SEVERE PNEUMONIA

Background: The signs and symptoms of pneumonia are often nonspecificand widely vary based on the patient’s age and the infectious organisms involved. IMNCI hasimproved case improved diagnose of pneumonia. This study was conducted to study thefrequency of correctly diagnosed cases of severe pneumonia by IMNCI classification in childrenbetween 2 – 59 months of age. Study Design: Cross sectional study. Setting: Departmentof Pediatrics, Mayo Hospital, Lahore. Period: January to June 2013. Methodology: Total155 cases were included through Non probability purposive sampling. Chest radiographswere taken within the first 6 hours from Radiology Department and reports were obtained forevidence of pneumonia. Data was entered and analyzed in SPSS version 16. Age, weight,height were presented as mean ± standard deviation. Sex and radiological findings of severepneumonia were presented as frequency tables and percentages. Results: The mean age ofpatients was 12.76±11.54 months. There were 47.1% females and 52.9% males. Out of 155patients 134(86.5%) had pneumonia on CXR where as only 21(13.5%) appeared with normalstatus which were already positive on IMNCI. Only 21 (13.5%) appeared with bilateral patchof consolidation, 62 (40%) appeared with Unilateral patch of consolidation, 11 (7.1%) wereappeared with Bronchopneumonia, 30 (19.4%) were appeared with lung collapse condition and(12.9%) were appeared with Pleural Effusion. Conclusion: Clinical assessment of pneumonia inchildren on IMNCI is equivalent to the assessment on chest X-ray.

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Lag screw cutout in intertrochanteric fractures fixed with DHS.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.09.4083 ◽

2020 ◽

Vol 27 (09) ◽

pp. 1862-1866

Author(s):

Muhammad Nasir Ali ◽

Muhammad Khalid Chishti ◽

Kashif Siddiq ◽

Muhammad Hamayun Hameed ◽

Muhammad Tayyab Waheed ◽

...

Keyword(s):

Cross Sectional Study ◽

Intertrochanteric Fractures ◽

Cross Sectional ◽

Middle Position ◽

Lag Screw ◽

Screw Position ◽

Hip Screw ◽

The Mean ◽

Study Setting

Objectives: To determine the failure of DHS (dynamic hip screw) in terms of lag screw cutout. Study Design: Hospital Based Cross Sectional study. Setting: BVH and Civil Hospital Bahawalpur. Period: From 2013 to 2018. Material & Methods: 273 patients of both genders with age more than 50 years having stable intertrochanteric fractures were included in this study. With the help of C arm, the best possible anatomical reduction and rigid internal fixation was done with 135 degree DHS. Lag screw position and TAD determined on first postoperative day on radiographs (Anteroposterior & Lateral). Failure of fixation was determined on the radiographs during follow up. Lag screw cut-out was the projection of the screw from the femoral head by more than 1mm. Results: The mean age of the patients was 68.6 years (50-88). There were 132 (51.1 %) males and 126 (48.8%) females. Overall lag screw cutout rate was 11.2%. 21(30.8%) had screw cutout while 47 (69.1%) healed successfully among 68 patients with TAD ≥ 25mm. On the other hand 8(4.2%) had screw cutout while 182 (95.7%) healed successfully among 190 patients with TAD < 25mm. Middle middle and inferior middle position had highest success rate (˃ 92%) while inferior posterior position had highest cutout rate (36.2%). Among different age categories high failure rate (17.8%) seen in patients more than 70 years. Conclusion: The incidence of lag screw cutout is 11.2 % and risk of cutout can be minimized by placing lag screw in middle middle or inferior middle position and keeping the TAD < 25mm. More attention during follow up should be paid to patients with age ˃ 70 years.

