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The effects of honey compared to silver sulfadiazine for the treatment of burns: A systematic review of randomized controlled trials

Aziz Z, Abdul Rasool Hassan B

Burns, 2017 Feb;43(1):50-57.
PMID: 27576926 DOI: 10.1016/j.burns.2016.07.004

Evidence from animal studies and trials suggests that honey may accelerate wound healing. The objective of this review was to assess the effects of honey compared with silver dressings on the healing of burn wounds. Relevant databases for randomized controlled trials (RCTs) of honey compared with silver sulfadiazine (SSD) were searched. The quality of the selected trials was assessed using the Cochrane Risk of Bias Assessment Tool. The primary endpoints considered were wound healing time and the number of infected wounds rendered sterile. Nine RCTs met the inclusion criteria. Based on moderate quality evidence there was a statistically significant difference between the two groups, favoring honey in healing time (MD -5.76days, 95% CI -8.14 to -3.39) and the proportions of infected wounds rendered sterile (RR 2.59; 95% CI 1.58-2.88). The available evidence suggests that honey dressings promote better wound healing than silver sulfadiazine for burns.

Matched MeSH terms: Burns/therapy*
Sea cucumber (Stichopus hermanii) based hydrogel to treat burn wounds in rats

Zohdi RM, Zakaria ZA, Yusof N, Mustapha NM, Abdullah MN

J Biomed Mater Res B Appl Biomater, 2011 Jul;98(1):30-7.
PMID: 21504052 DOI: 10.1002/jbm.b.31828

Malaysian sea cucumber was incorporated into hydrogel formulation by using electron beam irradiation technique and was introduced as novel cross-linked Gamat Hydrogel dressing. This study investigated whether Gamat Hydrogel enhanced repair of deep partial skin thickness burn wound in rats and its possible mechanism. Wounds were treated with either Gamat Hydrogel, control hydrogel, OpSite® film dressing or left untreated. Skin samples were taken at 7, 14, 21, and 28 days post burn for histological and molecular evaluations. Gamat Hydrogel markedly enhanced wound contraction and improved histological reorganization of the regenerating tissue. Furthermore, the dressing modulated the inflammatory responses, stimulated the activation and proliferation of fibroblasts, and enhanced rapid production of collagen fiber network with a consequently shorter healing time. The level of proinflammatory cytokines; IL-1α, IL-1β, and IL-6, were significantly reduced in Gamat Hydrogel treated wounds compared with other groups as assessed by reverse transcription-polymerase chain reaction (RT-PCR). In summary, our results showed that Gamat Hydrogel promoted burn wound repair via a complex mechanism involving stimulation of tissue regeneration and regulation of pro-inflammatory cytokines. The resultant wound healing effects were attributed to the synergistic effect of the hydrogel matrix and incorporated sea cucumber.

Matched MeSH terms: Burns/metabolism; Burns/pathology; Burns/therapy*
Fulltext Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing

Mohd Zohdi R, Abu Bakar Zakaria Z, Yusof N, Mohamed Mustapha N, Abdullah MN

Evid Based Complement Alternat Med, 2012;2012:843025.
PMID: 21941590 DOI: 10.1155/2012/843025

A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25 kGy). In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P < 0.05) wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P < 0.05). Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P < 0.05) suppressed the expression of proinflammatory cytokines (IL-1α, IL-1β, and IL-6). The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing.

Matched MeSH terms: Burns
Fulltext Metagenomic datasets of air samples collected during episodes of severe smoke-haze in Malaysia

James GL, Latif MT, Isa MNM, Bakar MFA, Yusuf NYM, Broughton W, et al.

Data Brief, 2021 Jun;36:107124.
PMID: 34095374 DOI: 10.1016/j.dib.2021.107124

Transboundary emissions of smoke-haze from land and forest fires have recurred annually during the dry period (June to October, over the past few decades) in South East Asia. Hazardous air quality has been recorded in Malaysia during these episodes. Agricultural practices such as slash-and-burn of biomass and peat fires particularly in Sumatera and Kalimantan, Indonesia, have been implicated as the major causes of the haze. Past findings have shown that a diversity of microbes can thrive in air including in smoke-haze polluted air. In this study, metagenomic data were generated to reveal the diversity of microorganisms in air during days with and without haze. Air samples were collected during non-haze (2013A01) and two haze (2013A04 and 2013A05) periods in the month of June 2013. DNA was extracted from the samples, subjected to Multiple Displacement Amplification and whole genome sequencing (Next Generation Sequencing) using the HiSeq 2000 Platform. Extensive bio-informatic analyses of the raw sequence data then followed. Raw reads from these six air samples were deposited in the NCBI SRA databases under Bioproject PRJNA662021 with accession numbers SRX9087478, SRX9087479 and SRX9087480.

