Mehtab Ahmad

International Journal of Burns and Trauma

Comparative outcome of ultrasound guided vs. fluoroscopy guided hydrodilatation in adhesive capsulitis: a prospective study

The objective of this study is to characterize the University of Florida (UF) Health Shands Burn Centers enteral nutrition protocol as it relates to total protein intake and clinical outcomes.

Ada Selina Jutba

Amir Kamel

Quynhnhu Nguyen

Kunal Patel

Julie Cash

Janet Popp

Pavel Mazirka

Laura Roberson

Ashlee Allen

Quennie Omalay

Amalia Cochran

International journal of burns and trauma

Impact of an enteral nutrition protocol in critically ill patients with burn injuries

Ankle fractures are among the most common lower limb fractures. There is no agreement about the best treatment for these fractures. This study compared the short-term results of screw and plate fixation methods.

Mehdi Teimouri

Operative treatment results of posterior malleolar fractures in trimalleolar fractures with screw fixation and plate fixation: short-term results

This case report describes a unique scenario in which antimycobacterial-induced peripheral neuropathy (PN) culminates in severe bilateral foot frostbite. Drug-induced peripheral neuropathy (DIPN) is explored in the context of TB treatment, highlighting the role of medications such as isoniazid (INH) and their potential to cause PN. The report highlights the importance of identifying PN in patients undergoing antimycobacterial treatment. Early recognition and proper management of PN is crucial to prevent complications. Notably, the report advocates for patient education regarding medication side effects and avoiding harmful practices, such as ice immersion, to alliviate neuropathic pain. Emphasis is directed towards the need for a multidisciplinary approach to patient care and a focus on preventative strategies to improve patient outcomes and avoid severe debilitating complications.

Shahad N Alanazi

Dana A Bali

Nawaf M Alwagdani

Youssof Mal

Maram T Alkhatieb

Hattan A AlJaaly

Zahir T Fadel

Frostbite secondary to antimycobacterial-induced peripheral neuropathy: a case report

In this experimental study, we aimed to determine whether platelet-rich plasma (PRP) is a suitable preservative for dermo-epidermal grafts. An additional objective was to investigate how long grafts can be stored without biological degradation.

Sarka Odlozilova

Jiri Paral

Igor Slaninka

Jan Zajak

Michal Lesko

Tomas Geryk

Lucie Gerykova

Miroslav Sirovy

Use of autologous platelet-rich plasma for skin graft preservation: an experimental comparative study

Pasquale Rinaldi

Combined awake videolaryngo-bronchoscopy intubation with HFNC preoxygenation for predicted difficult airway in a patient with post-burn mentosternal scar contracture

Latif Zafar Jilani

Autologous non-vascularized fibula with compression plating in the management of aseptic complex non-union of long bones

The primary objective of this study was to juxtapose the union rate and incidence of complications in paediatric patients presenting early (≤ 7 days) following injury with children presenting later (> 7 days) with femoral neck fractures.This critical appraisal evaluated 15 patients according to their timing of presentation and surgery from the initial day of injury (Group A: operated ≤ 7 days or Group B: > 7 days of injury).Patients with traumatic femoral neck fractures with Delbet 1 to 4 subtypes who were skeletally immature (age ≤ 16 years) were included in the study.Pathological fractures and post-infective fractures were not included.Each patient's secondary loss of reduction was calculated by measuring the Neck shaft angle (NSA) on the immediate post-operative radiograph and at the union.A change in NSA of ≥ 5 degrees was considered a significant loss of reduction.Ratliff's Criteria was used to analyze the final result, and a thorough record of complications was kept.There were no significant variations in the two groups' with respect to distributions of age, sex, injury mechanism, or fracture pattern.The most frequent injury culprit in both groups was falling from a height.Type II fracture pattern (54.54%) was more common in group A, while Type III and Type II fracture pattern was equally distributed in group B. In group A, the mean operation time was 55 ± 8.25 minutes, whereas in group B, it was 65 ± 15 minutes (p-value > 0.05).In group A, 90.9% of patients underwent CCS fixation, and in group B, 75% underwent fixation by CCS.The quality of reduction in post-operative radiographs was anatomical in 10 (90.9%) patients and unacceptable in 1 (9.1%) patient.In group B, 2 (50%) patients had an anatomical reduction, while 2 (50%) patients had an unacceptable reduction.Timing of reduction and its association with complications showed that early stable reduction and fixation decrease the occurrence of complications in femoral neck fractures (p-value = 0.033).Fracture union was seen in all our patients in both groups and none of our patients underwent non-union.The mean union time was 11.11 ± 7.06 weeks in group A and 16.5 ± 2.59 weeks in group B (p-value = 0.0189).In group A, only 1 (9.1%) patient developed coxa vara.In group B, out of 4 patients, the femoral head of one patient underwent avascular necrosis, one patient exhibited coxa vara, and 1 patient developed premature physeal closure with limb length inequality.Management of femoral neck fractures in children is challenging because of the paediatric bone's peculiar anatomic and physiological considerations.In our study, patients operated within 7 days developed fewer complications as compared to patients who were operated after 7 days, which was statistically significant.Although AVN is a frequent adverse consequence of pediatric femoral neck fractures, early reduction and stable fixation lowers AVN rates, as observed in our study.Our short-term functional and radiological results using the Ratliff scoring system were comparable to previous studies owing to stable anatomic reduction.Based on our findings and the existing literature, we emphasize long-term follow-up and recommend an early stable anatomic reduction in the treatment of paediatric femoral neck fractures.

