Thrombocytopenia and thrombocytosis as a predictor of neonatal sepsis: a hospital-based cross-sectional study

Background: Hematological changes in sepsis can aid in the early diagnosis of sepsis even before the culture reports are obtained. Of the various hematological parameters, the platelet count can be an early marker for sepsis. This study was carried out to evaluate the role of thrombocytopenia and thrombocytosis as a marker of sepsis in neonates.Methods: A cross-sectional study was carried out at neonatal intensive care unit (NICU) at a tertiary care center from1st January 2014 to 30th September 2014. During this period,623 neonates had features suggestive of sepsis, of which 190 turned to be having culture-positive sepsis. One hundred and ninety neonates aged between 0 to 28 days of life admitted in NICU with culture-positive sepsis were included in the study. The newborns were categorized based on platelet count and type of organism cultured. Chi square test was used to test statistical significance. P<0.05 was considered statistically significant.Results: Among 190 participants, 50% had gram-positive organisms in culture, 37.9% had gram-negative sepsis, and 12.1% had fungal sepsis. The prevalence of thrombocytopenia among the participants was 39.47%. There was a statistically significant difference across the type of organism in sepsis (p<0.05). The difference in outcome across the platelet count status was insignificant, with a p=0.391. Conclusions: The most common organism causing neonatal sepsis was gram-positive organisms, followed by gram-negative organisms and fungus. Thrombocytopenia was present in all forms of neonatal sepsis irrespective of the causation. Hence, thrombocytopenia can be considered as an early marker of neonatal sepsis.

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Antimicrobial Sensitivity Pattern of Isolates from Neonatal Sepsis in Yekatit 12 Teaching Hospital, Addis Ababa, Ethiopia

Ethiopian Pharmaceutical Journal ◽

10.4314/epj.v36i1.8 ◽

2020 ◽

Vol 36 (1) ◽

pp. 67-72

Author(s):

Oumer Sada Muhammed ◽

Getachew Alemkere ◽

Beshir Bedru Nasir

Keyword(s):

Teaching Hospital ◽

Neonatal Sepsis ◽

Addis Ababa ◽

Cross Sectional Study ◽

Gram Negative Bacteria ◽

Sectional Study ◽

Gram Positive ◽

Cross Sectional ◽

Gram Negative ◽

Sensitivity Pattern

Sepsis is one of the commonest reasons of neonatal deaths. It is accountable for about 30 - 50% of the whole baby deaths in the developing ountries. The current study aimed to assess drug susceptibility patterns of isolates from cases of neonatal sepsis. Institution based cross-sectional study was conducted among 132 neonates admitted to Yekatit 12 teaching hospital with the diagnosis of sepsis and who had a positive result for culture and sensitivity test. Data was collected through medical chart review using data abstraction tool. The data was analyzed using excel and reported using descriptive tables. Gram-negative bacteria were the commonest organisms identified 124 (93.9%), followed by gram-positive isolates (6.1%). Klebsiella (87.9%) was the predominant gram-negative bacteria. Of the gram-positive organisms, coagulase negative staphylococci (3.03%) were the commonest pathogen, followed by Staphylococcus aureus (2.27%). Among the gram-negative isolates, overall sensitivity was high to meropenem (96.0%), amikacin (94.3%) and amoxicillin + clavulanate (74.2%) but sensitivity was very low to ampicillin (2.7%), and amoxicillin (7.3%).Generally, the isolated pathogens were resistant to commonly used antibiotics in the study setting and resistance of gram-positive pathogens Against penicillins and cephalosporins was also high. Hence, rational and tailored antibiotic use based on the susceptibility data is recommended and regular antibiotic susceptibility surveillance should be conducted. Keywords: neonatal sepsis, cross-sectional study, antibiotics, culture, sensitivity, resistance

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Organism Specific Response of Platelet Count in Neonatal Sepsis

BIRDEM Medical Journal ◽

10.3329/birdem.v4i2.33193 ◽

2014 ◽

Vol 4 (2) ◽

pp. 79-83

Author(s):

Biplob Kumar Raha ◽

Md Abdul Baki ◽

Tahmina Begum ◽

Nazmun Nahar

Keyword(s):

Platelet Count ◽

Neonatal Sepsis ◽

Specific Response ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Prolonged Duration ◽

