MyMedR

Marjolin's Ulcer in Laron Syndrome - an Unexpected Combination: A Case Report

de la Paz EM

Malays Orthop J, 2020 Mar;14(1):78-80.

PMID: 32296486 DOI: 10.5704/MOJ.2003.012

Marjolin's ulcer is an atypical malignancy that develops from deep scars of chronically traumatised skin. Laron syndrome (LS) is a rare autosomal recessive growth retardation from a mutation in the growth hormone receptor (GHR) gene leading to defective GHR, growth hormone insensitivity and eventual low levels of insulin-like growth factor type 1 (IGF-1). Affected individuals present with proportionate dwarfism and other characteristic physical defects, but at the same time are conferred protection against cancer due to low serum levels of IGF-1. We report an exceptional case of Marjolin's ulcer in the foot of a female LS patient 30 years after she sustained flame burns as a 6-month-old baby. Three months before coming to us, she had a 2x3cm ulcer that turned into a rapidly enlarging fungating mass involving the leg, ankle, and foot. Histopathologic analysis of an incision biopsy showed well-differentiated squamous cell carcinoma. The extent of her lesion precluded wide excision. Below knee amputation was done. A second biopsy confirmed the histopathologic diagnosis. This is the first reported case in the literature of Marjolin's ulcer in LS which raises the possibility that IGF-1 deficiency does not completely protect against squamous cell cancer.

Matched MeSH terms: Burns

El Niño driven haze over the Southern Malaysian Peninsula and Borneo

Khan MF, Hamid AH, Rahim HA, Maulud KNA, Latif MT, Nadzir MSM, et al.

Sci Total Environ, 2020 Aug 15;730:139091.

PMID: 32413602 DOI: 10.1016/j.scitotenv.2020.139091

The Southeast Asian (SEA) region is no stranger to forest fires - the region has been suffering from severe air pollution (known locally as 'haze') as a result of these fires, for decades. The fires in SEA region are caused by a combination of natural (the El Niño weather pattern) and manmade (slash-and-burn and land clearing for plantations) factors. These fires cause the emissions of toxic aerosols and pollutants that can affect millions of people in the region. Thus, this study aims to identify the impact of the SEA haze on the Southern region of the Malaysian Peninsula and Borneo region of East Malaysia using the entire air quality observation data at surface level in 2015. Overall, the concentration of PM10 was about two-fold higher during the haze period compared to non-haze period. The concentrations of CO, flux of CO and flux of BC were aligned with PM10 during the entire observation period. The wind field and cluster of trajectory indicated that the Southern Malaysian Peninsula and Borneo were influenced mainly from the wildfires and the combustion of peat soil in the Indonesian Borneo. This study finds that wildfires from Borneo impacted the Southern Malaysian Borneo more seriously than that from Sumatra region.

Matched MeSH terms: Burns

Wound Healing Property of Curcuminoids as a Microcapsule-Incorporated Cream

Ang LF, Darwis Y, Koh RY, Gah Leong KV, Yew MY, Por LY, et al.

Pharmaceutics, 2019 May 01;11(5).

PMID: 31052413 DOI: 10.3390/pharmaceutics11050205

Curcuminoids have been used for the management of burns and wound healing in traditional Chinese medicine practices but the wide application of curcuminoids as a healing agent for wounds has always been a known problem due to their poor solubility, bioavailability, colour staining properties, as well as due to their intense photosensitivity and the need for further formulation approaches to maximise their various properties in order for them to considerably contribute towards the wound healing process. In the present study, a complex coacervation microencapsulation was used to encapsulate curcuminoids using gelatin B and chitosan. This study also focused on studying and confirming the potential of curcuminoids in a microencapsulated form as a wound healing agent. The potential of curcuminoids for wound management was evaluated using an in vitro human keratinocyte cell (HaCaT) model and the in vivo heater-inflicted burn wound model, providing evidence that the antioxidant activities of both forms of curcuminoids, encapsulated or not, are higher than those of butylated hydroxyanisole and butylated hydroxytoluene in trolox equivalent antioxidant capacity (TEAC) and (2,2-diphenyl-1-picryl-hydrazyl-hydrate) (DPPH) studies. However, curcuminoids did not have much impact towards cell migration and proliferation in comparison with the negative control in the in vitro HaCaT study. The micoencapsulation formulation was shown to significantly influence wound healing in terms of increasing the wound contraction rate, hydroxyproline synthesis, and greater epithelialisation, which in turn provides strong justification for the incorporation of the microencapsulated formulation of curcuminoids as a topical treatment for burns and wound healing management as it has the potential to act as a crucial wound healing agent in healthcare settings.

