scholarly journals Diagnostic accuracy of Yale observational scale in bacteremia in infants and children.

2020 ◽  
Vol 27 (07) ◽  
pp. 1346-1352
Author(s):  
Motia Javed ◽  
Mehboob Alam Siddiqui ◽  
Zahid Mahmood Anjum ◽  
Fazal Elahi Bajwa ◽  
Hina Ayesha
Keyword(s):  
Blood Culture ◽  
Diagnostic Accuracy ◽  
Rural Areas ◽  
Viral Infections ◽  
Signs And Symptoms ◽  
Early Screening ◽  
Cross Sectional ◽  
Observation Scale ◽  
Viable Bacteria ◽  
Yale Observation Scale

Bacteremia is the presence of viable bacteria in the circulating blood. Bacteremia is diagnosed by blood culture. Yale Observation Scale (YOS) is a scale consisting of six observational items originally and is validated in young febrile children to detect serious illness. If YOS found to be highly accurate, it will help us to design a protocol for early screening and diagnosis of bacteremia in infants so that patient’s morbidity and mortality can be minimized by early treatment. Objectives: To determine the diagnostic accuracy of Yale Observation Scale (YOS) for diagnosing bacteremia, taking blood culture as gold standard. Study Design: Cross-Sectional Validation study. Setting: Department of Pediatrics, D.H.Q Hospital, Faisalabad. Period: 26th May, 2016 to 25th November, 2016. Material & Methods: One hundred and five patients suffering from fever>38 0C, having age from 3-36 months were included in the study. Patients already taking antibiotics, immune compromised, patients with signs and symptoms of malaria or viral infections were excluded. YOS was calculated and blood culture was performed in all patients to diagnose bacteremia. Results: Out of 105 patients, mean age was 12.9±8.24 months. There were 55(52.4%) male and 50(47.6%) female patients. Sensitivity of YOS in diagnosing bacteremia was 90.63%, specificity 79.45%, PPV 65.91%, NPV 95.08% and diagnostic accuracy was 82.86%. Conclusion: YOS can be used as a key diagnostic tool in detecting bacteremia. So, by using this tool many cases in the rural areas can be diagnosed and managed early.

STUDY OF ABSOLUTE, IMMATURE NEUTROPHIL COUNT AND CRP AS DIAGNOSTIC MARKERS FOR EARLY ONSET NEONATAL SEPSIS.

2021 ◽  
pp. 25-26
Author(s):  
Pooja Poswal ◽  
Manisha Rohilla ◽  
Sunil Arora ◽  
Irbinder Kour Bali
Keyword(s):  
Blood Culture ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Neonatal Sepsis is difcult to differentiate from other conditions due to non- specic clinical signs and symptoms. Inammation in neonates shows variations in hematological parameters. Our study is to evaluate the hematological parameters and C-reactive protein estimation in neonatal sepsis for early diagnosis. Material And Methods: It was a cross-sectional study including 80 neonates admitted in the neonatal care unit, 40 (proven sepsis) and 40 probable cases); blood culture being the gold standard. Hematological parameters, immature to total neutrophil ratio (I/T ratio), Absolute neutrophil count (ANC), CRP and Blood culture were done as per standard protocols. Results: ANC had highest sensitivity of 90% followed by I/T ratio (87.5%) and CRP (77.5%). The sensitivity and specicity for the combination of ANC and I/T ratio was 78.3% and 83.6% respectively. Conclusion: ANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in neonatal sepsis prediction and to start proper and timely antibiotic therapy.

scholarly journals Assessment of the utility of Yale observation scale as a predictor of bacteremia in children aged 3 months to 36 months

2019 ◽  
Vol 6 (2) ◽  
pp. 559
Author(s):  
P. Sudhakar ◽  
P. Ajitha
Keyword(s):  
Bacterial Infections ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Roc Curves ◽  
Operating Characteristics ◽  
Good Tool ◽  
Early Management ◽  
Observation Scale ◽  
Clinical Signs And Symptoms ◽  
Yale Observation Scale

Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.

scholarly journals Human Astrovirus among Children with Cancer in Basrah

2019 ◽  
Vol 1 (2) ◽  
pp. 1-22
Author(s):  
Morroge Jassim ◽  
Janan Hasan ◽  
Hassan Hasony
Keyword(s):  
Solid Tumors ◽  
Rural Areas ◽  
Hematological Malignancies ◽  
Viral Infections ◽  
Acute Myeloblastic Leukemia ◽  
P Value ◽  
Cross Sectional ◽  
Specialty Hospital ◽  
Human Astrovirus ◽  
Oncology Center

