MO376CLINICAL OUTCOMES OF ACUTE KIDNEY INJURY FOLLOWING SNAKE BITE INJURIES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Weerakit Naweera ◽  
Thapat Wannarong

Abstract Background and Aims Snakebite is a common animal bite injury in tropical countries. Acute kidney injury (AKI) is an important complication in snakebite patients. This study aimed to comprehensively investigate the clinical profiles and outcomes of patients following hematotoxin-related snakebite associated with kidney impairment. Method We conducted a hospital-based, cross-sectional study of 238 patients with hematotoxin-related snakebite injuries. Data were retrieved from the King Narai Hospital Registry from October 2014 to August 2020. The prevalence of complications associated with snakebite injuries, including acute kidney injury (AKI) and its severity, was determined. Univariate and Multivariate predictors of AKI diagnosis were evaluated using binary logistic regression analysis Results A total of 238 patients, with 63.4% men, median (IQR) age 49.8 (39-61) years and median duration from injury to a hospital arrival of 1 hour (0.5-2) hours, were injured by Green pit viper (85.7%), Russell’s viper (12.6%) and Malayan pit viper (1.7%). AKI mostly occurred in Russell’s viper group 66.7%. An AKI was reported in thirty (12.6%, 95% CI: 8.7 % - 17.5%) patients, with the severity of 66.7% stage one, 6.7% stage two, 26.6% stage three by KDIGO classifications, and 13.3% requiring hemodialysis. Complete renal recovery was seen in twenty-two patients (73.3%), while partial renal recovery was 23.3%. Other complications included 84.4 % limb cellulitis, 4.6% significantly bleeding, 2.5% hypotension, 25.6% prolonged venous clotting time (VCT), 46.7% prolonged prothrombin time (PT), and 14.3% prolonged partial thromboplastin time (PTT). Of total patients, 60.1% were treated with anti-venom. Mortality was relatively low (0.4%). In multivariable logistic regression analyses, AKI was significantly associated with time to hospital arrival more than 3 hours (p = 0.04), Russell’s viper bitten (p = 0.01), clinical bleeding (p = 0.01), and prolonged PT (p < 0.01). Conclusion The prevalence of AKI in patients bitten by hematotoxin snakes was 12.6%, mostly from Russell’s viper. Factors associated with AKI outcomes were time to hospital arrival more than 3 hours, Russell’s viper bitten, clinical bleeding, and prolonged PT. Besides, one-fourth of AKI patients turned to chronic kidney disease.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1471.2-1472
Author(s):  
N. Gokcen ◽  
I. Coskun Benlidayi ◽  
L. Tamam ◽  
M. E. Demirkol ◽  
C. Yesiloglu ◽  
...  

Background:Fibromyalgia (FM) is a condition characterized by chronic widespread pain, fatigue, sleep disturbances. Etiopathogenesis remains unclear; however, growing data regarding the effect of psychosocial factors on disease etiopathogenesis have drawn attention. Psychosocial elements such as type D personality and low level of self-esteem might increase disease burden (1). Accordingly, many researchers so far, have examined psychological parameters in FM and a limited number of studies focused on the personality type among patients with FM (2-5).Objectives:The current study aimed to investigate type D personality and self-esteem in patients with FM.Methods:Female patients with fibromyalgia and age-matched healthy controls were enrolled in this cross-sectional study. Type D personality was evaluated by using the type D scale (DS-14). The Rosenberg self-esteem scale (RSES) was used to assess self-esteem and psychosomatic symptoms. Psychological status was evaluated by the Beck Depression and Beck Anxiety Inventories. Fibromyalgia Impact Questionnaire (FIQ) was performed to assess functional impairment and health status in patients with FM. The potential confounders of type D personality were evaluated by binary logistic regression analysis.Results:Seventy patients with FM and 60 controls were included. Type D personality was observed in 58.6% of the patients and in 21.7% of the control group (p<0.001). When compared to patients with non-type D personality, those with type D personality revealed lower self-esteem and poorer health status (p<0.05 for both), higher anxiety and depression scores (p<0.001 for both). According to binary logistic regression analysis, depression (β=1.178, Cl 95% 1.055−1.316, p=0.004) and lower education level (β=0.818, Cl 95% 0.682−0.982, p=0.031) were significantly related to type D personality in FM (Table 1).Conclusion:Type D personality is more common in female patients with FM when compared to healthy women. Patients with type D personality have lower level of self-esteem when compared to those with non-type D personality. Depression and lower education level are potential confounders of type D personality in FM.References:[1]Bazzichi L, Giacomelli C, Consensi A, Giorgi V, Batticciotto A, Di Franco M, Sarzi-Puttini P (2020) One year in review 2020: fibromyalgia. Clin Exp Rheumatol 38 Suppl 123(1):3-8.[2]Conversano C, Marchi L, Ciacchini R, Carmassi C, Contena B, Bazzichi LM, Gemignani A (2018) Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review. Clin Pract Epidemiol Ment Health 14:263.[3]Türkoğlu G, Selvi Y (2020) The relationship between chronotype, sleep disturbance, severity of fibromyalgia, and quality of life in patients with fibromyalgia. Chronobiol Int 37(1):68-81.[4]Garip Y, Güler T, Bozkurt Tuncer Ö, Önen S (2019) Type D Personality is Associated With Disease Severity and Poor Quality of Life in Turkish Patients With Fibromyalgia Syndrome: A Cross-Sectional Study. Arch Rheumatol 35(1):13-19.[5]Ablin JN, Zohar AH, Zaraya-Blum R, Buskila D (2016) Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients. PeerJ 4:e2421.Table 1.Binary logistic regression analysis for the evaluation of potential confounders of type D personality in patients with fibromyalgia.WaldSEβ (95%CI)pEducation (years)4.6640.0930.818 (0.682−0.982)0.031Occupation duration (years)0.1160.0371.013 (0.942−1.089)0.733Self-esteem scale (D1)0.3690.4230.774 (0.338−1.771)0.544BDI8.4460.0561.178 (1.055−1.316)0.004BAI0.7890.0321.029 (0.966−1.095)0.374BDI: Beck Depression Inventory, BAI: Beck Anxiety Inventory, SE: standard error, CI: confidence intervalDisclosure of Interests:None declared


