scholarly journals Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

2021 ◽  
Vol 7 (2) ◽  
pp. 107-117
Author(s):  
JO Ogunkoya ◽  
AO Oluwole ◽  
BO Adefuye ◽  
AO Adebola-Yusuf ◽  
O Ehioghae
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Large Population ◽  
Tertiary Hospital ◽  
Pulmonary Angiography ◽  
University Teaching ◽  
Western World ◽  
High Morbidity ◽  
Co Morbidity ◽  
Few Data

Background: Pulmonary embolism (PE) is a disease associated with high morbidity and mortality in the more technically advanced western world. However, in Africa and Nigeria in particular, the burden of PE is largely poorly defined as few data are available. Objectives: To characterize the clinical profile, management and outcomes in PE patients confirmed with Computerized Tomography Pulmonary Angiography (CTPA). Methods: A retrospective study was conducted at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. The medical records of PE patients confirmed by CTPA and admitted to the intensive care unit of the hospital spanning July 2016 to June 2020 were retrieved for analysis. Results: Thirty-one patients with the age range of 26 to 93 years were included and the mean age was 55.5±18.5 years. Breathlessness was the most prevalent presenting symptom. In the majority of patients (48.4%), the risk factors were not known. However, the most common risk factor and co-morbidity was pregnancy (16.1%). The in-hospital mortality rate was 9.7%. Conclusion: The clinical characteristics of PE in this cohort were similar to those described in the literature. The high mortality rate in this study also underscores the need for large population studies in black Africans.

Clinical Pattern of Perforated Prepyloric and Duodenal Ulcer at Ile-Ife, Nigeria

1998 ◽  
Vol 28 (3) ◽  
pp. 152-155 ◽  
Author(s):  
O O Lawal ◽  
S F Oluwole ◽  
O A Fadiran ◽  
B Campbell
Keyword(s):  
Duodenal Ulcer ◽  
Mortality Rate ◽  
Operative Management ◽  
Late Presentation ◽  
University Teaching ◽  
High Morbidity ◽  
Simple Closure ◽  
Clinical Pattern ◽  
Bacterial Peritonitis ◽  
Yearly Rate

High morbidity and mortality often attend perforation of duodenal ulcer. Over a 6-year period at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, 22 patients presented with prepyloric or duodenal ulcer perforations- a relatively low yearly rate of about four. Of the 15 patients evaluated, approximately three-quarters were working class young men and eight 53%) had no ulcer history. The high morbidity, and 20% mortality rate, observed were attributable to late presentation and the presence of advanced bacterial peritonitis in 67% of the patients at admission. Imprecise clinical features in those with small perforations led to misdiagnosis in a third of cases. Treatment of perforations in the majority (93%) of patients was by simple closure or truncal vagotomy and pyloroplasty. An increase in patients' awareness of the potentials of optimal operative management should encourage earlier presentation.

scholarly journals Clinical profile of patients of acute pulmonary thromboembolism

2019 ◽  
Vol 6 (4) ◽  
pp. 1089
Author(s):  
Arundhati Diwan ◽  
Supriya Barsode ◽  
Chandrakant Chavan ◽  
Rohit Jakhotia ◽  
Krishnapriya Vadlapatla
Keyword(s):  
Pulmonary Embolism ◽  
Risk Factor ◽  
Mortality Rate ◽  
Tertiary Care ◽  
Pulmonary Angiography ◽  
Clinical Profile ◽  
Care Hospital ◽  
Male Predominance ◽  
Co Morbidity ◽  
History Of

Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.

scholarly journals Pattern of Bone Mineral Density (BMD) Among Patients Attending Tertiary Hospital: 9 years’ Experience

2017 ◽  
Vol 18 (1) ◽  
pp. 47-50
Author(s):  
Zeenat Jabin ◽  
Raihan Hussain ◽  
Shamim MF Begum ◽  
Rahima Parveen ◽  
Nasreen Sultana ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Weight ◽  
Back Pain ◽  
Retrospective Study ◽  
Bone Density ◽  
Bone Mineral ◽  
Large Population ◽  
Tertiary Hospital ◽  
Mineral Density ◽  
Age Range

