Community Knowledge and Attitude about Burns First Aid (BFA) in Jazan, Saudi Arabia

Introduction and Significance: Burn injury (BI) is a considerable health issue which is responsible for around 300,000 deaths and affecting about 11 million people every year worldwide. In Saudi Arabia, the prevalence of BIs array from 112 to 518 per 100,000 per year. The appropriate awareness of performing first aid could facilitate to improve the outcomes of burns. Purpose and Objectives: To appraise the community that acknowledges burns, first aid, and associated factors among the community population in Jazan City, Saudi Arabia. The paper aims to identify limitations to encourage additional research and persuade legislators to develop improved burn-injury care recommendations and training programs. Materials and Methods: An observational-based sample survey was conducted among the people who live in Jazan City aging 13 years or more, during April 5 to May 5, 2023. Data collection was done by a validated online self-administrated questionnaire sent randomly to community members in different parts of Jazan City via social media platforms. Collected data were coded and cleaned by an excel program, and finally exported on SPSS 26.0 software. The variables were analyzed using descriptive statistics like frequencies and percentages. Also, the Chi-square test was used to investigate the relation between different variables, with a significance value of P Results: This study included 243 participants (about 62%) among them were mostly male participants (151) having a university degree. The majority of participants 75% did not take any form of BFA training in the past. This study shows that 69.9% of the participants have inadequate awareness, despite 72% having a constructive attitude towards burn first aid. Previous burn-related first aid training was significantly associated with participants’ knowledge of BFA at a p-value less than 0.05. Conclusion: This study indicates a high frequency of Jazan population having inadequate knowledge of burn first aid despite the high prevalence of a favorable attitude. There is a need to develop an effective nationwide burn prevention program and early burn first aid treatment in Saudi Arabia and promote a consistent guideline for burn first aid.

Analysis of the Cicatricial Acceleration Method (MAC®) in Skin Repair in Wistar Rattus norvegicus with Induced Chemical Burns

Introduction: The cicatricial acceleration method (MAC®) promotes photobiological effects of an anti-inflammatory and healing nature. Its therapeutic radiation is emitted, producing photobiostimulant effects that result in rapid tissue repair and better tissue quality. The treatment of burns has always been a challenge, which involves both performing surgery and controlling and guiding scar regeneration, avoiding possible morbidities. Objective: To evaluate the effects of applying the MAC methodology with an AlGa (aluminum, gallium arsenide) laser on the time and quality of tissue repair in the skin of rats after induced chemical burns. Method: 22 adult male rats were subjected to a second-degree chemical burn on the back using 50% trichloroacetic acid. After the burns, the animals were randomly separated into 2 groups: control and experimental. The control group (G1) received placebo laser therapy and the laser group (G2) underwent laser irradiation with an energy density of 100 J/cm2. Histological analysis and macroscopic evaluation were carried out by means of the paper template method. Results: Group G1 showed (53%) of the necrosis area and group G2 showed (11%) necrosis area. Conclusion: The cicatricial acceleration method (MAC®) favored the repair of wounds caused by a 2nd-degree chemical burn, optimizing time and improving quality.

Nomogram for predicting the risk of anxiety and depression in patients with non-mild burns

BACKGROUND Post-burn anxiety and depression affect considerably the quality of life and recovery of patients;however,limited research has demonstrated risk factors associated with the development of these conditions.AIM To predict the risk of developing post-burn anxiety and depression in patients with non-mild burns using a nomogram model.METHODS We enrolled 675 patients with burns who were admitted to The Second Affiliated Hospital,Hengyang Medical School,University of South China between January 2019 and January 2023 and met the inclusion criteria.These patients were randomly divided into development(n=450)and validation(n=225)sets in a 2:1 ratio.Univariate and multivariate logistic regression analyses were conducted to identify the risk factors associated with post-burn anxiety and depression dia-gnoses,and a nomogram model was constructed.RESULTS Female sex,age<33 years,unmarried status,burn area≥30%,and burns on the head,face,and neck were independent risk factors for developing post-burn anxiety and depression in patients with non-mild burns.The nomogram model demonstrated predictive accuracies of 0.937 and 0.984 for anxiety and 0.884 and 0.923 for depression in the development and validation sets,respectively,and good predictive per-formance.Calibration and decision curve analyses confirmed the clinical utility of the nomogram.CONCLUSION The nomogram model predicted the risk of post-burn anxiety and depression in patients with non-mild burns,facilitating the early identification of high-risk patients for intervention and treatment.

