scholarly journals P116: Impact of young age on outcomes of emergency department procedural sedation

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S106
Author(s):  
M. Schlegelmilch ◽  
M. Roback ◽  
M. Bhatt
Keyword(s):  
Emergency Department ◽  
Young Children ◽  
Age Groups ◽  
Secondary Analysis ◽  
Young Age ◽  
Oxygen Desaturation ◽  
Procedural Sedation ◽  
P Value ◽  
Serious Adverse Events ◽  
Significant Difference

Introduction: Procedural sedation in the emergency department (ED) for children undergoing painful procedures is common practice, however little is known about sedation in very young children. We examined the effect of young age on sedation outcomes. Methods: This is a secondary analysis of an observational cohort study of children 0-18 years undergoing procedural sedation in six pediatric EDs across Canada. We compared presedation state, indication for sedation, medications, sedation efficacy and four main post-sedation outcomes (serious adverse events (SAE), significant interventions, oxygen desaturation and vomiting) between patients who ≤2 years with those >2 years. Pre-sedation state, medications, indication for sedation and time intervals were summarized using frequency and percentage and compared with chi2 test. Logistic regression was used to examine associations between age group and outcomes. Results: 6295 patients were included; 5349 (85%) were >2 years and 946 (15%) were ≤2 years. Children ≤2 years were sedated most commonly for laceration repair (n = 450; 47.6%), orthopedic reduction (165; 17.4%) and abscess incision and drainage (136; 14.4%). Children >2years were sedated most commonly for orthopedic reductions (3983; 74.5%). Ketamine was the most common medication in both groups, but was used most frequently in children ≤2 years (80.9% vs 58.9%; p < 0.001). There was no difference in the incidence of SAE, significant interventions or oxygen desaturation between age groups, however children ≤2 years were less likely to vomit (Table 1). Young children had decreased odds of a successful sedation (OR 0.48; 95%CI: 0.37 to 0.63). On average, patients ≤2 years were sedated for 7 minutes less (74.1 vs 81.0 p < 0.001) and discharged 10 minutes sooner (90.1 vs 100.8 p < 0.001). Table 1 ≤2 years (n = 946) >2 years (n = 5349) OR (95%CI)* p-value n(%) n(%) Serious Adverse Event 8 (0.85) 59 (1.0) 0.76 (0.43-1.7) 0.477 Significant intervention 10 (1.0) 76 (1.4) 0.74 (0.34-1.4) 0.374 Oxygen Desaturation 50 (5.3) 303 (5.6) 0.93 (0.67-1.3) 0.640 Vomiting 14 (1.5) 314 (5.9) 0.24 0.13-0.41) <0.001 *Reference category: ≤2 years. Conclusion: Children ≤2 years most commonly received ED sedation for laceration repair using ketamine. Young age was not associated with a significant difference in SAEs, significant intervention or desaturation but was associated with decreased odds of vomiting and of successful sedation.

scholarly journals 84 Impact of young age on outcomes of emergency department procedural sedation

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e34-e35
Author(s):  
Michael Schlegelmilch ◽  
Maala Bhatt ◽  
Mark Roback
Keyword(s):  
Emergency Department ◽  
Young Children ◽  
Age Groups ◽  
Secondary Analysis ◽  
Young Age ◽  
Oxygen Desaturation ◽  
Procedural Sedation ◽  
Serious Adverse Events ◽  
Significant Difference ◽  
Observational Cohort

Abstract Background Procedural sedation in the emergency department (ED) for children undergoing painful procedures is common practice, however little is known about sedation in very young children. Objectives We examined the effect of young age on emergency department sedation outcomes. Design/Methods This is a secondary analysis of an observational cohort study of children 0-18 years undergoing procedural sedation in six pediatric EDs across Canada. We compared presedation state, indication for sedation, medications, sedation efficacy and four main post-sedation outcomes (serious adverse events (SAE), significant interventions, oxygen desaturation and vomiting) between patients who ≤ 2 years with those > 2 years. Pre-sedation state, medications, indication for sedation and time intervals were summarized using frequency and percentage and compared with chi2 test. Logistic regression was used to examine associations between age group and outcomes. Results 6295 patients were included: 5349 (85%) were > 2 years and 946 (15%) were ≤ 2 years. Children ≤2 years were sedated most commonly for laceration repair (n=450; 47.6%), orthopedic reduction (165; 17.4%) and abscess incision and drainage (136; 14.4%). Children >2years were sedated most commonly for orthopedic reductions (3983; 74.5%). Ketamine was the most common medication in both groups, but was used most frequently in children ≤ 2 years (80.9% vs 58.9%; p<0.001). There was no difference in the incidence of SAE, significant interventions or oxygen desaturation between age groups, however, children ≤ 2 years were less likely to vomit (Table 1). Young children had decreased odds of a successful sedation (OR 0.48; 95%CI: 0.37 to 0.63). On average, patients ≤ 2 years were sedated for 7 minutes less (74.1 vs 81.0 p<0.001) and discharged 10 minutes sooner (90.1 vs 100.8 p<0.001). Conclusion Children ≤ 2 years most commonly received ED sedation for laceration repair using ketamine. Young age was not associated with a significant difference in SAEs, significant intervention or desaturation but was associated with decreased odds of vomiting and of successful sedation.

