Background: Burn pain is a complex condition and specific Pain measuring scale like Numerical Rating Scale (NRS) is required to assess its severity. Aim: The goal of our study is to use the NRS to measure pain in burn patients and treat it accordingly, as per the World Health Organization (WHO) analgesic ladder. Through this study, we intend to gain a comprehensive understanding of burn-related pain experience, the effectiveness of analgesics, and the factors that may influence pain perception. Methods: In our prospective observational study, we assessed 30 burn patients for their pain scores using NRS at different points of burn wound care, and the response of pain to analgesics was noted. They were evaluated based on the intensity of their pain and how they responded to analgesics given as per the modified WHO pain ladder at different points of burn wound care. Results: The analgesics demonstrated significant efficacy in reducing pain across multiple categories: at rest (P < 0.001, median decrease from 5.0 to 3.0), in motion (P < 0.001, median decrease from 7.0 to 4.50), sudden pain without stimulus (P < 0.001, median decrease from 7.0 to 4.0), procedural pain/intraoperative (P < 0.001, median decrease from 8.0 to 4.0), and postoperative pain/postprocedural (P < 0.001, median decrease from 7.5 to 3.0). These findings signify the broad-spectrum effectiveness of analgesics in managing diverse pain scenarios. Conclusion: This study has provided a valuable insight into the potential clinical utility of medications/analgesics in managing pain in different burn scenarios, supporting their consideration as a viable option for comprehensive pain management strategies.
Purpose: Artificial intelligence (AI) is a rapidly advancing field with significant applications in healthcare, including voice-activated virtual assistants (VAs) such as Amazon’s Alexa, Google Assistant, Microsoft’s Copilot, and Apple’s Siri. These VAs have potential utility in providing information and support to patients, including those with burn injuries. This study evaluates the effectiveness of four widely used VAs in answering commonly asked questions regarding burns. Materials and Methods: Four VAs were assessed: Siri (VA1), Google Assistant (VA2), Alexa (VA3), and Copilot (VA4). These VAs were queried using ten frequently asked questions about burn injuries. Responses were rated using a modified Likert scale, where a score of 1 indicated a high-quality, adequate voice response and a score of 5 showed the lowest. One-way analysis of variance and Tukey’s post hoc analyses were conducted to compare the Vas’ performance. Results: Significant differences were found in the average scores per question among the VAs. VA4 (1.2 ± 0.15) achieved the best performance, followed by VA2 (1.62 ± 0.45), VA1 (3.67 ± 0.35), and VA3 (3.82 ± 0.65). The combined mean scores revealed a highly significant difference (P < 0.001) among the VAs, except between VA4 and VA2 (P = 0.123) and VA1 and VA3 (P = 0.580). Conclusion: VA4 proved to be the most effective in answering burn injury-related questions, followed by VA2, VA1, and VA3. The integration of advanced AI in VAs has the potential to enhance patient care, but further studies are needed to address real-world variability and expand the scope of inquiries.
Hypertension and stroke are two common problems affecting seriously burned patients. It seems that high blood pressure (BP) can increase the likelihood of stroke in these patients. This study was an attempt to offer an analysis of literature in the area of hypertension and stroke in burn patients to investigate the relationship between these two complications in these patients. Electronic databases, including PubMed, Scopus, and Web of Science, were searched systematically to identify the relevant articles. The synonymous terms and abbreviations for the words “burn,” “stroke,” and “hypertension” were searched in the databases. Articles related to the aim of our study were selected and reviewed. Cerebral infarction is a relatively uncommon but important complication following a burn injury. Hypertension, hypovolemia, hypercoagulopathy, and most importantly sepsis are the main risk factors for stroke in burn patients. Ghrelin therapy can be effective in preventing stroke in burn patients. Burn patients can also develop noncerebral infarction complications such as gastrointestinal infarction and myocardial infarction. Hypertension is another complication in burn patients. Prevalence of hypertension depends on age, sex, and severity of burn injury. The cardiovascular system of younger children is more vulnerable; therefore, they cannot resist the effects of high BP caused by burns. Thus, although the number of cases with hypertension was high, the mortality in pediatric burn patients was low. The complication of hypertension in burn patients can be of different types. One of the most important types is intra-abdominal hypertension, which can have a devastating effect on various systems of the body. Medications used to treat burn patients such as hydrocortisone and tumescence can affect BP in these patients. As mentioned earlier, hypertension is responsible for damage to various organs, such as the brain. For example, stroke can be caused by hypertension. Hypertension and stroke are usually observed in patients with a serious burn. Prevention is difficult, yet it can be reached by high-volume fluid resuscitation strategies, changing medications taken by burn patients, and treatment strategies such as ghrelin therapy. In this article, we reviewed the likelihood of stroke and hypertension in burn patients. According to the study, it seems that hypertension in burn patients can increase their risk of stroke.
Background: The aim of this study is to evaluate the role and potential benefits of hyperbaric oxygen therapy (HBOT) in the management of burns, particularly focusing on its impact on morbidity, mortality, and overall outcomes in burns patients and to emphasize the importance of trained burns intensivists for selecting burns patients in delivering this therapy safely and effectively. Materials and Methods: Data of patients admitted in burns intensive care unit in our institution from January 2012 to December 2022 were analyzed. Of 1556 who required hyperbaric oxygen treatment, 482 patients were willing to undergo treatment. They underwent a pre-HBOT session assessment by burns intensivist and fitness to undergo sessions were evaluated. Unfit patients were reevaluated on later stages of treatment. Results: Three hundred and fifty-one patients were fit to undergo HBOT during the initial 3 days postburns and 414 patients during 4–10 days. Patients who were unfit initially due to correctable causes were stabilized and later taken up for hyperbaric sessions. Expert assessment of risk benefits of each critically ill burns patients before HBOT by burns intensivist helps to authentically choose the right candidates for treatment. Conclusion: Role of burns intensivist is significant in providing hyperbaric oxygen sessions in critically ill burns patient and have the skillsets to manage the complications of both acute burns and hyperbaric oxygen treatment.
Background: Homemade explosives containing gandhak (sulfur) and potash (salts of potassium) are increasingly being used as substitutes for firecrackers, posing a significant burn hazard. Materials and Methods: We retrospectively analyzed 14 patients with gandhak–potash-related burns admitted between 2021 and 2024 at a tertiary care center. Data collected included demographics, burn characteristics, ocular injuries, management, and outcomes. Ethical approval was obtained from the institutional review board. Results: Most patients were young males (mean age: 24 years). The upper limbs (92.8%) and face (57.1%) were the most affected areas. Ocular injuries occurred in 57.1% of cases, with 21.4% developing permanent visual impairment. Three patients (21.4%) died. Distinctive features included tattooing, singeing, punctate abrasions, and deposition of unburnt particles. Blast-related injuries led to amputations and fractures. Conclusions: Gandhak-potash burns represent a unique and dangerous category of injuries requiring specialized and multidisciplinary care. These burns have a signatory presentation and pattern of injury. These incidents also highlight the public health risks associated with the unregulated availability of hazardous substances. Regulatory action and community education are urgently needed to prevent further injuries, particularly among children and adolescents during festive seasons.