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Comparison of granulomatosis with polyangiitis clinical features in patients depending of involvement or absence of kidney involvement

Current Rheumatology Reviews ◽

10.2174/1573397117666210726143757 ◽

2021 ◽

Vol 17 ◽

Author(s):

Mateusz Puchala ◽

Andrzej Rydzewski ◽

Ilona Kowalik ◽

Małgorzata Wisłowska

Keyword(s):

Clinical Features ◽

Crescentic Glomerulonephritis ◽

Immunosuppressive Treatment ◽

Cross Sectional Study ◽

Cross Sectional ◽

X Ray ◽

Small Vessels ◽

Kidney Involvement ◽

Chest X Ray ◽

The Mean

Background: GPA is a necrotizing inflammation of the small vessels with granulomas. Kidney involvement deteriorated its prognosis. Objective: Comparison of GPA patients with kidney (KI) and without kidney involvement (nKI). Material and methods: We conducted a cross-sectional study of 50 consecutive adult GPA patients, 25 KI from Nephrology and 25 nKI from Rheumatology Department of Central Clinical Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory, serological, imaging, histopathological data, BVAS, treatment. Results: The mean age of KI patients was statistically older then nKI (67.3±9.5 vs 55.1±15.9, p=0.002). Generalized, severe, resistance disease was observed respectively in 92% vs 44%, p<0.001. The number of red blood cells (3.47 vs 4.41T/l, p<0.001), hemoglobin (10.0 vs 12.9g/dl, p<0.001) was lower in KI, higher mean serum creatinine (3.95 vs. 0.89mg/dl, p<0.001), lower GFR (20.1 vs. 79.3, p<0.001), higher CRP (median: 43.4 vs 2.0mg/l, p<0.001), BVAS (16.6±4.4 vs 10.1±6.2, p<0.001), c-ANCA (median: 119.0 vs 15.2CU, p=0.017). Nodules in 28% KI, in 4% nKI (p=0.048) in chest X-ray, infiltration in 43.5% KI, in 15% nKI (p=0.042) in HRCT were observed. Skin granulomas were found in 61.5% nKI vs 18.2% KI, (p=0.047). Renal biopsy revealed in KI patients focal segmental glomerulonephritis in 11.8%, crescentic glomerulonephritis in 17.6%, pauci-immune crescentic glomerulonephritis in 70.6%. Conclusions: In patients with KI more frequently we found generalized, severe, resistant GPA, higher BVAS in comparison in patients without KI. The results of laboratory parameters, were worse in patients with KI. Aggressive immunosuppressive treatment is often used in KI group.

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Abstract P134: ASSOCIATION OF HYPERTENSION WITH MORTALITY RISK IN PATIENTS WITH COVID 19 PNEUMONIA IN A HOSPITAL IN MEXICO CITY

Hypertension ◽

10.1161/hyp.76.suppl_1.p134 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

José Martín Alanís Naranjo ◽

Gabriela Olguín Contreras ◽

Cristo Raymundo Ibarra Jaimes

Keyword(s):

Severe Pneumonia ◽

Ground Glass Opacity ◽

Cross Sectional Study ◽

Community Acquired Pneumonia ◽

P Value ◽

Cross Sectional ◽

Risk Of Mortality ◽

Chest X Ray ◽

Time Of Admission ◽

First Time

Introduction: The world is currently suffering from the outbreak of a pandemic caused by the SARS-CoV-2 coronavirus, which causes the disease called COVID-19. This disease was reported for the first time in Wuhan, Hubei Province, China, on December 31, 2019. Hypertension, diabetes and cardiovascular disease are common among patients with COVID-19. In Mexico, information on the association between COVID-19 and hypertension is scarce. Methods: This investigation was a descriptive, observational and cross-sectional study that included patients over 18 years of age who had been hospitalized with laboratory-confirmed COVID-19 between April 6, 2020, and May 6, 2020, and exhibited chest X-ray abnormalities (ground-glass opacity, interstitial alterations and/or multilobar infiltrate). Severity of pneumonia (severe vs. nonsevere) at the time of admission was defined using the community-acquired pneumonia guidelines of the American Thoracic Society (ATS). Results: Information was collected from 89 patients with COVID-19 pneumonia, 34 of whom (38.2%) were hypertensive. When studying risk factors in hypertensive patients and their degree of statistical association with risk of mortality, only the severity of pneumonia stood out. The association between severe pneumonia and mortality was statistically significant (OR: 10.9, CI 1.19-99.6, p value = 0.034). Conclusions: Severity of pneumonia upon admission can be regarded as a marker of adverse clinical outcome in hypertensive COVID-19 patients. Among hypertensive COVID-19 patients, in-hospital mortality was high (68%); such mortality was higher in our study than has been reported in other series worldwide.

