The treatment of paediatric burns using topical papaya.

Due to the limited resources for the management of burns in most regions of Africa there is a significant role for many aspects of traditional African medicine. The active component of many traditional preparations is often of plant origin and more than 25 plants have been described as useful in relations to burns and wound healing. Carica papaya is currently used in The Gambia at the Royal Victoria Hospital, Banjul in the Paediatric Unit as the major component of burns dressings, where it is well tolerated by the children. Cheap and widely available, the pulp of the papaya fruit is mashed and applied daily to full thickness and infected burns. It appears to be effective in desloughing necrotic tissue, preventing burn wound infection, and providing a granulating wound suitable for the application of a split thickness skin graft. Possible mechanisms of action include the activity of proteolytic enzymes chymopapain and papain, as well as an antimicrobial activity, although further studies are required.

Biomechanical characterization of tissues in Dupuytren's disease.

The aim of this study was to characterize mechanical properties of tissues of Dupuytren's disease and to attempt to identify changes due to cellular activity. Tensile tests confirmed the heterogeneity of Dupuytren's disease tissue with distinct stress-strain curves for the three tissue types normally present, namely, cord, transition zone and nodule. The tensile strength for cord tissue was nearly twice that of nodule tissue, but the latter was nearly twice as stretchable as cord. In contrast, the transition tissue had the tensile strength of cord with the stretchability of nodule. It was found that tensile loading stimulated a cellular response as demonstrated by an increase in the creep strain rate of the tissue at 37 degrees C compared with that at 4 degrees C using Dupuytren's tissue in an in vitro culture test. The creep strain rate for nodule at 37 degrees C was more than seven times that for cord at a nominal creep stress of 0.75 MPa.

The revolutionary dual cyclone vacuum cleaner--a new cause of digital friction burns in children.

Household domestic appliances are often sources of potential hazard for young children. This case report illustrates this with reference to a revolutionary dual cyclone vacuum cleaner causing a full thickness burn in a young child.

An investigation into changes in lung function and the subjective medical benefits from breast reduction surgery.

The aim of this study was to assess the respiratory changes following reduction mammaplasty in women presenting for elective surgery; In addition, to assess whether these changes might be related to any symptomatic improvement. This was a prospective study examining women attending for breast reduction surgery over a 3-month period. Preoperative pulmonary function studies (PFTs) and a symptom questionnaire were completed before operation. These were repeated 6-8 weeks after surgery. Pulmonary function testing was carried out in all cases by the same operator. The study was carried out within a sub regional centre for plastic and reconstructive surgery. Local Ethics committee approval was obtained. Nineteen healthy women mean age 34.9 years and with a mean Body Mass Index of 27.62 were recruited. The mean weight of excised breast tissue was 1546 g. All preoperative pulmonary function tests were within normal limits. Six of the women smoked, none changed their smoking habits over the course of this study. Changes in pulmonary function studies were analysed using the paired t-test. A 'P' value of < 0.05 was considered to be significant. Seventeen women had a post operative improvement in PFTs. Statistically significant improvements were obtained for changes in peak expiratory flow rate (PEFR, P = 0.005) and peak inspiratory flow rate (PIFR, P < 0.0001). The 'P' values for changes in FEV1 (forced expired volume in 1 second) and FEV1/FVC (forced vital capacity) did not reach significance, whilst the 'P' value for the change in FVC was statistically significant (P = 0.01), although the actual mean change was small (0.07 litres). The study sample was too small to relate these changes to mass of excised tissue or BMI. All women taking part claimed an increased confidence and a cessation in analgesic use. Other reported benefits included an improved exercise tolerance (12/19), reduced sleep disturbance (4/19) and reduced breathing difficulties (1/19).

Hand trauma and herpes infection.

A herpes simplex type 2 infection of the hand after injury is described in a 26-year-old man. The management and implications of such an unusual hand infection are discussed.