Risk Factors for Gastrointestinal Stromal Tumors: A 10-Year Retrospective Review from a Tertiary Care Facility

2015 ◽  
Vol 110 ◽  
pp. S1015
Author(s):  
Shahzaib Nabi ◽  
Adeel Arshad ◽  
Absia Jabbar ◽  
Mona Hassan ◽  
Philip Kuriakose
Keyword(s):  
Risk Factors ◽  
Retrospective Review ◽  
Gastrointestinal Stromal Tumors ◽  
Tertiary Care ◽  
Care Facility ◽  
Stromal Tumors ◽  
Tertiary Care Facility

Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country

2017 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
Erum S Khan ◽  
Sheikh Irfan ◽  
Natasha Khalid
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Developing Country ◽  
Gynecologic Oncology ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Care Facility ◽  
Site Infection ◽  
Tertiary Care Facility

ABSTRACT Introduction Surgical site infections (SSIs) are among the most common complications in surgical patients and have serious consequences for outcomes and costs. There is a dearth of information on risk factors for developing SSI in patients undergoing gynecologic cancer surgery, and this has not been studied using national data. Objectives The objectives of this study were to estimate the prevalence, preoperative and operative risk factors associated with the higher risk of SSIs in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Setting Department of Obstetrics and Gynaecology, Aga Khan University Hospitals, Karachi, Sindh, Pakistan. Materials and methods Retrospective record review of gynecologic oncology patients admitted for surgery from January 2015 to December 2015 was performed. Results A total of 100 patients met the inclusion criteria. Of these, 15 were identified with SSIs, which were all found to be of the superficial type. Approximately, 44, 40, and 7% were diagnosed with endometrial, ovarian, and cervical cancers respectively. The mean time from surgery to developing SSI was 12.9 days. Among endometrial cancer, 22.7% (10/44) had SSI compared with 7.5% (3/40) for ovarian cancer and 14.2% (1/7) for cervical cancer. The significant predictors of SSI were body mass index ≥35 (p-value <0.004), endometrial cancer diagnosis, the American Society of Anesthesiologists class more than 3, modified surgical complexity scoring system 3 to 4, and blood sugar levels more than 180 mg/dL within 48 hours after surgery in known diabetics. Conclusion About 15% of patients undergoing laparotomy for gynecologic malignancy developed SSIs. In this study, we identified several risk factors for developing SSI among gynecologic cancer patients. These findings may contribute toward identification of patients at risk for SSIs, and the development of strategies to reduce SSI rate and potentially reduce the cost of care in gynecologic cancer surgery. How to cite this article Khan ES, Irfan S, Khalid N. Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country. J South Asian Feder Menopause Soc 2017;5(1):23-27.

scholarly journals DEMOGRAPHICS AND CORRELATION OF RISK FACTORS FOR HEPATOCELLULAR CARCINOMA IN PATIENTS PRESENTING TO A TERTIARY CARE FACILITY IN PAKISTAN

2021 ◽  
Vol 71 (2) ◽  
pp. 614-18
Author(s):  
Hafsa Rashid ◽  
Laima Alam ◽  
Muhammad Asif Farooq ◽  
Muhammad Zafar Ali
Keyword(s):  
Risk Factors ◽  
Tumor Staging ◽  
Tertiary Care ◽  
Care Facility ◽  
Decompensated Cirrhosis ◽  
Military Hospital ◽  
Continuous Variables ◽  
Male Population ◽  
Cross Sectional ◽  
Tertiary Care Facility

Objective: Demographics of HCC in Pakistan. Correlation of HCC with its possible etiology. Correlation of tumoraggressiveness with PCR status and anti-viral treatment. Study Design: Cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi from Jul 2017 to Jun 2018. Methodology: Patients with age >18 years presenting with space occupying lesion(s) of liver were confirmed to be HCC according to standard guidelines. The variables such as age, gender, presence of cirrhosis, etiology of cirrhosis, tumor staging, viral status through PCR study and the treatment offered were documented. Baseline descriptive data was reported as mean with SD for continuous variables. Chi square test was used to compare qualitative data. Results: A total of 195 patients were enrolled for one year. Male population with HCC was in predominance (75.9%). Sixty one percent of the afflicted population was having liver cirrhosis, 34.9% had decompensated cirrhosis and 3.8% had no cirrhosis. HCV accounted for the bulk of patients with cirrhosis (82%) followed by HBV (9.2%), HBV and HCV co-infection (3.1%), NASH and cryptogenic cirrhosis (1.5% each). Majority got diagnosed with triphasic CECT scan Abdomen, only 3.6% needed liver biopsy for diagnosis. Majority (43.6%) belonged to BCLC B. Viral PCR was positive for 58.5% and 73.8% of the patients were treatment naïve. Conclusion: HCC shows highest rates seen in male patients presenting in old age. Gender, classes of cirrhosis, number of lesions, portal vein thrombosis and extrahepatic metastasis correlated with possible risk factors of HCC. Tumor aggressiveness correlated with PCR status..............

scholarly journals An audit of extra-uterine pregnancy in a tertiary care facility in Northern India

