Effects of a Spiritual Care Program on Body Image and Resilience in Patients with Second-Degree Burns in Iran

This research was conducted with the aim of investigating the effect of a spiritual care program (SCP), on the body image and resilience of second-degree burn patients in Iran. In this semi-experimental study, 60 patients with second-degree burns were selected in the Tehran Mottahari Burns Hospital, Iran in 2022. These patients were divided through random allocation into two intervention and control groups. The patients of both groups filled out Beck's self-esteem Test (BSCT) and Connor-Davidson Resilience Scale (CD-RISC) before, immediately, and 3 months after the intervention. In the intervention group, SCP was performed for eight sessions over two weeks. Firstly, the 4D Model of Spiritual Health and Well-Being was examined, then two one-hour sessions were held with each patient about each dimension, with a total of four dimensions including eight sessions, in which these dimensions were examined and discussed. There was no difference in the score of body image (P = 0.326) and resilience (P = 0.597) before intervention in the control and intervention groups. However, the mean of body image score in the intervention group immediately (109.56 ± 4.86) and 3 months after (109.16 ± 6.06) the intervention was significant, respectively. Also, the mean of resilience score in the intervention group was significant immediately (85.86 ± 6.78) and 3 months after the intervention (85.73 ± 6.27). It is suggested for healthcare providers to use the SCPs to reduce the recovery time of burned patients and reduce complications and treatment costs.

The Role of Serum Albumin Level during Hospitalization as a Predictor of Complications and Mortality in Children with Burns

Background

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

Methods

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

Results

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

Conclusion

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

Evaluation of Patient's Knowledge of Prevention and Treatment of Burn Injuries

Background

Burn injuries are amongst the most devastating causes of trauma worldwide. Preventive measures can be of great value in decreasing burn incidents. Increasing the knowledge and education of patients is a crucial step in this process.

Methods

In this prospective cross-sectional study, we evaluated 82 patients with burn injuries who were divided into two groups randomly during the 2018 to 2019 at Shahid Motahari Hospital, Tehran, Iran. The first group received an e-Book, and the second group a paperback booklet to read before visiting their primary care. Besides, both groups received a questionnaire on their knowledge of burn injuries and prevention before and after the visit. The e-Book and paperback booklet included basic information about burn injuries and preventive measures. We compared the questionnaire results in both groups before and after reading the e-book and booklet using a paired t-test analysis.

Results

There was a significant improvement in self-reported knowledge of burn prevention (P < 0.05; CI: 95%). Subjects receiving the eBook performed significantly had better post-survey (P < .01, 95% CI), despite equivalent pre-survey scores compared to those receiving the booklet.

Conclusion

Increased use of interactive educational modalities, such as an e-book, can benefit patients with knowledge of their disease and improve the quality of care. These modalities may increase compliance with the physician's recommendations regarding their disease states and treatments.

A to Z Steps of In-person Screening, Treatment, and Caring Procedure in Orthodontic Clinics During COVID-19 Pandemic: A Rapid Mini-review

Background: A novel coronavirus emerged from Wuhan, China, in December 2019. Dental healthcare providers are at the highest risk of exposure since the primary source of the virus is saliva, and dentists are the front-line personnel working with the oral cavity. Since orthodontic treatment is a long-term procedure for children and teenagers, and because of the critical gap in preparing a specific guideline on orthodontic treatment procedures, orthodontic practitioners have faced numerous complicated issues in this regard. This mini-review aimed to summarize the facts that the orthodontic settings should be aware of the dental difficulties during COVID-19 with a particular focus on orthodontic treatment. Methods: In this short review, electronic databases of Medline, Scopus, Web of Science, and Google Scholar were searched for relevant articles and guidelines from January 2019 to March 2021 using the following key terms: “COVID-19,” “SARS-CoV-2,” “Pandemic,” “Orthodontics,” and “Orthodontists.” Results: Gathering recommendations of experts and several guidelines led to the following crucial steps in orthodontic procedures: screening through a telehealth questionnaire; admitting just patients into the dental center; ventilating the waiting room; measuring the temperature of patients’ bodies; disinfecting the dental unit and instruments after each visit; using personal protective equipment; washing hands; minimizing the use of high-speed handpieces to reduce the aerosol generation; and sterilization of archwires, orthodontic markers, photographic retractors, molar bands, burs, miniscrews, and unit waterline with proper methods. Conclusions: All dentists should be up-to-date on cross-transmission of SARS-CoV-2 and follow the international infection control protocols as well as national/provincial/local guidelines and apply them to the regional settings after generalization and matching with the condition.

