Correlation of Clinical Score and Serum Acetylcholinesterase Level as a Predictor of Outcome among Patients with Acute Organophosphate Poisoning Admitted in Emergency Ward of a Tertiary Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 19-27
Author(s):  
R Chaudhary ◽  
R Bhandari ◽  
G Malla ◽  
M. Poudel ◽  
M Lamsal

Background: Monitoring a patient's serum acetylcholinesterase (AChE) status after clinical score of organophosphate poisoning enables the verification of exposure to anticholinesterase agents. Methods: A cross-sectional study was conducted among the patients fulfilling the inclusion criteria and was categorized according to POP (Peradeniya Organophosphorus Poisoning) score. The study was conducted at a tertiary hospital for one year in the period of Jan 2016 to Dec 2016. POP score was applied and serum acetylcholinesterase level was determined in the lab. Spearman’s rho coefficient method was applied for correlation. Results: Seventy four patients survived in emergency ward who presented within (4.1 ± 2.9; 95% confidence interval [CI], 3.43- 4.80; P= 0.021) hours of ingestion of OP compounds, POP score 3 (Q1, Q3, 2, 4), serum AChE 2221 (Q1, Q3, 768.5, 4703.5) IU/L with 9 ( Q1,Q3, 8.75, 34.75) mg of atropine used, 94% received PAM for 5 (Q1, Q3, 3, 7) days of hospital stay. Four patients died within (7.5 ± 5.4; 95% CI, -1.16- 16.16; P= 0.021) hours of presentation, POP score of 4 (Q1, Q3, 4, 7.75), serum AChE 588 (Q1, Q3, 173, 1912) IU/L, atropine used 170 (Q1, Q3, 152.5, 297) mg, 5.1% received PAM for 3.5 (Q1, Q3, 1, 11.25) days of hospital stay. Spearman’s rho coefficient showed well correlation between POP score and serum AChE level (coefficient -0.356; P= 0.001), POP score for the need of atropine (coefficient= 0.536; P= 0.001). Serum AChE also correlated with the length of hospital stay (coefficient= 0.414; P= 0.001) compared to POP score (coefficient= 0.420; P= 0.001). Conclusions: The higher degree of POP score correlated to higher degree of serum acetylcholinesterase derangement, need for atropine, PAM and length of hospital stay. Thus, it enhances in the prediction of outcome among patients with acute organophosphate poisoning at index visit.

2015 ◽  
Vol 9 (3) ◽  
pp. 257
Author(s):  
Rini Sundari ◽  
Dinyar Supiadi Widjaya ◽  
Aditya Nugraha

