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Background & Aims Experiencing stigmatization behaviors in children with post-burn deformities can leave lasting negative effects on their mental and social health, and is considered an important issue in the child's growth and development. This research aims to investigate the perceived stigmatization in children with deformities or visible scars caused by burns referred to treatment centers in Tehran, Iran. Materials & Methods In this cross-sectional study, 190 children aged 8-18 years with a history of burns resulted in deformities or visible scars participated. Sampling was done using a convenience method from October 20, 2021, to October 20, 2022. The 21-item perceived stigmatization questionnaire (PSQ) was used to collect information. Data analysis was performed in SPSS software, version 21 using independent T-tests and analysis of variance. Results The mean total score of PSQ was 2.199±0.562. The domain of confusing/staring behaviors had the highest score of 2.517±0.820. Perceived stigmatization showed significant relationships with children’s age (P=0.030), gender (P= 0.010), educational level (P< 0.001), time since burn (P<0.001), and frequency of reconstructive burn surgery (P=0.009). Moreover, perceived stigma in children was significantly correlated with their mothers' education level (P=0.007) and occupation (P=0.003). Conclusion Female children with deformities or visible scars caused by burns tend to experience stigmatization behaviors more frequently than males. These children experience these behaviors mostly during early adolescence. Additionally, a higher number of reconstructive surgeries and a shorter time since the burn accident are linked to high perception of stigmatization in these children. Moreover, children of employed mothers and those whose mothers have higher educational levels report more perceived stigmatization. It is important for nurses to identify these issues and refer the cases who require additional support to available social treatment centers for further assistance. [ABSTRACT FROM AUTHOR]

Background: Pseudomonas aeruginosa infections are resistant to antimicrobial agents and produce toxic virulence factors such as exotoxin A. Studies have shown that some nanoparticle compounds and antibiotics have a synergistic effect. Therefore, the aim of this study was to investigate the synergistic effect of silver nanoparticles and erythromycin on antibiotic-resistant P. aeruginosa. Materials & Methods: In this descriptive cross-sectional study, 40 cultured samples of burn wound secretions were taken from Imam Musa Kazem (PBUH) Burns Hospital in Isfahan, Iran. Diagnostic and differential tests were performed. Antibiogram was performed to obtain the bacterial resistance pattern and the exotoxin A gene was detected by PCR. The bacterial minimum inhibitory concentration (MIC) was then applied to the silver nanoparticles (shape and mean size) and erythromycin separately and a common mixture of both in 10 dilutions to investigate the synergistic effect. Results & Conclusion: A number of 26 bacteria were strains of P. aeruginosa. Of samples, 25 (96.15%) had exotoxin A gene. All samples were sensitive to all erythromycin concentrations. The mean MIC of nanoparticles against bacteria was reported to be 2 μg/mL. A solution of 40 μg/mL erythromycin and 2 μg/mL nanoparticles was also considered as MIC solution. Pseudomonas aeruginosa is sensitive to erythromycin to very low concentrations of silver particles. But no synergistic effect between silver nanoparticles and erythromycin was reported for this bacterium. Based on PCR results and antibiotic resistance pattern, a significant number of the samples contained the exotoxin A gene and the use of erythromycin alone was not appropriate for treatment. [ABSTRACT FROM AUTHOR]

Background and Aims: The type IV Pilin is an important colonization factor for opportunistic pathogens of Pseudomonas aeruginosa, which plays a role in the formation of biofilms and binding to the host cells. Each type of Pilin is coded with a particular auxiliary gene. This specific relationship can be used as a therapeutic target for detecting P. aeruginosa strains as well as its molecular classification. The purpose of this study was to evaluate the frequency of different types of auxiliary genes in cystic fibrosis, burns, and environmental samples. Materials and Methods: Pseudomonas aeruginosa samples were collected from patients with cystic fibrosis, burns as well as environmental wastewaters during 2016-2017. Samples were cultured and identified using standard microbial and biochemical methods. DNA extraction was performed by boiling and PCR was performed through specific primers. Results: Totally, 90 isolates of P. aeruginosa samples (35 environmental, 30 burns, and 25 cystic fibrosis) were examined. tfpO and tfpZ were positive in 71 and 2 isolates, respectively . Conclusion: The results indicated that Pseudomonas aeruginosa Pilin types are very diverse. Regardless of the source of the samples, the most common tfp was tfpO. Taking into account the fact that tfpZ was found only in burns, it can be assumed that this particular type may appear in severe clinical conditions. Ultimately, larger statistical population and use of more comprehensive typing methods is suggested for better results. [ABSTRACT FROM AUTHOR]

