Tuberculosis: a narrative review on epidemiology, risks, implications, preventions and treatments

Tuberculosis (TB) is an airborne disease that generally affects the pulmonary portion of the human body leading to severe coughing, fever and chest pain. It is caused by a bacterium known as Mycobacterium tuberculosis, which kills human beings each and every year globally more than the death toll of combined HIV and malaria. However, it is preventable, treatable, and curable. The world is suffering due to this dreaded disease with an approximate number of 11 million TB cases and 1.6 million deaths annually. Tuberculosis increases the public health attention because of its high mortality rates after HIV/AIDS. World Health Organisation (WHO) and Centre for Chronic Disease Control (CCDC) are the leading organizations playing an important role to combat against TB by publishing proper health guidelines and treatments through reliable awareness campaigns whenever there is sudden outbreaks of TB, COVID-19 and related diseases. A wide range of research findings, clinical reports and new treatment methods like multi-drug therapy have been developed to combat TB. It is still necessary to develop new research and innovative ideas and proper implementations of the treatment and prevention guidelines of WHO and CCDC to fight against this fatal disease. In countries having higher increase of populations due to immunosuppressed chronic diseases like HIV, diabetes and pandemics like COVID-19, eradication of TB infection is a very difficult and challenging task. This mini review is based on the critical analyses of the data available from the official websites of WHO (Global Tuberculosis Report), CCDC, and search engines like Medline, PubMed, Google Scholar, and research findings of selected articles, textbooks were used as additional sources which are cited in the reference section.

Virulence of Native Isolates of Metarhizium anisopliae (Metschnikoff) against Helicoverpa armigera (Lepidoptera: Noctuidae) in Western Uttar Pradesh, India

The Chickpea pod borer, Helicoverpa armigera (Hubner) (Lepidoptera: Noctuidae), is a destructive pest of chickpeas that has proven difficult to control using conventional methods. We isolate and evaluate the virulence of five isolates of M. anisopliae against larvae of H. armigera. All isolates of M. anisopliae, SVPUAT 1, SVPUAT 2, SVPUAT 3, SVPUAT 4 and SVPUAT 5 were most effective against second instar, H. armigera at 2 ×108 conidia/ml. Among the all isolates, SVPUAT 1 Accession no. ON183248 had the highest virulence 100 percent mortality; whereas, LT50 and LT90 were 3.16 and 5.16 days.

Climate Smart Foods: Nutritional Composition and Health Benefits of Millets

Millets are a diverse group of small-seeded grasses that have served as staple cereal crops in many parts of Asia and Africa for thousands of years. The major millets include finger millet, foxtail millet, pearl millet, proso millet, barnyard millet, little millet, and kodo millet. Millets are highly resilient crops that can thrive in arid zones and marginal farming conditions where rainfall is limited. As climate change increases drought pressures globally, millets are gaining renewed interest for their adaptability. Millets also possess highly favorable nutritional attributes. The grains are rich in protein with balanced amino acids, dietary fiber, polyphenols, vitamins, and essential minerals such as iron, zinc and calcium. The majority of millets have a low glycemic index, which helps regulate blood glucose levels. These properties give millets functional advantages over more commonly consumed cereals such as wheat and rice. This review provides a detailed analysis of the proximate composition, nutritional profile, and potential health benefits of major millets. Evidence from animal studies and clinical trials regarding the role of millets in diabetes management, cardiovascular health, cancer prevention, gut health, anemia reduction, and bone health are examined. Millets appear beneficial for weight management and obesity control Research also indicates promising avenues for millets in gluten-free diets, enhancing nutrition security for the poor, and addressing malnutrition concerns globally. However, more human studies on bioavailability, optimal dosages, food product development, and farming practices are warranted to further realize the immense potential of these “Smart Foods”. In conclusion, millets are climate-smart, nutrient-dense grains that can play a pivotal role in holistic approaches to tackle food insecurity, malnutrition, and the escalating rates of chronic diseases worldwide. Their diverse nutritional and therapeutic properties warrant the resurrection of millets as invaluable crops for the present and future.