Asad Khan

Does early stable fixation reduce complications in paediatric femoral neck fractures?

Background: Burns is a disease of poverty, disproportionately affecting populations in low-and middleincome countries, where most of the injuries and the deaths caused by burns occurs.In Sub-Saharan Africa, it is estimated that one fifth of burn victims die from their injuries.Mortality prediction indexes are used to estimate outcomes after provided burn care, which has been used in burn services of high-income countries over the last 60 years.It remains to be seen whether these are reliable in low-income settings.This study aimed to analyze inhospital mortality and to apply mortality estimation indexes in burn patients admitted to the only specialized burn unit in Rwanda.Methods: This retrospective study included all patients with burns admitted at the burn unit (BU) of the University Teaching Hospital in Kigali (CHUK) between 2005 and 2019.Patient data were collected from the BU logbook.Descriptive statistics were calculated with frequency (%) and median (interquartile range, IQR).Association between burns characteristics and in-hospital mortality was calculated with Fisher's exact test, and Wilcoxon rank, as appropriate.Mortality estimation analysis, including Baux score, Lethal Area 50 (LA50), and point of futility, was calculated in those patients with complete data on age and TBSA.LA50 and point-of-futility were calculated using logistic regression.Results: Among the 1093 burn patients admitted at the CHUK burn unit during the study period, 49% (n=532) had complete data on age and TBSA.Their median age, TBSA, and Baux score were 3.4 years (IQR 1.9-17.1),15% (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38), respectively.Overall, reported in-hospital mortality was 13% (n=121/931), LA50 for Baux score was 89.9 (95% CI 76.2-103.7),and the point-of-futility was at a Baux score of 104.Conclusion: Mortality estimation indexes based on age and TBSA are feasible to use in low-income settings.However, implementation of systematic data collection would contribute to a more accurate calculation of the mortality risk.

Ian Shyaka

Estimating mortality risk in burn patients admitted at Rwanda’s largest referral hospital

Mohd Hadi Aziz

Malignant peripheral nerve sheath tumour presenting as pathological fracture of proximal femur in neurofibromatosis type-1: a case report with brief literature search

Connor L Kenney

Evaluation of pain associated with the application of burn dressings

The objective of this clinical appraisal was to assess the clinical-radiological results of ankle deformity correction secondary to physeal injury, utilizing the methods based on the age of the child, site & severity of the deformity, remaining growth potential, condition of the soft tissue envelop and integrity of neurovascular status. Fifteen subjects ≤ 16 years of age, with angular deformities of the ankle secondary to physeal injury, were included. Deformities secondary to infection and pathological fractures were excluded. Demographic data, type of injury, treatment method, and follow-up were recorded from the case files. Treatment categories included osteotomies for acute correction (> 10 years) and growth modulation (≤ 10 years). Male to female ratio was 7:8, with an average age of 11.8 ± 2.31 years (range 9-16 years). The right and left ratio was 7:8. Mean duration of follow-up was 1 year and 4 months. Gradual deformity correction was done in 2 cases utilizing the principle of growth modulation, while acute correction by osteotomy was done in 13 cases. The average pre-operative ankle deformity was 20.8 ± 3.11 degrees (Range -25 to 24 degrees). Radiological union was attained at a mean of 11 weeks (8-24). Nine patients achieved neutral ankle alignment. The mean residual varus was 2.3°, and the valgus was 4°. There was a statistically significant improvement of the AOFAS score by 17 points from a mean pre-operative score of 57 (44-84) to 74 (56-100) points at the final follow-up (