Background and Aims: Staphylococcus aureus infection needs long-term treatment with antibiotics which may cause adverse effects on many body organs and antibiotics resistance. Therefore, the use of natural and herbal compounds has been under consideration. Materials and Methods: In the present study, the effects of sunflower (Helianthus annuus) and sesame (Sesamum indicum) oils were assessed on S. aureus growth regarding zone of inhibited growth (Antibiogram test), Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). Results & Discussion: considering antibiogram test, there was a statistically significant difference between sesame and sunflower oil (72 hours ozonate) and pure sesame and sunflower oils and ciprofloxacin antibiotic, as well as negative control distilled water after 24 and 48 hours (P≤0.05). The results showed that antibiotic, ozonated water, ozonated sesame and sunflower oils had 12, 8, 4, and 3 mm inhibition zones after 24 hours on S. aureus bacteria, respectively. The MBC and MIC values of ozonated sunflower and sesame oil on S. aureus were 0.064, 0.032, 0.322 and 0.008 mg/mL, respectively. Sesame and sunflower oils can be used as inhibitors of the growth of S. aureus in pharmaceutical formulations such as wound and burn healing ointments. [ABSTRACT FROM AUTHOR]

Background and Aims: Pseudomonas aeruginosa is an opportunistic pathogen that causes serious infections and high mortality among burn patients. The aim of this study is to evaluate the protective effects of a candidate divalent vaccine containing type A flagellin and pilin of P. aeruginosa in a burn wound mouse model. Materials and Methods: Recombinant flagellin A and pilin proteins were generated by expressing fliC and pilA genes (cloned in pET-28a and pET-22b vectors, respectively) in E. coli BL-21. Groups of mice were immunized by injection of 10 μg of either flagellin A and pilin, or flagellin A, or pilin. Specific IgG titer was measured by ELISA. The functional activity of antibodies was evaluated by opsonophagocytosis assay. The protective effects of the vaccine were evaluated by measuring mortality and bacterial load in mice. Results: Immunization with flagellin A and pilin mixture significantly increased the specific IgG antibody titer as well as opsonophagocytosis compared to monovalent antigens (P<0.05). Immunization with flagellin A and pilin mixture significantly reduced the bacterial load, and increased the survival of mice challenged with P. aeruginosa, as compared to the monovalent antigens (P<0.05). Conclusions: Immunization with flagellin A and pilin mixture provides effective protection against P. aeruginosa wound infection in burned mice. Reduced bacterial load, and high survival rates among immunized mice suggest that flagellin A and pilin candidate vaccine shows therapeutic potential against P. aeruginosa infections among burn patients. [ABSTRACT FROM AUTHOR]

Background and Objective: Second-degree burns are associated with several complications such as infection, septicemia, and unpleasant skin appearance and are one of the main causes of in-hospital mortality. Therefore, this study was designed to determine the therapeutic effects of Q. persica fruit skin on the healing of second-degree burn wounds. Materials and Methods: In this experimental study, 60 mice were randomly assigned into three groups. Vaseline was used for group 1, 1% Silver sulfadiazine (SSD) cream was used for group 2, and Vaselinebased Quercus persica L. hydroalcoholic extract was used for group 3. After the development of seconddegree burns with a pathologist's confirmation, the wound area was measured for a month by AutoCAD software. The wound was pathologically examined and data were analyzed by repeated measures ANOVA and Kruskal-Wallis using SPSS 18. Results: Decrease in wound area was 72.01% in the Quercus persica L. group, 65.95% in the SSD group, and 59.12% in the Vaseline group. Mean wound recovery was higher in the Q. persica fruit skin group but not significant (P>0.05). The mean number of wound hair follicles and sebaceous glands and mean wound angiogenesis were higher while wound inflammation intensity was lower in Quercus persica L group, but no significant difference in these variables was seen between the Quercus persica L and SSD groups (P>0.05). Conclusion: Quercus persica L. had relatively acceptable therapeutic effects on the healing of second-degree burn wounds compared to SSD and Vaseline. [ABSTRACT FROM AUTHOR]

Background and Objective: Burn injury is not a disease، but it is a disaster with many social، economic and mental effects which contribute to the problem and make it several times larger. Several studies have examined various factors in burn. In this study، we evaluated the effect of L-glutamine on biochemical tests in mice with second degree burns. Materials and Methods: In this experimental study، 30 male mice were included and randomly divided into two groups. First، the mice underwent general anesthesia and then using an iron plate with 80°C thermal injury for duration of one second، a second-degree burn injury was induced on the animal's skin. In the case group، the mice received glutamine powder (1 g/kg/day) dissolved in water. The control group did not receive such supplementation. The data gathered on different days and analyzed by SPSS software. Results: There was no significant difference between two groups regarding weight and serum albumin، urea، and creatinine levels. The mean of serum levels of albumin is (4.93“0.24 and 4.84“0.79) on day 1 and 22th respectively (P≤0.4) and in the control group on day 1 and 22th (4.21 “ 0.46 and 4.21 “ 0.45) respectively (P≤0.7). The mean of serum levels of urea is (30.10 “ 3.3 and 30.48 “ 4.27) on day 1 and 22th respectively (P≤0.3) and in the control group on day 1 and 22th (25.89 “ 0.14 and 25.89 “ 2.4) respectively (P≤0.7). The mean of serum levels of creatinine is (0.82 “ 0.17 and 0.86 “ 0.25 on day 1 and 22th respectively (P≤0.9) and in the control group on day 1 and 22th (0.86 “ 0.14 and 0.86 “ 0.19) respectively (P≤0.4). Conclusion: The results of this study indicate that glutamine did not have any significant effect on biochemical parameters in burn. The role of glutamine in burn wound healing has not been established completely، but there is a lot of evidence supporting the beneficial effects of glutamine for treating burns. However، further research is necessary in order to understand which stage of the treating process glutamine supplementation affected. [ABSTRACT FROM AUTHOR]

