scholarly journals Sex differences in clinical presentation in acute MI

2017 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Ashwin Kodliwadmath ◽  
Naren V. Nimbal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Care Hospital ◽  
Acute Mi

Background: Acute myocardial infarction differs in women and men with respect to risk factors and clinical presentation. There are studies carried out worldwide on this issue but few from India. This study was done to study the sex based differences in the risk factors and clinical features of acute MI in patients with Indian ethnicity.Methods: Comparative prospective study consisting of 100 women as study group and 100 men as control group with acute MI, who were admitted in a tertiary care hospital, from December 2016 to June 2017.Results: Chest pain was the main complaint in majority of the women (82%) and men (88%). Radiation of chest pain (87%) and sweating (90%) were significantly present in men compared to women (65% and 62% respectively), while breathlessness was significantly present in women (78%) compared to men (64%) and fatigue in women (76%) significantly more than men (55%). Smoking was a significant risk factor in men (69%) compared to women (5%), while diabetes mellitus was a significant risk factor in women (62%) compared to men (39%).Conclusions: Women with acute MI had more atypical presentation of symptoms, similar risk factors, compared to men except for smoking which was more significant in men and diabetes more common in women.

scholarly journals Use of carbapenems and glycopepdides is significant risk for multidrug resistant Acinetobacter baumannii infections

2018 ◽  
Vol 12 (02) ◽  
pp. 67-72
Author(s):  
Salih Hosoglu ◽  
Eyup Arslan ◽  
Emel Aslan ◽  
Özcan Deveci
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Acinetobacter Baumannii ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Time Interval ◽  
And Control

Introduction: Multi-drug resistant Acinetobacter baumannii (MDR-Ab) infections are an important healthcare problem globally. The aim of this study was to evaluate risk factors associated with MDR-Ab infections in hospitalized patients in Turkey. Methodology: A case-control study was performed in a tertiary care 1,303-bed university hospital, among case patients with MDR-Ab infections. The hospital records of case and control patients were retrospectively evaluated over a year. Patients who were hospitalized in the same department and in the same time interval as the case patients, without MDR-Ab infection or colonization, were chosen for control group. Demographic characteristics, Acute Physiology And Chronic Health Evaluation II (APACHE II) scores, comorbid diseases, use of invasive tools and duration of usage, and duration of use of antibiotics were recorded for all patients. Comparisons between case and control groups for possible risk factors were performed. Results: In total, 95 cases and 95 controls were included in the study. Univariate analysis highlighted several variables as risk factors for MDR-Ab infections. Multivariate analysis showed that only antibiotic usage over seven days (OR = 2.38, CI = 1.18-4.83, p = 0.016) was found to be a significant risk factor. When antibiotic treatment patterns in both groups were compared, the use of carbapenems (p = 0.001) and glycopeptide antibiotics (p=0.001) in patient treatment were found significantly higher in the MDR-Ab case group. Conclusion: This study showed us that previous antibiotic use is a significant risk factor for MDR-Ab infections. The use of carbapenems and glycopeptides should be considered as primary risk factors for developing MDR-Ab infection.

Evaluation of Hospital Room Assignment and Acquisition of Clostridium difficile Infection

2011 ◽  
Vol 32 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Megan K. Shaughnessy ◽  
Renee L. Micielli ◽  
Daryl D. DePestel ◽  
Jennifer Arndt ◽  
Cathy L. Strachan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clostridium Difficile ◽  
Tertiary Care ◽  
Significant Risk ◽  
Extended Period ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Icu Discharge

Background and Objective.Clostridium difficile spores persist in hospital environments for an extended period. We evaluated whether admission to a room previously occupied by a patient with C. difficile infection (CDI) increased the risk of acquiring CDI.Design.Retrospective cohort study.Setting.Medical intensive care unit (ICU) at a tertiary care hospital.Methods.Patients admitted from January 1, 2005, through June 30, 2006, were evaluated for a diagnosis of CDI 48 hours after ICU admission and within 30 days after ICU discharge. Medical, ICU, and pharmacy records were reviewed for other CDI risk factors. Admitted patients who did develop CDI were compared with admitted patients who did not.Results.Among 1,844 patients admitted to the ICU, 134 CDI cases were identified. After exclusions, 1,770 admitted patients remained for analysis. Of the patients who acquired CDI after admission to the ICU, 4.6% had a prior occupant without CDI, whereas 11.0% had a prior occupant with CDI (P = .002). The effect of room on CDI acquisition remained a significant risk factor (P = .008) when Kaplan-Meier curves were used. The prior occupant's CDI status remained significant (P = .01; hazard ratio, 2.35) when controlling for the current patient's age, Acute Physiology and Chronic Health Evaluation III score, exposure to proton pump inhibitors, and antibiotic use.Conclusions.A prior room occupant with CDI is a significant risk factor for CDI acquisition, independent of established CDI risk factors. These findings have implications for room placement and hospital design.

scholarly journals Risk factors for mortality in children with Wilms tumor

2016 ◽  
Vol 56 (4) ◽  
pp. 226
Author(s):  
Yuni Purwanti ◽  
Sutaryo Sutaryo ◽  
Sri Mulatsih ◽  
Pungky Ardani Kusuma
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Wilms Tumor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Stage Iii ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Potential Risk Factors

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor. 

