Background: Burns injury continues to be the greatest challenge to the trauma surgeon. A multitude of factors determine the mortality in burns patients. The present study aims at identifying those factors which have a significant impact on mortality in burns patients.
Methods: A total 80 patients presenting with burns injury were studied prospectively. Various factors which included age, sex, aetiology, mode of injury, total body surface area which is burnt (BSA), duration of stay, time interval up to admission, pregnant state, inhalation injury, systemic complications, wound complications, and psychological impact were studied.
Results: The mean age was 24.07 years. 59 were females, 21 were males. 19 (23.75%) cases were suicidal in aetiology whereas the remaining 61(76.25%) were accidental. Flame injury was the most common mode of injury in 65 patients (81.25%). The mean BSA in the study was 53.5% whereas the mean BSA in those patients who expired was 71.4%. Mean duration of stay in hospital was 6.55 days whereas mean time interval between burns injury and admission to hospital was 101.33 minutes. All 12 pregnant women had spontaneous miscarriages with a mortality in 11 patients. Inhalation injury was seen in 49 patients (61%) with mortality of 42 (83.7%) patients. Systemic complications seen in 60 patients mortality and BSA was high in patients who had infection. 31 patients in the study had severe depression with a mortality of 91.32%. 50 out of the 80 patients studied expired.
Conclusions: Increased age, BSA, mode of injury, presence of inhalation injury, systemic complication, pregnant state, wound infection and depression had a significant impact on the mortality of burns patients.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxid...YogeshIJTSRD
The study sought to determine the extent to which the usage of social media in the marketing of agricultural products in South West Nigeria can enhance farmers turnover. It employed the survey research design to collect data with the help of a structured questionnaire to elicit information from respondents selected from six 6 south western states. Research data were analysed using structural equation modelling. The results showed that the use of social media WhatsApp and Facebook in marketing of agricultural products significantly enhances farmers turnover. The managerial implication is that use of Whatsapp and Facebook in the marketing of agricultural products for the enhancement of farmers’ turnover was found to have significant influence on the enhancement in farmers’ turnover from agricultural products. Policy makers in government should provide the enabling environment for the telecommunication companies to enhance their reach by installing their facilities across the length and breadth of the country so that the network coverage will be strong at all times so that the benefits of social media usage will not be constrained. Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45021.pdf Paper URL: https://www.ijtsrd.com/biological-science/biochemistry/45021/comparative-studies-of-diabetes-in-adult-nigerians-lipid-profile-and-antioxidants-vitamins-a-and-c/egejuru-leonard-o
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxid...YogeshIJTSRD
The study sought to determine the extent to which the usage of social media in the marketing of agricultural products in South West Nigeria can enhance farmers turnover. It employed the survey research design to collect data with the help of a structured questionnaire to elicit information from respondents selected from six 6 south western states. Research data were analysed using structural equation modelling. The results showed that the use of social media WhatsApp and Facebook in marketing of agricultural products significantly enhances farmers turnover. The managerial implication is that use of Whatsapp and Facebook in the marketing of agricultural products for the enhancement of farmers’ turnover was found to have significant influence on the enhancement in farmers’ turnover from agricultural products. Policy makers in government should provide the enabling environment for the telecommunication companies to enhance their reach by installing their facilities across the length and breadth of the country so that the network coverage will be strong at all times so that the benefits of social media usage will not be constrained. Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45021.pdf Paper URL: https://www.ijtsrd.com/biological-science/biochemistry/45021/comparative-studies-of-diabetes-in-adult-nigerians-lipid-profile-and-antioxidants-vitamins-a-and-c/egejuru-leonard-o
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
Background: The COVID-19 pandemic and control measures taken by countries around the worldcause stress and anxiety. The outbreak of corona virus not onlyhas a major impact on the physical health of the community, but also has a foremosteffect on thementalhealth of the public.Investigating the coping strategies to deal with this unique crisis is essential. Objective: The aim of this study was to assess the impact of covid-19 on stress and coping responses among general population. Methods: A descriptive cross-sectional study is adapted among 100 general populations. A convenient sampling technique was applied. The demographic data were collected using a structured questionnaire via interview method. The level of stress was measured by the perceived stress scale (PSS) and coping responses was evaluated by the brief cope scale. Result: The study outcomesdisplaysthat 53 (53%) had moderate stress, 28 (28%) had mild stress and 19 (19%) had severe stress during Covid-19. In respect to level of coping strategies among general population, 96% of the participants used planning coping strategy, 93% of them used religion coping strategy followed by 92% used self-distraction coping strategy. Conclusion: In our study, general population presented a moderate level of stress, in addition avoidance coping strategies was mostly used.Aiding the mental health care needs of public during these difficult times (pandemic) should be the top priority soadequate measures must be taken to promote the mental health of general public.
Watch the video of the presentation on Youtube: https://www.youtube.com/watch?v=WRegqg5yvRs
El Dr Welte té nombroses publicacions en àrees diverses relacionades amb el malalt crític. Particularment interessants són els seus estudis en relació al trasplantament pulmonar, així com els seus estudis sobre pneumònia i sèpsia. Així mateix, participa activament en la xarxa alemanya Capnetz, emprada per a l'elaboració d'estudis multicèntrics relacionats amb la pneumònia adquirida a la comunitat.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
The similarities and differences of the recommendations of azithromycin ther...WAidid
Slideset by Professor Blasi explains when and why using Azithromycin in pneumonia and underlines the importance of combination therapy, that reduces mortality and complications both in children and adults, particularly in moderate-severe pneumonia.
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
Background: The COVID-19 pandemic and control measures taken by countries around the worldcause stress and anxiety. The outbreak of corona virus not onlyhas a major impact on the physical health of the community, but also has a foremosteffect on thementalhealth of the public.Investigating the coping strategies to deal with this unique crisis is essential. Objective: The aim of this study was to assess the impact of covid-19 on stress and coping responses among general population. Methods: A descriptive cross-sectional study is adapted among 100 general populations. A convenient sampling technique was applied. The demographic data were collected using a structured questionnaire via interview method. The level of stress was measured by the perceived stress scale (PSS) and coping responses was evaluated by the brief cope scale. Result: The study outcomesdisplaysthat 53 (53%) had moderate stress, 28 (28%) had mild stress and 19 (19%) had severe stress during Covid-19. In respect to level of coping strategies among general population, 96% of the participants used planning coping strategy, 93% of them used religion coping strategy followed by 92% used self-distraction coping strategy. Conclusion: In our study, general population presented a moderate level of stress, in addition avoidance coping strategies was mostly used.Aiding the mental health care needs of public during these difficult times (pandemic) should be the top priority soadequate measures must be taken to promote the mental health of general public.
