Birth outcomes in a tertiary teaching hospitals and local outposts: a novel approach to service delivery from Iran

Public Health ◽  
2016 ◽  
Vol 135 ◽  
pp. 114-121 ◽  
Author(s):  
Z. Moudi ◽  
S.M. Tabatabaei
Keyword(s):  
Service Delivery ◽  
Birth Outcomes ◽  
Teaching Hospitals ◽  
Novel Approach ◽  
Tertiary Teaching

scholarly journals Pattern of childhood malignant tumours in two tertiary teaching hospitals in Nigeria: Comparative study

2013 ◽  
Vol 40 (2) ◽  
pp. 175-178
Author(s):  
UA Shehu ◽  
SA Adegoke ◽  
U Abdulsalam ◽  
M Ibrahim ◽  
OA Oyelami ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Public Health Problem ◽  
Bone Tumours ◽  
Teaching Hospitals ◽  
Malignant Tumours ◽  
Acute Leukemias ◽  
Female Ratio ◽  
Hospital Unit ◽  
Tertiary Teaching ◽  
Male To Female

Background: Cancer is a public health problem worldwide affecting all categories of persons. It is the second common cause of death in developed countries and among the three leading causes of death in developing countries.Objective: To compare the patterns of malignant childhood tumours intwo tertiary hospitals in the north- Western and South western Nigeria.Methods: Retrospective studies of childhood malignancies diagnosedat Aminu Kano Teaching Hospital (AKTH), Kano and Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) (Ife Hospital Unit, Ile-Ife and Wesley Guild Hospital Unit, Ilesa, Osun state) were undertaken from January, 2001 to December, 2010. The patterns of childhood cancers inthese hospitals were compared.Results: Four hundred and ten children aged 7 months to 15 years were admitted at AKTH with malignancies of which 236 were males and 174 females with male to female ratio of 1.4:1. At OAUTHC, 568 children aged two months to 15 years were admitted with malignancies over the ten year period. There were 401 males and 167 females, with male to female ratio of 2.4:1. Lymphomas were the commonest type of malignancy in both centers, which accounted for 47.3% and 59.7% at AKTH and OAUTHCrespectively. Retinoblastoma was the second commonest tumour atAKTH constituting 14.9% of all malignancies followed by nephroblastomaand acute leukemias. In contrast, acute leukemias were the second commonest malignancy at OAUTHC accounting for 12.7% of all malignancies followed by retinoblastoma and nephroblastoma. Tumoursof central nervous system were observed to be commoner at AKTH, while bone tumours were commoner at OAUTHC.Conclusion: The pattern of childhood cancer varies rather little betweendifferent regions in Nigeria, with malignant lymphomas being the most common as is the case in most developing countries. However, the findings in this study suggest that there is variation in prevalence of leukemia, CNS and bone tumours in northern and southern Nigeria.Key words: Childhood, malignant tumours, pattern, teaching hospitals,Nigeria

scholarly journals Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

2020 ◽  
Vol 9 (2) ◽  
pp. 635
Author(s):  
Rupali Modak ◽  
Amitrajit Pal ◽  
Amitava Pal ◽  
Mrinal K. Ghosh
Keyword(s):  
Area Under Curve ◽  
Uterine Artery ◽  
Urinary Protein ◽  
Teaching Hospitals ◽  
Doppler Velocimetry ◽  
Creatinine Ratio ◽  
Singleton Pregnancy ◽  
Chi Square ◽  
Uterine Artery Doppler ◽  
Tertiary Teaching

