scholarly journals Difference of Procalcitonin Levels in Gram-Positive and Gram-Negative Bacterial Sepsis Patients of Indonesia Army Central Hospital Gatot Soebroto in 2016

Author(s):  
Nindy Handayani ◽  
Soroy Lardo ◽  
Nunuk Nugrohowati

Introduction: Procalcitonin is known as a marker of infection and indicator for severity of infections. In sepsis, elevated procalcitonin levels in blood have a significant value that can be used as a sepsis biomarker. The aim of this study was to determine the mean difference of procalcitonin levels in Gram-positive and Gram-negative bacterial sepsis patients.Methods: This study used quantitative method with cross sectional approach. The sample of this study were bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 which were divided into two groups: Gram-positive and Gram-negative bacterial sepsis patients with the number of each group was 30 samples. The data were analyzed by using independent t test.Results: This study showed that mean levels of procalcitonin in Gram-positive bacterial sepsis patients was 6.47 ng/ml and Gram-negative was 66.04 ng/ml. There was a significant difference between mean levels of procalcitonin in Gram-positive and Gram-negative bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 with p value = 0.000 (p < 0.05).Conclusion: The mean difference of procalcitonin levels in Gram-negative bacterial sepsis patients were higher than Gram-positive bacterial sepsis patients, because Gram-negative bacteria have lipopolysaccharide which is a strong immunostimulator and increases TNF-α production higher than Gram-positive bacteria. 

Materials ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3550
Author(s):  
Aerin Choi ◽  
Kyung-Hyeon Yoo ◽  
Seog-Young Yoon ◽  
Bong-Soo Park ◽  
In-Ryoung Kim ◽  
...  

Self-adhesive resins (SARs) contain adhesives, which simplify the procedures of resin application, and primers, which provide sufficient bonding ability. In this study, mesoporous bioactive glass nanoparticles (MBN) were added to a SAR to easily improve the physical properties and remineralization ability. The experimental resins comprised 1%, 3%, and 5% MBN mixed in Ortho Connect Flow (GC Corp, Tokyo, Japan). As the MBN content in the SAR increased, the microhardness increased, and a statistically significant difference was observed between the cases of 1% and 5% MBN addition. Shear bond strength increased for 1% and 3% MBN samples and decreased for 5% MBN. The addition of MBN indicated a statistically significant antibacterial effect on both gram-negative and gram-positive bacteria. The anti-demineralization experiment showed that the remineralization length increased with the MBN content of the sample. Through the above results, we found that SAR containing MBN has antibacterial and remineralization effects. Thus, by adding MBN to the SAR, we investigated the possibility of orthodontic resin development, wherein the strength is enhanced and the drawbacks of the conventional SAR addressed.


Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 436
Author(s):  
Giovanni Parente ◽  
Tommaso Gargano ◽  
Stefania Pavia ◽  
Chiara Cordola ◽  
Marzia Vastano ◽  
...  

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; moreover, to identify a proper empiric therapeutic strategy. A retrospective study was conducted on antibiograms on urine cultures from PNs in vesicoureteral reflux (VUR) patients admitted to pediatric surgery department and from PNs in not VUR patients admitted to Pediatric Emergency Unit between 2010 and 2020. We recorded 58 PNs in 33 patients affected by VUR and 112 PNs in the not VUR group. The mean age of not VUR patients at the PN episode was 1.3 ± 2.6 years (range: 20 days of life–3 years), and almost all the urine cultures, 111 (99.1%), isolated Gram-negative bacteria and rarely, 1 (0.9%), Gram-positive bacteria. The Gram-negative uropathogens isolated were Escherichia coli (97%), Proteus mirabilis (2%), and Klebsiella spp. (1%). The only Gram-positive bacteria isolated was an Enterococcus faecalis. As regards the antibiograms, 96% of not VUR PNs responded to beta-lactams, 99% to aminoglycosides, and 80% to sulfonamides. For the VUR group, mean age was 3.0 years ± 3.0 years (range: 9 days of life–11 years) and mean number of episodes per patient was 2.0 ± 1.0 (range: 1–5); 83% of PNs were by Gram-negatives bacteria vs. 17% by Gram-positive: the most important Gram-negative bacteria were Pseudomonas aeruginosa (44%), Escherichia coli (27%), and Klebsiella spp. (12%), while Enterococcus spp. determined 90% of Gram-positive UTIs. Regimen ampicillin/ceftazidime (success rate: 72.0%) was compared to ampicillin/amikacin (success rate of 83.0%): no statistically significant difference was found (p = 0.09). The pathogens of PNs in uropathic patients are different from those of community-acquired PNs, and clinicians should be aware of their peculiar antibiotic susceptibility. An empiric therapy based on the association ampicillin + ceftazidime is therefore suggested.