Objective: A retrospective study was conducted to assess the pattern of bone density status in a large population of both sexes who attended tertiary hospital National Institute of Nuclear Medicine and Allied Sciences (NINMAS) in a specific time period.Materials and Methods: A retrospective study was carried out on 2777 patients who were referred to NINMAS for dual energy X- ray absorptiometry (DXA) measurement of bone mineral density (BMD) during the year March 2005 to January 2014. BMD was measured at femoral neck (Ward’s triangle) and lumbar spines with a Norland XR-36 machine. Data about age, sex, body weight, presentations, back pain status and menstrual history were recorded. Few of them had known osteoporosis and history of fracture. Reporting was done according to the T score following WHO criteria. Few reports were based on the Z-score.Results: A total of 2777 (M=788, F=1989 with a ratio of 1: 2.5) patients with age ranging from 12 to 85 (mean + SD 43 + 11.1). BMD findings and relevant history were recorded. Results showed normal bone density in 478 (17.21%), osteopenia in 866 (31.18%), osteoporosis in 1108 (39.91%) and discrepancy of BMD in hip and spine in 325 (11.70%) patients. Female patients (n=1989) were sub divided into 6 sub groups according to age range and significant relationship of bone loss with pre peri and postmenopausal status of women were observed. These 6 groups included women of 25-34 years, 35-44years, 45-54 years, 55-64 years, 65-74 years and 75-85 years. Among them, the largest subgroups of 845 (42.4%) were of 55-64 years and maximum number (54.9%). of osteoporosis cases were of this age range. About 70% patients experienced low back pain with variable severity and duration. Mean body weight (± SD) among the premenopausal women was 49.9 ± 9.4 Kg and 48.2 ± 10.8 kg in postmenopausal women.Conclusion: The results of this study suggest that advancing age and menopausal condition of female and low body weight are important risk factors for the occurrence of low BMD.Bangladesh J. Nuclear Med. 18(1): 47-50, January 2015

scholarly journals Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Khaled Gomaa ◽  
Ahmed R. Abdelraheim ◽  
Saad El Gelany ◽  
Eissa M. Khalifa ◽  
Ayman M. Yousef ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
Control Group ◽  
Site Infection ◽  
Incidence Risk

Abstract Background Surgical site infection (SSI) is one of the commonest complications following cesarean section (CS) with a reported incidence of 3–20%. SSI causes massive burdens on both the mother and the health care system. Moreover, it is associated with high maternal morbidity and mortality rate of up to 3%. This study aims to determine the incidence, risk factors and management of SSI following CS in a tertiary hospital. Methods This was an observational case control retrospective study which was conducted at Minia maternity university hospital, Egypt during the period from January 2013 to December 2017 (Five years). A total of 15,502 CSs were performed during the studied period, of these, 828 cases developed SSI following CS (SSI group). The control group included 1500 women underwent cesarean section without developing SSI. The medical records of both groups were reviewed regarding the sociodemographic and the clinical characteristics. Results The incidence of SSI post-cesarean section was 5.34%. Significant risk factors for SSI were; chorioamnionitis (adjusted odds ratio (AOR) 4.51; 95% CI =3.12–6.18), premature rupture of membranes (PROM) (AOR 3.99; 95% CI =3.11–4.74), blood loss of > 1000 ml (AOR 2.21; 95% CI =1.62–3.09), emergency CS (AOR 2.16; 95% CI =1.61–2.51), duration of CS of > 1 h (AOR 2.12; 95% CI =1.67–2.79), no antenatal care (ANC) visits (AOR 2.05; 95% CI =1.66–2.37), duration of labor of ≥24 h (AOR 1.45; 95% CI =1.06–2.01), diabetes mellitus (DM) (AOR 1.37; 95% CI =1.02–2.1 3), obesity (AOR 1.34; 95% CI =0.95–1.84), high parity (AOR 1.27; 95% CI = 1.03–1.88), hypertension (AOR 1.19; 95% CI = 0.92–2.11) and gestational age of < 37 wks (AOR 1.12; 95% CI = 0.94–1.66). The mortality rate due to SSI was 1.33%. Conclusions The obtained incidence of SSI post CS in our study is relatively lower than other previous studies from developing countries. The development of SSI is associated with many factors rather than one factor. Management of SSI is maninly medical but surgical approach may be needed in some cases. Registration Local ethical committee (Registration number: MOBGYN0040).

scholarly journals Prevalence and Pattern of Diabetic Ketoacidosis among Children an Enugu, Southeast Nigeria: a 10 Year Retrospective Study

2021 ◽  
Vol 3 (1) ◽  
pp. 36-43
Author(s):  
Ikenna Kingsley Ndu ◽  
Ugo Nnenna Chikani ◽  
Benedict Onyeka Edelu ◽  
Obinna Chukwuebuka Nduagubam ◽  
Adaobi Ijeoma Bisi-Onyemaechi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Diabetic Ketoacidosis ◽  
Teaching Hospital ◽  
University Teaching ◽  
State University ◽  
Emergency Rooms ◽  
Tertiary Institutions ◽  
Nigeria Teaching Hospital ◽  
Enugu State

