Treatment of Post-Burn Leucoderma With Superficial Dermabrasion Followed by Suction Blister Epidermal Grafting: A Clinical Prospective Study.

Post-burn leucoderma patients remain the most challenging to treat because they have two distinct issues: textural changes and hypopigmentation that must be managed simultaneously. A variety of surgical techniques have been used with variable outcome. This prospective study evaluated the efficacy of superficial dermabrasion followed by suction blister epidermal grafting (SBEG) in post-burn leucoderma treatment. Twenty patients, 15 females and 5 males, ages ranging from 18 to 52 years, all having post-burn leucoderma ranging from 10 to 36 months, were included. The recipient sites were prepared by superficial dermabrasion. The Chinese cupping device was used for blister induction. Blister formation times, as well as the number of blisters, were noted. Complications, extent of the repigmentation, treatment efficacy and color matching were recorded. The mean time taken for blister formation was 91.75±10.29 min. The number of blisters harvested for each case ranged from 2 to 9. Regarding complications, 1 had partial graft loss, 3 developed perigraft halo at the recipient site, and all patients had temporary hyperpigmented circular macules at the donor sites. After a mean follow up period of 8.5±1.73 months, repigmentation percentage ranged from 40 to 100% with good color matching. Treatment efficacy was excellent in 3 cases (15%), good in 12 cases (60%), fair in 4 cases (20%), and poor in 1 case (5%). As regards patient satisfaction, 15 patients (75%) were satisfied, while 5 patients (25%) weren't. Combined superficial dermabrasion and SBEG appears to be a simple and cost-effective surgical treatment modality for localized post-burn leucoderma.

L'hypochromie post-brûlure reste l'une des séquelles les plus compliquées à traiter car elle relève de deux problèmes distincts : les modifications qualitatives de la peau et l'hypopigmentation qui doivent être traitées simultanément. De nombreuses techniques chirurgicales ont été utilisées, avec des résultats variables. Cette étude prospective évalue l'efficacité de la dermabrasion superficielle suivie de greffes épidermiques prélevées sur des phlyctènes induites mécaniquement (SBEG) dans le traitement de l'hypochromie post brûlure. Nous avons inclus 20 patients, 15 femmes et 5 hommes, âgés de 18 à 52 ans, présentant tous une hypochromie post-brûlure datant de 10 à 36 mois. Les sites receveurs étaient préparés par dermabrasion superficielle. Nous avons utilisé des ventouses chinoises pour créer les phlyctènes. La durée nécessaire à leur formation ainsi que le nombre de phlyctènes ont été notés. Les complications, le degré de repigmentation, l'efficacité du traitement et la justesse de la teinte ont été enregistrées. La durée nécessaire à la formation des phlyctènes a été de 91.75±10.29 min.. Le nombre de phlyctènes prélevées pour chaque cas allait de 2 à 9. En ce qui concerne les complications, un patient a présenté une lyse partielle de la greffe, trois patients ont présenté des halos autour de la greffe au site receveur et tous les patients ont présenté des macules circulaires hyperpigmentées transitoires au site donneur. Après un suivi moyen de 8.5±1.73 mois, nous avons obtenu entre 40 et 100% de repigmentation avec une teinte correcte. L'efficacité du traitement a été jugée excellente dans trois cas (15%), bonne dans 12 cas (60%), moyenne dans quatre cas (20%) et mauvaise dans un cas (5%). 15 patients ont été satisfaits (75%) alors que cinq patients ont été déçus (25%). L'association d'une dermabrasion superficielle et de greffes épidermiques prélevées sur des phlyctènes induites mécaniquement (SBEG) semble être une technique chirurgicale simple et peu coûteuse pour le traitement des hypochromies post- brûlure localisées.

Effect of probiotic administration in the therapy of pediatric thermal burn.

