Antifungal susceptibility profile of invasive Candida glabrata isolates (2009–2020) from a tertiary care hospital laboratory in Pakistan

2021 ◽  
Vol 70 (12) ◽  
Author(s):  
Saba Memon ◽  
Joveria Farooqi ◽  
Urooj Zafar ◽  
Syed Faheem Naqvi ◽  
Afia Zafar ◽  
...  
Keyword(s):  
Candida Glabrata ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Clinical History ◽  
Antifungal Resistance ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Susceptibility Data

Introduction. Invasive infections with Candida glabrata are a global concern due to poor clinical outcomes and propensity to acquire resistance to antifungal agents. Hypothesis/Gap Statement. Monitoring emerging resistance and trends in Candida glabrata, an important agent of candidemia in Pakistan, is critical for patient management; data that is missing from Pakistan. Aim. Thus, this study evaluated antifungal resistance and MICs) distribution in invasive C. glabrata isolates from Pakistan. Methods. This cross-sectional and retrospective study was conducted from January 2009 to March 2020 at a clinical laboratory in Pakistan that has a nation-wide network. Antifungal susceptibility data of 277 candidemia, deep organ and soft tissue (invasive) C. glabrata sensu lato isolates against fluconazole, itraconazole, voriconazole, posaconazole, anidulafungin, micafungin, caspofungin and amphotericin B was retrieved. Susceptibility testing was performed using colorimetric broth microdilution and interpreted using CLSI criteria. Demographics, clinical history and outcome were studied. Chi-square test was used to demonstrate association between antifungal resistance and clinical characteristics of the patients. Results. We identified 277 patients with invasive C. glabrata infection. Of which 48 (18.4%) isolates were resistant to fluconazole (MIC ≥64 mg l−1), one isolate each was resistant to amphotericin (MIC=2 mg l−1), anidulafungin (MIC=1 mg l−1) and micafungin (MIC=0.5 mg l−1). MIC90 for fluconazole was 64 mg l−1 and other triazoles 2 mg l−1, caspofungin 0.12 mg l−1, anidulafungin 0.06 mg l−1, micafungin 0.03 mg l−1 and amphotericin 0.5 mg l−1. Fluconazole MIC ≥64 mg l−1, caspofungin MIC >0.06 mg l−1 and amphotericin MIC >0.25 mg l−1 (above MIC50) were significantly associated with patient being alive at the time of reporting, no use of healthcare devices, nor infection with other fungi. Fluconazole resistance was significantly associated with prior antifungal use by the patient. Conclusion. Surveillance data of antifungal resistance among common Candida species should be monitored closely for identification of resistant strains.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

scholarly journals Mental stress in infertility: a tertiary care hospital-based study

2018 ◽  
Vol 7 (10) ◽  
pp. 4249
Author(s):  
Susmita Bhattacharya ◽  
Amit Kyal ◽  
Payel Mondal ◽  
Partha Mukhopadhyay ◽  
Mrinalini Chowdhury ◽  
...  
Keyword(s):  
Mental Stress ◽  
Married Couple ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Dyadic Adjustment ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Primary Infertility ◽  
Icd 10

Background: Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life, more so if it is a primary infertility. Studies regarding the prevalence and role of infertility-specific stress especially in eastern part of India is very limited. The objective of the present study was to estimate the prevalence of infertility-specific stress and its role in marital adjustment in women diagnosed with infertility.Methods: It was a cross-sectional study done on 80 married couple diagnosed with infertility (both primary and secondary) over 1 year from July 2016 to June,2017. Dyadic Adjustment Scale (DAS), "semi-structured questionnaire" compiled by the authors and "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)" were used for the evaluation. The analysis was done using SPSS (version 16) and Chi-square test.Results: Around 86% infertile women and 21% infertile men were found to suffer from mental stress. Infertility related stress were more in patients with primary infertility than in secondary one. Women mostly (56.5%) coped with stress by self-blaming whereas men (58.2%) by blaming the partner.Conclusions: Mental stress was significantly associated with infertility. In fact, maladjustment in marital relation caused by the stress adversely affected the conjugal life and thus also the fertility. Proper counselling of both partners might be helpful to solve this problem.

