A rare type of burn injury due to butane gas inhalation.

BACKGROUND: Abusive inhalation of butane gas is becoming a serious public health problem among teenagers and young adult population; however, there has been little reporting on explosion burns associated with abuse of butane cigarette lighter fluid. METHODS: Retrospective study was conducted of 22 patients who were burned in last 2 years in explosion of butane gas, a flammable, odorless, and colorless aliphatic hydrocarbon. RESULTS: Details of sociodemographic profile of the patients, any underlying psychiatric illness, alcohol abuse, depth of burn injury, any associated injury, duration of hospitalization, and percentage of burned area were recorded and analyzed. CONCLUSION: All of the patients were young men, and most had superficial burn injury. Hospital stay ranged from 0 to 11 days. All of the patients were treated with conservative management.

Attitudes and behaviors of physicians in dealing with difficult patientsand relatives: a cross-sectional study in two training and research hospitals.

BACKGROUND/AIM: The aim of this study was to examine the reasons constituting the definition of 'difficult patient' and to evaluate attitudes and behaviors of physicians in coping with these patients and their relatives. MATERIALS AND METHODS: This cross-sectional study was conducted in May and June 2013 with 400 randomly selected physicians from different specialties working in two training and research hospitals in Ankara. A questionnaire was created by reviewing the relevant literature, by family medicine clinic, and delivered to the physicians following a pilot study. RESULTS: In our study 92.8% of the physicians participating had experienced a negative contact with patients and/or their relatives, previously; 46.8% of the participants stated that they used their own experiences in coping with those situations. The frequency of negative communications was higher in surgical departments, increasing with average daily working hours and number of patients and decreasing with the experience of the physicians. The ways of coping with a difficult patient were nonjudgmental listening, patience, tolerance, and empathy, in declining order of importance. CONCLUSION: Physicians frequently experience negative communications with patients and/or relatives. Awareness of physicians about the concept of difficult patients and the causes and solutions should be enhanced.

Estimated beginning time of local anesthesia effectiveness in forced cold air application: A preliminary study.

BACKGROUND: The literature has reported that forced cold air anesthesia decreases the discomfort effect of various laser therapies. The aim of this preliminary study was to determine the average beginning time of the local anesthetic effect of the forced cold air application when it is applied to all body surfaces except the face. MATERIALS AND METHODS: A total of 52 participants (26 females and 26 males) were included in this study. During application of the forced cold air, the beginning time of local anesthesia effectiveness for each volunteer was determined by giving painful stimuli. The results were then analyzed statistically. RESULTS: The mean beginning time value of the local anesthesia was 52.88 (ranging between 30 and 60) seconds in the female group and 56.34 (ranging between 30 and 60) seconds in the male group. The mean beginning time value of the local anesthesia was 54.61 (ranging between 30 and 60) seconds in both genders. There was no statistical difference between the two groups (Z = - 0.834, p = 0.404). CONCLUSION: Forced cold air anesthesia-which is a quick, safe, cost-effective, and practical local anesthesia method-seems to be useful and effective when used alone in laser treatment.

Comparison of Subciliary Approaches in Orbito-Zygomatic Fractures: Skin Flap Versus Skin-Muscle Flap.

BACKGROUND: Because of the complications of classical subciliary incision, some modified subciliary approaches have been described in recent literature. OBJECTIVES: The aim of this study was to compare 2 commonly used subciliary approaches according to development of postoperative complications (scar formation, and ectropion). MATERIALS AND METHODS: Ninety patients were included in this retrospective study. Subciliary skin flap technique (SF group) was performed to 39 patients, while the others were operated by using skin-muscle (stepped) flap technique (SMF group). Fitzpatrick skin types, genders, ages, scar scores, and ectropion scores of the patients also were recorded. RESULTS: The mean age of the patients was 39.3 (18-99) years, and the mean follow-up period was 2.1 (1-6) years. Fitzpatrick skin-type levels were between 2 and 4 (median = 3). No difference was found between 2 groups in terms of age, follow-up period, and Fitzpatrick skin-type levels. However, the scar values of the SMF group were significantly lower than the SF group statistically. Also, there was no significant difference between males and females in SF and SMF groups in terms of scar and ectropion formation. On the other hand, scar values were lower in SMF groups rather than SF group in males. Although ectropion values were not different between SF and SMF groups in females, ectropion values of SMF group were significantly lower than SF group in males statistically. CONCLUSION: Subciliary skin-muscle (stepped) flap technique can be more reliable than subciliary skin flap technique for approach to orbitozygomatic fractures.