Jumlah perokok dan jumlah rokok yang dikonsumsi mengalami peningkatan dari waktu ke waktu. Rokok dapat memengaruhi trombosit yang dapat menyebabkan gangguan kardiovaskular. Penelitian ini merupakan penelitian potong lintang yang bertujuan untuk menganalisis lama merokok dan jumlah rokok yang dikonsumsi terhadap jumlah trombosit, mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), dan platelet large cell ratio (PLCR). Penelitian dilakukan di Pabrik Garmen Cimahi pada tahun 2014 yang diikuti oleh 31 laki-laki perokok aktif berusia 19 - 50 (32,97 + 10,28) tahun, 70,9% di antaranya sebagai perokok sedang. Analisis data dilakukan secara deskriptif, uji normalitas Shapiro-Wilk, dan uji korelasi Spearman’s rho. Peserta telah merokok selama minimal dan maksimal dengan rata-rata (+ SB), yaitu 3 - 25 tahun (10,48 + 6,33) dan konsumsi rokok sebanyak 5 - 25 batang per hari (13,10 + 4,99). Jumlah trombosit 171 - 422 (280,9 + 56,2) x 10^3 sel/mm3, MPV 8,8 - 13,6 (10,14 + 0,93) fL, PDW 8,7 - 13,8 (10,27 + 1,22) fL, PLCR 14,4 - 38,8% (24,91 + 5,46), dan PCT 0,1 - 0,4%(0,28 + 0,06). Sebaran ukuran trombosit ditemukan normal, namun dengan ukuran besar sesuai nilai MPV dan PLCR yang tinggi. PCT normal berkorelasi sangat kuat dengan jumlah trombosit. Jumlah batang rokok yang dikonsumsi berkorelasi lemah dengan lamanya merokok. Lama merokok dan jumlah rokok yang dikonsumsi berkorelasi negatif dengan jumlah trombosit, MPV, PDW maupun PLCR.Smoking Period and Number of Cigarette Consumption with Thrombocyte among Active Male SmokersNumber of smokers and cigarette consumption are increasing from time to time. Cigarettes influence thrombocytes which may cause cardiovascular disorder. This study was a cross sectional study aiming to analyze smoking period and cigarette consumption number toward the number of thrombocytes, MPV, PDW, PCT and PLCR. This study was conducted at Cimahi Garment Factory in 2014 participated by 31 active male smokers in age of 19 - 50 (32,97+10,28) years old in which 70,9% of them were medium smokers. Data analysis was conducted descriptively, using Shapiro-Wilk normality test and Spearman’s rho correlation test. Participants had been smoking for the minimum and maximum 3 - 25 (10.48 + 6.33) years and 5 - 25 (13.10 + 4.99) cigarettes in average per day. The number of thrombocytes was worth 171 - 422 (280,9 + 56,2)x10^3 cells/mm3, MPV 8.8 - 13.6 (10.14 + 0.93) fL, PDW 8.7 - 13.8 (10.27+ 1.22) fL, PLCR 14.4 - 38.8% (24.91 + 5.46) and PCT 0.1 - 0.4% (0.28 + 0.06). PDW was found normal with the giant shape in accordance with the high MPV and PLCR value. PCT was normal correlated strongly with thrombocyte number. The cigarette consumption number had a weak correlation with the smoking period. The smoking period and the cigarette consumption number had a negative correlation with the number of thrombocytes, MPV, PDW and PLCR.


2021 ◽  
Author(s):  
müjdat karab ◽  
sinem karabulut ◽  
Aylin karalezli

Abstract Background: To compare the refractive results of two autorefractors.Methods: We designed this study as an observational, cross-sectional study. We compared the mean spheric and cylinder power, spherical equivalent, Jackson cross-cylinder values, determined the limits of agreement (LoA), and evaluated reliability.Results: Nidek HandyRef-K autorefractor measured more astigmatism and myopia in terms of the mean cylindrical power (P<.001) and spherical equivalent (P=.024). Nidek HandyRef-K showed significantly more myopic results in subgroups with spherical power more than +1.50 Diopters (D) hyperopia and -3.00 D myopia (P=.031; P=.045; P=.026; respectively) and higher astigmatism in the subgroup with the cylindric power less than -1.00 D (P<.001). The mean differences and 95% LoA were 0.06 D ± 0.47 D (-0.82 D to 0.98 D) in spherical power, 0.08 D ± 0.28 D (-0.47 D to 0.64 D) in cylindrical power, 0.11 D ± 0.47 D (-0.81 D to 1.01 D) in spherical equivalent, 0.02 D ± 0.36 D (-0.73 D to 0.69 D) in Jackson cross-cylinder power at 0°, 0.005 D ± 0.54 D (-1.07 D to 1.06 D) in Jackson cross-cylinder power at 45°. There was a strong correlation for spherical power (Spearman’s rho=0.99, P<.001), cylindrical power (Spearman’s rho=0.88, P<.001), spherical equivalent (Spearman’s rho=0.98, P<.001).Conclusion: Nidek HandyRef-K showed more myopic results regarding spherical equivalent and cylindrical power. Nidek HandyRef-K showed significantly more myopia in spherical power more than +1.50 D hyperopia, -3.00 D myopia, and more prominent astigmatism in cylindrical power less than -1.00 D subgroups.


