ABSTRACT
BACKGROUND: Although burns are a major problem in health care, a lot of the variation in risk factors exists from region to region which if uncovered correctly could help take effective prevention measures. AIMS AND OBJECTIVES: To assess the 3-year (January 2012 to January 2015) epidemiology of burn injuries admitted to our hospital (primary objective) and to find areas of improvement in burn care (secondary objective). MATERIALS AND METHODS: After obtaining ethical approval data were obtained from the medical record section regarding age, sex, residence, occupation, marital status, socioeconomic status, dates of admission and discharge, circumstances regarding the place, intent, cause, and source of heat. Clinical assessment was done using Wallace's "Rule of Nine" in adult and "Lund and Browder" chart in the pediatric age groups. The interrelationships between clinical and epidemiological variables with burn injury were studied. RESULTS: An increasing trend in the admission rates of burn victims noted in last 3 years males (55.47%) outnumbered females (44.52%). The most common age group affected is older children, adolescents, and young adults (between 11 and 30 years). Flame (38.3%) and scald (25.3%) burns contributed to most of the injuries. Females (52.30%) are the major victim of flame burns. Electrical and chemical burns affected only the males suggesting work-related injuries. Trunk (30.8%) is the most severely affected site in all cases. Depression (6.8%) and power line workers (4.7%) seem to be important risk factors in our study. Inability to complete treatment (26.7%) was a major concern in our study. CONCLUSIONS: This study highlights the need for proper burn care that could be provided at the primary health-care level. The majority of burns were accidental in nature in school going children, young adults, and females. Flame and scald burns were the most common cause. Preventive measures directed toward burn safety and first aid measures may improve the outcome in burn injuries.
ABSTRACT
BACKGROUND: Laparoscopic cholecystectomy (LC) is normally performed under general anesthesia. But of late this operation has been tried under regional anesthesia successfully without any added complications like epidural anesthesia. AIMS: The aim of the study was to study the feasibility of performing LC under epidural anesthesia in normal patients so that the benefits could be extended to those high-risk patients having symptomatic gallstone disease and compromised cardio-pulmonary status where general anesthesia is contraindicated. MATERIALS AND METHODS: In all, 20 patients with the American Society of Anesthesiologist's class I or II were enrolled in the study. The level of epidural block and satisfaction score, both for the patient and the surgeon, were noted in the study. RESULTS: The LC was performed successfully under epidural anesthesia in all but two patients who had severe shoulder pain in spite of giving adequate analgesia and were converted to general anesthesia. CONCLUSIONS: The LC can be performed safely under epidural anesthesia with understanding between patient and surgeon. However, careful assessment of complications in the patients should be done to make the procedure safer.