Watch the video of the presentation on Youtube: https://www.youtube.com/watch?v=WRegqg5yvRs
El Dr Welte té nombroses publicacions en àrees diverses relacionades amb el malalt crític. Particularment interessants són els seus estudis en relació al trasplantament pulmonar, així com els seus estudis sobre pneumònia i sèpsia. Així mateix, participa activament en la xarxa alemanya Capnetz, emprada per a l'elaboració d'estudis multicèntrics relacionats amb la pneumònia adquirida a la comunitat.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
The similarities and differences of the recommendations of azithromycin ther...WAidid
Slideset by Professor Blasi explains when and why using Azithromycin in pneumonia and underlines the importance of combination therapy, that reduces mortality and complications both in children and adults, particularly in moderate-severe pneumonia.
Presented by Jane Dematte, MD at the Scleroderma Patient Education Conference hosted by the Scleroderma Foundation on Saturday, October 12, 2019 in Chicago, IL
A study on clinical presentation and various risk factors associated with pht...IjcmsdrJournal
Background: Tuberculosis is one of the most ancient infectious diseases caused by Mycobacterium tuberculosis. The population most affected is the young and economically productive one. The social factors include poor quality of life, poor housing, overcrowding, population explosion, under nutrition, lack of education, and last but not the least lack of awareness of cause of illness.
Aims and Objectives:
1. To study the clinical presentation of tuberculosis in patients.
2. To study various risk factors of tuberculosis.
Material and Methods: This study was conducted at selected designated microscopic centre (DMCs) Kanpur Nagar district has a population of 45.73lakh ( Census 2011).All the patients who were registered in the selected DMCs in the last one month of the year 2016 ( between April and May) were taken into consideration for the present study. Data was collected on predesigned and pretested questionnaire using direct personal interview method of patients at DMCs on the DOTS days of the week i.e Monday, Wednesday and Friday. Informed consent of the study subjects was taken before interview. A total of 105 registered patients were interviewed personally and also the treatment card of patients was obtained from their respective DMCs.
Results: Out of 105 cases of tuberculosis which reported at DMCs maximum no. of patients belongs to age group between 21-40 yrs of age group (58%). Majority of cases were married (65.7%) cases. (62%) cases were Hindu by religion and (58%) belongs to other backward caste. In the study we found majority of patient was illiterate (34.3%). Most common clinical presentation was cough, fever and cough with expectoration, anorexia was reported in (61.9 %) of cases (77%) were cigarette/bidi smokers, 60% were tobacco chewer. Diabetes was reported in (12.4%) cases and (3.8%) cases were HIV positive.
CT coronary angiography in ED chest pain patientskellyam18
CT coronary angiography is the new kid on the block for assessing emergency department patients with chest pain. How accurate is it? What are the down sides? How useful is it? Which patients is it suitable for? This presentation attempts to answer these questions in light of current evidence.
Edward Cachay, MD, MAS
Professor of Medicine
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
This is part 2 of a two part session deliver for a Common Awards (Theology, Ministry and Mission, University of Durham) course on health and the Church. The first part focuses on a theological perspective and the second part focuses on public health perspectives
Similar to Factors affecting mortality in burns: a single center study (20)
Meckel’s diverticulum in a hernia sac is designated as a Littre’s hernia. It is an uncommon type of hernia. The diagnosis
is invariably made at the time of surgery. Resection anastomosis of the adjacent segment of the small bowel with the diverticulum is
a contentious issue. A case of Littre’s hernia is reported. A case of Littre’s hernia in a 17-year-old boy is reported to highlight the
diagnostic and therapeutic issues confronting the attending surgeon. A short segment resection anastomosis of the small bowel along
with the Meckel’s diverticulum was done. A herniorrhaphy was done with no complications. The diagnostic challenges, the dilemma
of selecting the best option for removing Meckel’s diverticulum, and the choice of hernia repair are discussed. Littre’s hernia is
invariably diagnosed intraoperatively. A short segment resection anastomosis of the adjacent small bowel and Meckel’s diverticulum
prevents complications arising due to the diverticulum. A herniorrhaphy for a young patient and the use of an absorbable mesh for
other age groups is advisable.
Hyperbaric oxygen therapy a boon for complex post traumatic woundsKETAN VAGHOLKAR
Post-traumatic wounds especially after run over accidents are difficult to manage. The vascularity and regenerative potential of the tissues is severely compromised. Surgical intervention is of limited value. A conservative approach with concomitant hyperbaric oxygen therapy (HBOT) serves as a great salvage in such cases. A case of post-traumatic forefoot gangrene in a 27-year-old laborer is presented to highlight and create an awareness of the potential benefit of HBOT in salvage of distal parts of the lower extremity where the blood supply is severely compromised.
Deep vein thrombosis (DVT) usually affects the deep vein of the legs, though it may also occur in the veins of the arms, mesenteric and cerebral
veins. Venous thromboembolism can cause sudden pulmonary embolism with instantaneous death. In patients who have developed deep vein
thrombosis there is likelihood of recurrent thrombosis and post thrombotic syndrome. Deep venous thrombosis is preventable in majority of the
cases. Understanding the etiopathogenesis, clinical presentation, evaluation and management is essential for both prevention and management
thereby reducing the morbidity and mortality associated with the disease.
Bilateral Secondary Femorocele in a Case of Ascites Due to Cardiac Cirrhosis ...KETAN VAGHOLKAR
Background: Fluid collection in a femoral hernia sac designated as a femorocele is an
extremely uncommon surgical condition. Till date 9 cases of unilateral femorocele and
one case of bilateral femorocele have been reported in English literature. Objective: Thus
making the case presented the second case of bilateral femorocele in English literature.
Case report: A case of bilateral femorocele in a patient suffering from rheumatic heat disease
who had undergone dual valvular replacement with ascites due to cardiac cirrhosis
is presented to highlight the surgical challenges in management of such a rare case. Discussion:
Pathophysiology, clinical features, investigations and managemeny of femorocele
are discussed. Conclusion: Contrast enhanced CT scan of the abdomen and scrotum is
diagnostic. Open surgery in the form of dissection of sac with high ligation followed by
obliteration of femoral ring is therapeutic. There is no scope of laparoscopy in such a case.
