The Burden of Laboratory-confirmed Influenza Infection in Lebanon Between 2008 and 2016: A single tertiary care center experience

Abstract BACKGROUND: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited particularly from Lebanon. METHODS: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30 th , 2016 at a tertiary care center in Beirut was performed. All laboratory-confirmed cases of influenza were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis. RESULTS: A total number of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14%. Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (<2 years and ≥ 65years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION: Influenza causes a substantial hospitalization burden annually in Lebanon with significant morbidity across all age groups. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.

Download Full-text

The Burden of Laboratory-confirmed Influenza Infection in Lebanon Between 2008 and 2016: A single tertiary care center experience

10.21203/rs.2.22568/v3 ◽

2020 ◽

Author(s):

Aia Assaf-Casals ◽

Zeina Saleh ◽

Sarah Khafaja ◽

Danielle Fayad ◽

Hady Ezzeddine ◽

...

Keyword(s):

Influenza A ◽

Influenza Infection ◽

Care Center ◽

Severe Disease ◽

Tertiary Care ◽

High Rate ◽

World Health ◽

Influenza B ◽

Age Group ◽

Tertiary Care Center

Abstract BACKGROUND: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. METHODS: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30 th , 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis. RESULTS: A total of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14% (positive tests over total requested). Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (<2 years and ≥ 65years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION: Patients with laboratory-confirmed influenza at our center had a high rate of hospitalization and mortality. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.

Download Full-text

The Burden of Laboratory-confirmed Influenza Infection in Lebanon Between 2008 and 2016: A single tertiary care center experience

10.21203/rs.2.22568/v2 ◽

2020 ◽

Author(s):

Aia Assaf-Casals ◽

Zeina Saleh ◽

Sarah Khafaja ◽

Danielle Fayad ◽

Hady Ezzeddine ◽

...

Keyword(s):

Influenza A ◽

Influenza Infection ◽

Care Center ◽

Severe Disease ◽

Tertiary Care ◽

High Rate ◽

World Health ◽

Influenza B ◽

Age Group ◽

Tertiary Care Center

Abstract BACKGROUND: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. METHODS: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30 th , 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis. RESULTS: A total of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14% (positive tests over total requested). Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (<2 years and ≥ 65years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION: Patients with laboratory-confirmed influenza at our center had a high rate of hospitalization and mortality. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.

Download Full-text

The Burden of Laboratory-confirmed Influenza Infection in Lebanon Between 2008 and 2016: A single tertiary care center experience

10.21203/rs.2.22568/v4 ◽

2020 ◽

Author(s):

Aia Assaf-Casals ◽

Zeina Saleh ◽

Sarah Khafaja ◽

Danielle Fayad ◽

Hady Ezzeddine ◽

...

Keyword(s):

Influenza A ◽

Influenza Infection ◽

Care Center ◽

Severe Disease ◽

Tertiary Care ◽

High Rate ◽

World Health ◽

Influenza B ◽

Age Group ◽

Tertiary Care Center

Abstract BACKGROUND: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon.METHODS: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30th, 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis.RESULTS: A total of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14% (positive tests over total requested). Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (<2 years and ≥ 65years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION: Patients with laboratory-confirmed influenza at our center had a high rate of hospitalization and mortality. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.

Download Full-text

Nosocomial Pneumonia in a Canadian Tertiary Center: A Prospective Surveillance Study

Infection Control and Hospital Epidemiology ◽

10.1086/646356 ◽

1991 ◽

Vol 12 (6) ◽

pp. 356-363 ◽

Cited By ~ 5

Author(s):

M. Louie ◽

B. Dyck ◽

S. Parker ◽

L. Sekla ◽

L.E. Nicolle

Keyword(s):

Active Surveillance ◽

Nosocomial Pneumonia ◽

Influenza A ◽

Care Center ◽

Tertiary Care ◽

Influenza B ◽

Tertiary Care Center ◽

Prospective Surveillance ◽

Surveillance Period ◽

Tertiary Center

AbstractObjective:To determine the contribution of etiologic agents, including Legionellapneumophilaand respiratory viruses to nosocomial pneumonia at a tertiary care center.Design:Prospective surveillance of nosocomial pneumonia with standardized laboratory investigations.Setting:A 1,100-bed tertiary care center.Patients:All adult inpatients.Results:One hundred and thirty-five Nosocomial pneumonias (5.7/1,000 discharges) were identified. Four (3.0%) were L pneumophila sero-group 1 infections (0.17/1,000 discharges). LegionelIosis occurred in non-high-risk patients, and three cases would not have been identified without active surveillance. viral seroconversion was identified in seven (19%) of 36 cases with specimens available (0.59/1,000 discharges): five influenza B, one influenza A, and one respiratory syncytial virus. IgM serology was positive in one case each for Mycoplasma pneumoniae and Chlamydia species. No geographical clustering was observed for viral infections, and these would not have been identified without active surveillance. Mortality for all nosocomial pneumonia was 25%. Patient factors significantly associated with a poorer outcome included older age, underlying disease, low serum albumin, renal insufficiency, lower platelet count, endotracheal intubation, respiratory failure, bacteremia, and use of antacids.Conclusions:This prospective surveillance suggested that L pneumophila and viral agents were uncommon causes of nosocomial pneumonia at our institution during this surveillance period.

