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   Table of Contents - Current issue
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July-December 2018
Volume 14 | Issue 2
Page Nos. 17-54

Online since Wednesday, November 28, 2018

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ORIGINAL ARTICLES  

The cost of burn wound care in low-income nations could be reduced with the use of palm kernel oil: A preliminary study p. 17
Muhammad H Ibrahim, Habiba Aminu, MomohSani A Yakubu, Aliyu Muhammad, Rilwan O Maleeq
DOI:10.4103/njps.njps_5_18  
INTRODUCTION: Palm kernel oil, Shea butter and honey are used traditionally for the treatment of variety of ailments in West Africa, but there are no scientific report on burn wound healing activity of Shea butter and palm kernel oil, although honey has been in use for the treatment of burn wound. This study aim to compare the wound healing effect of these organic compounds (palm kernel oil, Shea butter and honey) in the treatment of deep dermal or full thickness burn wound to the conventional Silver sulfadiazine and povidone iodine creams in laboratory albino rats. MATERIALS AND METHODS: 25 rats weighing from 250–300 grams were randomly divided into five groups. About 225 mm2 deep dermal burn/or full thickness burn wound was created on the dorsum of the rats. The burn wound were dressed every alternate day with group (1) treated with honey; group (2) Shea butter; group (3) palm kernel oil; group (4) 1% silver sulfadiazine and group (5) 5% povidone iodine cream. Epithelialization observed and contraction was measured at the time of the dressing. FINDINGS: There was rapid reduction in the wound size by day 6 (P≤0.05) in the palm kernel and povidone iodine cream treated group and by day 8 the wound in both group were completely closed, the Shea butter treated group wound shows significant contraction by day 10 and the wound were closed only from day 14 on ward. CONCLUSION: Palm kernel oil is an affordable and readily available topical agent that holds potential for rapid burn wound healing.
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Epidemiology of hand burns among children in Zaria, Northwestern Nigeria p. 22
Muhammad L Abubakar, DJ Maina, WO Adebayo, MA Kabir, A Ibrahim, I Abdulkadir
DOI:10.4103/njps.njps_7_18  
BACKGROUND: The events leading to hand burns injuries in a child are a complex relationship between the child, heat source, mechanism, and the environment where the event occurs. Preventing hand burns in children needs an understanding of its epidemiology. OBJECTIVES: To describe the etiology, pattern, mechanism, and the environmental setting in childhood hand burn injuries. MATERIALS AND METHODS: The study was a retrospective study of all children who sustained burns injury to the hand over a 5-year period (January 2011–December 2015). The study was conducted at the Plastic Surgery Unit of the Department of Surgery, Ahmadu Bello University Teaching Hospital, Shika, Zaria. Recorded information included age, gender, agent of burns, pattern of injury, mechanism of injury, and the setting at the time of injury. A descriptive analysis of the data was performed using SPSS version 21. RESULTS: A total of 47 children sustained burn injuries to the hand. The mean age was 2.17 years, a standard deviation of ±2.15, and age range of 0 to 13 years. There were 26 children <2 years old (55.32%), whereas 18 (38.30%) were of 2 to <4 years of age. Twenty-six (55.32%) were male, and the male-to-female ratio was 1.23:1. Most of the children suffered scald injury [29 (61.7%)] followed by contact burns in 12 (25.53%). Dipping hands into hot water was the most common cause of injury. Holding hot charcoal was the most common type of contact burns. The hands only were affected in 37 (78.72%) of the children. The burns mostly [45 (97.87%)] occurred at home. Mothers were the custodians of the children in 42 (93.33%). CONCLUSION: Targeted preventive approach for mothers, especially through maternal education using ante natal, immunization, and pediatric clinics are suggested.
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To evaluate effectiveness of flap surgery in patients of grades 3 and 4 pressure ulcers p. 28
Sudhanshu Punia, RB Singh, Roop Singh
DOI:10.4103/njps.njps_9_18  
OBJECTIVE: To evaluate the effectiveness of flap surgery for grades 3 and 4 pressure ulcers. DESIGN AND SETTING: Patients were included in this prospective study conducted in the Department of Burns and Plastic Surgery, Post Graduate Institute of Medical Sciences, Rohtak, along with the institute’s Paraplegia Unit. The outcome of flap surgery was assessed. PARTICIPANTS: The sample size was of 25 spinal cord injury patients with grades 3 and 4 pressure ulcers. INTERVENTION: After wound preparation, flaps were used to cover the resultant defect. OUTCOME MEASURES: The outcome was assessed on the parameters of wound dehiscence, flap necrosis, and recurrence. RESULTS: Points were allotted for the overall outcome assessed over the said parameters, 92% of the patients had excellent outcome and the remaining 8% had a good outcome, proving that flap surgery is extremely effective in management of patients with pressure ulcers. CONCLUSION: Pressure ulcers are a common sequalae of spinal cord injury. Irrespective of the cause, a patient of spinal cord injury would develop a pressure injury at some point of time. Pressure ulcers were best treated with flap surgery, after thorough debridement including dead or necrotic bone, along the special care to positioning.
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Experience with management of nasal defects p. 36
Ayodeji O Oladele, Jimoh K Olabanji, Anthony A Olekwu, Oluwafemi O Awe
DOI:10.4103/njps.njps_8_18  
INTRODUCTION: Nasal reconstruction is a challenging undertaking for the reconstructive surgeon. Clinical patterns and outcomes in nasal reconstruction in blacks are relatively less well reported. The purpose of this article is to document a review of patients who had nasal reconstruction in our practice, a black African setting. PATIENTS AND METHODS: Clinical records of patients with nasal deformities requiring reconstruction were retrieved. Patient’s biodata as well as type and extent of nasal deformities, etiology of deformities, and outcomes of treatment were documented. RESULTS: Twenty-nine patients were managed over a 15-year period. There were more males than females. The average age was 27 years. Trauma accounted for 62% of cases with road traffic injuries, human bites leading the pack. Defects from resection of skin malignancies were few. The parts of the nose most commonly affected were the alar, tip, and columella. Forehead flap and nasolabial flaps with or without cartilaginous grafts were most commonly employed means of repair. CONCLUSION: Nasal defects were more commonly due to trauma, rather than excision of skin malignancies. Primary suturing of avulsed nasal tissue in human bites should be avoided as necrosis results. Delayed presentation may complicate outcomes.
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CASE REPORTS Top