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Clinical profile and outcome of the patients admitted in PICU in tertiary hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.04.6052 ◽

2021 ◽

Vol 28 (04) ◽

pp. 548-551

Author(s):

Maria Saleem ◽

Asim Khurshid ◽

Amna Wajdan ◽

Muhammad Salman Zafar

Keyword(s):

Intensive Care ◽

Pediatric Intensive Care ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Clinical Profile ◽

Cross Sectional ◽

Respiratory Disorders ◽

The Mean ◽

Seriously Ill Patients ◽

Study Setting

Objectives: To analyze the clinical profile, etiologies and outcome of seriously ill patients admitted in Pediatric Intensive Care Unit (PICU). Study Design: Cross Sectional study. Setting: PICU of Nishtar Medical Hospital, Multan, Pakistan. Period: January 2018 to December 2018. Material & Methods: During the study period, a total of 150 children, aged 1 to 12 years, with better prognosis and post-surgical cases requiring intensive care were registered. Age, gender, cause for hospitalization (clinical, surgical or emergency), length of PICU stay, diagnosis and outcome were recorded for all patients. Results: During the year of the study, 83 (55.3%) children were noted to be male. The mean age was 56.9+12.5 months. Mechanical ventilation was done in 62 (41.3%) patients. Major indications for admission to the PICU were respiratory disorders (21.5%), followed by sepsis (11.4%) and meningitis (8.1%). Majority, 80 (53.3%) patients improved and were shifted to ward and later discharged while 27 (18.0%) expired. Conclusion: Most of the children admitted in the PICU were male, aged below 5 years. Most common indication for admission in the PICU were respiratory disorders followed by sepsis and meningitis.

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ORAL HEALTH;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.12.605 ◽

2017 ◽

Vol 24 (12) ◽

pp. 1894-1898

Author(s):

Shahid Ali Mirani ◽

Syed Yousif Ali Shah ◽

Muhammad Ameen Sahito

Keyword(s):

Oral Health ◽

Dental Caries ◽

Cross Sectional Study ◽

Female Students ◽

Sectional Study ◽

Cross Sectional ◽

Male And Female ◽

The Mean ◽

And Gender ◽

Study Setting

Objectives: This study was carried out to evaluate the dental students’perception about condition of their gums and teeth and prevalence of dental caries. StudyDesign: Descriptive cross sectional study. Setting: Liaquat University of Medical and HealthSciences. Period: July 2011 to December 2011. Material and Method: The sample size was200 students comprising of both male and female. Clinical Oral examination was performedwith the help of mouth mirror and explorer in dental chair. The perception of dental studentsabout condition of their gums and teeth was obtained through questionnaire. Results: Theresults revealed that 25 % of students in present study had dental decay. The mean DMFT scorewas 0.625. Moreover, the mean DMFT score for male and female students was 0.658 and 0.576respectively. The results about distribution of DMFT components indicated that the decayed(D) teeth were in greatest number followed by filled (F) and missed (M) teeth. Conclusion:There was statistically no significant association between dental caries and gender. Moreover,prevalence of dental caries was significantly different between those who perceived their gumsand teeth condition excellent and good compared to the students who perceived their gumsand teeth condition as poor.

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Sonographic Measurement and Sex Variability of Portal Vein Using US scan in a sample of Sudanese Adults

10.21203/rs.3.rs-944749/v1 ◽

2021 ◽

Author(s):

◽

Elbagir Mustafa ◽

Mohamed Abdulkarim ◽

Khalid A. Awad ◽

Alaa Osman Mohamed Koko

Keyword(s):

