An in depth look into intracranial Abscesses and Empyemas: a 10-year experience in a single institute.

Abstract Background As the incidence of intracranial infections increase due to diagnostic procedures improvement, more real-life data is needed to reach a more solid informed management approach. This study aims to describe and analyse clinical features of intracranial abscesses patients treated at a tertiary hospital in North Jordan during a 10-year period. Methods We retrospectively identified 37 patients treated at King Abdullah University Hospital (KAUH) from 2011 to 2020 in Irbid, North Jordan. Treatment consisted of either aspiration, open craniotomy excision (OCE) or conservative therapy. Extracted variables included demographic data such (age, gender), clinical presentation, lab findings, radiological findings as well as management plan. Retrieved data was compared between the patients who underwent a single operation and those who underwent reoperation after the initial procedure. Results Thirty-seven patients with 55 intracerebral abscesses were identified, 29 of whom had intraparenchymal brain abscesses, 4 patients had epidural empyema, and 4 had subdural empyema. The mean age was 28.8 (± 20.7) years, with a male predominance (78.4%). Sixteen patients underwent open craniotomy excision (OCE), 14 patients were treated by aspiration and 7 patients were treated conservatively. When comparing the single operation and the reoperation groups, there was no statistically significant difference across variables. Conclusion Our study presents valuable insight from a tertiary hospital in north Jordan on intracranial abscesses and empyemas. Our findings confirm that good recovery can be established after aspiration or OCE in the majority of patients. Similar results were obtained when comparing the SOP and the ROP groups.

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Spectrum of childhood interstitial and diffuse lung diseases at a tertiary hospital in Egypt

ERJ Open Research ◽

10.1183/23120541.00880-2020 ◽

2021 ◽

pp. 00880-2020

Author(s):

Salma G. Abdelhady ◽

Eman M. Fouda ◽

Malak A. Shaheen ◽

Faten A. Ghazal ◽

Ahmed M. Mostafa ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Lung Disease ◽

Lung Diseases ◽

Demographic Data ◽

Tertiary Hospital ◽

University Hospital ◽

Systematic Evaluation ◽

Pulmonary Hemosiderosis ◽

Diffuse Lung Diseases ◽

Diffuse Lung

BackgroundChildhood interstitial and diffuse lung diseases (chILD) encompass a broad spectrum of rare pulmonary disorders. In most developing middle eastern countries, chILD is still underdiagnosed. Objective: To describe and investigate patients diagnosed with chILD in a tertiary university hospital in Egypt.MethodsWe analyzed data of consecutive subjects (<18 years) referred for further evaluation at the Children's Hospital, Ain Shams University. Diagnosis of chILD was made in accordance with the chILD-EU criteria. The following information was obtained: demographic data, clinical characteristics, chest CT findings, laboratory studies, spirometry, BAL and histopathology findings.Results22 subjects were enrolled over 24 months. Median age at diagnosis was 7 years (range 3.5–14 years). The most common manifestations were dyspnea (100%), cough (90.9%), clubbing (95.5%) and tachypnea (90.9%). Systematic evaluation led to the following diagnoses: hypersensitivity pneumonitis (n=3), idiopathic interstitial pneumonias (n=4), chILD related to chronic granulomatous disease (n=3), chILD related to small airway disease (n=3), postinfectious chILD (n=2), Langerhans cell histiocytosis (n=2), Idiopathic pulmonary hemosiderosis (n=2), granulomatous lymphocytic interstitial lung disease (n=1), systemic sclerosis (n=1), familial interstitial lung disease (n=1). Among the subjects who completed the diagnostic evaluation (n=19), treatment was changed in 13 (68.4%) subjects.ConclusionSystematic evaluation and multidisciplinary peer review of chILD patients at our tertiary hospital led to changes in management in 68% of the patients. This study also highlights the need for an Egyptian chILD network with genetic testing, as well as the value of collaborating with international groups in improving health care for children with chILD.

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Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

F1000Research ◽

10.12688/f1000research.73988.1 ◽

2021 ◽

Vol 10 ◽

pp. 1197

Author(s):

Yolima Cossio ◽

Marta-Beatriz Aller ◽

Maria José Abadias ◽

Jose-Manuel Domínguez ◽

Maria-Soledad Romea ◽

...