Matched MeSH terms: Burns
Fulltext Running designs that affect calories burned

Zahayu Md Yusof, Masnita Misiran, Adyda Ibrahim

Jurnal Sains Sukan & Pendidikan Jasmani, 2018;7(2):103-112.
MyJurnal

Balanced between good diet and regular physical activity is among the important factors in avoiding unhealthy weight gain. Our objective in this study was to investigate the amount of calorie loss against a variety of running exercises. In this study, an experiment on running as a calorie burning physical activities was conducted. Two factors were selected, the distance, and the level of difficulties. The result and statistical analysis concluded that both factors play significant roles in burning calories, with distance as being the most significant factor. The findings also suggest that other than increasing the distance, choosing a hilly terrain when training can give more efficient calories burn. There is no interaction between distance and the level of difficulties. Individuals should plan their workout accordingly only after knowing how many calories they burned through each activity. For individual with aims to burn more calories, an increase in distance and a hilly terrain is more favorable.

Matched MeSH terms: Burns
Fulltext The effects of Carica papaya Linn. latex on the healing of burn wounds in rats

Ahmad Nazrun Shuid, Mohd Syukri Anwar, Ahmad Asmadi Yusof

Jurnal Sains Kesihatan Malaysia, 2005;3(2):39-47.
MyJurnal

This study was carried out to compare the rate of burn wound healing with the applications of the latex of Carica papaya Linn. (papaya) or of silver sulfadiazine cream (SSD). Partial and full thickness burn wound (2 cm x 2 cm) was induced on the dorsal part of anaesthetized rats by using heated metal plates. The rats were divided into three groups, i.e. untreated group and groups treated daily with SSD and papaya latex, respectively. A digital camera was used to take photographs of the burn wounds daily to monitor their healing. It was found that there was no significant difference in the healing time of papaya latex treated group compared to the SSD treated group. Papaya latex contained digestive enzymes which might clean burn wounds but might also cause wound bleeding in a few rats of the papaya latex group.

Matched MeSH terms: Burns
Fulltext The relationship between psychosocial distress and oral health status in patients with facial burns and mediation by oral health behaviour

Chaudhary FA, Ahmad B

BMC Oral Health, 2021 04 01;21(1):172.
PMID: 33794862 DOI: 10.1186/s12903-021-01532-0

BACKGROUND: There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship.
METHODS: The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour.
RESULTS: From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p

Matched MeSH terms: Burns*
Nail bed and flap reconstructions for acute fingertip injuries - A case review and report of a chemical burn injury

Gunasagaran J, Sian KS, Ahmad TS

J Orthop Surg (Hong Kong), 2019 4 5;27(2):2309499019839278.
PMID: 30943852 DOI: 10.1177/2309499019839278

Nail bed injuries were commonly found concomitantly with fingertip injuries. Reconstruction of fingertip including the nail bed should be attempted at acute stage. Aim of the surgery was to restore as much finger length and achieve normal nail growth. In chemical burns, the initial presentation might not reflect the exact extent of injury. Appropriate acute management must be initiated while waiting for demarcation. We report a case of young stewardess who presented with fingertip chemical burn injury. Surgical debridement was done on third day post-injury. A cross-finger flap to cover skin defect and split-thickness nail bed grafting from the remnant of injured finger were done. Excellent functional and cosmetic outcome was achieved in 6 months. Surgical treatment in a chemical burn was similar to traumatic injury. Nail bed graft was the best option for nail bed reconstruction. In cases of soft tissue loss, advancement or pedicle flaps are beneficial.

Matched MeSH terms: Burns, Chemical
Fulltext Palm oil thorn-induced squamous cell carcinoma with underlying burns scar

Qi Qi C, Ajit Singh V

BMJ Case Rep, 2012;2012.
PMID: 22865804 DOI: 10.1136/bcr-2012-006401

Marjolin's ulcers are malignancies that arise from previously traumatised, chronically inflamed or scarred skin. We present a case with childhood burns, who had repeated irritation of his forearm skin with palm oil thorns that eventually led to malignant change.