Oral probiotic administration has been advocated for treatment and prevention of a diverse range of disorders. This study was undertaken to evaluate the effect of probiotic supplementation on outcome of pediatric post-burn patients. Forty thermally-injured pediatric patients with total body surface burns between 20-50% and depth between 5-10% were randomized in a prospective, double-blind, controlled clinical trial into two even groups: probiotic group (n=20), who received probiotic preparations, and placebo control group (n=20). Clinical outcomes, including GIT tolerance, incidence of infection, need for grafting, length of hospital stay and mortality were recorded. Laboratory measurements of serum CRP, serum albumin, serum IgA and total lymphocyte count were done upon admission and on days 4, 7 and 14. There were no significant differences between the groups regarding age (3.67 ± 0.67 vs. 3.56 ± 0.73), sex, %BSA (34.5 ± 1.96 vs. 33.9 ± 1.82) and %deep burns (6.95 ± 0.34 vs. 7.25 ± 0.39). Frequency of diarrhea (3 vs. 9), need for grafting (2 vs. 8) and length of hospital stay (17.25 ± 0.5 days vs. 21.9 ± 2.2 days) were significantly lower in the probiotic group (p=0.038, p=0.028 and p=0.044, respectively). A trend towards a decrease in incidence of infections (7 vs. 12) was noted in the probiotic group (p=0.113). There was no mortality in our series. There was improvement in the patients' overall outcome related to wound healing and length of hospital stay following the use of probiotics. However, their effects on infectious morbidity and mortality remain unclear and require further investigation.

L'administration orale de probiotiques a été évoquée pour la prévention et le traitement de pathologies variées. Cette étude a été réalisée pour évaluer l'effet d'une supplémentation probiotique sur l'évolution d'enfants brûlés. Quarante enfants brûlés sur une surface de 20 à 50% (5 à 10% de profond) ont été inclus dans une étude prospective randomisée et répartis en 2 groupes de 20, l'un recevant une préparation probiotique (C), l'autre un placebo (T). Le devenir, la tolérance digestive, l'incidence des infections, la nécessité de greffes, la mortalité et la durée d'hospitalisation ont été colligés. Une mesure de la CRP, de l'albumine sérique, des IgA et un compte lymphocytaire étaient réalisés à l'admission et à J4, 7 et 14. Les groupes étaient comparables en termes d'âge (3,67+/-0,67 ans VS 3,56+/-0,73), de sexe, de surface brûlée (34,5+/-1,96% VS 33,9+/-1,82%) et de pourcentage profondément atteint (6,95+/-0,34% VS 7,25+/-0,39). L'occurrence de diarrhée (3 VS 9), la nécessité de greffe (2 VS 8), la durée de séjour (17,25+/-0,5 jours VS 21,9+/-2,2) étaient significativement moindres dans le groupe C (p=0,038 ; 0,028 et 0,044 respectivement). Dans ce même groupe C, on notait une tendance (p=0,013) vers une diminution des infections (7 VS 12). Aucun patient n'est décédé. Nous avons observé une amélioration de la cicatrisation et une réduction de la durée d'hospitalisation en cas d'utilisation de probiotiques. Toutefois, leurs effets sur la morbidité infectieuse et la mortalité restent flous et nécessitent d'autres études.

Ternary metal complexes of guaifenesin drug: Synthesis, spectroscopic characterization and in vitro anticancer activity of the metal complexes.

The coordination behavior of a series of transition metal ions named Cr(III), Fe(III), Mn(II), Co(II), Ni(II), Cu(II), Zn(II) and Cd(II) with a mono negative tridentate guaifenesin ligand (GFS) (OOO donation sites) and 1,10-phenanthroline (Phen) is reported. The metal complexes are characterized based on elemental analyses, IR, (1)H NMR, solid reflectance, magnetic moment, molar conductance, UV-vis spectral studies, mass spectroscopy, ESR, XRD and thermal analysis (TG and DTG). The ternary metal complexes were found to have the formulae of [M(GFS)(Phen)Cl]Cl·nH2O (M=Cr(III) (n=1) and Fe(III) (n=0)), [M(GFS)(Phen)Cl]·nH2O (M=Mn(II) (n=0), Zn(II) (n=0) and Cu(II) (n=3)) and [M(GFS)(Phen)(H2O)]Cl·nH2O (M=Co(II) (n=0), Ni(II) (n=0) and Cd(II) (n=4)). All the chelates are found to have octahedral geometrical structures. The ligand and its ternary chelates are subjected to thermal analyses (TG and DTG). The GFS ligand, in comparison to its ternary metal complexes also was screened for their antibacterial activity on gram positive bacteria (Bacillus subtilis and Staphylococcus aureus), gram negative bacteria (Escherichia coli and Neisseria gonorrhoeae) and for in vitro antifungal activity against (Candida albicans). The activity data show that the metal complexes have antibacterial and antifungal activity more than the parent GFS ligand. The complexes were also screened for its in vitro anticancer activity against the Breast cell line (MFC7) and the results obtained show that they exhibit a considerable anticancer activity.

Effect of immune-enhancing diets on the outcomes of patients after major burns.