Yasir Salam Siddiqui

Mohd Julfiqar

Mazhar Abbas

Adnan Anwer

Mohd Owais Ansari

Mohd Adnan

Syed Mohd Shoaib

Mohammad Ibran

Management of post-traumatic ankle deformities in children

BACKGROUND Although there is an emergent increase in the epidemiology of skin cancer in Saudi Arabia, yet knowledge, attitude, and awareness towards skin cancer prevention measures is still poor. Therefore, the present study aimed to assess the knowledge and attitudes and practice towards skin cancer among the Saudi population, as well as, to evaluate the level of awareness relating to exposure to sunlight. METHODS This cross-sectional survey involved 438 participants who were randomly selected from Riyadh city, Saudi Arabia. A standard questionnaire was used to collect data regarding skin cancer. The questionnaire focused on three main aspects knowledge, attitude, and practice. The skin cancer quality of life impact tool (SCQOLIT) was employed. RESULTS The present study included 438 participants, aged 18 to 55 years old. The response in the present study was 81.9%. Regarding the causes and effects of skin cancer, 61.2% of the respondents have prior knowledge about it. The positive attitude about skin cancer was exhibited by 68.9%, and only 31.1% showed a negative attitude towards it. CONCLUSION In conclusion, Knowledge, attitude, and practice towards skin cancer still under the desired level to prevent skin cancer and its related conditions in Saudi Arabia. Greater emphasis should be made through awareness campaigns and available media to raise the knowledge about implications related to prolonged exposure to sunlight.

Bassam Ahmed Almutlaq

Asma S Al-Gebaly

Wedad Saeed Al-Qahtani

Rgya Solaiman Alfraihi

Abdulqader Saeed Alqahtani

Alanood S Almurshedi

Abdelbaset Mohamed Elasbali

Hussain Gadelkarim Ahmed

Assessment of the knowledge, attitude, and practice towards sun-exposure and skin cancer in Riyadh city, Saudi Arabia.

Traumatic injury is a major cause of morbidity and mortality in pediatric patients. Hemorrhage is a known but treatable component of these outcomes. Evidence exists that major trauma patients are at high risk for hypocalcemia but the rate of pediatric occurrence is not documented. The purpose of this study was to determine the incidence of hypocalcemia in pediatric trauma patients, as well as to investigate any correlation between hypocalcemia and the need for transfusion and operative intervention. After IRB approval a retrospective analysis was conducted of all pediatric trauma patients seen in our Adult Level One, Pediatric Level Two trauma center. Significance testing for mortality was performed using Pearson's χ

Brian G Cornelius

Daniel Clark

Ben Williams

Anna Rogers

Andreea Popa

Phillip Kilgore

Urska Cvek

Marjan Trutschl

Kevin Boykin

Angela Cornelius

A retrospective analysis of calcium levels in pediatric trauma patients.

Interleukin 6 (IL-6) is an established biomarker of inflammation with one of the earliest responses in sepsis. Serum levels can easily be measured within a few hours. The clinical significance of IL-6 in the early stage of sepsis in burned patients has not yet been confirmed. The purpose of our research was to investigate the predictive value of IL-6 for positive blood cultures in comparison to Procalcitonin (PCT), white blood cell (WBC) count, body temperature and the Sequential Organ Failure Assessment (SOFA) score in the presence of suspected sepsis in burn patients. In a retrospective study, we included all patients admitted to a regional burn centre in a 7-year period. Patients with a clinical suspicion of sepsis and complete laboratory tests underwent further analysis. Patients were categorized following culture results into either positive or negative bloodstream infection (BSI or non-BSI) groups. 39 of the 101 included patients had positive blood cultures (BSI). The serum IL-6 levels were significantly higher in the BSI group [1047 (339.9; 9000.5) vs. 198.5 (112.4; 702.5) ng/l; P = 0.001]. Receiver operating characteristic (ROC) curve analysis showed an AUC of 0.7 (59; 80.8%). The optimal IL-6 cut-off level was 312.8 ng/l (sensitivity 79.5%, specificity 56.5%). Other biomarkers (PCT, WBC), the maximum body temperature and increase of SOFA score were not different between the groups. IL-6 can be used to predict a positive blood culture even in the early stage of suspected sepsis in burned patients. In this context, other biomarkers (PCT, WBC) and body temperature are of limited clinical utility.

Jochen Gille

Jovan Jocovic

Thomas Kremer

Armin Sablotzki

The predictive role of Interleukin 6 in burn patients with positive blood cultures.

