219. Is the modified quick SOFA scale superior to quick SOFA in patients with diagnosed septic shock?

Abstract Background In this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country. Methods Modified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant. Results The number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572). Conclusion In terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts Disclosures All authors: No reported disclosures.

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Prognosis and Survival Study in Patients with Glioblastoma Multiform and Its Relationship with EGFR Expression

Iranian Journal of Neurosurgery ◽

10.32598/irjns.6.3.2 ◽

2020 ◽

Vol 6 (3) ◽

pp. 113-120

Author(s):

Zeinab Amirpour ◽

◽

Arezoo Bahari ◽

Behrad Nafisi ◽

Koorosh Rahmani ◽

...

Keyword(s):

Survival Rate ◽

Survival Rates ◽

Growth Factor Receptor ◽

P Value ◽

Anatomical Location ◽

Chi Square ◽

Egfr Expression ◽

Significant Difference ◽

Chi Square Test ◽

The Mean

Background and Aim: Glioblastoma multiforme (GBM) is the most common malignant and invasive tumor of the brain. The relation between prognosis and survival of GBM patients with Epidermal Growth Factor Receptor (EGFR) expression is challenging. Thus, we aimed to evaluate the prognosis and survival of patients with GBM and its relationship with EGFR expression. Materials and Methods: This single-arm cohort study was conducted on 70 patients with GBM during 2012-2018 in Shahid Rahnemoon and Mortaz hospitals. The immunohistochemistry technique was applied to paraffin blocks of brain tumors for examining EGFR expression. Other data were extracted from medical records. To determine the survival rate, the Kaplan–Meier curves were used. A chi-square test was used for the analysis of data. Statistically, p-value <0.05 was assumed significant. Results: The mean survival of patients with GBM was 22.3 ± 2.5 months (95% CI=17.41 - 27.10). In addition, 1, 2- and 5-year survival rates were 90%, 30% and 5%, respectively. The mean survival of patients with negative and positive EGFR was 27.4±7.3 and 20.6±2.4 months, respectively. Besides, 11.1% and 14.3% of patients in negative and positive EGFR groups were alive. There was no significant difference in patient’s survival in terms of EGFR expression (p=0.36). No significant difference was seen between the two groups (EGFR positive and negative groups), regarding the frequency of age, sex, tumor’s anatomical location, and place of living (p>0.05). Conclusion: Based on our study, it seems that the GBM tumor was associated with poor prognosis and a low survival rate. It was also found that the expression of the EGFR gene did not affect the survival rate of patients with GBM. Therefore, its use as a predictor factor for survival and prognosis is questionable.

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EARLIEST SYMPTOMS OF PRESENTATION IN COVID-19 PATIENTS IN TERTIARY CARE HOSPITAL

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v1i1.7941 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S500-03

Author(s):

Maqbool Raza ◽

Muhammad Ali Raza ◽

De Emmal Asjad Cheema ◽

Maham Asjad Cheema ◽

Atif Rafique ◽

...

Keyword(s):

Tertiary Care ◽

Sampling Technique ◽

Military Hospital ◽

P Value ◽

Care Hospital ◽

Chi Square ◽

Cross Sectional ◽

Presenting Symptoms ◽

Significant Difference ◽

Chi Square Test

Objective: To determine the frequency of earliest symptoms of COVID-19 infection among patients with confirmed SARSCOVID-19 infection. Study Design: Cross-sectional analytical study. Place and Duration of Study: Combined Military Hospital Multan, from Jun to Dec 2021. Methodology: Data from 299 patients admitted in tertiary care settings was collected on a questionnaire. Patients regardless of gender and age who had confirmed COVID-19 infection through Real Time Polymerase Chain Reaction (RT-PCR) were included in the study. A nonprobability consecutive sampling technique was used to select samples. Data was entered and analyzed through SPSS version 22. Frequencies and percentages of various presenting symptoms were calculated. Sample size calculated at 95% level of confidence, 1% required precision, and 27% anticipated population proportion were 299. The overall difference in frequencies of symptoms in various groups was compared by using chi-square test. p-value <0.05 was taken as significant. Results: A total of 299 participants were included in this analysis. The median age for participants (interquartile range [IQR]) was 46 (36-54) years. Among 299 adults the reported symptoms were cough 238 (79.6%), fever 176 (58.7%) and, dyspnea 113 (37.8%). Only 78 (26.1%) of participants with confirmed infection reported having all three symptoms of cough, fever, and dyspnea. Other reported symptoms in patients were diarrhea 54 (18.1%), fatigue 128 (42.8%), myalgia 113 (37.8%), and anosmia 98 (32.8%). There was no significant difference in the frequency of symptoms across both genders. Conclusion: The most frequent symptoms of COVID-19 are cough, fever, and dyspnea.

