Investigating the Psychosocial Empowerment Interventions through Multimedia Education in Burn Patients.

BACKGROUND: Burns patients often encounter lots of psychological problems affecting all parts of life. This study investigated the psychosocial empowerment interventions through multimedia education in burn patients. METHODS: In a randomized clinical trial study undertaken in Shahid Motahari Burn Center in Tehran, Iran in 2016, 50 patients were selected as control and 50 patients as intervention group. The demographic characteristics and the quality of life questionnaires (BSHS-B) were used. Patients in the control group received only routine educational self-care, but the intervention group received routine cares as well as the multimedia trainings. Then, the psychological quality of life was evaluated in both groups before the interventions and after three and six months. RESULTS: Before interventions, the mean of mental dimension in intervention and control groups were 2.08±0.59 and 1.64±0.47, respectively (p<0.001). Three and six months after the intervention, they were 3.37±0.93 and 2.24±0.4, 4.11±0.74 and 2.75±0.58, respectively (p<0.001). CONCLUSION: The multimedia intervention was shown to be effective in empowering the psychology of burn patients.

The Effect of Self-Care Compact Disk-Based Instruction Program on Physical Performance and Quality of Life of Patients with Burn At-Dismissal.

BACKGROUND: Burn injuries still negatively influence the various aspects of life like physical performance and quality of life. This study was conducted to investigate at-dismissal self-care compact disk-based instruction program on the physical performance life quality of the patients with burns. METHODS: One-hundred burn patients in Shahid Motahhari Burn Center, Tehran, Iran were randomly assigned to two equal groups of intervention (n=50) and control (n=50). The latter received only routine dismissal self-care program and the former an instruction compact disc plus the routine self-care program at dismissal. The demographic information and burn patients' quality of life questionnaires were completed before and at months three and six after the intervention self-report program. RESULTS: The physical performance of the intervention and control groups before intervention was 1.61±0.71 and 1.45±0.47, respectively (p=0.41). The physical performance of the intervention group was higher than the control group at three and six months after the intervention (p<0.001). CONCLUSION: At-dismissal self-care compact disk-based instruction program can increase physical performance and quality of life in patients with burns. Therefore, the burn patients can be instructed based on self-care compact disk-based instruction program as an easy, available and less-costly method to take part in more satisfied treatment.

The Effect of Rhythmic Breathing on Pain of Dressing Change in Patients with Burns Referred to Ayatollah Mousavi Hospital.

BACKGROUND: Burn is the worst tragedy among modern societies that individuals may experience. One of the most important problems of burns is pain; particularly at the time of treatment including burn dressings, debridement, surgical incisions and physiotherapy. The aim of this study was to determine the effect of rhythmic breathing on pain of dressing change in patients with burns. METHODS: This semi-experimental clinical trial study with a control group was conducted on 60 eligible burn patients who were selected using convenient sampling method and allocated randomly in two groups of test and control (each n=30). Data collection tools included demographic data and pain observation questionnaires. The rhythmic breathing was individually and orally trained to the patients of test group in a room separated by dividers for a 20-minute session. The pain intensity in test and control groups before and after dressing was investigated for three consecutive days. RESULTS: Friedman test results showed that pain intensity in both control and test groups had statistically significant differences. The pain intensity after rhythmic breathing reduced more in the test group, and this reduction was more significant during 3 days. CONCLUSION: Rhythmic breathing is an effective method on pain reduction of dressing change in patients with burn injuries.

Effect of Multimedia Self-Care Education on Quality of Life in Burn Patients.

BACKGROUND: Burn injuries can have adverse effects on quality of life of patients and can disturb their physiological, psychological, social and spiritual well-being. This study aimed to investigate the effect of multimedia self-care program on quality of life in burn patients. METHODS: This Randomized controlled clinical trial was conducted from November 2015 to December 2016. The samples were hospitalized burn patients with 10% to 45% of 1st, 2nd and 3rd degree burns of total body surface area (TBSA). The patients were randomly allocated into experimental (n=50) and control (n=50) groups. Both groups received the routine in-person self-care trainings of the hospital and then the experimental group received self-care compact disks. The quality of life questionnaire in both groups were completed before intervention and after 3-months and statistically analyzed. RESULTS: Accordingly, the changes in quality of life and the dimensions between both groups after 3 month of intervention were significant. The changes in quality of life in experiment group was significantly greater than control group for physical, psychological and social variables. CONCLUSION: According to the findings, using multimedia self-care programs can improve burn patient's quality of life, so it is recommended for nurses and hospital staffs of burn injury wards to use multimedia self-care programs as a complementary therapy measure.

Epidemiology of Acid-Burns in a Major Referral Hospital in Tehran, Iran.