Sliding inguinal hernia continues to be the most challenging hernia to treat. Both diagnosis and treatment pose a
dilemma to the attending surgeon. Understanding the pathological anatomy of the sliding inguinal hernia is essential
for optimal choice of surgical procedure without causing damage to the involved viscera. A case of sliding inguinal
hernia is presented to highlight the diagnostic and technical challenges for repair of sliding hernia. Majority of sliding
hernias are diagnosed at the time of surgery. Sigmoid colon is a commonest content in a left sided sliding hernia.
Bevan’s technique is best suited to deal with the sac followed by Lichtenstein tension-free mesh repair.
Gallbladder carcinoma is fifth most common gastrointestinal malignancy. Main indication for cholecystectomy is gallstone disease. Majority of gallbladder carcinomas are diagnosed during the course of histopathological evaluation of specimens obtained at cholecystectomy. Accomplishing radical cholecystectomy is advisable in these patients. Technically difficult gallbladder dissection during the course of laparoscopic surgery should raise a high suspicion of malignancy. Specimen retrieval bags should be used in all cases to avoid external spillage of bile giving rise to port side metastasis. A good outcome depends on prompt diagnosis and radical surgical resection. It is essential for a general surgeon to be aware of predisposing factors, pathology, patterns of presentation, and surgical options in gallbladder carcinoma.
Fournier’s gangrene of the scrotum after inguinal hernia repair: case reportKETAN VAGHOLKAR
Fournier’s gangrene is a severe necrotizing fasciitis affecting the scrotum, perianal and perineal region. Development of this condition after inguinal hernia repair is extremely rare. A 54-year-old diabetic male patient who had undergone right inguinal hernia repair in a private clinic presented with severe necrotizing infection of the scrotum, predominantly of the right side. He was referred to our surgical unit. Initial resuscitation followed by broad spectrum antibiotic therapy and aggressive debridement of necrotic tissue followed by closure of scrotum was performed with excellent outcome. The purpose of presenting this case is to create awareness about this complication after hernia repair surgery especially in cases with comorbidities like diabetes mellitus.
Hydrocele of the Canal of Nuck (HCN) is a rare condition seen in adult females. Diagnosis of HCN poses a
great challenge to the attending surgeon. There are various variants of embryological abnormality of the
processes vaginalis manifesting in different forms. Understanding the embryological development of the
processes vaginalis and the gubernaculum in female is therefore essential for determining the best surgical
option for treating these rare cases.
Carbuncle is a confluent folliculitis that is infection affecting multiple hair follicles leading to multiple
sinuses discharging pus. It is commonly seen on the back of immuno-compromised patients. Admission to
hospital with aggressive treatment, both systemic and locally is necessary. Optimisation of co-morbidities
such as diabetes, adequate hydration, and antibiotics and are mainstay of initial treatment. Surgical
intervention in the form of debridement and desloughing followed by wound care is the next line of
management. Patient education at the time of discharge is necessary for prevention of recurrence.
Foreign body in the male urethra: case reportKETAN VAGHOLKAR
Cases of self-inserted foreign bodies into the lower urinary tract are uncommon. They are associated with a mental illness called polyembolokoilomania. The site, size and nature of the foreign body determines both the symptomatology and complications. A case of self-inserted needle into the penile urethra by a 15-year-old boy is presented. A plain X-ray of the pelvis revealed the needle. The needle was successfully removed by cystoscopy. Plane X-ray imaging and CT scan are essential to locate the site, size, and nature of the foreign body. Endoscopic approach is preferred in majority cases. Psychiatric counselling in the post-operative period is required to prevent further episodes of reinsertion of such foreign bodies.
Morel-Lavallée Lesion: Uncommon Injury often MissedKETAN VAGHOLKAR
Introduction: Morel-Lavalleé lesion is an uncommon closed degloving injury usually affecting the lower extremity. Although these lesions have
been documented in literature, yet there is no standard treatment algorithm for the same. A case of Morel-Lavallée lesion following blunt injury to
the thigh is therefore presented to highlight the diagnostic and therapeutic challenges in managing such lesions. The aim of presenting the case is
to create awareness of clinical presentation, diagnosis, and management of Morel-Lavallée lesions, especially in the setting of polytrauma
patients.
Case Report: A case of Morel-Lavallée lesion in a 32-year-old male with history of a blunt injury to the right thigh caused by a partial run over
accident is presented. A magnetic resonance imaging (MRI) was done to confirm the diagnosis. A limited open approach for evacuating the fluid
in the lesion was performed followed by irrigation of the cavity with a combination of 3% hypertonic saline and hydrogen peroxide in order to
induce fibrosis to obliterate the dead space. This was followed by continuous negative suction accompanied with a pressure bandage.
Conclusion: A high index of suspicion is necessary especially in cases of severe blunt injuries to the extremities. MRI is essential for early
diagnosis of Morel-Lavallée lesions. A limited open approach is a safe and effective option for treatment. The use of 3% hypertonic saline along
with hydrogen peroxide irrigation of the cavity to induce sclerosis is a novel method for treating the condition.
Background: The development of a pseudocyst after mesh repair of an incisional hernia is a rare complication. Both diagnosis and management pose a great challenge to the attending surgeon. Therefore, the need to report such
an uncommon complication and its management in order to create awareness of this distinct though rare entity. Case
report: A pseudocyst formation following an onlay mesh repair of an incisional hernia is reported. Contrast-enhanced
CT scan was diagnostic. It revealed a well-formed cyst with no communication with the peritoneal cavity. Complete
excision of the cyst was curative. Conclusion: Pseudocyst formation is a rare complication following mesh repair.
Contrast-enhanced CT scan is essential for confirming the diagnosis. Complete surgical resection of the cyst is the
mainstay of surgical treatment.