scholarly journals Knowledge, Attitude and Practices Regarding First Aid against Domestic Injuries in Mothers of Children less than 5 Years of Age Attending Fauji Foundation Hospital Islamabad

2021 ◽  
Vol 11 (3) ◽  
pp. 151-157
Author(s):  
Raima Asif ◽  
Naila Azam ◽  
Fatima Ali Raza ◽  
Mehwish Riaz ◽  
Shaista Zulfiqar ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Tertiary Care ◽  
First Aid ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Strongly Agree ◽  
Home Accidents

Background: The objective is to assess the knowledge, attitude and practices regarding first aid towards home related injuries among mothers of children less than 5 years of age at tertiary care hospital of Islamabad. Methods: A questionnaire based cross sectional study was conducted in Fauji Foundation Hospital Islamabad. 400 participants were selected using convenience sampling the mother of children under 5 years of age were included and mother of children with any major co morbidity, congenital abnormalities and who didn’t give consent were excluded from the study. A pretested, structured, self-administered questionnaire was used for data collection after obtaining permission from Institutional Ethical Committee. Statistical analysis was carried using SPSS version 20. Frequencies and percentages were computed, descriptive statistical analysis was done. Chi- Square was applied for association between socio demographic variables and knowledge of mothers regarding first aid. Results: About 44% of the mothers and 63% children fall in age group of 31 and 2-5 years respectively. Half of the mothers (48%) are below intermediate level of education. About 34% of the respondents stated bleeding as most urgent and important injury requiring first aid. Regarding attitudes, 50% of the mothers strongly agree towards necessity of first aid and lack of awareness about dealing with domestic injuries. Sixty-five (65%) of the mothers had given first aid to their child. About 33%, 75%, 44% and 39% of the mothers have faced a child with difficulty in breathing; bleeding, burning and insect/sibling bite respectively. Age of mother (p=0.041), education of mother (p=0.001) and total no of children (p=0.001) were significantly associated with knowledge of first aid. Conclusion: Although home accidents are a common problem, mother’s knowledge regarding home accidents was deficient although majority of the respondents have positive attitude.

scholarly journals Frequency of Depression in Burn Patients at a Tertiary Care Hospital

2020 ◽  
Vol 11 (3) ◽  
pp. 3-7
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Care Hospital ◽  
Burn Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Residential Status ◽  
Duration Of Illness ◽  
Chi Square Test ◽  
Medical University

Background: Burns are physically, psychologically and economically challenging injuries and the factors leading to them are many and under studied. Different studies have associated burn injuries with psychiatric disorders from different parts of the world. Objective: To determine the frequency of depression among the burn patients. Methodology: This cross sectional study was conducted at the Pak Italian Modern Burn Unit, Nishtar Medical University, Multan and the Department of Psychiatry, Nishtar Medical University, Multan. Non probability consecutive sampling technique was used to collect the data from study subjects, which consisted of 150 patients of burn. All patients were assessed by a single psychiatrist on Hospital Anxiety and Depression scale (HADS) scale for screening of depression. Chi square test was applied to determine association between the socio demographic factors of burn patients and depression. Results; Of these 150 study cases, 91 (60.7 %) were male patients while 59 (39.3 %) were female patients. Mean age of our study cases was 33.94 ± 8.88 years. The frequency of depression was noted as 88 (58.7%). Post stratification Pearson chi square test revealed significant associations between age (p=0.001), residential status (p=0.038), occupation (p= 0.000), etiology of burn (p=0.044) and duration of illness (p=0.000) with depression. Conclusion: A high frequency of depression was noted among burn patients in our study. Depression was significantly associated with age, residential status, occupation, duration of illness and etiology of the burn. Healthcare professionals treating such patients should anticipate depressive symptoms in these patients and treat them accordingly.

scholarly journals Patient Attitudes towards Physician Nonverbal Behaviors during Consultancy: Result from a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad Hanif Khan ◽  
Raheela Hanif ◽  
Rumina Tabassum ◽  
Waris Qidwai ◽  
Kashmira Nanji
Keyword(s):  
Nonverbal Communication ◽  
Tertiary Care ◽  
Eye Contact ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Nonverbal Behaviors ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.

