scholarly journals A Cluster ofBacillus cereusBacteremia Cases among Injection Drug Users

2015 ◽  
Vol 26 (2) ◽  
pp. 103-104 ◽  
Author(s):  
Michael A Benusic ◽  
Natasha M Press ◽  
Linda MN Hoang ◽  
Marc G Romney
Keyword(s):  
Injection Drug Users ◽  
Drug Users ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Injection Drug ◽  
Hospital Treatment ◽  
Temporal Association ◽  
Common Source ◽  
Care Hospital ◽  
Heroin Use

Bacillus cereusis a ubiquitous spore-forming organism that is infrequently implicated in extraintestinal infections. The authors report three cases ofB cereusbacteremia among injection drug users presenting within one month to an urban tertiary care hospital. Treatment with intravenous vancomycin was successful in all three cases. While temporal association suggested an outbreak, molecular studies of patient isolates using pulsed-field gel electrophoresis did not suggest a common source. A review of the association ofB cereusinfections with heroin use and treatment of this pathogen is provided.

scholarly journals A Descriptive Study on Sepsis: Causes, Outcomes, and Adherence to Guidelines on Patients with Sepsis at a Tertiary Care Hospital in Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Anne Thushara Matthias ◽  
J. Indrakumar ◽  
Tharushi Ranasinghe ◽  
Shalini Wijekoon ◽  
Charuni Yashodara
Keyword(s):  
Sri Lanka ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Bundle ◽  
Common Source ◽  
Care Hospital ◽  
Poor Countries ◽  
Arterial Blood ◽  
Resource Poor ◽  
Sepsis Care

The global incidence of sepsis is increasing, and mortality remains high. The mortality is even higher in resource-poor countries where facilities and equipment are limited. The Surviving Sepsis Campaign (SSC) recommends an updated hour-1 bundle based on the evidence from the International Guidelines for Management of Sepsis and Septic Shock 2018. To reduce mortality from sepsis, compliance with the “bundle” is essential. Data from developing countries like Sri Lanka on the management of sepsis according to the SSC guidelines are not available. Hence, this study looks at the patient characteristics and management of septic patients at a tertiary care hospital in Sri Lanka. Patients admitted to the University Medical Unit of Colombo South Teaching Hospital from January to August 2019 fulfilling the inclusion criteria were included. The hour-1 sepsis bundle adherence, demographic data, and management were recorded. There were 387 patients: 163 males and 224 females. The age range was 15-95 with a mean age of 63. 83.7% were direct admissions while 16.3% were transfers from a peripheral hospital. The most common source of infection was urine (82 (21.2%)) followed by blood stream (105 (27.1%)) and skin and soft tissue (114 (29.5%)). One-hour SSC bundle compliance is as follows: administration of intravenous fluids: 42 (10.9%), blood cultures before antibiotics: 225 (58.1%), first dose antibiotic: 15 (3.9%), and arterial blood gas: 60 (15.5%). Staffing capacity did not make a difference to adherence to the bundle. The study mortality rate was 37 (9.6%). Binary logistic regression indicates that quick sequential organ failure assessment (qSOFA) score is a significant predictor of mortality (chi‐square=35.08, df=3, and p=0.001 (<0.05)) with an odds ratio (OR) of 7.529 (95% CI 3.597-14.323). The other predictors, age, sex, adherence to sepsis care bundle, and comorbidities, were not significant. In conclusion, mortality of sepsis is high and adherence to sepsis care bundle is poor in Sri Lanka even at a tertiary care hospital. Education and training of staff are needed to boost adherence. This will in turn improve quality of care and outcomes of septic patients in resource-poor countries.

scholarly journals A STUDY ON KNOWLEDGE, ATTITUDE AND PRACTICE OF SELF MEDICATION FOR DIARRHOEAAMONG UNDERGRADUATE MEDICAL STUDENTS IN A TERTIARY CARE HOSPITAL OF ASSAM