Comparison of Human Thymus Gland between Young and Old Age

2021 ◽  
Vol 15 (6) ◽  
pp. 1907-1909
Author(s):  
Faiza Mehboob ◽  
Ponum Mirani ◽  
M. Kamran Ameer ◽  
Khurram Shabeer ◽  
Muhammad Ali Qamar ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Old Age ◽  
Age Groups ◽  
Young Age ◽  
University Hospital ◽  
P Value ◽  
Old Patients ◽  
Human Thymus ◽  
Group I ◽  
Significant Difference

Aim: Study was conducted to examine the different parameters of human thymus glands of young and old patients and compare the findings between both age groups. Study Design: Comparative/observational study Place and Study: Study was conducted at Anatomy department of Nishtar Medical University Hospital, Multan for duration of six months from 15th January 2020 to 15th July 2020. Methods: Total 54 specimens of human thymus of 54 patients were enrolled in this study. All specimens were divided in to two groups I and II, Group I contains 27 patients with ages <30 years and group II with 27 patients having ages 45 to 60 years. All specimens were fixed in 10% formalin solution and then processed for paraffin embedding. Compare the different parameters such as thickness of interlobular connective tissue and thymic capsule, length and number of Hassal’s corpuscles between both groups. Data was analyzed by SPSS 24.0. Results: In group I 12 (44.44%) patients were ages <15 years and 15 (55.56%) patients were ages >15 years. In group 13 (48.15%) and 14 (51.85%) patients were ages <50 years and >50 years. There was a significant difference observed between both groups regarding thickness of interlobular connective tissue and thymic capsule, quantity and length of Hassal’s corpuscles with p-value <0.05. Conclusion: It is to be concluded that patients with young age had significantly less thickness of thymic capsule and interlobular connective tissue with more in number and decreasing size of Hassal’s corpuscles as compared to old age patients. Keywords: Human Thymus Glands, Young Age, Old Age

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

Impact of young age on outcomes of emergency department procedural sedation

2021 ◽  
Vol 46 ◽  
pp. 116-120
Author(s):  
Michael Schlegelmilch ◽  
Mark G. Roback ◽  
Maala Bhatt ◽  
David W. Johnson ◽  
Ken J. Farion ◽  
...  
Keyword(s):  
Emergency Department ◽  
Young Age ◽  
Procedural Sedation

scholarly journals Prevalence of Hepatitis C Virus in the Population of Albania for the Period 2007-2010

2014 ◽  
Vol 2 (3) ◽  
pp. 525-528 ◽  
Author(s):  
Hysaj Vila Brunilda ◽  
Shundi Lila ◽  
Abazaj Erjona ◽  
Bino Silva ◽  
Rexha Tefta
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Age Groups ◽  
Viral Disease ◽  
Hcv Infection ◽  
University Hospital ◽  
P Value ◽  
Hcv Rna ◽  
Significant Difference ◽  
Males And Females

BACKGROUND: Hepatitis C is a blood-borne, infectious, viral disease that is caused by a hepatotropic virus called Hepatitis C virus (HCV).AIM: The aim of this study is to determine the prevalence of active HCV infection (HCV–RNA) in the cases that were anti-HCV positive.MATERIAL AND METHODS: Plasma of 301 high-risk for HCV infection consecutive from University Hospital Centre “Mother Theresa” Tirana-Albania, during January 2007 to December 2010 was included in this study. To identify the presence of HCV RNA, the samples were examined by Cobas Amplicor HCV test (qualitative method).RESULTS: From 301 samples analyzed in total, 214 of them resulted positive for the presence of HCV-RNA's, corresponding to a prevalence of 71.1%, with 95% CI interval [65.8 - 75.9] for value of χ2 = 52.7 p value <0.0001. Divide by the sex 56% were males and 44% females, with statistically significant difference between them for value χ2 =4306 p value=0.0380. Among the age groups the highest prevalence was observed in the age groups > 25 years with a significant difference with other age groups for p value <0.001.CONCLUSION: Among tested samples, 71.1 % were confirmed to be positive for HCV –RNA infections. The prevalence of male was highest compared to female. For males and females infected the prevalence was highest in the age group of > 25 years.