Novel Technique for Mesh Fixation to the Bone in Recurrent Post Traumatic Lum...KETAN VAGHOLKAR
Background: Traumatic lumbar hernia is due to shearing of bony insertions of the muscle
in the lumbar region. In recurrent cases, there is more attenuation of muscles. This makes
fixation of the mesh extremely difficult. Hence, the need to develop a new technique. Case
report: A 27-year-old male presented with a recurrent post-traumatic right- sided lumbar
hernia. He had a severe two wheeler accident. Following the accident he had undergone
various surgical interventions for a fractured pelvis with a deglowing injury involving the
right gluteal region and upper thigh. He had also developed a post-traumatic lumbar hernia
for which he had undergone open mesh repair. Subsequently he developed recurrence of
the post traumatic right-sided lumbar hernia. After complete investigation he underwent
open mesh repair for the recurrent post traumatic lumbar hernia. The defect was wide and
was devoid of healthy surrounding muscles. The mesh was fixed to the ileal bone with
bone anchors and to the twelfth rib with trans-osseous fiber sutures passed through holes
drilled in the twelfth rib. Flaps were created from the remnant surrounding attenuated muscles.
They were double-breasted to cover the mesh. Postoperative outcome was excellent
with no recurrence for the last six months. Discussion: The various anatomical and technical
considerations of bone fixation of the mesh for hernia repair are discussed. Conclusion:
Bone fixation of the mesh with bone anchors is a viable option especially in cases where
there is severe attenuation of adjacent muscles for mesh fixation.
LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CALCULOUS CHOLECYSTITIS (STUDY OF 75 CA...KETAN VAGHOLKAR
Background: Acute calculous cholecystitis is one of the commonest biliary tract emergencies. The advent of
laparoscopic cholecystectomy has changed the treatment approach from conservative to emergency surgical intervention.
As a result, emergency laparoscopic cholecystectomy is emerging as the standard of care. Therefore, the needs to
evaluate the various factors that determine the procedure’s safety. Aims: The study aims to evaluate the efficacy and
safety of laparoscopic cholecystectomy in acute calculous cholecystitis. Materials and methods: Consecutive patients
who underwent laparoscopic cholecystectomy for acute calculous cholecystitis over a 2-year-old period were studied
prospectively. Results: 75 patients were evaluated. The mean age was 49.48 years. Majority presented with right
hypochondriac pain. 22 patients had hypertension. 26 had diabetes and 6 patients had both hypertension and diabetes.
In 61 patients the mean duration of surgery was less than 60 minutes. 5 patients needed conversion to an open procedure.
10 patients developed complications. Mean hospital stay was 4.34 days. Conclusion: Early emergency laparoscopic
cholecystectomy is a safe and viable option for treating acute calculous cholecystitis
Lipoma is one of the most common soft tissue tumor arising from the mesenchyme. It is slow growing, encapsulated, and usually benign in nature. Tumors over the back, shoulder, and neck region have a high propensity to assume large size thereby getting redefined as a giant lipoma when they exceed 10 cm in width or weigh more than 1000 grams. MRI is the investigation of choice for evaluating giant lipomas. Fine needle aspiration cytology (FNAC) or frozen section may be pertinent in suspected cases of liposarcoma. Complete surgical incision is the treatment of choice. A case of a giant lipoma on the back of a 64-year-old lady is presented with a view to revisit conceptual understanding of the clinical evaluation, investigation, and management of giant lipomas.
LAPAROSCOPIC VERSUS OPEN APPENDICECTOMY IN ADULTS. (STUDY OF 50 CASES)KETAN VAGHOLKAR
Background: Appendicectomy is one of the common procedures performed by a general surgeon. However,
the advent of laparoscopic appendicectomy has reduced the number of open appendicectomies performed. Therefore
there is a need to study the advantages of the laparoscopic approach over the traditional open approach. Aims: The
study aimed to compare laparoscopic appendicectomy with open appendicectomy based on various intraoperative and
postoperative parameters Materials and methods: 50 patients undergoing interval appendicectomy were randomised
into two groups. Group A comprised 25 patients who underwent laparoscopic appendicectomy and group B comprised
25 patients who underwent open appendicectomy. Results: Confirmation of diagnosis and evaluation of intraoperative
findings was easier in group A patients. In addition, early commencement of feeds with early bowel movements, reduced
need for postoperative analgesia due to less pain, lesser complications and shorter duration of hospital stay was observed
in group A patients. Conclusion: Laparoscopic appendicectomy has better outcomes rendering it a preferable procedure
for appendicectomy.
Background: The incidence of abdominal tuberculosis is increasing. Preoperative diagnosis continues to
be the biggest challenge. Diagnosis is established only after histopathological examination. The modes of presentation
and therapeutic options need to be assessed. Objectives: To study the patterns of presentations, the extent of organ
involvement and therapeutic options. Materials and methods: Fifty histopathologically proven cases of abdominal
tuberculosis were studied. In addition, epidemiologic data, clinical patterns of presentation, diagnostic and various
surgical options, including outcomes, were studied. Results: The mortality in the study was 8%. The disease was
commonly seen in 21 to 40 years old and commonly seen in females. HIV positivity, anaemia and hypoproteinaemia
were associated with poor outcomes. Four types of presentations were observed. Diagnostic laparoscopy enabled early
histopathological diagnosis of biopsy specimens. Chemotherapy is the mainstay of treatment Surgery is a significant
adjunct in diagnosing and managing complications. Patients presenting with perforative peritonitis had a poor prognosis
Conclusion: Critical evaluation of chronic abdominal pain is essential. Supportive evidence such as the history of TB or
contact with a patient suffering from TB is highly suggestive of abdominal tuberculosis. Radiological tests are highly
suggestive but not diagnostic. Diagnostic laparoscopy enables tissue diagnosis. Chemotherapy accompanied by surgical
intervention for complications is the mainstay of treatment.
PERFORATIVE PERITONITIS: CONTINUING SURGICAL CHALLENGE.(PROSPECTIVE STUDY OF ...KETAN VAGHOLKAR
Background: Perforative peritonitis poses a significant diagnostic and therapeutic challenge to the attending
surgeon. Delay in diagnosis followed by sub-optimal treatment may lead to many complications, thereby increasing both
morbidity and mortality. This is by virtue of various factors which affect the prognosis. Hence the need arises to identify
these prognostic factors. Aims and Objectives: To study the various etiological factors of perforative peritonitis and to
identify prognostic factors and comorbid conditions which influence the outcome in perforative peritonitis. Materials
and Methods: 50 patients with an established diagnosis of perforative peritonitis due to various aetiologies confirmed
by clinical and radiological investigations were included in the study and studied prospectively. On admission to the
hospital, various haematological and radiological investigations were conducted to confirm the diagnosis. Patients
subsequently underwent surgical intervention. Postoperative recovery and outcomes assessed. Results were tabulated
and statistically analysed. Results: The mean age of patients in the study was 36.5 ±5 years. Patients who presented
in an advanced stage developed complications. The majority of patients were males. The interval between the onset
of symptoms and operative intervention was directly related to postoperative complications. Pneumoperitoneum was
the most common x-ray finding, followed by dilated bowel loops with free fluid in the peritoneal cavity as the most
common ultrasonography finding. Tachycardia and oliguria, which were markers of the severity of the disease process,
were associated with an increased rate of complications. Peptic ulcer perforation was the most common, followed by
perforations caused by infective aetiology. Perforations caused by infective aetiology had a higher rate of complication.
