جستجوی مقالات مرتبط با کلیدواژه « burns » در نشریات گروه « پزشکی »

Fungal burn wound infections (FBWIs) are one of the most disastrous complications in burn patients. The present study investigated the incidence and the species distribution of fungal agents isolated from burn lesions and reviewed the feautures, underlying conditions, and outcomes of patients.

The wounds were swabbed and cultured on Sabouraud Dextrose Agar with chloramphenicol medi- um. Fungal identification was performed using internal transcribed spacer (ITS) and beta-tubulin sequencing.

A total of 380 swab specimens were obtained. Of these, 101 patients (26.75 %) were positive in culture. Among the 101 positive cases, most isolates were from males (n= 68, 67.33%) and most of them were over 30 years old. Flame (n=38,37.63%) was the predominant cause of burns, and previous history of ICU admission (n=35, 34.66%), presence of central venous catheter (n=25, 24.75%), and diabetes mellitus (n=17, 16.83%) were the main underlying conditions. Candida para- psilosis complex (n=36, 35.64%), and Pichia kudriavzevii (C. krusei) (n=8, 7.92%) represent the most commonly isolated species Also, 2 out of 101 patients (2%) died.

In the present study, non-albicans Candida species were much higher frequent than C. albicans with most cases associated with Candida parapsilosis complex.

The main cause of mortality in burn patients is infection from burns. Drug-resistant bacteria are the main causes of wound infection, so alternative antibiotic therapies hold significant importance. The objective of this study was to examine the impact of a collagen hydrogel that contains a nanoemulsion of Lavandula essential oil on the heal- ing process of infected burn wounds.

In this experimental study, 20 rats were randomly divided after applying burns with a 10 mm diameter hot plate and infecting the wounds with multidrug-resistant Pseudomonas aeruginosa into four groups, including a positive control, a negative control, the first experiment (collagen hydrogel), and the second experiment (collagen hydrogel containing Lavandula essential oil nanoemulsion). On the 4th, 11th, and 18th days, tissue samples were taken for pathology studies. The important parameters in burn wound healing with hematoxylin and eosin and Masson's trichrome staining meth- ods were investigated and scored according to Abramov’s method.

Based on the pathology findings, experimental groups 1 and 2 compared to the negative and positive control groups were effective in rat infection wound healing. The hydrogel scaffold in the experimental groups increased fibroblasts and an- giogenesis compared to the control groups. Epithelization was noticed only in the hydrogel group containing nanoemulsion.

The study findings suggest that the use of collagen hydrogel with Lavandula essential oil nanoemulsion has potential as a wound dressing. This is because it has the potential to effectively promote healing and act as an antibacterial agent to prevent infections.

Burn injuries represent a prevalent concern among children, often resulting in irreversible complications. Hence, this study aimed to investigate the epidemiology and severity of burns in children under 12 years of age admitted to Imam Khomeini Hospital in Ilam from 2015 to 2019.

This retrospective descriptive study examined the medical records of 150 children under 12 years old admitted to Imam Khomeini Hospital in Ilam with burn injuries between 2015 and 2019. Data were collected through chart reviews and interviews with the patients' families, and analyzed using SPSS v-19.

The majority of burn cases occurred in children under three years old (61.3%, 92 individuals), with more than half being boys (55.3%, 83 individuals). Second-degree burns accounted for 87.3% (131 individuals) of cases, with approximately 80% (120 individuals) involving burns covering 1-20% of the body surface area. Hot liquids were the leading cause of burns (79.9%, 119 individuals), and 84% (126 individuals) of burns occurred in enclosed spaces. Only 18.7% (122 individuals) of cases required hospitalization, with no fatalities reported.

 Preventive measures targeting young children, particularly those under three years old, and boys, given their active nature, are crucial in reducing burn incidents. Additionally, addressing factors such as the availability of combustible materials, particularly hot liquids, through educational programs can significantly contribute to burn prevention efforts.