2013 ◽  
Vol 04 (S 01) ◽  
pp. S40-S44 ◽  
Author(s):  
Thekkumkara Surendran Nair Anish ◽  
Reshmi Ramachandran ◽  
P Sivaram ◽  
Seetha Mohandas ◽  
Archana Sasidharan ◽  
...  

ABSTRACT Context: There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP). Aim: To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same. Setting and Design: This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram. Materials and Methods: Children between 3 and 12 years of age diagnosed with CP were subjects for the study. Statistical Analysis Used: Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer′s exact test. Independent association of each factor was evaluated through binary logistic Regression analysis. Results and Conclusions: The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of them being girls. Diplegia was the commonest limb abnormality found. Fifty-two (60.5%) children were undergoing some kind of schooling. Those children who were less dependent physically and those who had achieved better language development were regular school goers. After binary logistic regression the ability of a child to speak in sentences (P = 0.008) and ambulatory level of the child (P = 0.019) were factors which favored, whereas delay in attaining the adaptive developmental milestone of transferring objects from one hand to another (P = 0.014) was found to be detrimental for school enrollment.


2019 ◽  
Author(s):  
Mohammed Bukari ◽  
Muzamil Mohammed Abubakari ◽  
Mohammed Majeed ◽  
Abdul-Razak Abizari ◽  
Anthony Wemakor ◽  
...  

Abstract Objective: This study sought to assess maternal growth monitoring knowledge and its effect on stunting, wasting and underweight among children 0-18 months in the Tamale Metropolis.An analytical cross-sectional study design, involving 340 mother-child pairs randomly selected from 4 health facilities in the Tamale Metropolis, was used. A structured questionnaire was used to collect information on socio-demographic characteristics and maternal growth monitoring knowledge. Weight and length of children were taken to assess nutritional status (stunting, underweight and wasting). Logistic regression analysis was used to determine the association between maternal growth monitoring knowledge level and child nutritional status. Results: The study revealed that 87.6% of mothers had good knowledge on growth monitoring. The prevalence of stunting, underweight and wasting were 9.4%, 25.9% and 17.9% respectively. A binary logistic regression analysis revealed that there is no association between maternal growth monitoring knowledge and stunting [Adjusted Odds Ratio (AOR) = 0.593; 95% Confidence Interval (CI): 0.170-2.067], underweight (AOR= 1.56; 95% CI: 0.697-3.612) and wasting (OR= 0.881; 95% CI: 0.414-1.876) among children 0-18 months in the Tamale Metropolis.


