scholarly journals P0325FREQUENCY AND PREDICTORS OF NON URINARY INFECTIONS AMONG THE ADULT PATIENTS WITH STERILE PYURIA ATTENDED IN NEPHROLOGY DEPARTMENT OF BSMMU, BANGLADESH

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hossain Md Ismail ◽  
Dr A H Hamid ahmed Hamid ◽  
Dr Mirza Sumaiya Tanzin Tanzin ◽  
Rafi Nazrul Islam
Keyword(s):  
Logistic Regression ◽  
Urinary Tract ◽  
Febrile Illness ◽  
Adult Patients ◽  
Urinary Infections ◽  
Causative Factors ◽  
Group A ◽  
Study Population ◽  
Sterile Pyuria ◽  
Group B

Abstract Background and Aims Urinalysis is a test commonly ordered, especially when the patient has a febrile illness. In most cases it provides useful information, but it can sometimes be misleading. A significant proportion of patients with acute febrile illness have transient pyuria without bacteuria. Identification and management of such cases could be improved by better predictive models.To determine predictors of non urinary infections in adult patients with sterile pyuria and to develop a preliminary predictive model. Method This cross sectional study was done in the department of Nephrology, BSMMU, during the period of September 2016 to August 2017. All adult patients with sterile pyuria were included in the study. A total number of 233 cases who had urinary WBCs >5 per high power field (HPF) with a negative culture were selected as sample by convenient sampling technique. We performed detailed clinical and laboratory investigations to identify potential causes of the sterile pyuria. Patients were then divided into two groups, those with causative factors within the urinary tract and those with causative factors outside of the urinary tract. Logistic regression was used to create a model to predict causative group. Results Most 196(84.1%) patients were found to have disorders related to urinary tract (Group A) and 37(15.9%) patients had infections outside of the urinary tract (Group B). Significant proteinuria and urinary casts were more common in Group A, while urinary WBCs>20/hpf and microscopic hematuria were more common in Group(B). All of these differences were statistically significant (p<0.05). In the logistic regression model patients with sterile pyuria with fever (OR 32.9) and/or pyuria with urinary WBC>20/HPF (OR 2.14) were more likely to involvement outside of the urinary tract. Those with urinary tract symptoms (OR 0.28) and/or proteinuria (OR 0.20) were more likely to have renal and urinary tract involvement. Conclusion In patients attended to the nephrology department, sterile pyuria was more likely to have its origin in the urinary tract if there were urinary tract symptoms and/or proteinuria and less likely if there was fever or urinary WBCs >20/hpf. Figure: Diagnosis of the study population (n=233) Figure : Bar diagram shows renal status of the study population P=0.047 P value reached from chi square test Multivariable logistic regression analysis for infections outside the urinary tract

scholarly journals ABO groups can play a role in susceptibility and severity of COVID-19

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
S. Samra ◽  
M. Habeb ◽  
R. Nafae
Keyword(s):  
Blood Group ◽  
Abo Blood Group ◽  
Infection Group ◽  
Mechanically Ventilated ◽  
Blood Group A ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
The Relationship ◽  
Seriously Ill

Abstract Background A few people infected by the coronavirus become seriously ill, while others show little to no signs of the symptoms, or are asymptomatic. Recent researches are pointing to the fact that the ABO blood group might play an important role in a person’s susceptibility and severity of COVID-19 infection. Aim of the study: try to understand the relationship between ABO groups and COVID-19 (susceptibility and severity). Results A total of (507) patients were included in this study. The study population was divided based on the ABO blood group into types A+, A−, B+, AB, O+, and O−. Blood group A was associated with high susceptibility of infection: group A, 381 (75.1%); and less common in group O, 97 (19.2%), group B, 18 (3.5%), and group AB, 11 (2.2%). The severity of COVID-19 infection was common in non-blood group O where (20 (7.1%), 4 (26.7%), 2 (11%), and 1 (9%) in type A+, A−, B+, and AB, respectively), while in type O 3.1%. And mechanically ventilated patients were 22 (5.9%), 2 (13.4%), 2 (11.1%), and 1 (1%). Mortality was high in blood groups A and B, 16 (4.37%) and 1 (5.5%), respectively, while in blood group O, it was 1%. Conclusion The incidence, severity, and mortality of COVID-19 were common in non-blood group O. While blood group O was protected against COVID-19.