Primary closure of the perforation was the most commonly performed procedure. Significant abdominal contamination
found intraoperatively contributed to a negative outcome, as were comorbid conditions, which also increased the
complication rate significantly. Conclusion: Delayed intervention after the onset of symptoms, tachycardia, oliguria
and comorbidities are associated with a higher complication rate. Radiological investigations help in confirming the
diagnosis. Infective aetiology of the perforation and extensive peritoneal contamination was associated with higher
complication rates. Prompt and aggressive resuscitation on admission, optimum antibiotic administration, and early
meticulous surgical intervention can reduce morbidity and mortality to a bare minimum.
COMPARISON BETWEEN SUTURING AND STAPLE APPROXIMATION OF SKIN IN ABDOMINAL INC...KETAN VAGHOLKAR
Background: Skin approximation is a very important step in a surgical operation. The quality of skin
approximation affects the quality of the scar. Traditional skin suturing is associated with quite a few wound complications.
Staple approximation is an innovative alternative with good results. Aim: The aim of the study is to compare
traditional suturing of skin edges versus staple approximation and to evaluate the impact of these techniques on wound
complications such as pain, surgical site infections, scarring and patient satisfaction. Materials and methods: 150 patients
are included in the study and divided into two groups. Group A (skin suturing) and group B (staple approximation).
The effect of the technique on wound healing is evaluated. Results: Patients belonging to group B (staple approximation)
had less pain, shorter skin closure duration, no wound complications, fine scarring and greater patient satisfaction.
Conclusion: Staple approximation of skin edges during the closure of laparotomy incisions is recommended.
COMPARATIVE STUDY BETWEEN LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY (STUDY OF 50 ...KETAN VAGHOLKAR
Background: Laparoscopic cholecystectomy is a new alternative to the traditional open approach for
treating calculous cholecystitis. It is, therefore, necessary to assess the efficacy of laparoscopic cholecystectomy over the
open cholecystectomy. Objectives: To compare the surgical outcomes of laparoscopic cholecystectomy with those of open
cholecystectomy. Materials and methods: 50 patients diagnosed as symptomatic cholelithiasis proven by radiological
investigations were distributed into two groups of 25 each. Group A patients were subjected to laparoscopic cholecystectomy, and group B patients underwent open cholecystectomy. The surgical outcomes were studied prospectively.
Intraoperative complications and postoperative care parameters were evaluated. Results: Mean age of patients in group
A was 46.68±13.6 years, and in the group, B was 42.64±14.1 years. Majority of patients were in the age group of 41 to 60
years. Patients who had diabetes in group B developed wound infections, whereas diabetic patients in group A did not
develop any infection. Significant bleeding necessitating blood transfusion occurred in one patient belonging to group B.
The duration of postoperative analgesia required was 3.16 days in group A and 5.16 days in group B. The duration of
postoperative antibiotics administered in laparoscopic and open cases was 1.48 and 4.8 days, respectively. One of the
patients in group A developed a postoperative biliary leak, whereas none in group B had any such complication. The
commencement of oral feeds and after that return of bowel movements was earlier in group A than group B. The mean
hospital stay was 4.5 days in group A as compared to 6.3 days in group B. Conclusion: Laparoscopic cholecystectomy
is superior to open cholecystectomy regarding reduced postoperative discomfort and pain, antibiotic and analgesic
requirement, early commencement of oral feeds, and shorter duration of hospitalization
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. Vagholkar K et al. Int Surg J. 2021 Jan;8(1):78-85
International Surgery Journal | January 2021 | Vol 8 | Issue 1 Page 79
Inclusion criteria
All children with 10% or more BSA, adults with 15% or
more BSA, patients with inhalation burns injury and
pregnant women with any percentage of burns.
Exclusion criteria
Patients with known co-morbid conditions like diabetes,
heart disease, etc and patients who left the hospital against
medical advice.
The observational study was approved by the Institutional
Ethics Committee. 80 cases presenting to a single surgical
unit in a tertiary care hospital in Navi Mumbai, India over
a period of 6 months from July 2019 to December 2019
were studied prospectively. Sample size was based on all
patients admitted in the six month period. After admission
to hospital, a detailed proforma was completed which
included all the demographic data as well as details
pertaining to each factor during the course of the hospital
admission. Each patient was managed by uniform
protocol. All patients on admission underwent preliminary
procedures such as central venal access, urinary
catheterization, and nasogastric decompression with a
Ryle’s tube. Intravenous fluid resuscitation was done using
the modified Brooke’s formula. Presence of facial burns,
burning of facial hair, burns injury to the nostrils, singing
of nasal hair was noted as evidence of inhalation burns
injury. Antibiotic combination comprised of ceftriaxone
and amikacin. Analgesia was achieved by administering
pentazocine, phenergan and paracetomol. Injectable
antacids were commenced as well. For patients with upto
20% BSA and superficial burns, open method of wound
management was done which comprised of daily bathing
of patient followed by application of topical Silver
Sulphadiazine. Patients with more than 20% BSA were
managed with closed method of dressing. After
completion of initial fluid resuscitation, psychological
evaluation was done. Wound management was continued
taking care to avoid infection and contractures. The
patients were followed up to discharge. The data collected
was studied and statistically analysed.
RESULTS
Age
The mean age of the patients in the study was 24.07 (±SD
14.39) (Table 1) with a range of 9 months to 80 years. The
mortality increased with advancing age. There was a
significant correlation between age and mortality.
(p<0.001)
Sex
Of the 80 cases studied, 59 were females and 21 were
males. Thereby revealing a female preponderance in
burns. There was no correlation between sex and outcome.
(Table 2)
Table 1: Age-wise distribution of mortality.