 Antibiotic resistance in bacterial infections poses a global health crisis, leading to over 1.27 million annual global deaths in 2019. Pseudomonas aeruginosa is the major cause of healthcare-associated infections, particularly in severe burn cases. The use of lytic phages in a mono- or combination therapy with antibiotics, can be helpful to combat antimicrobial-resistant infections in burn wound patients. This study explores stability in mupirocin and Abukhalsa of three P. aeruginosa-specific characterized and annotated phages (PA45, PA32, PA6) belonging to the Myoviridae group.

 Each phage was mixed with the mupirocin and Abukhalsa and incubated for 2, 4, and 24 hours at 37°C, with quantification using the agar-overlay method. The results were measured with a one-way analysis of variance statistical method (ANOVA) followed by Holm-Sidak's multiple comparisons test.

 The study shows that all three phages were stable above the effective therapeutic titer (ETT) which is considered >107 pfu/mL, with mupirocin more affecting phage activity and retaining efficacy after 24 hours. Notably, Abukhalsa inhibited phage activity even though phages remained active above the ETT after 24 hours.

 This study highlights the suitability of mupirocin and Abukhalsa ointments for the studied phages, sustaining their activity beyond the ETT for 24 hours. PA6 and PA32 (jumbo phage) were more stable than PA45 in both ointments tested. These findings emphasize the potency of further investigations for an effective topical combination treatment option in burn wound infections.

Wound healing in grade II burns is one of the treatment priorities. Advances in new sciences, such as stem cell therapy, biological scaffolds, and growth factors, have renewed hopes in this area. The present study aimed to assess the impact of ADSCs encapsulated in PRP/Chitosan-based gel and PRP/Chitosan cell-free gel on the healing of grade-II burn wounds in rats as compared to the control group. Thirty rats were randomly assigned to one of three groups. Following adipose stem cell extraction, a deep grade II burn was induced in the back of the rats using a standardized catheter. The first group served as a control and received simply routine treatments. The second group received a gel based on PRP/Chitosan and ADSCs, and the third group received a gel free of PRP/Chitosan cells. The results were based on response to treatment, observable granulation tissue formation, or epithelialization at 7, 14, 21, and 28 days after treatment. The findings revealed that the use of a cell-based PRP/ Chitosan scaffold or cell-free PRP/Chitosan scaffold reduced the rate of necrosis and inflammation and increased the rate of epithelialization, granulation, and neovascularization compared to the control group (P < 0.05). Moreover, the use of stem cells in scaffolds resulted in greater wound healing than the cell-free scaffolds group (P < 0.05). Due to their porosity and the improved efficacy of stem cells placed in them, PRP/Chitosan scaffolds could have a positive impact on healing and speed up the wound healing process.

Burns are among the most life-threatening forms of trauma requiring timely and effective treatment.

The present study aimed to assess the inhibitory effect of remifentanil on the stress response of burn patients undergoing escharectomy and skin grafting.

A total of 52 patients undergoing burn scab removal surgery were selected and randomly assigned to two groups: remifentanil group (group R) and fentanyl (group F). Anesthesia induction: Group R was administered an intravenous injection of propofol, rocuronium, and remifentanil, while Group F received an intravenous injection of propofol, rocuronium, and fentanyl. After tracheal intubation, group R was injected intravenously with remifentanil and propofol to maintain anesthesia. Group F was induced with fentanyl. Thereafter, the patient's blood pressure and heart rate (HR) were recorded. Subsequently, their carotid artery blood was withdrawn, and they were tested for epinephrine (E), norepinephrine (NE), and blood glucose. Finally, the patients' eye-opening time and extubation time at the end of anesthesia were recorded.

After anesthesia induction, the mean artery pressure, HR, and E in group R were lower than those in group F. There was no statistically significant difference between the levels of NE in the two groups. Nonetheless, the eye-opening time and extubation time in group R were significantly shorter than those in group F.

Compared to fentanyl, remifentanil can more effectively reduce the stress response of surgery and anesthesia. It can integrate anesthetic drugs with blood pressure control. Furthermore, this method is simple, effective, safe, and reliable.

