PEDIATRIC BURNS: BIOCHEMICAL MARKERS OF SEPSIS AND FORENSIC INDICATORS OF ABUSE
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Keywords
Pediatric burns, Sepsis, Biochemical markers, Procalcitonin, Forensic indicators, Child abuse
Abstract
Background: To evaluate the role of biochemical markers in the early detection of sepsis and to identify forensic indicators of abuse in pediatric burn patients.
Methods: A prospective observational study was conducted at Hayatabad Medical Complex, Peshawar, under Khyber Girls Medical College, from June 2023 to June 2024. A total of 65 children aged 0–15 years with acute burns were enrolled. Demographic data, burn characteristics, biochemical parameters (WBC, CRP, procalcitonin, lactate, cultures), and forensic indicators (burn pattern, site, caregiver history) were assessed. Outcomes included ICU admission, complications, hospital stay, and mortality.Results: The majority of children were under five years old, with scald burns being most common. Elevated CRP (50.8%), procalcitonin (29.2%), and lactate (24.6%) were significantly associated with clinical sepsis and adverse outcomes. Blood culture positivity was seen in 33.8% of cases. Forensic red flags such as symmetrical immersion burns, atypical sites, multiple burn stages, and inconsistent caregiver history were significantly linked to suspected abuse. Mortality occurred in 15.4% of patients, mainly due to sepsis and inhalation injury.
Conclusion: Biochemical markers provide valuable support in the early detection of sepsis in pediatric burns. Forensic vigilance remains essential, as non-accidental injuries may mimic accidental burns. A multidisciplinary approach is vital for both improved survival and child protection.
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Naheed Siddiqui
Assistant Professor, Department of Forensic Medicine and Toxicology, Khyber Girls Medical College, Peshawar, Pakistan
Sabika Hussain
Assist Professor, Department of Forensic Medicine and Toxicology, Rawal Institute of Health Sciences, Islamabad, Pakistan.
Bubrak Amin
Paediatrics Registrar, Department of Paediatrics, Sligo University Hospital, Ireland
Jamil Ahmed Siddiqui
Associate Professor, Department of Biochemistry, Loralai Medical College, Loralai Balochistan, Pakistan
Arif Mehmood Khan
Assistant Professor, Department of Paediatric Medicine, Women and Children Hospital – MTI, Bannu Medical College, Bannu, Pakistan
Muhammad Sami Khan
Lecturer, Department Pathology, Pak International Medical Collage, Peshawar, Pakistan