Fungal Sepsis ◽

Culture Positive

Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries and it is caused by Gram positive bacteria, Gram negative bacteria and fungi. Thrombocytopenia has been used as an early but nonspecific marker for sepsis. About 75% of culture positive neonates have thrombocytopenia. The severity and duration of thrombocytopenia varies in different types of organism. So, the objectives of this study were to examine platelet counts and platelet indices in neonates with culture proven sepsis and to determine if there was an organism specific platelet response.Methods: This cross- sectional prospective study was carried out in the special care baby unit (SCABU) under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka from November 2008 to September 2009.Results: Total 120 newborn babies with culture positive sepsis were included in this study. Gram positive bacteria was found in 06 (5%), Gram negative bacteria was found in 58(48.3%) and fungi was found in 56 (46.7%) neonates. Thrombocytopenia was found in 95% of culture positive neonates. When compared with neonates with Gram positive sepsis, those with Gram-negative or fungal sepsis had a significantly lower platelet count, platelet nadir and prolonged duration of thrombocytopenia (p=<0.05). Fungal sepsis was also associated with prolonged duration of thrombocytopenia when compared with that of Gram negative sepsis (p=0.03).Conclusion: Neonatal sepsis is frequently associated with thrombocytopenia. However, Gram negative and fungal sepsis is associated with a lower platelet count, platelet nadir and prolonged duration of thrombocytopenia compared with that of Gram positive sepsis.Birdem Med J 2014; 4(2): 79-83

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Organism specific platelet response in neonatal sepsis in neonates weighing ≤1800 gm

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212471 ◽

2021 ◽

Vol 8 (7) ◽

pp. 1195

Author(s):

Dipal M. Zanzrukiya ◽

Pareshkumar A. Thakkar ◽

Abhishek K. Thakkar

Keyword(s):

Platelet Count ◽

Neonatal Sepsis ◽

Tertiary Care ◽

Specific Marker ◽

Specific Response ◽

Platelet Response ◽

Gram Positive ◽

Gram Negative ◽

Significant Difference ◽

Fungal Sepsis

Background: Thrombocytopenia is an important but non-specific marker of severity of neonatal sepsis. Few studies have observed organism-specific response in platelet count, however this finding in not consistently seen in various studies. We carried out this study to look for organism-specific response of platelet count and indices in neonatal sepsis in our setup.Methods: A prospective analytical study was conducted during December, 2019 to November, 2020 at tertiary care centre of central Gujarat. Neonates weighing ≤1800 gm (n=100) were enrolled according to eligibility criteria. Sepsis screen including TLC, ANC, platelet count, platelet indices, micro ESR, CRP, and blood culture was done. Patients with culture-proven sepsis were divided according to organisms isolated from blood or CSF. Patients were followed up to the final outcome of their hospital stay. Appropriate analytical tests were used for the results.Results: Out of 100 patients, 69 had culture-proven sepsis, of which 40 (58%) were gram-negative, 21 (30%) were gram-positive and 8 (12%) had fungal sepsis. Of these 48/69 (70%) patients had thrombocytopenia. Of these patients with thrombocytopenia 60%, 30% and 10% in the first sample while 48%, 38% and 16% in the second sample had gram positive, gram negative and fungal sepsis respectively. Commonest organisms isolated were Enterococcus and MRCONS, and thrombocytopenia was not having specific correlation with any particular organism. There was no significant difference between mean and median platelet count of gram-positive, gram-negative, and fungal sepsis.Conclusions: Thrombocytopenia is significantly associated with neonatal sepsis. The effects of sepsis on platelet count are not organism-specific.

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Comparison of predicted psychological distress among workers between artificial intelligence and psychiatrists: a cross-sectional study in Tsukuba Science City, Japan

BMJ Open ◽

10.1136/bmjopen-2020-046265 ◽

2021 ◽

Vol 11 (6) ◽

pp. e046265

Author(s):

Shotaro Doki ◽

Shinichiro Sasahara ◽

Daisuke Hori ◽

Yuichi Oi ◽

Tsukasa Takahashi ◽

...