Epidemiological data of national Kawasaki disease registry in Iran, 2007-2019

INTRODUCTION

Kawasaki disease(KD) is a vasculitis of childhood that tends to influence the coronary arteries. There is no national data about the prevalence of KD in Iran. This study aimed to perform a national registry in Iran for 13 years.

METHODS

In this retrospective study, the data for KD extracted from medical records of <19 year-old patients admitted to tertiary hospitals in Iran between 2007 and 2019 were recorded in the national KD registry system. Age, admission date, gender, location, and presence of KD criteria, laboratory and echocardiography findings, and treatment modalities were evaluated. Complete KD was considered if ≥4 clinical criteria of the KD existed and otherwise, incomplete KD was considered.

RESULTS

Data from 1,682 KD patients including 999(59.39%) boys and 683(40.61%) girls and male/female ratio of 1.46 were evaluated. The mean age was 3.08 ± 2.49 years and 1465(87%) were living in urban regions. The yearly incidence of the disease was between 2.62 to 3.03 from 2015 to 2019. The highest age-specific incidence was observed in children <1-year-old. Incomplete and resistant KD included 1,321(78.54%) and 9(0.54%) patients, respectively. Abnormal echocardiography was detected in 619(36.80%) patients. Leukocytosis, with dominancy of neutrophils, anemia, thrombocytosis and increased ESR and CRP were the most noticeable laboratory findings. No death due to KD disease was reported.

CONCLUSION

Based on this study, most of the KD cases are presented with atypical presentation in Iran. So, increasing awareness of primary healthcare workers by educating and updating their data is very important in timely diagnosis and management of the disease.

Determination of Serum Levels of Interleukin-6, Interleukin-8, Interleukin-10, and Tumor Necrosis-Alpha and their Relationship With The Total Body Surface Area in Children

There are few studies on the inflammatory processes and the role of cytokines involved in pediatric burn injuries. The present study aims to measure the serum levels of cytokines and their relationship with the degree of burn injury in children. Within the 48 hours of hospitalization, the serum samples were obtained to measure inflammatory cytokines (interleukin-6, interleukin-8, interleukin-10 [IL-6, IL-8, and IL-10] and tumor necrosis factor-alpha [TNF-α]). The level of all of these cytokine factors was assessed by enzyme-linked immunosorbent assay technique. The mean levels of IL-6, IL-8, IL-10, and TNF-α was 18.15 ± 4.77 pg/ml, 59.54 ± 4.59 pg/ml, 8.41 ± 2.09 pg/ml, and 1.48 ± 0.15 pg/ml, respectively, which were higher than the normal range designated for the healthy pediatrics age group. The levels of TNF-α were higher in patients with sepsis (P = .03) and deceased patients (P = .001). There was a statistically significant difference in the levels of IL-8 in patients with second- (.001) and third-degree (.001) burn injuries in comparison to the first-degree burn injuries, and the level of IL-8 was statistically significantly higher in patients with electrical burn injuries in comparison to scald burn injuries (.01). IL-10 was statistically significantly higher in patients with contact burn injuries in comparison to scald (.001) and flame (.03) burn injuries. Cytokine levels in pediatric burn patients increased after severe burn injuries. There was a significant correlation between the levels of IL-8 and the degree of burn injuries.

Evaluation of Electrical Burn Injuries in Iran: A 7 year retrospective study

Electrical burn injuries can cause devastating and debilitating morbidities and impairments for patients. This cross-sectional descriptive study was performed on electrical burn patients hospitalized from 2014 to 2019 to evaluate electrical burn injuries' epidemiology and characteristics. A total number of 726 patients with the mean age of 31.17 years were evaluated for electrical burn injuries. Mean total burn surface area (TBSA) was 16.61 ± 12.56. Most victims were male (696 cases, 95.7%); and most patients did not have a constant job (n = 458, 63%). Most affected burn sites were hands (28.6%) and upper limbs (27.8%). A total number of 89 (12.2%) patients suffered amputations with the hand fingers (64 cases) as the most common site. Low voltage injuries were more common (n = 649 , 89%). Most incidents happened at the workplace (n =459 , 63%). Comparison of patients with high voltage and low voltage injuries showed significant correlations and statistical difference between these 2 groups regarding TBSA, mean hospital stays, escharectomy, fasciotomy, amputations, debridement, fracture and mortality rate (P = 0.001). Our observation revealed that electrical burn injuries are still significant causes of morbidity and mortality among trauma patients. In contrast to previous studies, low voltage injuries were more common than high voltage ones. We propose improvements in the manufacturing of electrical appliances; paying attention to safety measures will reduce thenumber of incidents. Moreover, training and education play important roles in reducing the number of incidents and mortality rates.