Matched MeSH terms: Burns

Sodium carboxymethylcellulose scaffolds and their physicochemical effects on partial thickness wound healing

Ramli NA, Wong TW

Int J Pharm, 2011 Jan 17;403(1-2):73-82.

PMID: 20974238 DOI: 10.1016/j.ijpharm.2010.10.023

This study investigated critical physicochemical attributes of low (LV), medium (MV) and high molecular weight (HV) sodium carboxymethylcellulose (SCMC) scaffolds in partial thickness wound healing. SCMC scaffolds were prepared by solvent-evaporation technique. Their in vitro erosion, moisture affinity, morphology, tensile strength, polymer molecular weight and carboxymethyl substitution, and in vivo wound healing profiles were determined. Inferring from rat wound size, re-epithelialization and histological profiles, wound healing progressed with HV scaffold>LV-MV scaffold>control with no scaffold. The transepidermal water loss (TEWL) from wound of rats treated by control>HV scaffold>LV-MV scaffold. HV scaffold had the highest tensile strength of all matrices and was resistant to erosion in simulated wound fluid. In spite of constituting small nanopores, it afforded a substantial TEWL than MV and LV scaffolds from wound across an intact matrix through its low moisture affinity characteristics. The HV scaffold can protect moisture loss without its excessive accumulation at wound bed which hindered re-epithelialization process. Regulation of transepidermal water movement and wound healing by scaffolds was governed by SCMC molecular weight instead of its carboxymethyl substitution degree or matrix pore size distribution, with large molecular weight HV preferred over lower molecular weight samples.

Matched MeSH terms: Burns/pathology; Burns/therapy

Oesophageal replacement with colon in corrosive stricture

Wai NC

Med J Malaya, 1969 Sep;24(1):49-57.

PMID: 4243844

Matched MeSH terms: Burns, Chemical*

Localization of burn mark under an abnormal topography on MOSFET chip surface using liquid crystal and emission microscopy tools

Lau CK, Sim KS, Tso CP

Scanning, 2011 Jan-Feb;33(1):13-20.

PMID: 21462221 DOI: 10.1002/sca.20216

This article focuses on the localization of burn mark in MOSFET and the scanning electron microscope (SEM) inspection on the defect location. When a suspect abnormal topography is shown on the die surface, further methods to pin-point the defect location is necessary. Fault localization analysis becomes important because an abnormal spot on the chip surface may and may not have a defect underneath it. The chip surface topography can change due to the catastrophic damage occurred at layers under the chip surface, but it could also be due to inconsistency during metal deposition in the wafer fabrication process. Two localization techniques, liquid crystal thermography and emission microscopy, were performed to confirm that the abnormal topography spot is the actual defect location. The tiny burn mark was surfaced by performing a surface decoration at the defect location using hot hydrochloric acid. SEM imaging, which has the high magnification and three-dimensional capabilities, was used to capture the images of the burn mark.

Matched MeSH terms: Burns

Fulltext Predictors of mortality and validation of burn mortality prognostic scores in a Malaysian burns intensive care unit

Lip HTC, Idris MAM, Imran FH, Azmah TN, Huei TJ, Thomas M

BMC Emerg Med, 2019 11 07;19(1):66.