Author(s):  
Priyanka Jain ◽  
Rakesh Jain

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.


2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Shakeel Ahmad ◽  
Rashida RIaz ◽  
Muhammad Haseeb ◽  
Hafiza Ammara Rasheed ◽  
Samia Iqbal

Purpose: To compare the mean difference of visual acuity as measured by auto refraction and subjective refraction. Study Design:  Descriptive cross-sectional study. Place and Duration of Study:  Department of ophthalmology, Services hospital Lahore from November 2013 to April 2014. Material and Methods:  Using non-probability consecutive sampling 300 eyes of 300 patients fulfilling inclusion criteria were recruited through OPD registration slip. Demographic data including age and gender was recorded. Complete ophthalmic examination was performed. This included measurement of refractive error by auto-refraction as well as subjective refraction. Detailed anterior segment examination with slit lamp and dilated fundus examination with indirect ophthalmoscopy was performed. The collected data was analyzed by using software SPSS version 17. Results:  The mean age of patients was 34.71 ± 7.45 years. There were 156 (52%) males and 144 (48%) females. There were 263 (87.69%) patients who had visual acuity of 6/6 and 37 (12.33%) had 6/9. Mean spherical auto-refraction and subjective refraction was 0.0290 ± 2.58 and -0.2842 ± 2.37 D with mean difference of -0.3133 ± 1.27 D. The mean cylindrical auto and subjective refraction in this study was -.9742 ± 0.78 D and -0.7500 ± 0.81 D and mean difference was 0.2242 ± 0.74 D. The mean cylindrical axis of auto and subjective refraction was 114.88 ± 49.75 and 115.60 ± 49.70 with mean difference as 0.72 ± 3.02 D (p-value < 0.05). Conclusion:  Difference of spherical, cylindrical and cylindrical axis in auto and subjective refraction was significantly different.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 878
Author(s):  
Gerald Mboowa ◽  
Ivan Sserwadda ◽  
Dickson Aruhomukama

Background: Antimicrobial resistance threatens the achievements of modern medicine as well as the sustainability of effective global public health responses to the threat posed by infectious diseases. Extended-spectrum β-lactamase production in bacteria provides the main mechanism of resistance in gram-negative bacteria, particularly those belonging to the Enterobacteriaceae family as well as gram-positive bacteria. This study hence aimed at providing insights into the potential role of in-patients, their immediate hospital environments, out-patients, and their communities in the transmission of antimicrobial resistance via identifying gram-negative and gram-positive bacteria commonly isolated in samples collected from each of these patients/sites as well as their antimicrobial susceptibility profiles using extended-spectrum β-lactamase production in the same as the basis. Methods: Our study reviewed four cross-sectional studies conducted at national and regional referral hospitals in Uganda. Data on bacterial aetiology and antimicrobial susceptibility testing retrieved from the studies was imported into Microsoft Excel, cleaned, sand then exported to IBM SPSS statistics (version 16) for statistical analysis. The databases used were PubMed and Embase.  Results: We report that; Escherichia coli and Klebsiella pneumoniae are the most prevalent Enterobacteriaceae species in the samples that were collected in the studies reviewed; these species account for the highest proportions of extended-spectrum β-lactamase producers; Staphylococcus aureus is the most prevalent of the gram-positive bacteria isolated from the same samples, and accounts for the highest proportions of extended-spectrum β-lactamase producers in the gram-positive bacteria isolated, and similar Enterobacteriaceae species and gram-positive bacteria, are predominant in samples from in-patients, their immediate hospital environments, and out-patients. Conclusion: The insights provided indicate antimicrobial resistance transmission dynamics be re-thought and more comprehensive studies aimed at investigating the same be done to ascertain the source and transmission routes of antimicrobial-resistant bacteria in clinical settings.