Background and Objectives: Infection is known as a major challenge for a burn team to deal with; meanwhile, it's responsible for almost 75% of the burn death. The main underlying cause of this problem is because of this fact that the environment at the site of the wound is ideal for the proliferation of infecting organisms. The aim of this study was to investigate the causative microorganisms and antimicrobial resistance profiles of the isolated microorganisms in patients hospitalized at the burn ICU of Zareh hospital, Sari, Iran. Materials and Methods: All of the 100 patients who were hospitalized at the burn unit were enrolled in this prospective cross sectional study. Demographic, clinical data, including sex, age, total burned surface area were collected for each patient. Laboratory specimens included wound discharge, tissue debridements, tracheal tube and Centeral Venus Presher (CVP). Environmental specimens were also collected from patient's room including medical instatements located in the room. Conventional microbiologic tests were performed for isolation and identification of burn infections causative organisms and to detect antibiotic sensitivity by disc agar diffusion method. Results: Two hundred and twenty six different microorganisms isolated were collected from the 615 samples including 280 swabs, 35 tissue biopsies, 100 urine samples, 100 bloods, 50 CVP samples and 50 endotracheal specimens. Acintobacter baumannii was the most prevalent bacterium isolated. 550 samples of patients' environment were also studied. Regarding antibiotic sensitivity of the isolated bacteria over 90% of Acintobacter baumannii isolates were resistant to amikacin, gentamicin, piperacillin/ tazobactam, ceftazidime and cefepime. The highest susceptibility was observed for tobramycin (58.2 %) and imipenem (41.9 %). The most common type of burn was flash injury. Nearly 60% of participants were aged from 21 to 40 years . Conclusions: Acintobacter baumannii was the most prevalent bacterium causing infection. Detection of high levels of antibiotic resistance in our Acintobacter baumannii and other medically important isolated bacteria underlines need for continuous surveillance of burn infections and developing strategies for antimicrobial resistance control. [ABSTRACT FROM AUTHOR]

Background: Pseudomonas aeruginosa is a gram-negative, non-fermentative bacillus and one of the most common opportunistic human pathogen causing 10-15% of nosocomial and burn wound infections worldwide. These bacteria are resistant to most of the antibiotics. This study aimed to investigate the frequency of extended spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) enzymes in P.aeruginosa strains isolated from burn wounds. Materials and Methods: In this descriptive cross-sectional study, 180 wound specimens were collected from patients hospitalized in burn hospital and then cultured. The suspected colonies were identified using the conventional biochemical methods. Susceptibility testing was performed using the Kirby-Bauer method. Moreover, the Combination Disk and E.test methods were used for the determination of ESBLs and MBL, respectively. Results: Fifty-four (30%) out of 180 cultured samples were identified as p.aeruginosa; 12 (22%) and 16 (29.5%) isolates were ESBLs and MBL producer, respectively. Overall, 42 (79%), 40 (74%), 40 (74%), 38 (70%), 35 (66%) and 34 (62%) isolates were resistant to ceftizoxime, imipenem, gentamycin, piperacillin, cefepime, meropenem and ertapenem, respectively. Conclusion: Results reveal that the antimicrobial resistance and prevalence of ESBLs and MBL producing P.aeruginosa strains is increasing in our hospital and it is necessary to perform susceptibility testing, control risk factors and reasonably prescribe the appropriate antibiotics. Considering the diversity of ESBL and MBL classes and their prevalence in different areas, performing molecular research is needed. [ABSTRACT FROM AUTHOR]