scholarly journals Population-based survey of HIV sero-status and vertical transmission among naive pregnant women in Sokoto, Nigeria

2014 ◽  
Vol 6 (3) ◽  
pp. 49-57 ◽  
Author(s):  
Fiekumo Igbida Buseri ◽  
Charity Ngozi Okonkwo
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Statistical Significance ◽  
Demographic Data ◽  
Age Groups ◽  
P Value ◽  
Full Time ◽  
Cross Sectional ◽  
Significant Difference

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57  

scholarly journals Prevalence of elongated styloid process in Saudi population of Aseer region

2013 ◽  
Vol 07 (04) ◽  
pp. 449-454 ◽  
Author(s):  
Mohammed Asif Shaik ◽  
Sultan Mohammed Kaleem ◽  
Abdul Wahab ◽  
Shahul Hameed ◽  
Keyword(s):  
Age Groups ◽  
Styloid Process ◽  
Frequent Pattern ◽  
P Value ◽  
Type I ◽  
Saudi Population ◽  
Radiographic Appearance ◽  
Panoramic Radiographs ◽  
Elongated Styloid Process ◽  
Significant Difference

ABSTRACT Objective: The study was performed to investigate the prevalence, morphology and calcification pattern of elongated styloid process in Saudi population of Aseer (Southern) region and its relation to gender and sub-age groups. Materials and Methods: This study was analyzed digital panoramic radiographs of 1,162 adults. Any radiograph with questionable styloid process was excluded from the study. The apparent length of the styloid process was measured by a single experienced dental and maxillofacial Radiologist. The elongated styloid process was classified with the radiographic appearance based on the morphology and calcification pattern. The data were analyzed by using Student′s t-test and Chi-square test with P value less than 0.05. Results: A total of 1,085 Digital panoramic radiographs showed elongated styloid process of which 686 (63.2%) were noticed in males and 399 (36.8%) were noticed in female patients. There was a statistical significant difference noticed in the mean difference of elongated styloid process between 20-29, 50-59 and 60 years and above sub-age groups. The elongated styloid process was more prevalent in elderly aged male patients (P < 0.05). Type I morphology with calcified out line (a) was the most frequent pattern of calcification noticed in the present study.Conclusion: The panoramic radiographs are economical, easily accessible and useful diagnostic tool for early detection of elongated styloid process with or without symptoms. However, studies with larger sample size would further help to assess the prevalence of this elongated styloid process in Saudi population of various other regions.

scholarly journals The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

2020 ◽  
Vol 15 (1) ◽  
pp. 81-88
Author(s):  
Masoud Latifi-Pour ◽  
Hossein Hassanian-Moghaddam ◽  
Helya-Sadat Mortazavi ◽  
Shahin Shadnia ◽  
Nasim Zamani ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Prospective Trial ◽  
Laboratory Data ◽  
Age Groups ◽  
Acute Poisoning ◽  
P Value ◽  
Poison Center ◽  
Double Blind ◽  
Laboratory Confirmation ◽  
Significant Difference

Background: Benzodiazepine is one of the most important causes of substance abuse and intoxication throughout the world and Iran. Objective: The aim of our study is to determine the role of stimulants in reversing CNS level in acute Benzodiazepine poisoning patients who were hospitalized at referral poison center. Methods: This was a randomized double-blind placebo-controlled trial study on 32 cases with pure acute Benzodiazepine poisoning from March 2016 to February 2017. Diagnosis of pure acute poisoning was based on history, and laboratory confirmation. We gathered the demographics, clinical data, laboratory data, hospitalization and outcome. Participants were randomized into two groups: Methylphenidate Group (MPH) and Placebo Group (PBO). Results: The randomized sample consisted of 32 participants who were predominately female (83%). The majority of the PBO group and the MPH group reported improvement in their consciousness with a significant difference between the two groups (p = .005). Paired sample t-test analyses on Reed Scale data revealed an increase in the probability of improvement during the trial for the MPH group compared to the PBO group. Furthermore, the HCo3 (bicarbonate) level has a significant p-value with respect to age groups (p = .02). None of our cases required either the ICU facility or intubation. Conclusion: Our study provided the MPH superiority over PBO in reversing CNS symptoms in loss of consciousness in acute BZD poisoned patients. Thus, this trial provides concrete evidence that improvement in consciousness levels (Reed Scale rated) among those patients receiving MPH was associated with a methylphenidate use.