Keyword(s):

Tertiary Hospital ◽

Healthcare Systems ◽

University Hospital ◽

Emergency Rooms ◽

Daily Number ◽

Patient Demographics ◽

Significant Difference ◽

The University ◽

Hospital Wards ◽

Second Wave

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d’Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves. Methods: A retrospective observational analysis of COVID-19 patients attending the hospital from February 24 to April 26, 2020 (first wave) and from July 24, 2020, to May 18, 2021 (second wave) was carried out. We analysed the data of the electronic medical records on patient demographics, comorbidity, severity, and mortality. Results: The daily number of COVID-19 patients entering the emergency rooms (ER) dropped by 65% during the second wave compared to the first wave. During the second wave, patients entering the ER were significantly younger (61 against 63 years old p<0.001) and less severely affected (39% against 48% with a triage level of resuscitation or emergency; p<0.001). ER mortality declined during the second wave (1% against 2%; p<0.000). The daily number of hospitalised COVID-19 patients dropped by 75% during the second wave. Those hospitalised during the second wave were more severely affected (20% against 10%; p<0.001) and were referred to the intensive care unit (ICU) more frequently (21% against 15%; p<0.001). Inpatient mortality showed no significant difference between the two waves. Conclusions: Changes in the flow, severity and mortality of COVID-19 patients entering this tertiary hospital during the two waves may reflect a better adaptation of the health care system and the improvement of knowledge on the disease.

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Evaluation of Hepatitis C Patients' Satisfaction Regarding Care and Treatment in Different Hospitals in Cairo, Egypt, 2020

QJM ◽

10.1093/qjmed/hcab118.010 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Shaimaa S Yousef ◽

Lamyaa S Al Bagoury ◽

Sahar A Dewedar ◽

Sahar M Sabbour ◽

Wagida A Anwar

Keyword(s):

Viral Hepatitis ◽

Demographic Data ◽

University Hospital ◽

Health Providers ◽

Cross Sectional ◽

Indirect Measure ◽

Patients Satisfaction ◽

Significant Difference ◽

Care And Treatment

Abstract Background Patient satisfaction can be considered as an indirect measure of health outcomes and quality of provided services. Objectives To compare HCV patients' satisfaction regarding care and treatment in different selected Viral Hepatitis Outpatients Clinics in Cairo. Method: The current study is a cross sectional study. It recruited 300 HCV patients from Viral Hepatitis Outpatients Clinics in University, Ministry of Health (MOH) and Insurance Hospitals (100 HCV patients from each clinic). Recruited HCV patients attended at least 2 visits to the Viral Hepatitis Clinics. They completed an interview questionnaire about socio- demographic data, history of diagnosis of HCV, onset and type of treatment and Hepatitis Patients Satisfaction Questionnaire (HPSQ). Results Mean age of HCV patients were (48.9 ±13.5), (50.4 ± 10.4), and (54.8 ± 10.9) from University, MOH and Insurance Hospitals, respectively. Females accounted for (63%) of HCV patients in University Hospital sample however, males were (54%) and (57%) in MOH and Insurance Hospitals, respectively. Most of studied HCV patients were referred by specialists; (59%), (86%) and (87%) from University, MOH, and Insurance Hospitals, respectively. A statistically significant difference was found between the 3 Clinics as regards rating the quality of received HCV services, meeting patients’ needs, coping with HCV disease, and helping patients access to specialist services (p < 0.01). The study revealed that the majority of health providers in the 3 Viral Hepatitis Clinics didn't involve HCV patients in making decisions about their treatment. Conclusion HPSQ findings identified University Hospital's patients more satisfied about their HCV treatment management than MOH and Insurance Hospitals' patients except for involvement of HCV patients in making decisions which was lacking in the 3 hospitals.

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Role of the nurse in preventing or reducing increase intracrani-al pressure following craniotomy

International Journal of Advanced Nursing Studies ◽

10.14419/ijans.v6i2.8293 ◽

2017 ◽

Vol 6 (2) ◽

pp. 92

Author(s):

Rasha Abdelmowla ◽

Abdelhakeem Essa ◽

Esmat Abdelmaged

Keyword(s):

Intracranial Pressure ◽

Educational Program ◽

Demographic Data ◽

Quality Care ◽

Adult Patients ◽

University Hospital ◽

Control Group ◽

Significant Difference ◽

Before And After ◽

Nurses Knowledge

Background: Increase intracranial pressure following craniotomy is common and different measures should be taken to prevent or treat it promptly. Aim: Preventing or reducing increase intracranial pressure following craniotomy. Research design: Quasi-experimental.Subjects and methods: All nurses (26) in neurosurgery department at Assiut Neurological, Psychiatric and Neurosurgery University Hospital, in addition to a sample of 124 patients after craniotomy. Control group (62 adult patients before implementing the nursing educational program) and study group (62 adult patients after implementing the nursing educational program). Nurses’ knowledge and practice were assessed before and after implementation of the nursing educational program. Tools: Structured questionnaire to assess nurses` demographic data and knowledge about intracranial pressure, observation checklist for nurses` practice, patients’ assessment sheet, and teaching booklet for nurses about postoperative increase intracranial pressure. Results: Highly significant differences were found as regarding nurses` knowledge and nurses` practice pre and post implementing the nursing educational program. Significant difference was found between study and control groups as regarding increase intracranial pressure following craniotomy. Conclusion: Nursing educational program had a significant effect on preventing or reducing postoperative increase intracranial pressure.Recommendation: Nurses should have continuous education through programs, workshops, seminars and/or training courses to maintain high quality care.

