scholarly journals Rooming in and Breast Feeding Practices and Rate of Horizontal Transmission of SARS-CoV-2 Virus in 5 UAE Hospitals—An Observational Study

2021 ◽  
pp. 097321792110606
Author(s):  
Monika Kaushal ◽  
Venkata Subba Yamuna Tulasi ◽  
Ayush Kaushal ◽  
Aditya Rakhecha ◽  
Rafiq Memon ◽  
...  
Keyword(s):  
Observational Study ◽  
United Arab Emirates ◽  
Horizontal Transmission ◽  
Tertiary Care ◽  
Newborn Care ◽  
Perinatal Period ◽  
Retrospective Observational Study ◽  
Post Discharge ◽  
Formula Milk ◽  
Increased Risk

Objectives: To assess risks of mother to child horizontal transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus during rooming in and breastfeeding in infants born to mothers with the coronavirus (COVID-19) disease. Design: Retrospective observational study. Participants: Five tertiary care centers located in the United Arab Emirates. Infants born to mothers positive for SARS-CoV-2 polymerase chain reaction (PCR) at the time of delivery, born between April 1 and October 30, 2020. Methods: In this retrospective observational study, we analyzed the newborn care practices in various tertiary care hospitals and the rate of horizontal transmission of SARS-CoV-2 from mother to infant (horizontal) while rooming in, breastfeeding, and post-discharge. Results: There were total of 2,405 deliveries in the 5 stated hospitals of which 40 infants were born to mothers with positive SARS-CoV-2 PCR at the time of delivery. One infant tested positive for SARS-CoV-2 after birth at 24 h of life and had respiratory symptoms and fever. Twenty-three of the well infants were roomed in during their hospital stay and were breastfed. In 8 cases, the mother and baby were separated and isolated from the time of birth till discharge. 95% of the discharged infants were rooming in with mothers, 45% of the infants were exclusively breastfed, and 55% were on mixed feeding (breast milk and formula milk) at the follow-up. None of the infants developed significant health issues or symptoms attributable to SARS-CoV-2. Conclusion: The risk of mother to infant horizontal transmission of COVID-19 in the perinatal period is very low. Our study reaffirms the American Academy of Pediatrics guidelines that rooming in and breastfeeding of newborns born to SARS-CoV-2 positive mothers is safe without an increased risk of horizontal transmission by following mandated safety precautions.

scholarly journals Analysis of Management Approach to Newborn Care of Infants Delivered to COVID-19 Positive Mothers at Five Tertiary Care Centers in the UAE over a 7 Month Period 

2021 ◽  
Author(s):  
Monika Kaushal ◽  
Yamuna Tulasi ◽  
Ayush Kaushal ◽  
Aditya Rakhecha ◽  
Rafiq Memon ◽  
...  
Keyword(s):  
Observational Study ◽  
Tertiary Care ◽  
Newborn Care ◽  
Retrospective Observational Study ◽  
Management Approach ◽  
Post Discharge ◽  
Formula Milk ◽  
Increased Risk ◽  
Care Practices ◽  
Tertiary Care Centers

Abstract ObjectivesTo assess newborn care practices, clinical characters and risks of mother to child transmission during rooming in and breastfeeding in infants born to mothers with COVID-19.DesignRetrospective observational study.Participants5 Tertiary care centers located in the UAE. Infants born to mothers diagnosed with COVID-19 at the time of delivery, born between April 1st and October 30th 2020.MethodsIn this retrospective observational study, we analyzed the newborn care practices in various tertiary care hospitals and the rate of transmission of SARS-CoV-2 from mother to infant (vertical or horizontal) while rooming in, breastfeeding and post discharge. Results40 infants were born to mothers with COVID-19 at the time of delivery. One infant tested positive for SARS-CoV-2 after birth and had respiratory symptoms and fever. 23 of the well infants were roomed in during their hospital stay and were breastfed. In 8 cases, the mother and baby were separated and isolated from the time of birth till discharge. 95% of the discharged infants were rooming in with mothers, 45% of the infants were exclusively breastfed and 55% were on mixed feeding (breast milk and formula milk) at the follow-up. None of the infants developed significant health issues or symptoms attributable to SARS-CoV-2.ConclusionThe risk of mother to infant transmission of COVID-19 in the perinatal period is very low. Our study reaffirms the AAP guidelines that rooming in and breastfeeding of newborns born to COVID-19 positive mothers is safe without an increased risk of transmission by following mandated safety precautions.

scholarly journals ECG CHANGES IN PATIENTS WITH COVID-19 – A RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN CHENNAI

2021 ◽  
pp. 5-7
Author(s):  
A .Shaik Sulaiman Meeran ◽  
T. Balaji ◽  
P. Raja ◽  
Kiran Chandramohan
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Virus Disease ◽  
Tertiary Care ◽  
P Wave ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Icu Admission ◽  
Corona Virus ◽  
Increased Risk

