scholarly journals Metastatic Spreading of Community AcquiredStaphylococcus aureusBacteraemia

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Giovanna Fabio ◽  
Maria Carrabba ◽  
Luca Mellace ◽  
Cinzia Hu ◽  
Diego Spagnoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epidural Abscess ◽  
Tertiary Care ◽  
Skin Lesions ◽  
University Hospital ◽  
Serious Infection ◽  
History Of ◽  
Associated Risk Factors ◽  
Healthcare Associated ◽  
And Control

A 29-year-old woman presented to the Fondazione IRCCS “Cà Granda” Ospedale Maggiore, a tertiary care university hospital in Milan (Italy), with skin lesions, fever, myalgia, joint pain and swelling, and a one-week history of low back pain. The diagnosis wasStaphylococcus aureus(S. aureus) bacteraemia spreading to skin, bones, and joints and a lumbosacral epidural abscess L5-S2. Neither initial focus nor predisposing conditions were apparent. The antibiotic therapy was prolonged for six-weeks with the resolution of fever, skin lesions, articular inflammation, and the epidural abscess. Community-acquiredS. aureusinfections can affect patients without traditional healthcare-associated risk factors, and community acquisition is a risk-factor for the development of complications. Raised awareness ofS. aureusbacteraemia, also in patients without healthcare-associated risk factors, is important in the diagnosis, management, and control of this infection, because failure to recognise patients with serious infection and lack of understanding of empirical antimicrobial selection are associated with a high mortality rate in otherwise healthy people.

Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Congenital Heart ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

2021 ◽  
pp. 175717742110358
Author(s):  
Sailesh Kumar Shrestha ◽  
Swarup Shrestha ◽  
Sisham Ingnam
Keyword(s):  
Prevention And Control ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Healthcare Associated ◽  
And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

scholarly journals Predictive Risk Factors for Post Tonsillectomy Hemorrhage in Children

2021 ◽  
pp. 42-47
Author(s):  
Amrat Kumar ◽  
Ghulam Shabir Mehar ◽  
Junaid Hussain ◽  
Ahmed Ali ◽  
Abdul Waheed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
University Hospital ◽  
Age Group ◽  
Tonsillar Hypertrophy ◽  
Recurrent Tonsillitis ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
History Of ◽  
Predictive Risk

Objective: To assess the risk factors which determine the magnitude of post-tonsillectomy hemorrhage.  Study Design: Prospective cross sectional study. Setting: A study carried out at otolyrangical unit at a tertiary care Isra University hospital Hyderabad, from June 2018 to April 2019. Materials and Methods: 110 pediatric patients age 5-17 years were included in this study. We administrated a structured questionnaire to parents of the patients. We selected cases for tonsillectomy as per criteria of the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS). Those patients with a history of recurrent tonsillitis presented at the otolaryngology department were included. Patients with a history of use of anticoagulant therapy, obstructive sleep apnea, patients with a history of a bleeding disorder, and patients not giving consent were excluded. We diagnosed patients selected for tonsillectomy included with recurrent tonsillitis, peri-tonsillar hypertrophy, and tonsillar hypertrophy. Patients were observed and followed for postoperative hemorrhage. Data were analyzed by using Statistical Package for Social Sciences version 21 (SPSS 21). Results:  Among 110 children included in the study, 41.8% patients were in the age group of 5-10 years, 30% were in the age group of 11-15 years and 28.2% were over 15 years. Among 110 patients 21.8% underwent tonsillectomy were diagnosed as recurrent tonsillitis, 19% were diagnosed as having tonsillar hypertrophy, 40.0% were suffering from both recurrent tonsillitis and tonsillar hypertrophy and 19.2% had peritonsillar hypertrophy. This shows that 14.5% were admitted to the hospital after 1-5 days, 58.1% developed post-tonsillectomy hemorrhage after 6-10 days and 27.2% developed post-tonsillectomy hemorrhage after 10 days. Conclusion: We conclude that age >10 years was significant predictive risk factors for post-tonsillectomy hemorrhage among children who undergo tonsillectomy.

scholarly journals Prevalence and Associated Risk Factors of Gestational Diabetes Mellitus at a University Hospital in Saudi Arabia

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Shahad Abualhamael ◽  
Hala Mosli ◽  
Mukhtiar Baig ◽  
Abdulelah M. Noor ◽  
Fahd M. Alshehri
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Saudi Arabia ◽  
Family History ◽  
Gestational Diabetes ◽  
Antenatal Clinic ◽  
University Hospital ◽  
History Of ◽  
Working Status ◽  
Associated Risk Factors