Diabetic ketoacidosis (DKA) is the most severe complication in pediatric cases of type 1 diabetes and also the leading cause of death in these children. There is a broad geographic variation in the frequency of DKA at the onset of diabetes. This study sought to determine DKA's prevalence and pattern in Enugu and review the treatment and outcome over ten years. This retrospective study conduct in the Children Emergency Rooms (CHER) of the two tertiary institutions in Enugu State, southeast Nigeria: Enugu State University Teaching Hospital (ESUTH) and the University of Nigeria Teaching Hospital (UNTH). The biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) base on the presence of hyperglycemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L), and ketonuria (urine ketone ?1+). A total of 16,488 children were admitted during the ten years, of which 21 children presented with DKA, representing a prevalence of 0.13%. Six (28.6%) of the patients were newly diagnosed diabetics, while fifteen (71.4%) known diabetics, of which 9 (60%) were presenting with DKA for the first time. A total of two patients died, giving a mortality rate of 9.5%. The rest treated and discharged. The total hospitalization duration ranged from 1–31 days, with a mean duration of 13.3 ± 7.5 days. This study has revealed some of the challenges with the management of children with DKA and the unacceptably high mortality rate.

scholarly journals A Three-year Retrospective Study of Perioperative Mortality at a Tertiary Children Hospital in Iran

2020 ◽  
Author(s):  
mohammad gharavifard ◽  
majid sharifian
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Pediatric Population ◽  
Tertiary Hospital ◽  
Mean Value ◽  
Time Interval ◽  
Perioperative Mortality ◽  
Post Surgery ◽  
Duration Of Surgery ◽  
Type Of Surgery

Abstract Introduction: Mortality is a key criterion for quality and safety in surgery. Studies show the higher rate of perioperative mortality in children compared with adults. The aim of present study was to determine the mortality rate after surgery among pediatric population. Methods: This retrospective study of perioperative mortality rate was performed in children younger than 18 years who operated at surgery unit of Dr. Sheikh pediatric tertiary hospital, Iran. Records of all cases of pediatric surgery performed under anesthesia between March 2015 and March 2018 were reviewed. Mortality rate at different time intervals after surgery, demographic characteristics and comorbidities of patients, type and duration of surgery, the number of operations in each child, the time interval between surgery and death, and the emergency level of surgery were recorded. Chi-square test was used for analysis of results. Results: Out of 5,5027 surgeries, 214 deaths were recorded, 78.6% of which occurred within one month after surgery. Mortality rate per 10,000 surgeries in the first year was about 49, which dropped to 10 in the third year. The mean value of mortality within 30-day post-surgery was 27.44 per 10000 procedures. The highest mortality rate was observed in people under 3 years of age with 67.2% and in females with 52.8%. Cardiac disease was at the top of comorbidities among dead patients. There was significant relationship between age and type of surgery with time interval between surgery and death. Conclusion: Infant age group and type of surgery was the main predictor of perioperative mortality.

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

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.

scholarly journals Trends of critical care management of obstetric patients in a tertiary hospital in sub-Saharan Africa

2019 ◽  
Vol 7 (5) ◽  
pp. 1420
Author(s):  
Fidelis A. Onyekwulu ◽  
Tochukwu C. Okeke
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Obstetric Hemorrhage ◽  
Icu Admission ◽  
Sub Saharan

Background: The maternal mortality rate in sub-Saharan Africa is high compared to other regions of the world. Management of critically ill obstetric patients is very challenging. We therefore evaluate the trends, clinical characteristics and outcome of the obstetric patients admitted into the intensive care unit of a tertiary hospital in sub Saharan Africa.Methods: This was a 9- year retrospective study carried out at the multidisciplinary Intensive Care Unit (ICU) of a University Teaching Hospital which serves as a referral centre for the south east region of the country. Data were collected from the patients’ record, ICU admission and discharge register. Also collected was data concerning labor ward admission and deliveries. Data was analyzed using SPSS Version 17 (SPSS Inc., Chicago, IL, USA).Results: The total admission into the ICU during the study period was 1243 patients of which 73 (5.87%) were obstetric patients. They were between the ages of 17 and 54 years with mean of 32.05±5.96 years. The total number of deliveries within the period was 11224 (1247 per year). The commonest obstetric cases admitted into the ICU were (pre) eclampsia 28.8% followed by obstetric hemorrhage 24.7%. The overall mortality rate in this study was 39.7%. The commonest intervention carried out in the ICU was mechanical ventilation.Conclusions: The two leading indications for ICU admission and maternal mortality are (pre)eclampsia and obstetric hemorrhage.

scholarly journals Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India

2021 ◽  
Vol 28 (4) ◽  
pp. 425-431
Author(s):  
Sudhir BHANDARI ◽  
◽  
Shivankan KAKKAR ◽  
Amitabh DUBE ◽  
Mohnish GROVER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
High Morbidity ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Invasive Fungal Diseases ◽  
Co Morbidity ◽  
History Of ◽  
Second Wave

Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20 30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre existing diabetes mellitus. Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).

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