Background: Preeclampsia (PE) is heterogeneous disorder. The aim of the study was to observe the role of a spot urinary protein - creatinine ratio (UPCR) and uterine artery doppler velocimetry measured between 20-24 weeks of gestation in prediction of preeclampsia.Methods: Prospective observational study conducted on 120 pregnant mothers with singleton pregnancy between 20-24 weeks of gestational age in two tertiary teaching hospitals in eastern India. A spot urinary protein creatinine ratio (UPCR) was determined in a mid- stream urine sample and estimation of protein was done by immunoturbidimetric micro albumin method and creatinine by modified Jaffe’s method. Doppler velocimetry was also determined at 20-24 weeks of gestation. A notch in uterine artery, unilateral or bilateral; or RI > 0.7 and PI of > 1.45 were considered to have an abnormal result. Women were followed-up and relationship between variables was assessed by Chi- square test.Results: Women who subsequently developed preeclampsia had significantly higher UPCR (median 44.8 mg/mmol) when compared with women of unaffected groups (median 26.6 mg/mmol). The optimum spot urinary UPCR to predict preeclampsia was 35.5 mg/mmol and the cut-off value >35.5 mg/mmol had a test sensitivity (80%), specificity (94.06%), PPV (66.76%) and NPV (96.94%).The area under curve (AUC) of spot UPCR in ROC curve was  0.949 (95% CI,0.891 - 1.000). For predicting preeclampsia, the mean uterine artery RI had to be >0.7 having sensitivity (60%), specificity (97.03%), PPV (75%) and NPV (94.23%). The area under curve (AUC) was 0.856 (95% CI, 0.742 - 0.971).Conclusions: Second trimester UA doppler is a useful screening test for prediction of preeclampsia. This test works best when combined with a spot UPCR and accuracy of both the methods for prediction of preeclampsia was 92.24%.

scholarly journals Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice

2019 ◽  
Vol 31 (7-8) ◽  
pp. 378-387 ◽  
Author(s):  
Aubrey Chichonyi Kalungia ◽  
Haabingozi Mwambula ◽  
Derick Munkombwe ◽  
Sarah Marshall ◽  
Natalie Schellack ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Teaching Hospitals ◽  
Policy And Practice ◽  
Tertiary Teaching ◽  
Future Policy

scholarly journals Spectrum of central nervous system involvement in rheumatic diseases: pictorial essay

2018 ◽  
Vol 51 (4) ◽  
pp. 262-267
Author(s):  
Renata Mendes Vieira ◽  
Felipe Barjud Pereira do Nascimento ◽  
Alcino Alves Barbosa Júnior ◽  
Inês Carmelita Minniti Rodrigues Pereira ◽  
Zoraida Sachetto ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Clinical Presentation ◽  
Central Nervous System Involvement ◽  
Teaching Hospitals ◽  
Tertiary Teaching ◽  
Pictorial Essay

Abstract The rheumatic diseases, which include systemic lupus erythematosus, rheumatoid arthritis, Behçet's disease, scleroderma, and ankylosing spondylitis, are characterized by involvement of connective tissue, with multiple manifestations. In those diseases, there can be involvement of the peripheral or central nervous system, and that involvement can be primary, presenting as a major feature of the clinical presentation, or secondary, as an effect of the drugs used in order to control a given disease or its complications. Knowledge of the wide variety of imaging findings is crucial to the diagnosis of a rheumatic disease, especially in the early stages, enabling effective treatment and minimizing disability. This pictorial essay, presenting cases from the records of two tertiary teaching hospitals, encompasses cases of patients diagnosed with rheumatic disease and illustrates the neuroradiological findings on magnetic resonance imaging and computed tomography, in order to emphasize the importance of these methods for properly diagnosing rheumatic diseases.

scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background: Critically ill children require optimum feeding in the intensive care for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units.Methods: A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N=42).Results: The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children.Conclusions: Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU is recommended to reduce possible infant and child mortality resulting from feeding.

scholarly journals Ritual scalp shaving-a risk factor for community acquired late onset neonatal sepsis

2014 ◽  
Vol 9 (3) ◽  
pp. 35-44
Author(s):  
S Sen ◽  
KB Mondal ◽  
A Roy ◽  
N Kumar ◽  
P Pant ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Teaching Hospitals ◽  
Causative Organism ◽  
Medical Sciences ◽  
Tertiary Teaching ◽  
History Of ◽  
Independent Variable ◽  
The Difference

Background Neonatal sepsis is one of the major causes of morbidity and mortality at the community and hospital levels in India. There are several community practices associated with and contributing to Neonatal sepsis, especially late onset variety.Objective To analyze whether scalp shaving is an independent risk factor associated with community acquired late onset neonatal sepsis and the causative organism responsible.Methods This was a prospective, non-interventional, observational study. The study was conducted at two tertiary teaching hospitals in Eastern India from 1st May 2010 to 30th April 2011. A total of 382 babies were diagnosed as Late Onset Neonatal Sepsis and 410 , age and sex matched controls were taken from the Well Baby and Immunization clinics. The patients were clinically screened for sepsis and "septic screen" and blood, urine and CSF cultures sent, as needed.Results History of scalp shaving was present in 46(12.04%) out of 382 cases of Late Onset Neonatal Sepsis as compared to 20(4.87%) of 410 matched community controls, the difference was statistically significant (p<0.005). Positive blood cultures were obtained in 20(43.48%) out of 46 scalp shaven babies as compared to 118(35.11%) out of 336 non scalp shaven babies. The commonest organism in babies with scalp shaving was found to be methicillin resistant Staphylococcus aureus(MRSA), whereas the most common organism in non scalp shaven babies was Klebsiella pnuemoniae.Conclusion Scalp shaving appears to be an independent variable associated with community acquired Late Onset Neonatal Sepsis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 35-44