Portal Vein ◽

Cross Sectional Study ◽

Radiology Department ◽

P Value ◽

Cross Sectional ◽

Normal Diameter ◽

Vein Diameter ◽

The Mean ◽

Computed Topography ◽

And Gender

Abstract Background: Measurements of the normal portal venous dimension in a specified population is so crucial. portal vein can be measured by several methods for assessing different parameters, Computed topography (CT) and sonographic imaging are common examples. The diagnosis of portal hypertension depends on the transverse portal vein diameter (normal diameter from 6-15 mm). The aim of this study is to establish baseline value for the portal vein diameter and assess the correlation with age, gender, weight, height and BMI in Sudanese populations.Methodology: This was a descriptive cross-sectional study that included a sample of Sudanese adults who were requested to have routine abdominal sonographic scanning due to reasons not related to liver or portal vein problems. The study was carried out at the Radiology Department of Qatar Alnada Hospital, Umbadda, Khartoum, Sudan 2020.Results: In this study, 376 participants were included of which more than half were females (56.1%, n=211), while 165(43.9%) were males. The mean age of the participants was 38.12 + 15.57 years. The mean portal vein diameter was 10.79 + 1.27 millimeters. From this study the portal vein diameter varied with age (p value = 0.000), weight (p value = 0.002), height (p value = 0.000) and gender (p value = 0.000). It is not related to BMI (p value = 0.3).Conclusion: This study has revealed that the portal vein diameter has positive correlation with age, gender, height, and weight of the person and has no correlation with the BMI.

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Characteristics of Heat Illness during Hajj: A Cross-Sectional Study

BioMed Research International ◽

10.1155/2018/5629474 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Doaa A. Abdelmoety ◽

Nahid K. El-Bakri ◽

Wedian O. Almowalld ◽

Zyad A. Turkistani ◽

Bassam H. Bugis ◽

...

Keyword(s):

Signs And Symptoms ◽

Cross Sectional Study ◽

Interdisciplinary Teams ◽

Electrolyte Imbalance ◽

Heat Illness ◽

Sectional Study ◽

Cross Sectional ◽

Heat Exhaustion ◽

The Mean ◽

Elevated Creatinine

Introduction. Data regarding the characteristics and outcomes of heat illness are lacking in the literature. The present study aimed to identify the clinical characteristics, morbidity, management, and mortality associated with heat illness among Hajj participants. Methods. A cross-sectional study was conducted during the Hajj in 2016 on patients who presented to emergency departments and were diagnosed with heat exhaustion or heatstroke. Data were collected using a structured collection sheet developed based on the literature. Results. A total of 267 patients were recruited. Of these, 80 (29%) and 187 (67.75%) were diagnosed with heatstroke and heat exhaustion, with 6.3% and 0.0% mortality, respectively. The mean age of the patients was 54.0±16 years. Diabetes mellitus was the most common comorbidity among both heatstroke and heat exhaustion patients. The majority of patients had hyperthermia and electrolyte imbalance. Most of the heat illness cases were treated per heat illness guidelines. Conclusions. Although authorities are working on research and forming interdisciplinary teams to prevent health problems during the Hajj, the mortality rate from heatstroke is high and the majority of the patients had hyperthermia, varied signs and symptoms, elevated creatinine levels, and electrolyte imbalances.

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Determinants of hypoxemia in children associated with pneumonia

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i2.13049 ◽

2015 ◽

Vol 7 (2) ◽

pp. 64-70 ◽

Cited By ~ 1

Author(s):

Pramila Ramawat ◽

Balkishan Sharma

Keyword(s):

Clinical Signs ◽

Severe Pneumonia ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Medical Sciences ◽

