scholarly journals Healthcare-Associated Pneumonia in a Mexican Tertiary Care Center Micro to Systemic Analysis: A 2017–2019 Case Series Study

2020 ◽  
Vol 41 (S1) ◽  
pp. s247-s248
Author(s):  
Miguel Ángel García Salcido ◽  
Roxana Trejo González ◽  
Lucio Antonio Hernández González
Keyword(s):  
Mechanical Ventilation ◽  
Incidence Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Age Group ◽  
Data Set ◽  
Case Series Study ◽  
Healthcare Associated ◽  
Series Study

Objectives: The aim of this study was to identify the biological, microbiological, and healthcare factors related to the occurrence of nosocomial pneumonia in our confirmed cases during 2017–2019. Methods: We conducted a case series study. For the selection of the cases we used the CDC criteria for hospital-acquired pneumonia, we collected cases from the data set for healthcare-associated infections from a tertiary-care hospital in Mexico City. For the quantitative analysis, we used Stata v14 software, and we obtained frequencies, proportions, accumulated incidence rate, lethality rate, central tendency, and dispersion metrics. This study was a secondary data set analysis; we obtained signed authorization for the use of the data from the Epidemiological Surveillance Unit. Results: During our analysis period (January 2017 to June 2019), we identified 107 cases that fulfilled the CDC criteria: 47 cases (43.93%) from 2017, 38 cases (35.51%) from 2018, and 20.56% from 2019. The month that reported the highest frequency was February, with 17 cases (15.89%). The median age was 63 years (range, 0–97 years; IQR, 36). The most affected age group was 65 years (48.60%), and the most affected 5-year age group was 75–79 years (13.08%). Moreover, 60 cases (56.07%) were men and 47 (43.93%) were women. Regarding the reason for discharge, 71% were discharged due to improvement, 27% died, and 2% were transferred to another healthcare facility. Also, 17 patients (15.89%) required readmission due to respiratory illness within 72 hours of previous discharge. The most common diagnosis was a solid malignant neoplasm (20.19%), followed by heart or vascular malformation or anomaly (12.50%). The mean inpatient hospital stay was 39.95 days (46.40; median, 27 days, range, 2–317 days; IQR 35 days). The median time elapsed until detection was 14 days. The hospitalization area with the most cases was the intensive care unit, with 24 cases (22.43%); the service with most cases was oncology with 21 cases (20.56%). The most isolated pathogen was Pseudomonas aeruginosa (14%). Moreover, 59% were gram-negative, 36% were gram-positive, 19.67% were viruses, and 14.75% were fungi. Our accumulated-incidence-rate was 0.58 cases per 1,000 patient days and our case-fatality-rate was 25.23%. Furthermore, 41% of cases required invasive mechanical ventilation, 52.34% required noninvasive mechanical ventilation, 5% cases had an endo-pleural tube, 9.35% had a nasogastric tube, and 41.12% had a central venous catheter. The most-prescribed antimicrobial was meropenem (33.33%), and meropenem-resistance was 61.54%. Conclusions: Infection prevention efforts should target oncological patients, critical-care units, and the elderly. We must reinforce our antimicrobial policy due to our overprescription of carbapenems. Early detection is needed to reduce mortality.Funding: NoneDisclosures: None

scholarly journals INTRA-ABDOMINAL PATHOLOGIES

2012 ◽  
Vol 19 (04) ◽  
pp. 488-495
Author(s):  
GULZAR AHMAD MALIK ◽  
MUHAMMAD SAJID ANSARI ◽  
SHAHID HUSSAIN CHOUDHARY ◽  
Sabir Hussain
Keyword(s):  
Relative Frequency ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Female Ratio ◽  
Low Level ◽  
Primary Surgery ◽  
Case Series Study ◽  
Tertiary Care Hospitals ◽  
Series Study

Objectives: To evaluate relative frequency, reasons, avoidable responsible factors and outcomes of relaparotomy. StudyDesign: Observational case series study Setting: Department of Surgery Unit III BVH Bahawalpur Duration: From 01-9-2009 to 31-8-2010Patients and Methods: All the patients who presented in surgical outdoor, indoor and casualty department with severe intra-abdominalpathologies after primary laparotomies referred from low level, secondary care and tertiary care hospital and underwent relaparotomy electivelyor on demand were included in the study. Retrospectively their demographic characteristics, initial diagnosis with surgical information of primarylaparotomy, factors and outcomes after relaparotomies were analyzed statistically. Results: A total 54 patients were included in the study withmale to female ratio of 1:2. Mean age of the study group was 30.91±12.5 years. Relative frequency of relaparotomy was 5.6%. Common centerof referral was low level hospital 66.7%.Most common indication of relaparotomy was peritonitis in 52%. Most common complication ofrelaparotomy was wound infection 74%. Avoidable factors responsible for relaparotomies were found to be surgery at low level hospitals(77.3%) and by nonqualified surgeons (72.1%). Conclusions: The rate of relaparotomy is very high because of unsupervised primary surgeryin institutions and surgery by unqualified operators in private sector. Many of these are avoidable. In addition to decreasing the complicationrate, primary surgery performed at tertiary care hospitals would decrease need for patients to undergo re-exploration.