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Feto-maternal outcomes following labor induction at a tertiary care center

Journal of Chitwan Medical College ◽

10.3126/jcmc.v10i2.29665 ◽

2020 ◽

Vol 10 (2) ◽

pp. 29-32

Author(s):

Upendra Pandit ◽

Basant Sharma ◽

Rakshya Joshi ◽

Julli Chaudhari ◽

Prekshya Singh ◽

...

Keyword(s):

Apgar Score ◽

Care Center ◽

Tertiary Care ◽

Mode Of Delivery ◽

Fetal Distress ◽

Labor Induction ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test

Background: Labor induction is one of the most common Obstetrics interventions worldwide. It has got significant risks and benefits. Careful selection of cases for induction improves the fetomaternal outcomes. So, the study was designed to assess the fetomaternal outcome and factors associated with mode of delivery following the induction of labor. Methods: It was a descriptive observational study conducted in the department of Obstetrics and Gynecology from July 17, 2018, to July 16, 2019. The study comprised of 264 mothers admitted in the labor ward subjected to labor induction as clinical management of labor and delivery. Data analyzed with chi-square test and one-way analysis of variance (ANOVA) wherever appropriate. Results: Of 2950 deliveries, the induction rate was 8.94%. Out of them, 264 mothers undergone labor induction. A caesarean was the highly associated mode of deliveries 168(63.63%) due to induction failure 94(55.97%) followed by fetal distress 37(22%). The mean birth weight of neonates was 3.09±0.41 kg. Apgar score in one minute and hospital stay showed a significant difference (p-value .002), in modes of deliveries. No significant association was observed in maternal and fetal complications like PPH, endometritis, and low Apgar score <7 in five minutes. The majority of neonates admitted for observation at the care unit. The neonatal mortality was two. Conclusions: Caesarean mode of delivery highly was associated with labor induction due to induction failure and fetal distress. Carefully selected cases improve morbidity and fetomaternal outcomes following labor induction.

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Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽

10.1161/circ.142.suppl_3.14721 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

ghufran adnan ◽

Osman Faheem ◽

Maria Khan ◽

Pirbhat Shams ◽

Jamshed Ali

Keyword(s):

Emergency Department ◽

Tertiary Care ◽

Reduction Rate ◽

Care Hospital ◽

Chi Square ◽

Coronary Syndrome ◽

Significant Difference ◽

Drastic Increase ◽

Chi Square Test ◽

The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

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Orthodontics-Awareness Amongst Medical Students

Orthodontic Journal of Nepal ◽

10.3126/ojn.v10i3.35496 ◽

2020 ◽

Vol 10 (3) ◽

pp. 49-56

Author(s):

Türkan SEZEN ERHAMZA ◽

Kübra A ARSLAN ÇARPAR

Keyword(s):

Medical Students ◽

Statistical Evaluation ◽

P Value ◽

Chi Square ◽

Level Of Education ◽

Significant Difference ◽

Chi Square Test ◽

Treatment Procedures

Introduction: The study aimed to evaluate the knowledge and awareness of orthodontics, a specialty of dentistry,amongst Medical Students. Materials and Method: A sample of 550 students (279 female, 226 male aged between 18 and 36 years) were attented.Of the subjects, 58.6% (n = 296) were preclinical students, while 41.4% (n = 209) were clinical students. The students were informed about the questionnaire and asked to fill in the questionnaire forms. For the comparison of data between groups (gender, level of education), the chi-square test was used. A chi-square test was used for statistical evaluation and the p-value < 0.05 was considered statistically significant. Result: 385 students (76.2%) had heard the term orthodontics although 41.2% of the subjects knew that orthodonticswas concerned with malocclusions and their treatment. The question about treatment procedures was answeredas scaling by 35.8%, tooth polishing by 40%, tooth aligning by 89.9% of the students. The percentage of knowingorthodontics to be related to tooth aligning showed a significant difference between female and male (p = 0.006), andpreclinical and clinical students (p = 0.033). Of the participants, 42.8% thought that dentures, 83% brackets, 78.8% ofremovable appliances were used by orthodontists. Conclusion: Our results have shown that medical students should have more information about orthodontics, aspecialty of dentistry.

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Position of lips and tongue in rest in newborns with and without ankyloglossia

CoDAS ◽

10.1590/2317-1782/20202020069 ◽

2021 ◽

Vol 33 (6) ◽

Author(s):

Silvia Márcia Andrade Campanha ◽

Roberta Lopes de Castro Martinelli ◽

Durval Batista Palhares

Keyword(s):

Visual Inspection ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Hospital Data ◽