Evaluating Vancomycin Use at a Pediatric Hospital: New Approaches and Insights

2005 ◽  
Vol 26 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Maureen K. Bolon ◽  
Alana D. Arnold ◽  
Henry A. Feldman ◽  
David H. Rehkopf ◽  
Emily F. Strong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Factor Analysis ◽  
Risk Factor ◽  
Tertiary Care ◽  
Significant Risk ◽  
Risk Factor Analysis ◽  
Cell Transplant ◽  
Care Hospital ◽  
Inappropriate Use ◽  
Tertiary Care Medical Center

AbstractObjectives:To characterize vancomycin use at a pediatric tertiary-care hospital, to discriminate between initial (≤ 72 hours) and prolonged (> 72 hours) inappropriate use, and to define patient characteristics associated with inappropriate use.Design:Vancomycin courses were retrospectively reviewed using an algorithm modeled on HICPAC guidelines. Data were collected regarding patient demographics, comorbidities, other medication use, and nosocomial infections. The association between each variable and the outcome of inappropriate use was determined by longitudinal regression analysis. A multi-variable model was constructed to assess risk factors for inappropriate initial and prolonged vancomycin use.Setting:A pediatric tertiary-care medical center.Patients:Children older than 1 year who received intravenous vancomycin from November 2000 to June 2001.Results:Three hundred twenty-seven vancomycin courses administered to 260 patients were evaluated for appropriateness. Of initial courses, 114 (35%) were considered inappropriate. Of 143 prolonged courses, 103 (72%) were considered inappropriate. Multivariable risk factor analysis identified the following variables as significantly associated with inappropriate initial use: admission to the surgery service, having a malignancy, receipt of a stem cell transplant, and having received a prior inappropriate course of vancomycin. No variables were identified as significant risk factors for inappropriate prolonged use.Conclusions:Substantial inappropriate use of vancomycin was identified. Prolonged inappropriate use was a particular problem. This risk factor analysis suggests that interventions targeting patients admitted to certain services or receiving multiple courses of vancomycin could reduce inappropriate use.

Association of Low Back Pain with Common Risk Factors: A Community Based Study

2014 ◽  
Vol 25 (2) ◽  
pp. 50-55 ◽  
Author(s):  
Mohammad Moin Uddin ◽  
Aminuddin A Khan ◽  
Ahsanul Hoque Chowdhury ◽  
Ranjan Kumar Guha
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Low Back Pain ◽  
Back Pain ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Body ◽  
Control Group ◽  
Low Back ◽  
Community Based

Abstract Background Low back pain is very common in Asian communities. It is a major cause of activity limitation. Its risk factors were not studied well in Asian communities. This study was performed in the rural area to see the association of some common posture related and modifiable risk factors of low back pain. Methods This is a community based case-control study. Participants of both sexes between 30 and 60 years were selected who had low back pain. Data were collected with a semi-structured questionnaire and fifty-one participants were interviewed from which 32 had back pain (cases). Risk factor association was compared with age and ethnicity matched 19 patients without low back pain (control group). Results The point prevalence of low backache was 63%. Mean age of the patients was 45.8 (±10.8 SD) years. Seventy per cent of the back pain patients were females and 30% were males. Back pain was significantly associated with the risk factor ‘bending and twisting movements of the body’ (OR= 4.6 with 95% CI= 1.1 to 18.9, p= 0.041). It was not found to be significantly associated with the other studied risk factors. Conclusion Low back pain had a very high prevalence in rural Bangladesh. Bending and twisting movements of spine was the only posture related significant risk factor of low back pain.

scholarly journals Asphyxia as a Risk Factor for Neonatal Hypoglycemia

2018 ◽  
Vol 37 (2) ◽  
pp. 111-116
Author(s):  
Luthfina Mufidati ◽  
Alifah Anggraini ◽  
Tunjung Wibowo
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Large For Gestational Age ◽  
Control Group ◽  
Neonatal Hypoglycemia ◽  
Cohort Data

Introduction: Hypoglycemia leads to brain developmental disturbances and abnormality on its function. Perinatal stress including asphyxia is a significant cause of neonatal hypoglycemia, thus, it is important to prevent it by controlling its relevant confounding variables. The aims of this study were to identify the risk factors of neonatal hypoglycemia and its related variables, focusing on the role of asphyxia in neonatal hypoglycemia.Material and Methods: We conducted a nested case control study using a cohort data from South East Asia Regional Neonatal-Perinatal Database year 2013 of the Maternal and Perinatal Unit, Dr. Sardjito General Hospital Yogyakarta. We randomly selected neonatal hypoglycemia as a case and neonatal without hypoglycemia as a control group. We identify the risk factors from the cohort data. Logistic regression analyses were performed to investigate the association between hypoglycemia and risk factors.Results: A total of 1563 newborns were recruited in this study. Five hundred and twenty newborns were excluded due to incomplete data and major congenital anomalies. By simple randomization sampling, we selected 52 newborns in cases group and 104 newborns in control group. In multivariate models, being asphyxia, low birth weight (LBW), large for gestational age (LGA), and early onset of neonatal sepsis showed significant effects on risk of hypoglycemia, OR= 2.8 (95% CI: 1.01 – 7.80), OR 7.1 (95% CI 1.54-32.37), OR 37.2 (95% CI 6.28-219.85), and OR 40.6 (95% CI 10.84-152.01), respectively.Conclusion: Asphyxia, LBW, LGA and early onset neonatal sepsis were significant risk factor for neonatal hypoglycemia.