A Rational Design of Metal–Organic Framework Nanozyme with High‑Performance Copper Active Centers for Alleviating Chemical Corneal Burns

Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.

A 94-year-old patient with severe burns: a case report

Burns often happen unexpectedly and have the potential to cause death,lifelong disfigurement and dysfunction.[1]According to the depth of the burn wound and extent of affected burned body surface area,burns are classifi ed as mild or severe.Mild burns usually refer to burns that encompass less than 10%of the total body surface area(TBSA),mainly superficial burns.Severe burns are defined as TBSA>10%in elderly patients,TBSA>20%in adults,and TBSA>30%in children.[2]Burn injuries,particularly severe burns,are accompanied by an immune and inflammatory response,metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.[3]Therefore,burn care providers face many challenges,including acute and critical care management,long-term care,and rehabilitation.Here,we report a 94-year-old patient with severe burns who recovered well and was discharged from the hospital in a wheelchair.

Pediatric thermal burn injury:A retrospective analysis from pediatric care institutes,Eastern India

Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural hospital.This study explores the burn‑treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.Materials and Methods:A retrospective analysis of clinical data of 199 children who received treatment for burn‑injury in an isolated general surgical ward.Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort.Until the wounds healed,the treatment was repeated every alternate day.The patient’s demographic data,number of surgical dressings,length of hospital stay,and outcome were analyzed.Results:The mean age of the patients was 51.68±23.79 months.The male‑female ratio was 1.45:1.The survival rate was 99.00%.The disability rate was 4.52%.Univariate logistic regression identified the age group,total body surface area affected,depth of the wound,and time of intervention as statistically significant variables(P<0.05)predicting the disfigurement.Multivariate logistic regression identified the time intervals between surgical intervention and injury as an important predictor of morbidity.In addition,delayed presentation and delayed intervention led to a longer hospital stay,and more interventions than the early intervention cohort.Conclusions:Early debridement accelerates recovery and lessens the need for future skin grafts or contracture procedures.This approach can be used in rural hospitals as well because pediatric burns can be manageable in an isolated general ward.

基于改良Burns撤机评分量表的程序化撤机方案在机械通气>48h重症病人中的应用

目的:探讨运用改良Burns撤机评分量表启动程序化撤机方案对机械通气>48 h重症病人撤机的应用效果。方法:选取我院重症监护室(ICU)机械通气>48 h的重症病人为研究对象,将2021年1月—2021年6月的61例由医生凭临床经验评估撤机的病人设为对照组;2021年7月—2021年12月的61例按基于改良Burns撤机评分量表的程序化撤机方案进行撤机的病人作为试验组。比较两组每日撤机筛查及时率、第1次自主呼吸试验(SBT)成功率、撤机时间、平均机械通气时间、撤机失败率、ICU住院时间。结果:试验组每日撤机筛查及时率、第1次SBT成功率高于对照组,撤机时间及平均机械通气时间短于对照组,差异有统计学意义(P<0.05)。两组撤机失败率、ICU住院时间比较,差异无统计学意义(P>0.05)。结论:基于改良Burns撤机评分量表的程序化撤机方案缩短了病人平均机械通气时间以及撤机的时间。ICU护士经过培训后有足够的能力主导程序化撤机,撤机过程中病人更易获得护士的全面监护及心理照护,减轻了病人的痛苦,提高了病人的就医体验。

Effective administration of cranial drilling therapy in the treatment of fourth degree temporal,facial and upper limb burns at high altitude:A case report