Chi Square ◽

Cross Sectional ◽

Significance Level ◽

Significant Difference ◽

Chi Square Test

ABSTRACT Purpose Verify the position of lips and tongue at rest in newborns with and without ankyloglossia. Methods Cross-sectional study, carried out with 130 newborns in University Hospital. Data collection was performed by the researcher and speech-language pathologists from the Hospital. Information on gestational age, sex, weight, height and days of life was collected. The position of the lips and tongue at rest was evaluated through visual inspection with the newborns asleep. After the newborns were awakened, Neonatal Screening of the validated Protocol for the evaluation of the lingual frenulum for infants was performed to detect the alteration of the lingual frenulum. The data obtained were described and submitted to statistical analysis using the Chi-Square test to verify the association between the position of the lips with the tongue and to compare the position of the lips and tongue with and without ankyloglossia. The Mann-Whitney test was used to verify the behavior of the variables the differed between newborns with and without ankyloglossia. The significance level of 5% was adopted. Results When comparing the data, a significant difference was found between: weight and height with and without ankyloglossia; position of lips and tongue. An association between the position of the tongue and lips with and without ankyloglossia was also found. Conclusion Newborns without alteration of the lingual frenulum have a tendency to remain with their lips closed and their tongue elevated during rest and newborns with ankyloglossia have a tendency to keep their lips parted and their tongue low during rest.

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A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191602 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1067

Author(s):

Mallikarjuna Rao I. ◽

Usha Kiran Prayaga ◽

Dharma Rao Uppada ◽

Ramachandra Rao E. ◽

B. L. Kudagi

Keyword(s):

Depressive Disorders ◽

Low Dose ◽

Rating Scale ◽

Controlled Study ◽

P Value ◽

Chi Square ◽

Double Blind ◽

Increased Risk ◽

Significant Difference ◽

Chi Square Test

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.

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The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

BioScientia Medicina ◽

10.32539/bsm.v5i11.369 ◽

2021 ◽

Vol 5 (11) ◽

pp. 1030-1036

Author(s):

Galih Aktama ◽

Henky Agung Nugroho ◽

Muhammad David Perdana Putra

Keyword(s):

Cancer Patients ◽

Elective Surgery ◽

Pulmonary Complications ◽

P Value ◽

Chi Square ◽

Elective Surgical Procedures ◽

Significant Difference ◽

Before And After ◽

Chi Square Test ◽

Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

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Variation in lip print pattern between two ethnic groups, Oraon tribals and Bengalee Hindus, residing in West Bengal, India

Anthropological Review ◽

10.2478/anre-2019-0031 ◽

2019 ◽

Vol 82 (4) ◽

pp. 405-415

Author(s):

Archita Dey ◽

Mahua Chanak ◽

Kaustav Das ◽

Koel Mukherjee ◽

Kaushik Bose

Keyword(s):

Ethnic Groups ◽

West Bengal ◽

Personal Identification ◽

P Value ◽

Type Ii ◽

Ethnic Variation ◽

Criminal Cases ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test

Abstract Lip print pattern (LPP) is unique to each individual. For decades, forensic experts have used LPP for personal identification to solve criminal cases. However, studies investigating ethnic variation in LPP are scanty. Our study wanted to investigate variation in LPP between two ethnic groups, Oraon tribals and Bengalee Hindus, residing in West Bengal, India. A total of 280 participants included 112 Oraons and168 Bengalee Hindus of both. Prints were taken using dark shaded lipstick and transparent cellophane tape and recorded into white A4 sheet. Prints were divided into four quadrants and examined by magnifying glass. For analysis of results, classification of Suzuki and Tsuchihashi was followed. A p value of 0.05 was considered to be statistically significant. It was observed that Type II pattern was dominant in first and second quadrants in both ethnic groups, irrespective of sex. Combination of Type II+III was found to be the most common pattern in males among both Oraons (16.2%) and Bengalee Hindus (12.2%) whereas in females Type II pattern (25.0%) among Oraons and Type III pattern among Bengalee Hindus (11.4%) was the most common. Chi square test showed statistically significant difference among females (p<0.05) and in third and fourth quadrants among males (p<0.01) of both ethnic groups. Our investigation clearly demonstrated sex and ethnic variations in LPP. Further studies are required to investigate ethnic variation in LPP among the various populations groups, both tribal as well as non-tribal, from different regions of India.

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Instrumental delivery: a comparative study in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180896 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1079

Author(s):

Bhanu B. T. ◽

Anitha G. S.

Keyword(s):

Post Partum ◽

Tertiary Care ◽

Neonatal Morbidity ◽

Fetal Distress ◽

Care Hospital ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Maternal And Neonatal Outcomes ◽

Vertex Presentation

Background: To compare maternal and neonatal outcomes of vacuum versus forceps application in assisted vaginal delivery.Methods: Women in labor with vertex presentation were delivered by indicated/propylactic vacuum or forceps. A total of 500 cases were included in this retrospective study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum hemorrhage, Apgar score, neonatal jaundice, perinatal mortality, NICU admissions etc. Chi square test was used to analyze the data.Results: Maternal morbidity was significant in the forceps group. With regards to neonatal morbidity, in NICU admissions, statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the modern obstetrics. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother and decrease NICU admissions.

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