based on burn degrees. The senseburn system is designed to support doctors to gather vital info of the injuries wirelessly and hence provide efficient treatment for burn victims, thus saving lives.

706 High Versus Low Dose Vitamin C in Burn Care

IntroductionWhile vitamin C is a regular part of burn management, there is no consensus on the most effective dose for a reduction in mortality, fluid resuscitation requirement, and other various clinical benefits. In this study, we aim to evaluate the potential protective effects of a higher dose of intravenous vitamin C in burn patients with greater than 40% total body surface area (TBSA) as compared to the effects on low dose oral vitamin C with lower TBSA burns.MethodsA total of 54 subjects were retrospectively reviewed with burns greater than 20% TBSA from January 2018 to 2021. In our burn unit, patients with smaller burns were given 2,500 mg PO vitamin C and larger TBSA burns were given 15,000 mg IV vitamin C within 72 hours. During this period, we found 40 patients in the low dose group and 14 patients in the higher dose group. Demographics, length of stay, length on a ventilator, fluid requirements, number of procedures, days to the first infection, and mortality were compared using the Chi-square test.ResultsWe found that there was a significant difference in the degree of burn on admission and reassessment between the dosing groups (30% vs. 48%, p = 0.006; 32% vs. 57%, p < 0.001). Overall fluid requirements for the first three days (9 liters vs. 25 liters, p < 0.001), length of stay (13 days vs. 38 days, p = 0.011), length on a ventilator (2 days vs. 13 days, p < 0.001), and total procedures required (1 vs. 5, p = 0.014) were also significantly higher in the group given the IV dose. No significant difference in other outcomes such as days until first infection and mortality rate were found, (p=0.451 and 0.326, respectively).ConclusionsParameters that were statistically significant were consistent with the higher burn TBSA. Despite the group with larger surface area burns to require much higher fluid requirements (25 liters vs. 9 liters in 72 hours), high dose IV vitamin C may have been protective since the outcomes of days until first infection and mortality rate had no significant difference compared to the group with the smaller TBSA burn which should have predictably better outcomes. This clinical study supports other studies that high dose vitamin C may improve outcomes from a reduction in capillary leak to mortality but an adequately powered randomized prospective approach is needed to better define the benefits as well as dosing.

Thermo-physical evaluation of firefighter outer garment in high flux environments

Thermal protective performance tests have been conducted and improved over the years to assess the safety provided by firefighters’ outer thermal garments. Existing evaluation criteria based on empirical relations require an iterative process to estimate skin burn injuries. In this work, the concept of critical time – maximum exposure time before physical failure, is proposed, and utilized to abate this iterative process. The critical time relation to the fabric performance is investigated at an incident heat flux of 41, 84 and 126 kW/m2. Furthermore, parametric studies are performed to characterize the fabric thermo-physical behavior and associated burn degree. The tested specimens consist of an outer shell, a moisture barrier and a thermal liner. The methodology of visual assessment as per ISO 6942 is implemented to approximate the critical time. The critical time relation to increasing incident heat flux displayed a nonlinear performance reduction in the garment. An increase in the second degree burn time was observed for a vertically oriented bench-scale test. The firefighter’s current outer garment failed at a high flux of 126 kW/m2. The concept of relating the critical time to cumulative incident flux will aid the education of firefighters on fluctuating fire environments. This research opens a new domain to analyse the protective garments utilising the critical time.

A Clinical Study of Acute Hand Burns

Background: Hand is one of the most common part of the body involved in burns i.e. 80%. Even small burns in hand mayresult in severe limitations of function. Early initiation of physiotherapy, topical treatment, splintage, passive exercise,early excision and grafting in indicated cases are important treatment principles. Aims &amp; Objectives: To study the clinicalprofile and management outcome of acute hand burns. Materials and Methods: A prospective study was conducted in50 patients of acute hand burns due to thermal burns (scald, flame) at Dr. Vasantrao Pawar Medical College and ResearchCentre and SCL Hospital from January 2011 to December 2020 to study clinical profile and outcome. Results: A total 50patients were included in our study. Majority of the patients were in 21 to 30 years 28%. Incidence of burns in femaleswas found to be 68% and 24% in paediatric group. Second degree superficial burns were in 46% patients and treated withdaily dressing and splintage. Deep dermal burns were in 34% patients and treated with daily dressing and split thicknessskin graft. Collagen application was done in 14% patients with second degree superficial burns for early presenters. Earlyexcision and grafting was done in 6% patients with second degree deep burns with exclusive hand burns who presentedearly. Hypertrophic scar accounts 20% of complications. Conclusion: Outcome of acute hand burns depends upon degreeof burns, time interval and initiation of treatment protocol.