BACKGROUND: Most of the acid- burns are due to assault or accidental. The epidemiology of burns is diverse across the world and within a country. We evaluated the epidemiology and outcome of acid-burns in tertiary health care center in Tehran, Iran. METHODS: This study was retrospective descriptive among patients referred for acid-burn injury that was done in a referral Burn Care Center in Tehran, Iran, during a ten-year period since 2005 to 2014. Patient's data collected by a specially designed check list. The subjects included 37 consecutive patients with various causes of acid burn injury. Descriptive statistics (means with standard deviations or frequency distribution) of sociodemographic variables were computed. RESULTS: The patients' mean age was 31.97±11.02 years. The mean hospitalization period was 18.08±15.25 days. The grade of burn was III in 75.7% patients. Among the acid-burn patients, 64.8% suffered from <20% of total body surface area burn. Most affected part of the body was Head /face/neck 17 (45.9%). Most of the acid-burn occurred from attack (67.6%). Burns mortality rate for this study was identified 8.1% (N=3). CONCLUSION: The results of this study showed high acid attacks rates. Prevention strategies must be coordinated at national level. So acid-burn patients have to receive the best medical care possible, first locally and then in a specialized center.

The Role of Human Adult Peripheral and Umbilical Cord Blood Platelet-Rich Plasma on Proliferation and Migration of Human Skin Fibroblasts.

BACKGROUND: Wound healing is a complex and dynamic process following damage in tissue structures. Due to extensive skin damage caused by burn injuries, this study determined the role of human adult peripheral and umbilical cord blood platelet-rich plasma on proliferation and migration in human skin fibroblasts. METHODS: Platelet-rich plasma (5, 10, 15, 20 and 50% PRP) from human umbilical cord blood and adult peripheral blood were provided and added to fibroblasts cultured from a human skin sample. Migration and proliferation of fibroblasts were assessed in comparison to 10% FBS and by the fibroblast responses to a concentration gradient. RESULTS: All components of the umbilical cord blood PRP significantly stimulated the growth of fibroblasts when compared to the negative control. Fibroblast growth was enhanced in a dose dependent manner. All fibroblast cultures retained normal morphology. No significant difference was noted between umbilical cord blood and adult peripheral blood PRP preparations regarding cell proliferation and migration, but the difference to 10% FBS was significant. 1% and 50% PRP reduced cellular proliferation. The 20% umbilical cord blood PRP and 10% adult peripheral blood PRP had a significant stimulatory effect on the migration of the skin fibroblast cells in comparison with 10% FBS. CONCLUSION: As PRP could promote the migration and proliferation of dermal fibroblasts, it can be safely added in cultures when treatment of chronic wounds without triggering the immune response is needed.

The Effect of Massage on Anticipatory Anxiety and Procedural Pain in Patients with Burn Injury.

BACKGROUND: Pain related to burn injuries is one of the most troublesome pain intensity. This study aimed to investigate the effect of massage on anticipatory anxiety, procedural pain intensity, vital signs and relaxation level of patients with burn injury. METHODS: In this quasi-experimental study, through convenience sampling, 60 hospitalized adult burn patients were selected from a specialized burn and reconstructive hospital. Subjects were assigned to massage and control groups through simple randomization. Massage was offered by using non aromatic oil about 10-15 minutes before wound care on intact part of the body once a day for 20 minutes on patients' bedside for 3 consecutive days. In the 3 days, the control group did not received any massage and were asked to stay at bed. Demographic and clinical characteristics and vital signs, Visual Analogue Scale and the Persian version of Burn Specific Pain Anxiety Scale were used to determine baseline and procedural pain, anxiety and relaxation levels and anticipatory anxiety. RESULTS: No significant difference was noted between mean score of pain intensity, anxiety and relaxation level, and vital signs in massage and control groups after intervention following wound care. In massage and control groups, there was no significant differences between mean scores of anticipatory anxiety before and after intervention. There was no significant difference between the mean scores of anticipatory anxiety in massage and control groups after intervention prior wound care. CONCLUSION: Massage was shown not to have any effect on anticipatory anxiety and procedural pain.

Cloning: A Review on Bioethics, Legal, Jurisprudence and Regenerative Issues in Iran.

In recent years, the cloning technology has remarkably developed in Iran, but unfortunately, the required legal framework has not been created to support and protect such developments yet. This legal gap may lead to abuse of scientific researches to obtain illegal benefits and to undermine the intellectual property rights of scientists and researchers. Thus to prevent such consequences, the attempts should be made to create an appropriate legal-ethical system and an approved comprehensive law. In this review we concluded that the right method is guiding and controlling the cloning technology and banning the technique is not always fruitful. Of course, it should be taken into accounts that all are possible if the religion orders human cloning in the view of jurisprudence and is considered as permission. In other words, although the religious order on human cloning can be an absolute permission based on the strong principle of permission, it is not unlikely that in the future, corruption is proved to be real for them, Jurists rule it as secondary sanctity and even as primary one. If it is proved, the phenomenon is considered as example of required affairs based on creation of ethical, social and medical disorders, religious and ethical rulings cannot be as permission for it, and it seems that it is a point that only one case can be a response to it and it needs nothing but time.

Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty.

BACKGROUND: Filler materials are gaining popularity in nonsurgical rhinoplasty the major advantages are the ability to camouflage the surface deformities, and also the soft and malleable consistency; while the major drawback of the safe fillers such as hyaluronic acid is short durability. In this study, we evaluated the injectable cartilage shaving as an autologous filler material for correction of minor contour deformities in rhinoplasty. METHODS: Injectable cartilage shaving was used for correction of surface irregularities in primary or secondary rhinoplasty, and long term results of 128 patients were evaluated. The source of cartilage was autologous septum, rib or less frequently, the ear concha. The material was injected with 14 to 18 gauge needles or blunted tip lipofilling cannulas with 1.3-1.7 mm internal diameters. It was performed whether during the septorhinoplasty or as a separate single procedure without elevation of the flap. Success was defined as the long term survival of the graft in the desired site and absence of recurrent deformity or complications such as extrusion, infection or displacement. RESULTS: Twenty seven males and 101 females underwent the procedure from May 2008 to January 2014. Mean follow up period was 31 (13-58) months. Ninety five percent of patients were satisfied or very satisfied with the results at the last follow up visits and touch up procedure was performed for the unsatisfied patients. CONCLUSION: Injectable cartilage shaving is a reliable filler to correct and camouflage the surface irregularities, and it is durable and predictable in long term follow ups.

A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit.

BACKGROUND: In recent years, there is an increasing tendency to use diced cartilage grafts in rhinoplasty surgery for improving dorsum contour irregularities. This study was designed to compare graft resorption between three techniques of diced cartilage using surgical blade, electrical grinder and grater in rabbit model. METHODS: Thirteen New Zealand rabbits were divided into three groups. Three 2×2 cm cartilage specimens were harvested from one of their ears. In group one, the cartilage was diced by use of No:11 surgical blade to o.5 to 1 mm cube pieces. In group two, an electrical grinder was used and in group three, a grater was applied. The grafts were placed in three subcutaneous pockets in the back of rabbits and after 12 weeks, the implants were removed and their weight and volume were recorded and were evaluated by histological techniques. RESULTS: There was no difference between the three methods in the 3 groups for graft resorption. There was no change in the volume, but the weight showed a decrease in the control group. CONCLUSIONS: As the histological results had no statistically difference between groups, we may recommend use of these two techniques in reconstructive and in aesthetic cases.

Acute disseminated encephalomyelitis mimicking acute meningoencephalitis.

Acute disseminated encephalomyelitis is an inflammatory demyelinating disease of the central nervous system that usually occurs following an antecedent infection or vaccination. Children and young adults are predominantly affected, but it has low incidence in children younger than 3 years. The disease manifests with a wide range of neurological abnormalities and a variable combination of fever, headache, meningism, convulsion and cranial nerve palsies, and there are no pathognomonic clinical or laboratory findings. So, establishment of definitive diagnosis is challenging in infants. This challenge may result in delayed diagnosis and consequently delayed treatment of acute disseminated encephalomyelitis, which may cause permanent neurological disability. Herein, we report an infant with acute disseminated encephalomyelitis, who mimicked the symptoms of meningoencephalitis and the correct diagnosis and treatment were delayed till the development of a severe phase of the disease.

Effects of platelet-rich plasma on cartilage grafts in rabbits as an animal model.

BACKGROUND: Cartilage tissue has limited regenerative capacity and the management of cartilage defects has always been a challenging issue. Platelet-rich plasma (PRP) has been recently been used to improve healing of cartilage defects. In the present experiment, we aimed to investigate the effects of PRP on regeneration capacity as well as survival of the cartilage grafts in a rabbit model. METHODS: In 15 white New Zealand rabbits, auricular cartilage was used to produce 4 pieces of cartilage (each about 2×2 cm). Two samples were diced to small pieces and 2 samples left intact. PRP was prepared using 5 ml of auricular blood. After measuring of the weight and volume of cartilages, they mixed with either normal saline or PRP and then implanted on the back of the rabbit. After 12 weeks, the implants were removed and the weight and volume were measured and the numbers of nucleated lacunae were counted on H & E staining. RESULTS: Histological findings showed that in both the intact and diced cartilages, adding PRP resulted in increasing regeneration of chondrocytes. Moreover, adding PRP to intact cartilages had a significant effect in maintaining the grafts 'weight and volume (p<0.05) but in diced cartilages, this effect was not significant. CONCLUSION: Our findings yielded valuable information on the effect of PRP on survival and regeneration of autologous cartilage grafts as the extent of angiogenesis and the diameters of vessels were more pronounced in the side using PRP and markedly lesser reduction of weight and volume were visible in this group. PRP was effective in increasing survival and regeneration capacity of cartilage grafts in rabbit model.