2017 ◽  
Vol 6 (11) ◽  
pp. 5025
Author(s):  
Sheeba Marwah ◽  
Kumari Usha Rani ◽  
Archana Mishra
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Previous History ◽  
Care Facility ◽  
First Trimester ◽  
Hospital Data ◽  
Northern India ◽  
Tertiary Care Facility ◽  
Incidence Risk

Background: Ectopic pregnancy is the most frequent lethal gynaecological predicament, befalling worldwide in all strata of reproductive women. It remains the leading cause of pregnancy-related first trimester deaths. Though prompt diagnosis has furthered a decline in associated morbidity, an upsurge has been seen in its prevalence owing to a rise in predisposing risk factors. The objectives of this study were to identify incidence, risk factors, and outcome in patients presenting with ectopic pregnancy in a tertiary care hospital.Methods: This two-year retrospective study was conducted in Department of Obstetrics and Gynecology in Vardhaman Mahavir Medical College and Safdarjung hospital, on patients presenting with a diagnosis of ectopic pregnancy (either ruptured or un-ruptured). The primary outcome was incidence of ectopic pregnancy. Secondary outcomes noted were demographic characteristics, predisposing risk factors, clinical presentation and management course in hospital. Data was recorded on a predesigned proforma and deciphered later.Results: Incidence of ectopic pregnancy was 0.82%. Significant causative factors were previous history of PID (29.28%), TB (21.4%), previous pelvic surgeries (18.57%) and preceding ectopic pregnancy (12.14%).Conclusions: Increase awareness and knowledge of risk factors amenable to modification and features will aid early diagnosis of extra-uterine pregnancy, besides planning conservative treatment if possible, and devising effective risk-reduction strategies.

Sympathetic Cochleolabyrinthitis in Revision Stapedectomy Surgery

2002 ◽  
Vol 126 (3) ◽  
pp. 273-280 ◽  
Author(s):  
Michele L. Richards ◽  
Jacquelyn E. Moorhead ◽  
Patrick J. Antonelli
Keyword(s):  
Hearing Loss ◽  
Revision Surgery ◽  
Retrospective Review ◽  
Tertiary Care ◽  
Bone Conduction ◽  
Care Facility ◽  
Speech Reception ◽  
Tertiary Care Facility ◽  
Contralateral Ear ◽  
Air Conduction

OBJECTIVE: The purpose of this study was to determine whether revision stapedectomy could precipitate sensorineural hearing loss in the contralateral ear. METHODS: We conducted a retrospective review of 148 patients undergoing primary or revision stapedectomy at an academic, tertiary care facility. RESULTS: Stapedectomy resulted in significant improvements in mean air conduction thresholds in the ipsilateral ear. Overall, there were no significant changes in either the air or bone conduction values of the contralateral ear. Two patients demonstrated a >20-dB decline in speech reception threshold and/or >20% decrease word recognition in the contralateral ear. Both of these patients demonstrated the decline only after revision surgery. CONCLUSION: Revision stapedectomy is on rare occasions associated with hearing loss in the contralateral ear. Contralateral hearing loss after revision stapedectomy may be due to sympathetic cochleolabyrinthitis.

Risk Factors for Surgical Site Infection Complicating Laminectomy

2007 ◽  
Vol 28 (9) ◽  
pp. 1060-1065 ◽  
Author(s):  
N. Deborah Friedman ◽  
Daniel J. Sexton ◽  
Sarah M. Connelly ◽  
Keith S. Kaye
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Risk Index ◽  
Tertiary Care ◽  
Operating Experience ◽  
Care Facility ◽  
Site Infection ◽  
Surgical Specialty ◽  
Tertiary Care Facility ◽  
Independent Risk Factors

Objective.To examine risk factors for surgical site infection (SSI) following spinal surgery and to analyze the associations between a surgeon's years of operating experience and surgical specialty and patients' SSI risk.Design.Case-control study.Setting.A tertiary care facility and a community hospital in Durham, North Carolina.Patients.Each case patient who developed an SSI complicating laminectomy was matched with 2 noninfected control patients by hospital, year of surgery, and National Nosocomial Infection Surveillance System risk index score.Results.Forty-one case patients with SSI complicating laminectomy and 82 matched control patients were analyzed. Nonwhite race, diabetes and an elevated body mass index (BMI) were more common among case patients than among control patients. Subjects with a BMI greater than 35 were more likely to undergo a prolonged procedure, compared with case patients who had a BMI of 35 or less. The SSI rate for patients operated on by neurosurgeons was 28%, compared with 43% for patients operated on by orthopedic surgeons (odds ratio [OR], 0.5; P = .12). The number of years of operating experience were not associated with SSI risk. Multivariate analysis revealed diabetes (OR, 4.2 [95% confidence interval {CI}, 1.1-16.3]; P = .04), BMI greater than 35 (OR, 7.1 [95% CI, 1.8-28.3]; P = .005), and laminectomy at a level other than cervical (OR, 6.7 [95% CI, 1.4-33.3]; P = .02) as independent risk factors for SSI following laminectomy.Conclusion.Diabetes, obesity, and laminectomy at a level other than cervical are independent risk factors for SSI following laminectomy. Preoperative weight loss and tight perioperative control of blood glucose levels may reduce the risk of SSI in laminectomy patients.

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 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 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.

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