Matched MeSH terms: Burns/complications*; Burns/surgery
A revisit to the effects of zinc salt on skin burn wound healing to reflect the risks in current pharmaceutical care

Osman MAH, Wong TW, Anuar NK

J Dermatolog Treat, 2020 Sep;31(6):651-654.
PMID: 31264929 DOI: 10.1080/09546634.2019.1639607

The lower limit of soluble zinc content that can possibly be applied onto a wounded skin as a healing promoter was not known. This study examined skin wound healing process of rats inflicted by partial thickness thermal burn wound as a function of applied soluble zinc contents (0.1 ml of zinc chloride solution 0.01% (w/w) or 5.0% (w/w)). The size, surface morphology and histological profiles of wound beds of untreated rats and those treated with zinc chloride solutions were characterized. A soluble zinc content as low as 10.5 μg/cm2 of skin negated skin wound healing when compared to the untreated rats. This was alarming as the commercial products currently in the market are formulated with a high level of zinc content. Albeit the zinc salt employed was water-insoluble, a minute fraction of soluble zinc might be available to the treatment sites. This could be partially responsible for the late adverse effects such as pruritis and inflammation reported with calamine/diphenhydramine lotion, medicated shampoo, Olay Complete defense moisturizing lotion and Zineryt® topical solution. The skin irritation was likely a resultant oxidative stress action of soluble zinc, where a small fraction could be adequate to negate the skin homeostasis.[Figure: see text]Key messagesZinc is essentially a cofactor for skin collagen formation.Soluble zinc content as low as 10.5 μg/cm2 of skin irritates skin and negates burn wound healing.Skin irritation of commercial products relates to minute soluble zinc content availability.

Matched MeSH terms: Burns
Fulltext Robust model of systemic inflammation through Lipopolysaccharide

Khan H., Aamir K., Arya A.

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):50-50.
MyJurnal

Introduction: Systemic inflammation is the major clinical problem which is constellation of communicable and non-communicable infection equipped with acute to chronic inflammation. It may lead to unfavourable conditions for instance, systemic inflammatory syndrome, burns and sepsis. Systemic inflammation might rotate the steering towards vital clinical maladies including cardiomyopathy, neuroinflammation, hepatitis, liver and kidney diseases and even diabetes. In order to elucidate the molecular insights in these clinical implications, there is an intensive need
to design rodent model of systemic inflammation having close association with systemic inflammatory conditions in humans. Methods: Presently, lipopolysaccharide (LPS) induced systemic inflammatory rodent model is widely established, reproducible and acceptable among scientists. In this model animals are treated with intraperitoneal injection of LPS ranging from 1-10 mg/kg which leads to instant release of proinflammatory cytokines to provide robust model of systemic inflammation in order to elucidate pathological conditions and their in-depth mechanism to uncover the new anti-inflammatory therapeutic targets. Conclusion: Robust model would open new window to explore anti-inflammatory activities of phytochemicals, small molecules and drug candidates along with crosstalk of different signaling pathways at molecular level.

Matched MeSH terms: Burns
Fulltext Iatrogenic Mucosal Burn : A Case Report

Musa, S., Awang, H.

Ann Dent, 1996;3(1):-.
MyJurnal

A case of mucosal burn during the placement of fissure sealant on the first permanent molars of a 9-year-old Malay boy is presented. The erythematous lesion with accompanying burning sensation appeared a few minutes after the etching liquid, containing 37% by weight phosphoric acid, had accidentally come into contact with the buccal mucosa on the right side of the angle of the mouth. The mucosa showed complete healing after one week. The use of rubber dam for tooth isolation while doing fissure sealant is essential to avoid accidental contact of potentially caustic chemicals, such as the phosphoric acid etchant, with the oral mucosa as it can result in mucosal burns.

