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.

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.

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。

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.

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.

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.

A Preliminary Exploration of the Metrical Musicality in Robert Burns's A Red,Red Rose

The musicality of poetry is a project that has been in great need of scholars'attentions and studies due to its charming typicality,which has been a rarely-visited for a long time.To get away with this intellectual sterility and poverty,and highlight the aesthetic universality of the musicality in poetic texts,this paper aims to give a preliminary exploration of the metrical musicality in A Red,Red Rose.

The Translation and Reception of Robert Burns in China

As one of the most popular foreign poets, Robert Burns has been introduced into China since the beginning of 20th century. However the translation and acception of his works has been neglected in some scholars' research. In order to under stand the acception and influence of Burns in China, the translating and reception progress of Burns and his works will be intro duced and divided into four stages accordingly.

The Paean of Old People’s Love——The Appreciation and Analysis of Burns’John Anderson,My Jo

Robert Burns is a great Romanticism poet in Scotland; his poem absorbs the essence of Scotland ballad, and has the national feature. The poem John Anderson, My Jo, Burns chooses the subject matter from the old people’s love and praises their love as if praises the beautiful setting sun. This paper aims to appreciate this poem from the perspective of rhythm, content and form.

Efficacy of the nucleotide-binding oligomerization domain 1 inhibitor Nodinhibit-1 on corneal alkali burns in rats

AIM: To evaluate the therapeutic effect of Nodinhibit-1 on alkali-burn-induced corneal neovascularization (CNV) and inflammation. The nucleotide-binding oligomerzation domain 1 (NOD1) is a potent angiogenic gene. METHODS: The alkali -burned rat corneas (32 right eyes) were treated with eye drops containing Nodinhibit-1 or phosphate buffered solution (PBS, pH 7.4) only, four times per day. CNV and inflammation were monitored using slit lamp microscopy, and the area of CNV was measured by formula. Vascular endothelial growth factor (VEGF) and pigment epithelium -derived factor (PEDF) was determined by Western blot analysis. The TUNEL assay was used to assess the corneal apoptosis cells. RESULTS: Alkali-burn-induced progressive CNV and inflammation in the cornea. After treatment for 7d and 14d, there were statistically significant differences in the CNV areas and inflammatory index on that between two group(P<0.05, respectively). Epithelial defect quantification showed a significant difference between the two groups at days 4 and 7 after the alkali burns (P<0.05). The apoptotic. cells on days 1, 4, and 7 between the two groups showed significant differences at all time points (P<0.05, respectively). Compared to that in control group, the protein level of VEGF expression was significantly reduced whereas the PEDF expression was increase in the Nodinhibit-1 groups on day 14(P<0.05, respectively). CONCLUSION: Topical application of 10.0 mu g/mL Nodinhibit -1 may have potential effect for the alkali burn -induced CNV and inflammation. The effect of Nodinhibit -1 on CNV may be by regulation the equilibrium of VEGF and PEDF in the wounded cornea.

Potentially fatal electrolyte imbalance caused by severe hydrofluoric acid burns combined with inhalation injury: A case report

BACKGROUND Hydrofluoric acid(HF)is one of the most common causes of chemical burns.HF burns can cause wounds that deepen and progress aggressively.As a result,HF burns are often severe even if they involve a small area of the skin.Published cases of HF burns have mostly reported small HF burn areas.Few cases of HF inhalation injury have been reported to date.CASE SUMMARY A 24-year-old man suffered from extensive hydrofluoric acid burns covering 60%of the total body surface area(TBSA),including deep second degree burns on 47%and third degree burns on 13%of the TBSA,after he fell into a pickling pool containing 15%HF.Comprehensive treatments were carried out after the patient was admitted.Ventricular fibrillation occurred 9 times within the first 2 h,and the lowest serum Ca2+concentration was 0.192 mmol/L.A dose of calcium gluconate(37 g)was intravenously supplied during the first 24 h,and the total amount of calcium gluconate supplementation was 343 g.Extracorporeal membrane oxygenation(ECMO)was applied for 8 d to handle the acute respiratory distress syndrome(ARDS)induced by the HF inhalation injury.The patient was discharged after 99 d of comprehensive treatment,including skin grafting.CONCLUSION Extensive HF burns combined with an inhalation injury led to a potentially fatal electrolyte imbalance and ARDS.Adequate and timely calcium supplementation and ECMO application were the keys to successful treatment of the patient.