Author(s):  
Aren Sinedeh Lemin ◽  
Md Mizanur Rahman ◽  
Cliffton Akoi Pangarah ◽  
Andrew Kiyu

Objective: Voluntary HIV testing is one of the key strategies in the HIV/AIDS prevention and control program. New National Strategic Plan for 2016-2030 in Malaysia, adapt three zeros viz. ‘zero new infections of HIV/AIDS, zero discrimination and zero AIDS-related deaths’. This study aimed to determine the predictors of voluntary HIV testing in Sarawak. Materials and methods: A cross-sectional study was conducted with a total of 900 respondents (450 males and 450 females) from the state of Sarawak, aged 18 years and above, who were selected by gender-stratified multistage cluster sampling. Data were obtained by face-to-face interview using a pretested questionnaire. Binary logistic regression analysis was done to determine the potential predictors for voluntary HIV testing. Results: The prevalence of HIV testing was higher among female respondents (26%) compared to male respondents (14.2%), and the difference was statistically significant (p < 0.001). Binary logistic regression analysis revealed that household income more than MYR 1501 (p = 0.009), not living with a partner (p < 0.001) and discussion on HIV/AIDS (p = 0.019) appeared to be predictors for the male respondents, while, ethnicity was statistically significant for female respondents (p < 0.001). Conclusion: The utilisation of HIV testing was low in both males and females. Thus, the finding of this study could be considered when designing HIV education and screening program in Sarawak.


2017 ◽  
Vol 41 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Ana C Mafla ◽  
Ximena A Cerón-Bastidas ◽  
Maria E Munoz-Ceballos ◽  
Diana C Vallejo-Bravo ◽  
Maria C Fajardo-Santacruz

Objective: This manuscript examined the prevalence and extrinsic risk factors for dental erosion (DE) in early and middle adolescents in Pasto, Colombia. Study design: Dental erosion was evaluated in a random sample of 384 individuals aged 10–15 years attending three primary and high schools in this cross-sectional study. Clinical dental assessment for DE was done using O'Sullivan index. Data on general sociodemographic variables and extrinsic risks factors were obtained. Descriptive and univariate binary logistic regression analyses were performed. Results: Dental erosion was observed in 57.3% of individuals. The univariate binary logistic regression analysis showed that frequency of drinking natural fruit juices (OR 2.670, 95% CI 1.346 – 5.295, P=0.004) and their pH (OR 2.303, 95% CI 1.292 – 4.107, P=0.004) were more associated with the odd of DE in early adolescence. However, a high SES (OR 10.360, 95% CI 3.700 – 29.010, P&lt;0.001) and frequency of snacks with artificial lemon taste (OR 3.659, 95% CI 1.506 – 8.891, P=0.003) were highly associated with the risk of DE in middle adolescence. Conclusions: The results suggest that DE is a prevalent condition in adolescents living in a city in southern Colombia. The transition from early to middle adolescence implies new bio-psychosocial changes, which increase the risk for DE.


2018 ◽  
Vol 6 (3) ◽  
pp. 7-14
Author(s):  
F. Vuvor ◽  
M. Steiner-Asiedu ◽  
F. K. Saalia

Anaemia is a reduction in circulating red blood cells which directly affect the concentrations of haemoglobin. The most common form dietary anaemia is known to be iron deficiency. Many factors such as socioeconomic status, and lifestyles contribute to anaemia. Studies are done on children and women but scanty information aree available on men. It was relevant to find out such information on men. This problem persists in the world especially, in the underdeveloped countries. A cross-sectional study in a peri urban community in Ghana enrolled 1449 healthy men aged ≥18 years. The study assessed their lifestyle, nutrient adequacy ratio (NAR), body mass index (BMI), haemoglobin (Hb) level. risks of developing anaemia and binary logistic regression analysis with significance set at p<0.05. Biochemical and clinical examinations revealed that 18.8% of the participants were anaemic (Hb ≤13b/dL). Their dietary status was below the cutoff of 60% NAR for all nutrients except iron (84%) and protein (55%). The binary logistic regression indicated that participants who used tobacco were about 16 (Odds ratio: 16.39, p<0.01) times more likely to be anaemic compared with nonusers. In the same model men whose intake of protein was (<60% NAR) were 3 (Odds ratio: 3.44, p<0.01) time more likely to be anaemic. In conclusion, tobacco smoking and mainly plant-base sources of protein and iron did not guarantee their availability for optimum utilization for Hb synthesis to lower incidence of high risk of among participating men in the study in Ghana.Journal of Medical and Biomedical Sciences (2017) 6(3), 7 - 14


PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5405
Author(s):  
Danielly Botelho Soares ◽  
Juliana Vaz de Melo Mambrini ◽  
Gabriela Rebouças Botelho ◽  
Flávia Fialho Girundi ◽  
Fernando Antonio Botoni ◽  
...  