scholarly journals A study on demographic and obstetric profile, its relation with present antenatal practices and prevalence of anaemia in pregnant women attending tertiary care hospital

2021 ◽  
Vol 8 (5) ◽  
pp. 2233
Author(s):  
Nitin A. Lodha
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Health Services ◽  
Study Data ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional

Background: Antenatal care is the care of a woman during pregnancy. The primary aim of antenatal care is to achieve at the end of pregnancy a healthy mother and a healthy baby. To improve maternal health, barriers which limit access to quality maternal health services must be identified and addressed at all levels of health system. Objectives were to determine demographic and obstetric factors affecting utilization of ANC service and prevalence of anaemia among pregnant women.Methods: This is cross-sectional descriptive study carried out in tertiary care hospital, using structured questionnaire, interviews were conducted with married pregnant women age between 18-45 years, who visited ANC clinic. Total 170 pregnant women visited hospital during a period was included in study. Data was analysed using MS excel and Epi info. Chi –square test was applied.Results: Maximum number of study subjects (42.9%) from age 23-27 years. 66.5% were Hindu, 56.5% study subjects from joint family. 14.7% were illiterate. 45.3% were primigravida, 54.7% were multigravida. 71.1% study subjects were from third trimester of pregnancy. 94.7% were taken at least one dose of Tetanus Toxoids. Iron folic acid tablets were taken by 87.6%. Prevalence of anaemia was 55.8%.Conclusions: Majority of pregnant women came for antenatal check-up, but regularity was not seen in most of cases. The presence study has brought out no significant socio-cultural barrier like women’s literacy, socio economic class and parity of women affecting the utilization of services.

scholarly journals Survival outcomes of trachea esophageal fistula in infant

2019 ◽  
Vol 6 (4) ◽  
pp. 1680
Author(s):  
S. Prabkaran ◽  
K. Kasthuri Thilagam
Keyword(s):  
Tertiary Care ◽  
Surgical Techniques ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Esophageal Fistula ◽  
Chi Square ◽  
Cross Sectional ◽  
Cardiovascular Defects ◽  
Chi Square Test ◽  
Type 3

Background: Tracheo-esophageal fistula (TEF) is a rare congenital abnormality often associated with several other anomalies including renal, vertebral column, gastrointestinal or cardiovascular defects. This study was carried out to evaluate the outcome of trachea esophageal fistula among patients who underwent various surgeries for the anastomosis of trachea esophageal fistula.Methods: This study was conducted as a record based cross sectional study among 88 patients who were diagnosed and treated for trachea-esophageal fistula in tertiary care hospital between 2015 and 2018. Data regarding the type of anomaly, presence of associated anomalies, type of surgery and outcomes were documented. Findings of echocardiography and ultrasonography were also documented. Data was analyzed using SPSS software. Chi square test was used to evaluate the outcome of the surgical procedures for management of TEF.Results: Majority of the participants in our study belong to <1 month of age and were males (56.8%). Type 3 tracheo esophageal fistula (80.7%) was the most common type. Associated cardiovascular anomalies were present in 50% of the participants. Thoracotomy with TEF repair was most preferred surgery (76%). Present study demonstrated that surgical techniques improve the physical and physiological outcome of the patients (p <0.05).Conclusions: Trachea esophageal fistula needs to be corrected with surgical procedure. Modern techniques like thorocoscopic anastomosis, thorocosopic techniques to achieve an anastomosis can also be explored. Future studies may be directed in detecting congenital anomalies during the pre-natal period with the help of genetic techniques.

scholarly journals Awareness and practices regarding standard precautions for infection control among the hospital support staff in a tertiary care hospital in South India: a cross sectional study

2017 ◽  
Vol 4 (8) ◽  
pp. 2690
Author(s):  
Anusha Taarinie Jha ◽  
George P. Jacob ◽  
Mahathi Ramireddy ◽  
Yogesh Kini K.
Keyword(s):  
Infection Control ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Support Staff ◽  
Care Hospital ◽  
Sectional Study ◽  
Standard Precautions ◽  
Chi Square ◽  
Cross Sectional