BACKGROUND Fourth degree burns damage the full thickness of the skin and affect underlying tissues.Skin grafting after debridement is often used to cover the wounds of salvageable severe burns.A granulation wound can be formed by drilling the skull to the barrier layer to solve the problem of skull exposure.Low oxygen levels present at high altitudes aggravate ischemia and hypoxia which can negatively impact wound healing.The impaired healing in such cases can be ameliorated by hyperbaric oxygen therapy.CASE SUMMARY We describe a patient who presented with fourth degree burns to the left temporal and facial regions upon admission in December 2018.The periosteum of the skull and the deep fascia of the face were exposed.After the first stage of debridement and skin grafting,the temporal skin did not survive well.Granulation was induced by cranial drilling,and then a local flap was transferred to cover the wound.The left temporal and facial wounds were completely covered and the patient recovered well.CONCLUSION Skin grafting and flap transfer after early debridement to cover the wound and control infection were of great significance.In the later stages of the patient's treatment,survival of the skin graft and skin flap was observed.The second stage repair was performed to achieve successful skin grafting by cranial granulation.Granulation was formed by drilling the skull,and then the wound was closed,which is suitable for cases with skull exposure and wounds with poor blood supply.We consider that hyperbaric oxygen treatment and improving tissue oxygen supply were beneficial in this patient.

Integration of Multiple Spectral Data via a Logistic Regression Algorithm for Detection of Crop Residue Burned Areas:A Case Study of Songnen Plain,Northeast China

The burning of crop residues in fields is a significant global biomass burning activity which is a key element of the terrestrial carbon cycle,and an important source of atmospheric trace gasses and aerosols.Accurate estimation of cropland burned area is both crucial and challenging,especially for the small and fragmented burned scars in China.Here we developed an automated burned area mapping algorithm that was implemented using Sentinel-2 Multi Spectral Instrument(MSI)data and its effectiveness was tested taking Songnen Plain,Northeast China as a case using satellite image of 2020.We employed a logistic regression method for integrating multiple spectral data into a synthetic indicator,and compared the results with manually interpreted burned area reference maps and the Moderate-Resolution Imaging Spectroradiometer(MODIS)MCD64A1 burned area product.The overall accuracy of the single variable logistic regression was 77.38%to 86.90%and 73.47%to 97.14%for the 52TCQ and 51TYM cases,respectively.In comparison,the accuracy of the burned area map was improved to 87.14%and 98.33%for the 52TCQ and 51TYM cases,respectively by multiple variable logistic regression of Sentind-2 images.The balance of omission error and commission error was also improved.The integration of multiple spectral data combined with a logistic regression method proves to be effective for burned area detection,offering a highly automated process with an automatic threshold determination mechanism.This method exhibits excellent extensibility and flexibility taking the image tile as the operating unit.It is suitable for burned area detection at a regional scale and can also be implemented with other satellite data.

Therapeutic effects of anti-endotoxin antibodies and antibiotics on endotoxemia in patients with severe burns

To observe the therapeutic effects of anti-endotoxin antibodies and antibiotics on endotoxemia in patients with severe burns. Methods: After 29 patients with severe burns were divided into the anti-endotoxin antibody + antibiotic-treated group and antibiotic-treated group, the levels of plasma endotoxin, serum TNF, IL-6 and IL-8 were determined at different time points postburn. Results: The anti-endotoxin antibodies remarkably decreased the levels of endotoxin, IL-6, IL-8 and TNF in the blood but some antibiotics could not. Ceftazidime and ciprofloxacin were strong endotoxin inducers while impenem was a weak one. Conclusion: The appropriate choice of antibiotics in combination with anti-endotoxin antibodies to treat endotoxemia in sever burn injury exerts considerable effects on cytokine release, i. e. on the body’s inflammatory response.

Multidisciplinary treatment of molten aluminum combined burn:An unusual case report

Molten aluminum is among the most common causes of burns in the metal industry.However,only few reports are available on molten aluminum injuries.Herein,we report an unusual case of molten aluminum burn.The patient had burns not only on the body surface but also in the respiratory tract and esophagus,adding to the difficulty of treatment.Multidisciplinary consultation and cooperation led to the development of a treatment plan for the patient,which included tracheotomy,respiratory management,endoscopic therapy,infection control,and psychological support.To our knowledge,this is the first report of molten aluminum-induced burns involving the face,neck,respiratory tract,esophagus,and eyes.We also describe our experience with multidisciplinary treatment for the management of molten aluminum burns.

Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.

