scholarly journals THE IMPACT OF ANTITUBERCULOSIS DRUG-INDUCED HEPATOTOXICITY TO SUCCESFUL TUBERCULOSIS TREATMENT IN INDONESIA

2017 ◽  
Vol 10 (11) ◽  
pp. 194 ◽  
Author(s):  
Nisa Maria ◽  
Maksum Radji ◽  
Erlina Burhan
Keyword(s):  
Retrospective Study ◽  
Tertiary Hospital ◽  
Successful Outcome ◽  
Antituberculosis Drug ◽  
Duration Of Treatment ◽  
Drug Induced ◽  
Tb Treatment ◽  
Prolonged Duration ◽  
The Mean ◽  
The Impact

  Objective: This study aimed to evaluate the impact of antituberculosis (anti-TB) drug-induced hepatotoxicity (DIH) to outcome TB treatment.Methods: A cohort retrospective study conducted at a tertiary hospital in Jakarta - Indonesia, from the period of 2013-2016. A total of 76 samples of TB patient with and without anti-TB DIH were analyzed.Results: Successful outcome TB treatment for TB patient with anti-TB DIH is 47.4% compared to TB patient without anti-TB DIH is 78.9%. Relative risk (RR) analysis showed that risk of unsuccessful TB treatment for TB patient with anti-TB DIH is 2.50 fold higher (95% confidence interval: 1.259- 4.960) than TB patient without anti-TB DIH. Age, sex, and comorbidities are not statistically significant to outcome TB treatment. For TB patient with anti-TB DIH, onset anti-TB DIH and recurrence anti-TB DIH also not statistically significantly influence outcome TB. The mean duration of treatment for a successful outcome for TB patient with and without anti-TB DIH was statistically significant (p<0.05), respectively, 8.44±1.85 and 6.52±0.93 months.Conclusion: Anti-TB DIH increases the risk of unsuccessful and prolonged duration TB treatment.

scholarly journals Role of Occupational Footwear and Prolonged Walking on Lower Extremity Muscle Activation during Maximal Exertions and Postural Stability Tasks

Biomechanics ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 202-213
Author(s):  
Harish Chander ◽  
Sachini N. K. Kodithuwakku Arachchige ◽  
Alana J. Turner ◽  
Reuben F. Burch V ◽  
Adam C. Knight ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Postural Stability ◽  
Muscle Activation ◽  
Medial Gastrocnemius ◽  
Lower Extremity Muscle ◽  
Prolonged Duration ◽  
The Mean ◽  
The Impact

Background: Occupational footwear and a prolonged duration of walking have been previously reported to play a role in maintaining postural stability. The purpose of this paper was to analyze the impact of three types of occupational footwear: the steel-toed work boot (ST), the tactical work boot (TB), and the low-top work shoe (LT) on previously unreported lower extremity muscle activity during postural stability tasks. Methods: Electromyography (EMG) muscle activity was measured from four lower extremity muscles (vastus medialis (VM), medial hamstrings (MH), tibialis anterior (TA), and medial gastrocnemius (MG) during maximal voluntary isometric contractions (MVIC) and during a sensory organization test (SOT) every 30 min over a 4 h simulated workload while wearing ST, TB, and LT footwear. The mean MVIC and the mean and percentage MVIC during each SOT condition from each muscle was analyzed individually using a repeated measures ANOVA at an alpha level of 0.05. Results: Significant differences (p < 0.05) were found for maximal exertions, but this was limited to only the time main effect. No significant differences existed for EMG measures during the SOT. Conclusion: The findings suggest that occupational footwear type does not influence lower extremity muscle activity during both MVIC and SOT. Significantly lower muscle activity during maximal exertions over the course of the 4 h workload was evident, which can be attributed to localized muscular fatigue, but this was not sufficient to impact muscle activity during postural stability tasks.

scholarly journals Adherence to Beers Criteria in Geriatrics: A Retrospective Study in a Saudi Teaching Hospital