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The Effect of Humor Intervention Program on Positive and Negative Symptoms among Schizophrenic Patients

10.53350/pjmhs211572022 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2022-2028

Author(s):

Eman Asran Mohamed ◽

Enayat Abd El Wahab Khalil ◽

Zeinab Abd El Halim Osman ◽

Mona Rakhawy ◽

Naglaa Mostafa G

Keyword(s):

Intervention Program ◽

Negative Symptoms ◽

Demographic Data ◽

Intervention Group ◽

University Hospital ◽

Control Group ◽

Significant Difference ◽

Schizophrenic Patients ◽

And Control ◽

Positive And Negative Symptoms

Background: Schizophrenia is a chronic disease characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. Humor could be used as an alternative to conventional treatment with the goal of helping patients with schizophrenia cope with symptoms, enhance recovery through its emotional, cognitive, social and physiological effects. The aim of the study was to evaluate the effect of humor intervention program on positive and negative symptoms among schizophrenic patients. Design: Randomized control trial (RCT) design was used. Sample: Purposive sample consisted of 40) schizophrenic patients, the study group (n= 20) and control group (n= 20). The patients were selected and allocated randomly into two groups, intervention group (received the humor interventions program) and control group (received traditional care). The study conducted in the Psychiatry and Addiction Prevention "El Kasr AlAini University Hospital and al Rakhawy Hospital for Mental Health. Tools: three tools were used for data collection were; the Socio Demographic Data Sheet, Positive and Negative Syndrome Scale (PANSS) and Multidimensional Sense of Humor Scale (MSHS). Results: revealed that, there was a statistical significant difference between total score of PANSS between study and control groups post intervention. Conclusion: The present study emphasizes the importance of humor intervention program in reducing severity of symptoms of patients with schizophrenia. Key words: schizophrenia, humor intervention, positive symptoms, negative symptoms

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174 SARS-Cov-2 Increases The 30-Day Mortality in Hip Fracture Patients. A UK District Hospital’s Experience

British Journal of Surgery ◽

10.1093/bjs/znab134.042 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

U Oduoza ◽

G Mamarelis ◽

R Chekuri ◽

R Estfan ◽

A Greer

Keyword(s):

Hip Fracture ◽

Mortality Rate ◽

Demographic Data ◽

University Hospital ◽

Neck Of Femur ◽

Exact Test ◽

Fisher's Exact Test ◽

Significant Difference ◽

Fisher’S Exact Test ◽

Mortality Ratio

Abstract Introduction Coronavirus disease 2019 (COVID-19) is a worldwide pandemic with a case mortality ratio of approximately 6.4%. Hip fracture patients are vulnerable if contracting COVID-19. Evidence is lacking regarding the mortality rate of hip fracture patients admitted during the COVID-19 pandemic. Method Retrospective review of all patients admitted to Southend University Hospital from March – April 2020. Demographic data (age, BMI, gender, co-morbidities) along with diagnosis of COVID-19 (clinical + (radiology +/- microbiology positive) and operative characteristics (time to operation, length of stay, ASA grading, Nottingham Hip Fracture Score), blood tests. Primary outcome was 30-day mortality rate in COVID-19 positive/negative patients who had hip fracture. Results 41 patients were included in the study of which 37 had a COVID-19 swab. Overall mortality in the group was 22%. Eleven patients tested positive for COVID-19. There was a statistically significant difference in mortality between those testing positive compared to those testing negative (54.5% versus 7,69% respectively, Fisher’s exact test, p = 0.004) and when comparing those who had an operation and tested positive for COVID-19 against those who had an operation and tested negative (37.5% versus 4,34% respectively, Fisher’s exact test, p = 0.043). Conclusions COVID-19 increases the 30-day mortality in neck of femur fracture patients.