Cenani–Lenz syndrome: A case report p. 45
Hayat Al-Nougidan, Shabeer A Wani, Ahmad Wafeeq Wafa
DOI:10.4103/njps.njps_1_18  
Cenani–Lenz syndrome is a rare autosomal recessive congenital malformation syndrome characterized by syndactyly and oligodactyly of fingers and toes, disorganization and fusion of metacarpals, metatarsals, and phalanges, radioulnar synostosis, and mesomelic shortness of the upper limbs, with lower limbs usually being less severely affected and associated with facial dysmorphism and renal abnormality. A case report of a 16-year-old Saudi male presented with four limbs syndactyly of fingers and toes, mild facial dysmorphism, dextroscoliosis, and crossed fused ectopia of the left kidney at the right side is presented here.
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The effectiveness of saline washout in the management of exytravasation of cytotoxics p. 50
Komla S Amouzou, Elodie J. L. Malonga-Loukoula, Tiemoko M Haidara, Mounia Diouri, Mohamed Ezzoubi
DOI:10.4103/njps.njps_12_18  
Extravasation of cytotoxics is a dreaded complication of the intravenous route medication, especially in chemotherapy. The use of saline washout is insufficiently documented in the literature. Here, we report the excellent results of using saline washout in the management of these injuries. Three patients presenting extravasation of anthracycline, calcium gluconate, and radiologic contrast were treated in our department by saline washout. The technique was a use of saline to flush the extravasation area after liposuction of the body site injured. All patients were treated in an outpatient setting. No case of skin necrosis nor other complications related to the extravasation or to the surgical technique have been reported during the follow-up. Patients with extravasation should be referred to the plastic department at early stage. Saline washout is reliable technique to prevent skin and soft tissue necrosis caused by extravasation of cytotoxics.
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