Age group
(in years)
No. of
cases
Mortality
Mortality in
% terms
0-10 16 3 18.75
11-20 13 9 69.23
21-30 34 25 73.52
31-40 10 6 60
41-50 4 4 100
51-60 2 2 100
> 60 1 1 100
Total 80 50 62.5
Table 2: Outcome based on sex.
Count
Row Pct
Col Pct
Male Female Total
Expired 11 39 50
Row Pct 22 78 62.5
Col Pct 52.4 66.1
Discharged 10 20 30
Row Pct 33.3 66.7 37.5
Col Pct 47.6 33.9
Column total
%
21
26.3
59
73.8
80
100.0
Chi-Square Value DF Significance
Pearson 1.24401 1 0.26570
Continuity
correction
0.72747 1 0.39371
Likelihood
ratio
1.22325 1 0.26872
Mantel-
Haenszel test
for linear
association
1.22846 1 0.26771
Minimum expected frequency – 7.875
Number of missing observations: 0
The above table shows that sex of the patient does not
influence the outcome.
Etiology
Amongst the 50 cases who expired, 19 (23.75%) were
suicidal and 31 (76.25%) were accidental. The mean BSA
in suicidal cases was 76.26% (± SD 21.6). This was
statistically significant (p< 0.001) (Table 3).
Mode of injury
65 (81.25%) patients had flame injuries and 15(18.75%)
patients had scalds. (Table 4) Therefore, flame injury was
the most common mode of injury. There were no electric
or chemical burns in the patients studied.
Of the 65 patients of flame injury, 19 (29.23%) were
burned by setting ablaze, 39(60%) by stove burst, 2 (3%)
by candle falling on bed, 3(4.6%) by close catching fire
and 2 (2%) by cylinder burst. (Table 4)
3. Vagholkar K et al. Int Surg J. 2021 Jan;8(1):78-85
International Surgery Journal | January 2021 | Vol 8 | Issue 1 Page 80
Table 3: Outcome based on aetiology.
Count
Row Pct
Col Pct
Male Female Total
Expired 11 39 50
Row Pct 22 78 62.5
Col Pct 52.4 66.1
Discharged 10 20 30
Row Pct 33.3 66.7 37.5
Col Pct 47.6 33.9
Column Total
%
21
26.3
59
73.8
80
100.0
Chi-Square Value Df Significance
Pearson 1.24401 1 0.26570
Continuity
Correction
0.72747 1 0.39371
Likelihood
Ratio
1.22325 1 0.26872
Mantel-
Haenszel test
for linear
association
1.22846 1 0.26771
Minimum Expected Frequency – 7.875
Number of Missing Observations: 0
The above table shows that sex of the patient does
not influence the outcome.
Amongst the male patients, 15 (71.25%) sustained flame
injuries while 6 (28.57%) sustained scalds, whereas in
female group, 50 (84.74%) patients sustained flame
injuries while 9 (15.25%) patients sustained scalds. (Table
4).
Table 4: Distribution of patients based on mode of
injury.
Mode of Injury
No. of
patients
%
Flame 65 81.25
Scald 15 18.75
Electric 0 0
Chemical 0 0
Total 80
Mode of flame injury
No. of
patients
%
Setting ablaze 19 29.23
Stove burst 39 60.00
Candle falling on bed 2 3.07
Clothes catching fire 3 4.61
Cylinder burst 2 3.07
Total 65
With respect to the age-wise distribution of mode of injury,
flame injuries were common in age group 21-30 years
whereas scalds were common in age group 0-10 years.
Table 5: BSA.
No. of cases Mean SD SE of Mean
Expired 50 70.4600 21.614 3.057
Discharged 30 25.2333 10.855 1.982
Total 80
Mean difference = 45.2267, Levene’s test for equality of variances: F= 22.555; p=0.000, t-test for equality of
means 95%
Variances t-value df 2-Tail sig SE of diff CI for diff
Equal 10.66 78 0.000 4.241 (36.781, 53.672)
Unequal 12.41 76.13 0.000 3.643 (37.969, 52.484)
BSA
Of the 80 cases studied, the mean BSA was 53.5% ranging
from 10-100%. In the patients who expired (n=50), the
mean BSA was 70.46% which was found to be statistically
significant (p<0.001). (Table 5)
Time interval from injury to hospital admission
The mean time interval between sustaining the injury and
admission to hospital was 102.31 minutes. 98.75% of the
patients presented within 24 hours of the injury. Of the 50
patients who expired, the mean time interval of
presentation was 80 minutes. However, the mean time of
presentation in the discharge group of patients was 139
minutes. However, no significant correlation was found
between time interval and outcome. (Table 6)
Pregnancy
Out of the 59 female patients studied, 12 were pregnant at
the time of admission. All 12 of them had a spontaneous
abortion. Of the 50 patients who expired in the female
group, 11 were pregnant. (Table 7) Pregnancy is a
significant risk factor which significantly increases
mortality.
Inhalation injury
49 (61%) patients had inhalation injury, out of which 41
(83.7%) patients expired. Inhalation injury was found to be
4. Vagholkar K et al. Int Surg J. 2021 Jan;8(1):78-85
International Surgery Journal | January 2021 | Vol 8 | Issue 1 Page 81
a significant factor in predicting the outcome (p<0.001).
(Table 8) Another observation was that the presence of
inhalation injury significantly increased the chances of
developing systemic complications. Of the patients who
had inhalation injury, 9 developed septicaemia, 6
developed respiratory distress syndrome (RDS), 4
developed shock, and 28 had a combination of shock and
RDS, whereas 2 did not develop any systemic
complication. Inhalation burns injury significantly
increases the chances of developing systemic
complications. (Table 9)
Table 6: Time interval from injury to admission versus outcome.
No. of cases Mean SD SE of mean
Expired 50 80.1000 70.837 10.018
Discharged 30 139.3333 262.953 48.008
Total 80
Mean Difference = -59.2333, Levene’s Test for Equality of Variances: F= 5.853; p=0.018, t-test for Equality of Means
95%
Variances T-value df 2-Tail sig SE of diff CI for diff
Equal -1.51 78 0.135 39.232 (-137.357, 18.890)
Unequal -1.21 31.55 0.236 49.043
Table 7: Pregnant state vs outcome.
