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Introduction: Spontaneous rupture of the membranes any time beyond the 28th week of pregnancy but before the onset of labour is called Premature Rupture of Membranes (PROM). There are many techniques for diagnosing PROM that is based on both clinical assessments and biological studies. Each of these procedures has benefits and drawbacks. Since foetal urine is the major source of amniotic fluid, the presence of vagina and a high creatinine level may aid in the diagnosis of PROM. Aim: To determine the cut-off levels of serum creatinine in predicting the PROM. Materials and Methods: A cross-sectional study was conducted at Dr. DY Patil Medical College, Hospital and Research Centre in Pune, Maharashtra, India from June 1 2020 to June 5 2021. Two equal groups of 140 each pregnant women with gestational ages ranging from 28-42 weeks were created: one with a history of vaginal leaking (the study group, P), and the other with gestationally matched no leakage (the control group, C). Patient's details such as age, gestational age, and obstetric history were noted. Each patient was examined and cervicovaginal secretions were collected. A 5 mL of saline was flushed in the posterior fornix of vagina. This fluid with vaginal wash was aspirated and creatinine concentration from vaginal fluid was determined by Jaffee synthetic chemical colorimetric method. The Student's t-test and the Chi-square test were used to analyse the data. Results: The study group's vaginal fluid creatinine level was substantially higher (p-value<0.001). The cut-off value of 0.6 mg/dL had highest sensitivity 96.1% and specificity 100%. The area under the Receiver Operating Characteristics (ROC) curve was 0.917. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of serum creatinine at cut-off 0.6 mg/dL was 100% and 96.3% respectively. Conclusion: Vaginal fluid creatinine is simple and easily available, which makes it acceptable to the candidate for a diagnosis of PROM. [ABSTRACT FROM AUTHOR]

Background: Paediatric burns are a major health concern, and treatment of choice for less extensive intermediate-depth scald burns is debatable. In a developing country like India where the incidence and complications are high, the need for an easy and cost-effective treatment is highly necessary. The study aimed to retrospectively analyse the need for interventions in paediatric scald burns in a single tertiary referral centre over 4 years, comparing early application amniotic membrane vs wet collagen and paraffin gauze dressings. Methods: All paediatric scald burn patients admitted to the Department of Plastic and Reconstructive Surgery between Jan 2015 and Dec 2018 were identified. Demographics were collected from hospital records and operation theatre logbook. Acute scald burns in patients younger than 15 years were analysed according to dressing applied to find the need for intervention, days of hospitalisation, antibiotics usage and rate of infection. Results: A total of 71 paediatric scald burn patients were analysed between 2015 and 2018. Thirty-six were treated with early application of human amniotic membrane and the remaining 35 were treated with wet collagen and paraffin gauze dressings. Patients treated with human amniotic membrane had lower in-hospital stay (p 0.000) and underwent less frequent dressing change (p 0.046), and none of them needed grafting (p 0.000). Conclusions: Our study results suggest that early application of human amniotic membrane can significantly reduce the need for surgical intervention and should be the preferred method of treatment in less extensive paediatric scald burns. Level of evidence: Level III, therapeutic study. [ABSTRACT FROM AUTHOR]