Background. The impairment of the T-lymphocyte system leads to reduced viral clearance, resulting in intensified disease and the possibility of prolonged infection.(2) The poor functioning of B lymphocytes makes the host susceptible to bacterial and viral infections, especially in cases of malignant disease. Aim of the study. The present study set out to determine the frequency of human astrovirus infection among patients who suffered from malignancies who were being treated in the Oncology Center of the Basrah Children’s Specialty Hospital. Patients and Method. A cross-sectional study was approved for a population of children with cancers during the period from October 1, 2015 through the end of January, 2016. Forty-five children (24 females and 21 males), all with cancers, were admitted to the Oncology Center of Basrah Children’s Specialty Hospital. Their ages ranged from under 1 year to 15 years. According to the results of a specially designed questionnaire, data were obtained from patients who were either symptomatic or asymptomatic for human astrovirus infections, including 3 newly diagnosed cases (before chemotherapy) and 38 cases (during chemotherapy), with the remaining 4 cases admitted after chemotherapy. Ninety stool samples were collected at day 0 and day 4 after admission, and all were tested using astrovirus antigen enzyme-linked immuno sorbent assay (ELISA) kits (EIA-4456). Results. On both days, the rate of astrovirus infections was 15.6% in the hospitalized children with cancers, and there were no statically significant differences between hematological malignancies and solid tumors (P value was 0.857). Among hematological malignancies, astrovirus was detected at a significant rate (the P value was 0.0001) in patients with acute myeloblastic leukemia, while patients with solid tumors exhibited significant expression of rhabdomyosarcoma (the P value was 0.001). Astrovirus infection was more prevalent in females (85.8%) than in males (the P value was 0.001). Infection was most prevalent in the age group of >1–5 years (57%), and most of the infected patients (85.8%) were from rural areas (the P value was 0.012). In most of the symptomatic infected cases (71.4%) the symptom was acute diarrhea (the P value was 0.05), and this was typically during chemotherapy. Conclusion. Astrovirus infections occur at significant rates in acute myeloblastic leukemia, among hematological malignancies, and in patients with rhabdomyosarcoma, in the solid-tumor category. Therefore, astrovirus screening should be done for all children with cancers, and especially for patients with acute myeloblastic leukemia or rhabdomyosarcoma. Keywords: Cancer in children, human astrovirus

scholarly journals Evaluating Malaria Prevalence Using Clinical Diagnosis Compared with Microscopy and Rapid Diagnostic Tests in a Tertiary Healthcare Facility in Rivers State, Nigeria

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
M. N. Wogu ◽  
F. O. Nduka
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Rural Areas ◽  
Randomized Study ◽  
Malaria Prevalence ◽  
Sub Saharan Africa ◽  
World Health ◽  
High Morbidity ◽  
Cross Sectional ◽  
Sensitivity Specificity

The World Health Organization’s policy on laboratory test of all suspected malaria cases before treatment has not yielded significant effects in several rural areas of Sub-Saharan Africa due to inadequate diagnostic infrastructure, leading to high morbidity and mortality rates. A cross-sectional randomized study was conducted to evaluate the validity of clinical malaria diagnosis through comparison with microscopy and rapid diagnostic test kits (RDTs) using 1000 consenting outpatients of a tertiary hospital in Nigeria. Physicians conducted clinical diagnosis, and blood samples were collected through venous procedure and analyzed for malaria parasites using Giemsa microscopy and RDT kits. Microscopy was considered the diagnostic “gold standard” and all data obtained were statistically analyzed using Chi-square test with aPvalue <0.05 considered significant. Malaria prevalence values of 20.1%, 43.1%, and 29.7% were obtained for clinical diagnosis, microscopy, and RDTs, respectively (P<0.05). Values of 47.2%, 95.9%, and 77.8% were obtained for sensitivity, specificity, and diagnostic accuracy, respectively, in clinical diagnosis, while RDTs had sensitivity, specificity, and diagnostic accuracy values of 73.7%, 97.3%, and 88.3%, respectively, when compared to microscopy (P<0.05). Clinical diagnosed malaria cases should be confirmed with a parasite-based laboratory diagnosis and more qualitative research is needed to explore why clinicians still use clinical diagnosis despite reported cases of its ineffectiveness.