Keyword(s):

Neural Network ◽

Artificial Intelligence ◽

Psychological Distress ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Explanatory Variables ◽

The Neural Network ◽

Significant Difference ◽

Total Data

ObjectivesPsychological distress is a worldwide problem and a serious problem that needs to be addressed in the field of occupational health. This study aimed to use artificial intelligence (AI) to predict psychological distress among workers using sociodemographic, lifestyle and sleep factors, not subjective information such as mood and emotion, and to examine the performance of the AI models through a comparison with psychiatrists.DesignCross-sectional study.SettingWe conducted a survey on psychological distress and living conditions among workers. An AI model for predicting psychological distress was created and then the results were compared in terms of accuracy with predictions made by psychiatrists.ParticipantsAn AI model of the neural network and six psychiatrists.Primary outcomeThe accuracies of the AI model and psychiatrists for predicting psychological distress.MethodsIn total, data from 7251 workers were analysed to predict moderate and severe psychological distress. An AI model of the neural network was created and accuracy, sensitivity and specificity were calculated. Six psychiatrists used the same data as the AI model to predict psychological distress and conduct a comparison with the AI model.ResultsThe accuracies of the AI model and psychiatrists for predicting moderate psychological distress were 65.2% and 64.4%, respectively, showing no significant difference. The accuracies of the AI model and psychiatrists for predicting severe psychological distress were 89.9% and 85.5%, respectively, indicating that the AI model had significantly higher accuracy.ConclusionsA machine learning model was successfully developed to screen workers with depressed mood. The explanatory variables used for the predictions did not directly ask about mood. Therefore, this newly developed model appears to be able to predict psychological distress among workers easily, regardless of their subjective views.

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Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-043814 ◽

2021 ◽

Vol 11 (3) ◽

pp. e043814

Author(s):

Mesfin Tadese ◽

Andargachew Kassa ◽

Abebaw Abeje Muluneh ◽

Girma Altaye

Keyword(s):

Risk Factors ◽

Academic Performance ◽

University Students ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Grade Point ◽

Significant Difference ◽

Associated Risk Factors

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

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Evaluation of e-health (Seha) application: a cross-sectional study in Saudi Arabia

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01437-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abeer Alharbi ◽

Joharah Alzuwaed ◽

Hind Qasem

Keyword(s):

Saudi Arabia ◽

Health Services ◽

Healthcare Services ◽

Cross Sectional Study ◽

Advanced Technology ◽

Sectional Study ◽

Cross Sectional ◽

Technical Problems ◽

Significant Difference ◽

Ease Of Access

Abstract Background The Ministry of Health in Saudi Arabia is expanding the country’s telemedicine services by using advanced technology in health services. In doing so, an e-health application (app), Seha, was introduced in 2018 that allows individuals to have face-to-face visual medical consultations with their doctors on their smartphones. Objective This study evaluated the effectiveness of the app in improving healthcare delivery by ensuring patient satisfaction with the care given, increasing access to care, and improving efficiency in the healthcare system. Methods A cross-sectional study design was used to assess the perceptions of users of the Seha app and non-users who continued with traditional health services. The data were collected using an online survey via Google Forms between June 2020 and September 2020. Independent t tests and chi-square (χ2) tests were conducted to answer the research questions. Results There was a significant difference between users and non-users in terms of ease of access to health services (t = − 9.38, p < 0.05), with app users having a higher mean score (4.19 ± 0.91) than non-users (3.41 ± 1.00); satisfaction with health services (t = − 6.33, p < 0.05), with users having a higher mean score (3.96 ± 0.91) than non-users (3.45 ± 0.94); and efficiency (only one visit needed for treatment) (t = − 3.20, p < 0.05), with users having a higher mean score (3.71 ± 0.93) than non-users (3.45 ± 0.93). There were significant associations between the use of the Seha app and age (χ2 = 8.79, p < 0.05), gender (χ2 = 22.19, p < 0.05), region (χ2 = 19.74, p < 0.05), and occupation (χ2 = 22.05, p < 0.05). There were significant relationships between the three items (on access, satisfaction, and efficiency) and experiencing technical issues (t = 4.47, t = 8.11, and t = 3.24, respectively, p < 0.05), with users who faced technical problems having significantly lower mean scores for all three items. Conclusion This study provided evidence that the Seha app improved the delivery of healthcare in Saudi Arabia. Users of the app had a better health experience in terms of their perceived ease of access to healthcare services; their satisfaction with healthcare services; and the efficiency of the system, measured by the number of required doctor visits. Other factors that appeared to influence the use of the app included age, gender, usual source of care, and technical difficulties.