Burns are a major health challenge in developing countries. Post-discharge problems of patients with burn are complex and require home care and educational interventions. However, few studies are available in this area. This study explored challenges of home care in burn patients from the perspective of patients, family caregivers, and health care providers. This qualitative study was conducted during 2022 and 2023. Participants were purposively recruited from Imam Musakazem Hospital in Isfahan, Iran. Data were collected using semi-structured interviews. The qualitative content analysis approach proposed by Graneheim and Lundman was used for data analysis. The trustworthiness of the data was ensured using the criteria of confirmability, credibility, dependability, and transferability proposed by Lincoln and Guba. The study comprised 24 participants, including seven patients, four family caregivers, two physicians, two managers, and nine nurses. Three main categories were extracted including “the vague structure of home care,” “inefficient home care” and “informal home care.” Each category included 2-3 subcategories. The home care program for burn patients requires reforms, such as changes in the administrative structure of home care, increasing the quality of home care centers, interdisciplinary collaboration between health team members, and boosting patients and their families’ awareness about the goals and application of the home care program.

Intestinal infections with Helicobacter pylori mainly occur during childhood. If contracted, these infections may cause chronic gastritis, frequently leading to peptic ulcer disease in later life. This study aims to detect the prevalence of H. pylori infections in patients with active gastritis.

The study included 150 participants who were consuming daily anti-gastritis drugs to reduce the gas and were considered active gastritis patients and were recruited from Lekhnath 12, now known as Pokhara metropolitan-30, from May 2018 to March 2019. They were screened for H. pylori antibodies for detection of infection by the immunochromatographic rapid detection kit, and the data were analyzed using SPSS 2016.

Serum anti-Helicobacter pylori antibodies were used to detect the presence of Helicobacter pylori in these participants. Among the 150 participants, 54 were males (36%) and 96 were females (64%). The results showed that 47 (31.3%) of the patients were positive for anti-Helicobacter pylori test. The age group 30 to 40 had the highest prevalence of 21 (14.0%). Using public water showed the highest prevalence with a P value of 0.04.

There should be an additional aspect required for the diagnosis and treatment of gastritis, which is the healthcare providers' and patients' awareness of the cause and most efficient treatments for this medical condition. Using only anti-gastritis drugs is not sufficient; treatment against Helicobacter pylori requires the right pathway of treatment by the use of several antibiotics.

Considering the importance of deliriumdisorder in burn patients and its complications, the present systematic review andmeta-analysis aimed to determine the prevalence of deliriumand its related factors in burn patients.

A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, and Web of Science, as well as Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted fromMedical Subject Headings such as "Prevalence", "Delirium", and "Burns" from the earliest to the 17th of July, 2023.

In total, 2,710 burn patients participated in ten original studies. Among the participants, 64.6% were male. In the ten studies, the reported pooled prevalence of delirium among burn patients was 20.5% (95% CI: 10.9% to 35.0%; I2=96.889%; P<0.001). Also, factors such as total body surface area, duration of hospitalization, mortality, days on ventilator, alcoholism, benzodiazepine dose, methadone dose, age, male gender, ICU days, operation days, wound care under anesthesia, and opioid dose had a significant correlation with the prevalence of delirium in burn patients.

Health managers and policymakers can reduce the prevalence of delirium in burn patients by eliminating or reducing factors associated with it.

Although art and aesthetics are important aspects in nursing care, there is scarcity of literature regarding this area, particularly in relation to patient expectations of art nursing care. This study aims to explore the perceptions of patients with burn injuries regarding art nursing care.

The present phenomenological study was conducted on 14 patients with burn injuries based on convenience and purposive sampling. Data were collected through deep open‑ended and semi‑structured interview. Data analysis was performed based on van Manen’s Hermeneutic Phenomenology.

Patients’ experience of art nursing care emerged in the form of three main themes, including “being a healer for patients’ wounds”, “skilled and specialized care”, “praiseworthy care”, and six subthemes.