Background: Compliance with standard precautions reduces the risk of exposure to blood and body fluids. The awareness regarding infection control and appropriate practices among hospital support staff is critical to prevent HAIs. Hence this study was conducted with the objectives of evaluating the awareness regarding standard precautions for infection control among hospital support staff and to identify the barriers, if any, to comply with standard infection control protocol among them. Methods: A cross-sectional study was conducted in a tertiary care hospital after obtaining the necessary ethical clearance and required permissions. Sample size was calculated to be 80. Written informed consent was taken from the participants. A questionnaire in the local language was used to collect the data. The statistical analysis was done using SPSS version 15. The results were expressed as proportions. Chi-square test was applied to study the association. Results: 81 workers participated in the study. 91.4% knew that hand washing is the most effective way to prevent health care associated infections. 75.3% were aware about categories of wastes. Among 59 staff who were liable to come in contact, 57 (96.6%) used protective barriers while serving HIV/TB patients. 51.9% of the participants were vaccinated against Hepatitis B infection. Conclusions: The awareness and practices of the hospital support staff regarding standard precaution for prevention of infection was inadequate. 

scholarly journals Socio-demographic factors associated with low birth weight in a tertiary care hospital of Odisha

2018 ◽  
Vol 5 (5) ◽  
pp. 1797
Author(s):  
Pradip Kumar Bhue ◽  
Himansu Prasad Acharya ◽  
Subrat Kumar Pradhan ◽  
Pratima Biswal ◽  
Amit Pritam Swain ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Health Organization

Background: World Health Organization has defined low birth weight (LBW) as birth weight less than 2,500 grams. Giving birth to a LBW infant is influenced by several factors. Objective of the study was to measure the proportion of low birth weight babies delivered in V.S.S medical college and hospital, Burla and its association with socio-demographic factors.Methods: Hospital based cross -sectional study comprising of 1030 postnatal women who delivered single live baby in V.S.S Medical College and Hospital, Burla. Selection of study participants was done by systematic random sampling in the study period October 2012 to September 2014. Chi-square test was used to measure association between LBW and socio-demographic factors.Results: The proportion of LBW was found to be 27.76%. The proportion of LBW babies was high and significant in extremes of age i.e. teenage (44.19%) and 30 years and above age group (39.56%) and Muslim mothers (36.36%), illiterate mothers (53.52 %), manual labourer (67.14%), socioeconomic class IV and V (32.98%), consanguinity history (60.58%), smoky fuel (30.02%), consumption of tobacco (49.11%).Conclusions: The proportion of LBW (27.76%) was found to be higher than national average (21.5%).

scholarly journals Thrombocytosis in Febrile Illness in Children of Age Three Months to 14 Years at a Tertiary Care Hospital of Nepal

2018 ◽  
Vol 6 (1) ◽  
pp. 5-14
Author(s):  
Sajan Kumar Thakur ◽  
Pramod Kattel
Keyword(s):  
Bacterial Infection ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background and Objectives: Acute febrile illness is common presentation in children. Thrombocytosis can be used as a predictor of febrile illness in children. The objectives of this study were to find out the prevalence and causes of thrombocytosis among febrile children and to access the utility of platelet count as a potential predictor of serious bacterial infection alone or in association with other predictors.Material and Methods: A cross-sectional descriptive study was done in 290 febrile children following convenience sampling method. Statistical analysis was done using SPSS. Univariate analysis using chi-square test for categorical and independent samples and “t” test for continuous variables were done.Results: Thrombocytosis was present in 13.1% of cases. Most cases had mild thrombocytosis (10%) whereas moderate thrombocytosis was present in 2.8% of cases and 0.3% cases had severe thrombocytosis. Lymphocyte level, erythrocyte sedimentation rate and C-reactive protein also showed a significant association with thrombocytosis (p<0.05). Serious bacterial infection was present in 209 cases out of which 30 children had thrombocytosis but was not significant compared to children with non serious bacterial infection with thrombocytosis (p=0.171).Conclusion: Thrombocytosis was found to have an association with febrile illnesses. More so, it indicated a fair discriminate ability to diagnose infectious cause of disease. However there was no statistical significance between thrombocytosis and serious bacterial infection.

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