The effect of adding impurities to the high density fuel matrix on the reactivity of the RSG-GAS core

The safety calculation of the RSG-GAS reactor core needs to be done if new high-density fuel is used in the RSG-GAS core. The use of new high-density fuels is very much needed in the RSG-GAS core so that it is necessary to calculate its safety. When using high density fuel there will be a “bottle neck” effect where there is a problem with the fuel and cladding interaction. According to previous researchers this can be overcome by adding metal elements Si, Ni or Ti to fuel. However, with the addition of metal elements Si, Ni or Ti to the fuel, it needs to be analyzed in the RSG-GAS core. The analysis was carried out calculations using a computer program by simulating the Si metal used 1%, 2%, 3% 4% and 5% in the fuel. The calculation of the additional metal element in the high-density fuel effect on the reactivity of the RSG-GAS core was carried out with the WIMSD-5B and Batan-FUEL programs. The WIMSD-5B program is a computer program consisting of several modules including the transport module which is used for the calculation of the generation of macroscopic constants for the 19.75% enriched uranium silicide fuel and the density of 4.8 gU/cc as a function of degree of burn. Core calculations were performed using a neutron diffusion program, namely Batan-FUEL. By calculating the core criticality at operating temperature, the core neutronic parameter values are obtained. The results of the analysis show that the amount of Si 5% in the high density fuel matrix can solve the bottle neck problem and the neutronic parameters are still within the safety limit. This value will determine how much the value of the fuel burn up and control rods are in accordance with the acceptance criteria so that the safety analysis can be carried out on the RSG-GAS core using high density. From the analysis, it was found that the addition of the element Si in the high-density fuel matrix did not find any significant changes in core reactivity and neutronic parameter.

Burn injury during pregnancy

Burn injuries represent an important health problem, resulting in severe comorbidity and even death. Described as one of the most uncommon conditions during pregnancy, burn injuries represent a challenge for obstetricians and health care providers among the world, primarily because of the need to find proper treatment options that could benefit both the future mother and the foetus. Diagnosis and treatment require the combined effort of a multidisciplinary team in order to find the best therapeutic options. Given the physiological changes that occur during pregnancy, the body's ability to respond as a result of the stress caused by a burn injury may be affected, while maintaining the viability of the fetus is also considered. Although there is a number of dressings which can be used in superficial burn injuries, in the case of a pregnant woman there are emerging concerns regarding absorption and toxicity. Nonetheless, treatment is individualized according to the degree of burn and gestational age.

Assessment of urinary interleukin-18 in the early post-burn period to predict acute kidney injury of various degrees of burn patients

Background: Early detection of acute kidney injury (AKI) in burn-injured patients can help modify the treatment to prevent progression of acute renal failure and reduce the need for renal replacement therapy. The aim of the study was to evaluate urinary interleukin-18 in the early post-burn period to predict the AKI for the various degrees of burn patients.Methods: This prospective observational study was conducted in the department of nephrology, Dhaka medical college in collaboration with burn and plastic surgery unit of the same medical college hospital, from July 2017 to June 2018 for a period of one year. The 48 burn patients (Age&gt;18 years) who attended in the burn unit of Dhaka medical college, Dhaka of both sexes were enrolled in this study. Data were analyzed by using SPSS 22.0. A value of p&lt;0.05 was considered statistically significant for all tests.Results: In this study, mean age of the burn patients was 32.41±10.59 years. Male female ratio was 3.36:1. Urinary IL-18 in diagnosis of AKI showed accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 93.8%, 91.7%, 94.4%, 84.6% and 97.1% respectively. AUC for urinary IL-18 at admission was 0.968 (CI, 0.921-1.000) and AUC for serum creatinine at admission was 0.937 (CI, 0.871-1.000). Conclusions: According to Kappa value, AUC and sensitivity and specificity urinary IL-18 is a good biomarker in predicting of early AKI in burn patients.

Prediction and test of stable transmission time of spiral bevel gear during a loss-of-lubrication event in helicopter transmission system

PurposeThis paper aims to establish a prediction model of stable transmission time of spiral bevel gear during a loss-of-lubrication event in helicopter transmission system.Design/methodology/approachTo observe the temperature change of spiral bevel gear during working condition, a test rig of spiral bevel gear was developed according to the requirements of experiments and carried out verification experiments.FindingsThe prediction is verified by the test of detecting the temperature of oil pool. The main damage form of helicopter spiral bevel gears under starved lubrication is tooth surface burn. The stable running time under oil-free lubrication is mainly determined by the degree of tooth surface burn control.Originality/valueThe experimental data of the spiral bevel gear oil-free lubrication process are basically consistent with the simulation prediction results. The results lay a foundation for the working life design of spiral bevel gear in helicopter transmission system under starved lubrication.