scholarly journals Correlation of predisposing factors and Esophageal Malignancy in high risk population of Baluchistan

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Syed Muhammad Ishaque ◽  
Muhammad Sadiq Achackzai ◽  
Zia Ud Din ◽  
Shahid Pervez

Objectives: To determine frequency of esophageal malignancy in Balochistan and to evaluate its correlation with predisposing and dietary factors. Methods: This cross-sectional study was conducted from Jan 2019 to Dec 2020, at two tertiary care hospital of Quetta which caters to the entire population of province. The total number of 207 cases of esophageal biopsies were received and morphological diagnosis done by H&E staining. Results: Out of 207 (N) esophageal biopsies cases, malignancy were observed in 65%, chronic esophagitis in 19%, benign esophageal lesion in 1% and other esophageal lesions were observed in less than 4% of samples. Association with aggravating factors included tea 80.5%, use of drugs 64%, spicy food 57%, salted food 53%, quid & tobacco taken orally and through nose 44% and cigarette smoking 21.5%. The protective factors include fresh fruit 90%, fish 64% and milk 55% which were never or occasionally taken, meat chicken and beef intake was 63% & 53% and vegetable intake was 52%, but 72.5% of cases never used alcohol and mutton meat was not used by 50%. Conclusion: Esophageal cancer was associated in those groups of people which may regard as having high risk factors. These include increased intake of spicy/salted food, hot beverages, drugs, quid and smoked tobacco, coupled with low intake of fruits and vegetables, lack of awareness and low socioeconomic status. doi: https://doi.org/10.12669/pjms.38.3.4612 How to cite this:Ishaque SM, Achakzai MS, Ziauddin, Pervez S. Correlation of predisposing factors and Esophageal Malignancy in high risk population of Baluchistan. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4612 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.

2021 ◽  
Vol 36 (2) ◽  
pp. e236-e236
Author(s):  
Adil Al Lawati ◽  
Faryal Khamis ◽  
Samiha Al Habsi ◽  
Khazina Al Dalhami

Objectives: Healthcare workers (HCWs), especially those working on the front line, are considered to be at high risk of nosocomial acquisition of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Little is known about the effectiveness of the recommended protective methods as few reports have described spread of the disease in hospital settings among this high-risk population. We describe the hospital-based transmission of SARS-CoV-2 related to non-invasive ventilation (NIV) in one of the main tertiary care hospitals in Oman. Methods: All exposed patients and HCWs from Royal Hospital were screened, quarantined, and underwent telephone interviews to stratify their risk factors, clinical symptoms, and exposure risk assessment. Results: A total of 46 HCWs and patients tested positive for SARS-CoV-2 after exposure to an index case who received 48 hours of NIV before diagnosing COVID-19 infection. Over half of the exposed (56.5%; n = 26) were nurses, 26.1% (n = 12) were patients, and 15.2% (n = 7) were doctors. None of the HCWs required hospitalization. Sore throat, fever, and myalgia were the most common symptoms. Conclusions: NIV poses a significant risk for SARS-CoV-2 transmission within hospital settings if appropriate infection control measures are not taken.


2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e26-e27
Author(s):  
Lea Restivo ◽  
Gurpreet Khaira ◽  
Amonpreet Sandhu ◽  
Susan Kuhn

Abstract Background The circumstance in which internationally adopted children are born and live prior to adoption put them at high risk for health issues. Nearly all adoptees have complex medical conditions, the most common being cleft lip/palate, orthopaedic problems, infectious diseases, congenital heart diseases, and/or nutritional deficiencies, as well as cognitive impairments, and/or developmental delays. Specifically, nearly all institutionalized children will have expressive language delays and most will have motor delays. Although improvement can be seen with time, most do not attain their full potential. Additionally, by nature of adoption, all children experience trauma. In some situations, this will be further compounded by neglect and/or abuse faced prior to adoption, or during institutionalization. Consequently, almost all adoptees develop attachment difficulties. Trained medical professionals are required to screen, monitor, and provide management suggestions for this complex and unique population. Objectives To our knowledge, parental experience of an international adoption clinic has not yet been published. This parent-based evaluation of the parental experience at a pediatric tertiary care center’s international adoption clinic, provides insights that may help guide provision of care for this high-risk population in our centre, throughout the country, and internationally. Design/Methods A qualitative, exploratory design was employed using telephone interviews of eighteen parents of adoptees assessed by a pediatric tertiary care center’s international adoption clinic since 2010. This approach was chosen to allow for more extensive exploration of parental experience, and to identify barriers and facilitators of care. Interviews were 30 to 90 minutes, semi-structured, and transcribed verbatim. Field notes were made during the interviews to note intonation and major concerns, and were used to supplement transcripts during data analysis. Questions covered experiences with pre-adoption counselling, arranging the first clinic visit, health and developmental assessments, life after clinic discharge, and general comments/suggestions. Thematic analysis was performed on the transcripts using Maguire’s step-by-step guide. Results Analysis resulted in four main themes and seven subthemes. The first theme was “difficulty of international adoption”. The second theme “utility and impact of services offered” was subdivided into “pre-adoption counselling”, “clinic visits and medical assessments”, and “post adoption seminars”. The third theme “the administrative procedures of the clinic” was subdivided into “timing and ease of organizing a first visit”, and “hours of operation”. The final theme “gaps in care” was divided into “ongoing difficulty with attachment”, and “allied healthcare services”. These results demonstrate that parents of internationally adopted children often feel overwhelmed by the medical needs of their children and feel unsupported. They recommend comprehensive and in-person pre-adoption counselling with standard referral processes to ensure timely access to care. Post-arrival medical and developmental assessments should be flexible and complete. Most importantly, clinics should incorporate support from allied healthcare professionals, including social work, psychology, occupational therapy, and physiotherapy. In particular, parents were interested in further management of attachment. Conclusion This first parent-based evaluation of the parental experience at a pediatric tertiary care center’s international adoption clinic provides insights that may help guide provision of care to this high-risk population in centres across Canada and internationally.