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 97
Author(s):  
Samah Alshehri ◽  
Mohannad Alshibani ◽  
Ghaydaa Magboul ◽  
Albandari Albandar ◽  
Roaa Nasser ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Older Patients ◽  
Adverse Drug Events ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Inappropriate Medications

Background: The aging process makes geriatric populations more prone to various chronic diseases. Such diseases require older patients to be on more medications than any other age group and make them more susceptible to adverse drug events related to potentially inappropriate medications (PIMs). Aim: To identify the prevalence of potentially inappropriate medications among older people and explore the most commonly prescribed PIMs in hospitalized patients. Design and Setting: A retrospective study conducted in a large tertiary hospital among patients hospitalized in a 4 year period from January 2015 to December 2018. Methods: The 2019 Beers Criteria were used to assess PIMs in all inpatient prescribed medications focusing on the first class (i.e., drug/drug class to be avoided in older adults). Results: The mean age was 75.17 ± 7.66 years. A total of 684 (80.6%) patients were prescribed at least one medication listed in the first-class category of the 2019 Beers Criteria. Top five drugs were proton pump inhibitors (40.3%), nonsteroidal anti-inflammatory drugs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is high among older patients admitted to the hospital. More efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers.

scholarly journals Lymphopenia predicted illness severity and recovery in patients with COVID-19: A single-center, retrospective study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241659
Author(s):  
Jiheng Liu ◽  
Heng Li ◽  
Ming Luo ◽  
Jiyang Liu ◽  
Lingzhen Wu ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Retrospective Study ◽  
Clinical Laboratory ◽  
Tertiary Hospital ◽  
Outcome Data ◽  
Single Center ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Prolonged Duration ◽  
Duration Of Hospitalization

The outbreak of SARS-CoV-2 began in December 2019 and rapidly became a pandemic. The present study investigated the significance of lymphopenia on disease severity. A total of 115 patients with confirmed COVID-19 from a tertiary hospital in Changsha, China, were enrolled. Clinical, laboratory, treatment and outcome data were gathered and compared between patients with and without lymphopenia. The median age was 42 years (1–75). Fifty-four patients (47.0%) of the 115 patients had lymphopenia on admission. More patients in the lymphopenia group had hypertension (30.8% vs. 10.0%, P = 0.006) and coronary heart disease (3.6% vs. 0%, P = 0.029) than in the nonlymphopenia group, and more patients with leukopenia (48.1% vs 14.8%, P<0.001) and eosinopenia (92.6% vs 54.1%, P<0.001) were observed. Lymphopenia was also correlated with severity grades of pneumonia (P<0.001) and C-reactive protein (CRP) level (P = 0.0014). Lymphopenia was associated with a prolonged duration of hospitalization (17.0 days vs. 14.0 days, P = 0.002). Lymphocyte recovery appeared the earliest, prior to CRP and chest radiographs, in severe cases, which suggests its predictive value for disease improvement. Our results demonstrated the clinical significance of lymphopenia for predicting the severity of and recovery from COVID-19, which emphasizes the need to dynamically monitor lymphocyte count.

scholarly journals COVID-19 in the Intravitreal Injection (IVI) Procedure at a Spanish Urban Tertiary Hospital

2021 ◽  
Author(s):  
Jonathan Jesús Cancelliere Fernández ◽  
María Muxima Patricia Acebes García ◽  
Francisco Javier Moreno-Alemán Sánchez ◽  
J. Jacobo González-Guijarro
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Intravitreal Injection ◽  
Preventive Measures ◽  
Admission Rate ◽  
Tertiary Hospital ◽  
Viral Transmission ◽  
Sex Diagnosis ◽  
Group A ◽  
The Mean