Matched MeSH terms: Burns
Wound healing effect of Haruan (Channa striatus) spray

Laila L, Febriyenti F, Salhimi SM, Baie S

Int Wound J, 2011 Oct;8(5):484-91.
PMID: 21722317 DOI: 10.1111/j.1742-481X.2011.00820.x

Haruan (Channa striatus) is a type of fresh water fish in Malaysia that is known to promote wound healing. Haruan water extract has been formulated in an aerosol system which can produce a film for wound dressing. As topical preparation, Haruan spray needs to be evaluated in terms of the possibility to cause irritation reaction or toxic response. Three experiments were carried out to evaluate the safety of Haruan spray which are Primary Skin Irritation test, Intracutaneous test and Systemic Injection test. The result shows that Haruan spray gave no significant responses to all the above tests. The investigation of the effect of Haruan spray as wound dressing in the healing process was performed in Sprague-Dawley rats where 6-cm long full-thickness incision wound and burn wound were made on the back of the animals. Haruan spray was tested and compared with blank formula as control. Tensile strength test of treated wound was carried out at the 3rd, 6th, 9th and 12th day after wounding and treatment. The burn wounds contraction was measured daily for 21 days. Results showed that haruan water extract spray formula is not only effective but also safe for application to both incision and burn wounds.

Matched MeSH terms: Burns/drug therapy*; Burns/pathology
Fulltext Dental health status and oral health behaviours of patients with facial burn in Pakistan

Chaudhary FA, Ahmad B, Bashir U

BMC Oral Health, 2019 06 26;19(1):127.
PMID: 31242898 DOI: 10.1186/s12903-019-0819-0

BACKGROUND: There is a limited understanding about the oral health of patients with facial burn, hence the aim was to describe the oral health status and the related risks factors.
METHODS: This cross-sectional study had randomly and systematically recruited facial burn patients from the Burn Care Center, Pakistan Institute of Medical Sciences, Islamabad, from June of 2016 to July of 2017. Intraoral examination recorded the DMFT, CPI and OHI-S. Information on the socio-demographic status, self-perceived oral health, oral health behaviours were collected using a self-administered questionnaire and; the burn characteristics were obtained from the patients' medical record. The t-test, ANOVA, SLR, and chi-square test were used to examine the relationship between oral health and each factor. A parameter was derived from the clinical indices using the principal component analysis and used in the multiple linear regression analysis to determine the important factors associated with oral health status.
RESULTS: A total of 271 burn patients (69% female and 31% male) had participated in the study. All of the participants had caries with mean DMFT = 10.96 (95%CI: 10.67, 11.25). There were 59.0% (95%CI: 53.15, 64.93%) and 66.1% (95%CI: 60.38, 71.73%) of the participants who had periodontitis and poor oral hygiene respectively. About 79 and 80% of the participants rated their dental and periodontal status as poor. About 78% reported brushing once daily and 89% did not practice regular dental visit. The DMFT, CPI and OHI-S were associated with the burn characteristics and oral health behaviours (p

Matched MeSH terms: Burns/complications*; Burns/epidemiology
A case of facial burn due to the misuse of garlic face mask for acne

Hisham A, Mohamed Sukur S, Basiron N

Australas J Dermatol, 2018 Nov;59(4):336-337.
PMID: 29377074 DOI: 10.1111/ajd.12789
Matched MeSH terms: Burns, Chemical/etiology*
A life saved at the cost of hand injury - A case of hand burn due to airbag deployment

Fadzullah NA, Kasthuri S, Basiron N

Med J Malaysia, 2019 Oct;74(5):452-453.
PMID: 31649230

According to the Malaysian Department of Statistics motor vehicle accidents are the third leading cause of death in Malaysia and accounts for 7.4% of premature deaths in 2016. With the invention of the airbag, the number of serious injuries and fatalities have been reduced significantly. However, there has also been a corresponding increase in the number of injuries attributable to these devices. The patient narrated in this case report sustained a mixed dermal thickness burn over the upper limb as a result of an airbag deployment. She recovered without other life threatening injuries.

Matched MeSH terms: Burns
Fulltext Integrating multiple genomic technologies to investigate an outbreak of carbapenemase-producing Enterobacter hormaechei

Roberts LW, Harris PNA, Forde BM, Ben Zakour NL, Catchpoole E, Stanton-Cook M, et al.