2020 ◽  
pp. 48-50
Author(s):  
Dipsikha Das ◽  
Kalpana Gohain
Keyword(s):  
Medical Students ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Common Source ◽  
Care Hospital ◽  
Undergraduate Medical Students ◽  
Self Medication ◽  
Medication Practice ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Introduction: Self medication is referred to the use of medications to treat self-diagnosed disorders or symptoms without a valid prescription. Self medication practice is seen widely due to availability of over the counter drugs and lack of awareness of adverse drug reactions. Aims and Objectives: To study the knowledge, attitude and practice of self medication for diarrhoea among undergraduate medical students in a tertiary care hospital of Assam. Materials and methods: A cross-sectional questionnaire based study was carried out among the Undergraduate medical students of Assam Medical College & Hospital, Dibrugarh. The questionnaire was designed to assess the Knowledge, attitude and practice of self-medication for diarrhoea. A total of 130 students were included in the study after obtaining written informed consent from them. The data of the completely filled up questionnaire was analyzed and presented as mean and percentage. Results: Out of 130 students 89.23% practised self-medication for diarrhoea. The most common cause of self medication practice was to save time and source of information was from medical textbooks. The most common source of medicines was medical stores and commonly used drugs for diarrhoea were ORS, Metronidazole, Ofloxacin, probiotics and anti-motility drugs. Only 17.25% of students had awareness of the harmful effects of self medication for diarrhoea. Conclusion: There is high prevalence of self-medication practice to treat diarrhoea among undergraduate medical students which necessitates proper education and awareness regarding the benefits and hazards associated with self medication practice.

scholarly journals FREQUENCY OF HBV, HCV, AND HIV AMONG INJECTION DRUG USERS (IDUS), AND CO-RELATION WITH SOCIOECONOMIC STATUS, TYPE USE AND DURATION OF SUBSTANCE USE.

2019 ◽  
Vol 26 (07) ◽  
pp. 1147-1150
Author(s):  
Muhammad Ilyas Jat ◽  
Ghulam Rasool Rind
Keyword(s):  
Socioeconomic Status ◽  
Substance Use ◽  
Drug Use ◽  
Injection Drug Users ◽  
Drug Users ◽  
Tertiary Care ◽  
Hiv Infections ◽  
Injection Drug ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Psychoactive drug use is a continual and chronic psychological and physical disease that is characterized by persistent substance use, regardless of detrimental results. Hepatitis B, C and HIV infections constitute serious healthcare issues worldwide. Objectives: To determine the frequency of HBV, HCV, and HIV among Injection Drug Users (IDUs), visiting a tertiary care centre at Karachi, Pakistan, co-relation with socioeconomic status, type of substance use and duration of substance use. Study Design: A descriptive cross-sectional study. Setting: Psychiatry Outpatient Department (OPD), Department of Psychiatry and Behavioral Sciences, JPMC, Karachi. Period: 5th Aug 2016 to 5th Feb 2017. Material and Methods: Total 280 cases of both genders having Injection Drug Use history were enrolled in the study. Non-probability (consecutive) sampling was done. The data was analysed on SPSS version 20.0. Results: The average age of patients was 32.26 ±9.83 years. Majority 256 (91.4%) were male. Out of 280, 142 (50.7%) were married, 108 (38.6%) were single, 20 (7.1%) were widow and 10 (3.6%) were divorced/separated. Most of patients belonged to lower socioeconomic class. Opioids were the most common substance used and most of patients were using substance for more than 2 years. Majority of patients were preliterate or educated till primary and were jobless. HCV was predominantly present followed by HBV, HIV as 47 (16.8%), 22 (7.9%) and 9 (3.2%) respectively. Conclusion: Frequency of infections with HBV, HCV and HIV is quite high and alarming.

scholarly journals Elevated troponin level as a predictor of inpatient mortality in patients with infective endocarditis in the Southeast United States

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
William Lorson ◽  
Michael P. Veve ◽  
Eric Heidel ◽  
Mahmoud A. Shorman
Keyword(s):  
Infective Endocarditis ◽  
Injection Drug Users ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Injection Drug ◽  
Care Hospital ◽  
Troponin Level ◽  
Elevated Troponin ◽  
Inpatient Mortality ◽  
Methicillin Resistant