scholarly journals Comparative study between two empirical antibiotic regime in the management of childhood malignancy with fever

2015 ◽  
Vol 5 (2) ◽  
pp. 329-331 ◽  
Author(s):  
Laila Helaly ◽  
Md Zakir Hossain Sarker ◽  
MA Mannan ◽  
Md Tafazzal Hossain ◽  
Shafi Ahmed ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Study Drug ◽  
Successful Outcome ◽  
Medical College ◽  
Pediatric Hematology ◽  
Pediatric Cancer Patients ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Oncology Unit

Objective : The present prospective randomized clinical trial was carried out to assess whether combined cefepime and amikacin as empirical antibiotic therapy was more effective than combined ceftriaxone and gentamicin in the treatment of febrile neutropenic children with malignant diseases.Material & Methods : The study was conducted in the Pediatric Hematology and Oncology unit of BSMMU over a period of 2 years. (From January 2006 to December 2007) Hospitalised pediatric cancer patients who developed febrile neutropenia following chemotherapy or radiotherapy were the study population. A total 64 cases were consecutively included in the study and were randomly assigned to either cefepime & amikacin group (Group- A) or ceftriaxone & gentamicin group (Group-B). The Group-A received cefepime 1500 mg/m2/dose infused over 15 minutes in two divided doses intravenously(IV) while amikacin was administered as thrice daily dose of 200 mg/m2/dose. Patients of Group-B received ceftriaxone 1500 mg/m2/dose in two divided doses and gentamicin 60 mg/m2/dose thrice daily IV. The therapy was continued until absolute neutrophil counts reached >1000 neutrophils/mm3. The treatment outcome was considered successful if fever resolves within 4 days and does not recur within 7 days of completion of therapy. Of the 64 patients, 13 cases were excluded from the final analysis.Results : Bacteria were isolated from culture in only 16.7% of cases Group-A and 9.5% of group-B. Patients E. coli was the most common isolate found in blood specimen (37%). Following intervention, 90% of cefepime & amikacin group and 85.6% of ceftriaxone & gentamicin group improved absolute neutrophil count to >1000/mm3 of blood. Persistence of fever after start of study drug and duration of antibiotic therapy were significantly less in the former group than those in later group (p = 0.049 and p = 0.004 respectively). Only 1 patient of group B had recurrence of infection within 7 days of treatment completion. The mean duration of hospital stay was less in the former group (7.97 ± 2.61 days) than that in the latter group (11.00 ± 3.42 days) (p = 0.06). Evaluation of final outcome shows that majority (86.6%) of cefepime & amikacin group had successful outcome, while majority of ceftriaxone & gentamicin group (81%) failed to resolve infection with continuation of fever for > 4 days.Conclusion : The study concluded that combined cefepime and amikacin is a better option for empirical treatment of fever and neutropenia in children with malignancies than combined ceftriaxone and gentamicin (p<0.001).Northern International Medical College Journal Vol.5(2) 2014: 329-331

scholarly journals Incidence of Bacteriuria after Urodynamic Study with or without Antibiotic Prophylaxis in Women with Urinary Incontinence

2017 ◽  
Vol 39 (10) ◽  
pp. 534-540 ◽  
Author(s):  
Elizabeth Hirakauva ◽  
Ana Bianchi-Ferraro ◽  
Eliana Zucchi ◽  
Marcio Kajikawa ◽  
Manoel Girão ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Placebo Group ◽  
Urinary Tract ◽  
Antibiotic Prophylaxis ◽  
Urine Culture ◽  
Placebo Control ◽  
Urodynamic Study ◽  
Group A ◽  
Group B ◽  
Group D

Introduction The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study. Methods Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS. Results We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria. We didn't observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group. Conclusion The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.