Abstract Purpose: To describe the rate of COVID-19 in intravitreal injection (IVI) procedure at the onset of the pandemic.Methods: This transversal, observational and retrospective study included patients treated with IVI, in 3 groups. A: from February 20 to March 15, 2020, a period prior to lockdown and the first preventive measures against viral transmission. B: from March 16 to May 3, after the start of both, and C: from May 4 to June 19, after lockdown. Age, sex, diagnosis, drug, IVI laterality, visual acuity, percentage of single eyes, date of COVID-19 diagnosis, incidence among the Hospital attended population and number of COVID-19 patients admitted daily, were collected.Results: 1049 patients were treated, 564 (53.7%) on two or more occasions. COVID-19 rate was 1.51% (8/529) in group A, 0.21% (1/469) in B and 0% in C (0/926) (p=0.0001). The highest incidence peak x105 inhabitants and the mean daily admission rate, for the periods corresponding to the three groups, were 93.70/7.70 (SD 7.32), 418.72/27.83 (SD 24.68) and 24.58/2.28 (SD 1.97), respectively.Conclusion: The favourable trend in the COVID-19 rate among our patients, after implementing preventive measures against viral transmission, may assist in adequately planning IVI procedure in the future.

scholarly journals Tinnitus and Otosclerosis: An Exploratory Study about the Prevalence, Features and Impact in Daily Life

2021 ◽  
Author(s):  
Antonio Fontes Lima ◽  
Filipa Carvalho Moreira ◽  
Isabel Esteves Costa ◽  
Catia Azevedo ◽  
Fernando Mar ◽  
...  
Keyword(s):  
Daily Life ◽  
Demographic Data ◽  
Age Groups ◽  
Female Gender ◽  
Tertiary Hospital ◽  
Aged Patients ◽  
Low Frequencies ◽  
Female Predominance ◽  
The Mean ◽  
The Impact

Abstract Introduction Tinnitus is experienced by a significant part of the patients suffering from otosclerosis. Objective To assess the prevalence of tinnitus in otosclerosis, its main features, and the impact on the daily life. Methods Patients diagnosed with otosclerosis in 2019 in a tertiary hospital were enrolled in the study. Demographic data were retrieved and, besides a regular audiometric evaluation, the patients underwent acuphenometry to assess the psychoacoustic measurements (pitch and loudness), and the Tinnitus Handicap Inventory (THI). Results In total, 66 patients fulfilled the inclusion criteria, with a female predominance (63.6%; n = 42), and a mean age of 48.7 years. The mean air-bone gap was of 26.3 dB. A total of 72.7% complained of tinnitus; it was mostly unilateral, identified in the low frequencies, namely 500 Hz, with median loudness of 7.5 dB. The median score on the THI score was of 37; most patients had a mild handicap (33.3%, n = 16), followed by those with a severe handicap (22.9%; n = 11). The female gender had a statistically significant association with the presence of tinnitus. The THI scores were higher in middle-aged patients (age groups: 40 to 49 and 50 to 59 years), which was statistically significant. No correlation was found between audiometry results and the prevalence of tinnitus or score on the THI. On the other hand, high-pitched tinnitus, compared to low pitched-tinnitus, was associated with larger air-bone gaps. Conclusion The prevalence of tinnitus in our population was in line with the prevalences reported in the literature. It caused a catastrophic handicap in 22.9% of the patients. High-pitched tinnitus was associated with higher handicap. Nonetheless, the existence of tinnitus and its severity were not associated with the degree of hearing loss.

scholarly journals Factors Influencing the Total Inpatient Pharmacy Cost at a Tertiary Hospital in Malaysia: A Retrospective Study

2018 ◽  
Vol 55 ◽  
pp. 004695801875548
Author(s):  
Syed Mohamed Aljunid ◽  
Saad Ahmed Ali Jadoo
Keyword(s):  
Retrospective Study ◽  
Tertiary Hospital ◽  
Pharmacy Cost ◽  
Policy Makers ◽  
Severity Level ◽  
Factors Affecting ◽  
Pharmaceutical Expenditures ◽  
Steady Growth ◽  
Hospitalization Period ◽  
The Impact

The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III ( B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC ( B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC.