Unlocking the Potential: Impact of Plant Growth Regulators on Hybrid Rice Growth, Grain Yield and Harvest Index

Aim: This research focused on rice, especially in Asia, and examined how plant growth regulators, including hormones and synthetic compounds, affect crucial plant processes. The findings strongly support the use of foliar Indole-3-Acetic Acid (IAA) application to enhance hybrid rice growth, grain yield, and harvest index, promising advancements in agriculture.Study Design: Randomised Block Design with 11 treatments.Place and Duration of Study: The study, conducted at the Student Instructional Farm of C. S. Azad University of Agriculture & Technology in Kanpur, aimed to investigate the impact of foliar application of plant growth regulators on rice growth and yield during 2021 and 2022.Methodology: The experiment employed a rigorous randomized block design, testing various treatments involving the foliar application of IAA (25 & 50 ppm), IBA (25 & 50 ppm), NAA (25 & 50 ppm), Ascorbic Acid (50 & 100 ppm), and Kinetin (5 & 10 ppm). The profound effects of these different regulator concentrations were observed at key developmental stages, including tillering, anthesis, dough, and maturity.Results: Significant improvements in growth parameters, such as leaf and stem dry weights per plant, along with total leaf area per plant, were evident with the application of IAA at 50 ppm. Moreover, a notable increase in grain yield per plant and harvest index was observed at maturity, primarily with the foliar spray of IAA at 50 ppm, followed closely by IAA at 25 ppm. This consistent trend was also observed in yield-related attributes.Conclusion: The use of Indole-3-acetic acid (IAA) significantly impacted plant growth and yield, including leaf and stem dry weights, leaf area, grain yield, and harvest index, showing promise for enhancing hybrid rice production.

A study on the contents of prescription of the in-patients of a tertiary care hospital, Manipur

Background: Appropriate medications are the backbone for effective control of infections and diseases. Objective of the study was to analyse the prescriptions relating to national list of essential medicines (NLEM) of a tertiary care hospital. Methods: Data was collected from 525 case sheets of the surgical in-patients for a period of 1 year which included total number of drugs prescribed, single (NLEM/non-NLEM) drugs, fixed dose combinations (NLEM/non-NLEM) drugs, most common drugs (NLEM/non-NLEM), route of administration, ADR/ADE and herbal drugs. Descriptive statistics was used for analysis of the data. Results: The total number of drugs observed in the case sheets was 2575. Out of the total drugs, 1942 drugs (75.4%) were from the list of NLEM (2022) while 633(24.6%) drugs were of non-NLEM. 266 drugs (10.33%) were generic drugs and 2309 drugs (89.67%) were proprietary drugs. The total number of single drug was 1839 (NLEM, 1805 + non-NLEM, 34) and that of the total FDC was 736 (NLEM, 137 + non-NLEM, 599). The most common drugs which were prescribed were analgesics: paracetamol 517 (NLEM); diclofenac supp.14 (non-NLEM), antibiotics: ceftriaxone 258 (NLEM, 14.5%), cefpodoxime proxetil 3 (non-NLEM, 8.9%), antihypertensive: telmisartan 13 (NLEM, 0.7%), non-NLEM nil, anti-diabetics: metformin 15 (NLEM, 0.8%), dapagliflozin 6 (non-NLEM, 16.7%), and gastroprotective drugs: pantoprazole 493 (NLEM, 27%), non-NLEM nil. Conclusions: Non-NLEM drugs should be prescribed only when there is definite advantages of the same over the NLEM drugs. Prescription of proprietary FDC drugs, factors for non-availability and under-prescription of NLEM drugs should be highlighted through CME coupled with awareness about the aim and objectives of the NLEM during clinical practice to the prescribers.

Impact of COVID-19-related lockdown on metabolic syndrome variables in healthcare workers with pre-existing metabolic syndrome: A prospective study

Background: An extraordinary impact on health-care personnel has been caused by the coronavirus disease-2019 (COVID-19) pandemic, a health-care crisis. Aims and Objectives: Our aim was to assess the effects of a changing lifestyle on anthropometric measurements, blood glucose levels, atherogenic lipid profiles, and blood pressure over the course of a year in Indian healthcare workers (HCWs). Materials and Methods: A prospective study was carried out on 40 HCWs including 23 male and 17 females between the age of 22 and 59 years. The study was conducted in the Department of Physiology and the Department of Biochemistry, Government Medical College, Kathua, UT of Jammu and Kashmir. Informed written consent was obtained from the subjects and ethical clearance was obtained from the Institutional Ethics Committee. Height, weight, waist circumference, and systolic and diastolic blood pressure were measured using standard methods. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Results: The present study found statistically significant increase in systolic blood pressure and statistically significant decrease in mean HDL-cholesterol before and after COVID-19 pandemic in HCWs. Conclusion: The onset of metabolic syndrome and its potential effects could be stopped by early use of preventative interventions in the changed parameters.