BACKGROUND Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) surgeries and prompt diagnosis and treatment are vital; however, no study has been conducted to determine the relationship between characteristics and duration of surgical site discharge and PJI. METHODS This is a longitudinal observational study that was performed at Al-Zahra and Kashani and Sadi university hospitals from 2017 until 2019. A total of 961 elective TKA were performed on 850 consecutive patients. Patients were followed up for two years after surgery. Data regarding the occurrence of discharges, types of discharges, duration of discharges, the incidence of PJI and superficial infections were collected. RESULTS The rate of superficial and prosthetic joint infection was 0.3% and 0.3%. Patients with infections (either PJI or superficial) had a longer duration of discharge (14.6 days and 13.3 days in PJI and superficial infections respectively, compared to 7.7 days in all of the study population); Bloody-purulent discharge was associated with the development of prosthetic and superficial infections. CONCLUSION Bloody purulent discharge reaching seven days postsurgical in TKA patients is highly suggestive of an underlying infection (PJI or superficial infection) but type and duration of discharge could not be used to differentiate between PJI and superficial infection. Other risk factors for PJI or superficial infection include women's gender, longer surgical duration, longer hospitalization and longer discharge duration.

Mehdi Motififard

Khalilolah Nazem

Mehdi Meshkati

Determining the relation between total knee arthroplasty surgery site drainage in two weeks after surgery with periprosthetic joint infection (PJI) in two years.

Thoracic trauma is one of the most common types, corresponding to 10% of the traumas admitted in emergency services.

Gabrielle Filinkoski Pasquali

Kelser de Souza Kock

Epidemiological profile of chest trauma and predictive factors for length of hospital stay in a hospital in Southern Brazil.

Introduction The COVID-19 pandemic has changed the world and intensified health management in many parts of the world. Sensitivity in burn patients' care and prevalence of COVID-19 have a major impact on this group's healthcare system and infection control strategies. The purpose of this study is to review burn care strategies during the COVID-19 outbreak. Materials and methods The present study is a narrative review study. In writing this paper, to access information, the keywords of Coronavirus, COVID-19, burn, strategy, care, and SARS were used. Due to the emergence of COVID disease, searches in Science Direct, PubMed, Scopus, Web of Science, Google Scholar, SID, Magiran, Springer, and Elsevier databases were performed without time limit. Research articles were purposefully selected and approved to be investigated based on the criteria for entering the research. A total of 14 articles had a full text related to the research scope. The researchers used qualitative content analysis to analyze the data. Data analysis was conducted as a comprehensive review of articles, qualitative conclusions, and results. Results In this study, 14 articles related to burn care strategies in the COVID-19 epidemic were selected. Their results were reviewed in two areas of staff care strategies and burn patients during the COVID-19 outbreak. Findings indicate that appropriate prevention and protection strategies and measures should be followed to prevent the transmission of the COVID-19 virus to burn care professionals. In addition, burn patient care strategies were proposed in two levels of minor and moderate to severe burns, so that patients with burns receive adequate burn care during the COVID-19 outbreak. Conclusion Implementation of staff and burn patient care strategies during the COVID-19 pandemic is essential to treat burn patients and prevent the spread of the COVID virus.

Fatemeh Delfani

Mahnaz Shoghi

Burn care strategy in the covid-19 pandemic: a narrative review study

Root resorption consists of the loss of mineralized tissue (enamel, dentin, and cementum) of the inner or outer surface of the tooth due to the action of clastic cells. The correct diagnosis, the location, degree of tissue destruction, and the type of treatment are obstacles to the resolution of these lesions. The external cervical resorption is initiated in the amelocemental region progressively resorbing cementum, dentin, and enamel, constituting multiples ducts of resorption in an apical direction. This study reports a clinical case of treatment of a tooth affected by external cervical resorption with six-year clinical and radiographic follow-up. A 28-year-old male patient attended the clinic reporting a stain in the element 11. On clinical examination, there was a pinkish stain in the cervical lingual region, small cavitation in the enamel cervical region, and gingival bleeding with no insertion loss. Radiographically was observed a change at the root in the right central incisor, which was diagnosed as external root resorption. The negative response to the pulp sensitivity test confirmed the condition of pulp necrosis, indicating the need for endodontic treatment. To the treatment, it was opted for a minimally invasive approach, with endodontic access, instrumentation, and monthly exchanges of calcium hydroxide, for three months. After this period, the root canal has been filled with gutta-percha and sealer 26, in the apical third. The cervical and medium third were filled with MTA (mineral trioxide aggregate) leaving a central space for later fiberglass posts placing. The fiberglass post has been cemented with resinous cement and the tooth restored with resin composite. After six years of a radiographic control semiannual and annual, noticed normality in the periradicular tissues and disruption of the resorption process, was observed. The clinical management minimally invasive adopted reported in this case presents a viable treatment for external root resorption of the cervical third, especially in anterior teeth.