scholarly journals Prevalence of Sarcopenia Was Higher in Women Than in Men: A Cross-Sectional Study From a Rural Area in Eastern China

2021 ◽  
Author(s):  
Yichen Yang ◽  
Qin Zhang ◽  
Jing Chen ◽  
Caihong He ◽  
Danfeng Deng ◽  
...  
Keyword(s):  
Rural Area ◽  
Rural Areas ◽  
Elderly Women ◽  
Eastern China ◽  
Impedance Analysis ◽  
Gender Disparity ◽  
Study Cohort ◽  
Early Screening ◽  
Cross Sectional ◽  
Men And Women

Abstract Purpose There were limited studies specifically evaluating whether the difference of the prevalence of sarcopenia exists in men and women in older adults from rural areas in China. The aim of this study was to compare the prevalence of sarcopenia between men and women in a rural area in eastern China and to explore the underlying causes. Methods This study included 1,105 participants aged 60~89 years. Muscle mass was measured by bio-electrical impedance analysis. Hand grip strength was measured by Jamar Hydraulic Hand Dynamometer. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia-2019 Consensus. Data were analyzed using a log-binomial and linear regression. Findings: The prevalence of sarcopenia was 21.7% in women and 12.9% in men among the study cohort. After adjusting for age, education level, number of diseases, smoking, drinking, and eating habits, the prevalence of sarcopenia was 151% times higher in women than in men (PR=1.51, 95% CI = 1.01-2.26, P<0.05). Conclusions The prevalence of sarcopenia in elderly women in this rural area of eastern China is higher than in men, suggesting that women in rural areas in China seems more vulnerable for sarcopenia, thus early screening and prevention need to be provided for them to eliminate such gender disparity in health.

Antibiotic Susceptibility Patterns in the NICU of Ghaem Hospital of Mashhad

2021 ◽  
Author(s):  
Hassan Boskabadi ◽  
Elahe Heidari ◽  
Fatemeh Bagheri ◽  
Maryam Zakerihamidi
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Antibiotic Susceptibility ◽  
Clinical Signs ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Cross Sectional ◽  
E Coli

Background and Aims: Neonatal sepsis is considered a clinical syndrome characterized by signs and symptoms of infection associated with positive blood culture. The present study investigates the rate of sensitivity and resistance to antibiotics in neonates with definite sepsis. Materials and Methods: This cross-sectional study was conducted on 268 neonates with definitive sepsis (positive blood culture with clinical signs of infection) hospitalized in the NICU of Ghaem Hospital of Mashhad, from 2008 to 2018. To investigate the antibiotic susceptibility pattern, identifying microorganism and antibiogram tests was performed according to the standard microbiological method. The data were collected through a questionnaire designed by the researchers. It included neonates’ characteristics, types of microorganisms in neonatal unite, and sensitivity and resistance to neonatal sepsis’s common microorganism. Results: Based on the results, Klebsiella showed sensitivity to norfloxacin (100%), ciprofloxacin (100%), meropenem (100%), imipenem (94%), cotrimoxazole (73%), and vancomycin (67%). Similarly, Enterobacter showed 100% sensitivity to ciprofloxacin, meropenem, norfloxacin, and high sensitivity to imipenem (94%) and co-trimoxazole (83%). Acinetobacter turned out to be sensitive to co-trimoxazole and norfloxacin (both of them were 67%) and to amikacin in 33% of the cases. E. coli was sensitive to imipenem (83.33%), ciprofloxacin (80%), and ceftazidime (71.43%). Finally, staphylococcus coagulase negative was sensitive to piperacillin in 100%, vancomycin in 96.67%, and imipenem in 71.43% of the cases. Conclusions: The findings of the present study suggest that high-sensitivity drugs for the treatment of definite neonatal sepsis are Meropenem(Klebsiella and E. coli), Enterobacter(Ampicilin), Acinetobacter(Imipenem) and Staphylococcus coagulase negative (vancomycin).

scholarly journals Efficacy of Yale observation scale to detect serious bacterial infection in febrile children aged one to 36 months

