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Save involving serious leg osteo arthritis: usefulness of tibial condylar valgus osteotomy vs . available sand wedge high tibial osteotomy.
Developing a monitoring system and a conservation strategy against the negative impact of global change on threatened plant species, is nowadays the challenge for conservation experts. The Plant Micro-Reserve (PMR) approach became a highly effective approach in protecting plant species, since mild active management of vegetation plots and protection of plant populations takes place. The PMR has greatly evolved since its initial concept of managing a large network of PMRs, to having fewer protected areas subject to intensive scientific monitoring (e.g. Intensive Monitoring PMR; IM-PMR). This study further improved the IM-PMR approach by focusing on the threatened plant species of Ophrys kotschyi in Cyprus. The proposed IM-PMR enhances the available knowledge on the biology, physiology and ecology of the targeted plant species, through implementing an intensive monitoring system and assessing its genetic diversity. Within the framework of IM-PMR, the population size of O. kotschyi recorded statistically signifiinked loci. Such observations support the non-random association of different loci in this subpopulation, and the ineffective pollen flow within this single subpopulation. The improvement of the original PMR approach in the current IM-PMR proposal denotes that different ecological aspects are taken into account towards gaining a holistic knowledge on a target species. The IM-PMR approach as implemented for O. kotschyi, could lead to the development of an integrated conservation approach for rare, threatened, or endangered species.
To compare the quality of life and psychological impact of cases of facial burn scar between male and female patients.

An observational cross sectional study done in a tertiary care university level teaching hospital, on a hospital based sample over a period ranging from January 2018 to July 2019.

The study was carried out on 32 patients of facial burn scar, who were screened for psychiatric diagnoses by MINI International Neuropsychiatric Interview; severity of depression and anxiety assessed by HDRS and HAM A; assessed for QoL and scar ratings of both patient and observer. QoL was assessed using the WHO QOL BREF questionnaire. The scar assessment was done with the help of POSAS by interviewing the patient and examination of the scar.

None of other socio-demographic variables patient showed any significant association with the number of psychiatric diagnoses of the patient or QoL domains; barring years of schooling, which had a significant positive correlation with the psychological domain score of Qing of the patients; whereas scar extent was found to negatively affect the physical and psychological domains of QoL.
No statistically significant gender difference in QoL and psychological impact of patients with facial burn scar were found. However educational level was found to positively influence the psychological well-being of the patients; whereas scar extent was found to negatively affect the physical and psychological domains of QoL.
Intensive care (ICU) patients' burn pain is difficult to assess, communicate and address, risking chronic pain syndromes and psychological morbidity.

To understand how the introduction of validated pain tools (Critical Care Pain Observation Tool [CPOT], Numerical Rating Scale [NRS], Pain Assessment in Advanced Dementia [PAINAD]) affected clinical judgement processes, analgesia/sedation administration and the experience of burn-injured patients.

Consecutive chart review compared type and amount of analgesia/sedation administered, ventilation time and length of ICU/hospital stay between consecutive burn patients pre- and 6-months post-intervention (n=70). GSK2110183 cost Analysis of 36 qualitative interviews with ICU clinicians (n=12) and burn-injured adults (n=12) pre- and post-intervention was guided by Tanner's (2006) Clinical Judgement Model.

Overall, there was a significant increase in morphine (P=0.04) and propofol (P=0.04) use and a trend towards increased paracetamol (P=0.06) use post-intervention. There was a trend towards greater Midazolam use for TBSA<20% (P=0.06), and significantly increased propofol use for TBSA≥20% (P=0.03). Ventilation time and ICU/hospital length of stay were unchanged. Qualitative analysis revealed complex clinical judgement dependent on the context of the patient's situation, unit culture, background beliefs of clinicians and in knowing the patient. Whilst the CPOT and NRS enhanced analytic reasoning and pain advocacy, the PAINAD appeared redundant.

Effective pain assessment, management and advocacy are assisted by evidence-based assessment practices.
Effective pain assessment, management and advocacy are assisted by evidence-based assessment practices.
The burden of global trauma disproportionately affects low- and middle-income countries, with a high incidence in children. Thermal injury represents one of the most severe forms of trauma and is associated with remarkable morbidity and mortality. The predictors of burn mortality have been well described (age, % total body surface area burn [TBSA], and presence of inhalation injury). However, the contribution of the burn mechanism as a predictor of burn mortality is not well delineated.

This is a retrospective analysis of prospectively collected data, utilizing the Kamuzu Central Hospital (KCH) Burn Surveillance Registry from May 2011 to August 2019. Pediatric patients (≤12 years) with flame and scald burns were included in the study. Basic demographic variables including sex, age, time to presentation, %TBSA, surgical intervention, burn mechanism, and in-hospital mortality outcome was collected. Bivariate analysis comparing demographic, burn characteristics, surgical intervention, and patient outcomes we potentially prevent metabolic dysfunction and improve clinical outcomes.
Dressing changes and wound care-debridement procedures often cause fear and anxiety in burn patients, as these processes are quite painful. In order to determine the best method for alleviating pain during these procedures, the current study compared the efficacy and safety of intravenous dexmedetomidine and midazolam for premedication prior to these painful burn care procedures.

This comparative and randomized study included patients who had a burn size of 1563%, were aged 1870 years, were diagnosed with the American Society of Anesthesiologists physical status (ASA I-II), and who underwent painful burn care procedures. Patients were intravenously administered either 1 mcg/kg dexmedetomidine (Group 1) or 0.03 mg/kg midazolam (Group 2) prior to the burn care procedure. Recorded at predetermined time points for each patient were heart rhythm (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO
, standard bispectral index (BIS), and Ramsay Sedation Scale (RSS).

In the dexmedetomidine group, HR and MAP measurements of patients at the 3rd, 5th, and 10th mins during sedation were significantly lower than the baseline values (p < 0.
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