2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Thales Philipe Rodrigues da Silva ◽  
Bruna Luiza Soares Pinheiro ◽  
Karolina Yukari Kitagawa ◽  
Renato Camargo Couto ◽  
Tânia Moreira Grillo Pedrosa ◽  
...  

ABSTRACT Objectives: to analyze the relationship between maternal age and the source of healthcare payment with mode of delivery in public and private national hospitals between the years 2012 to 2017, and the length of hospital stay. Methods: cross-sectional study of 91,894 women who had children in public and private hospitals between 2012 and 2017. Data were collected from the Diagnosis-Related Groups Brazil system and a comparative analysis was performed between patients in public care and those in supplementary healthcare. Results: in public care, the majority were vaginal deliveries and the reverse occurred in supplementary health. The proportion of cesarean sections was higher in the age group 31 to 40 years old in both services. The hospital stay was longer among women who underwent a cesarean section. Conclusions: high maternal age and the source of healthcare payment influence the mode of delivery, which interfere with the length of hospital stay.


2021 ◽  
Vol Volume 14 ◽  
pp. 839-852
Author(s):  
Hassan Alwafi ◽  
Abdallah Y Naser ◽  
Sultan Qanash ◽  
Ahmad S Brinji ◽  
Maher A Ghazawi ◽  
...  

2018 ◽  
Vol 1 (1) ◽  
pp. 44-51
Author(s):  
Jean Henry Raule

Dalam Praktek pelayanan Kesehatan prinsip Sterilisasi merupakan hal yang mutlak di lakukan, Sterilisasi merupakan rangkaian suatu proses yang bertujuan untuk menghilangkan semua bentuk kehidupan mikro Organisme (bakteri, jamur, parasit, dan virus termasuk spora). Perawat gigi berkewajiban menghindari atau mencegah infeksi silang dalam prakteknya dengan cara melakukan sterilisasi pada alat kesehatan gigi dengan tepat dengan benar. Penelitian ini bertujuan untuk mengetahui apakah ada hubungan pengetahuan perawat gigi tentang metode sterilisasi dengan pencegahan infeksi silang di poli gigi puskesmas di kota Manado. Metode penelitian ini adalah Survei analitik dengan pendekatan cross sectional study dimana data dikumpulkan dalam waktu bersamaan. Populasi penelitian pada perawat gigi yang bekerja di 7 puskesmas yang berjumlah 16 orang, sampel yang diambil yaitu total populasi. Alat ukur menggunakan kuesioner pengetahuan dan lembar checklist  tindakan.  Hasil uji correlation spearman’s rho  pada taraf  signifikansi pemaknaan 99% (α = 0.01), diperoleh nilai (p) = 0.001 (0.001 < α 0.01) yang artinya terdapat hubungan bermakna antara pengetahuan tentang metode sterilisasi dengan pencegahan infeksi silang, dengan koefisien korelasi 0.741 yang mempunyai kekuatan hubungan yang kuat.  Kolerasi antara variable ini berada pada arah korelasi positif, dimana semakin tinggi pengetahuan tentang sterilisasi semakin baik juga tindakan pencegahan infeksi silang.


2016 ◽  
Vol 47 (5) ◽  
pp. 1383-1391 ◽  
Author(s):  
James Fingleton ◽  
Irene Braithwaite ◽  
Justin Travers ◽  
Darren Bowles ◽  
Rianne Strik ◽  
...  