Antibacterial effect of carbon nanotube containing chemical compounds on drug-resistant isolates of Acinetobacter baumannii

Background and Objectives:

Acinetobacter baumannii is recognized as an important pathogen responsible for serious infections causing episodes of hospital infection. Carbon nanotubes (CNTs) have recently emerged as superior materials against antibiotic-resistant bacteria. In this study, a new chemical compound was designed in order to combat A. baumannii infections. Subsequently, the effect of this novel carbon nanotube coated with an antibacterial compound on Extensively Drug-Resistant (XDR), Multidrug-Resistant (MDR) and Pan-Drug-Resistance (PDR) strains of A. baumannii was investigated.

Materials and Methods:

A total of 122 clinical isolates of A. baumannii were cultured from burn patients and their susceptibility to antibiotics were checked using disk diffusion method and Minimum inhibitory concentration. Antimicrobial effects of the coated carbon nanotube were evaluated on XDR, MDR and PDR isolates of A. baumannii. Cell viability was determined using tetrazolium reduction assay (MTT) on human fibroblast cell line (HDFa). Wound healing processes were assessed by quantitative polymerase chain reaction.

Results:

Of the 50 A. baumannii isolates, 38 (76%) were found to be MDR and 12 (24%) were XDR. No PDR strains were detected. Results indicated that the carbon nanotube combined with mercury had antibacterial effect against different A. baumannii species and it also was able to increase the expression of epidermal growth factor, platelet-derived growth factor and vascular endothelial growth factor A mRNA levels which are involved in wound healing.

Conclusion:

The engineered carbon nanotube compound can potentially be used for treatment of burn related infections. This can potentially give clinicians a new tool for treating A. baumannii infections.

Wiskott-Aldrich syndrome with possible congenital Cytomegalovirus infection: A diagnostic dilemma

Wiskott-Aldrich syndrome (WAS) is an X-linked recessive disorder, characterized by thrombocytopenia, eczema and recurrent infections. We report a 4-month-old boy who presented with respiratory distress, petechiae, organomegaly and eczema. He was admitted to the paediatric intensive care unit because of severe respiratory distress due to Cytomegalovirus (CMV) infection. As peripheral blood smear showed microthrombocytopenia, Sanger gene sequencing was performed, which confirmed the diagnosis of WAS. This rare combination of possible congenital CMV infection in the background of WAS, misled the initial diagnosis.

Candidemia in pediatric burn patients: Risk factors and outcomes in a retrospective cohort study

Background and Purpose :

Despite advances in burn care and management, infections are still a major contributor to morbidity and mortality rates in patients with burn injuries. Regarding this, the present study was conducted to investigate the prevalence and importance of candidemia in pediatric burn patients.

Materials and Methods:

Blood samples were collected from the patients and cultured in an automated blood culture system. Candida species were identified using specific culture media. The relationship between candidemia and possible risk factors was evaluated and compared to a control group.

Results:

A total of 71 patients with the mean age of 4.52±3.63 years were included in the study. Blood cultures showed candidemia in 19 (27%) patients. Based on the results, C. albicans was the most common fungus among patients with and without candidemia. The results of statistical analysis also showed that candidemia was significantly correlated with total body surface area (TBSA), mechanical ventilation, duration of total parenteral nutrition, length of intensive care unit (ICU) stay, presence of neutropenia, and R-Baux score (all P≤0.001). In this regard, TBSA, length of ICU stay, R-Baux score, and Candida score were identified as the determinant factors for mortality due to candidemia.

Conclusion:

Candidemia increases the mortality and morbidity rates associated with burn injuries. Prompt diagnostic and prevention measures can reduce the unfortunate outcomes via controlling the possible risk factors.

The effects of probiotics, prebiotics and synbiotics on the reduction of IBD complications, a periodic review during 2009-2020

AIMS

To perform a systematic review on randomized controlled trials to examine the efficacy of probiotics, prebiotics and synbiotics in the treatment of IBD.

