scholarly journals Clinical features and outcomes of infective endocarditis in Egypt: an 11-year experience at a tertiary care facility

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Hussein Hassan Rizk ◽  
Ahmed Adel Elamragy ◽  
Ghada Sayed Youssef ◽  
Marwa Sayed Meshaal ◽  
Ahmad Samir ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Tertiary Care ◽  
Care Facility ◽  
Period 2 ◽  
Peripheral Embolization ◽  
Tertiary Care Facility ◽  
Few Data ◽  
Healthcare Associated ◽  
Complications And Mortality

Abstract Background Few data are available on the characteristics of infective endocarditis (IE) cases in Egypt. The aim of this work is to describe the characteristics and outcomes of IE patients and evaluate the temporal changes in IE diagnostic and therapeutic aspects over 11 years. Results The IE registry included 398 patients referred to the Endocarditis Unit of a tertiary care facility with the diagnosis of possible or definite IE. Patients were recruited over two periods; period 1 (n = 237, 59.5%) from February 2005 to December 2011 and period 2 (n = 161, 40.5%) from January 2012 to September 2016. An electronic database was constructed to include information on patients’ clinical and microbiological characteristics as well as complications and mortality. The median age was 30 years and rheumatic valvular heart disease was the commonest underlying cardiac disease (34.7%). Healthcare-associated IE affected 185 patients (46.5%) and 275 patients (69.1%) had negative blood cultures. The most common complications were heart failure (n = 148, 37.2%), peripheral embolization (n = 133, 33.4%), and severe sepsis (n = 100, 25.1%). In-hospital mortality occurred in 108 patients (27.1%). Period 2 was characterized by a higher prevalence of injection drug use-associated IE (15.5% vs. 7.2%, p = 0.008), a higher staphylococcal IE (50.0% vs. 35.7%, p = 0.038), lower complications (31.1% vs. 45.1%, p = 0.005), and a lower in-hospital mortality (19.9% vs. 32.1%, p = 0.007). Conclusion This Egyptian registry showed high rates of culture-negative IE, complications, and in-hospital mortality in a largely young population of patients. Improvements were noted in the rates of complications and mortality in the second half of the reporting period.

scholarly journals CONVULSIVE STATUS EPILEPTICUS

2016 ◽  
Vol 23 (06) ◽  
pp. 660-664
Author(s):  
Dileep Kumar ◽  
Awais Bashir Larik ◽  
Amir Shahzad
Keyword(s):  
Status Epilepticus ◽  
Hospital Mortality ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Facility ◽  
Convulsive Status Epilepticus ◽  
Inhospital Mortality ◽  
Tertiary Care Facility ◽  
History Of ◽  
History Of Epilepsy

Objectives: To determine the in hospital mortality of convulsive status epilepticusin a tertiary care facility. Study Design: Cross sectional study. Place and Duration of Study:Neurology ward, Jinnah Postgraduate Medical Centre, Karachi, Medicine Department ofPeoples University Of Medical And Health Sciences Nawabshah from July 2015- Dec 2015.Material and Methods: All patients of either gender with age >15 years with status epilepticus,were included in the study. A detailed clinical history and relevant neurological examinationwas performed. All the patients who fulfill the inclusion criteria were enrolled in the study afterinformed written consent and explanation of the study protocol. All the information including inhospital mortality was entered on annexed proforma. All the patients were observed three to fivedays. Results: A total of 108 patients were included in this study fulfilling the inclusion criteria.The overall mean age of these patients was 31.3 ± 13.5 years. The age range of these patientswas 16 to 76 years. History of epilepsy was found in 106 (93.5%) of the patients, 88 (81.5%) ofthe patients had status epilepticus in past, 56 (51.9%) of the patients had drug withdrawal, 20(18.5%) of the patients had febrile illness and 2 (1.9%) of the patients had in hospital mortality.There was no statistical significance proportion difference was observed when comparedgender, history of epilepsy and status of epilepticus in past by in hospital mortality (p-values>0.05). Statistical significance proportion difference (p-value <0.05) was found in age and inhospital mortality. Conclusion: We recommend further studies to reach the firm conclusion.