2017 ◽  
Vol 9 (01) ◽  
pp. 016-019 ◽  
Author(s):  
Swapna Muthusamy ◽  
Selvi Elangovan

ABSTRACT Introduction: Women with high-risk sexual behavior accounts for more than half of the sexually transmitted infection (STI) clinic attendees. The prevalence of trichomoniasis is as low as 5% in the general population to as high as 60% in high-risk population. This infection can pave the way to the acquisition of human immunodeficiency virus and other STIs, vice versa and is even associated with cancer. Objectives: To identify, isolate and study the prevalence of Trichomonas vaginalis in genital specimens of female outpatients. Materials and Methods: Total number of subjects involved in the study was 130, among them 85 belonged to high-risk group and 45 belonged to low-risk group. Two high vaginal swabs were collected from each patient. Saline wet mount, Giemsa stain, and culture in modified cysteine peptone liver infusion maltose medium were performed. Results were tabulated and analyzed. Results: Saline wet mount was positive for trichomoniasis in seven individuals, Giemsa detected trichomoniasis in five patients, and culture was positive in eight patients. Of these eight culture positive cases, one was wet mount negative and four were Giemsa stain negative. Conclusion: Culture is more sensitive than wet mount and Giemsa stain.


CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S54-S54
Author(s):  
J.A. Taylor ◽  
E.N. Vu ◽  
M. Dawar ◽  
J. Li Brubacher ◽  
A. Leon

Introduction: Influenza and pneumococcal disease are vaccine preventable diseases that account for significant morbidity and mortality in Canada. Influenza vaccination has been shown to reduce mortality and pneumococcal vaccination reduces invasive pneumococcal disease. Previous studies have shown that emergency department (ED) patients are often at high risk for influenza and pneumococcal disease and willing to be vaccinated during their ED stay. Our study set out to determine what proportion of adult patients in the ED qualify for and are willing to be vaccinated against influenza and pneumococcus during their ED visit. Methods: Our study used a convenience sample of patients presenting to the ED at a large Canadian tertiary care centre (Vancouver General Hospital). Inclusion criteria were: adult patients (19 years or greater); consenting to be screened for immunization status; and able to communicate in English. The exclusion criteria were: critically ill patients and patients in severe pain. The primary outcome was the proportion of patients presenting to the ED that could be immunized for influenza and pneumococcus (member of a high risk group, unvaccinated and willing to be vaccinated). Secondary outcomes included additional demographic characteristics and patient attitudes regarding vaccination. Results: We screened 413 patients of which 55 did not meet inclusion/exclusion criteria and 104 declined participation. A total of 254 patients completed the survey for a response rate of 71%. Our primary outcome was present in 20% of patients for influenza (high risk for complications, unvaccinated and willing to be vaccinated in the ED). For pneumococcus, 15% were at high risk, unvaccinated and willing to be vaccinated in the ED. In our population, 83% were at high risk of complications from influenza and 58% were at high risk of complications from pneumococcus. In total, 53% of patients would accept influenza vaccine and 44% would accept pneumococcal vaccine. Conclusion: Our study demonstrates that there is a significant high-risk population that is otherwise unreached and are willing to be vaccinated for influenza and pneumococcus in the ED. Our patient population has a very high prevalence of risk factors for complications of pneumonia and influenza. This data suggests that ED patients are a high-risk population and could be a target group for vaccination campaigns.


F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1798 ◽  
Author(s):  
João Fonseca ◽  
Flávio Costa ◽  
José Mateus ◽  
Diana Ferreira ◽  
Hugo Clemente ◽  
...  

Background: Unplanned readmissions are frequent, associated with high costs and potentially preventable. Pre-discharge risk screening is a crucial step to prevent hospital readmissions. This study evaluates the LACE index as a tool capable of identifying patients with high risk of early readmission or death in an older Portuguese population. Methods: We performed a retrospective study in a tertiary care hospital in Portugal. All acute patients, aged ≥ 65 years, discharged from the Internal Medicine Service between 1 January and 30 June 2014 were included. Data was collected from hospital records. The LACE index was calculated for each patient. A comparative analysis was performed based on a cutoff of 10 (≥10 indicates a high-risk population) for the LACE score. Results: 1407 patients were evaluated, with a mean age of 81.7±7.6 years; 41.2% were male, 52.2% were dependent for ≥1 activities of daily living, the average Charlson comorbidity index was 3.54±2.8. There were 236 (16.8%) readmissions, 132 (9.4%) deaths and 307 (21.8%) patients were dead and/or readmitted within 30 days of discharge. At 90 days, 523 (37.2%) patients were dead and/or readmitted. The LACE score was higher in patients who died or were readmitted within 30 days compared with those who were not (13.2±2.7 versus 11.5±3.0, p <0.0001). Patients with LACE score ≥10 had significantly higher mortality and readmission rates compared to those with LACE score <10: at 30 days, 25.5% versus 9.3% (OR 3.34, 95% CI 2.24-4.98, p <0.0001); at 90 days, 43.4% versus 16.2% (OR 3.98, 95% CI 2.89-5.49, p <0.0001). However, the discriminative capacity of LACE index assessed by C-statistic was relatively poor: 0.663 (95% CI 0.630-0.696) and 0.676 (95% CI 0.648-0.704), respectively. Conclusions: This study shows that the LACE index should be used with reservations for predicting 30 and 90-day readmission or death in complex elderly patients.


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