Exploring the Demographic and Social Correlates of Burn Injuries: A Comprehensive Study From a Regional Burn Center in Pakistan.

Burn injuries pose significant challenges to both patients and healthcare systems globally. This retrospective observational study, conducted at the burn center in a tertiary care hospital in Rawalpindi, Pakistan, aimed to delineate the patterns of burn injuries and correlate them with demographic and clinical presentations. A total of 99 patients were included, with 54 males and 45 females, ranging in age from three months to 70 years. Flame burns were the most common type (n=69), with the majority being accidental (n=87). Limbs were the most frequently affected body parts (n=32), often with lesser-degree burns (n=28). Notably, self-inflicted injuries were predominantly observed in males (n=7), while assault cases were more common in females (n=4). Statistical analysis revealed significant associations between the degree of burn and the body parts affected, as well as between the mode of injury and the affected body parts. Burn injuries due to assault or self-infliction tended to have higher morbidity rates, often resulting in fatalities. Additionally, the cause of burn injury showed significant associations with the affected body parts, with contact and electric burns affecting limbs and chemical burns mainly affecting the head and face. These findings underscore the need for targeted burn prevention programs, emphasizing first aid education and addressing specific risk factors in high-risk groups and settings. By implementing preventive strategies and evaluating their effectiveness, the burden of burn injuries can be reduced, leading to improved patient outcomes and quality of life.

Prevalence of non-suicidal self-injury in medical students of Rawalpindi; its socio-demographics, methods, and functions.

Objectives: To investigate the prevalence of non-suicidal self-injury among Pakistani medical students, its association with demographic variables, and the distribution of its methods and functions. METHODS: The cross-sectional study was conducted from April 2021 to March 2022 at Rawalpindi Medical University, Rawalpindi, Pakistan, and comprised medical students regardless of gender and year of study. Data was collected using the inventory of statements about self-harm scale to assess their socio-demographics, non-suicidal self- injury behaviors and functions. Data was analyzed using SPSS 28. RESULTS: Of the 411 subjects approached, 386(94%) correctly filled the forms; 170(44%) males and 216(55.9%) females. The overall mean age was 19.7 ±1.5 (range: 17-27 years). There were 132(34.1%) students from first year, 146(37.8%) second year, 44(11.3%) third year, 54(13.9%) fourth year and 10(2.5%) from the final year. There were 110(28.4%) with non-suicidal self-injury; 60(54.5%) males and 50(45.4%) females (p=0.008). There were 18 (4.7%) subjects aged 18 years, and, of them, 14(77.7%) exhibited self-harm behaviour. Among specific non-suicidal selfinjury behaviours, 'interfering with scabs and wound healing' was the most common method 80(72.7%). As for the functions of non-suicidal self-injury behaviour, there was a significant difference between intrapersonal and interpersonal functions (p<0.05). CONCLUSIONS: Non-suicidal self-injury was highly prevalent among the young subjects, and it needs proper intervention for timely management.

Empyema necessitans (EN) as a rare complication of tuberculosis - A case report.

INTRODUCTION: Empyema necessitans (EN) is an uncommon condition where an intrathoracic empyema extends into surrounding extra-thoracic tissues. This case report presents a rare instance of tuberculous EN in an immunocompetent individual. PRESENTATION OF CASE: We present a case of a healthy young male with complaints of weight loss and a chest wall swelling, initially treated as a subcutaneous abscess. He had a history of TB contact and initial laboratory tests showed elevated CRP and ESR, with no bacterial growth on initial culture from FNAC sample. Subsequent imaging revealed the presence of pleural empyema. Following surgical intervention, a connection between fluid collection outside the thoracic wall and the pleural cavity was identified. Diagnosis of tuberculous EN was made on results of second culture of the fluid collection. The patient was further treated with anti-tuberculous treatment. DISCUSSION: EN, rare extrapulmonary complication of tuberculosis, is challenging to diagnose due to nonspecific symptoms and paucibacillary nature of extrapulmonary TB. Imaging plays a crucial role in diagnosis. A multidisciplinary approach involving surgery and anti-tuberculous treatment is effective in managing EN. CONCLUSION: This case underscores the scarcity of EN occurrences and emphasizes the potential for latent TB to surface as atypical complications. Accurate diagnosis requires a combination of clinical insight, imaging, and laboratory tests. EN should be considered in individuals with chest wall masses, particularly in TB endemic areas, and those with a history of TB contact. Treatment involves surgical intervention and anti-tuberculous therapy.

Histopathological Spectrum And Role Of Clinicopathological Correlation In The Diagnosis Of Vesiculobullous Lesions.

Background: Histopathology is an important diagnostic modality for vesiculobullous lesions, however the diagnosis may at times require use of Immunofluorescence techniques which are expensive and not widely available. The aim of this study was to determine the histopathological spectrum of vesiculobullous diseases and to determine the role of clinic-pathological correlation in diagnosing bullous lesions. Methods: This was cross sectional validation study conducted in a tertiary care hospital, over a period of 18 months. All the clinically diagnosed cases of bullous diseases were included and examined as histological sections by three histopathologists. Results: Out of 58 total cases, the most frequently diagnosed lesions included Pemphigus vulgaris (27%), Bullous pemphigoid (13.8%) and Pemphigus foliaceous (12.1%). Females comprised 55% of cases, age distribution was wide but most patient were in age bracket of 20-39 years. Conclusion: There was 89.6% correlation between clinical and histopathological diagnosis. Only 2 cases were sent for Immunofluorescence studies, as histopathology was inconclusive in those cases. Therefore, we conclude that histopathological examination along with clinical correlation is a very useful way of diagnosing vesiculobullous disorders.

Intradermal application of tranexamic acid (TA) as treatment of melasma in the out-patients department of a public sector hospital: A pilot study.

The effect of intradermal TA on melasma was evaluated as a possible treatment modality on all of the 11 patients (fitting the inclusion criteria) presenting in the out-patient department of the Benazir Bhutto Hospital, Rawalpindi during Sep 2019 to Mar 2020. Their pre- and post-interventional results were evaluated after being injected with 4 mg/ml of TA on the lesions once weekly for 6 weeks, using Wilcoxon signed rank test in SPSS v 24. The average duration of melasma in our patients was 25.3±7.6 in months. The mean modified MASI score rating was 12.2 (2.3) and 5.1 (1.4) before and after intervention with intradermal TA respectively. The largest difference obtained in the mMASI scores of the patients was 10.8. TA has a distinctive effect as a treatment modality for melasma, as it is easily employable with very few side effects.