THERAPEUTICAL DOSES OF SALBUTAMOL INHIBIT THE SOMATOTROPIC RESPONSIVENESS TO GROWTH HORMONE-RELEASING HORMONE IN ASTHMATIC CHILDREN

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 262-263
Author(s):  
Hemalini Mehta ◽  
Robert F. Lemanske
Keyword(s):  
Growth Hormone ◽  
Systemic Disease ◽  
Forced Expiratory Volume ◽  
Growth Hormone Releasing Hormone ◽  
Assay Sensitivity ◽  
Releasing Hormone ◽  
Children With Asthma ◽  
Group A ◽  
Study Population ◽  
Group B

Purpose of the Study. To determine the effects of therapeutic β2 agonists (specifically salbutamol) on growth hormone (GH) response to growth hormone releasing hormone (GHRH) in children with asthma. Study Population. Fifteen prepubertal children with asthma, ages 6-11 (average age of 9) with normal or normal short stature were studied. Those with an endocrine abnormality, nutritional deficiency, psychological deprivation, or other systemic disease were excluded. Only those children with known bronchial asthma, who showed a 15% decrease of the 1-second forced expiratory volume (FEV1) with methacholine challenge were included. All patients were asymptomatic, and had not experienced an asthma exacerbation, respiratory infection or allergen exposure in the month preceding the study. No child was on medications. Methods. Subjects were divided into two groups. Both groups had baseline GH response to GHRH determined. After an overnight fast, GH levels were obtained the following morning at -60, 0, and then every 15 minutes until 120 minutes after GHRH administration. Two days following this, Group A received salbutamol (0.125 mg/kg) orally at -60 minutes and GH response to GHRH was remeasured. Group B received aerosolized salbutamol (2 mg over 15 minutes) (details of administration were not specified by the authors). All serum GH levels were measured in duplicate by immunoradiometric assay (sensitivity of 0.1 µg/L). Findings. Basal GH levels were similar in both groups. Orally administered salbutamol (Group A) markedly inhibited GH response to GHRH (peak of 3.7 ± 0.6 vs. 18.6 ± 4.7 g/L). Inhaled salbutamol (Group B), although blunting the GHRH-induced GH response, did so to a lesser extent (peak of 20.0 ± 7.5 vs. 35.8 ± 9.4 g/L, P &lt; .02).

scholarly journals Efficacy of Tamsulosin in the Medical Management of Juxtavesical Ureteral Stones: A Randomized Control Trial

2017 ◽  
Vol 42 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Abu Sayeed Md. Feroz Mustafa ◽  
Md. Saiful Islam ◽  
Abdullah Al Mamun ◽  
Muhammad Syeef Khalid
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Randomized Control Trial ◽  
Dose Titration ◽  
Ureteral Stones ◽  
Common Disease ◽  
Group A ◽  
Randomized Control ◽  
Group B

Urolithiasis is the third most common disease of the urinary tract. Among all urinary tract stones, majorities are ureteral stones located in the distal part of the ureters. At present, multimodalities of treatment are available to the urologists. The purpose of the present study was to observe the efficacy of Tamsulosin in conventional treatment of juxtavesical ureteric stone having size up to 8 mm. This was a single centered, parallel randomized control trial carried out in the outpatient department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2007 to June 2008. The patients with unilateral, juxtavesical ureteral stone with normal functioning kidney and absence of clinical and laboratory signs of urinary tract infection and stone size up to 8 mm were included in the study. Patients were divided into two groups according to the computer generated simple random sampling. Patients of Group-A  were given conventional hydrotherapy treatment and patients of Group-B were given Tamsulosin 0.4mg/day along with the conventional hydrotherapy. Each patient was followed-up weekly until stone expulsion for 4 weeks. In Group-A and Group-B, the mean age with SD was 38.55±10.05 and 37.7±9.33 years. Expulsion occurred in 32 (53.33%) of 60 patients in Group-A and 51 (85%) of 60 patients in Group-B (p <0.05). The number of pain episodes in this study was statistically significantly lower in Group-B patients compared to Group-A (p <0.05). Urinary tract infection was encountered in 12 (20%) patients of Group-A and 2 (3.33%) patients of Group-B (p <0.05) during four weeks therapy which was treated by appropriate antibiotics. No side effects of Tamsulosin were encountered in any patients of Group-B which could require the cessation of the medication or might need for dose titration. Findings of the study revealed that the Tamsulosin supplemented conventional therapy is more effective than conventional hydrotherapy alone in management of juxtavesical ureteral stones.

scholarly journals Effect of atorvastatin on lipid and cardiovascular events in patients on maintenance hemodialysis

2019 ◽  
Vol 10 (1) ◽  
pp. 34-39
Author(s):  
Muhammed Arshad Ul Azim ◽  
Md Habibur Rahman ◽  
Abdus Salam ◽  
Sayed Mahtabul Islam ◽  
Shahryar Waheed
Keyword(s):  
Cardiovascular Events ◽  
Disease Patient ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Maintenance Hemodialysis ◽  
Prospective Clinical Study ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Lipid Abnormalities