scholarly journals QUALITY OF LIFE IN THE PRE- AND POSTOPERATIVE PERIODS IN SPINAL FUSION AND DISCECTOMY

2019 ◽  
Vol 18 (1) ◽  
pp. 55-59
Author(s):  
Gibran Franzoni Rufca ◽  
Flavio Ramalho Romero ◽  
Drielly Lívia Cristino Braga Rufca ◽  
Bruna da Silva ◽  
Catilaine de Oliveira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Telephone Interview ◽  
Tertiary Hospital ◽  
Lumbar Pain ◽  
Functional Importance ◽  
Level Of Evidence ◽  
Spinal Arthrodesis ◽  
The Impact

ABSTRACT Objectives: Considering the epidemiological and functional importance of spinal pathologies and the large number of surgeries performed today, the study aimed to evaluate the impact of spinal arthrodesis and discectomy surgeries on patients’ quality of life. Methods: This is a retrospective, descriptive, and longitudinal study developed in the neurology and neurosurgery department of a strategic tertiary hospital in an inland town in the state of São Paulo. Data were collected through a telephone interview, using the Oswestry questionnaire (ODI) to assess lumbar pain in patients submitted to surgery in 2014 and 2015. Results: There was an improvement in the ODI results in all the periods analyzed. When the evaluations were subdivided by surgical type, there was an absolute improvement in the median ODI results in all procedures, however, only the cervical spine arthrodesis procedure was not statistically significant, probably due to the low number of procedures analyzed (n = 12). Conclusion: It can be concluded that the current surgical technique can contribute to the improvement of patients’ quality of life. Level of Evidence III; Comparative retrospective study.

scholarly journals Antituberculosis drug-induced hepatotoxicity: a comparison between patients with and without human immunodeficiency virus seropositivity

2010 ◽  
Vol 43 (6) ◽  
pp. 624-628 ◽  
Author(s):  
Natalia Saldanha Magalhães Coca ◽  
Marcelo Silva Oliveira ◽  
Izabela Voieta ◽  
Carlos Maurício de Figueiredo Antunes ◽  
José Roberto Lambertucci
Keyword(s):  
Hiv Infection ◽  
Fold Increase ◽  
Antituberculosis Drug ◽  
Drug Induced ◽  
Antituberculosis Therapy ◽  
Immunodeficiency Virus ◽  
Definition Of ◽  
The Impact ◽  
Lower Limit Of Normal ◽  
Hiv Negative

INTRODUCTION: The prevalence and risk factors for rifampin, isoniazid and pyrazinamide hepatotoxicity were evaluated in HIV-infected subjects and controls. METHODS: Patients with tuberculosis (30 HIV positive and 132 HIV negative), aged between 18 and 80 years-old, admitted to hospital in Brazil, from 2005 to 2007, were selected for this investigation. Three definitions of hepatotoxicity were used: I) a 3-fold increase in the lower limit of normal for alanine-aminotransferase (ALT); II) a 3-fold increase in the upper limit of normal (ULN) for ALT, and III) a 3-fold increase in the ULN for ALT plus a 2-fold increase in the ULN of total bilirubin. RESULTS: In groups with and without HIV infection the frequency of hepatotoxicity I was 77% and 46%, respectively (p < 0.01). Using hepatotoxicity II and III definitions no difference was observed in the occurrence of antituberculosis drug-induced hepatitis. Of the 17 patients with hepatotoxicity by definition III, 3 presented no side effects and treatment was well tolerated. In 8 (36.4%) out of 22, symptoms emerged and treatment was suspended. Alcohol abuse was related to hepatotoxicity only for definition I. CONCLUSIONS: Depending on the definition of drug-induced hepatitis, HIV infection may or may not be associated with hepatotoxicity. The impact that minor alterations in the definition had on the results was impressive. No death was related to drug-induced hepatotoxicity. The emergence of new symptoms after initiating antituberculosis therapy could not be attributed to hepatotoxicity in over one third of the cases.