A Clinical Case Study on Pittaja Atisara with reference to Ulcerative Colitis

The symptomatology of Ulcerative Colitis (UC) presents from irregular, incomplete bowel evacuation to mucous and bloody defecation. Direct correlation of UC in Ayurvedic literature is not possible, may be correlated to Pittaja Atisara, Rakthaja Atisara, Kshataja Grahani, Samgrahini Grahani. This case report shows diagnosed case of Ulcerative Colitis with nidana (etiology), Samprapti (pathophysiology) and Rupa (clinical presentation) similar to Pittaja Atisara. Signs and symptoms observed were stools mixed with blood & mucous (Pita-Haridra-Saraktha-Sadavalaprabham), Udarashula (abdominal pain), Payusanthapa (burning sensation in anal region) and showed Rupa that of Pittaja Atisara. Treatment was given according treatment approach of Pittaja Atisara viz., Langhana, Pachana and Picha Vasthi. Initially patient general condition was worst, managed under the guidance of modern medicine consultation and gradually tapered to Ayurvedic medicines. Oral medicines chosen were based on Rakthasthambaka, Vranaropana, Agni deepana and Grahi action, the drugs used for Pichha vasti are Madhu, Charngeryadi ghritam, Murivenna, Yashtimadhu kalka, Shalmali kwatha. A 45-day course of treatment was given, during which 30 Picha Vasthi were administered, includes 14 days of solely Vasthi and the final 11 days of Samsarjana Kala. Treatment outcomes were evaluated using partial Mayo scores and through routine blood tests and colonoscopy. Partial Mayo score was evaluated at 0th, 15th, 30th, and 45th day of the treatment cycle. Total partial Mayo Index score went from Severe Disease (9) to Remission (1). Total Leucocyte Count (TLC) and indices for hemoglobin and RBC returned to normal range after treatment. The patient got improvement and Ayurveda treatment protocol was successful.

Comparative evaluation of therapeutic efficacy and safety of 40% hydrogen peroxide versus 80% of trichloroacetic acid in genital warts

Background: Warts are a common manifestation of infection due to HPV, prevalence more common in developing world. No modality is 100% efficacious in the management of warts. Topical therapy is more preferred method by majority of patients. Trichloroacetic acid (TCA) solution is well established modality in treatment of genital warts. Hydrogen peroxide used in higher concentrations is a good cautery agent. Aim and Objectives: The study was conducted to evaluate and compare the therapeutic efficacy and safety of 40% hydrogen peroxide solution and 80% TCA solution in genital warts. Materials and Methods: Topical 40% hydrogen peroxide and 80% TCA were used in Group A (20 patients) and Group B (20 patients), respectively, for three sittings at 2 weeks interval. Results: About 65% of the patients in TCA and 55% patients in H2O2 group had significant improvement (Grade 4 and Grade 3) (P = 0.311). Descriptive statistical methods and 2-Chi-square relation were used for analyzing data with Statistical Package for the Social Sciences (SPSS) 21 (SPSS Inc., Chicago, IL, USA). Results: About 40% H2O2 and 80% TCA, both are cost-effective and easy to use modalities with 40% H2O2 having better safety profile as compared to 80% TCA. H2O2 group showed decrease in size of lesions 63.33% versus and TCA group 70% (p value 0.311) with 10% of TCA group patients having ulcer formation versus none of the patients having significant adverse effect in H2O2 group. Conclusion: We found both the modalities to be safe and effective. However, we recommend further studies should be carried out to assess the safety and efficacy with bigger sample size and control arms for both the groups topical 40% hydrogen peroxide solution and topical 80% TCA solution.