Burns and frostbite in the Red Army during World War Ⅱ

The start of World War Ⅱ(WWⅡ) led to the deployment of combat troops in several continents. Destruction and many casualties among both the military and civilians became an inevitable consequence. A large amount of people injured were in need of life-saving treatment and a speedy return to duty. Intensive studies of the specific issues of diagnosis and treatment of thermal injury were conducted in the Soviet Union before the war. The first special units for patients with burn injuries were created, and the first specialists received their first clinical experience. The contributions of famous Soviet scientists in the development of the treatment of burns and frostbite in WWⅡ are studied in this article. The structure of thermal injuries among military personnel and the results of their treatment are shown. Treatment, classification and quantity frostbite in the structure of sanitary losses during the WWⅡ are studied in this article.

Long-term medical treatment of patients with severe burns at exposed sites

BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.

Free Flow-through Anterolateral Thigh Flaps for Wrist High-tension Electrical Burns:A Retrospective Case Series

Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018.The clinical and pathological data were extracted from electronic hospital medical records.We obtained follow-up information through clinic visits.Results The injury sites for all 8 patients were the wrists,specifically 5 right and 3 left wrists,all of which were on the flexor side.Five patients had ulnar artery embolism necrosis and patency,with injury to the radial artery.Two patients had ulnar and radial arterial embolization and necrosis.The last patient had ulnar arterial embolization and necrosis with a normal radial artery.After debridement,the wound area ranged from 12 cm×9 cm to 25 cm×16 cm.The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns.Free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)were used to repair the wounds.The prognosis for all patients was good after six months to one year of follow-up.Conclusion Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice.The use of free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns.

Early debridement and delayed primary vascularized cover in forearm electrical burns: A prospective study

AIM To look into the management options of early debridement of the wound, followed by vascularized cover to bring in fresh blood supply to remaining tissue in electrical burns. METHODS A total of 16 consecutive patients sustaining full thickness forearm burns over a period of one year were included in the study group. Debridement was undertaken within 48 h in 13 patients. Three patients were taken for debridement after 48 h. Debridement was repeated within 2-4 d after daily wound assessment and need for further debridement. RESULTS On an average two debridements(range 1-4) was required in our patients for the wound to be ready for definitive cover. Interval between each debridement ranged from 2-18 d. Fourteen patients were provided vascularized cover after final debridement(6 free flaps, 8 pedicled flaps). Functional assessment of gross hand function done at 6 wk, 2 mo, 3 mo and 6 mo follow-up. CONCLUSION High-tension electrical burns lead to significant morbi-dity. These injuries are best managed by early decompression followed by multiple serial debridements. The ideal timing of free flap coverage needs further investigation.

The Burns Menace: Antibiotics for the Fight against Burns Bacterial Infection, a Systemic Review

Burn wound infection delays wound healing, leading to varying degrees of morbidity and mortality. Various antibiotics are administered to burn patients in burn wound management. The emergence of antibiotic resistance is a menace that costs families and the country. This review seeks to expound on infections related to burn wounds, common bacteria of burn wound infections and choice of antibiotics in burns treatment. Words such as burns, wound infection, burns injury and antibiotics were put into the Google search engine. Only articles related to the subject of burns, burn wound infection and antibiotics were used to write the review. Articles obtained included case reports on burns, research articles, review articles, short notes, briefs, literatures and other articles relating to burns. We found that the choice of antibiotics in the management of burns is an issue of major concern due to the evolution of pathogens causing these infections. The challenge of antibiotic resistance still persists in burns wound management. The commonly used topical antimicrobials included silver sulphadiazine, silver nitrate solution, silver impregnated dressings and mafenide acetate. Mafenide acetate has a wide antibacterial activity and also acts against the usual wound pathogens that were identified: Pseudomonas aeruginosa and Staphylococcus aureus. The role of antibiotic resistance is of major concern. Antibiotics must be administered after culture evidence in order to reduce the chance of increasing evolution of resistant strains of bacteria.

Factors influencing resilience in patients with burns during rehabilitation period

Purpose:To investigate the factors that influence levels of resilience in patients with burns during rehabilitation,and to provide theoretical guidance for psychological crisis prevention and intervention.Methods:A total of 129 patients with burns and undergoing rehabilitation were investigated using a demographic questionnaire,the Connor-Davidson Resilience Scale(CD-RISC),the Social Support Rating Scale(SSRS),and the Simplified Coping Styles Questionnaire.Results:The overall resilience score of burn patients was at a middle level.Multiple regression analysis showed that gender,marital status,occupation,educational level,burn severity,and a positive coping style were all significant factors influencing patient resilience.Conclusion:During psychological crisis intervention,medical staff should guide burn patients according to their individual coping styles.Such guidance would achieve a better effect,improve patient resilience,and promote positive psychological adaptation.