Contamination assessment of orthodontic bands after different pre-cleaning methods at a tertiary care hospital

2019 ◽  
Vol 46 (3) ◽  
pp. 220-224 ◽  
Author(s):  
Sarah Irfan ◽  
Seema Irfan ◽  
Mubassar Fida ◽  
Israr Ahmad
Keyword(s):  
Bacterial Growth ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Brain Heart Infusion ◽  
University Hospital ◽  
Growth Effect ◽  
Care Hospital ◽  
Contamination Assessment ◽  
Significant Difference ◽  
Cleaning Methods

Introduction: Infection control in dentistry is a major concern due to risk of transmission of communicable diseases. The aim of this study is to evaluate and compare the efficacy of various pre-cleaning methods for the tried-in orthodontic bands. Material and methods: An in-vitro experimental study was conducted at the Central Sterilization Services Department (Dental Clinic) and the Microbiology lab at our university hospital. A total of 130 bands were included in our study which comprised 10 controls and the rest were equally divided into three groups according to the pre-cleaning methods, i.e. manual scrubbing, enzymatic solution and a combination of both. The orthodontic bands were incubated in the brain heart infusion broth at 37 °C for five days after pre-cleaning and sterilisation in a steam autoclave and were assessed for any bacterial growth. The chi-square test was applied to determine any significant association between the various pre-cleaning methods and the frequency of bands that showed growth. Effect size was calculated using the phi coefficient. Results: The enzyme method revealed 5% of the sample to exhibit bacterial growth, whereas manual scrubbing and the combination of both showed no growth. There was no statistically significant difference among the three methods ( P = 0.131). Further investigations showed the presence of Staphylococcus non-aureus bacterial species in contaminated bands from group II. Conclusions: All pre-cleaning methods were found to be equally effective in the decontamination of bands. Hence, the tried-in bands can be safely reused after pre-cleaning and sterilisation.

Surgical-site infections in emergency abdominal paediatric surgeries at a tertiary-care hospital in Pakistan

2020 ◽  
pp. 1-9
Author(s):  
Ali Faisal Saleem ◽  
Huma Faiz Halepota ◽  
Hasaan Omar ◽  
Areeba Zain ◽  
Muhammad Arif Mateen Khan
Keyword(s):  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Stable Condition ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Site Infection ◽  
Significant Difference ◽  
Pathogen Occurrence

Abstract A retrospective chart review was carried out in children (neonates to 18 years) who underwent acute surgical abdominal exploration during 2012-2016 at the Aga Khan University Hospital, Karachi, to evaluate the post-operative surgical site infection rates in emergency paediatric abdominal surgery. Incidence of surgical site infection (SSI) was estimated. P-value was calculated, chi-square and non-parametric tests were performed by comparing pre-surgical and post-surgical procedure pathogen occurrence and pre-procedure wound status. Pathogen occurrence related to time-trend of 98 paediatric patients who underwent emergency abdominal surgery was plotted. Of the 94 who were discharged in stable condition, it was found that there was no significant difference between pre- and post-surgical pathogens. Escherichia coli (n=10) was found to be the most common pathogen. Contaminated wounds were associated with higher SSI (p=0.036, OR 1.95 95% CI 0.7-5.4). Continuous...  

MO1017PSYCHOSOCIAL REPERCUSSIONS AND QUALITY OF LIFE OF CHILDREN UNDERGOING HEMODIALYSIS IN A DEVELOPING COUNTRY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Salma Naouaoui ◽  
Kamal Ahtitich ◽  
Meriem Chettati ◽  
Wafaa Fadili ◽  
Inass Laouad
Keyword(s):  
Quality Of Life ◽  
Tertiary Care ◽  
Life Assessment ◽  
University Hospital ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Daily Life Activities ◽  
Significant Difference

Abstract Background and Aims Despite major advances in the provision of renal replacement therapy, children and adolescents on dialysis frequently have compromised daily life activities and a worse quality of life compared with healthy peers. While these aspects have been studied extensively in affluent countries, data from developing regions are scant. The aim of our study was assessing the psychosocial repercussions and the quality of life (QoL) of children with end stage renal disease (ESRD) undergoing hemodialysis in a Moroccan tertiary care hospital and comparing them with healthy controls. Methods We performed a cross-sectional investigation, at Mohammed VI university hospital of Marrakesh, using parent/child reports of generic module for QoL assessment: PedsQLTM Inventory version 4 for both cases and controls. Disease-specific module: PedsQLTM ESRD version 3 was used for ESRD cases. Twenty-two children on maintenance hemodialysis and 50 controls were enrolled in our study. Results The mean age of the ESRD cases was 11.6 ± 4.7 years (range 4– 18 years) with female predominance (58%). Controls were age- and sex-matched. A statistically significant difference was observed between ESRD cases and controls regarding all aspects of QoL. The total QOL mean score was 51.2 ± 13.6 and 82.8 ± 11.2 among cases and controls, respectively. All individual QoL domains were significantly worse in ESRD cases. Conclusion Our findings showed that the quality of life of children undergoing hemodialysis may be dramatically affected especially in limited-resources countries. And this raises the need to introduce quality of life assessment as a part of pediatric ESRD management.

scholarly journals Staphylococcus spp Resistance to Chlorhexidine: Is There Any Impact Related to the Routine Use for Hand Hygiene?