Evaluation of sleeping patterns during the pandemic

Background: As the ongoing pandemic has triggered negative psychological effects and these negative effects have a role to play in affecting the quality of sleep, leading to sleep disorders. This demonstrates the need to implement the strategies which would be helpful in preventing and reducing the complications caused due to altered sleeping patterns. Aim and Objectives: The aim of the study was to evaluate the alteration in the sleep quality during pandemic. Materials and Methods: A questionnaire-based survey scheduled for a month was conducted in the students, office, and health-care workers. Questionnaire was based on Pittsburgh Sleep Quality Index (PSQI). This is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. The PSQI differentiates “poor” from “good” sleep by measuring seven components: Subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction over the past 4 weeks. Consent was obtained from all participants and participation was voluntary. Results: There was observed a decline in all the seven components of PSQI score, namely, subjective quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction in COVID times as compared to the pre-COVID times. Conclusion: Pandemic has led to the alteration of the sleeping patterns and has led to decline in the sleep quality index.

Unilateral Vocal Cord Paralysis In Gastrointestinal Malignancies- A Rare Presentation

Background Advancements in diagnostic modalities have brought many hidden etiological causes of unilateral vocal cord paralysis (UVCP) to light. Here we are presenting two cases of gastrointestinal (GI) malignancies with metastases causing UVCP which can further add to another rare cause of UVCP. Case summary We are presenting a case of 40 year male with metastatic periampullary carcinoma leading to UVCP and another case of 45 year female with rectal carcinoma further causing UVCP. Both patients were under treatment while during follow-up, symptoms of UVCP were observed which changed our perspective towards cases of UVCP. Conclusion Vocal cord palsy is a symptom of an underlying disorder and not a disease. In above case reports metastases are the commonest etiology for vocal cord palsy. Relevant investigations have to be conducted in order to diagnose the etiology and the modality of treatment varies depending on the etiology of the condition.

Prospective Study on Road Traffic Accident Cases in Sub-urban Region of Chennai, Tamil Nadu State

The present study consists of 100 road traffic injury cases admitted in our tertiary health care centre. In the present study, males victims (84 cases, 84%) outnumbered the females victims (16 cases, 16%) with an approximate male female ratio of 5:1. Four wheelers and two wheelers involving mainly pedestrians were the most common cause for fatal head injury seen in 66 cases, 66%. Multiple abrasions were the most commonly seen external injury, seen in 68 cases, 68%. Skull bone fracture was seen in 40 cases, 40%. Temporal and parietal bones were common site of fracture seen in 41 cases, 41%.The mean survival period was 73.42 hours, range being 6 hours to 600 hours.

Quantitative Assessment of Muscle Activity and Joint Load in Braced and Unbraced Osteoarthritis Knee by External Strain Gauge Sensor.

Objectives: Altered biomechanics leads to the development of degenerative joint disease. The joint pressure and dynamic loading varies during activities of daily living. The study was undertaken to assess the muscle activation pattern of the medial and lateral knee compartments (tibiofemoral joint) during gait in osteoarthritis subjects without and with knee brace undergoing either exercise therapy or balance therapy. The joint load was assessed by the strain gauge transducer and the weight shift pattern is taken as an indicator for the muscle activation pattern. Methods: In a prospective design study on 57 male subjects diagnosed osteoarthritis knee with KellagrenLawrennce scale walked barefooted with and without designed offloader knee brace on a level surface for three minutes. The subjects were allocated in two different study groups i.e. Conventional (exercise therapy) (Control Group, n=31) and Structured Neuromuscular Postural Training (SNPT) group (Balance therapy) (Study Group, n=26). The subjects were sub grouped as pre-elderly (40-60 Years) and elderly (>61 years) group in both. The quantitative assessment of muscle activity and joint loading with and without knee brace was done using designed strain gauge sensor instrument. The pressure changes of strain gauges of muscles around the knee joint viz. vastus medialis (VM), vastus lateralis (VL), semi membranosus / tendinosus (Medial Hamstring) (MH), Biceps Femoris (Lateral Hamstring) (LH), gastro-soleus (GS) and tibialis anterior (TA) muscles during normal gait were observed at baseline and 6 weeks follow up after undergoing exercise therapy or balance therapy treatment as per allocation of study groups. The digital values from MATLAB were recorded and analyzed. Results: At the end of 6 weeks conventional / SNPT (structured neuromuscular postural training) treatments, medial hamstring muscle activity showed significant difference (p<0.001) in pre-elderly subgroup, while significant difference was seen in vastus laterals (VL), medial hamstring (MH) (p<0.005) and lateral hamstring (LH) muscles (p<0.001) in elderly subgroup

Clinical evaluation of the role of tulsi and turmeric in the management of oral submucous fibrosis: A pilot, prospective observational study.