Assessing Acute St-Elevation Myocardial Infarction With Prognostic Significance Of The Hyponatramia

2020 ◽  
Vol 11 (3) ◽  
pp. 3251-3260
Author(s):  
Makrand B Mane
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Care Facility ◽  
Early Death ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tertiary Care Facility ◽  
Significant Public Health

Acute Myocardial Infarction (AMI) has become a significant public health issue in developed and developing nations, following extensive diagnostic and management research over recent decades. The study intended to research the prognostic values of inexplicable Hyponatremia in patients with severe STelevation of myocardial infarction, in 100 consecutive patients admitted to Tertiary care hospital. In the analysis, identified patients on admission were diagnosed with or produced Hyponatremia within 72 hours—a lower ejection fraction than those with usual amounts of sodium. The research aimed to evaluate the prognosis significance of Hyponatremia for the estimation of early death in acute ST-elevated myocardial infarction. One hundred straight patients admitted in the Coronary Centre Tertiary Care Facility with severe STelevated myocardial infarction were studied. The data of the study on various risk factors in association with the development of Hyponatremia like as age, sex, use of tobacco, diabetes, hypertension, ejection fraction etc. were analyzed. Thus, the researchers reported that in patients diagnosed with severe ST section escalation, Hyponatremia showed the initial emergence of hyponatremia myocardial infarctions. This condition correlates with the severity of LV dysfunction (in term of LVEF) and can be considered as an individual early death indicator as well as a prediction exacerbates with hyponatremia frequency.

scholarly journals Characteristics of Critically Ill Patients with COVID-19 Compared to Patients with Influenza—A Single Center Experience

2021 ◽  
Vol 10 (10) ◽  
pp. 2056
Author(s):  
Frank Herbstreit ◽  
Marvin Overbeck ◽  
Marc Moritz Berger ◽  
Annabell Skarabis ◽  
Thorsten Brenner ◽  
...  
Keyword(s):  
Influenza A ◽  
Health Care Systems ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Facility ◽  
High Volume ◽  
Single Center Experience ◽  
Severe Influenza ◽  
Tertiary Care Facility ◽  
Care Systems

Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.

scholarly journals Assessment of diabetes among tuberculosis patients presenting at a tertiary care facility in Pakistan

2016 ◽  
Vol 5 ◽  
pp. S248 ◽  
Author(s):  
Muhammad Irfan ◽  
Naseem Salahuddin ◽  
Qamar Masood ◽  
Owais Ahmed ◽  
Umme Salama Moosajee ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Tuberculosis Patients ◽  
Tertiary Care Facility

Radionecrosis after Treating Oral Cavity & Oropharyngeal SCC

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P43-P44
Author(s):  
Sundip H Patel ◽  
Mike Yao ◽  
Tara Brennan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tertiary Care ◽  
Care Facility ◽  
Tertiary Care Facility ◽  
Pertinent Data ◽  
Associated Risk Factors ◽  
Oropharynx Squamous Cell Carcinoma

Objective 1) The primary goal of this study was to evaluate the incidence of radionecrosis among patients treated with radiation therapy for oral cavity & oropharynx squamous cell carcinoma at our institution. Many patients with oral cavity & oropharyngeal cancers receive radiation to preserve the tongue, knowing the risks of post-treatment radionecrosis. However, recent protocols have intensified chemo-radiotherapy in an effort to improve local control while possibly increasing risk. 2) Among those patients with radionecrosis, we also analyzed their cancer treatment regimen, associated risk factors, the severity of the radionecrosis and the resulting treatment they recieved. Methods We performed a retrospective review of all adult patients at our tertiary care facility with biopsy proven squamous cell carcinoma of the oral cavity & oropharynx from 1999 to 2007 who completed a full course of radiotherapy at our facility with at least 6 months follow-up. Medical charts were reviewed for the presence of radionecrosis as well as for other corresponding, pertinent data. Results After reviewing 241 patients, a total of 107 patients were included. 5 of 65 with oropharynx disease had radionecrosis, revealing an incidence of 7.7%. Among the oral cavity group there were 8 out of 42 patients with radionecrosis, revealing an incidence of 19%. The overall incidence among our treatment group was 12.1%. Conclusions Radiation-induced necrosis of the oral cavity & oropharynx is still a significant complication in the treatment of head and neck cancer and poses a higher risk in the oral cavity than the oropharynx.

scholarly journals MORTALITY AND COVID-19: A SNAPSHOT OF A TERTIARY CARE FACILITY IN PAKISTAN

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
MA Rana ◽  
A Qayyum ◽  
M Hashmi ◽  
MMU Saif ◽  
MF Munir ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cause Of Death ◽  
Tertiary Care ◽  
Sudden Cardiac Arrest ◽  
Care Facility ◽  
Multiple Organ ◽  
Coronary Syndrome ◽  
Tertiary Care Facility ◽  
Biochemical Profiles ◽  
Novel Coronavirus

Background: Since SARS CoV-2 infection began in China and has evolved into a pandemic, mortality associated with this illness has been under discussion and hypercoagubility, severe acute respiratory syndrome and septicemia with multiple organ insufficiency have been cursed as potential causes of death in cases infected with the novel coronavirus. We did a retrospective analysis of cases admitted to our highly dependent and intensive care unit, and we tried to identify the leading cause of death in our cases. Methods: This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3-month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. Results: A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. Conclusion: Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients.

scholarly journals Accidental childhood poisoning in Paediatrics department of a tertiary care facility: A retrospective review

