Burn_Injuries

DEPARTMENT OF PREVENTIVE AND SOCIAL MEDICINE A PROJECT ON DIFFERENT ASPECTS OF BURN INJURIES UNDER THE GUIDANCE OF DR. KALPANA KALE MD PSM DR. MOHAN RAUT MD PSM PROJECT BY PRATEEK LADDHA D4 2003 NARENDRA VARMA D1A 2003 INTRODUCTION: In 1998, India was the only country in the world where fire (burns) was classified among the 15 leading causes of death. High mortality in young married women from burns has already become an alarming and contentious medical problem in rural India. The incidences of burn mortality by age, sex, residence, marital status; manner and reasons have been reported only infrequently from the rural parts of India. From a total of 4042 medico legal deaths reported at an Apex medical centre of a rural health district, over a period of 5 years 1997–2001, 942 deaths (23.3%) were due to burns; with mortality rate of 15.1 per year per 100,000 populations. Of all burn death cases, 80.8% were females, 82.4% married ones, 71.9% belonged to the young age group of 21–40 years and 75.0% came from the rural parts of the district. Out of all burn deaths, 50.7% were accidental, 47.8% suicidal and 1.5% were homicidal in manner. In all female suicides, burns were the commonest method adopted by over 60% females. Torture by in-laws (32.1%) was the commonest reason for committing suicide by burns in married women. The present study has tried to identify the high-risk group and reasons for high burn mortality in this rural area. Religious and sociocultural reasons prevalent in the area are discussed, which play the determinant role in such a high mortality rate in burns in rural India. Further studies in India into psychodynamics of sociocultural, religious and family life are advised. Reference: Burns, Volume 29, Issue 3, May 2003, Pages 270-275 Anil K. Batra Indian women, twice as likely to burn to death • Twelve Indian women burn to death every hour on average – almost double the corresponding number for men Reference: http://www.timesonline.co.uk/tol/news/world/asia/article5832650.ece AIMS AND OBJECTIVES: • To study various aspects of burn injuries in regards with age, sex, mortality, prognosis, religion and distribution in district of Akola. MATERIAL & METHODS: A retrospective study was done with the help of burns wards’ admission register and patients details were retrieved in respect to age, sex, and % of burns, residential location and religion. 273 patients were admitted during the period from 1- January ’09 to 31- June ’09 and study was conducted on them in GOVERNMENT MEDICAL COLLEGE, AKOLA. Table No. 1 Age wise distribution of burn patients admitted in last 6 months and there outcome. |Age Group |No. of cases |Expired |Discharged |AMA | |0-15 |37 |6 |13 |16 | |16-30 |135 |66 |41 |28 | |31-45 |77 |29 |29 |19 | |46-Above |24 |10 |9 |5 | |Total |273 |111 |92 |68 | [pic] Inference: • Most of the cases belong to age group of 16 – 30 years. Table No.2 Sex wise distribution of burn patients and there outcomes |Sex |No. of case |Expired |Discharge |AMA | |Male |85 |18 |35 |32 | |Female |188 |93 |51 |40 | [pic] Inference: Two out of every three patients were females out of which half of them succumbed to burns, whereas males showed better outcome with a mortality of about 21%. Table No.3 Age wise distribution of Female patients admitted along with there outcomes. |Age Group |No. of case |Expired | |0-15 |19 |5 | |16-30 |127 |60 | |31-45 |44 |22 | |46 & above |18 |11 | [pic] Inference: Most of the cases (~68%) among females belong to early marital age group of 16 to 30 years, whereas maximum mortality increases with increasing age. Table No.4 Region wise distribution of burn cases |Region |No. of cases | |Rural |194 | |Urban |48 | |Town |31 | [pic] Inference: Above pie diagram clearly indicates the grass roots of the problem. Table No.5 Distribution of burn cases among Muslims. |Sex |No. of cases |Expired | |Male |14 |2 | |Female |12 |2 | Distribution of burn cases among standard population |Sex |No. of cases |Expired | |Male |85 |18 | |Female |188 |93 | [pic] [pic] Inference: Female to male ration in Muslim population was a little lower than 1 compared to the standard population ration of more than 2. Also the percentage of deaths occurring in females of standard populations is almost 50 % whereas it is about ~18%. Table no 6: % burn wise prognosis at GMC Akola |% Burns upto |No. Of Cases |No. of deaths |No. Survivors |% of deaths | |10% |20 |0 |20 |0 | |20% |25 |0 |25 |0 | |30% |38 |2 |37 |5.26 | |40% |32 |3 |29 |9.38 | |50% |23 |7 |16 |30.4 | |60% |20 |15 |5 |75 | |70% |25 |21 |4 |84 | |80% |28 |26 |2 |92.9 | |90% |16 |16 |0 |100 | |100% |36 |36 |0 |100 | [pic] Inference: • Maximum no. of cases is between 20 to 40 % burns with peak of about 30%. • Survival prognosis decreases with increasing % of burn. No one has survived with burns more than 72% in last 6 months. Note: Those patients who left AGAINST MEDICAL ADVICE (AMA) and were more than 50% burns are considered as expired. Table No.7 Comparison of Severity of burns in males and females |  |Burn % < 50 |Burn % >50 | |  |  |  | |Female |83 |106 | |Male |66 |19 | [pic][pic] Inference: • More than ¾ males that had burn less than 50 %. • Females had high severity of burns with almost >80 % those having burns more than 50 % were females. Abstract: • Most of the cases belong to age group of 16 – 30 years. • Two out of every three patients were females out of which half of them succumbed to burns, whereas males showed better outcome with a mortality of about 21%. • Most of the cases (~68%) among females belong to early marital age group of 16 to 30 years, whereas maximum mortality increases with increasing age. • Majority of the cases undoubtedly are from rural populations. • Female to male ration in Muslim population was a little lower than 1 compared to the standard population ration of more than 2. • Also the percentage of deaths occurring in females of standard populations is almost 50 % whereas it is about ~18%. • Maximum no. of cases is between 20 to 40 % burns with peak of about 30%. • Survival prognosis decreases with increasing % of burn. No one has survived with burns more than 72% in last 6 months. • More than ¾ males that had burn less than 50 %. • Females had high severity of burns with almost >80 % those having burns more than 50 % were females. Conclusion: It is clearly evident that burn injuries are a major cause of mortality and morbidity not only physical but also mental to Indian women and it is need of the hour to take adequate measures with political, social & individual contribution to help prevent deaths of MOTHERS of India. References: • www.google.com • www.wikipedia.com • Burns, Volume 29, Issue 3, May 2003, Pages 270-275 Anil K. Batra • www.elsevier.com • K PARK TEXTBOOK OF PSM • Indoor admission register burns ward GMC Akola