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A PILOT STUDY TO COMPARE NUTRITION SCREENING TOOLS: CUSTOMIZED NUTRITION SCREENING TOOL FOR BURN PATIENTS (NSTB) AND MALNUTRITION UNIVERSAL SCREENING TOOL (MUST)
(Jose J., Louri N.A., Al Jabbar N., Dey N., Showaiter M., Al Mannai M., Ebrahim F.K. - Bahrain)
Nutrition screening is an initial procedure in which the risk of malnutrition is identified. It plays a role in and can incur costs to health systems and patients. A customized nutrition screening tool for burn patients (NSTB) was formulated and the nutritional risk score of 22 patients from a burn unit in Bahrain using NSTB and MUST was compared. The samples selected were adult patients aged 18 years or over; pregnant and mentally retarded patients were excluded. Mean age of the total sample was 29.40, and 90.9% were male. Mean BMI was 26.96. The mean and SD for NSTB was 2.18±1.65, and for MUST 2.0±0.0. A difference in the nutritional screening risk score of the same group of patients was observed. In the MUST group, 100% patients were classified as high risk, while in the NSTB group 50% patients were classified as high risk, 36.36% as moderate risk and 13.63% as low risk respectively. The variability of the risk score in the NSTB group helps prioritize the patients based on high, medium, and low risk, whereas MUST categorizes all patients as high risk. A unique screening tool for burns will be more effective in determining risk patients due to tailor-made characteristics. Even though the data sample is small, the difference gives scope for extensive study.
PREVALENCE AND MANAGEMENT OUTCOMES OF BURNS IN A TEACHING HOSPITAL IN EKITI STATE, NIGERIA: A FIVE-YEAR REVIEW
(Akinlabi A.A., Ojo A.A., Akpor O.A. - Nigeria)
Burn injuries are significant sources of morbidity and mortality globally. Despite the advances in the management of burn injuries, a great number of victims still develop complications. This study aimed at determining the prevalence and management outcomes of burn injuries in a Teaching Hospital in Ekiti State, Nigeria. The study was retrospective in nature. A total of 203 hospital records of burn patients seen between January 2015 and December 2019 were collected and analyzed, using descriptive and inferential statistics. Findings from the study revealed that half (51.7%) of the respondents were within ages 0-10 years and more than half (63.1%) were males. The study findings also revealed a relative decline in the prevalence of burn injury as the average prevalence in the years under review. Some of the reported complications were wound infection (4.9%), delayed healing (4.4%), residual wound (4.4%) and death (9.4%). In addition, the study revealed that there was no relationship between gender, age, socioeconomic factors and prevalence and management outcomes of burn in the study setting. The study recommends that efforts should be made by health workers to equip themselves with knowledge of the complex needs of burn victims and also to keep abreast with the advances in critical care.
THE ROLE OF ALCOHOL AND DRUG INTOXICATION IN FIRE-RELATED INCIDENTS IN AFRICA: A SYSTEMATIC REVIEW
(Hlela M.B.K.M., du Toit C., Davies B. - South Africa)
Fire-related burns contribute significantly to the global burden of burn injury and mortality. Alcohol and/or drug intoxication poses a risk to burn and fire-related injury, whether intentional or unintentional, but such evidence is scarce in the African context. This review aimed to fill the knowledge gap on health determinants of fire-related morbidity and mortality regionally by investigating the role of alcohol and drug intoxication in such events. Using key concepts, an extensive search was performed on 25 databases for relevant publications. Eligible articles were critically appraised using the appraisal tool for cross-sectional studies (AXIS tool), adapted to the review's objectives and outcomes. A total of 42 articles were included, of which less than half were solely investigating burn/fire-related events. Others indirectly mentioned burn injuries as part of larger health burdens such as injury, trauma, violence and other diseases. The measurement of alcohol and/or drug intoxication was inconsistent between studies with varying results. Alcohol and drug impairment in burn incidents in Africa requires evidence-based epidemiological research, and this review illustrated the limited scope of this topic in current literature. Routine toxicological results from post-mortem examinations were identified as important data sources and several research recommendations were provided.
SECURING THE ORAL ENDOTRACHEAL TUBE IN PATIENTS WITH FACIAL BURNS: A CRITICAL CARE CLINICIAN TECHNIQUE
(Ross E., Wilson B.J. - New Zealand)
Securing an endotracheal tube (ETT) in a patient with facial burns poses many challenges. There is no standard practice and the existing literature provides solutions to this problem with limited detail outlining the specifics of their techniques. The teeth offer a rigid point of fixation and are an adaptable method to secure the ETT. For their dental insight, oral and maxillofacial surgeons are often tasked with the procedure of fixing the ETT to the dentition. The aim of this technical note is to review the previously published methods of securing an ETT in burns patients and to present a logical technique to secure the ETT to the dentition for critical care clinicians without dental experience.