METHODS AND RESULTS

PubMed, Web of science, Scopus and Google Scholar were systematically searched from January 2009 to January 2020 using the following keywords: 'Inflammatory Bowel Disease', 'Probiotics' and 'Clinical trial'. The statistical analysis was performed using SPSS software version 24.0. A total of 1832 articles were found during the initial search and 21 clinical trials were eligible. Studies comparing the effects of probiotics and placebo among patients with active ulcerative colitis (UC) showed a significant difference in clinical outcomes. Moreover, probiotics improved the overall induction of remission rates among patients with Crohn's disease (CD). Probiotics significantly decreased the IL-1β, TNF-α and IL-8 levels. Also, the need for systemic steroids, hospitalization, surgery, as well as histological score and disease activity index significantly decreased in patients who used probiotic or pro-/synbiotics.

CONCLUSIONS

The use of probiotics, as food supplements, can induce anti-inflammatory reactions, balance the intestinal homeostasis and induce remission in IBD. The efficacy of probiotics on remission induction is more reported in UC rather than CD. Larger well-designed clinical trials are needed to further determine whether probiotics are of clear benefits for remission in IBD.

The Construction of Carbon Nanotubes Containing an Anti-Bacterial Chemical Component and its Effect on MDR and XDR Isolates of Pseudomonas Aeruginosa

Background

Pseudomonas aeruginosa is an opportunistic human pathogen that causes severe acute and chronic nosocomial infections, especially in immunocompromised burn patients. and can lead to severe mortality and morbidity. The emergence of antibiotic resistant P. aeruginosa infections has created significant challenges in treating these patients. A potential alternative treatment for antibiotic resistant pathogens includes the use of carbon nanotubes (CNTs), which have received considerable attention due to their potent antibacterial activity. The aim of this study was to construct a novel CNT containing an anti-bacterial chemical component to effectively combat drug resistant P. aeruginosa infections.

Methods

In this study, a novel chemical component was synthesized and coated the CNT. The antimicrobial effects were then evaluated on MDR, XDR, and PDR strains of P. aeruginosa isolated from burn patients. Antibiotic susceptibility was evaluated using the disk diffusion test and minimum inhibitory concentration (MIC) testing. In order to determine the potential cytotoxicity, an MTT assay was performed on Human Dermal Fibroblasts. The effect of treatment on the expression of wound healing genes was analyzed via qRT-PCR.

Results

Experimental data indicates that our CNT coated chemical compound had antibacterial properties, negligible cytotoxicity, and could accelerate the wound healing process.

Conclusion

Given the antibacterial properties of our CNT chemical compound, it has the potential to treat and reduce the occurrence of multi-drug resistant P. aeruginosa burn wound infections and aid in wound healing by turning on genes (VEGFA, EGF and PDEGF) involved in the wound healing process.

Pan drug-resistant Acinetobacter baumannii causing nosocomial infections among burnt children

Background: Nosocomial infection caused by Acinetobacter baumannii has emerged as a world-wide serious problem in the emergence of multidrug-resistant (MDR). Infections caused by antibiotic-resistant strains of A. baumannii cannot be completely eliminated among the infected patients. This study aimed to monitor antibiotic resistance among A. baumannii strains isolated from burnt children.

Methods: After performing biochemical identification tests on 115 isolates, 62 were detected as A. baumannii . Minimum inhibitory concentration (MIC) was used to test susceptibility to colistin, and disk agar diffusion was used for the susceptibility of the isolates to the antibiotics Ciprofloxacin, Amikacin, Gentamicin, Cefepime, Meropenem, Imipenem, Ceftazidime, Levofloxacin and Piperacillin/Tazobactam. Bacterial species were isolated and identified as multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan drug-resistant (PDR), based on the susceptibility patterns to elected antibiotics, deputing different classes of antimicrobial.

Results: The antibiotic susceptibility pattern out of a total of 62 bacterial strains used in this study. Thirty-six (58%) strains were categorized as MDR, 17 (27.5%) as XDR, and nine (14.5%) as PDR.

Conclusion: To reduce the threat of antimicrobial resistance, MDR, XDR and PDR A. baumannii strains must be evaluated by all clinical microbiology laboratories.

The Effect of Mentha Pulegium on Healing of Burn Wound Injuries in Rat

BACKGROUND

Burn is one of the most common injuries and the 4th common cause of trauma globally. This study was designed to evaluate the effect of the Mentha pulegium extract on second degree burn injuries in rats assessing histopathologic and macroscopic.