2015 ◽  
Vol 1 (2) ◽  
pp. 23-26
Author(s):  
Prerana Kansakar ◽  
Prakash Sundar Shrestha ◽  
Merina Shrestha
Keyword(s):  
Bacterial Infection ◽  
Febrile Illness ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Predictive Values ◽  
Serious Illness ◽  
Observation Scale ◽  
Yale Observation Scale ◽  
Sensitivity Specificity

Introductions: In most children aged 1-36 months, the cause of a febrile illness is a self limiting viral infection. It is very difficult to distinguish these from serious bacterial infection. Objective of this study is to assess the efficacy of the Yale Observation Scale (YOS) to detect serious bacterial infection in febrile children aged 1-36 months.Methods: YOS scores were assigned as a part of a cross- sectional study in 100 children presenting in Tribhuvan University teaching hospital with fever to divide the child into well- looking if YOS ≤10 or ill- looking if YOS >10. Then the history, examination and necessary investigation was performed to come to a diagnosis of non- serious illness and serious bacterial infection.Results: Serious bacterial infection was found in 33(33%) of the patients. The sensitivity, specificity, positive and negative predictive values for a YOS score greater than 10 to detect serious bacterial infection were 45.45%, 88.05%%, 65.21% and 76.62%, respectively.Conclusions: A YOS ≤10 predicts non-serious illness while a YOS>10 does not necessarily indicate serious bacterial infection and should undergo further evaluation to confirm serious bacterial infection.

scholarly journals YALE OBSERVATION SCALE AS A PREDICTOR OF BACTEREMIA AND FINAL OUTCOME IN 3-36 MONTHS OLD FEBRILE CHILDREN ADMITTED IN TERTIARY HEALTH CENTRES: A HOSPITAL-BASED CROSS-SECTIONAL STUDY

2016 ◽  
Vol 9 (9) ◽  
pp. 219
Author(s):  
Shagun Walia ◽  
Haris M M ◽  
Ali Kumble ◽  
Soundarya Mahalingam ◽  
B Shantharam Baliga ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Clinical Course ◽  
Cross Sectional Study ◽  
Final Outcome ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Observation Scale ◽  
Yale Observation Scale

ABSTRACTObjectives: The objective of the study was to assess predictability of bacteremia in febrile children in the age group of 3-36 months by application ofYale observation scale (YOS) and to predict clinical course during hospital stay and final outcome by YOS.Methods: A hospital-based cross-sectional study was carried out at Kasturba Medical College, Mangalore, Karnataka, for a period of 2 years(September 2013-September, 2015) in 100 febrile children in the age group of 3-36 months with probable infectious etiology admitted in ward/PICU.Children with any non-infectious causes of fever (vaccination, autoimmune, and immunodeficiency disorder) were excluded from the study. Caseswere selected by simple random sampling. The primary study outcome was bacteremia based on positivity on blood culture and sensitivity sampledrawn at admission. Secondary outcomes are clinical course in the hospital, use of antibiotics, need for mechanical ventilation, hospital stay, andmortality.Results: 100 cases were included in the study out of which 18 cases were bacteremic with a mean YOS of 26 (non-bacteremic - 11), mean hospitalstay 19.5 days (non-bacteremic - 12 days). All 18 bacteremic children had YOS ≥20, but YOS ≥20 had 8 false positives cases. There was no significantinterobserver variability in YOS assessment (Cronbach’s alpha - 0.993 showing good correlation with intraclass correlation coefficient - 0.986).Higher YOS scores had good sensitivity, specificity, positive and negative likelihood ratios, and area under curve for prediction of bacteremia atYOS >20 (100%, 90.2%, 10.2, 0.00, and 0.970), need for mechanical ventilation at YOS >21 (100%, 91.7%, 12.04, 0.00, and 0.969), need for scaling upantibiotics at YOS >21 (70.4%, 94.4%, 12.5, 0.31, and 0.822), and mortality at YOS >21 (90.9%, 85.4%, 6.2, 0.106, 0.878).Conclusion: YOS is a good tool to rule out bacteremia and to prognosticate the clinical course at the first visit. This simple scale can be of value inmonitoring admitted patients for deteriorating clinical state and for assessing the need for referral to higher centers for further management.Keywords: Yale observation scale, Bacteremia, Febrile patients.

scholarly journals Prevalence and associated factors of hypertension in selected urban and rural areas of Dhaka, Bangladesh: findings from SHASTO baseline survey

