Prevalence of Burns in Females in Mosul City

Aim: The aim of present descriptive study resumption to appear extent prevalence of burn in female in Mosul city. Methodology: The sample was collecting from review the register for burn unit in AL-Jaumhory Teaching Hospital during one year (2012). It registry (244) burn case. Where (115) male, and (129) female with ages ranged between (1 - 80) years old for period from(1 st January 2012 to 31 st December 2012). Data was analyzed


INTRODUCTION
Burn injuries remain a major cause of morbidity and mortality in low and middleincome countries. During the past two decades the Iraqi population has being struggling to cope with the impact of wars, sanctions and internal conflicts with poor public services and deteriorating living standards (1) . Burns constitute a major role in mortality and morbidity in the whole world, whether accidental, suicidal or homicidal. Burn injuries are among the most devastating of all injuries and a major global public health crisis. Burns are the fourth most common type of trauma worldwide, following traffic accidents, falls, and inter personal violence. Approximately (90) percent of burns occur in low to middle income countries, regions that generally lack the necessary infrastructure to reduce the incidence and severity of burns (2) . Despite of them modernization, the domestic fire is the major cause of the burns with maximum involvement of females and the accidental injury the main cause. In developed countries like USA, the magnitude of burns injury is (450,000) per year, (3500) deaths per year and (45,000) hospitalizations per year (3) . In a study done in Iran, mortality rate among the hospitalized burn victims was observed to be (25.9%) (4) . In India, approximately, there are (6) million burns cases annually, of which around (0.7) million cases require hospitalization, of which approximately, (0.12) million die annually. Survival rate for burns patients in developing countries like India is around (50%) for burns less than (40%) while those in developed countries it is around (75 -90%) for (50%) burns. Burn injuries cause significant morbidity and mortality, both in developing and developed countries and have considerable physical, psychological and economic effects on the patients, their families and society (5) . In another study done in Iran, it was concluded that among the domestic injuries, burns are a major public health problem for women of reproductive age (6) . The aim of present study resumption to appear extent prevalence of burns in females in Mosul City.

METHODOLOGY:
A descriptive study to assess of all female burns patients presented in the burn Unit, Al Jaumhory Hospital in Mosul City during the period 2012. This study started from (1 st January 2012 to 31 st December 2012). All relative information was collected from patient's treatment files. Inclusion criteria were females of any age with second and third degree burns.
Patients were admitted through casualty and detailed history and thorough examination were carried out. Cause and place of burns. Total Body Surface area (TBSA) burnt was calculated using Lund and Browder Chart. The degree of burns was also established. The questionnaire was designed to achieve the aims of study, it was consist two parts, the first content the demographic information (age of female, area of burn, place of burn, seasonal burn happened, material Status, level of education, occupation, socioeconomic status), the second part content the burn characteristic include (causes of burn, site of burn injury, duration of stay in burn unit, depth degree of burns, total body surface area and death). Data was analyzed through inferential statistical approach were used. This approach isemployed through (Percentage, Mean and Standard deviation).  While, occupation revealed housewife (56%), (6%) employee, (23%) child, students (15%) and according to Socio-economic status, low (44%), middle (35%) and high (21%) were found. and third degree is the commonest depth of injury (36%), followed by second degree (27%).

DISCUSSION:
Burn injuries have been a major cause of concern since pre-historic days to the present era of modern medicine. However, the general belief that burns usually occurs at the two extreme of age, indicating the accidental nature of infliction does not hold true in the present study set-up where the majority of the reported cases belongs to third decade of life. Despite of the modernization, the domestic fire is the major cause of the burns with maximum involvement of females and the accidental injury the main cause (2) . In the present study, there is a predominance of female victims (53%) than males (47%) in burns cases and majority of them where were in the reproductive and productive age groups (21-30 years, 34%) Similarly, in an earlier study, Chawla, et al (2010) had observed (64%) cases belonging to females and (52%) cases were in the age group of 21-30 years (7) . These observations are confirmatory with other studies from various regions of India (8) . This may be due to gender difference, sociocultural factors, and dowry problems. Secondly most of the women are house wives and they come more in contact with fire (9) . Rural patients (60%) outnumbered urban patients (40%).
The present study findings similar to the findings of Haralkar et al (2011), this may be due to standard of living and low socioeconomic status. Use of Shagadi, Chulha, and kerosene pressure stove etc. for cooking is more seen in rural areas than in urban areas. In present study, majority of the cases (44%) were from lower socio-economic and these findings are comparable with Haralkar et al (9) . The present study revealed the kitchen as the major site of the burn incidences in comparison to the outdoor incidences. However, Pegg has reported slightly different results in this regard and this mismatch could be due to the difference in the socio economic conditions of various countries and difference in the cultures, habits and behaviors of different populations being studied (10) . Flame burn was the most common cause of burns accounting for (53%) of the total burns, followed by scald burn seen in (46%) subjects in the present study. This was probably because of faulty and unsafe cooking practices. Similar results were obtained in various studies done in India as well as in other countries (10,11,12) . In another study done in Iran, (37.7%) of all women and (32.3%) of women in the reproductive age group were injured by hot liquids (6) . Maximum average total body surface area (TBSA) of burn (21%) occurred in (21 -40) yrs age group. In all age groups female exceeded male for total body surface area of burn. The mean total body surface area (TBSA) burnt in our study was comparable with other international studies by Pegg, (2005) Song, (2003) and Komalafe, (2003) (10,13,14) . The data from these international studies confirmed the observation that in the bulk of burn patients, the total body surface area (TBSA) burnt is not more than (20%). Mean duration of hospital stay for all patients, for patients who died, for those who survived (15.5) days were all similar to a study from Iran (15) .
As found in other studies the most frequent admissions occurred in winter (16,17) due to greater use of heating devices.

CONCLUSION:
Maximum incidence of burn injury seen in females. Most of the patient were in the age group of (21 -30) years. Most burns were domestic, in low socio-economic class and in house wives. Most of the burn injury caused by flam.

RECOMMENDATION:
The study recommended guidance to community to preventable, educational programs might to reduce the incidence of burn injury. Guidance to family to put directories of gas service stations should be maintain at home so as to ensure immediate repair of any fault in the cooking appliances. Education and promoting best practices in fire safety can have a direct impact on preventing burn injuries.