2019 ◽  
Vol 13 (1) ◽  
pp. 301-307
Author(s):  
Alem A. Kalayu ◽  
Ketema Diriba ◽  
Chuchu Girma ◽  
Eman Abdella

Background: Surgical Site Infections (SSIs) are among the frequently reported healthcare-acquired infections worldwide. Successful treatment of SSIs is affected by the continuous evolvement of drug-resistant microbes. This study investigated the incidence of SSIs, identifying the major etiologic agents and their drug resistance patterns in Yekatit 12 Hospital, Ethiopia. Methods: A cross-sectional study was conducted on 649 patients who underwent surgery at Yekatit 12 hospital from April 2016 to April 2017. Socio-demographic and clinical data were collected from each patient on admission. After surgery, they were followed for SSI occurrence. SSI was initially diagnosed by a senior surgeon based on standard clinical criteria and then confirmed by culture. Isolates were tested for drug resistance according to the clinical and laboratory standards institute guideline. Results: Of the 649 study participants, 56% were females. Their age ranged from 9 months to 88 years with a median age of 37 years. The incidence of culture-confirmed SSI was 10.2% (66/649) where 73 isolates were recovered. About two-third of the isolates were Gram-positive bacteria. Staphylococcus aureus was the most frequently isolated (27/73, 37%) followed by Coagulase-negative staphylococci (18/73, 24.7%), Escherichia coli (11/73, 15.1%) and Klebsiella species (10/73, 13.7%). About 89% and 44% of S. aureus isolates were resistant to penicillin and trimethoprim-sulfamethoxazole, respectively. MRSA constituted 11% of the S. aureus isolates. All the Gram-negative isolates were resistant to ampicillin and trimethoprim-sulfamethoxazole but susceptible to amikacin and meropenem. Klebsiella species showed 70-100% resistance to ceftazidime, cefuroxime, augmentin, chloramphenicol, ciprofloxacin, cefepime and gentamicin. About 82% of E. coli isolates were resistant for chloramphenicol, cefepime, ceftazidime, augmentin, cefuroxime and 64% for gentamicin and ciprofloxacin. Conclusion: The incidence of surgical site infection in Yekatit 12 hospital is 10.2%. Most of the SSIs were due to Gram-positive bacteria. Gram-negative isolates showed high resistance to the most commonly prescribed drugs. No resistance was found for meropenem indicating the absence of carbapenem-resistant bacteria. SSI treatments should be guided by culture and drug resistance test. Better infection prevention practices and continuous surveillance of antimicrobial resistance in the hospital are recommended for better patient care.


Author(s):  
N. Jyothsna ◽  
A. Ramya ◽  
K. Abhilash ◽  
Bathsa Liza Johnson

<p class="abstract"><strong>Background:</strong> Our study was done to determine the pattern of antibiotic resistance of various strains of bacteria causing acute tonsillitis.</p><p class="abstract"><strong>Methods:</strong> the study was a randomized cross sectional study. Patients matching the inclusion criteria were included. Duration of study was 6 months.</p><p class="abstract"><strong>Results:</strong> Out of 120 cases, 46 cases showed no bacterial growth (NBG) and 74 cases showed bacterial growth. 42 cases were gram-negative bacterial strain and 32 cases were positive bacterial strain out of 72 bacterial grown cases. A list of 25 antibiotic drugs in gram-negative and 31 drugs in gram-positive strain, their sensitivity and resistance were taken and noted. Among gram-negative bacteria imipenem (71.4%) showed highest sensitivity. Highest antibiotic resistance was seen in ampicillin (85.71%). Least sensitivity is observed in clindamycin, amoxicillin+clavulanic acid with 2.38%. Among gram-positive bacteria, highest sensitivity was noted in cefotaxime (75%). Highest antibiotic resistance was seen in cotrimoxazole (46.8%). Least sensitivity is observed in netilmicin, sulbactam with 3.12%.</p><p class="abstract"><strong>Conclusions:</strong> The number of drugs resistant to the gram-positive bacteria are lesser than number of drugs sensitive, which showed significant difference (p&lt;0.05). Significant difference of antibiotic drugs was not found in gram-negative bacteria. Our study findings helped in appropriate and guarded use of the antibiotic drugs in acute tonsillitis, minimizing the exposure of individuals to antibiotic resistance by choosing an appropriate sensitive drug, therefore improving the quality of therapy.</p>