Background:A global outbreak of corona virus disease, caused by severe respiratory corona virus 2, has emerged since December 2019. However electrocardiographic manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of ICU admission Methods:This retrospective observational study included the patients with COVID-19 at the Government Kilpauk Medical College, Chennai between June 1st and 31st, 2020. Demographic, clinical and ECG characteristics were collected and comparison were made between ICU and non ICU admission groups. Logistic regression was used to identify risk factors of ICU admission Results:Among the 159 patients included ST-T abnormalities were the most common ECG feature followed by arrhythmias. Compared with non ICU group, the ICU group showed higher heart rate and P wave duration and was more frequently associated with CVD, ST-T abnormalities, arrythmias, QTc prolongation and pathological Q waves. ST-T abnormalities and history of CVD were associated with increased risk of ICU admission Conclusion:COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission

scholarly journals Time in blood glucose range 70 to 180 mg/dL and survival rate in critically ill patients: A retrospective observational study

2020 ◽  
Author(s):  
Hiromu Naraba ◽  
Tadahiro Goto ◽  
Toru Shirakawa ◽  
Tomohiro Sonoo ◽  
Naoki Kanda ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Cox Proportional Hazards Model ◽  
Retrospective Observational Study ◽  
Sensitivity Analyses ◽  
Increased Risk ◽  
Blood Glucose Range

Objective: Time in targeted blood glucose range (TIR) 70-140 mg/dL has been associated with an increased risk of mortality in critically ill patients. Nevertheless, it remains unclear whether TIR is associated with 28-day mortality in critically ill patients under glycemic control with a less tight target glucose range of 70-180 mg/dL. We aimed to assess whether TIR 70-180 mg/dL was associated with 28-day mortality and to identify the optimal TIR. Design: A retrospective observational study. Setting: Data from a tertiary care centre in Japan, from 1 January 2016 through 31 October 2019. Participants: 1,230 adult patients admitted to the intensive care unit for more than three days. Outcome measure: The primary outcome was 28-day mortality. Results: Of 1,230 patients, patients with HbA1c ≥6.5% had a higher 28-day mortality than those with <6.5% (32.0% vs. 22.7%; p=0.003). In the multivariate logistic regression, TIR <80% was associated with an increased risk of 28-day mortality in patients with HbA1c <6.5% with an adjusted odds ratio (OR) of 1.88 (95% confidence interval [CI]: 1.36-2.61). When using 10% incremental TIR as a categorical variable, lower TIR was associated with worse 28-day mortality compared to TIR ≥90% in patients with HbA1c <6.5% (e.g., adjusted OR of TIR <60%, 3.62 [95%CI 2.36-5.53]). Similar associations were found in the analyses using the COX proportional hazards model. In addition, sensitivity analyses using TIR of the first three days showed that the overall associations were consistent with primary analyses. Conclusions: Our study demonstrated that lower TIR 70-180 mg/dL was associated with higher 28-day mortality in nondiabetic critically ill patients.

P–349 Does concomitant autoimmunity affect IVF/ICSI outcomes in women with endometriosis? A retrospective observational study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Rebecchi ◽  
N Salmeri ◽  
C Patruno ◽  
R Villanacci ◽  
P Rover Querini ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Observational Study ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Retrospective Observational Study ◽  
Histopathological Diagnosis ◽  
Increased Risk ◽  
The Mean ◽  
Icsi Outcomes

Abstract Study question To investigate differences in In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) outcomes between endometriosis women who do or don’t have a concomitant autoimmune disease. Summary answer Despite a higher oocyte yield, a trend for reduction in clinical pregnancy rates was observed in the autoimmunity group compared to women without concomitant autoimmunity. What is known already Endometriosis is an inflammatory chronic gynaecological disorder with a known detrimental impact on fertility. Endometriosis pathogenesis is still unclear. It has been postulated a role of both innate and adaptive immune system. The coexistence of endometriosis and autoimmunity is a well-documented occurrence Some recent findings have revealed an increased risk to have concomitant autoimmune disease in women with endometriosis, but no study has so far investigated whether this association could affect IVF/ICSI outcomes. Indeed, autoimmune phenomena, including proinflammatory cytokines and auto-antibody production, may result in diminished quality of oocytes/embryos with lower pregnancy rates among these patients. Study design, size, duration This was a retrospective observational study carried out at the Fertility Unit of IRCSS San Raffaele Hospital (Milan). We reviewed medical patients’ notes of women with a confirmed diagnosis of endometriosis who referred to our Fertility Unit from October 2018 to January 2021. Participants/materials, setting, methods Out of 1441 patients undergoing IVF/ICSI, 98 women had surgical/histopathological diagnosis of endometriosis. 25 of them had a clinical and/or serological diagnosis of autoimmunity. Autoimmunity was assessed by clinical data (blood tests for auto-antibodies or rheumatological records) obtained from the electronic patient files stored in the database of our Fertility Centre. Clinical pregnancy was defined as the presence of at least one intrauterine gestational sac with a viable embryo at week 6 after transfer. Main results and the role of chance 25/98 (25.5%) endometriosis women with a concomitant autoimmune disease (cases) were compared with 73/98 (74.5%) endometriosis patients without autoimmunity (controls). The mean age was 37.36±3.63 and 36.93±3.79 (p=.623) in cases and controls respectively. The mean number of oocytes retrieved was higher in cases (5.78±4.07) than in controls (3.82±2.69;p=.041); similarly, cases showed an higher number of embryos (2.13±1.93 vs. 1.19±1.37;p=.041) and blastocysts (1.89±2.02 vs. 0.85±1.61;p=.041) obtained. A total of 47 fresh embryo transfer (ET) were performed. Considering all the endometriosis patients, the clinical pregnancy rate (CPR) per cycle was 34.0% (16/47); when stratifying for the presence of autoimmunity the CPR was 23.1% (3/13) in cases, and 38.2% (13/34) in controls (p=.494). Limitations, reasons for caution This is a retrospective study based on data extraction from electronic records of our Fertility Centre. The sample size is limited and some information about past medical history could be missed. Results should be interpreted with caution until validated by future research providing more standardized data collection. Wider implications of the findings: Despite significantly higher numbers of oocytes retrieved and embryos/blastocysts formed, the presence of concomitant autoimmune disease in patients with endometriosis may impair pregnancy rates. Whether this finding is confirmed and whether it could be due to a defect in embryo/blastocysts quality or in endometrial receptivity deserves further studies. Trial registration number Not applicable