Background: Cardiovascular disease is the major cause of death in chronic kidney disease patient as well as in patients on hemodialysis. Dyslipidaemia is highly prevalent in patients on maintenance haemodialysis which increases the risk for cardiovascular mortality. This study was designed to evaluate the lipid abnormalities, effect of atorvastatin on lipid profile and cardiovascular events in patients on maintenance hemodialysis. Methods: In this prospective clinical study, 55 end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis participated voluntarily. The study population was divided randomly into group-A (atorvastatin was prescribed) and group-B (without atorvastatin). We compared the lipid status and cardiovascular events of both groups after 6 months. Results: The two groups of patients were well matched in respect to baseline characteristics, history of risk factors and dialysis duration and session. Mean age of study population was about 48 years. Low density lipoprotein (LDL) cholesterol was reduced by 18.79%, total cholesterol was reduced by 9.32% and triglyceride was reduced by 22% in group-A. In group-A, high density lipoprotein (HDL) cholesterol was increased by 6% and it was reduced by 6% in group-B. In this study, myocardial ischemia/infarction on electrocardiogram (ECG) was present 22% in group-A and 14% in group-B at randomization. After 6 months, ischemia/infarction was found 33% in group-A and 25% in group-B. Statistically the ECG findings showed no significant changes after 6 months. In this study, mean ejection fraction (EF %) was 54% in group-A and 51% in group-B at 0 month, after 6 months atorvastatin group failed to show any significant change. In this study, after 6 months of statin therapy there was slight increase of serum glutamic pyruvic transaminase (16.13%) but that was not significant. Conclusion: In this study atorvastatin improved the lipid abnormalities significantly but a significant reduction of cardiovascular events was not achieved. Birdem Med J 2020; 10(1): 34-39

scholarly journals Surgical treatment of pulmonary sequestration in adults and children: long-term results

2020 ◽  
Vol 31 (1) ◽  
pp. 71-77
Author(s):  
Beatrice Trabalza Marinucci ◽  
Giulio Maurizi ◽  
Camilla Vanni ◽  
Giuseppe Cardillo ◽  
Camilla Poggi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory Symptoms ◽  
Pulmonary Sequestration ◽  
Adult Patients ◽  
Long Term Results ◽  
Study Results ◽  
Group A ◽  
Group B ◽  
Histological Results

Abstract OBJECTIVES Few experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection. METHODS Between 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: ≤16 years old) and 14 were adults (group B: &gt;16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared. RESULTS Thirty-seven percent of the patients in group A presented with respiratory symptoms and 79% in group B (P = 0.44). Most symptomatic patients were treated with a lobectomy. In group A, 2 patients (3%) had a malignant transformation of the lesion. Patients with a prenatal diagnosis treated after the age of 1 year became more symptomatic than those operated on before the age of 1 year (57% vs 23%; P = 0.08). No differences were found in postoperative complications. Long-term stable remission of respiratory symptoms was obtained in 91% of patients in group A and 100% in group B. Adulthood (P = 0.03) and the association with congenital cystic adenomatoid malformation (P = 0.03) were negative prognostic factors for the development of respiratory symptoms. CONCLUSIONS Surgical treatment of PS is safe and feasible. Despite the small number of patients included, study results indicated that an early operation during childhood may prevent the subsequent development of respiratory symptoms. Surgical treatment is also recommended to prevent the rare transformation into malignancy.

scholarly journals Multiple Factor Analysis of Symptomatic Intracranial Arterial Stenosis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-89
Author(s):  
Chuanqiang Qu ◽  
Yuanyuan Zhao ◽  
Qinjian Sun ◽  
Yifeng Du
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Protective Factor ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
Group A ◽  
Group B