Nonlinear dynamics of the reversed shear Alfvén eigenmode in burning plasmas

In a tokamak fusion reactor operated at steady state,the equilibrium magnetic field is likely to have reversed shear in the core region,as the noninductive bootstrap current profile generally peaks off-axis.The reversed shear Alfvén eigenmode(RSAE)as a unique branch of the shear Alfvén wave in this equilibrium,can exist with a broad spectrum in wavenumber and frequency,and be resonantly driven unstable by energetic particles(EP).After briefly discussing the RSAE linear properties in burning plasma condition,we review several key topics of the nonlinear dynamics for the RSAE through both wave-EP resonance and wave-wave coupling channels,and illustrate their potentially important role in reactor-scale fusion plasmas.By means of simplified hybrid MHD-kinetic simulations,the RSAEs are shown to have typically broad phase space resonance structure with both circulating and trapped EP,as results of weak/vanishing magnetic shear and relatively low frequency.Through the route of wave-EP nonlinearity,the dominant saturation mechanism is mainly due to the transported resonant EP radially decoupling with the localized RSAE mode structure,and the resultant EP transport generally has a convective feature.The saturated RSAEs also undergo various nonlinear couplings with other collective oscillations.Two typical routes as parametric decay and modulational instability are studied using nonlinear gyrokinetic theory,and applied to the scenario of spontaneous excitation by a finite amplitude pump RSAE.Multiple RSAEs could naturally couple and induce the spectral energy cascade into a low frequency Alfvénic mode,which may effectively transfer the EP energy to fuel ions via collisionless Landau damping.Moreover,zero frequency zonal field structure could be spontaneously excited by modulation of the pump RSAE envelope,and may also lead to saturation of the pump RSAE by both scattering into stable domain and local distortion of the continuum structure.

Therapeutic approach to emotional reactions accompanied with thermal skin injury–from basic to epidemiological research

In this editorial,we discuss the status of a therapeutic approach to emotional reactions accompanying thermal skin injuries.Burns are considered a major health problem,as well as an economic and social problem,with potentially devastating and life-changing consequences.They affect a wide range of patients with different damage mechanisms,varied depths,and localizations of the burns.The most common are thermal burns,with more than 11 million occurrences annually according to the World Health Organization data.Thermal skin injuries are among the most tragic and catastrophic injuries,almost unsurpassed in terms of severity,morbidity,and mortality,as well as functional,aesthetic,social,economic,and psychological consequences.Burn survivors face stress,anxiety,depression,low self-esteem,body deformity,social isolation,unemployment,financial burden,and family problems.The advances in acute burn care have allowed researchers and physicians to pay more attention to other effects of burns,focusing on psychological consequences in particular.Apart from the significant improvements in routine protocols,it seems useful to take care of psychological disturbances that occur simultaneously but may emerge as the most lasting outcome of those injuries.In that sense,various standards and additional approaches may be involved to achieve overall recovery.

Infection control and prevention in burn victims:The role of nurses

Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.

Angioinvasive mucormycosis in burn intensive care units:A case report and review of literature

BACKGROUND Mucormycosis is a rare,rapidly progressive and often fatal fungal infection.The rarity of the condition lends itself to unfamiliarity,delayed treatment,and poor outcomes.Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients.CASE SUMMARY An 11-year-old girl with a history of 15%total body surface area scald burns involving both lower limbs progressed to develop angioinvasive mucormycosis.This further led to a thrombosis of the right external iliac artery and vein and rapidly progressive necrosis of surrounding soft tissues.She also had dextrocardia and patent foramen ovale.A right hip disarticulation and serial aggressive debridements were performed but she went on to develop systemic sepsis with multisystem involvement and succumbed to the infection.Pathology revealed mucor species with extensive vascular invasion.CONCLUSION This case highlights the importance of maintaining vigilance for mycotic infections and acting appropriately when there are signs of fulminant wound infection.