Introduction: Aloe Vera or yellow Sabr is a durable plant belonging to Sousanian family. This plant has a strange potential to treat scars and burns. Aloe Vera leaf has antimicrobial and anticancer attributes. This study is designed to assess the probable effects of Aloe Vera sap on progesterone, estrogen and gonadotropin in female rats. Materials and Methods: In this experimental study, 40 female rats with the mean weight of 180 ± 20 gr were divided into five groups of control, sham, and intervention groups 1, 2, and 3. The control group did not receive any drug. The sham group only received 2 ml distilled water. Intervention groups received 50, 100 and 200 mg/ kg hidroalcoholic extract of Aloe Vera during 10 days orally (equal to 2 sexual cycles). Finally, the rats were anesthetized using ether and blood samples were taken through their ventricles. Blood serum was extracted and the serum concentration of estrogen, progesterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was measured using immunoassay. Data were analyzed using one-way ANOVA. Results: The mean serum level of estrogen was significantly higher in intervention groups 2 (100 mg) and 3 (200 mg) compared to the control group (P<0.05). No significant difference was found between the intervention groups and control group for serum level of progesterone, LH and FSH. Conclusion: Given these findings, the Aloe Vera sap may have favorable effects on estrogen synthesis due to its phytoestrogen components such as beta sitosterol, and can increase the estrogen level. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the epidemiology of burning and its related risk factors in Chaharmahal and Bakhtiari province, Iran in 2009. Patients were identified using both active and passive methods. A 20-item questionnaire was employed to interview the participants. 2257 burned cases detected, 55.57% occurred in women, 44.93% in urban areas, 51% in individuals younger than 20 years old, 37.12% in children below 9 years, 80.86% in houses, and 31.4% in winter.Associations were found between female gender and burns related to boiling water, intentional burns, and burns in the house and in the kitchen. Moreover, burns with molten bitumen and male gender were significantly related. Generally, at least in terms of burning, houses can be a dangerous environment especially for children and women. [ABSTRACT FROM AUTHOR]

Background: In conventional methods of surgical debridement for deep burn wounds, application of pre and post-operative antibiotics is a routine prescription in many centers. But, recently some new ideas indicate that decreasing antibiotics prescription has the same or better clinical results. This study evaluates the role of antibiotics in the management of burn wound which require surgical debridement. Methods: In this clinical trial, 214 patients with deep (3rd degree and deep 2nd degree) burn and total body surface area (TBSA) between 35 to 50% were randomly divided in control (105 patients) and intervention (109 patients) groups. In intervention group, only a pre-operative single dose of ceftazidme was prescribed. But in control group, pre and post-operative antibiotics was administered for 7 days. Sign and symptom of infection and tissue culture were compared in 2 groups for detection of wound infection. Findings: The incidence of wound infection was 28% in intervention group and 26.5% in control group (P > 0.05). The other benefits of single dose pre-operative antibiotic therapy were decrease in antibiotic resistant germs, the cost, and the time for nursing care. Conclusion: In deep burn wounds with total body surface area of less than 50%, application of single dose pre-operative antibiotic do not increase the risk of infection and can also decrease the final cost, multi-drug resistant bacteria production, and spent time in nursing care. As a result of this investigation, single dose pre-operative ceftazidme is recommended for all burned patients with less than 50% of total body surface area. [ABSTRACT FROM AUTHOR]

Background: Tissue expansion has developed as a routine procedure in plastic surgery in the past two decades. Also, tissue expander has become a useful adjuvant in pediatric burn reconstruction. As any other surgical endeavor, tissue expansion has its own disadvantages and potential complications. Our study was the first comprehensive study in Iran about tissue expansion. Methods: All patients underwent tissue expansion surgery in Imam Musa Kazem burn hospital and Alzahra hospital, Isfahan, Iran from 1995 to 2007 for reconstructive purposis were reviewd retrospectively. 208 expanders were placed in 135 patients. Data were gathered from medical and operative reports and through interviewin the patients. Each patient was studied with respect to indication for the procedure, location, shape and volume of expander, previous expansion if any concomitant expansion, and complications. Finding: 75 patients (55.6%) were women and 60 (44.4%) were men. The most common indications for tissue expansion were burn sequelae (80%), trauma scar (12.8%), and congenital abnormalities (6.6%) respectively. The age of patients ranged from 4-47 years (mean of 21.96 ± 7.2 years). Rectangular expanders were used in 52.4% of cases, round expanders in 13.4%, and crescend in 2%. The volume of expanders ranged from 30 ml to 1200 ml and the most common volume were 200-299 ml (47%). Period of tissue expander remaining in body were 312 days in breast and 78 days in forehead. Complications were seen in 34.2%; the most common complications were expander expousure (59.6%), infection (46.1%), and bad function of expander (13.5%) respectively. Conclusion: However, although afflicated with abread range of possible complications, the tissue expansion procedure remain a valuable and reliable technique for the reconstruction of burn patients suffering from extensive scarring. Knowledge of the frequency of complications, and precise instruction of the medical stuff as well as detailed and continious education of patients may help to further increase the efficacy of tissue expansion process. [ABSTRACT FROM AUTHOR]