The patients in the burn unit demonstrated an understanding and appreciation for the qualities of patience, hard work, compassion, and love that the nurses possess. They also noted the meticulous attention paid by the nurses to their needs, which exemplifies the purest human traits and professional characteristics in patient care and can be seen as an art form in nursing.

Serum albumin can function as a potential biomarker to determine the severity of the injury and clinical staging of children with burns. Therefore, in this study, we investigated the association between serum albumin level and complications and mortality rate in children with burns.  

In this descriptive-analytic cross-sectional study, 85 patients younger than 18 years with burns who were admitted to Shahid Motahari hospital between 2021 and 2022 were studied. Demographic information, including patients' age, sex, weight, underlying diseases, medical information, albumin level, and C-reactive protein (CRP), was obtained from patient records. Patients were observed until discharge. The independent t-test, chi-square, Pearson correlation, and logistic regression were used for analysis and to examine the predictive role of albumin.  

Out of 85 patients, 47 and 38 were boys and girls, respectively. The mean age of the participants was 3.69 ± 3.09 years. The mean length of hospital stay was 2.3 days, with a median of 1.5 days. The mean percentage of burns was 23.44 ± 16.50, and burn grade 2 was the most common. A total of 25 patients (29.41%) were admitted to the intensive care unit (ICU), and 13 deaths (15.29%) were observed among the patients. The mean albumin level was significantly lower than in other patients with outcomes of pulmonary infection, sepsis, renal failure, ICU admission, and death (P < 0.001).  

Serum Albumin has a significant predictive value in death, pulmonary infection, sepsis, admission to the ICU, and renal failure. Serum albumin may be a good prognostic marker associated with morbidity and mortality.

The quality of the wound healing at the donor site significantly determines the overall condition of the burn patient, the extent of wound fluid and protein losses, the severity of any systemic in-flammatory reaction, and the intensity of the pain syndrome. It is known that the stromal vas-cular fraction (SVF)  has a beneficial effect on the healing of wound defects. This study is aimed at assessing the safety and effectiveness of the application of the SVF of autologous adipose tis-sue to stimulate wound healing of the donor site in patients with burns.  

This placebo-controlled clinical study included 38 patients with third-degree thermal skin burns. The patients underwent liposuction, enzymatic isolation of the SVF, and intradermal injection of the preparation into the wounds in the donor site, followed by tewametry, cutome-try, thermography and biopsy after 12 days. Quantitative indicators were compared using the Mann-Whitney test for unrelated groups and the Wilcoxon test for related groups. Spearman's rank correlation coefficient (RS) was used to assess the correlation  

Epithelization of the wounds in all patients was seen over an average area of 88 (84;92) %, there being no significant differences between the actual and the control wound sites for this parameter. Transdermal water loss in the test wound sites was 2 times lower than in the control sites (P = 0.001). The wound donor sites regained their temperature distribution faster than the control sites (P = 0.042). Histological preparations of the skin of the wound sites revealed that their epidermal layer was 19% thicker compared to the controls (P = 0.043). It should be noted that five adverse events related to manipulations in the postoperative period were registered.

Transplantation of SVF autologous adipose tissue into the wound area in most clinical cases proceeded without complications. The area of epithelialization of wound areas af-ter the introduction of SVF did not change, although a significant decrease in transdermal water loss was observed in the wound areas with an improvement in their thermoregulation and an increase in the thickness of the epidermis.

Background: 

Burns constitute one of the most important etiologies of infection and mortality worldwide, with the most significant number of cases in low- and middle-income countries. This is a cross-sectional study on deaths due to burns in southern Iran.

Methods: 

In this study, data on all deaths due to burns in southern Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of crude mortality rate, standardized mortality rate, and years of life lost (YLL) rate. In order to measure YLL, the number of deaths and life expectancy for different age and gender groups were used, for which the standard life table was considered.

Results: 

During this study, 2175 deaths due to burns occurred, 50.6% (1106 cases) of which were in men and 38.7% (841 cases) were in the 15-29 age group. The crude and the standardized mortality rate had a decreasing trend during the study years. The total number of YLL was 25260 (0.8 per 1000) in men, 25,785 (0.8 per 1000) in women, and 51,045 (0.8 per 1000) in both genders during the 16 years of the study.