Humic Acid Effects on Reducing Corn Leaf Burn Caused by Foliar Spray of Urea-Ammonium Nitrate at Different Humic Acid/Urea-Ammonium Nitrate Ratios

Technologies for reducing corn leaf burn caused by foliar spray of urea-ammonium nitrate (UAN) during the early growing season are limited. A field experiment was carried out to evaluate the effects of humic acid on corn leaf burn caused by foliar spray of undiluted UAN solution on corn canopy at Jackson, TN in 2018. Thirteen treatments of the mixtures of UAN and humic acid were evaluated at V6 of corn with different UAN application rates and different UAN/humic acid ratios. Leaf burn during 1 2, 3, 4, 5, 6, 7, and 14 days after UAN foliar spray significantly differed between with or without humic acid addition. The addition of humic acid to UAN significantly reduced leaf burn at each UAN application rate (15, 25, and 35 gal/acre). The reduction of leaf burn was enhanced as the humic acid/UAN ratio went up from 10% to 30%. Leaf burn due to foliar application of UAN became severer with higher UAN rates. The linear regression of leaf burn 14 days after application with humic acid/UAN ratio was highly significant and negative. However, the linear regression of leaf burn 14 days after application with the UAN application rate was highly significant and positive. In conclusion, adding humic acid to foliar-applied UAN is beneficial for reducing corn leaf burn during the early growing season.

Detection of Burned Areas through Spectral Indices Analysis of Sentinel-2A Satellite Images in the Abokouamékro Wildlife Reserve (Central, Côte D’Ivoire)

In Côte d’Ivoire, the recurring and unregulated use of bushfires, which cause ecological damage, presents a pressing concern for the custodians of protected areas. This study aims to enhance our comprehension of the dynamics of burnt areas within the Abokouamékro Wildlife Reserve (AWR) by employing the analysis of spectral indices derived from satellite imagery. The research methodology began with the calculation of mean indices and their corresponding spectral sub-indices, including NDVI, SAVI, NDWI, NDMI, BAI, NBR, TCW, TCG, and TCB, utilizing data from the Sentinel-2A satellite image dated January 17, 2022. Subsequently, a fuzzy classification model was applied to these various indices and sub-indices, guided by the degree of membership α, with the goal of effectively distinguishing between burned and unburned areas. Following the classification, the accuracies of the classified indices and sub-indices were validated using the coordinates of 100 data points collected within the AWR through GPS technology. The results revealed that the overall accuracy of all indices and sub-indices declines as the degree of membership α decreases from 1 to 0. Among the mean spectral indices, NDVI-mean, SAVI-mean, NDMI-mean exhibited the highest overall accuracies, achieving 97%, 95%, and 90%, respectively. These results closely mirrored those obtained by sub-indices using band 8 (NDVI-B8, SAVI-B8, and NDMI-B8), which yield respective overall accuracies of 93%, 92%, and 89%. At a degree of membership α = 1, the estimated burned areas for the most effective indices encompassed 2144.38 hectares for NDVI-mean, 1932.14 hectares for mean SAVI-mean, and 4947.13 hectares for mean NDMI-mean. A prospective approach involving the amalgamation of these three indices could have the potential to yield improved outcomes. This study could be a substantial contribution to the discrimination of bushfires in Côte d’Ivoire.

Modified moist occluded burn therapy for the treatment of cervicofacial burns due to splashing molten steel

We present the case of a 35-year-old male foundry worker with painful burns after exposure to splashing 1500°C molten steel. This rare case involves a localized occupational-related molten steel burn on the cervicofacial region. The lesion was induced by hyperthermal contact of the skin with molten steel. This case report highlights a modified moist occluded burn therapy that is applied using a combination of modified chitin wound rehabilitating biogel (AmPoSa (?)) and sterile polyethylene film. The patient in our report achieved favourable aesthetic restoration without residual scars and hyperpigmented areas.

Modified moist occlusive burn therapy:a novel therapeutic approach for thermal burns

Severe thermal burns usually result in complex facial problems such as contracture and formation of hyper/hypopigmentation,contracture,hypertrophic scars or deformity,with patients often requiring reconstructive surgery.Therefore,seeking a superior and reliable burn therapy remains a great challenge for plastic and burn surgeons.However,the optimal treatment of thermal injuries remains controversial.In the 1960s,a new therapeutic concept,that sterile polyethylene film might be used as a type of moist occlusive dressing,was successively proposed.Below we present a hypothesis that combined utilization of sterile polyethylene film and burn cream may be a novel and superior therapeutic approach for thermal burns.To distinguish this method from traditional moist burn therapy,this new therapy we proposed is named modified moist occlusive burn therapy(MMOBT).