Abstract Background Despite recent improvement in management, infective endocarditis (IE) continues to be associated with considerable risk of morbidity and mortality. Early identification of predictors of inpatient mortality is key in improving patient outcomes in IE. The aim of our study was to evaluate the role of serum troponin levels measurements as a marker of increased mortality. Methods A case-control study included adult patients with IE admitted to a tertiary care hospital in east Tennessee between December 2012 and July 2017. Cases were defined as patients with definitive IE who died in-hospital; controls were patients who did not die in hospital. First patient admission was included only. Data collected included the patients’ demographic and baseline clinical information, microbiological data, injection drug use status, elevated serum troponins levels. Results Two hundred eighty three patients with definitive IE were included; median (IQR) age was 41 (30–57) years, and 153 (54%) patients were men. One-hundred sixty-four (58%) were injection drug users. The most frequent IE type was: 167 (59%) right-sided, 86 (30%) left-sided, 24 (9%) both left and right-sided, and 10 (4%) device related. The most commonly isolated organism was Staphylococcus aureus (n = 141), and 64% were methicillin-resistant. Two-hundred twelve (75%) patients had a troponin level obtained, and 57 (27%) had an elevated troponin value. Thirty-six (13%) patients died in-hospital; in-hospital mortality was associated elevated troponin values (adjusted odds ratio [adjOR], 7.3; 95%CI, 3.3–15.9), and methicillin-resistant S. aureus IE (adjOR 2.6; 95%CI, 1.2–5.8). Forty-four (16%) patients received IE valve surgery, and none of these patients died in the hospital. Conclusion Inpatient mortality was higher in patients with IE and elevated cardiac troponin levels compared to patients with normal levels.

Correlates of HIV Seropositivity among Injection Drug Users Not in Treatment

1992 ◽  
Vol 22 (4) ◽  
pp. 849-866 ◽  
Author(s):  
Martin Y. Iguchi ◽  
Jerome J. Platt ◽  
John French ◽  
Robert C. Baxter ◽  
Harvey Kushner ◽  
...  
Keyword(s):  
Injection Drug Users ◽  
Drug Users ◽  
Injection Drug ◽  
Global Rating ◽  
Heroin Use ◽  
Health History ◽  
Crack Use ◽  
Race And Education ◽  
Aids Risk ◽  
Hiv Risk Assessment

In 1989, from May to December, 1,440 injection drug users (IDUs) in Newark and Jersey City, not enrolled in treatment, were recruited by outreach to storefront offices, where they were interviewed about AIDS-risk behaviors and tested for antibodies to HIV. Information was gathered on drug use and sexual patterns, health, criminality and demographics. Data from 1,278 IDUs (88.75%) were analyzed; 667 (52.5%) tested HIV-antibody positive. Using univariate and multivariate analysis, thirteen variables were identified that were significantly and independently associated with seropositivity, including years since first drug injection, injecting mixed heroin and cocaine, frequent injection of cocaine by itself, no “crack” use, no noninjected heroin use, time in jail, abuse of glue or paint thinner, absence of sexual activity, subjects' global rating of their own AIDS risk, health history, gender, race and education. Implications for HIV risk assessment in other regions and for the development of interventions are discussed.

scholarly journals Critical analysis of disaster management plan in a tertiary care hospital

2021 ◽  
Vol 9 (4) ◽  
pp. 1163
Author(s):  
Ravi Kumar Gupta ◽  
Aditi Mehra ◽  
Sonali Shamdasani
Keyword(s):  
Disaster Management ◽  
Emergency Response ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Management Strategies ◽  
Management Plan ◽  
Hospital Treatment ◽  
Care Hospital ◽  
Hospital Emergency ◽  
Trained Manpower

Background: Disaster in hospital is when the resources of the hospitals (infrastructure, trained manpower and organization) are over-whelmed beyond its normal capacity and additional contingency measures are required to control the event. The calculation of hospital treatment capacity provides a baseline for Hospital Administration to plan accordingly. Critical anaylsis of the disaster management strategies as per the hospital emergency response checklist – an all hazards tool for hospital administrators and emergency managers helps in identifying the gaps and strengthening the disaster management plan.Methods: The study is a retrospective analysis of the response of a tertiary care hospital vis a vis hospital emergency response checklist.Results: The disaster preparedness was analyzed according to the hospital emergency response checklist and gaps were identified.Conclusions: The need for a comprehensive and easily deployable disaster management plan cannot be emphasized enough. The tools of continuous quality improvement can be used and analysis may be used to further strengthen the plan. 

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