Ceftazidime/avibactam and eravacycline susceptibility of carbapenem-resistant Klebsiella pneumoniae in two Greek tertiary teaching hospitals

2021 ◽  
Author(s):  
Maria Chatzidimitriou ◽  
Panagiota Chatzivasileiou ◽  
Georgios Sakellariou ◽  
MariaAnna Kyriazidi ◽  
Asimoula Kavvada ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Antimicrobial Agents ◽  
Carbapenem Resistance ◽  
Teaching Hospitals ◽  
Diffusion Method ◽  
Strain Identification ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
Tertiary Teaching

AbstractThe present study evaluated the carbapenem resistance mechanisms of Klebsiella pneumoniae strains isolated in two Greek tertiary teaching hospitals and their susceptibility to currently used and novel antimicrobial agents.Forty-seven carbapenem resistant K. pneumoniae strains were collected in G. Papanikolaou and Ippokrateio hospital of Thessaloniki between 2016 and 2018. Strain identification and antimicrobial susceptibility was conducted by Vitek 2 system (Biomérieux France). Susceptibility against new antimicrobial agents was examined by disk diffusion method. Polymerase chain reaction (PCR) was used to detect blaKPC, blaVIM, blaNDM and blaOXA-48 genes.The meropenem–EDTA and meropenem–boronic acid synergy test performed on the 24 K. pneumoniae strains demonstrated that 8 (33.3%) yielded positive for metallo-beta-lactamases (MBL) and 16 (66.6%) for K. pneumonia carbapenemases (KPC) production. Colistin demonstrated the highest in vitro activity (87.7%) among the 47 K. pneumoniae strains followed by gentamicin (76.5%) and tigecycline (51%). Among new antibiotics ceftazidime/avibactam showed the highest sensitivity (76.6%) in all strains followed by eravacycline (66.6%). The blaKPC gene was present in 30 strains (63.8%), the blaNDM in 11 (23.4%) and the blaVIM in 6 (12.8%). The blaOXA-48 gene was not detected.Well established antimicrobial agents such as colistin, gentamicin and tigecycline and novel antibiotics like ceftazidime/avibactam and eravacycline can be reliable options for the treatment of invasive infections caused by carbapenem-resistant K. pneumoniae.

A Forensic-as-a-Service Delivery Platform for Law Enforcement Agencies

2013 ◽  
pp. 313-330 ◽  
Author(s):  
Fabio Marturana ◽  
Simone Tacconi ◽  
Giuseppe F. Italiano
Keyword(s):  
Law Enforcement ◽  
Service Delivery ◽  
High Performance ◽  
Low Cost ◽  
Forensic Analysis ◽  
Design Guidelines ◽  
Functional Requirements ◽  
Law Enforcement Agencies ◽  
Novel Approach ◽  
Service Delivery Platform

With the global diffusion of cybercrime, the ever-growing market penetration of high-performance and low-cost personal digital devices, and the commercial success of cloud computing, the area of digital forensics is faced with various new challenges that must be taken seriously. In this chapter, the authors describe a novel approach to digital investigations based on the emerging “Forensics as a Service” (FaaS) model. This model attempts to optimize Law Enforcement Agency’s (LEA) forensic procedures, reduce complexity, and save operational costs. Inspired by previous work on distributed computing for forensic analysis, this chapter provides the reader with design guidelines of a FaaS platform for secure service delivery. The proposed FaaS platform should be able to support investigators and practitioners in their daily tasks (e.g. digital evidence examination, analysis, and reporting) once implemented by a cloud forensic provider or internally by a LEA. In this chapter, the authors also present the architecture components, interfaces, communication protocols, functional and non-functional requirements, as well as security specifications of the proposed framework in detail.

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