2020 ◽  
Vol 47 (3) ◽  
Author(s):  
D.C. Obu ◽  
M.C. Orji ◽  
U.V. Muoneke ◽  
U.V. Asiegbu ◽  
G.O. Ezegbe
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Accidental Poisoning ◽  
Female Ratio ◽  
The Public ◽  
Tertiary Care Facility ◽  
Childhood Poisoning ◽  
The Mean ◽  
The Relationship ◽  
Male To Female

Background: Accidental childhood poisoning is a recognized preventable cause of morbidity and mortality among children worldwide. This studywas aimed at determining the prevalence, pattern, and outcome of childhood poisoning among children in Abakaliki, Ebonyi State. Material and Methods: Medical records of all cases of accidental childhood poisoning admitted into Children’s emergency room (CHER) of the health facility of study between January 2014 and December 2018 were retrospectively identified and relevant data extracted and analyzed usingSPSS version 22. Results: Out of the 7,700 children that presented to CHER over a 5- year period, 42 were cases of poisoning, giving prevalence rate of 0.5%. Of the 42 cases, only 20 case notes were retrieved. The male to female ratio was 2.3:1 while the ages ranged between 6months and 14 years with the mean age of 3.06±2.88. Kerosene poisoning had the highest proportion of 50.0% (10/20) with the overall mortality rate of 5.0% (1/20).The relationship between age, place of residence and outcome in poisoned children was statistically significant (p = 0.038, 0.045 respectively). Conclusion: Accidental childhood poisoning is common in Abakaliki. Kerosene still remained the major agent while male toddlers were most  vulnerable. There is need to intensify enlightenment campaigns and education of the public about the hazard of improper storage of kerosene and other implicated substances at home. Keywords: Accidental poisoning, Childhood, Kerosene

scholarly journals Indian diabetes risk profile of employees in a tertiary care facility in north Maharashtra: a cross sectional study

2021 ◽  
Vol 8 (10) ◽  
pp. 4944
Author(s):  
Shyam V. Ashtekar ◽  
Aryaman Singh ◽  
Manasi S. Padhyegurjar ◽  
Sidrah M. Shaikh ◽  
Abhimanyu R. Kapse ◽  
...  
Keyword(s):  
Physical Activity ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Diabetes Risk ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Waist Size ◽  
Tertiary Care Facility

Background: The rising prevalence of type 2 diabetes (T2D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T2D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T2D in the employees.Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T2D, cereal intake and weekly physical activity (PA) was obtained in interview.Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T2D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T2D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T2D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant.Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.

Abstract 19639: Infective Endocarditis Following Transcatheter Valve Implantation: A Systematic Review

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ignacio J Amat-Santos ◽  
Henrique B Ribeiro ◽  
Marina Urena ◽  
Ricardo Allende ◽  
Cristine Houde ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
High Risk ◽  
Hospital Mortality ◽  
Risk Profile ◽  
Electronic Search ◽  
Transcatheter Valve ◽  
Few Data ◽  
Valve Implantation ◽  
Transcatheter Valves ◽  
Very High

Objectives: To describe the incidence, features, predisposing factors and outcomes of infective endocarditis (IE) following transcatheter valve implantation (TVI). Background: Very few data exist on IE following TVI. Methods: Studies published between 2000 and 2013 regarding IE in patients with aortic (TAVI) or pulmonary (TPVI) transcatheter valves were identified through systematic electronic search. Result: A total of 28 publications describing 60 patients (32 TAVI, 28 TPVI) were identified. Most TAVI patients (66% males, 80±7 years) had a very high-risk profile (LogEuroSCORE: 30.4±14.0%, p<0.001 compared to previous TAVI registries). In TPVI patients (90% males, 19±6 years), IE was more frequent in stenotic conduit/valve (61%) (p <0.001 vs. previous TPVI series). Median time between TVI and IE was 5.5 (2-12) months. Typical microorganisms were mostly found with a higher incidence of enterococci after TAVI (34.4% vs. 0%, p =0.009), and S.aureus after TPVI (29.4% vs. 6.2%, p =0.041). Up to 60% of the TAVI-IE patients were managed medically despite related complications such as local extension, embolism and/or heart failure in >50% of patients. Valve explantation rate was 57% and 23% in balloon- and self-expandable valves, respectively (p=0.07). In-hospital mortality for TAVI-IE was 34.4%. Most TPVI-IE patients (75%) were managed surgically, and in-hospital mortality was 7.1%. Conclusions: Most cases of IE post-TVI were males, with a very high-risk profile (TAVI) or underlying stenotic conduit/valve (TPVI). Typical -but different- microorganisms of IE were involved in half of the TAVI and TPVI cases. Most TPVI-IE patients were managed surgically as opposed to TAVI patients, and mortality rate was high in both cohorts.

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