scholarly journals Predictors of Major Bleeding and Mortality in Dengue Infection: A Retrospective Observational Study in a Tertiary Care Centre in South India

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Kevin John John ◽  
Karthik Gunasekaran ◽  
John Davis Prasad ◽  
Divya Mathew ◽  
Sohini Das ◽  
...  
Keyword(s):  
Observational Study ◽  
Major Bleeding ◽  
South India ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Total Leukocyte Count ◽  
Severe Dengue ◽  
Elderly Age ◽  
Tertiary Care Centre

We conducted a retrospective observational study to describe the clinical profile and outcomes of patients admitted with a diagnosis of dengue fever in a tertiary hospital in South India. A total of 159 patients admitted from April 2014 to October 2018 were included in the study. Vomiting (70.4%), myalgia (60.4%), headache (42.1%), abdominal pain (38.4%), bleeding (38%), and rash (37.1%) were the most common symptoms at presentation. The mean duration of hospital stay was 4.9 days (SD ± 2.4), and the median cost was INR 19,708 ($285) (IQR INR 12,968–32,056 ($188–$305)). Major bleeding was associated with elevated SGOT and SGPT, severe dengue, and secondary dengue. Mortality was associated with elderly age; elevated total leukocyte count, serum bilirubin, serum creatinine, SGOT, and SGPT; and high SOFA score. In view of these observations, we recommend stratifying patients according to the WHO classification of dengue and avoiding the use of thrombocytopenia as a single marker of the severity of the illness.

Temporary Central Venous Catheter Utilization Patterns in a Large Tertiary Care Center Tracking the “Idle Central Venous Catheter”

2012 ◽  
Vol 33 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Sheri Chernetsky Tejedor ◽  
David Tong ◽  
Jason Stein ◽  
Christina Payne ◽  
Daniel Dressler ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Observational Study ◽  
Dwell Time ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Care Facility ◽  
Venous Catheter ◽  
Retrospective Observational Study ◽  
Central Venous ◽  
Tertiary Care Facility

Objectives.Although central venous catheter (CVC) dwell time is a major risk factor for catheter-related bloodstream infections (CR-BSIs), few studies reveal how often CVCs are retained when not needed (“idle”). We describe use patterns for temporary CVCs, including peripherally inserted central catheters (PICCs), on non-ICU wards.Design.A retrospective observational study.Setting.A 579-bed acute care, academic tertiary care facility.Methods.A retrospective observational study of a random sample of patients on hospital wards who have a temporary, nonimplanted CVC, with a focus on on daily ward CVC justification. A uniform definition of idle CVC-days was used.Results.We analyzed 89 patients with 146 CVCs (56% of which were PICCs); of 1,433 ward CVC-days, 361 (25.2%) were idle. At least 1 idle day was observed for 63% of patients. Patients had a mean of 4.1 idle days and a mean of 3.4 days with both a CVC and a peripheral intravenous catheter (PIV). After adjusting for ward length of stay, mean CVC dwell time was 14.4 days for patients with PICCs versus 9.0 days for patients with non-PICC temporary CVCs (other CVCs; P< .001). Patients with a PICC had 5.4 days in which they also had a PIV, compared with 10 days in other CVC patients (P< .001). Patients with PICCs had more days in which the only justification for the CVC was intravenous administration of antimicrobial agents (8.5 vs 1.6 days; P = .0013).Conclusions.Significant proportions of ward CVC-days were unjustified. Reducing “idle CVC-days” and facilitating the appropriate use of PIVs may reduce CVC-days and CR-BSI risk.Infect Control Hosp Epidemiol 2012;33(1):50-57

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