The aim of the present study was to investigate the clinical efficacy of herbal medicines (1 gm tulsi and 1 gm turmeric mixed in glycerine base) for the treatment of oral submucous fibrosis (OSMF). Forty‑one patients in the age group of 17- 56 years without any systemic complications were included in the study. The patients were treated with medicines, which were to be applied 3-4 times a day. Blood samples were collected before and after treatment to screen for any systemic changes due to these medications. Burning sensation and mouth opening were recorded before and after treatment. Patients were followed up on monthly subsequent visits for three months. Changes in the burning sensation on visual analogue scale (VAS) scale and difference in the mouth opening were analyzed statistically. A statistically significant improvement was seen in both burning sensation and mouth opening. Tulsi and turmeric offers a safe and efficacious combination of natural products available for symptomatic treatment of OSMF.

Radiological assessment of age of adolescents from wrist joint: A prospective study of 151 cases .

It is a prospective, radiological study of age assessment of 151 cases of young adolescents (Boy = 70; Girl = 81) in the age range of 14-17 years by taking A-P view X-rays of their right wrist including hands. This study had resulted in considerable narrowing of the range of radiological age assessed using the X-ray of the hand, from 15 years 19 years to 14 years – 17 years in both boys and girls. Our finding was also consistent with the age from the available date of birth certificates of these students.

Trends of poisoning cases in Melmaruvathur region of Tamil Nadu: A retrospective study of 3 years.

Background: Poisoning cases is a significant contributor to mortality and morbidity all over the world. Acute poisoning cases form one of the commonest causes of emergency hospital admissions. Material and methods: It is a retrospective study of 106 poisoning cases admitted in M.A.P.I.M.S., which is a tertiary health care centre in Tamil Nadu, India from January 2010 to December 2012. Results: The incidence of poisoning was highest in the age range from 20-50 years. Most common poison was insecticide/ rodenticide and cases were mostly suicidal in nature. Conclusion: Trends of poisoning cases in melmaruvathur region of Tamil Nadu are more or less similar to other parts of India.

Fatal craniocerebral injuries in victims who survived for some period.

It is a prospective study of 50 fatal head injury cases whose medico legal autopsy was done in the Institute of Forensic Medicine, Madras Medical College and Government General Hospital, Chennai from December 2007 to June 2008. There were total 50 cases of fatal craniocerebral injuries which needed admission either in Intensive Care Unit or neurosurgery. In the present study, male victims (47 cases, 96%) outnumbered female victims (3 cases, 6%) with an approximate male-female ratio of 16:1. Road traffic accidents (RTA) involving mainly pedestrians and two wheeler users were the most common cause of fatal head injury, seen in 43 cases (86%). Out of the total 50 cases of fatal head injury, brain stem injury was seen in 41 cases (82%). Skull bone fracture was found in 26 cases (52%), 11 cases were associated with primary brain stem injury and 15 cases with the secondary brain stem injury. Temporal and parietal bones were the common site of fracture, observed in 17 cases (34%). The range of survival period was wide, spreading from 6 hours to 600 hours; the mean survival period being 73.42 hours. Brain stem injury, which is generally associated with skull base fracture, was found to be the main factor governing the prognosis of the case.

Comparison of Low- and High-dose Rate Brachytherapy in Carcinoma Cervix: Results From a Randomized Study.

Purpose: We are reporting results of a randomized study with the aim to compare the results of low-dose rate (LDR) versus high-dose rate (HDR) brachytherapy in locally advanced carcinoma cervix patients. Material and methods: Sixty cases of carcinoma of uterine cervix in Stage IIB-IIIB (FIGO) were included from a period of January 2002 to March 2003 and were randomized into HDR brachytherapy (6 Gy/fraction for 4 sessions) or LDR brachytherapy (27 Gy/single session) arm after completion of external beam radiotherapy (50 Gy/25#/5 weeks). Results: In HDR arm, 16/30 (53.33%) patients experienced complete response. In LDR arm, complete response was experienced by 13/30 (43.33%) of patients. Locoregional control in HDR group was 54.54%, 57.14% and 71.42% at 6, 9 and 12 months, respectively. Locoregional control in LDR group at 6, 9 and 12 months was 45%, 63.63% and 42.85%, respectively. Conclusion: The results of our study indicate that LDR and HDR groups are similar in locoregional control in the management of carcinoma uterine cervix. HDR brachytherapy can safely substitute LDR brachytherapy applications.