Serum periostin is a potential biomarker of response to therapies that target type 2 inflammation in asthma. The objectives of this study were to describe: 1) the distribution of serum periostin levels in adults with symptomatic airflow obstruction; 2) its relationship with other variables, including type 2 biomarkers; and 3) the effect of inhaled corticosteroids on periostin levels.Serum periostin levels were measured in a cross-sectional study exploring phenotypes and biomarkers in 386 patients aged 18–75 years who reported wheeze and breathlessness in the past 12 months. In 49 ICS-naïve patients, periostin levels were measured again after 12 weeks of budesonide (800 μg·day−1).The distribution of serum periostin levels was right skewed (mean±sd 57.3±18.6 ng·mL−1, median (interquartile range) 54.0 (45.1–65.6) ng·mL−1, range 15.0–164.7 ng·mL−1). Periostin was positively associated with exhaled nitric oxide (Spearman's rho=0.22, p<0.001), blood eosinophil count (Spearman's rho=0.21, p<0.001), and total IgE (Spearman's rho=0.14, p=0.007). The Hodges–Lehmann estimator (95% CI) of change in periostin level after ICS therapy was −4.8 (−6.7– −3.2) ng·mL−1 (p<0.001).These findings provide data on the distribution of serum periostin in adults with symptomatic airflow obstruction, the weak associations between periostin and other type 2 markers, and the reduction in periostin with inhaled corticosteroid therapy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Müjdat Karabulut ◽  
Sinem Karabulut ◽  
Aylin Karalezli

Abstract Background To compare the refractive results of hand-held and table-mounted autorefractors. Methods We designed this study as an observational, cross-sectional study. We compared the mean spheric and cylinder power, spherical equivalent, Jackson cross-cylinder values, determined the limits of agreement (LoA), and evaluated the reliability of two autorefractors. Results We evaluated 256 eyes of 256 pediatric patients (mean age, 9.12 ± 2.26 years; range, 5–16 years). 49% of the patients were female, and 51% were male. The Nidek HandyRef-K autorefractor measured relatively more astigmatism (P < 0.001) and less hyperopia (P = 0.024). The mean differences and 95% LoA were 0.06 D ± 0.47 D (− 0.82 D to 0.98 D) in spherical power, 0.08 D ± 0.28 D (− 0.47 D to 0.64 D) in cylindrical power, 0.11 D ± 0.47 D (− 0.81 D to 1.01 D) in spherical equivalent, 0.02 D ± 0.36 D (− 0.73 D to 0.69 D) in Jackson cross-cylinder power at 0°, 0.005 D ± 0.54 D (− 1.07 D to 1.06 D) in Jackson cross-cylinder power at 45°. We found the difference within 0.50 D in 244 (95%) eyes for spherical power, in 245 (96%) eyes for cylindrical power, 228 (89%) eyes for spherical equivalent, 224 (87%) eyes for Jackson cross-cylinder power at 0°, 213 (83%) eyes for Jackson cross-cylinder power at 45°. When comparing devices, there were strong correlations for spherical power (Spearman’s rho = 0.99, P < 0.001), cylindrical power (Spearman’s rho = 0.88, P < 0.001), and spherical equivalent (Spearman’s rho = 0.98, P < 0.001). Conclusion Two autorefractors showed clinically applicable agreement limits; excellent reliability for spherical power and spherical equivalent and good reliability for cylindrical power; high positive percent agreement for spherical and cylindrical power, spherical equivalent, Jackson cross-cylinder power at 0°and 45°. These results showed that both devices might be used interchangeably for screening of refractive error in children.


