ABSTRACT
This study describes the epidemiology of unintentional adult burn injury admissions in a tertiary hospital in Nepal, from 2002 to 2013, focusing on gender-specific patterns. Chi-square tests and Wilcoxon Rank Sum tests were performed. There were 819 unintentional burn admissions: 52% were male and 58% younger than 35 years. The median percentage total body surface area burned (interquartile range) was greater in females than in males (P < .001): 28% (17-40) versus 20% (12-35), and female mortality was higher (32% vs 11%). A higher proportion females were illiterate than males (48% vs 17%). Burns occurred at home (67%), work (28%), and public places (5%); gender-specific patterns were observed. Flame burns accounted for 77%, electricity 13%, and scalds 8%. Kerosene (31%) and biomass (27%) were the major fuels. Cooking, heating, and lighting were the main activities associated with burn injury. Results support interventions to reduce the use of open fires and kerosene and to promote electrical safety.
Subject(s)
Accidents/statistics & numerical data , Burns/epidemiology , Hospitals, Public , Patient Admission/statistics & numerical data , Tertiary Care Centers , Adult , Aged , Burns/therapy , Female , Humans , Male , Middle Aged , Nepal/epidemiology , Risk Factors , Sex Distribution , Young AdultABSTRACT
AIMS: Intentional burns injuries are associated with high mortality rates, and for survivors, high levels of physical and psychological morbidity. This study provides a comprehensive assessment of intentional burn admissions to the adult Burns Unit at Bir Hospital, Kathmandu, Nepal, during the period 2002-2013. METHODS: A secondary data analysis of de-identified data of patients hospitalized at Bir Hospital, Kathmandu, with a burn during the period of 1 January 2002 to 31 August 2013. Socio-demographic, injury and psychosocial factors of patients with intentional and unintentional burns are described and compared. Chi-square tests, Fisher's exact test and Wilcoxon rank sum tests were used to determine statistical significance. RESULTS: There were a total of 1148 burn admissions of which 329 (29%) were for intentional burn, 293 (26%) were self-inflicted and 36 (3%) were due to assault. Mortality rates for intentional burns were approximately three times those for unintentional burns (60 vs. 22%). When compared to unintentional burns, patients with intentional burns were more likely to be female (79 vs. 48%), married (84 vs. 67%), younger (25 vs. 30 years), have more extensive burns (total body surface area, %: 55 vs. 25) and higher mortality (60 vs. 22%). Intentional burns were more likely to occur at home (95 vs. 67%), be caused by fire (96 vs. 77%), and kerosene was the most common accelerant (91 vs. 31%). A primary psychosocial risk factor was identified in the majority of intentional burn cases, with 60% experiencing adjustment problems/interpersonal conflict and 32% with evidence of a pre-existing psychological condition. A record of alcohol/substance abuse related to the patient or other was associated with a greater proportion of intentional burns when compared with unintentional burns (17 vs. 4%). CONCLUSIONS: The majority of intentional burn patients were female. Almost all intentional burns occurred in the home and were caused by fire, with kerosene the most common accelerant used. Underlying psychosocial risk factors were identified in most cases. Intentional burns resulted in severe burns with high mortality. Intentional burns are not only a serious medical issue; they represent significant public health and gender issues in Nepal.
Subject(s)
Adjustment Disorders/epidemiology , Body Surface Area , Burns/epidemiology , Self-Injurious Behavior/epidemiology , Substance-Related Disorders/epidemiology , Suicide, Attempted/statistics & numerical data , Violence/statistics & numerical data , Adjustment Disorders/psychology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Burns/mortality , Burns/pathology , Child , Cohort Studies , Employment/statistics & numerical data , Female , Fires , Humans , Income/statistics & numerical data , Interpersonal Relations , Kerosene , Male , Marital Status/statistics & numerical data , Middle Aged , Nepal/epidemiology , Public Health , Retrospective Studies , Risk Factors , Self-Injurious Behavior/psychology , Sex Distribution , Social Class , Substance-Related Disorders/psychology , Suicide/psychology , Suicide/statistics & numerical data , Suicide, Attempted/psychology , Trauma Severity Indices , Urban Population/statistics & numerical data , Young AdultABSTRACT
The protein methyltransferase Set7/9 was recently shown to regulate p53 activity in cancer cells. However, the impact of Set7/9 on p53 function in vivo is unclear. To explore these issues, we created a null allele of Set7/9 in mice. Cells from Set7/9 mutant mice fail to methylate p53 K369, are unable to induce p53 downstream targets upon DNA damage, and are predisposed to oncogenic transformation. Importantly, we find that methylation of p53 by Set7/9 is required for the binding of the acetyltransferase Tip60 to p53 and for the subsequent acetylation of p53. We provide the first genetic evidence demonstrating that lysine methylation of p53 by Set7/9 is important for p53 activation in vivo and suggest a mechanistic link between methylation and acetylation of p53 through Tip60.