Count
Row Pct
Col Pct
Pregnant Not Pregnant Total
Expired 11 39
50
62.5
Row Pct 22.0 78.0
Col Pct 91.7 57.4
Discharged 1 29
30
37.5
Row Pct 3.3 96.7
Col Pct 8.3 42.6
Column Total (%) 12 (15.0) 68 (85.0) 80 (100.0)
Chi-Square Value DF Significance
Pearson 5.12418 1 0.02359
Continuity Correction 3.76471 1 0.05235
Likelihood Ratio 6.17397 1 0.01296
Mantel-Haenszel test for linear association 5.06013 1 0.02448
Fisher’s Exact Test:
One-Tail 0.02062
Two-Tail 0.02593
Minimum Expected Frequency – 4.500
Cells with Expected Frequency < 5- 1 of 4 (25.0%)
Number of Missing Observations: 0
Table 8: Inhalation injury vs mortality.
Count
Row Pct
Col Pct
Present Absent Total
Expired 41 9
50
62.5
Row Pct 82.0 18.0
Col Pct 83.7 29.0
Discharged 8 22
30
37.5
Row Pct 26.7 73.3
Col Pct 16.3 71.0
Column Total
%
49
61.3
31
38.8
80
100.0
Continued.
5. Vagholkar K et al. Int Surg J. 2021 Jan;8(1):78-85
International Surgery Journal | January 2021 | Vol 8 | Issue 1 Page 82
Chi-Square Value DF Significance
Pearson 24.18784 1 0.00000
Continuity Correction 21.91266 1 0.00000
Likelihood Ratio 24.88441 1 0.00000
Mantel-Haenszel test for linear association 23.88549 1 0.00000
Minimum Expected Frequency – 11.625
Number of Missing Observations: 0
The above table shows that inhalation injury is a significant factor in predicting the outcome (p<0.001).
Table 9: Inhalation injury vs systemic complications.
Count
Row Pct
Col Pct
Septicemia RDS Shock
Shock
+
RDS
Nil Total
Inhalation Inj Present 9 6 4 28 2
49
61.3
Row Pct 18.4 12.2 8.2 57.1 4.1
Col Pct 60.0 100.0 36.4 100.0 10.0
Inhalation Inj Absent 6 7 18
31
38.8
Row Pct 19.4 22.6 58.1
Col Pct 40.0 63.6 90.0
Column Total
%
15
18.8
6
7.5
11
13.8
28
35.0
20
25.0
80
100.0
Chi-Square Value DF Significance
Pearson 46.52343 4 0.00000
Likelihood Ratio 59.20440 4 0.00000
Mantel-Haenszel test for linear association 3.47304 1 0.06238
Minimum Expected Frequency – 2.325
Cells with Expected Frequency < 5- 3 of 10 (30.0%)
Number of Missing Observations: 0
Table 10: Systemic complications vs mortality
Count
Row Pct
Col Pct
Septicemia RDS Shock
Shock
+
RDS
Nil Total
Expired
Row Pct
Col Pct
15
30.0
100.0
7
14.0
63.6
28
56.0
100.0
50
62.5
Discharged
Row Pct
Col Pct
6
20.0
100.0
4
13.3
35.4
20
66.7
100.0
30
38.8
Column Total
%
15
18.8
6
7.5
11
13.8
28
35.0
20
25.0
80
100.0
Chi-Square Value DF Significance
Pearson 69.13939 4 0.00000
Likelihood Ratio 91.42952 4 0.00000
Mantel-Haenszel test for linear association 12.65045 1 0.00038
Minimum Expected Frequency – 2.250
Cells with Expected Frequency < 5- 3 of 10 (30.0%)
Number of Missing Observations: 0
Systemic complications
A combination of RDS and shock was the most common
complication. Septicemia and the combination of RDS and
shock were associated with a 100% mortality. It was
observed that presence of systemic complications
significantly increased the mortality (p<0.001) (Table 10).
Wound complications
57 (71%) patients developed infections, 3 (4%) developed
infections and contractures, whereas 20 (25%) did not
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develop wound complications. It was also observed that
wound complications were associated with higher
mortality which was statistically significant. Patients with
higher BSA had higher incidence of wound complications.
Psychological impact
31 (38.75%) patients developed depression, of whom, 28
(98.32%) expired. It was observed that depression
significantly increases the mortality (p<0.001).
Duration of stay
The mean duration of stay was 6.55 days (± SD 8.03)
ranging from 1 hour to 57 days.
DISCUSSION
The mortality rate in the study was 62.5% (50/80). Various
factors contributed to the higher mortality.1-3
Age
Mean age of the patients in the present study was 27.04
years. The mortality increased with increasing age,
especially after the age of 40 years. (Table 1) This was
observed in many other studies.1-3
Aged patients are more
prone to developing complications as well as have higher
incidence of increased BSA. The metabolic response to
injury weakens with advancing age, thereby weakening the
immune response as well as increased susceptibility to
infection.1,2
Aged patients also have increased difficulty in
protecting themselves at the time of injury, thereby
predisposing to increased BSA and poor outcomes.3
Sex
In the present study, 59 were females and 29 were males.
The preponderance of females is related to more kitchen
activities near gas or oil run heating appliances. The
mortality was high in females. However, the sex of the
patient did not influence the outcome. (Table 2) This was
in conformity with other studies.4,5
Etiology
Aetiology is an important determinant of BSA.6,7
In the
present study, 23% cases were suicidal whereas 76% were
accidental. The mean BSA in suicidal cases was higher i.e.
76.26 (± SD 21.6). This was found to be higher than the
overall BSA in the present study which was 53.5. This was
found to be statistically significant, hence a suicidal
aetiology is associated with high mortality due to increased
BSA. (Table 3)
Mode of injury
In the present study, flame injuries were seen in 65 patients
whereas scalding was seen in 15 patients. (Table 4) Flame
injuries have a variety of mechanisms. These include
cylinder burst, clothes catching fire, candles or oil lamps
falling on the bed, stove bursts and setting ablaze. (Table
4) Stove injuries were most common in female patients.
Stove is a traditional heating appliance used in India which
runs on kerosene. The safety mechanisms are extremely
poor with lack of manufacturing quality control.
Therefore, bursting of the oil chamber is a common cause
for severe accidental burns in women. The entire front side
which includes the face, chest, and abdomen is severely
burnt in stove-burst injuries. In men, 15 (71.42%) patients
had flame injuries whereas 6 (28.57%) patients had scalds.