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e038975
Author(s):  
Mehedi Hasan ◽  
Md Showkat Ali Khan ◽  
Ipsita Sutradhar ◽  
Md Mokbul Hossain ◽  
Moyazzam Hossaine ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Urban Areas ◽  
Final Analysis ◽  
Baseline Survey ◽  
Dhaka City ◽  
Early Screening ◽  
Cross Sectional ◽  
The Government ◽  
Urban And Rural Areas

ObjectiveWe implemented this study to report the prevalence and associated risk factors of hypertension among adult men and women aged >30 years residing in selected urban and rural areas of Dhaka division, Bangladesh.DesignCross-sectional study.SettingTwo urban (Dhaka city north and Dhaka city south) and two rural (Narsinghdi and Gazipur district) areas of the Dhaka division.ParticipantsA total of 4856 male and female participants were included in the final analysis, of whom 2340 (48.2%) were from urban and 2516 (51.8%) were from rural areas.Primary outcomeHypertension was the dependent variable for this study and was operationally defined as systolic blood pressure >140 mm of Hg and/or diastolic blood pressure >90 mm of Hg, and/or persons with already diagnosed hypertension.ResultsThe overall prevalence of hypertension was 31.0%, and the prevalence was higher among urban participants (urban: 36.9%, rural: 30.6%). Age (across all categories), female (urban—adjusted OR (AOR): 1.3, 95% CI: 1.0 to 1.5 and rural—AOR: 1.7, 95% CI: 1.4 to 2.1)), higher educational status (urban—AOR: 1.7, 95% CI: 1.3 to 2.2 and rural—AOR: 2.1, 95% CI: 1.5 to 3.1), inadequate physical activity (urban—AOR: 1.3, 95% CI: 1.0 to 1.7 and rural—AOR: 1.5, 95% CI: 1.2 to 1.9) and overweight/obesity (urban—AOR: 2.7, 95% CI: 2.1 to 3.3 and rural—AOR: 2.1, 95% CI: 1.7 to 2.5) were associated with hypertension in both urban and rural areas. Women who were not currently married during the survey had higher odds of hypertension only in the rural areas (rural—AOR: 1.8, 95% CI: 1.3 to 2.4), and respondents who were not working during the survey had higher odds of hypertension only in the urban areas (AOR: 1.7, 95% CI: 1.0 to 2.6).ConclusionSince the prevalence of hypertension was high in urban and rural areas, the government of Bangladesh should consider implementing hypertension prevention programmes focusing young population of Dhaka division. In addition, early screening programmes and management of hypertension need to be strengthened for people with hypertension in both the areas.

scholarly journals Prevalence of hypertension in a rural community of North Kerala, India: a cross sectional study

2017 ◽  
Vol 4 (2) ◽  
pp. 528 ◽  
Author(s):  
Satheesh B. C. ◽  
Mohammad Iliyas C.
Keyword(s):  
Rural Community ◽  
Rural Areas ◽  
Access To Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Health Concern ◽  
Sectional Study ◽  
Early Screening ◽  
Cross Sectional ◽  
Urban And Rural Areas

Background: Hypertension is major risk factor for CVDs and its complications account for 9.4 million deaths worldwide every year. Hypertension itself is responsible for about 45% and 51% deaths due to heart disease and stroke respectively. Hypertension is a major public health concern in India both in urban and rural areas and it is increasing at an alarming rate in rural population. Because of inadequate access to health care facilities at rural areas, the early screening and treatment of hypertension is not done regularly, so we conducted this study. Objectives: To determine the prevalence of hypertension in a rural community of North Kerala.Methods:A community based cross sectional study was conducted at rural field practice area of Kannur Medical College, Kannur. Sample size was 151 and convenient sampling method used. Data was collected visiting homes and blood pressure measured with mercury sphygmomanometer by. Descriptive statistics were used to analyse the data.Results: Among 152 participants, 52.3% and 47.7% were females and males respectively and mean age of the participants was 51.01±15.25 years. The overall prevalence of hypertension among them was 18.5% and the proportion of hypertension was more among the age group of 60-69 years (39.3%).Conclusions:Our study shows that hypertension is not only a concern of the urban population, but also important issue in rural areas. Newly diagnosed cases are more which indicates, people are not aware about importance of regular screening. Since screening helps in early detection, so strengthening of health facilities and creation of awareness at rural levels will reduce the morbidity and mortality due to hypertension and its complications. 

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