scholarly journals Providing safe care for patients in the coronavirus disease 2019 (COVID-19) era: A case series evaluating risk for hospital-associated COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Adult Patients ◽  
Care Hospital ◽  
Strict Adherence ◽  
Large Tertiary Care ◽  
Healthcare Associated ◽  
Serology Testing ◽  
Pcr Test

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.

scholarly journals Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Female Gender ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Case Series Study

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.

scholarly journals Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

2021 ◽  
Vol 19 (1) ◽  
pp. 25-29
Author(s):  
Manoj Chaudhary ◽  
Sudha Agrawal
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Case Series ◽  
Sun Exposure ◽  
Care Hospital ◽  
Facial Erythema ◽  
Case Series Study ◽  
The Face ◽  
Triggering Factor ◽  
Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour.   Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face.   Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017.   Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%).   Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

scholarly journals Tracheo-bronchial foreign bodies: our experience at a tertiary care hospital

2016 ◽  
Author(s):  
Shashidhar S. Suligavi ◽  
Mallikarjun N. Patil ◽  
S. S. Doddamani ◽  
Chandrashekarayya S. Hiremath ◽  
Afshan Fathima
Keyword(s):  
Foreign Body ◽  
Early Diagnosis ◽  
Foreign Bodies ◽  
Tertiary Care ◽  
Case Series ◽  
Team Work ◽  
Care Hospital ◽  
Retrospective Case ◽  
Presenting Symptoms ◽  
Case Series Study

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Tracheo- bronchial foreign bodies have always posed a challenge to the ENT surgeon as they present with varied symptomatology ranging from a simple cough and fever to more grave respiratory distress. It requires a strong suspicion, early diagnosis and timely intervention to reduce the overall morbidity and mortality .This study was undertaken to highlight our experiences in handling cases of tracheo- bronchial foreign bodies (FB) at our setup.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>It is a retrospective case series study conducted in S. Nijalingappa Medical College between January 2011 and January 2015.  </p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>Most commonly affected were children between 1year to 3years of age. Chronic cough and wheeze were the commonest presenting symptoms. Vegetative foreign body was found to be the commonest variety of foreign body. The mortality rate in our study was 4.7% (n=3).</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>A good clinical acumen, team work, early diagnosis and timely intervention are all needed to reduce the overall mortality and morbidity associated with tracheo- bronchial foreign bodies.</p>

scholarly journals Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

2014 ◽  
Vol 2 (1) ◽  
pp. 9-14
Author(s):  
Sheikh Shawkat Kamal
Keyword(s):  
Middle Ear ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Retrospective Case ◽  
Middle Ear Mucosa ◽  
Case Series Study ◽  
Temporal Bones ◽  
Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27  ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

NEAR FATAL AMITRAZ: A NOT SO UNCOMMON POISONING

2021 ◽  
pp. 42-43
Author(s):  
Rohan J Desai ◽  
Prasad Ugargol
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Clinical Features ◽  
Case Series ◽  
Agricultural Product ◽  
Common Symptom ◽  
Retrospective Case ◽  
Case Series Study ◽  
Cns Depression ◽  
Series Study

Background: Amitraz is a pharmaceutical, veterinary, and agricultural product which is used worldwide to control ectoparasites in animals. Its widespread use has led to increased cases of poisoning in rural parts of India. Aim: To study the clinical features, complications, laboratory abnormalities and outcome of the patients with acute amitraz intoxication. Methodology: The study is a retrospective case series study conducted in HSK hospital between the period of Feb 2019 and May 2020. Results: A total of 11 patients were analysed and results revealed CNS depression and vomiting in 8 of those patients with 1 patient with respiratory failure requiring mechanical ventilation. Conclusion: Amitraz poisoning appears to be severe with CNS depression being the most common symptom. But most patients stabilise and recover quickly. Patients should be monitored for respiratory failure as it is a dreadful complication. Treatment is symptomatic as no antidote is available.

Laparoscopic Surgical Management of Rectal Cancer at Tertiary Care Hospital

2021 ◽  
Vol 15 (11) ◽  
pp. 3285-3287
Author(s):  
Zubair Yousfani ◽  
Jabeen Atta ◽  
Khenpal Das ◽  
Madhu Bala ◽  
Shagufta Magsi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Operation Time ◽  
Health Sciences ◽  
Care Hospital ◽  
Average Hospital ◽  
Case Series Study

Objective: To evaluate the consequent outcomes in the patients with rectal cancer endured laparoscopic surgical excision at Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro, Hyderabad and to review their curative resection and recurrence rates, postoperative morbidities and complete survival. Methods: This prospective case series study was done at the Department of General Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan. All patients of 30-65 years ages with rectal cancer and underwent diagnostic laparoscopy either of gender were included. After removing the tumor, the specimen pinned out on a flat surface and placed in fixative solution to allow the orientation of the specimen and assessments of the exact margins. As the specimens had acceptable clear margins and limited invasion to the submucosa, no further surgical procedure was proceeded. Data was collected via study proforma. Results: A total of 40 patients were studied. Patients in the laparoscopic operation lost less blood with an amount of only 200mL during 190 minutes average operation time. The bowel functioning returned in 2 days averagely with 8 days average hospital stay. Conclusion: It is concluded that laparoscopic surgery for rectal cancer is an effective, safe and feasible approach in terms of less post-operative complications and recovery time as well as Hospital stay. Key words: Rectal Cancer, laparoscopic surgery

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