METHODS

M. Pulegium extract dressings was used as a treatment to deep dermal contact burns in rats, compared with two control groups of vaseline dressing and simple dressing by normal saline. After creating second-degree burn on the dorsum of rats, the treatments were applied for 15 min in three groups. Wound dressings were performed on days 1, 3, 7, 14 and 21^st and at the same time macroscopic assessment was performed using a digital camera and software processing of photos. Pathologic evaluation of skin specimens was undertaken on days 1, 3,7, 14 and 21^st. Wound healing parameters such as epithelialization, angiogenesis, granulation tissue formation, inflammatory cells were compared between these 3 groups.

RESULTS

Application of M. Pulegium extract on second degree burn wounds significantly decreased burn surface area and increased fibroblasts in comparison to simple dressing. There was not any statistically significant relationship between M. Pulegium extract treated group and vaseline treated or simple dressing groups on other wound healing parameters.

CONCLUSION

This study delineated that M. Pulegium extract had a positive effect on healing process of second degree burns.

Herpes simplex virus infection in minor burn injury: a case report

This is a relative rare case of 0.5% TBSA (total body surface area) burn wound infection caused by Herpes Simplex Virus (HSV). A 1-year-old male infant had deep second degree burn of the left fourth finger with 0.5% TBSA after exposure to a hot object. Blisters and vesicles surrounded by erythema were obvious in the examination of the burned area. The polymerase chain reaction (PCR) and gene sequencing analyses addressed contamination of the burn wound with HSV. Three days after the administration of antibiotics, the wound was relatively healed and finally, the patient was discharged in good general health, and no signs of relapse were observed in the 3-month follow-up. Although HSV infection is rarely reported in non-immunocompromised patients and TBSA burn injuries, due to the high prevalence of HSV infection and its mortality potential in the affected patients, HSV infection should be clinically suspected in the cases with delayed wound healing. In addition, since HSV infection is very contagious, and exposure to patients with HSV infection might be highly problematic for other patients hospitalized in burn wards; hence, proper facilities should be provided for the isolation care of the burn patients with HSV infection.

Autologous Cricoid Cartilage as a Graft for Airway Reconstruction in an Emergent Technique - A Case Report

INTRODUCTION

Laryngotracheal stenosis can be caused after traumatic injuries to the neck from the subglottic larynx to the trachea. Patients with laryngotracheal stenosis often need a tracheotomy and occasionally may become tracheotomy dependent. Different procedures have been described for the management of these lesions. Management options include techniques of endoscopic dilation, laser resection, laryngo-fissure, and an innovative array of plastic reconstructions with or without the use of stents.

CASE REPORT

This paper presents airway reconstruction in a young patient with severe subglottic stenosis due to a blunt trauma to the neck, who was treated using particles of an autologous fractured cricoid cartilage as the source for airway augmentation. An incision was made in the anterior midline of the cricoid lamina and deepened through the scar tissue to the posterior cricoid lamina. Then two lateral incisions (right & left) were made in the cricoid lamina and fractured cartilage particles and the scar tissue were removed via these two lateral incisions. The mucosal lining at the right and left of the midline incision, after debulking, were sutured to a lateral position. Thereafter three cartilage particles were used to reconstruct the anterior cricoid lamina and augment the lumen.

CONCLUSION

It is worth to mention that an autologus cartilage graft can be used for certain cases with traumatic airway stenosis. Further follow up and more patients are needed to approve this method of reconstructive surgery in emergent situations.

Serum 25-Hydroxyvitamin D Levels in Pediatric Burn Patients

Background

Previous studies have implicated the important and active role of vitamin D in the immune system.

Objectives

The aim of this study was to evaluate serum levels of 25-hydroxyvitamin D in children with burn injuries.

Materials and Methods

In this cross-sectional study, 118 patients with various degrees of burn injuries were enrolled. A checklist consisting of demographic data, total body surface area (TBSA) affected by burn, degree of burn, serum level of 25(OH)D, total protein, albumin, electrolytes, and parathyroid hormone was recorded for each patient.