Age is also a significant factor which determines the mode
of injury. Scald injuries are one of the most common in the
pediatric age group whereas flame injuries are more
common in the adult group.8,9
BSA
BSA continues to be the most important determinant of
outcome, especially mortality. As BSA increases, the
mortality also increases.1,2,10,11
As a large portion of body
tissues are affected, thereby leading to significant fluid
loss, loss of protective skin cover predisposing to
infection. In the present study, the mean BSA was 70.46 in
the 50 patients who expired whereas the mean BSA was
25.23 in remaining 30 patients who survived. (Table 5)
BSA therefore is a significant risk factor or determinant of
mortality in burns patients.
Time interval
The time interval between injury and admission to hospital
is an important determinant of survival. Longer the
duration, worst is the prognosis.1,2
This is best explained
on the basis of prolonged state of fluid depletion, thereby
leading to continuing hemodynamic instability. Prompt
fluid resuscitation is pivotal for a positive outcome.
Increased insensible loss of fluid leads to hypovolemia,
hypotension and multiorgan dysfunction. The dehydrated
tissues are more susceptible to infection. Therefore,
patients presenting late to hospital have increased
incidence of wound infection. Even in patients with
inhalation burns injury, the prolonged hypoxic state leads
to pulmonary complications, ending with ARDS.
Therefore, earlier presentation to hospital with prompt
commencement of resuscitation is associated with
improved survival. In the present study, 98.75% of patients
presented within 24 hours of the injury. The mean time
interval in patients who expired was 80.10 minutes.
However, there was no significant statistical correlation
between this time interval and outcome (Table 6).
Pregnancy
Out of the 59 women studied, 12 were pregnant at the time
of admission. (Table 7) All 12 of them had a spontaneous
miscarriage. 11 of the pregnant patients expired. This was
found to be statistically significant supporting the fact that
pregnancy is a risk factor which significantly increases
mortality in burns patients.12
A pregnant state leads to a
7. Vagholkar K et al. Int Surg J. 2021 Jan;8(1):78-85
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variety of hemodynamic changes. Severe burns can cause
fluid depletion which compromises the hemodynamic
status of both the mother and the fetus.13
Spontaneous
miscarriages add to the complexity of complications
thereby increasing the mortality.14
Inhalation injuries
Patients who sustained burns injury in a closed space or
room invariably have a component of inhalation injury.15
Presence of facial burns, burning of facial hair, burns
injury to the nostrils, singing of nasal hair are all
suggestive of inhalation burns injury.15
In the present
study, 49 patients (61%) had inhalation injury of which 41
patients (83.7%) expired. This was found to be statistically
significant. (Table 8) Inhalation injuries cause damage to
the respiratory passages as well as gross alteration in the
ventilation perfusion ratio. The respiratory defence
mechanisms are damaged predisposing to severe
respiratory infection. Hypersensitivity of the respiratory
passages can also cause severe bronchospasm. Alteration
in the gas exchange at alveolar level leads to hypo
perfusion and hypoxia.16
Hypoxia is instrumental in
initiating a diffuse inflammatory process in the lungs
leading to ARDS.16,17
Therefore, prompt identification of
inhalation injury with immediate treatment can
undoubtedly reduce the incidence of ARDS.18-20
In the
present study, inhalation injury was associated with
systemic complications which included shock due to
septicaemia. The correlation was found to be statistically
significant. (Table 9)
Systemic complications
Systemic complications are a known accompaniment of
burns injury.21,22
The most common complications are
hypovolemic shock followed by septicaemia. The
mortality in such cases is extremely high as seen in the
present study. (Table 10) Inhalation burns injury
complicates the problem.23
A combination of septic shock
with ARDS has an extremely high mortality.24
Systemic
complications eventually lead to multiorgan dysfunction
and death.
Wound complications
A typical burns injury has 3 zones. These include zone of
coagulation in the centre surrounded by zone of stasis
which is adjacent to it. This is surrounded by a zone of
hyperaemia. Prompt fluid resuscitation increases the
circulation in the zone of hyperaemia thereby limiting the
progression of the zone of stasis.25
The damaged central
portion will remain limited as long as the zone of stasis is
prevented from expanding. Initially, an eschar is formed
which covers the burnt wound. If the eschar is dry, it aids
or helps in enhancing wound healing by offering a
protective cover. However, if the depth of the burns is full
thickness, the protective effect of the eschar may not help
in wound healing. Infection especially hospital acquired is
commonly seen in burns patients.25,26
Therefore,
meticulous wound care with barrier nursing is the key to
success. In the present study, 57 (71%) patients developed
infection. 3 patients developed contractures after infection.
It was also observed that infection was more common in
patients who had increased BSA.27
These patients had
higher mortality.
Psychological impact
The main complication in patients who survive burns
injury is development of scarring which may cause
significant disfigurement. This is one of the common
causes for depression.28
It is a good clinical practice to
evaluate the patient’s psychological status. If found
depressed, treatment can be commenced immediately.
Depression is associated with increased mortality as of
seen in the present study. In the present study, out of the
80 cases studied, 31 patients (38.75%) developed
depression during the period of admission. 28 (98.32%) of
these patients expired. The correlation was found to be
statistically significant. Hence commencing antidepressant
therapy will perhaps reduce the severity of depression
thereby improving surgical outcomes.
Duration of stay
The duration of stay in hospital in variable. It is determined
predominantly by the severity of burns injury and
development of complications. In the present study, the
mean duration of stay was 6.55 days. However, it ranged
from 1 hour to 57 days. The study has few limitations. It is
limited by the sample size. The type of nursing unit for
managing burns patients needs to be further studied in
view of is impact on the outcome. The wound management
protocol also needs further appraisal.
CONCLUSION
The factors which affect mortality in burns patients were
identified based on the results of the study. These include
increasing age, increased BSA, inhalation burns injury,
presence of systemic burns complications, pregnant state,
wound infection and mental depression. Therefore,
maximum stress should be laid upon attending to these
factors while treating burns patients in order to reduce the
mortality.
ACKNOWLEDGEMENTS
The authors would like to thank the Dean, D.Y.Patil
University School of Medicine, Navi Mumbai, India, for
permission to publish the study.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
Institutional Ethics Committee
8. Vagholkar K et al. Int Surg J. 2021 Jan;8(1):78-85
International Surgery Journal | January 2021 | Vol 8 | Issue 1 Page 85
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Cite this article as: Vagholkar K, Hariharan N,
Vagholkar S. Factors affecting mortality in burns: a
single center study. Int Surg J 2021;8:78-85.