Estefano B Sarmento

Sandro Jo Tavares

Katherine Abr Thuller

Natalia Ps Falcao

Karoline M de Paula

Livia Aa Antunes

Cinthya C Gomes

Minimally invasive intervention in external cervical resorption: a case report with six-year follow-up.

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涉及主题	医学外科生物内科学病理心理学遗传学化学精神科解剖生物化学物理放射科地质学麻醉免疫学环境卫生古生物学急诊医学内分泌学社会学数学
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Comparative outcome of ultrasound guided vs. fluoroscopy guided hydrodilatation in adhesive capsulitis: a prospective study

Impact of an enteral nutrition protocol in critically ill patients with burn injuries

Operative treatment results of posterior malleolar fractures in trimalleolar fractures with screw fixation and plate fixation: short-term results

Frostbite secondary to antimycobacterial-induced peripheral neuropathy: a case report

Use of autologous platelet-rich plasma for skin graft preservation: an experimental comparative study

Combined awake videolaryngo-bronchoscopy intubation with HFNC preoxygenation for predicted difficult airway in a patient with post-burn mentosternal scar contracture

Autologous non-vascularized fibula with compression plating in the management of aseptic complex non-union of long bones

Does early stable fixation reduce complications in paediatric femoral neck fractures?

Estimating mortality risk in burn patients admitted at Rwanda’s largest referral hospital

Malignant peripheral nerve sheath tumour presenting as pathological fracture of proximal femur in neurofibromatosis type-1: a case report with brief literature search

Evaluation of pain associated with the application of burn dressings

Management of post-traumatic ankle deformities in children

Assessment of the knowledge, attitude, and practice towards sun-exposure and skin cancer in Riyadh city, Saudi Arabia.

A retrospective analysis of calcium levels in pediatric trauma patients.

The predictive role of Interleukin 6 in burn patients with positive blood cultures.

Determining the relation between total knee arthroplasty surgery site drainage in two weeks after surgery with periprosthetic joint infection (PJI) in two years.

Epidemiological profile of chest trauma and predictive factors for length of hospital stay in a hospital in Southern Brazil.

Burn care strategy in the covid-19 pandemic: a narrative review study

Minimally invasive intervention in external cervical resorption: a case report with six-year follow-up.

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International journal of burns and trauma

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Comparative outcome of ultrasound guided vs. fluoroscopy guided hydrodilatation in adhesive capsulitis: a prospective study

Impact of an enteral nutrition protocol in critically ill patients with burn injuries

Operative treatment results of posterior malleolar fractures in trimalleolar fractures with screw fixation and plate fixation: short-term results

Frostbite secondary to antimycobacterial-induced peripheral neuropathy: a case report

Use of autologous platelet-rich plasma for skin graft preservation: an experimental comparative study

Combined awake videolaryngo-bronchoscopy intubation with HFNC preoxygenation for predicted difficult airway in a patient with post-burn mentosternal scar contracture

Autologous non-vascularized fibula with compression plating in the management of aseptic complex non-union of long bones

Does early stable fixation reduce complications in paediatric femoral neck fractures?

Estimating mortality risk in burn patients admitted at Rwanda’s largest referral hospital

Malignant peripheral nerve sheath tumour presenting as pathological fracture of proximal femur in neurofibromatosis type-1: a case report with brief literature search

Evaluation of pain associated with the application of burn dressings

Management of post-traumatic ankle deformities in children

Assessment of the knowledge, attitude, and practice towards sun-exposure and skin cancer in Riyadh city, Saudi Arabia.

A retrospective analysis of calcium levels in pediatric trauma patients.

The predictive role of Interleukin 6 in burn patients with positive blood cultures.

Determining the relation between total knee arthroplasty surgery site drainage in two weeks after surgery with periprosthetic joint infection (PJI) in two years.

Epidemiological profile of chest trauma and predictive factors for length of hospital stay in a hospital in Southern Brazil.

Burn care strategy in the covid-19 pandemic: a narrative review study

Minimally invasive intervention in external cervical resorption: a case report with six-year follow-up.

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