Author(s):  
Samira Hajimaghsoodi ◽  
Ozra Mohiti ◽  
Shadi Paknejad

Introduction: Dental profession has an ethical and legal responsibility in patient care. A properly maintained patient record is a very important aspect of this patient care. The aim of this study was to evaluate dentists' practice in obtaining and recording the medical and pharmacological history of patients in Yazd City in 2020. Methods: In this descriptive cross-sectional study, 197 dentists working in Yazd City were selected during the study and their practice in obtaining and recording medical history was evaluated using a valid questionnaire. Data were analyzed by SPSS23 statistical software t-test and Pearson correlation coefficient. Results: Out of 197 dentists participating in this study, 93 (52.8%) were male and 104 (47.2%) were female. Their mean age was 39.37± 8.36 years and their mean clinical experience was 6.5± 9.25 years. The mean score of dentists' practice in obtaining and recording the medical and pharmacological history was 61.30±4.95 (range 45-72) out of 72 points. There was no statistically significant difference between the mean score of dentists' practice by gender, clinical experience, university of study and degree (P-value>0.05), but there was a statistically significant relationship between dentists' age and their practice score (P-value=0.040). Conclusion: Based on the results of the present study, the mean practice source of dentists in obtaining and recording the medical and pharmacological history of patients was good. The effect of gender, university of study and degree on dentists' practice was not significant. However, with increasing age and experience in dentistry, the practice score of dentists was lower.


2020 ◽  
Vol 5 (2) ◽  
pp. 24-27
Author(s):  
Leo Jumadi Simanjuntak ◽  
Patrick Anando Simanjuntak

Background: Estimated fetal weight (EFW) is important to determine mode of delivery. The use of estimated fetal weight based on fundal height has been widely used, but the use on overweight mothers is still limited. Objectives: This study aimed to compare the Johnson’s and Risanto’s formula in estimating fetal weight on overweight mothers. Method: The design used was cross-sectional, conducted at Mitra Sejati, Herna, and Methodist Sussana Wesley hospital on November 2019 until January 2020. Mann-Whitney test was used to compare EFW mean differences between Johnson’s and Risanto’s to actual birth weight. Paired t-test was used to compare EFW mean differences between Johnson’s and Risanto’s. Results: There were 103 overweight pregnant mothers fulfilling study criteria. The BMI mean was 31,26 ± 5l,54 kg/m2. Both Johnson’s and Risanto’s formula had no significant mean difference compare to actual birth weight, of 332,45 gram on Johnson’s (p value = 0,070) and 298,57 gram on Risanto’s (p value = 0,863). The mean difference between Risanto’s formula and actual birth weight was significantly lower than Johnson’s (mean difference = 33,88 gram, p value = 0,01). Conclusions: EFW measurement using Johnson’s and Risanto’s formula based on fundal height can be applied and used properly by health care workers. Risanto’s formula was more accurate to estimate fetal weight than Johnson’s in overweight mothers.   Latar belakang: Menentukan taksiran berat janin (TBJ) adalah penting bagi penolong persalinan untuk menentukan jenis persalinan. Pengukuran TBJ menggunakan tinggi fundus uterus merupakan metode yang banyak digunakan, namun penggunaan pada ibu hamil dengan berat badan berlebih masih terbatas. Tujuan: Penelitian ini bertujuan membandingkan rumus Johnson dan rumus Risanto dalam menentukan TBJ pada ibu hamil dengan berat badan berlebih. Metode: Desain penelitian adalah potong lintang, data diambil di RSU Mitra Sejati, RSU Herna, dan RSU Methodist Sussana Wesley pada November 2019 – Januari 2020. Dilakukan uji Mann-Whitney untuk membandingkan perbedaan rerata TBJ dengan rumus Johnson dan Risanto dengan berat badan lahir. Uji-t berpasangan digunakan untuk membandingkan perbedaan rerata TBJ dengan rumus Johnson dan Risanto. Hasil: Didapatkan 103 ibu hamil yang memenuhi kriteria penelitian dengan rerata IMT 31,26 ± 5l,54 kg/m2. Terdapat perbedaan rerata TBJ rumus Johnson dan rumus Risanto dibandingkan berat badan lahir sebesar 332,45 gram dan 298,57 gram. Tidak terdapat perbedaan rerata bermakna antara penghitungan TBJ menggunakan rumus Johnson dengan berat badan lahir (p = 0,070) dan rumus Risanto dengan berat badan lahir (p = 0,863). Perbedaan selisih TBJ Risanto dengan berat badan lahir lebih rendah dibandingkan selisih TBJ Johnson dengan berat badan lahir, yaitu sebesar 33,88 gram dan bermakna secara statistik (p = 0,01). Kesimpulan: Pengukuran TBJ menggunakan rumus Johnson dan rumus Risanto dapat diterapkan dan digunakan dengan baik oleh tenaga medis. Rumus Risanto memiliki tingkat ketepatan yang lebih baik dibandingkan rumus Johnson dalam menentukan TBJ pada ibu hamil dengan berat badan berlebih.


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