The use of immune-enhancing diets (IEDs) has been shown to be beneficial in some categories of critically ill patients. This study aimed to evaluate the effect of early enteral feeding supplemented with glutamine and omega-3 fatty acids, as immune-enhancing diets, on the outcomes of patients after major burns. Forty thermally injured adult patients with 30-50% total body surface area (TBSA) burns, including deep areas ranging from 5-20%, were randomized into a prospective, double-blind, controlled clinical trial. They were placed into two equal groups: group A (IED group), in which patients received early enteral feeding supplemented with glutamine and omega-3 fatty acids as immune-enhancing diets; and group B (control group), in which patients received early enteral feeding not supplemented with immune-enhancing diets. Laboratory assessment of serum albumin, serum C-reactive protein, total lymphocytic count and serum immunoglobulins (IgA, IgG and IgM) was performed at admission, and on days 4, 7 and 14. Finally, outcomes were assessed by monitoring the survival rate, the length of hospital stay and the incidence of infection. There were no significant differences between the IED and control group regarding age (28.7±5.32 versus 29.85±5.94), sex, weight, %TBSA (37.75±4.4 versus 38.3±4.84) and %burn depth (11.7±2.36 versus 10.7±2.036). The incidence of infection (2 versus 8) and the length of hospital stay (16.3±0.92 days versus 17.95±2.96 days) were decreased significantly in the IED group versus the control group. There was no significant difference between the survival rates in both groups as there was only one death in the control group. Thanks to IEDs, patient outcome was improved and infectious morbidity and length of hospital stay were reduced, but there was no effect on the survival rates following major burns.

L'utilisation de régimes qui stimulent le système immunitaire a été montrée à être bénéfique dans certaines catégories de patients gravement malades. Cette étude sur les patients atteints de grands brûlés visait à évaluer l'effet de l'alimentation entérale précoce complétée par la glutamine et les acides gras oméga-3 pour stimuler le système immunitaire. Quarante patients adultes thermiquement blessés avec 30-50% de la surface corporelle totale (SCT) brûlée, y compris les zones profondes allant de 5 à 20%, ont été randomisés dans une étude prospective et clinique contrôlée, en double aveugle. Ils ont été placés en deux groupes égaux: le groupe A, dans lequel les patients ont reçu une alimentation entérale précoce complété avec de la glutamine et acides gras oméga- 3 pour stimuler le système immunitaire; et le groupe B (groupe de contrôle), dans lequel les patients ont reçu une alimentation entérale précoce sans la régime pour stimuler le système immunitaire. L'évaluation en laboratoire de la sérum-albumine, sérum protéine C-réactive, la numération lymphocytaire totale et les immunoglobulines sériques (IgA, IgG et IgM) a été réalisée à l'admission et aux jours 4, 7 et 14 après l'admission. Enfin, les résultats ont été évalués en surveillant le taux de survie, la durée du séjour à l'hôpital et l'incidence de l'infection. Il n'y avait pas de différence significative entre le groupe A et le groupe de contrôle relative à l'âge (28,7 ± 5,32 contre 29,85 ± 5,94), le sexe, le poids, le % de la SCT (37,75 ± 4,4 contre 38,3 ± 4,84) et la profondeur de la brûlure (11,7 ± 2,36 ± contre 10.7 2.036). L'incidence de l'infection (2 contre 8) et la durée du séjour à l'hôpital (16,3 ± 0,92 jours contre 17,95 ± 2,96 jours) ont diminué significativement dans le groupe A par rapport au groupe de contrôle. Il n'y avait pas de différence significative entre les taux de survie des deux groupes car il y avait seulement une mort dans le groupe de contrôle. Il y avait une amélioration dans les résultats des patients, et une réduction de la morbidité infectieuse et la durée du séjour à l'hôpital, mais aucun effet sur les taux de survie après des brûlures importantes.

Cilostazol determination by the enhancement of the green emission of Tb3+ optical sensor.

The efficiency of excited-state interaction between Tb(3+) and the industrial product Cilostazol (CIL) has been studied in different solvents. High luminescence intensity peak at 545 nm of terbium complex in acetonitrile was obtained. The photophysical properties of the green emissive Tb(3+) complex have been elucidated, the terbium was used as optical sensor for the assessment of CIL in the pharmaceutical tablets and body fluids at pH 3.1 and λ(ex) = 320 nm with a concentration range 1.0 × 10(-9)-1.0 × 10(-6) mol L(-1) of CIL, correlation coefficient of 0.998 and detection limit of 7.5 × 10(-10) mol L(-1).