PMID: 31699024 DOI: 10.1186/s12873-019-0284-8

BACKGROUND: Majority burn mortality prognostic scores were developed and validated in western populations. The primary objective of this study was to evaluate and identify possible risk factors which may be used to predict burns mortality in a local Malaysian burns intensive care unit. The secondary objective was to validate the five well known burn prognostic scores (Baux score, Abbreviated Burn Severity Index (ABSI) score, Ryan score, Belgium Outcome Burn Injury (BOBI) score and revised Baux score) to predict burn mortality prediction.

METHODS: Patients that were treated at the Hospital Sultan Ismail's Burns Intensive Care (BICU) unit for acute burn injuries between 1 January 2010 to 31 December 2017 were included. Risk factors to predict in-patient burn mortality were gender, age, mechanism of injury, total body surface area burn (TBSA), inhalational injury, mechanical ventilation, presence of tracheotomy, time from of burn injury to BICU admission and initial centre of first emergency treatment was administered. These variables were analysed using univariate and multivariate analysis for the outcomes of death. All patients were scored retrospectively using the five-burn mortality prognostic scores. Predictive ability for burn mortality was analysed using the area under receiver operating curve (AUROC).

RESULTS: A total of 525 patients (372 males and 153 females) with mean age of 34.5 ± 14.6 years were included. There were 463 survivors and 62 deaths (11.8% mortality rate). The outcome of the primary objective showed that amongst the burn mortality risk factors that remained after multivariate analysis were older age (p = 0.004), wider TBSA burn (p

Matched MeSH terms: Burns/mortality*

Unusual ritual burns of the hand

Tay YG, Tan KK

Burns, 1996 Aug;22(5):409-12.

PMID: 8962663

Six hands from five patients were seen with full-thickness burns following a ritual practice between June 1993 and June 1994. Three hands were treated with excision and medium-thickness split-skin grafts, one patient was treated with a medium-thickness split skin graft taken from the instep of the foot. The first patient with bilateral burns of the palms refused surgery and returned 3 months later with contractures of the palms. The results of the treated hands are presented.

Matched MeSH terms: Burns/etiology*

Fulltext Corrosive oesophageal stricture in Malaysian adults

Krishnan MMS, Tan KC

Med J Malaysia, 1983 Dec;38(4):325-6.

PMID: 6599992

M. M. Sudhakar Krishnan, MS, FRCS (Edin & Glasg).
Department of Surgery, University Hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Burns, Chemical/complications*

Secrets of omega-3 oil

Suvarna BS

Kathmandu Univ Med J (KUMJ), 2008 7 1;6(23):406-11.

PMID: 20071830

Matched MeSH terms: Burns/diet therapy

Thermal burn of palate in an elderly diabetic patient

Kannan S, Chandrasekaran B, Muthusamy S, Sidhu P, Suresh N

Gerodontology, 2014 Jun;31(2):149-52.

PMID: 24797620 DOI: 10.1111/ger.12010

Burns of the oral mucosa may be caused by thermal, mechanical, chemical, electrical or radiation injury. Clinically, these burns can produce localised or diffuse areas of tissue damage depending on the severity and extent of the insult. Most oral thermal burns produce erosions or ulcers on the palate or tongue.

Matched MeSH terms: Burns

Honey use in burn management: potentials and limitations

Boukraâ L, Sulaiman SA

Forsch Komplementmed, 2010 Apr;17(2):74-80.

PMID: 20484914 DOI: 10.1159/000297213

Management of the burn wound still remains a matter of debate, and an ideal dressing for burn wounds has not yet been discovered. Naturally occurring substances such as honey have been found to be useful as a wound cover for burns. Unlike most conventional local chemotherapeutics, honey does not lead to the development of antibiotic-resistant bacteria, and it may be used continuously. Among the challenging problems of using honey for medical purposes are dosage, safety, and formulation. Many approaches have been suggested to overcome such problems. With the increased availability of licensed medical products containing honey, clinical use is expected to increase and further evidence will become available. Honey seems to have the potential to clear infection as well as to be an effective prophylactic agent that may contribute to reducing the risks of cross-infection. A better understanding of the therapeutic and chemical properties of honey is needed to optimise the use of this product in the clinical management of burns. Its use in professional care centres should be limited to those with certified healing activities. The potentials and limitations of using honey as burn dressing are discussed in this review.