Objectives: We aimed to find out the prevalence and associated risk factors of GDM among females who attended antenatal clinic at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia (SA). Methods: This retrospective study was carried out from 25th September 2016 till 20th December 2016, at the Endocrine Clinic, Faculty of Medicine, KAUH, Jeddah, SA. A total of 5000 women attended antenatal clinic and 637 women were referred to the endocrine clinic for GDM. The data of only 103 GDM was included in the study because only these patients’ complete data was available. The electronic record of 93 pregnant age and BMI matched females, not having GDM were selected as a control group. Results: The prevalence of GDM was 12.75% (637/5000). Parity was associated with GDM (X2=16.82, P=.001) and GDM was significantly higher in multigravida while no association of GDM was found with working status, place of living, hypertension, family history of DM and BMI. Logistic regression analysis revealed that grand multigravida female had the lower risk of GDM as compared to multi, primi and nulligravida while age, working status, place of living, hypertension, family history of DM and BMI were not found significant risk factors for GDM. In GDM group, according to nationality, 68(66%) women were Saudi while 35(34%) were expatriates’ (Yemeni 11.2%, Egyptians 3.9%, Indians 3.9%, Pakistanis 2.9%, Sudanese 2.9%, Syrians 2.9% and others). Conclusions: The prevalence of GDM was 12.75% and it was not associated with working status, place of living, hypertension, family history of diabetes and BMI. How to cite this:Abualhamael S, Mosli H, Baig M, Noor AM, Alshehri FM. Prevalence and Associated Risk Factors of Gestational Diabetes Mellitus at a University Hospital in Saudi Arabia. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.498 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Risk Factors for Acquisition of Multidrug-Resistant Pseudomonas aeruginosa Producing SPM Metallo-β-Lactamase

2005 ◽  
Vol 49 (9) ◽  
pp. 3663-3667 ◽  
Author(s):  
Simone Aranha Nouér ◽  
Marcio Nucci ◽  
Márcia P. de-Oliveira ◽  
Flávia Lúcia Piffano Costa Pellegrino ◽  
Beatriz Meurer Moreira
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Case Patient ◽  
Case Definitions ◽  
Duration Of Hospitalization ◽  
History Of

ABSTRACT To evaluate risk factors for colonization or infection due to multidrug-resistant Pseudomonas aeruginosa (MDRPa) carrying the bla SPM gene (SPM-MRDPa) among hospitalized patients, we undertook a case control study at a 480-bed, tertiary-care university hospital. Two different case definitions were used. In the first definition, a case patient (SPM case patient) was defined as a patient who had at least one isolate of SPM-MDRPa (14 patients). In the second, a case patient (non-SPM case patient) was defined as a patient who had at least one isolate of non-SPM-MDRPa (18 patients). For each case patient, we selected two controls, defined as a patient colonized and/or infected by a non-MDRPa isolate during the same study period and with the closest duration of hospitalization until the isolation of P. aeruginosa as cases. The use of quinolones was the single independent predictor of colonization and/or infection by bla SPM MDRPa (odds ratrio [OR] = 14.70, 95% confidence interval [95% CI] = 1.70 to 127.34, P = 0.01), whereas the use of cefepime was the single predictor of colonization and/or infection by non-bla SPM MDRPa (OR = 8.50, 95% CI = 1.51 to 47.96, P = 0.01). The main risk factor for MDRPa was a history of antibiotics usage. Stratification of risk factor analysis by a precise mechanism of resistance led us to identify a specific antibiotic, a quinolone, as a predictor for SPM-MDRPa.

scholarly journals Prevalence of Congenital Ocular Anomalies in Paediatric Age Group (0 - 14 Years) in a Tertiary Care Hospital at Kancheepuram, South India

2021 ◽  
Vol 8 (14) ◽  
pp. 899-903
Author(s):  
Syed Ali Nasar Waris ◽  
Rubina Huda
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Age Group ◽  
Paediatric Age ◽  
History Of ◽  
Associated Risk Factors ◽  
Global Blindness

BACKGROUND Congenital ocular anomalies are one of the important causes of childhood blindness. Blindness is a serious public health issue, and also a social and economic problem worldwide. Majority of global blindness is avoidable and curable. Most of global blindness is in developing countries. The objectives of this study were to determine the prevalence of congenital ocular anomalies in the paediatric age group and its associated risk factors in a tertiary care hospital in Kancheepuram. METHODS This cross-sectional study was conducted among children of 0 – 14 years age group attending the ophthalmology department of SRM Medical College and Hospital, Kancheepuram from December 2018 to November 2020. Congenital ocular anomalies were detected by detailed ocular examination and the type of congenital ocular anomaly was assessed. Associated risk factors like family history of congenital ocular anomalies, family history of consanguinity and significant antenatal history of the mother of the children were collected. RESULTS Out of 9865 cases, we found that 61 cases had congenital ocular anomalies. There was a male preponderance. Majority of the cases were in the age group 0 - 5 years. A positive history of consanguinity was present in 10 % of cases. The most commonly found cases were congenital cataract and congenital dacryocystitis. CONCLUSIONS Children with congenital ocular anomalies and functional vision should be given glasses and low vision aid. There is a great need for early screening, detection and treatment by paediatric or trained ophthalmologists in referral hospitals. KEYWORDS Congenital Ocular Anomalies, Paediatric Age Group, Prevalence

scholarly journals Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

2015 ◽  
Vol 22 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Chantal Robitaille ◽  
Esther Dajczman ◽  
Andrew M Hirsch ◽  
David Small ◽  
Pierre Ernst ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Screening Program ◽  
Tertiary Care ◽  
Airflow Obstruction ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Targeted Screening ◽  
History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