scholarly journals Does age affect symptom recovery after sports-related concussion? A study of high school and college athletes

2013 ◽  
Vol 12 (6) ◽  
pp. 537-544 ◽  
Author(s):  
Young M. Lee ◽  
Mitchell J. Odom ◽  
Scott L. Zuckerman ◽  
Gary S. Solomon ◽  
Allen K. Sills
Keyword(s):  
High School ◽  
College Athletes ◽  
Age Groups ◽  
Reliable Change Index ◽  
Health Concern ◽  
P Value ◽  
Symptom Scale ◽  
Older Athletes ◽  
Age Related ◽  
Significant Difference

Object Sport-related concussions (SRCs) in high school and college athletes represent a significant public health concern. Research suggests that younger athletes fare worse symptomatically than older athletes after an SRC. Using reliable change index (RCI) methodology, the authors conducted a study to determine if there are age-related differences in number, severity, and resolution of postconcussion symptoms. Methods Between 2009 and 2011, baseline measures of neurocognitive functions and symptoms in high school and college athletes were entered into a regional database. Seven hundred forty of these athletes later sustained an SRC. Ninety-two athletes in the 13- to 16-year-old group and 92 athletes in the 18- to 22-year-old group were matched for number of prior concussions, sex, biopsychosocial variables, and days to first postconcussion testing and symptom assessment. A nonparametric Mann-Whitney U-test was used to compare the severity of each of 22 symptoms comprising the Total Symptom Scale (TSS) at baseline and first postconcussion test. To obtain a family-wise p value of 0.05 for each test, the significance level for each symptom comparison was set at an alpha of 0.05/22 = 0.0023. The number of days to return to baseline TSS score was compared using the RCI methodology, set at the 80% confidence interval, equal to a change in raw score of 9.18 points on the TSS. Results There was no statistically significant difference in symptom presence, symptom severity, and total symptoms between the age groups at baseline or at postconcussion testing. There was no statistically significant difference in return to baseline symptom scores between the age groups. Conclusions Using RCI methodology, there was no statistically significant difference between younger and older athletes in return to baseline symptoms postconcussion.

scholarly journals Astigmatic change after pterygium excision with autologous limbal conjunctival graft

2020 ◽  
Vol 9 (1) ◽  
pp. 25-30
Author(s):  
Dikchhya Sharma ◽  
Gunjan Prasai ◽  
Om Krishna Malla
Keyword(s):  
Age Groups ◽  
College Teaching ◽  
Corneal Astigmatism ◽  
P Value ◽  
Ocular Surgery ◽  
Medical College ◽  
Corneal Scarring ◽  
Significant Difference ◽  
History Of ◽  
Pterygium Excision

Background: Pterygium induces a significant amount of astigmatism. Pterygium excision with conjunctival limbal autograft results in significant reduction in astigmatism by inducing a reversal of pterygium induced corneal flattening thereby improving the vision. Objectives: The aim of this study was to investigate the amount of corneal astigmatism in patients with pterygium before and one month (4 weeks) after surgery.  Methodology: The prospective observational study was conducted in 31 patients who underwent pterygium excision with limbal autograft in Kathmandu Medical College Teaching Hospital during the study period of 12 months duration. Patients with recurrent pterygium, pseudopterygium, history of ocular trauma, history of ocular surgery, corneal scarring were excluded from the study. After surgery, patients were followed for four weeks. Findings were recorded in the proforma and statistical analysis was done in SPSS version 19.   Results: Pterygium was seen in all age groups with majority being in the active age range of 41-50 yrs. Females were most commonly affected. Significant difference in corneal astigmatism was noted postoperatively with a p value being 0.01. Conclusion: The technique of pterygium excision with limbal conjunctival autograft not only reduces the chances of recurrence but also helps in reducing the induced corneal astigmatism which is responsible for decreased vision in patients with pterygium.

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