Matched MeSH terms: Burns/therapy*

Burns management

Subramaniam M

Family Physician, 1992;4:4-6.

Matched MeSH terms: Burns

Caustic strictures of the oesophagus

Skene-Smith H

Br J Radiol, 1975 Aug;48(572):646-8.

PMID: 810200

Twenty-two cases of corrosive oesophageal strictures were reviewed and divided into annular, short segment and long segment lesions. The lower third of the oeseophagus was involved in all the long segment strictures, but with sparing of the extreme distal portion in most. Irregularity of the stricture walls with an appearance similar to reported cases of intramural diverticulosis is a common finding but smooth strictures can also occur.

Matched MeSH terms: Burns, Chemical/complications; Burns, Chemical/radiography*

Burns in pregnancy--maternal and fetal prognosis

Cheah SH, Sivanesaratnam V

Aust N Z J Obstet Gynaecol, 1989 May;29(2):143-5.

PMID: 2803125

In this series the incidence of pregnancy in women in the reproductive age group admitted to hospital with burns was 7.8% (9 of 116). The maternal and perinatal outcome is related to the extent, presence or absence of complications of burns and to the gestational age of the fetus. Two maternal deaths in this series occurred in patients with burns involving more than 85% of the skin surface; in both instances stillbirths occurred less than 48 hours after the burns. In view of the high perinatal mortality, patients with extensive burns who are more than 32 weeks' pregnant should be delivered soon after admission. The extensively burned anterior abdominal wall can make assessment of uterine size difficult. An assessment in such a situation would be useful.

Matched MeSH terms: Burns/complications*

Fulltext Clinical experience of medical students at University Sains Malaysia

Quah BS, Malik AS, Simpson H

Malays J Med Sci, 2000 Jan;7(1):27-32.

PMID: 22844212 MyJurnal

Experience of acute medical, surgical conditions, and clinical procedures of undergraduate students were assessed via a questionnaire survey during the final week of the 1993/1998 programme at the School of Medical Sciences, Univestiti Sains Malaysia. Individual performances were assessed by a scoring system. One hundred and twenty four students responded, (response rate 97%). More than 90% had seen myocardial infarction, cerebrovascular accident, pneumonia, respiratory distress, gastroenteritis, coma, and snake bite. Less than 33% had witnessed acute psychosis, diabetic ketoacidosis, acute hepatic failure, status epilepticus, near drowning, hypertensive encephalopathy, acute haemolysis or child abuse.Acute surgical/obstetrics cases, seen by >90% students, included fracture of long bones, head injury, acute abdominal pain, malpresentation and foetal distress. Less than 33% had observed epistaxis, sudden loss of vision, peritonitis or burns. Among operations only herniorrhaphy, Caesarian section, internal fixation of fracture and cataract extraction were seen by >80% students. The main deficits in clinical procedures are in rectal and vaginal examinations, urine collection and microscopic examinations. The performance of individual students, assessed by a scoring system, showed 15 students had unacceptably low scores (<149/230, 50%), 37 had good scores (>181.4/230, 70%) and 5 had superior scores (197.6/230, 80%).

Matched MeSH terms: Burns

Cannon's disease: clinical and diagnostic implications: a case report

Ram S, Siar CH

Dent Update, 2004 Nov;31(9):557-9.

PMID: 15612463

Cannon's disease or white sponge naevus is a relatively rare genetically determined skin disorder. It is inherited as an autosomal dominant trait that displays a high degree of penetrance and expressivity. This article describes cases of Cannon's disease in a mother and her son.