Recovery of Both Vancomycin-Resistant Enterococci and Methicillin-ResistantStaphylococcus aureusFrom Culture of a Single Clinical Specimen From Colonized or Infected Patients

2009 ◽  
Vol 30 (2) ◽  
pp. 130-138 ◽  
Author(s):  
Sang Hoon Han ◽  
Bum Sik Chin ◽  
Han Sung Lee ◽  
Su Jin Jeong ◽  
Hee Kyung Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Multivariate Logistic Regression Analysis ◽  
University Hospital ◽  
Cell Contact ◽  
Patient Risk ◽  
Clinical Specimens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Objective.To describe the incidence of recovery of both vancomycin-resistant enterococci (VRE) and methicillin-resistantStaphylococcus aureus(MRSA) from culture of a single clinical specimen, to describe the clinical characteristics of patients from whom these specimens were recovered, and to identify the risk factors of these patients.Design.A retrospective cohort and case-control study.Setting.A tertiary care university hospital and referral center in Seoul, Korea.Methods.We identified 61 case patients for whom a single clinical specimen yielded both VRE and MRSA on culture, and 122 control patients for whom any clinical specimen yielded only VRE on culture. The control patients were selected by matching 2 :1 with the case patients for age, sex, and first date of sampling that led to isolation of VRE or both VRE and MRSA among 1,536 VRE-colonized patients from January 1, 2003, through December 31, 2006. To identify patient risk factors for the recovery of both VRE and MRSA in a single clinical specimen, we performed univariate comparisons between the 2 groups and then multivariate logistic regression analysis.Results.The incidence of recovery of both VRE and MRSA from culture of a single clinical specimen was 3.97% (for 61 of 1,536 VRE-colonized patients) over 4 years. Among these 82 single clinical specimens, the most common type was wound specimens (26.8%), followed by lower respiratory tract specimens (18.3%), urine specimens (17.1%), and catheter tips (15.9%). Of the 61 case patients, 14 (23.0%) had 2 or more single clinical specimens that yielded both VRE and MRSA on culture, and the longest interval from the first sampling that yielded both organisms to the last sampling that yielded both was 174 days. Independent patient risk factors for the presence of both VRE and MRSA in a single clinical specimen were chronic renal disease (odds ratio [OR], 7.00;P= .012), urinary catheterization (OR, 3.36;P= .026), and longer total cumulative duration of hospital stay within the previous year (OR, 1.03;P< .001).Conclusion.We confirmed that the recovery of VRE and MRSA from a single clinical specimen occurs continually. Because prolonged cell-to-cell contact can facilitate transfer ofvanA,close observation and surveillance for vancomycin-resistantS. aureus, especially among patients with risk factors for the recovery of both VRE and MRSA from a single clinical specimen, should be continued.

scholarly journals Prevalence of postnatal depression and associated risk factors among South Asian mothers living in a newly developing country

2016 ◽  
Vol 9 (6) ◽  
pp. 57
Author(s):  
Hashim Mohamed
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
South Asian ◽  
Postnatal Depression ◽  
Marital Problems ◽  
Primary Health ◽  
History Of ◽  
Associated Risk Factors ◽  
Asian Mothers

AbstractIntroductionPostnatal Depression (PND) is a major health problem affecting mother, her child and family.  Its prevalence and associated risk factors among South Asian mothers (SAM) living  in Qatar remain unknown. The objectives of this study were to estimate the prevalence of PND among (SEAM) in Qatar and to correlate risk factors contributing to the development of PND.Materials and methodsA total of (285 ) (SAM)females who were six months  postpartum were interviewed as  part of a prospective study conducted in primary health care centers in Qatar.  PND symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Descriptive statistics were used for summarizing the study and outcome variables. The χ2 test and ORs with 95% confidence intervals (CIs) were used for observation and quantifying the association between different variables. Multivariate binary logistic regression was used to identify the independent associated factors of PPD. P≤0.05 was considered significant. Variables included were age , occupation, education level ,previous psychiatric history ,comorbidities , ,history of depression during current  pregnancy, history of anxiety during current pregnancy, number of previous pregnancies, strong social support, husband support, marital problem before pregnancy and ongoing marital problems during current pregnancy.Results The prevalence of postnatal depression among 285 respondents was 33.2% .several psychosocial risk factors were significantly associated with postnatal depression and, after multiple regression analysis, a history of depressive illness ,anxiety ,marital problems before delivery ,a history of diabetes and asthma ,history of congenital malformations ,and lack of mother support.Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95), but marginally indicative of the risk of depressive symptoms.ConclusionThis study showed a high rate of depressive symptoms among(SAM) six months Postpartum . Future screening protocols  must be employed at primary care level and hospital based clinics in Qatar to detect and treat post natal depression.Keywords: postnatal  depression,  South Asians, primary health care ,Doha, EPDS  

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