Protective Effect of Ethyl Acetate Extract of Acacia Catechu in Carbon Tetrachloride Induced Hepatotoxicity.

Objective: To study the protective effect of ethyl acetate extract of Acacia catechu in carbon tetrachloride induced hepatotoxicity in albino rats. Methods: The liver damage in albino rat was induced by a subcutaneous injection of 50%v/ v carbon tetrachloride in olive oil at the dose of 2ml/kg twice a week for 14days. The hepatoprotective activity was monitored biochemically by estimating serum transaminases, serum alkaline phosphatase, serum bilirubin and serum protein after intraperitoneal injection of ethyl acetate extract of Katha(250mg/kg). Silymarin(5mg/kg.I.P) was given as a reference drug. The histopathological changes of liver samples were compared with that of control. Results: Ethyl acetate extract of Acacia catechu inhibited carbon tetrachloride induced liver toxicity in albino rats at 250mg/kg body weight as assessed by the biochemical and histological examination. Conclusion: Ethyl acetate extract of “Katha” exhibited significant hepatoprotective activity.

Mortalidad tras un año de protocolización en el manejo del paciente quemado / Effects of standarization of burn patient treatment on mortality

Background: In 2006, the burn unit of an emergency public hospital in Chile standardized its medical and surgical treatment protocols. Aim: To analyze the evolution of mortality among patients admitted to the unit after the standardization process. Material and Methods: Patients admitted to the unit between March 2005 and March 2006, were analyzed. An early surgical debridement was performed, according to the guide-lines, after a standardized reanimation with Lactate Ringer using Parkland formula (4 ml/kg/ percent burn surface area). All patients were monitored. An algorithm was used to decide the indication of vasoactive drugs or invasive monitorization. Results: Eighty eight patients aged 43 +/- 19 years (65 percent males) were admitted. The estimated percentage body burned was 30 +/- 21 percent, deep in 12.5 +/- 17 percent. A mean of 9.122 +/- 6.930 mi of fluid were administered in the first 24 hours. The first surgical debridement was performed at 48 hours (range 1 to 15 days). The first escharotomy was performed at 4.2 days (range 3 hours -15 days), the first covering at 3.8 days (range 3 hours-19 days) the first auto graft at 18 days (range 4-26 days). Operative times in the first three surgical procedures were less than 87 min. Global mortality was 37 percent. Conclusions: The standardized treatment of burns resulted in an absolute reduction of mortality.

Introducción: En el 2005 el Servicio de Quemados del HUAP inició un proceso de modernización. Durante el primer año se intervino en el protocolo terapéutico médico y quirúrgico. Se analizarán la mortalidad observada en este período. Materiales y Métodos: Se analizaron los pacientes admitidos en Cuidados Intermedios e Intensivos de nuestra unidad desde el Iº de marzo de 2005 a Iº de marzo de 2006. Se realizó aseo quirúrgico precoz, según protocolo, previa reanimación estandarizada con Ringer Lactato usando la fórmula de Parkland, 4 cc/kg/ por ciento SCT (superficie corporal total). Todos los casos fueron monitorizados, guiados por diuresis y con algoritmo para decidir inicio de drogas vasoactivas o monitorización invasiva. Resultados: Ingresan 88 pacientes, 58 por ciento trasladados de otros centros. Edad promedio 43 +/- 18,9 años; hombres 65 por ciento, mujeres 35 por ciento; superficie corporal quemada 30 +/- 21 por ciento, profunda 12,5 +/- 17 por ciento. Se administró en promedio 9.122 +/- 6.930 ce durante las primeras 24 hrs. Primer aseo se realizó a las 48 hrs (1 hr -15 días), Ia escarectomía a los 4,2 días (3 hrs - 15 días), Ia cobertura a los 3,8 días (3 hrs - 19 días), 1er autoinjerto a los 18 días (4 - 26 días). Tiempos operatorios promedio en las 3 primeras cirugías inferiores a 87 min. Mortalidad absoluta disminuyó a 19 por ciento. Mortalidad global 37 por ciento. Conclusiones: Luego del primer año del proceso de modernización, con reanimación estandarizada, equipos quirúrgicos proporcionales a la SCT quemada con disminución de los tiempos quirúrgicos, asociado a un manejo multidisciplinario, se logró una disminución de la mortalidad global.