Heterotopic calcification in burn scars and non-healing ulcers.

Heterotopic calcification (HC) is abnormal deposition of calcium salts in tissues other than bone and enamel. The heterotopic calcification in the burn patients is commonly found either in periarticular region or in the muscles, but the occurrence of heterotopic calcification of the burn scar itself in the presence of normal serum calcium, phosphate and alkaline phosphatase is not reported earlier. We present four adult male patients of lower limbs heterotopic calcification in burn scars with unusual presentation of non-healing ulcers with a latent period of 15-20 years.

Idiopathic purpura fulminans and varicella gangrenosa of both hands, toes and integument in a child.

Chicken pox is a common childhood illness and, though a vaccine is readily available, it is not routinely included in the vaccination schedule of most countries owing to its mild clinical nature. However, varicella gangrenosa is a rare complication of this disease, infrequently reported in the literature. We report the case of a child who developed purpura fulminans in the convalescent phase of chicken pox and subsequently presented with peripheral gangrene of both hands and the toes of the right foot, and skin gangrene.

Radiological manifestation of pulmonary complications in deceased intensive care burn patients.

The chest radiographs of 46 burn patients who died in the burn intensive care unit (BICU) were retrospectively analyzed to study the spectrum of pulmonary complications and their contribution to patient's mortality. There were 25 male and 21 female patients and their mean ages were 34 and 30 years, respectively. Forty-three patients had flame burns, two chemical, and one scald with a mean total burn surface area (TBSA) of 71%.

Only some septicaemic patients develop hypernatremia in the burn intensive care unit: why?

From April 1993 to January 2000, 105 patients in the burn intensive care unit (BICU) that developed septicaemia in the course of their treatment were studied retrospectively to investigate as to why only 36 septicaemic patients (34%) developed hypernatremia (serum sodium >150mmol/l). Septicaemic burn patients who developed hypernatremia were found to have a higher incidence of inhalation injury and a larger burn area (TBSA) signifying greater free water losses in the face of increasing fluid requirements. Patients who developed hypernatremia showed a characteristic pattern of septicaemia: early onset, multiple episodes, polymicrobial, need for multiple antibiotics, longer duration and a higher mortality, indicating a more severe degree of sepsis.

Standard of knowledge about their disease among patients with diabetes in Karachi, Pakistan.

Objective: The aim of this study was to determine the standard of knowledge among people with diabetes.

Method: Two hundred and thirty patients were randomly chosen from outpatient clinics and a 34-item multiple choice questionnaire administered to them. The questionnaire was structured to assess knowledge about the disease state, diagnostic tests, complications and management.

Burn mortality during 1982 to 1997 in Kuwait.

The study group is comprised of 234 patients (6.4%) who died out of 3680 patients treated for burn injuries during the period January 1982 to December 1997 in Kuwait. There were 112 (47.

Burn septicaemia: an analysis of 79 patients.

Out of 943 patients treated from June 92 to May 96 at the burns unit of the Al-Babtain Centre for Plastic Surgery and Burns, Kuwait, 280 (30%) required admission to the burns intensive care unit (ICBU) and were studied retrospectively. Seventy-nine (28.2%) developed clinically and microbiologically proven septicaemia.

A robust sensor fusion method for heart rate estimation.

Problem: Physiologic data measured in the clinical environment is frequently corrupted causing erroneous data to be displayed, periods of missing information or nuisance alarms to be triggered. To date, the possibility of combining sensors with similar information to improve the quality of the extracted data has not been developed. The objective of this work is to develop a method for combining heart rate measurements from multiple sensors to obtain: (i) an estimate of heart rate that is free of artifact; (ii) a confidence value associated with every heart rate estimate which indicates the likelihood that an estimate is correct; (iii) a more accurate estimate of heart rate than is available from any individual sensor.

Robust sensor fusion improves heart rate estimation: clinical evaluation.

Objective: To determine if Robust Sensor Fusion (RSF), a method designed to fuse data from multiple sensors with redundant heart rate information can be used to improve the quality of heart rate data. To determine if the improved estimate of heart rate can reduce the number of false and missed heart rate alarms.

Methods: A total of 85 monitoring periods were investigated, 12 from the operating room, 60 from adult ICU and 13 from pediatric ICU.

Vocal cord dysfunction after cardiac surgery: an overlooked complication.

Objective: To evaluate the complication of vocal cord dysfunction following open heart surgery and its short- and long-term effects.

Materials And Methods: Five cases (1.9%) of vocal cord dysfunction which were diagnosed among 270 cases of adult open heart surgery performed at this centre between February 1993 and May 1995.

Scalds among children in Kuwait.

In a prospective study of 560 children treated for burns as in-patients over a period of four-and-a-half years in specialized hospitals responsible for the majority of burn cases in Kuwait, 388 patients (69%) had sustained scalds. The mean age of these 388 children, between 0 to 12 years, was 3.02 +/- 2.

Foot reconstruction using vascularised fibula.

Vascularised fibula has been used to treat three patients with skin-bone defects of the foot following severe trauma. Similarity between fibula and metatarsal bone is obvious and makes fibula an ideal choice in the replacement of defects in the first metatarsal. Depending on the size of soft tissue defects, different combinations of fibula-skin transfer were used.

T flap hypospadias repair in circumcised patients.

Single stage repair of distal penile hypospadias with chordee in circumcised patients is described. A ventral 'T' flap is used, the horizontal part of the T flap forming the complete circumference of the new urethra and lying in the defect created due to chordee release. The vertical part of the T flap, in conjunction with the grooved glans, forms the neourethra like the flip flap procedure.

An analysis of childhood burns in Kuwait.

A prospective study of 394 burned children (in-patients) up to the age of 12 years old was carried out for the period from January 1984 to December 1986. They were categorized into three age groups, the infants and toddlers 0-2 years, early childhood 3-6 years and late childhood 7-12 years. In the first two groups scalding was the predominant cause of injury, while in late childhood there were many more flame burns.

Vulvar reconstruction with an abdominal flap.

There are many procedures for vulvar reconstruction after excision for cancer. The aim of which is to provide cosmetic and functional results with minimal secondary deformity. A patient presented with gross fibrous contracture and vaginal ectropion after radical vulvectomy and groin dissection for cancer.

Scald accidents during water aerosol inhalation in infants.

A study of 193 infants admitted for burns over a 4-year period revealed 11 infants (5.7 per cent) had sustained scalds during the process of water aerosol inhalation. The water aerosol inhalation therapy was prescribed for respiratory tract infection and carried out at home using either an electric kettle or a saucepan.