scholarly journals Study of Risk Factor for Congenital Heart Diseases in Children at Rural Hospital of Central India

2013 ◽  
Vol 33 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Amar M Taksande ◽  
Krishna Vilhekar
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Significant Risk ◽  
Central India ◽  
Significant Risk Factor ◽  
Control Group ◽  
History Of

Introduction: Congenital heart disease is the most common congenital problem that accounts for up to 25% of all congenital malformations. Hence this study was aimed at improving the knowledge related to risk factors associated with CHD in a rural Indian scenario. It was a hospital- based case control study. Materials and Methods: The children up to twelve year of age with clinical suspicion of CHD were subjected to chest x-ray and electrocardiography, and final diagnosis was confirmed by echocardiography (n=209) as cases. The control group (n=418) were randomly selected from children without CHD who were admitted during the same period. The etiological factors like environmental, infections, drugs, and maternal factors were analyzed by using EPI 6 version. Results: In cases group, 56% were male and 44% female children. 82% cases presented at age of less than 5 years and 18% after 5 year. Exposure to smoking (OR=10.45), tobacco intake by mother (OR=8.28) and family history of CHD (OR=7.21) were the significant risk factor present in cases. Conclusion: The risk factors for CHD child identified were exposure to smoking and tobacco intake by mother, family history of CHD, antenatal infection in 1st trimester and history of diabetic mother. DOI: http://dx.doi.org/10.3126/jnps.v33i2.8254   J Nepal Paediatr Soc. 2013; 33(2):121-124

scholarly journals Acute bilirubin encephalopathy and its associated risk factors in a tertiary care hospital, Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Munir Ahmad ◽  
Abdur Rehman ◽  
Mudasser Adnan ◽  
Muhammad Khalil Surani
Keyword(s):  
Risk Factors ◽  
Serum Bilirubin ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Total Serum ◽  
Care Hospital ◽  
Bilirubin Encephalopathy ◽  
Associated Risk Factors

Objective: To determine the incidence of acute bilirubin encephalopathy (ABE) and its risk factors in neonates presenting with hyperbilirubinemia in a tertiary care children hospital. Methods: This descriptive observational study was conducted from June 2018 to June 2019. A total of 300 infants who were admitted in neonatal ICU with diagnosis of hyperbilirubinemia in The Children’s Hospital & The Institute of Child Health, Multan, Pakistan were included in this period. Incidence of ABE was noted. ABE was divided into two categories on the basis of severity of symptoms; mild ABE and moderate to severe ABE. Total serum bilirubin (TSB) in all neonates was measured in all patients in hospital laboratory using colorimetric method. ABO incompatibility and Rh factor incompatibility was also noted for each neonate. Results: Out of 300 neonates who presented with hyperbilirubinemia, ABE was diagnosed in only 42 (14.0%) neonates (mild ABE in 17 (5.7%) and moderate in 25 (8.3%). Out of 42 neonates of ABE, total serum bilirubin levels were 20-29.9 mg/dL in 24 (40.5%) neonates, and >30 mg/dL in 18 (42.8%) neonates. Pre-term birth was a significant risk factor of ABE; 23.8% in ABE and 10.70% in non-ABE (p-value 0.01). During treatment, 02 (4.76%) neonates expired due to ABE. Conclusion: In present study, ABE was diagnosed in 14.0% neonates who presented with hyperbilirubinemia. We found pre-term delivery as a significant risk factor of ABE. doi: https://doi.org/10.12669/pjms.36.6.2222 How to cite this:Ahmad M, Rehman A, Adnan M, Surani MK. Acute bilirubin encephalopathy and its associated risk factors in a tertiary care hospital, Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2222 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.

Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

2020 ◽  
pp. 1-7
Author(s):  
Stephanie M. Cabral ◽  
Katherine E. Goodman ◽  
Natalia Blanco ◽  
Surbhi Leekha ◽  
Larry S. Magder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Risk Adjustment ◽  
Community Hospital ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Bivariate Analysis ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

scholarly journals Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India

2015 ◽  
Vol 7 (02) ◽  
pp. 108-111 ◽  
Author(s):  
Tuhina Banerjee ◽  
Shampa Anupurba ◽  
Joel Filgona ◽  
Dinesh K Singh
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Hospitalized Patients ◽  
University Hospital ◽  
North India ◽  
Care Hospital

ABSTRACT Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one. Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India. Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization. Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis. Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

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