Spectrofluorimetric assessment of doxycycline hydrochloride in pharmaceutical tablets and serum sample based on the enhancement of the luminescence intensity of the optical sensor Sm3+ ion.

A simple and sensitive spectrofluorimetric method for determination of trace amount of doxycycline hydrochloride (DC) in pharmaceutical tablets and serum samples was developed. In ammonia buffer solution of pH 8.9 the doxycycline hydrochloride can remarkably enhance the luminescence intensity of the Sm(3+) ion in Sm(3+)- DC complex at λ(ex)=400 nm. The produced luminescence intensity of Sm(3+)- DC complex in DMSO is in proportion to the concentration of DC and used as optical sensor for its determination. The dynamic range for the determination of DC is 1 × 10(-8)-5 × 10(-6) mol L(-1) and in case of quantum yield calculations is 7 × 10(-9)-5 × 10(-6) mol L(-1) with detection limit of 6.5 × 10(-10) mol L(-1). The enhancement mechanism of the luminescence intensity in the Sm(3+)- DC system has been also discussed. A comparison with other spectrofluorimetric methods for tetracycline derivatives in which Eu(3+) ion is used instead of Sm(3+) ion is also studied.

Mercury(II) ion-selective polymeric membrane sensors for analysis of mercury in hazardous wastes.

Two novel potentiometric sensors that are highly selective to Hg2+ ions are described. These are based on the use of 5,5'-dithio-bis(2-nitrobenzoic acid) (DTNB) and tricyclazole (TCZ) as neutral carriers in plasticized poly(vinyl chloride) membranes. Fast Nernstian responses are obtained for Hg2+ ions over the concentration ranges 7.0 x 10(-6) - 1.0 x 10(-2) and 7.7 x 10(-6) - 1.0 x 10(-2) mol l(-1) at pH 1.8 - 3.3 with lower detection limits of 5.0 x 10(-6) and 5.6 x 10(-6) mol l(-1) (approximately 1 microh ml(-1)) and calibration slopes of 30.0 and 29.7 mV decade(-1) with DTNB- and TCZ-based membrane sensors, respectively. Validation of the assay method reveals good performance characteristics, including long life span, good selectivity for Hg2+ ions over a wide variety of other metal ions, long term response stability, and high reproducibility. Applications for direct determination of mercury in hazardous wastes including dental amalgam, mercury bulbs, and fluorescent lamps give results with good correlation with data obtained using cold vapor atomic absorption spectrometry.

Determination of diclofenac in pharmaceutical preparations using a novel PVC membrane sensor.

A novel potentiometric PVC membrane sensor for determination of diclofenac in pharmaceutical preparations has been developed. The sensor is based on the use of the 2,4,6-tri(2-pyridyl)-s-triazine iron(II) diclofenac complex [diclofenac-TPTZ-Fe(II)] as an electroactive material in a plasticized PVC membrane matrix. The sensor exhibits fast, stable and near Nernstian response for diclofenac over the concentration range 10(-2)-10(-6) M and pH 5.5-9.5. Application to quality control analysis of diclofenac in various dosage forms shows an average recovery of 99% with a mean standard deviation of 0.2%. No significant interferences are caused by inorganic and organic anions and various drug excipients and diluents.

Ribonucleic acid as a novel ionophore for potentiometric membrane sensors of some transition metal ions.

Ribonucleic acid (RNA) is used as a novel ionophore in plasticized poly(vinyl chloride) matrix membrane sensors for some transition metal ions. Membranes incorporating RNA and doped in Cu(2+), Cd(2+) and Fe(2+) display fast near-Nernstian and stable responses for these ions with cationic slopes of 31.1, 31.3 and 35.5 mV per decade, respectively, over the concentration range 10(-6)-10(-2) M and pH range 4-6.5. The cadmium RNA-based sensor shows no interference by Cu(2+), Fe(2+) Hg(2+) and Ag(+), which are known to interfere significantly with the solid-state CdS/Ag(2)S membrane electrode. The copper RNA-based sensor displays general potentiometric characteristics similar to those based on macrocyclic ionophores and organic ion exchangers and has the advantage of a better selectivity for Cu(2+) over some alkaline earth, divalent and transition metal ions. The iron RNA-based membrane sensor exhibits no interference by Hg(2+) and Zn(2+), which are known to interfere with other previously suggested sensors. The nature and composition of the RNA ionophore and its cadmium complex are examined using electrophoresis, Fourier-transform infrared analysis, elemental analysis and X-ray fluorescence techniques.