MELANOCYTE-KERATINOCYTE TRANSPLANTATION IN POST-BURN LEUKODERMA SCARS: PRELIMINARY EXPERIENCE USING A MODIFIED TECHNIQUE
(Louri N.A., Dey N., De Sousa R.F., AlHasan R.N., Abdelhamid M.M. - Bahrain - India)
Post-burn leukoderma, commonly affecting the African and Asian communities, results from deep dermal burns. The associated stigma exacerbates the condition and significantly affects the rehabilitation and reintegration of post-burn survivors into society. Melanocyte-keratinocyte transplantation (MKTP) is a promising single-stage treatment for repigmentation in vitiligo. However, its use in post-burn leukoderma is undetermined. This study aims to evaluate the MKTP treatment in post-burn leukoderma patches. Six patients (five males and one female, mean age = 29±5.51 years) with ten patches of post-burn leukoderma underwent single-stage MKTP without adjuvant pigmentation therapy. The postoperative follow-up period ranged from twelve to twenty-four months for all the patients. The average size of leukoderma treated was 16.25±9 cm2 . Repigmentation was observed in 92.16±11.05% of the total treated area by the end of one year after MKTP application. All six patients were satisfied with the treatment outcome. MKTP without adjuvant therapy is an effective surgical treatment to treat post-burn leukoderma patches. Future studies should cover a larger sample over a longer follow-up period.
COMPLICATIONS D'UN TRAITEMENT DE L'HYPERHYDROSE AXILLAIRE PAR MICRO-ONDES: À PROPOS D'UN CAS
(Bayoux R., Barani C., Curings P., Vantomme M., Gebert L., Voulliaume D.)
L'hyperhydrose axillaire est un motif de consultation fréquent en médecine esthétique, des thérapeutiques à base de toxine botulique sont déjà utilisées depuis des années dans cette indication. Un traitement à base de micro-ondes (MiraDry®) est utilisé depuis 2011 en France. Il est utilisé pour détruire les glandes sudoripares sans causer de dommages aux tissus cutané et sous cutané environnants. Nous présentons le cas d'un patient ayant développé des complications dans les suites d'un traitement de l'hyperhydrose axillaire par micro-ondes: décollement dermique, collections sous cutanées puis épaississement dermique formant des brides rétractiles responsables de douleurs et d'une limitation marquée des amplitudes axillaires. Ces complications évoquent l'évolution spontanée des brûlures axillaires profondes. Nous proposons dans cet article un mode de prise en charge des patients présentant ce type de complications.
QUALITY OF LIFE AFTER SEVERE BURN INJURY: A CASE REPORT
(Eisler W., Held M., Wenger A., van der Merwe U., Daigeler A., Krauß S. - Germany)
The danger of fire and electric current is underestimated by many people. The associated severe burn injuries are mainly treated in special burn centers because they are challenging and tend to have a strong impact on health-related quality of life. This case report describes a 20-year-old female severe burn victim who suffered second- to third-degree burns to approximately 80% of her total body surface. During in-patient care, we focused on inhalation trauma and anti-infective therapy, surgical management, physiotherapeutic and occupational therapy, in-patient rehabilitation measures, compression therapy and accompanying psychological co-treatment. This interdisciplinary treatment focused on restoring the best possible quality of life for burn victims.
HOSPITALISATIONS POUR BRÛLURE EN FRANCE. DONNÉES 2019 EXTRAITES DE LA BASE PMSI NATIONALE
(Le Floch R., Lancien U., Mauduit N., Mahé P.J., Perrot P. - France)
Nous avons pu obtenir, grâce au Service d'Information Médicale (SIM) du CHU, les données de la base PMSI nationale, triées sur les Groupes Homogènes de Malades (GHM) « brûlés » de 2019. Nous avons répertorié 10 913 Résumés d'Unité Médicale (RUM) dont 10 347 en métropole et 566 outre-mer. Rapportés à la population française au 1er janvier 2020, ces nombres définissent des incidences de 16 (population française) ; 15,7 (métropole) et 27,1 (outre-mer)/100 000 habitants. La majorité (62,95%) des RUM sont issues d'un CTB. Ce qui laisse cependant 4 043 brûlés n'ayant jamais été évalués par un brûlologue. Néanmoins 88,54% des greffes pour brûlures peu étendues sont réalisées et 71,86% des RUM de gravité élevée (3 et 4) proviennent de CTB. Cent soixante-dix-neuf décès représentent une mortalité de 1,64%. Pour la première fois, nous avons pu dénombrer les séjours en réanimation, repérés à partir des actes marqueurs. Ils ont concerné 958 séjours (8,96%) et ont été réalisés pour 90,81% en CTB. Un gros quart (28,57%) d'entre eux sont liés à un RUM « brûlure étendue » (>30% SCT), qui regroupent 63,78% des jours avec acte marqueur.
REALITY CONSTRUCTION OF DISASTER DISCOURSES ON TWITTER: ANALYSIS OF CORPUS-ASSISTED DISCOURSE STUDY ON FOREST FIRES IN INDONESIA FROM 2014-2019
(Mirza I.M., Kusumasari B. - Indonesia)
This paper takes the form of a case study of forest fires that occurred in Indonesia from 2014 to 2019 and were reported on the social media of Twitter. The study was a corpus-assisted discourse study (CADS) using data scraping or text mining on Twitter based on the keyword "kebakaran hutan" [forest fire] and discourse analysis. The actor-network theory was used to map the actors involved. This study concludes that five discourses show a consistently large pattern of Twitter users responding to the problem of forest fires in Indonesia. Regarding the actors, the government takes an essential role of leadership and information arbitrage on Twitter. Seeing as it is the state's responsibility to ensure the safety of all people, the government must appear to be the main holder of control in managing disaster information traffic to avoid irresponsible information or hoaxes disseminated by parties or actors. These results indicate that the availability of information obtained from every conversation of Twitter users can be used as a study or input in the formulation of evidence-based policy about forest fires. It should be given more attention as an alternative means of solving the issue of forest fires, which has become an annual problem in Indonesia.
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