Matched MeSH terms: Burns, Chemical/diagnosis

Ocular burns and related injuries due to fireworks during the Aidil Fitri celebration on the East Coast of the Peninsular Malaysia

Rashid RA, Heidary F, Hussein A, Hitam WH, Rashid RA, Ghani ZA, et al.

Burns, 2011 Feb;37(1):170-3.

PMID: 20576358 DOI: 10.1016/j.burns.2010.05.019

This study aims to describe the epidemiology of ocular burns and related injuries due to fireworks during the Aidil Fitri celebration on the East Coast of the Peninsular Malaysia. A prospective analysis of all patients with ocular burns and related injuries due to fireworks attended three tertiary hospitals in East Coast of Peninsular Malaysia during Aidil Fitri, which was from 10 September to 17 October 2008. We observed the demographic and injury characteristics, extent of the injuries and presenting visual symptoms. Thirty patients with 34 eyes with ocular burns and related injuries were identified. Patients ranged between 2 and 43 years of age. 70.00% of the patients were 12 years old and below. Of the 30 patients, 29 (96.67%) were male and the left eye was affected in 14 (46.70%). Thermal injuries accounted for 60.0% of the injuries whereas 40.0% were due to exploding firework. Burns to the eyelid and cornea (35.29%) were the most common injuries noted. Fifteen patients (50%) were bystanders whilst a majority of patients (96.67%) had no eye protection. At presentation, 15 (44.12%) eyes had a visual acuity of 6/6 to 6/9 in the injured eyes, while 3 out of 34 eyes (8.82%) had vision acuity 6/60 or worse. In conclusion, fireworks cause serious preventable ocular burns and related injuries especially in children who are the most affected age group. It affects mainly eyelid and anterior segment structures which result in moderate visual loss on presentation. Health education, public awareness and tighter legislation are essential preventive measures to limit the effect of fireworks to the public.

Matched MeSH terms: Eye Burns/etiology*; Eye Burns/epidemiology*

The development of a tool to predict temperature-exposure of incinerated teeth using colourimetric and hydroxyapatite crystal size data

Rahmat RA, Humphries MA, Austin JJ, Linacre AMT, Self P

Int J Legal Med, 2021 Sep;135(5):2045-2053.

PMID: 33655354 DOI: 10.1007/s00414-021-02538-7

This study presents a novel tool to predict temperature-exposure of incinerated pig teeth as a proxy for understanding impacts of fire on human teeth. Previous studies on the estimation of temperature-exposure of skeletal elements have been limited to that of heat-exposed bone. This predictive tool was developed using a multinomial regression model of colourimetric and hydroxyapatite crystal size variables using data obtained from unheated pig teeth and teeth incinerated at 300 °C, 600 °C, 800 °C and 1000 °C. An additional variable based on the observed appearance of the tooth was included in the tool. This enables the tooth to be classified as definitely burnt (600 °C-1000 °C) or uncertain (27 °C/300 °C). As a result, the model predicting the temperature-exposure of the incinerated teeth had an accuracy of 95%. This tool is a holistic, robust and reliable approach to estimate temperature of heat-exposed pig teeth, with high accuracy, and may act as a valuable proxy to estimate heat exposure for human teeth in forensic casework.

Matched MeSH terms: Burns/physiopathology*

Acquired tracheo-oesophageal fistula following tracheal intubation in a burned patient

Tan KK, Lee JK, Tan I, Sarvesvaran R

Burns, 1993 Aug;19(4):360-1.

PMID: 8357487

A 27-year old male sustained a 60 per cent TBSA burn with inhalation injury following a road traffic accident. He developed respiratory distress on day 3 postburn, and was intubated and ventilated. He was noted to have greenish aspirate from his trachea on day 17 of ventilation. He succumbed from sepsis and died on day 21 post injury. At post-mortem, a large tracheo-oesophageal fistula (TOF) was found at the level of the cuff of the nasotracheal tube.

Matched MeSH terms: Burns, Inhalation/complications*

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