Cross Sectional ◽

Specific Sign ◽

Severe Manifestation ◽

Clinical Signs And Symptoms ◽

Very High

Background and Objectives: The most severe manifestation of pneumonia is hypoxemia has been shown to be a risk factor for morbidity and mortality. Authors investigated associating factors and determinants of hypoxemia in children with pneumonia.Materials and Methods: A cross-sectional study is designed among children of pediatric outpatient and emergency department that enrolled at Government Multi-Speciality Hospital, Chandigarh. One hundred fifty children recruited for study. The demographic and clinical parameters were recorded. Oxygen saturation measured by pulse oximeter.Results: The prevalence of hypoxemia was 48% and 61 (84.7%) infants aged 1 year found with hypoxemia. Age (p=0.006), respiratory rate (p=0.001) and severity of pneumonia (p=0.001) were strongly associated with hypoxemia. The prevalence of severe and very severe pneumonia among hypoxemic were 56.1% and 73.7% respectively. Central cyanosis (98.7%), peripheral (98.7%) cyanosis, head nodding (97.4%) grunting (96.15%) were highly specific but suprasternal (62.82%), subcostal (43.58%) and intercostal retractions (44.87%) were fairly specific sign. Sensitivity for subcostal (81.94%) and intercostal retractions (83.33%) was very high but was fair for intercostal (83.33%) retraction. Grunting (p=0.009), nasal flaring (p=0.008), subcostal (p=0.001) and intercostal (p=0.000) retractions were strongly but suprasternal retraction was significantly (p=0.024) associated with hypoxemia. Dyspnea (97.22%) was very sensitive while decrease feeding (84.61%) and irritability (83.33%) was highly but lethargy (58.97%) was fairly specific symptom.Conclusions: Study suggested that clinical signs and symptoms such as chest wall retraction, decrease feeding, dyspnea, grunting and nasal flaring in children with pneumonia may be utilized as markers for hypoxemia in conditions where pulse-oximeter isn’t available. This study supports the view of hypoxemia was disabling factor in better functional recovery in severity of pneumonia.Asian Journal of Medical Sciences Vol.7(2) 2015 64-70

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Frequency of helicobacter pylori stool antigen in individuals with dyspeptic symptom

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.06.3592 ◽

2019 ◽

Vol 26 (06) ◽

Author(s):

Khalid Ahmed Tareen ◽

Riaz Hussain Awan ◽

Seema Nayab ◽

Khadim Hussain Awan ◽

Faqir Muhammad Awan

Keyword(s):

Eradication Therapy ◽

Cross Sectional Study ◽

Dyspeptic Symptom ◽

National Hospital ◽

Cross Sectional ◽

Dyspeptic Symptoms ◽

Stool Antigen ◽

The Mean ◽

H Pylori ◽

Study Setting

Objectives: To evaluate the frequency of H. pylori stool antigen in individuals with dyspepsia. Study Design: Cross sectional study. Setting: Liaquat National Hospital, Karachi. Period: July-2017 to 31st December-2017). Patients and Methods: The individuals with dyspeptic symptoms for ≥3 months durations were included and explored for H. Pylori infection by H. Pylori stool antigen while the result were analyzed and frequencies and percentages were calculated. Results: The mean ± SD for overall population was 36.29±8.57 years while the frequency of H. pylori was recorded as 38.57% (54/140) patients respectively. Conclusion: H. pylori infection usually observed in dyspeptic individuals and should be screened for eradication therapy.

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IUCD;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.03.240 ◽

2019 ◽

Vol 26 (03) ◽

Author(s):

Aysha Khudija ◽

Attia Rabbani ◽

Huma Zafar Dar

Keyword(s):

Surgical Intervention ◽

Cross Sectional Study ◽

Cross Sectional ◽

Spontaneous Vaginal Delivery ◽

X Ray ◽

Pregnant Females ◽

Multiparous Women ◽

The Mean ◽

Age Range ◽

Study Setting

Objectives: To determine the frequency of expulsion of post PPIUCD after spontaneous vaginal delivery. Study Design: Cross sectional study. Setting: Department of Obstetrics & Gynaecology Unit-II, Lady Willingdon Hospital, Lahore. Period: October 2013 to October 2014. Methodology: In this study the pregnant females delivering vaginally at any age of gestation were included. The cases were selected irrespective of gravida, parity and having age range of 18 years or more. The cases undergoing any instrumentation or surgical intervention were excluded. Then these cases were followed for 6 weeks postpartum and X ray was done to confirm the position of IUCD and absence of the radio opaque shadow reveal its expulsion. Results: In this study 150 pregnant females were selected. The mean age of the subjects was 29.13±4.46 years. PPIUCD expulsion was seen in 11 (7.33%) of cases. PPIUCD expulsion was more commonly seen in age group more than 30 years affecting 7 (8.33%) of cases with p=0.24. PPIUCD was also more often seen in cases with multiparous women where it was observed in 08 (7.55%) cases with p= 0.78. Conclusion: Expulsion of PPIUCD is not uncommon and is more common in cases with age more than 30 years and multiparous women.

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