A novel potassium ion membrane sensor based on rifamycin neutral ionophore.

A novel potentiometric membrane sensor for potassium ion based on the use of rifamycin as a neutral ionophore is described. The sensing membrane is formulated with 2 wt.% rifamycin-SV, 69 wt.% dibutylsebacate plasticizer and 29 wt.% PVC. Linear and stable potential response with near-Nernstian slope of 56.7 +/- 0.2 mV decade(-1) are obtained over the concentration range 1 x 10(-1)-3 x 10(-5) M K(+). The detection limit is 0.3 microg ml(-1) K(+), the response time is 10-30 s and the working pH range is 4-11. Responses of the sensor toward alkali and alkaline earth metal ions are in the order K(+) > Rb(+) > Cs(+) > Na(+) > NH(4)(+) > Ba(2+) > Mg(2+) > Ca(2+) > Sr(2+) > Li(+). The selectivity coefficient data reveal negligible interference from transition metal ions. Direct potentiometric determination of K(+) in the presence of 10-50-fold excess of alkali and alkaline earth metals gives results with an average recovery of 99.1%, and a mean standard deviation of 1.2%. The data agree fairly well with those obtained by flame photometry.

Extraction-spectrophotometric determination of iron(II) by ternary complex formation with pyrocatechol violet and cetyltrimethylammonium bromide.

A method for iron(II) determination based on reaction with Pyrocatechol Violet to form a 1:2 binary complex at pH 5-7 is described and has been extended to an extraction-spectrophotometric procedure for the determination of iron(II) by formation of the 1:2:2 iron(II)-Pyrocatechol Violet-cetyltrimethylammonium bromide ternary complex. The molar absorptivities of the binary and ternary complexes at 595 and 605 nm are 6.55 x 10(4) and 1.35 x 10(5)1.mole(-1).cm(-1), respectively. The method has been successfully applied to the determination of iron in felspar, Portland cement and sodium hydroxide.

Brucellosis in man. I. Serological diagnosis.

50 Blood samples were collected from in-patients with febrile splenomegaly suspected to be Malta fever, in Sharkia fever hospitals; Egypt. The samples were subjected to serological tests (tube agglutination, Widal & Coombs) for diagnosis of brucellosis. The results of tube agglutination (TAT) revealed that 5 (10%) were positive; the titre ranging from 1/80-1/320, 3 doubtful (1/40) and 42 negative (1/20, 1/10 and no agglutination). Results of the Coombs test on negative and doubtful of TAT showed that out of 45 patients; 3 (6.66%) were positive; the titre ranging from 1/80-1/160, one doubtful and 41 negative. Coombs test improved the titre of one positive case of TAT from 1/320-1/640. Results of serological tests (TAT & Coombs) for MALTA fever were 8 (16%); the titre ranging from 1/80-1/640, one doubtful (1/40) and 41 negative. Results of the Widal test to detect Enteric fever in the way of differential diagnosis were 7 (14%) positive out of 50 patients examined; the titre ranging from 1/80-1/160. Five of them agglutinated typhoid (O&M) suspensions. One of the sera agglutinated paratyphi A (H) suspension, the remaining one serum agglutinated paratyphi. B(H) suspension and none of the sera agglutinated paratyphi. C(H) suspension. All the positive Coombs and negative Widal cases were obtained against typhoid (O) suspension and none against any of the (H) suspensions; Coombs test was positive in two (4.65) of 43 patients negative to Widal; no improvement of titre in the positive Widal. Results of Widal & Coombs to detect Enterica were 9 (18%) positive and 41 negative.

Brucellosis in man--II. Isolation of the causative organisms with special reference to blood picture and urine constituents.

Blood and urine samples were collected from 50 patients with febrile splenomegaly suspected to be Malta fever in Sharkia fever hospitals, Egypt. Blood samples were subjected to isolation of Brucellae; blood counts and erythrocyte sedimentation rate. Urine analysis. Four strains of brucella were isolated. Two of these isolated first from the 50 patients and typed as Br. melitensis Biotype I and the others were recovered secondly and thirdly from serologically positive patients and typed as Br. abortus Biotype I. All the strains from positive serology, titre ranging from 1/160-1/640. Br. melitensis is more readily isolated from the blood than Br. abortus. Blood picture of serologically positive Malta fever showed three patients with mild leukopenia; two with relative lymphocytosis; two with secondary anaemia and three with accelerated erythrocyte sedimentation rate. Urine analysis revealed five patients with albuminuria.