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Differences in clinical and prognosis patient's characteristics between acute heart failure with mid-range ejection fraction compared to heart failure with other ejection fraction groups

European Heart Journal ◽

10.1093/ehjci/ehaa946.0989 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Gorriz Magana ◽

M.J Espinosa Pascual ◽

R Olsen Rodriguez ◽

R Abad Romero ◽

C Perela Alvarez ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Acute Heart Failure ◽

Demographic Data ◽

University Hospital ◽

Main Diagnosis ◽

Kaplan Meier ◽

Significant Difference ◽

The Moment

Abstract Background There are scarce data on clinical profile and prognosis of pts with Heart failure with mid-range ejection fraction (HFmrEF). The aim of this study was to analyse the patient's characteristics and their prognosis in terms of morbidity and mortality compared to those patients with acute heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction Methods We performed a retrospective analysis from a prospective observational study developed in a University Hospital, which covers 220.000 individuals. We analysed 600 discharges with the main diagnosis of Heart Failure with 52 months of median follow up. We obtain clinical and demographic data at the moment of admission and during de follow up. To analyse mortality and readmission we used a Kaplan-Meier model. Results A total of 551 patients (91%) had a transthoracic echocardiogram (TEE) during the admission. Eleven percent (11.8%) of the patients (pts) had HFmrEF (35.6% of them were women), 66.7% HFpEF (81.8% women) and 20.6% HFrEF (29.0% women). Median age of HFmrEF was 80.5±1.3 years, similar to HFpEF (81±0.5 years). However, pts with HFrEF were younger (75.2±1.1 years). A higher percent of pts with HFrEF were on beta-blocker (BB) treatment at admission compared to HFmrEF (51.79% vs 47.54%) and HFpEF (39.91%). At discharge, all of them were on high doses of BB (64.55% HFrEF, 54.10% HFmrEF and 33.62% HFpEF). After an adjusted analysis by age, pts with HFmrEF had higher mortality compared to HEpEF (HR: 0.55; 95% CI: 0.38–0.80; p=0.002) with no statically significant difference compared to HFrEF (HR: 0.88; 95% IC: 0.57–1.35; p=0.5). Pts with HFmrEF were on a higher risk of readmission compared to HFpEF (HR 0.59; 95% CI 0.41–0.84, p=0.004). There was also no statistical difference compared to HFrEF (HR 0.72, 95% CI 0.47–1.11; p=0.14). Conclusions According to our results, pts with HFmrEF and HFpEF are older compared to HFrEF. HFpEF were mostly women, compared to other groups. A lower percent of HFmrEF were also on BB treatment. HFmrEF and HFrEF had a similar prognosis in terms of readmission and mortality. HFmrEF pts were on higher risk of mortality and readmission compared to HFpEF. We need more studies to find more information and confirm these results. Graph 1 Funding Acknowledgement Type of funding source: None

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Characteristics of Adult Sepsis Patients in the Intensive Care Units in a Tertiary Hospital in Jordan: An Observational Study

Critical Care Research and Practice ◽

10.1155/2021/2741271 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Anas H. A. Abu-Humaidan ◽

Fatima M. Ahmad ◽

Maysaa’ A. Al-Binni ◽

Amjad Bani Hani ◽

Mahmoud Abu Abeeleh

Keyword(s):

Intensive Care ◽

Mortality Rate ◽

Demographic Data ◽

Tertiary Hospital ◽

University Hospital ◽

Causative Organism ◽

High Morbidity ◽

Icu Patients ◽

Middle Income ◽

Tertiary Teaching

Sepsis is a global health issue that is commonly encountered in the intensive care unit (ICU) and is associated with high morbidity and mortality. Available data regarding sepsis in low- and middle-income countries (LMIC) is lacking compared to higher income countries, especially using updated sepsis definitions. The lack of recent data on sepsis in Jordan prompted us to investigate the burden of sepsis among Jordanian ICU patients. We conducted a prospective cohort study at Jordan University Hospital, a tertiary teaching hospital in the capital, Amman. All adult patients admitted to the adult ICUs between June 2020 and January 2021 were included in the study. Patients’ clinical and demographic data, comorbidities, ICU length of stay (LOS), medical interventions, microbiological findings, and mortality rate were studied. Descriptive and inferential statistics were used to analyse data from patients with and without sepsis. We observed 194 ICU patients during the study period; 45 patients (23.3%) were diagnosed with sepsis using the Sepsis-3 criteria. Mortality rate and median ICU LOS in patients who had sepsis were significantly higher than those in other ICU patients (mortality rate, 57.8% vs. 6.0%, p value < 0.001, resp., and LOS 7 days vs. 4 days, p value < 0.001, resp.). Additionally, sepsis patients had a higher combined number of comorbidities (2.27 ± 1.51 vs. 1.27 ± 1.09, p value < 0.001). The use of mechanical ventilation, endotracheal intubation, and blood transfusions were all significantly more common among sepsis patients. A causative organism was isolated in 68.4% of sepsis patients with a prevalence of Gram-negative bacteria in 77.1% of cases. While the occurrence of sepsis in the ICU in Jordan is comparable to other regions in the world, the mortality rate of sepsis patients in the ICU remains high. Further studies from LMIC are required to reveal the true burden of sepsis globally.