2021 ◽  
Author(s):  
Fentahun Meseret

Abstract Background: Length of hospital stay and overall in hospital mortality of diabetic keto acidosis during management are the foremost primary out comes that should be measured. Because, it is highly trusted on the improvement of diabetic keto acidosis related complication management. However, data associated to length of stay, mortality rate due to diabetic keto acidosis remains to be limited in Ethiopia.In addition to this, Nonfiction is much scarce in relation to factors associated with treatment outcome starting from its initial presentation and the overall management process. Objective: To assess treatment outcome of children<15 years old admitted with diabetic keto acidosis at Felege Hiwot comprehensive referral hospital, North West, Ethiopia, 2021Methods: Retrospective cross sectional study was conducted at Felege Hiwot comprehensive referral hospital among randomly selected sample of 176 children admitted with diabetic keto acidosis from 2016 to 2021.Data were collected by using data abstraction tool. Then it was coded, enter, cleaned and stored into Epi-data version 4.2 and was exported into STATA 14.0 statistical software for analysis. Categorical variables were described using proportions and compared using Chi-square test; whereas continuous parametric variables with mean and standard deviation and compared using parametric (t-test). Model goodness-of-fit and assumptions were checked. Finally, association between independent variables and length of hospital stay were assessed using binary logistics regression and Variables with p-value < 0.05 were considered as statistically significant.Result: The mean length of hospital stay was 9.5±6.2 days. About 59.3% of had long hospital stay (>7days).Majority of the clients (97.5%) were improve and discharged with 14.2% management complication and 4(2.5%) died in the hospital. Factors that affect long hospital stay were residence(AOR=4.31;95CI=1.25-14.80),family history of diabetes (AOR=0.12; 95%CI=0.02-0.64),glycaemia at admission (AOR=1.01;95%CI=1.00-1.02),insulin skipping (AOR=0.08;95%CI=0.01-0.98),abdominal pain(AOR=4.28;95%CI=1.11 -15.52), time in which the patient get out of diabetic keto acidosis(AOR=6.39;95%CI=1.09-37.50).Conclusion and Recommendation: Majority of clients were showed improvement and discharged to their home after longer hospital stay and with very low mortality rate followed by complication (14.2%).The time with in which the majority of the clients get out of DKA were found in between 24-48 hours. Thus, to achieve the intended treatment out come early in time, modification of the approach by emphasizing the above predictors is mandatory with the recommendation of multicenter study in this regard.


2017 ◽  
Vol 11 (12) ◽  
pp. 4938
Author(s):  
Camilla Christina Rodrigues ◽  
Rita de Cássia Helú Mendonça Ribeiro ◽  
Claudia Bernardi Cesarino ◽  
Daniela Comelis Bertolin ◽  
Renato Mendonça Ribeiro ◽  
...  

RESUMOObjetivo: investigar as causas de internação dos idosos hospitalizados, o perfil demográfico, o perfil clínico e o desfecho. Método: estudo quantitativo, transversal de análise de 14.892 prontuários eletrônicos, no período de 12 meses. Foi realizada uma análise descritiva das variáveis de caracterização amostral e aplicação do teste associativo pela estatística qui-quadrado. Resultados: a maioria dos pacientes avaliados era do sexo masculino, com grau de instrução fundamental, com companheiro, do lar, brancos, católicos e com doenças cardiovasculares, seguidas de neoplasias e doenças gastrointestinais em ambos os sexos.  A idade dos pacientes apresentou média de 72,1 anos e a média da permanência hospitalar foi de 5,9 dias. Houve associação significativa entre as doenças diagnosticadas, o sexo (p <0,001) e a etnia (p = 0,023) dos pacientes. O desfecho mais comum foi a alta dos pacientes. Conclusão: as doenças crônicas foram as principais causas de hospitalização dos idosos, acarretando mais tempo na hospitalização. A investigação destes fatores fornece subsídios para identificação dos problemas e realizar melhores ações de enfermagem. Descritores: Idoso; Hospitalização; Evolução Clínica.ABSTRACT Objective: to investigate the causes of older adult hospitalizations, demographic and clinical profiles, and patient outcome. Method: quantitative cross-sectional study conducted with 14,892 electronic medical records during 12 months. We carried out a descriptive analysis of the variables of the sample characterization, and an associative test using chi-square statistics. Results: most patients assessed were male, had primary education, lived with a partner, were white and Catholics, and had cardiovascular diseases, followed by neoplasms and gastrointestinal diseases in both sexes. The average age of the patients was 72.1 years, and the average length of hospital stay was 5.9 days. There was a significant association between diagnosed diseases, sex (p <0.001), and ethnicity (p = 0.023) of the patients. The most common outcome was hospital discharge. Conclusion: chronic diseases were the main causes of older adult hospitalizations and led to increased length of hospital stay. The assessment of these factors provides subsidies for identifying problems and performing best nursing interventions. Descriptors: Older Adult; Hospitalization; Clinical Evolution.RESUMEN Objetivo: investigar las causas de hospitalización de adultos mayores, perfil demográfico, perfil clínico y desenlaces. Método: estudio cuantitativo transversal con análisis de 14.892 registros médicos electrónicos de un período de 12 meses. Se realizó un análisis descriptivo de las variables de caracterización de la muestra y se aplicó la prueba chi-cuadrado. Resultados: la mayoría de los pacientes evaluados eran hombres, con educación primaria, vivían en pareja, eran blancos, católicos y tenían enfermedades cardiovasculares, seguidas de neoplasias y enfermedades gastrointestinales en ambos sexos. El promedio de edad de los pacientes fue de 72,1 años y de la estancia hospitalaria fue de 5,9 días. Hubo una asociación significativa entre enfermedades diagnosticadas, sexo (p <0.001) y etnia (p = 0.023) de los pacientes. El resultado más común fue el alta hospitalaria. Conclusión: las enfermedades crónicas fueron las principales causas de hospitalización de los adultos mayores, llevando a un tiempo más prolongado de internación. La investigación de estos factores proporciona subsidios para identificación de problemas y realizar mejores intervenciones de enfermería. Descritores: Adulto Mayor; Hospitalización; Evolución Clínica.