2020 ◽  
Vol 41 (S1) ◽  
pp. s390-s391
Author(s):  
Icaro Boszczowski ◽  
William Kazumassa Minami ◽  
Marcia Baraldi ◽  
Ana Paula Marchi ◽  
nia Alves dos Santos ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Efflux Pump ◽  
Tertiary Care ◽  
Intervention Group ◽  
Sodium Thiosulfate ◽  
Brain Heart Infusion ◽  
Control Group ◽  
Care Hospital ◽  
Significant Difference ◽  
The Impact

Background: Although guidelines recommend the use of chlorhexidine gluconate (CHG) for hand hygiene (HH), the impact of its routine use on antimicrobial resistance is not clear. Objective: To analyze the impact on the CHG susceptibility among isolates obtained from hands of HCW during its routine use for HH. Methods: We conducted a crossover study at 4 medical-surgical wards of a tertiary-care hospital in São Paulo, Brazil. In 2 units (intervention group), we established routine use of CHG for HH. For the other 2 units (control group), regular soap was provided. The availability of alcohol formulation for HH was not changed during the study. Every 4 months we swapped the units, ie, those using CHG changed for regular soap and vice versa. At baseline, we cultured the hands of HCWs. Only nursing staff hands were investigated. For hand culturing, HCWs placed their hands inside a sterile bag containing a solution of phosphate-buffered saline, Tween 80, and sodium thiosulfate. After the solution incubated overnight, it was inoculated onto brain-heart infusion. Next, it was plated on McConkey and Mannitol agar. MALDI-TOF was used for identification. Agar dilution was performed for Staphylococcus spp. We selected all Staphylococcus spp with MIC ≥ 8 and performed inhibition of efflux pump test. For isolates that showed a decrease of 2 dilutions, we searched the gene qacA/B by polymerase chain reaction. Results: We obtained 262 samples from HCW hands yielding 428 isolates. The most frequent genera were Staphylococcus spp (58%), Acinetobacter spp (8%), Enterobacter spp (8%), Stenotrophomonas spp (5%), Klebsiella spp (4%), Pseudomonas spp (3%), and others (14%). Staphylococcus spp were less frequent in the intervention compared to control group (43% vs 61%; OR, 0.48; 95% CI, 0.29–0.69; P = .005). Among all Staphylococcus spp, the proportion of chlorhexidine resistance (RCHG; MIC ≥ 8) was 12%. All resistant isolates recovered susceptibility after inoculation with pump-efflux inhibitor. For pump-inhibited isolates, 53% had the gene qacA/B amplified by PCR. We did not investigate RCHG among gram-negative isolates. There was a nonsignificant increase in Staphylococcus spp RCHG in the intervention group (4% to 6%; P = .90). Healthcare-acquired infection rates did not change significantly during the intervention. The consumption of CHG increased from 7.3 to 13.9 mL per patient day. Conclusions: We did not detect a significant difference in RCHG during the routine use of CHG for HH, although we observed increasing resistance. Further investigation is needed to clarify other reasons for increasing MIC to CHG.Funding: NoneDisclosures: None

Impact of Thyroid Dysfunction on Red Cell Indices in a Tertiary Care Hospital

2020 ◽  
Author(s):  
Erum Salim
Keyword(s):  
Thyroid Dysfunction ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
University Hospital ◽  
Categorical Variables ◽  
Care Hospital ◽  
Red Cell ◽  
Hematological Indices ◽  
Significant Difference ◽  
Red Cell Indices

Background: The role of thyroid gland is to regulate the hematopoiesis in the bone marrow, which is carried out by inducing erythropoietin gene expression. The study aimed to compare red cell indices among different thyroid dysfunction disorders patients in our setup. Methods: This retrospective observational study was conducted in Ziauddin University Hospital, Karachi in Clifton campus from January 2017 to September 2017. To maintain confidentiality, patient’s identification was deleted. Total number of recruited patients was 485, out of which 117 were labeled as hyperthyroid, 169 were hypothyroid and 199 were euthyroid. Subjects for all three groups were between 20-60 years old. TSH level of patients were determined by VITROS® ECiQ immunoassay analyzer by Enhanced chemiluminescence technique. Data analysis was done on SPSS 20 while, mean and Standard deviation were calculated for quantitative variables. Percentages and frequencies were calculated for categorical variables and an independent t-test was applied to see significant differences among the groups. Results: Comparison between hyperthyroid and hypothyroid groups revealed a statistically significant difference in the mean hemoglobin (p=0.036) and hematocrit (p=0.022). A statistically significant difference was also found in the RBC count (p=0.043) and hematocrit (p=0.032) while comparing hyperthyroid and euthyroid groups. There was no statistical difference between hypothyroid and euthyroid patients for any of the hematological parameters. Conclusion: There was a proven association between thyroid dysfunction and erythropoiesis, which caused hematological indices to fluctuate, therefore hematological parameters, should be monitored in patients with thyroid diseases.