Results

Sixty-eight (57.6%) males and 50 (42.4%) females with a mean age of 4.04 years (SD = 3.04) were evaluated. The mean level of 25(OH)D was 14.58 ng/mL (SD = 6.94). Levels of 25(OH)D in four (3.39%) cases were higher than 30 ng/mL, while 95 (81.35%) cases had levels lower than 20 ng/mL, and 19 (16.10%) cases had levels of 21 - 30 ng/mL. The level of 25(OH)D was below recommended levels in 96.61% of cases, while 81.34% had vitamin D deficiency and 16.1% had insufficiency. We found a significant correlation between vitamin 25(OH)D and total protein, albumin, and total and ionized calcium (P < 0.001). There was also a significant negative correlation between 25(OH)D and TBSA affected by burn (P = 0.001).

Conclusions

The levels of 25(OH)D in children suffering from severe burns were low. Supplementation might be useful in patients with very low levels of serum vitamin D.

Prevalence of beta lactamase producing species of pseudomonas and acinetobacter in pediatric burn patients

Burn wound infection is a major cause of morbidity and mortality in burn victims. Pseudomonas and Acinetobacter species are among the most common organisms complicating burn wounds. Presence of extended spectrum ß-lactamase (ESBL) and metallo-ß-lactamase (MBL) genes plays an important role in spreading ß-lactam resistant strains of these organisms and is a serious condition in the treatment of the affected patients. As a result, we aimed to determine the prevalence of SHV, TEM, PER and VIM ß-lactamases in Pseudomonas and Acinetobacter species isolates from burn wound swabs of children with burn injury. In this descriptive observational study, 107 Pseudomonas and Acinetobacter isolates collected from burn patients were subjected to PCR assay. Using PCR method and DNA sequencing, the existence of SHV-, TEM-, PER- and VIM-type ß-lactamase encoding genes were determined. Out of the 107 Pseudomonas and Acinetobacter isolates, 66 (77.6%) were ESBL positive, 26.2% were positive for SHV gene, 37.4% were positive for TEM gene, 14% were positive for PER gene and 15.9% of them harbored VIM gene. More than half of the Pseudomonas and Acinetobacter strains in our pediatric burn unit harbor ß-lactamase encoding genes that make them resistant to a wide range of ß-lactam antibiotics. Consequently, it is suggested to choose an appropriate antibiotic regimen based on the antibiogram pattern of the strains.

Colonization of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women and their transmission to offspring

BACKGROUND AND OBJECTIVES

Mycoplasma hominis and Ureaplasma urealyticum are important opportunistic pathogens that cause urogenital infections and accelerated newborn delivery in pregnant women. Moreover genital mycoplasmas have been implicated in different neonatal diseases such as pneumonia, sepsis and meningitis. This study was conducted to find out the prevalence and transmission rate of these two organisms in pregnant women and their neonates.

MATERIALS AND METHODS

Nasotracheal and pharyngeal specimens of 165 newborns hospitalized at Neonatal Intensive Care Unit (NICU) of Rasoul Akram Hospital (during 2010 - 2011) were assessed by PCR to detect M. hominis and U. urealyticum. Moreover, PCR of vaginal specimens from their mothers were obtained to determine the prevalence of these organisms in pregnant women and rate of transmission to their newborns. Data were analyzed using SPSS software.

RESULTS

Totally, the results of PCR were positive in 33 newborns (20%). Vaginal colonization among the mothers was found to be 15% (25/165) for U. urealyticum and 15% (25/165) for M. hominis. The transmission rate to their infants was 72% and 60% for U. urealyticum and M. hominis, respectively.

CONCLUSION

These data indicate that vertical transmission of mycoplasma and ureaplasma are prevalent in newborns. Since these organisms cause serious infections in neonates, it would be better to perform screening tests in pregnant women before the delivery in order to prevent transmission to neonates and consequent infections and morbidities among them.

Frequency and causes of seizure among hospitalized burned children

METHODS

In this cross-sectional retrospective study, frequency, type, time of occurrence and atiology of seizures in children with burn was investigated. All cases were under 18 years and were hospitalized in Shahid Motahari Burns Hospital during 2006-2011. Extracted data from patients' medical records was reviewed and statistically analyzed.

RESULTS

Among 1103 patients, 69 (6.2%) had seizures, more frequently in the first 24 h following burn. Thermal burn, especially with boiling water was the cause of burn in most of the children. Seizures occurred more commonly in children less than 3 years old and was generalized (tonic-clonic). Seizure was found to be primarily associated with febrile seizure, while hyponatremia was diagnosed as the second cause. Previous seizure history and seizure with unknown cause were identified as other etiologies. This paper summarizes the key information about seizure following burn, which health professionals, especially those in burn centers, should be aware. However, since this study was single-center more investigations in other centers are needed.