2019 ◽  
Vol 5 (2) ◽  
pp. 155-164
Author(s):  
James Richard Maramis ◽  
Claudia Priscilla Kandowangko

Mahasiswa perawat rentan mengalami keadaan lelah baik emosional, psikologi dan fisik yang dirasakan akibat melakukan aktivitas ataupun tuntutan praktik yang dilakukan secara berulang-ulang dan dalam waktu yang lama. Keluhan nyeri muskuloskeletal merupakan salah satu gejala yang terjadi pada gangguan musculoskeletal (MSDs). Tujuan penelitian adalah mengetahui hubungan antara burnout dan keluhan nyeri musculoskeletal pada mahasiswa profesi ners di Universitas Klabat. Metode penelitian yang digunakan ialah deskriptif correlation dengan menggunakan pendekatan cross sectional study dan menggunakan rumus Spearman's rho, proses pengambilan sampel dalam penelitan ini adalah menggunakan teknik purposive sampling. Pengumpulan data menggunakan kuesioner burnout dengan kuesioner Nordic Body Map yang diberikan kepada 127 mahasiswa profesi ners di Universitas Klabat, Didapati pada umumnya sebanyak 109 mahasiswa (85,8%) memiliki tingkat burnout sedang, dan 100 mahasiswa (78,7%) merasakan keluhan musculoskeletal ringan. Daerah tubuh yang paling banyak dikeluhkan ialah di punggung dengan jumlah nilai sebanyak 273 Sedangkan hasil uji statistic antara burnout dengan keluhan nyeri musculoskeletal menunjukkan  nilai p=0,000<0,05, dengan demikian ada hubungan antara burnout dengan keluhan nyeri musculoskeletal. Nilai r=0,337 yang menunjukkan arah korelasi positif antara dua variabel atau searah. Peneliti selanjutnya dapat meneliti pengaruh rutinitas kegiatan tertentu dan postur tubuh yang dilakukan oleh perawat ketika bekerja terhadap keluhan MSD-nya, dan juga agar mencari tahu hubungannya dengan keluhan-keluhan MSD yang dirasakan responden lebih dari tujuh hari.  Kata kunci : Burnout, keluhan nyeri musculoskeletal, Nordic Body Map


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