Background Acute kidney injury (AKI) is associated with a significant increase in morbidity, mortality, and health care costs. In intensive care units (ICU), AKI is commonly multifactorial and frequently involves diverse factors, such as hypovolemia, sepsis, and the use of nephrotoxic drugs. We aimed to investigate drug therapy and other factors associated with the development of AKI in a Brazilian public hospital. Methods This is a cross-sectional study involving critically ill patients at an ICU of a tertiary hospital. All data on sequential serum creatinine (SCr) level, glomerular filtration rate (GFR), and urine output were collected during ICU stay. The primary outcome was the occurrence of AKI assessed by the Acute Kidney Injury Network (AKIN) criterion. Sociodemographics, clinical data and drug therapy were considered as covariates. Factors associated with AKI were assessed using logistic regression. Results Overall, 122 participants were included in the study. Median age was 46.0 (interquartile range, IQ = 29.0–69.0) years, with a predominance of men (58.2%). Mean number of prescribed drugs throughout ICU stay was 22.0 ± 9.4. The number of potentially nephrotoxic drugs ranged from two to 24 per patient. A total of 29 (23.8%) ICU patients developed AKI. In the AKI-group, patients were older and showed higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, higher rates of sedation, mechanical ventilation, and infection. More drugs in general and specifically more vasoactive drugs were prescribed for AKI group. Patients who developed AKI tended to have extended stays in the ICU and a lower probability of being discharged alive than patients with no AKI development. Model adjustments of logistic regression showed that the number of medications (OR 1.15; 95% CI [1.05–1.27]) was the only factor associated with AKI in this study. This association was independent of drug nephrotoxicity. Discussion Intensive care is characterized by its complexity that combines unstable patients, severe diseases, high density of medical interventions, and drug use. We found that typical risk factors for AKI showed statistical association on bivariate analysis. The contribution of drug therapy in the occurrence of AKI in medical ICUs reinforces the need for prevention strategies focused on early recognition of renal dysfunction and interventions in drug therapy. These actions would help improve the quality of patient care and ensure progress towards medication safety.


Author(s):  
Manika Pal ◽  
Lina Bandyopadhyay ◽  
Aparajita Dasgupta

Background: Globally unplanned pregnancy has emerged as a major public health problem with its impact on demography and economy. Despite being the first country to initiate a nationwide family planning program, contraceptives access and utilization are low in India. As per a study conducted in 35 low- and middle-income countries, India contributed the largest number of undesired pregnancy. Our current study was aimed at determining the proportion of unplanned pregnancy and examining its predictors among currently married women aged 15-35 years, residing in a rural area. Methods: A facility based, observational, cross-sectional study was conducted in a rural area of Bengal. 158 participants were selected by purposive sampling and face to face interviews were conducted using structured schedule ensuring confidentiality. Statistically data were summarized with descriptive statistics and adjusted with binary logistic regression analysis in SPSS (version 16). Results: The proportion of unplanned pregnancy was found to be 28.5%. On multivariable logistic regression, it was observed that there was significant association between unplanned pregnancy and low SE status AOR (CI) 2.523 (1.074-5.926), lack of women’s empowerment AOR (CI) 2.971 (1.198-7.367), husbands’ lower level of education AOR (CI) 2.673 (1.041-6.866), and no contraception or traditional method of contraception AOR (CI) 2.391 (1.104-5.180). Conclusions: The study revealed alarmingly high proportion of unplanned pregnancy. In addition to the existing strategies of the national program, emphasis should be on IEC activities. All efforts should be made to educate women on hazards of unsafe abortion and unplanned pregnancy.  


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
In O Sun ◽  
Kwang Young Lee ◽  
A Young Cho

Abstract Background and Aims Urinary microRNA (miRNA)-21 is reported to be a biomarker for detection of acute kidney injury (AKI). Analysis of urinary exsome may serve as a novel diagnostic approach in kidney disease. The aim of this study is to investigate the clinical significance of urinary exosomal miRNA-21 for AKI in patients with scrub typhus. Method In a cross-sectional study, we collected 138 urine samples at the time of admission from 145 patients with scrub typhus. For 25 patients with scrub typhus-associated AKI and 25 age, sex-matched scrub typhus patient without AKI, we measured miRNA-21 in urinary exosomal fraction and compared diagnostic value in predictiong AKI. Results Compared with patients in the non-AKI group, patients in the AKI group were more likely to have one or more comorbidity such as diabetes (50% vs. 5%, P&lt;0.01) and chronic kidney disease (8% vs. 0%, P&lt;0.01). Total leukocyte count were higher in patients with AKI than in those without AKI (10.40 × 103/ mL vs. 6.40 × 103/mL, P&lt;0.01). The levels of urinary miRNA-21 were higher in the AKI group than in the non-AKI group. Urinary exosomal miRNA-21 levels correlated directly with serum neutrophil gelatinase-associated lipocalin values and total leukocyte counts and inversely with estimated glomerular filtration rate. The receiver operator characteristics curve analysis for urinary exosomal miRNA-21 showed good discriminative power for the diagnosis of scrub typhus-associated AKI, with area under the curve value of 0.907. Conclusion Urinary exosomal miRNA-21 could be a surrogate markers for the diagnosis of scrub typhus–associated AKI.


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