Mortality and morbidity of fireworks-related burns on the annual last wednesday of the year festival (charshanbeh soori) in iran: an 11-year study

BACKGROUND

Management of firework-related injuries is costly for the patient, society, and government.

OBJECTIVES

Evaluating effective factors yielding to such injuries may lead to better management of patients and decreased costs and morbidities.

PATIENTS AND MATERIALS

This retrospective cross-sectional study was performed on burn patients referred to Shahid Motahari Burns Hospital on Charshanbeh Soori day festival during the period extending from March 2000 to March 2011 (11 days in an 11-year period). Demographic data, causes of burn injury, severity, and affected body parts were recorded. Data were analyzed using SPSS version 16.

RESULTS

There were164 patients in the study with a mean age of 18.34 ± 9.31 years; 87% (145/164) were male. Homemade grenades were the most frequent cause of injury. Hand injury was reported in 56% (92/164) of the cases. Amputation was executed in 7 (4.3%) cases, and 6 (3.7%) patients died due to severe burn injuries and facial damage.

CONCLUSIONS

Fireworks- related injuries during Charshanbeh Soori ceremony causes significant morbidities and damage to different body parts (especially upper limbs and face), and some of these injuries will lead to life time disabilities, amputations, and even death. As most of the injured patients are young teenagers and children, special consideration must be taken into account to prevent long term morbidities.

The effect of vitamin E or vitamin A on the prevention of renal scarring in children with acute pyelonephritis

BACKGROUND

Numerous factors may contribute to renal tissue injury after urinary tract infection. We have evaluated the effects of vitamins A or E supplementation in combination with antibiotics for the prevention of renal scarring in acute pyelonephritis.

METHODS

A simple non-blind randomized clinical trial was conducted on 61 children aged 1 month to 10 years between 2004 and 2006. The inclusion criteria were positive urine culture, clinical findings, and 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy-based evidence in favor of acute pyelonephritis. The children were randomized into three treatment groups: 10-day treatment with only antibiotics (control group; n = 25) and 10-day treatment with supplements of vitamin A (n = 17) or vitamin E (n = 18) in addition to antibiotics during the acute phase of infection. The final analysis was performed after excluding male patients. Each patient was evaluated twice by 99mTc-DMSA scintigraphy performed at least 6 months apart. P < 0.05 was considered to be statistically significant.

RESULTS

The analysis included 108 kidney units. The frequency of inflammation at the beginning of therapy was not significantly different in the three groups (63.3 % in vitamin A, 61 % in vitamin E, and 76.2 % in the control group). A worsening of lesions, based on the second 99mTc-DMSA scan, was observed in 42.5, 0, and 23.3 % of the control, vitamin E, and vitamin A patients, respectively (LR = 26.3, P < 0.001).

CONCLUSION

Vitamins A or E supplements were effective in reducing renal scarring secondary to acute pyelonephritis.

Serum immunoglobulin levels in pediatric burn patients

Infections remain the leading cause of death in burn patients. Immune responses play an important role in patient's defense mechanism against infection and decreasing morbidity and mortality associated with burn. Our goal was to determine serum immunoglobulin levels in pediatric burn patients in order to understand role of humoral immune defense in these patients. During this analytic cross sectional study from January 2011 to February 2012, all patients with burn and younger than 6 years old that were referred to Shahid Motahari burn and reconstruction center were enrolled. Patients had no inhalation injury or sepsis. Immunoglobulin levels were measured once on 3-5 days after burn. The burn size in 12 patients (24%) was less than 30%, in 30 patients (60%) were between 30% and 50% and in the remained 8 patients (16%) were more than 50%. In 45 patients (90%) depth and severity of burn were 2nd degree (superficial and deep) and in the remaining 5 patients (10%), it was 3rd or 4th degree. In 28 (56%), 1 (2%), 3 (6%), 35 (70%), 48 (96%), 19 (38%) and 6 (12%) patients IgG, IgM, IgA, IgG1, IgG2, IgG3 and IgG4 were lower than normal values, respectively. No significant correlation was seen between burn size (TBSA) and value of immunoglobulin (P>0.05). Although the drop in the serum concentration of immunoglobulins is irrespective to the burn size, more severe burn is associated with more decrease in the serum levels of IgA, IgM, IgG and its subclasses. However, further studies are needed to provide complementary data on this issue.