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Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-037913 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037913

Author(s):

Mala George ◽

Geert-Jan Dinant ◽

Efrem Kentiba ◽

Teklu Teshome ◽

Abinet Teshome ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Cross Sectional Study ◽

Clinical Suspicion ◽

Secondary Outcome ◽

Northern Ethiopia ◽

Sectional Study ◽

Cross Sectional ◽

Smear Negative ◽

Culture Positive ◽

Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

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P20 Parental understanding of concussion in youth rugby is significantly improved by viewing the RFU concussion education video

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.97 ◽

2019 ◽

Vol 90 (3) ◽

pp. e31.1-e31

Author(s):

T Samuel ◽

K Aquilina ◽

W Dawes

Keyword(s):

Parental Education ◽

Cross Sectional Study ◽

Educational Video ◽

Sectional Study ◽

Online Questionnaire ◽

Cross Sectional ◽

Parental Experience ◽

Increased Risk ◽

Significant Difference ◽

Composite Scores

ObjectivesTo investigate the current understanding parents have of concussion in their rugby-playing children aged 9–17.DesignCross-sectional studySubjects86 parents from four clubs completed an online questionnaireMethodsAreas covered (1) Parental experience of concussion (2) Rate of viewing of the RFU concussion educational video (RFUCEV), (3) Identification of symptoms of concussion (4) Understanding of the risk of concussion. Each participant was given a composite score, out of 19, based on their performance in symptom identification and true/false questions. Independent-sample two-tailed t-tests were conducted to analyse scores, primarily controlling for viewing of the RFUCEVResultsThere was a significant difference in the scores between the group that had viewed the RFUCEV (n=32, M=14.75, SD=2.55) and those who had not (n=54, M=13.05, SD=2.87); t(84)=2.75, p=0.00721. Additionally, over 25% of parents reported that their child had suffered a concussion, and this was also found to significantly improve the awareness score (p=0.04678)ConclusionsStatistically significant improvement in composite scores after viewing the RFUCEV makes it reasonable to require compulsory parental education prior to signing up a child to play rugby. This would build on the protocol changes made by the RFU in 2014 and further progress the safety of the sport. We suggest the video be improved to emphasise the areas highlighted as inadequately understood, including the increased risk of concussion in under-18s compared to adults.

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Factors associated with physical inactivity among female and male rural adolescents in Borneo – a cross-sectional study

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2013-0319 ◽

2014 ◽

Vol 26 (3) ◽

pp. 447-453 ◽

Cited By ~ 3

Author(s):

Whye Lian Cheah ◽

Hazmi Helmy ◽

Ching Thon Chang

Keyword(s):

Self Efficacy ◽

Physical Inactivity ◽

Cross Sectional Study ◽

Perceived Barriers ◽

Anthropometric Measurement ◽

Rural Adolescents ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Significant Difference

Abstract Rural communities have shown marked increase in metabolic syndrome among young people, with physical inactivity as one of the main contributing factors. This study aimed to determine factors associated with physical inactivity among male and female rural adolescents in a sample of schools in Malaysia. A cross-sectional study was conducted among 145 students aged 13–15 years. Data on socio-demographic, health-related, and psychosocial factors (perceived barriers, self-efficacy, social influences) were collected using a self-administered questionnaire. Anthropometric measurement was taken to generate body mass index (BMI)-for-age, while physical activity (PA) level was assessed using pedometers. The mean steps per day was 6251.37 (SD=3085.31) with males reported as being more active. About 27% of the respondents were either overweight or obese, with more females in this group. There was no significant difference in steps among males and females (p=0.212), and nutritional status (BMI-for-age) (p=0.439). Females consistently scored higher in most items under perceived barriers, but had significantly lower scores in self-efficacy’s items. Males were more influenced by peers in terms of PA (p<0.001) and were more satisfied with their body parts (p=0.047). A significantly higher body size discrepancy score was found among females (p=0.034, CI –0.639, –0.026). PA level was low and almost one-third of the respondents were overweight and obese. Female students faced more barriers and had lower self-efficacy with regards PA. Based on the findings, it is recommended that interventions focus on reducing barriers while increasing support for PA. This is particularly important in improving the health status of the youth, especially among the females.

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