scholarly journals Clinical Experience With Pulmonary Nocardiosis In A Tertiary Care Hospital In Pakistan

2019 ◽  
Author(s):  
Kashif Aziz ◽  
Habib Ahmad
Keyword(s):  
Clinical Experience ◽  
White Cell Count ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Immunocompromised Patients ◽  
Pulmonary Nocardiosis ◽  
Significant Difference ◽  
High Index Of Suspicion

Abstract Background Pulmonary nocardiosis is a rare disease. It usually affects immunocompromised patients. In this study we evaluated our clinical experience with pulmonary nocardiosis in our centre. Method It was a retrospective study done in Aga Khan University Hospital. Study was started after ethical approval. Cases from 2007 to 2017 were retrieved. Patient with diagnosis of Culture positive Pulmonary Nocardiosis with age more than 18 years included. Patient who were already on treatment of Nocardiosis at time of admission were excluded. Patients’ medical records were reviewed to identify epidemiologic, clinical, microbiologic, and radiographic features. Data was entered on SPSS V22. Results 56 patient met inclusion criteria but 12 had missing data so 44 patients’ data was included at end. 8 patients had disseminated disease. 52% were immunocompromised and 48% were immunocompetent. 31 were females. Diabetes mellitus was most common comorbidity. Fever and shortness of breath were most common presentations. Pleural effusion and consolidation were most common chest xray findings. Mean white cell count was 12.35±7 ×109/L. 70% patient had some degree of hyponatremia. Culture showed that all strains were sensitive to amikacin and 67% were sensitive to imipenum. Mean length of stay was 7.7days. 30 day mortality was 23%. 16% required ICU stay. There was significant difference between immunocompromized and immunocompetent group regarding 30 day mortality (p value 0.019) and ICU admission need (p value 0.021). Conclusion Pulmonary nocardiosis is often missed, high index of suspicion is required especially in immunocompromised patients and mortality is often very high.

Assessment of Bacterial Contamination of Orthodontic Arch wire

2019 ◽  
Vol 31 (1) ◽  
pp. 48-51
Author(s):  
Suha S Hassan ◽  
Nidhal H. Ghaib ◽  
Batool H Al-Ghurabi
Keyword(s):  
Bacterial Contamination ◽  
Microbial Contamination ◽  
Ethylenediaminetetraacetic Acid ◽  
Bacterial Species ◽  
Brain Heart Infusion ◽  
Control Groups ◽  
Dental Practitioners ◽  
Significant Difference ◽  
Bacillus Spp ◽  
Droplet Transmission

Background: The microorganisms can impend the life of health care professional and particularly the dental practitioners. They can be transmitted by different ways like airborne and droplet transmission. The current study was carried out to identify whether the arch wires that received from the manufactures are free from microbial contamination and to determine the bacterial species attached to the arch wires. Materials and Methods: This study involved eighty samples, consisted of two types of arch wires (nitinol and stainless-steel) from four companies (3M, G&H, Jiscop, OrthoTechnology). These wires inserted in a plane tube that contains 10 -ml of (Tris [tris(hydroxymethyl)aminomethane] and EDTA (ethylenediaminetetraacetic acid) tris-EDTA and brain heart infusion (BHI) broth. A 0.1 ml was withdrawn from the tube and spread on agar plates. The control groups consist of 16 plane tube (8 tubes with tris-EDTA and other 8 tubes with (BHI). Results: Microbial sampling yielded growth from 5 of the 80 arch wires. The predominant bacteria that isolated were Bacillus spp. No growth was recovered from 75 of the samples and from controls. The bacteria were isolated by BHI reagent and no growth was observed by tris-EDTA reagent with statistically significant difference (P<0.05). The Bacillus spp. found only in the G&H and Jiscop companies, however, no statistically significant difference was found among them (P>0.05). With regard to the presence and distribution of bacteria according to the types of wires, the present results clarified that cases of contamination with Bacillus spp. were found in the nitinol arch wires with statistically significant difference (P<0.05). Conclusions: The results of the current study revealed low count of bacterial contamination in the two types of companies (G&H and Jiscop). Not all materials that received from the manufactures are free from contamination and an effective sterilization regimen is needed to avoid cross-contamination.

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.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

2021 ◽  
Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash
Keyword(s):  
Outcome Measures ◽  
Functional Outcomes ◽  
Rating Scale ◽  
Tertiary Care ◽  
Depression Scale ◽  
Inpatient Rehabilitation ◽  
University Hospital ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

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