Epidemiological studies of burn patients in a burn center in Ghana: any clues for prevention?

BACKGROUND: Burn injuries are a serious problem worldwide, with most occurrences in low- and middle-income countries. Depending on the extent of injury, burn victims are faced with the challenges of fitting into society due to complications such as extensive scarring and contractures. The current study seeks to determine whether epidemiological studies of burn patients can provide guidelines to enhance burn prevention among the Ghanaian population. METHODS: Data from the Burns Registry of the Burns Intensive Care Unit (BICU) of Komfo Anokye Teaching Hospital (KATH) was obtained. Data on sex, age, aetiology, % total body surface area (TBSA), and admission outcomes from May 1, 2009, to April 30, 2013, were retrieved for a total of 487 patients during this period. RESULTS: Data on burn admissions comprising 263 (54.0 %) males and 224 (46.0 %) females were obtained from the Burns Registry. Children 0-10 years were the most affected age group. The yearly mean % TBSA ranged from 24.74 % to 35.07 %. The majority of burns was caused by scalding. Mortality rates ranged from 8.4 % to 32.0 % during the period under review. CONCLUSIONS: The study shows that children of 10 years old and below are the most affected group; this may be due to inattention to these children by parents/caretakers. Safety and safe working environments should be provided at home and workplaces, and promotion of education on burn prevention should be intensified.

Burn disasters in the middle belt of Ghana from 2007 to 2008 and their consequences.

AIM: To study the survival and mortality trends in four fire disasters in the middle belt of Ghana from 2007 to 2008 and to explore measures that could minimize the risk of future disasters. METHODS: Data were collected from clinical records from the Burns Intensive Care Unit and the Casualty Unit of the Komfo Anokye Teaching Hospital, Kumasi, Ghana and from the various disaster sites and the Ghana Police Service. RESULTS: A total of 212 were injured from four burn disasters; 37 (17%) died on the spot; 175 (83%) reported to the Casualty Unit out of which 46 (26%) were admitted. The victims admitted had mean age 24.6 years with male to female ratio 2.3:1; 25 (54%) of the admitted victims died. The average burned surface area of the admitted victims was 63%, with a mean survival rate of 46%. Statistical analysis for mortality when the surface area of the burn was >70% was 0.0005 (P-value). CONCLUSION: The four petrol-related fire disasters showed variable mortality rates. Death and severe disability of victims of future disasters can be avoided if intensive road accident preventive measures and massive public education are encouraged.

Current prevalence of hepatitis delta virus (HDV) infection and the range of HDV genotypes in Lebanon.

Recently the prevalence of hepatitis B virus (HBV) genotypes and the association between these genotypes and the clinical status of HBV-infected patients were recently investigated in the Lebanese population. The aim of the additional study reported here was to determine the current prevalence of hepatitis delta virus (HDV) infection and the range of HDV genotypes in this Lebanese population. Two hundred and fifty-eight HBsAg-positive patients (107 asymptomatic blood donors, 92 with chronic hepatitis, 24 with cirrhosis, 15 with hepatocellular carcinoma, 20 patients on haemodialysis) from ten medical centers in Lebanon were tested for antibody to hepatitis D virus (anti-HDV). Those testing positive were analysed further for HDV-RNA and for genotyping by reverse transcriptase-polymerase chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP). Three samples (1.2%) were anti-HDV positive and out of these, only one was HDV-RNA positive (0.6%) and was analysed as HDV genotype I. Our results point to a low endemicity of HDV in the Lebanese population which is in sharp contrast to data reported from Lebanon 20 years ago and to the situation in neighbouring Arab and non-Arab countries in the Mediterranean region. HDV genotype I seems to be the predominant genotype in Lebanon and the Middle East.

[In situ hybridization in undifferentiated nasopharynx carcinoma in Tunisia. Report of 3 cases]. / Hybridation in situ dans les carcinomes indifférenciés du nasopharynx en Tunisie. A propos de 3 observations.

The undifferentiated carcinoma of nasopharyngeal type (UCNT) is highly prevalent in South East Asia countries and has intermediate incidence in Tunisia, where Epstein-Barr virus constitutes one of the key factors of oncogenesis. Our preliminary results, in 3 patients with UCNT, show an elevated rate of EBV antibodies and a latent infection (type II) (expression of LMP and absence of ZEBRA by immunohistochemical reaction) and a positive staining with EBERs probe by in situ hybridation (ISH) in all cases. These results confirm a close association between EBV and tunisian UCNT. Moreover, the use of HIS technique for detection of EBERs constitutes an additional and formal argument of this association.

Evaluation of efficacy and safety of thymus humoral factor-gamma 2 in the management of chronic hepatitis B.

BACKGROUND/AIMS: We investigated the antiviral and immunomodulatory effects of a combination treatment using thymus humoral factor-gamma 2 and alpha-interferon in patients with chronic hepatitis B in whom previous monotherapy with interferon had failed. METHODS: Nine HBeAg and HBV-DNA seropositive patients received thymus humoral factor-gamma 2 alone for 2 months, thymus humoral factor-gamma 2 plus alpha-interferon for 2 months and finally alpha-interferon alone for 2 months. RESULTS: Treatment with thymus humoral factor-gamma 2 alone was not associated with any side effects. The interferon-induced lymphopenia was significantly less marked during the combined therapy in comparison to the previous course with interferon alone (mean reduction of lymphocyte counts 33.5 +/- 11.6% versus 56.3 +/- 16.7%, respectively, p < 0.05). The combination of thymus humoral factor-gamma 2 plus interferon showed a significantly more profound inhibition of serum HBV-DNA (mean reduction from the pretreatment level 90.6 +/- 13.3%) compared to the earlier monotherapy with interferon in the same patients (mean reduction 55.5 +/- 34.7%, p < 0.01). As a result of the combined thymus humoral factor-gamma 2 plus alpha-interferon regimen three out of nine patients became HBV-DNA negative and seroconverted to anti-HBe. Thymus humoral factor-gamma 2 appears to exert mainly a functional effect on T lymphocytes, as interleukin-2 production was increased in the majority of treated patients, whilst the expression of lymphocyte activation markers remained unchanged. CONCLUSIONS: These data suggest that thymus humoral factor-gamma 2 may be useful in a combined therapeutic approach in chronic HBV carriers.

Orthotopic liver transplantation for hepatic complications of Wilson's disease.

Thirteen orthotopic liver transplantations were performed in 12 patients for hepatic complications of Wilson's disease between May 1988 and July 1992. Ten patients had fulminant hepatic failure and two chronic liver disease. One patient underwent retransplantation for liver abscess secondary to hepatic artery thrombosis. Nine patients survive at a median follow-up of 18 (range 6-31) months. Three patients have died: two from multiple organ failure and sepsis, one from B cell lymphoma. Postoperative complications included bleeding requiring laparotomy in two patients, renal impairment in five, bacterial septicaemia in three, fungal sepsis in two and acute cellular rejection in six. The nine surviving patients are well with normal liver function test results.