Nat Commun, 2020 01 24;11(1):466.
PMID: 31980604 DOI: 10.1038/s41467-019-14139-5

Carbapenem-resistant Enterobacteriaceae (CRE) represent an urgent threat to human health. Here we report the application of several complementary whole-genome sequencing (WGS) technologies to characterise a hospital outbreak of blaIMP-4 carbapenemase-producing E. hormaechei. Using Illumina sequencing, we determined that all outbreak strains were sequence type 90 (ST90) and near-identical. Comparison to publicly available data linked all outbreak isolates to a 2013 isolate from the same ward, suggesting an environmental source in the hospital. Using Pacific Biosciences sequencing, we resolved the complete context of the blaIMP-4 gene on a large IncHI2 plasmid carried by all IMP-4-producing strains across different hospitals. Shotgun metagenomic sequencing of environmental samples also found evidence of ST90 E. hormaechei and the IncHI2 plasmid within the hospital plumbing. Finally, Oxford Nanopore sequencing rapidly resolved the true relationship of subsequent isolates to the initial outbreak. Overall, our strategic application of three WGS technologies provided an in-depth analysis of the outbreak.

Matched MeSH terms: Burns/microbiology
Fulltext Impact of childhood burn injuries on breastfeeding: a case report

Arabi Z, Md Monoto EM, Bojeng A

Int Breastfeed J, 2019;14:17.
PMID: 31019544 DOI: 10.1186/s13006-019-0210-4

Background: Pre-pubescent girls with chest burns are at risk of complication associated with scarring and impairment in breast development. This case illustrates how burn injuries in childhood in a first-time mother have affected her in terms of breastfeeding.
Case presentation: In May 2015, a 20 year old first-time mother at 36 weeks gestation was seen in a district health clinic in Kuching, Sarawak in regards to her ability to breastfeed. She had a history of a flame burn at the age of 5 years old to her chest, abdomen, upper limb and part of her trunk. A skin graft was done on her whole chest and abdomen. Despite the injuries, she had pubertal and antenatal breast development. Her abdomen was able to stretch to accommodate her pregnancy. Physical examination showed a pregnancy which corresponded to date. The skin over her chest and abdomen appeared tight with areas of hyperpigmentation and hypopigmentation due to scarring from the skin graft. Breast tissues were palpable over her chest. The areola and nipple tissue were completely absent with complete scarring of the nipple-areolar complex. There was no duct opening to the areola for milk expression or leakage. Counselling regarding her breastfeeding issues was done. She delivered her baby at full term via spontaneous vaginal delivery with no complication. Oral cabergoline 1 mg was given on the first day postpartum. The baby was given infant formula via bottle feeding as the feeding method of choice.
Conclusion: Counselling plays an important part in the management of a mother with breastfeeding difficulty. Allaying the possible guilty feelings of not being able to breastfeed will fulfil the emotional gap which may arise in a mother with these challenges.

Matched MeSH terms: Burns/physiopathology*
How Safe Is High-Speed Burring in Spine Surgery? An In Vitro Study on the Effect of Rotational Speed and Heat Generation in the Bovine Spine

Singh TS, Yusoff AH, Chian YK

Spine (Phila Pa 1976), 2015 Aug 1;40(15):E866-72.
PMID: 25996539 DOI: 10.1097/BRS.0000000000000985

In vitro animal cadaveric study.

Matched MeSH terms: Burns/etiology; Burns/prevention & control
A systematic review of silver-containing dressings and topical silver agents (used with dressings) for burn wounds

Aziz Z, Abu SF, Chong NJ

Burns, 2012 May;38(3):307-18.
PMID: 22030441 DOI: 10.1016/j.burns.2011.09.020

Silver preparations are commonly used for burns, but evidence of their effectiveness remains poorly defined. The aim of the study was to evaluate the effectiveness of silver-containing dressings and topical silver for preventing infection and promoting healing in burns wounds through a meta-analysis of the available evidence. The Cochrane Central Register of Controlled Trials and relevant databases were searched. Drug companies and experts in this field were also contacted. Randomised controlled trials (RCTs) of silver dressings or topical silver (used with dressings) compared with non-silver dressings were eligible for inclusion. We identified 14 RCTs involving 877 participants. One small trial of a silver-containing dressing showed significantly better healing time compared to the control [MD -3.6; 95% CI -4.94 to -2.26 for partial thickness burns and MD -3.9; 95% CI -4.54 to -3.26 for superficial burns]. Topical silver showed significantly worse healing time compared to the non-silver group [WMD 3.96; 95% CI 2.41-5.51] and showed no evidence of effectiveness in preventing wounds infection [WMD 2.48; 95% CI 0.39-15.73]. Our review suggests that silver-containing dressings and topical silver were either no better or worse than control dressings in preventing wound infection and promoting healing of burn wounds.

Matched MeSH terms: Burns/therapy*

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