Objective To discuss the correlation among intracranial arterial stenosis and its risk factors. Methods A total of 486 patients with transient ischemic attack (TIA) or ischemic cerebral infarction were examined using color doppler flow imaging (CDFI) and transcranial doppler ultrosonography (TCD). According to the degrees of extracranial arterial stenosis, patients with mild-to-moderate extracranial stenosis were classified into group A (435 cases) while those with constant severe stenosis or occlusion were classified into group B (51 cases). The differences between the two groups of risk factors were compared, and the multi-factor logistic regression analysis of risk factors associated with moderately severe intracranial arterial stenosis was performed. Results ① The risk factors that were significantly associated with intracranial arterial stenosis included age (P = 0.034) and gender (P = 0.044). ② Intracranial artery stenosis was observed in both anterior and posterior cerebral arteries in patients with hypertension, diabetes, and coronary heart disease respectively (P < 0.05). ③ Compared with group A, patients in group B were older (P = 0.000), with a higher proportion of men (P = 0.037), and the intracranial arterial stenosis degrees were significantly higher (P = 0.013). ④ Multi-factor logistic regression analysis showed that diabetes is a risk factor for moderately severe intracranial arterial stenosis (P < 0.05), and hyperlipidemia is a protective factor (P = 0.012). Conclusions Age, gender, hypertension, diabetes, coronary heart disease, and smoking are risk factors for the distribution of intracranial arterial stenosis. The degrees of intracranial arterial stenosis are related with extracranial arterial stenosis. Diabetes is a risk factor for moderately severe intracranial arterial stenosis while hyperlipidemia is a protective factor.

scholarly journals Acute Cholecystitis in Very Elderly Patients: Disease Management, Outcomes, and Risk Factors for Complications

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Alfredo Escartín ◽  
Marta González ◽  
Elena Cuello ◽  
Ana Pinillos ◽  
Pablo Muriel ◽  
...  
Keyword(s):  
Disease Management ◽  
Elderly Patients ◽  
Acute Cholecystitis ◽  
Old Patients ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Very Old Patients ◽  
Grade Iii ◽  
Severe Grade

Background. The aim of this study was to evaluate the characteristics, management, and outcomes of acute cholecystitis in patients ≥80 years. Methods. This was a retrospective analysis of data from a prospective single-center patient registry. Results. The study population was composed of 348 patients, which were divided into two groups: those younger (Group A) and those older (Group B) than the median age (85.4 years). Although demographic and clinical characteristics of the two groups were similar, the disease management was clearly different, with older patients undergoing cholecystectomy less frequently (n=80 46.0% in Group A vs n=39 22.4% in Group B; p<0.001). The outcomes in both groups of age were similar, with 30-day mortality of 3.7%, morbidity of 17.2%, and readmissions of 4.2% and two-year AC recurrence in nonoperated patients of 22.5%. No differences were seen between operated and no operated patients. Severe (Grade III) AC was the only independent factor significantly associated with mortality (OR 86.05 (95% CI: 11–679); p<0.001). Conclusions. In elderly patients with AC, the choice of therapeutic options was not limited by the age per se, but rather by the disease severity (grade III AC) and/or poor physical status (ASA III-IV). In case of grade I-II AC, laparoscopic cholecystectomy can be safely performed and yield good results even in very old patients. Patients with grade III AC present high risk of morbidity and mortality, and the treatment should be individualized. ASA IV patients should avoid cholecystectomy, being antibiotic treatment and cholecystectomy the best option.

Extent of Practicing Creative Thinking Skills among Students of Educational Technology at the University of Ibb, Yemen, When Applying Innovative Educational technologies

2020 ◽  
Vol 11 (20) ◽  
pp. 75-94
Author(s):  
أ.د. داود عبدالملك يحي الحدابي ◽  
د. عيسى صالح
Keyword(s):  
Educational Technology ◽  
Creative Thinking ◽  
Thinking Skills ◽  
Educational Technologies ◽  
Technology Innovations ◽  
Technology Students ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
The University

The research aimed to identify the extent of practicing creative thinking skills among students of educational technology at the University of Ibb, Yemen in applying innovative educational technologies. To achieve the objectives of the study and answer its questions, the researchers used the descriptive method. The study population was educational technology students at the University of Ibb. The research sample involved (50) students of the second level in the Department of Educational Technology in the academic year 2018/ 2019. A scale of creative thinking and an open-ended questionnaire were used to assess creative thinking skills and identify the obstacles of creative thinking among students. The results showed a clear decline in the students' ability to practice creative thinking skills with a general average of (34.90) for group A students, and an average of (35.15) for group B students. The study revealed a number of obstacles of developing students' creative thinking. The study concluded with a set of recommendations and suggestions. Keywords: creative thinking skills, educational technology innovations, students of educational technology.

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