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The Role of Endometrial Volume and Endometrial and Subendometrial Vascularization Parameters in a Frozen Embryo Transfer Cycle

Reproductive Sciences ◽

10.1177/1933719118804421 ◽

2018 ◽

Vol 26 (7) ◽

pp. 1013-1018 ◽

Cited By ~ 1

Author(s):

Richard Bernhard Mayer ◽

Thomas Ebner ◽

Christoph Weiss ◽

Christina Allerstorfer ◽

Reinhard Altmann ◽

...

Keyword(s):

Embryo Transfer ◽

Demographic Data ◽

Power Doppler ◽

Three Dimensional ◽

University Hospital ◽

Flow Index ◽

Power Doppler Ultrasonography ◽

Significant Difference ◽

Endometrial Volume

The role of three-dimensional power Doppler ultrasonography of the endometrium in assisted reproduction is still far from clear. In this retrospective cohort study, transvaginal three-dimensional power Doppler examinations were performed 30 min before frozen–thawed embryo transfer. After pregnancy tests, two cohorts were established: P (pregnant, n = 31) and NP (nonpregnant, n = 31). The study only included nullipara with no uterine abnormalities who were undergoing infertility treatment at the Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Linz, Austria. The main outcome measures were the vascularization flow index (VFI), flow index (FI), and vascularization index (VI) in the endometrium/subendometrium, assessed using Virtual Organ Computer-aided AnaLysis (VOCAL™), and the endometrial volume. A total of 62 patients were enrolled in the study, forming two cohorts (pregnant, P; nonpregnant, NP). There were no significant differences between the two cohorts with regard to demographic data, numbers of embryos transferred, or embryo grading, but there was a significant difference in endometrial volume (cohort P, 3.17 ± 0.84 mL; cohort NP, 2.36 ± 0.9 mL; P = 0.001) and the pregnancy rate rises with larger volume. No differences were observed in the vascularization parameters FI, VFI, and VI in the endometrium and subendometrium. In the cohort of pregnant patients, there were 26 (41.9%) live births, with 21 term deliveries (80.8%). The endometrial volume was larger in the cohort of pregnant patients. Measurements were performed 30 min before embryo transfer, and no differences were observed in vascularization parameters in the subendometrium and endometrium.

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An overview of the health status of Syrian refugee children in a tertiary hospital in Turkey

Avicenna Journal of Medicine ◽

10.4103/ajm.ajm_17_17 ◽

2017 ◽

Vol 07 (03) ◽

pp. 110-114

Author(s):

Ibrahim Hakan Bucak ◽

Habip Almis ◽

Samet Benli ◽

Mehmet Turgut

Keyword(s):

Complete Blood Count ◽

Health Workers ◽

Demographic Data ◽

Tertiary Hospital ◽

University Hospital ◽

Refugee Children ◽

The Third ◽

Syrian Refugee ◽

Pediatric Clinic ◽

Hospital Pediatric

Abstract Objective: Migration is a problem affecting all family members, but particularly children. Child refugees are the highest risk group for the health systems of receiving countries. We investigated the health of 104 Syrian child refugees presenting to a tertiary hospital in Turkey. Settings and Design: A retrospective study was conducted in the pediatric clinic. Materials and Methods: The medical files of Syrian refugee children (0–18 years) presenting to Adiyaman University Hospital, Pediatric Clinic between 01 and 30 November 2015, were investigated. Demographic data, body measurements, and laboratory results obtained from patients' medical records were evaluated. Results: Mean age of patients was 53.5 ± 49.6 (2–198) months; 63 were male and 41 were female. Seventy-two patients (69.2%) were under 5 years of age. Weight in 20 patients (19.2%), height in 33 (31.7%), head circumference in 2 (1.9%), and body mass index in 7 (6.7%) were below the third percentile. All patients with body weight below the third percentile had chronic malnutrition. Anemia was present in 35 (50%) of the 70 patients for whom complete blood count data were available. Conclusion: Health workers involved with Syrian refugee children must consider the two preventable conditions; malnutrition and anemia.

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