scholarly journals Outcomes and Complications of Sutured Scleral-Fixated Foldable Intraocular Lens Implantation: A Retrospective Study of 5-Year Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ting Yu ◽  
Mengting Yu ◽  
Wenjie Wu ◽  
Xinna Wu ◽  
Suzhen Xiao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Intraocular Lens ◽  
Tertiary Hospital ◽  
Long Term Outcomes ◽  
Iol Implantation ◽  
Minimum Angle ◽  
The Mean ◽  
Iol Dislocation

Purpose. To evaluate long-term outcomes and complications of sutured scleral-fixated foldable intraocular lens (IOL) implantation. Design. Retrospective study. Methods. Patients who underwent sutured scleral-fixated foldable IOL implantation using 10-0 polypropylene suture were followed up for at least 5 years at one Chinese tertiary hospital and two primary hospitals. Results. 52 eyes among 48 patients (35 male and 13 female) were evaluated. The mean age (years) was 50.27 ± 20.08 (range: 6 to 81). The mean postoperative follow-up time (months) was 79.70 ± 18.84 (range: 60 to 121). The mean best-corrected visual acuity (BCVA) improved from 0.83 ± 0.69 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.50 ± 0.45 logMAR at the last follow-up visit. There was improved or unchanged BCVA in 44 eyes (84.62%) and reduced BCVA in 8 eyes (15.38%). Mild intraoperative intravitreal hemorrhage was observed in 3 eyes (5.77%). Early postoperative complications included transient elevated intraocular pressure (IOP) in 5 eyes (9.62%) and hypotony in 1 eye (1.92%). Secondary epimacular membrane occurred in 5 eyes (9.62%) and retinal detachment (RD; 3 years postsurgery), subconjunctival suture knot exposure (5 years postsurgery), and persistent elevated IOP (in a GRAVES patient) occurred in 1 eye (1.92%) each. No suture erosion or breakage nor IOL dislocation was observed. No visually threatening IOL tilt or decentration was reported in any patient. Conclusion. Sutured scleral-fixated foldable IOL implantation demonstrated satisfactory long-term outcomes and rare suture-related complications. This technology was safe and did not require complicated equipment and is of considerable interest in the setting of aphakia without adequate capsule support.

scholarly journals Renal Transplantation-Anaesthetic Experience of 12 years: A Retrospective Study

2018 ◽  
Vol 8 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Md Shafiul Alam Shaheen ◽  
Kawsar Sardar ◽  
AKM Nurnobi Chowdhury ◽  
Mahbubul Hasan ◽  
Mashfiqur Rahman ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Anaesthetic Management ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Background: Renal transplantation is the preferred treatment for end stage renal disease. Patients undergoing renal transplant surgery have several high risk features like cardiovascular diseases, diabetes mellitus and need for haemodyalysis. Renal transplant anaesthesia requires a thorough understanding of the metabolic and systemic abnormalities in end stage renal disease, familiarity with transplant medicine and expertise in managing and optimizing these patients for the best possible outcome. The aim of this study was to find out the characteristics of patients, causes of ESRD, anaesthetic management and the impact of pre-existing diseases on intraoperative or early postoperative complications of the recipients.Methods: In this retrospective study we described our experiences of 124 cases of living transplants from November 2004 – December 2016. We reviewed their medical history and noted age, sex, blood groups, causes of ESRD and history of dialysis. Preoperative investigation and preparation, as well as details of anaesthetic management, were also recorded.Results: General anaesthesia was performed in almost 97% of patients and for the rest of them, combined epidural and general anesthesia were done. The age of the patients was in the range of 15 – 65 years, with the majority of 30 - 39 years group. The mean of surgery duration was 4.5 (±1.20SD) hours. The most significant point during surgery is keeping the mean arterial pressure > 90mm Hg.Conclusions: Preoperative patient optimization, intraoperative haemodynamic stability and postoperative care of renal transplant patients have contributed to the success of renal transplant programmed in our hospital.Birdem Med J 2018; 8(2): 167-171

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