IMPORTANCE Total thyroidectomy is associated with risks related to temporary hypocalcemia and vocal quality dysfunction. Dexamethasone has been proposed to have a physiological effect on hypocalcemia and voice quality.OBJECTIVE To assess the effect of preoperative dexamethasone used to improve hypocalcemia and postthyroidectomy voice dysfunction.
Introduction: A patient who suffers from burn injuries can be subjected to various mental and psychological conditions that can adversely affect their health and wellbeing. Material and methods: A cross-sectional study was conducted between 1st September 2019 and 30th March 2020 in a tertiary care hospital in Pakistan. Patients were selected in the outpatient department and followup was done at two and four weeks following definitive. Some 225 patients in our study fulfilled the inclusion criteria. Patients were assessed using Urdu translated scales. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used. Data were analyzed with the help of SSPS software version 13.0. Result: Out of 119 (52.8 %) male patients, the highest percentage was of accidental injuries 106 (89%) followed by suicidal burns 9 (7.5%). A similar trend was seen in females; out of n=106 females, 92 (86%) presented with accidental burn injuries and only 11 (10%) patients have a history of suicidal burns. A fraction of the sample had a history of homicidal burn injuries, with 4 (3%) male and 3 (2%) female patients. The variation of anxiety level and depth of burn varied considerably. Among patients who suffered superficial thickness burns (n=105, 47%), 69.5% of patients experienced mild anxiety symptoms. Only 28 (26.6%) patients had moderate anxiety and severe anxiety was the lowest, at only 3.8% (n=4). A similar trend was observed in deep burn patients, but the level of severe anxiety was significantly higher at 26%. This was statistically significant (p < 0.05). Deep burn patients had the highest percentage (n=54, 45.3%) of very severe depression compared to only 10% in superficial burns. The variation between the two categories was statistically significant (p < 0.05). The majority of (35.2%) patients experienced mild symptoms of depression and this correlated with superficial burn injuries. Conclusion: A burn injury can seriously affect the mental wellbeing of patients. With the severity of burn injury we saw that severe depression was prevalent. This aspect must be taken into consideration when treating such patients and it warrants a multidisciplinary team (MDT) strategy.
Bhatti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Bhatti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background and aimContact burn injuries to the hand are common in the paediatric population, with the most common aetiology involving touching hot surfaces in the household. The hand is also often involved in paediatric scald injuries. The aim of this study was to determine the different presentations of hand burn injuries and analyse the outcomes in the paediatric population at Royal Aberdeen Children's Hospital (RACH). MethodsAnonymised clinic data for paediatric patients with hand burns presenting to our burn centre from 2017 to 2020 were retrospectively reviewed. A total of 52 patients (65 affected hands) were included in the study. Clinic letters stored on NHS Grampian's electronic patient record system were reviewed for burn surface area, time to healing, management measures including medications prescribed and sequelae of the burn injury. ResultsThe average patient age was three years and four months old. There were 31 male patients and 21 female patients. Paediatric hand burns were most commonly confined to the palm only, followed by the fingers only. Contact with a hob was the most common aetiology, followed by scald burns. The average time to healing was 10 days (range 2-28 days). No correlation was found between length of stay on initial hospital admission and time to complete healing. A total of 86.5% (n=45) of patients were managed with dressings and 13.5% (n=7) of patients underwent surgical management. Of these seven patients, four had surgical debridement of burn tissue, washout, and dressing, and the remaining three had an excision and grafting with thick split-thickness skin grafts. Of these three patients, one patient had to undergo secondary reconstruction with a full-thickness skin graft. ConclusionIt has been found that most patients in this study completely healed with primarily conservative measures of dressing care and regular check-ups. Isolated hand burns in the paediatric population present a low rate of sequelae and palms are the most common area of burn injury in this demographic.
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