Conclusion: 

Considering the high mortality rate in the 15-29 age group, which consists of the active and productive labor force, necessary actions are needed in order to improve safety equipment and to make the workplace safe.

Multidrug-resistant Pseudomonas aeruginosa is known as a major opportunistic pathogen in burn patients with hospital-acquired infections. The aim of this study was to investigate antibiotic resistance and the capability of (GTG) 5-PCR (polymerase chain reaction) assay for molecular typing of P. aeruginosa strains isolated from clinical samples of hospitalized burn patients in southern Iran.
Materials &

This cross-sectional research was carried out on 70 P. aeruginosa isolates collected from hospitalized burn patients in southern Iran from June 2020 to January 2021. Antimicrobial susceptibility patterns of the isolates were determined using disk diffusion method. Additionally, repetitive extragenic palindromic-PCR (rep-PCR) method was used to examine the genetic similarities among the strains.

Antimicrobial susceptibility patterns revealed that the highest antibiotic resistance was against gentamicin (95.8%), followed by imipenem (94.3%) and piperacillin–tazobactam (92.8%), while colistin was the most effective antimicrobial agent. Rep-PCR typing revealed that 60 P. aeruginosa strains were classified into 49 GTG5 types (G1-G49), which were then grouped into 12 clusters (A-L) and 10 isolates with unique banding patterns according to the 80% cut off point.

The present study data indicated a substantial resistance to the studied antimicrobial agents, especially the last-resort antimicrobial agents. In addition, rep-PCR analysis revealed that most of the evaluated strains had partial genetic diversity; therefore, infection control activities should be carried out to decrease the colonization of MDR P. aeruginosa isolates in the hospital setting.

Burn is one of the prominent causes of death around the world, however drug discovery attempts for burn healing has not been entirely successful. Aloe arborescens (A. arborescens), is effective in the burning wounds healing and growth inhibition of bacterial pathogens. Our objective was to assess the wound healing and antibacterial effects of A. arborescens in vivo.

Thirty healthy Wistar rat animals were enrolled. The treatment process continued for 21 days and sampling was conducted on days 14 and 21 and the tissue slides were sent to the pathology laboratory for testing. The bactericidal activity of A. arborescens extract was evaluated using the disc diffusion method.

A. arborescens demonstrated a significant effect on the healing of burn wounds. Furthermore, the antibacterial effects of the A. arborescens extract against Gram-negative (Escherichia coli, Pseudomonas aeruginosa) was significantly higher than that against Gram-positive (Staphylococcus aureus, Bacillus cereus) bacterial species.

In conclusion, this study indicated that A. arborescens extract had an improving effect on the healing process of third degree burns without toxicity to the tissue.

Areca catechu L. seeds contain flavonoids, tannins, saponins, and alkaloids that have antibacterial properties, can prevent skin infections, and have been used empirically for wound healing. This study aimed to determine the antibacterial activity and effectiveness of A. catechu ointment in wound healing at grade IIA burns in rats.

A. catechu seed extract was formulated into an ointment and then tested for its antibacterial activity using the agar diffusion method. Wound healing testing was conducted by dividing the rats into four groups: negative control, positive control, Formula I (F 1) ointment, and Formula II (F II) ointment. Grade IIA burns were made on the back skin of rats and treatment was performed for 14 days. The wound tissue was taken for histopathological observations.

In this study, F II ointment had better antibacterial activity than F I, as indicated by a wider diameter of inhibition against bacteria Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Streptococcus pyogenes, and Staphylococcus aureus. The scab formed on F II was faster on day 3, the wound diameter was reduced on day 7, and there was a decrease in inflammatory cell infiltration and coagulative necrosis and an increase in neovascularization and collagen formation on the 7th day (P < 0.05) compared to the negative control and F I.

A. catechu seed extract ointment with a concentration of 5.0% (F II) had a better effect on wound healing regarding the antibacterial and anti-inflammatory activity than that with a concentration of 2.5% (F I).