Download Full-text

Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

ISRN Tropical Medicine ◽

10.1155/2013/808571 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Vani Chandrashekar

Keyword(s):

Entamoeba Histolytica ◽

South India ◽

Care Center ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Center ◽

Care Centre ◽

Tertiary Care Centre ◽

Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

Download Full-text

Profile of Paediatric Poisoning at a Tertiary Care Center in Karnataka

International Journal of Applied Sciences and Biotechnology ◽

10.3126/ijasbt.v2i2.10140 ◽

2014 ◽

Vol 2 (2) ◽

pp. 142-145

Author(s):

DK Dnyanesh ◽

Suma Dnyanesh ◽

Roopa Bellad

Keyword(s):

Urban Areas ◽

Care Center ◽

Tertiary Care ◽

Gastric Lavage ◽

Acute Poisoning ◽

Definitive Treatment ◽

Accidental Poisoning ◽

Age Group ◽

Tertiary Care Center ◽

Paediatric Patients

Objectives: To determine the profile and outcome of paediatric patients presenting with poisoning to a tertiary care center in Karnataka. Methods: Retrospectively we studied the PICU records of all the paediatric patients who presented with acute poisoning during the 4-years period from Feb 2010 to Jan 2014. All children aged less than 18 years with a definite history and suspected cases of poisoning were included. Results: 106 patients presented with acute poisoning during the study period. The majority of our patients were in the 0 - 6 year age group. Poisoning in this age group was most common with higher frequency in males, the ratio being 1.2:1. The agents most frequently used were hydrocarbons (43.1%), pyrethrine compounds 15.5%, Organo-Chlorine compounds 12.1%drugs, Organo-Phospherous compounds 12.1%, drugs 1.8%. In 1 - 6 year age group 54.7% cases were accidental in nature, whereas in the 12 - 18 year group 93.3% were suicidal. All patients were symptomatic and needed symptomatic or definitive treatment. 21 patients required mechanical ventilation. Almost 3/4th of patients underwent Gastric lavage. Specific antidote was given to 41 patients. 2 patients of OP poisoning died. Conclusion: Our study concluded that accidental poisoning is common in 0-6 year children, the common substance being used in rural areas was kerosene and in urban areas it was found to be pyrethrin compounds. Lack of awareness of parents regarding appropriate storage of these dangerous household products is the main cause. Measures should be taken to educate the parents and public in order to decrease the poisoning cases. Suicidal cases are increasing in adolescents and precipitating factors like exam fear, exam failure, love failure and parental pressure regarding studies needs counseling of both parents and childrenDOI: http://dx.doi.org/10.3126/ijasbt.v2i2.10140Int J Appl Sci Biotechnol, Vol. 2(2): 142-145

Download Full-text

Metabolic syndrome in alopecia areata: an observational study at a tertiary care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20213338 ◽

2021 ◽

Vol 7 (5) ◽

pp. 647

Author(s):

Subrata Kumar Das ◽

Saptadipa Das

Keyword(s):

Metabolic Syndrome ◽

Observational Study ◽

Alopecia Areata ◽

Care Center ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Center ◽

Cross Sectional ◽

Laboratory Parameters ◽

Number Of Patients

Background: The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).Methods: This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.Results: This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17 patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44 had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.Conclusions: In the present study we did not observe any significant derangement of clinical and laboratory parameters of MS in patients of alopecia areata.

Download Full-text

Cardiac Health Awareness Among Women Presenting for Routine Health Checkup at Tertiary Care Center: Time Trends Over 15 Years

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0039-1695652 ◽

2019 ◽

Vol 04 (02) ◽

pp. 079-084

Author(s):

Shibba Takkar Chhabra ◽

Gurleen Kaur ◽

Samir Kapoor ◽

Gagandeep Nagi ◽

Devanshi Kajal ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Treatment Modalities ◽

Age Group ◽

Tertiary Care Center ◽

Health Awareness ◽

Health Checkup ◽

Cardiac Health ◽

Presenting Symptoms ◽

The Past

Abstract Background Women have been thought to be protected against the perils of cardiovascular disease (CVD) till late in their lives. But the literature suggests quite the opposite with CVD being a major cause of death even in young women. In contrast, the lack of awareness among women is disheartening and needs to be addressed radically. Methods The study was designed and conducted as retrospective cohort at a tertiary care center. Data was collected from patients presenting for routine cardiac health checkup over the past 15 years. The parameters observed included age at presenting, symptoms and/or signs, plus area of residence or domicile. Results A total of 32,831 patients presented for routine cardiac health checkup, of which 9,211 (28.1%) patients were women and 23,620 (71.9%) were men. On 5 yearly cumulative assessment, the mean attendance of women was 28.1 ± 2.5% as compared with 71.9 ± 2.6% men. Trend observed over the past 15 years revealed little change in the number of women versus men presenting for cardiac health checkup annually. Statistical significance was seen at p < 0.01. Among the women presenting for the checkup, it was observed that most women were in the postmenopausal age group (42.8%), followed by perimenopausal age group (34.6%), and least in premenopausal age group (22.5%) during the timeline of the study. A similar trend was observed in the male attendance; the input of males being higher at all instances. Noteworthy were trends of urban women (69.6%) presenting for health checkup more often as compared with 30.4% visiting from rural residence. Conclusions Coronary artery disease (CAD) is not uncommon in female gender. It is accompanied by varying symptom presentation with high mortality. It is seen that cardiac health awareness is significantly lacking among women as compared with men. There are almost static trends observed over the past 15 years, especially in premenopausal age group and rural domicile. Corrective actions inclining toward campaigns and communication to distribute information on cardiac disease prevention and treatment modalities among women are needed to curb CAD. This may promote early detection of CAD leading to early interventions to promote a healthy heart among women. Recommendations and necessary actions steps for a woman oriented cardiac program are the need of the hour.

Download Full-text