scholarly journals Ritual scalp shaving-a risk factor for community acquired late onset neonatal sepsis

2014 ◽  
Vol 9 (3) ◽  
pp. 35-44
Author(s):  
S Sen ◽  
KB Mondal ◽  
A Roy ◽  
N Kumar ◽  
P Pant ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Teaching Hospitals ◽  
Causative Organism ◽  
Medical Sciences ◽  
Tertiary Teaching ◽  
History Of ◽  
Independent Variable ◽  
The Difference

Background Neonatal sepsis is one of the major causes of morbidity and mortality at the community and hospital levels in India. There are several community practices associated with and contributing to Neonatal sepsis, especially late onset variety.Objective To analyze whether scalp shaving is an independent risk factor associated with community acquired late onset neonatal sepsis and the causative organism responsible.Methods This was a prospective, non-interventional, observational study. The study was conducted at two tertiary teaching hospitals in Eastern India from 1st May 2010 to 30th April 2011. A total of 382 babies were diagnosed as Late Onset Neonatal Sepsis and 410 , age and sex matched controls were taken from the Well Baby and Immunization clinics. The patients were clinically screened for sepsis and "septic screen" and blood, urine and CSF cultures sent, as needed.Results History of scalp shaving was present in 46(12.04%) out of 382 cases of Late Onset Neonatal Sepsis as compared to 20(4.87%) of 410 matched community controls, the difference was statistically significant (p<0.005). Positive blood cultures were obtained in 20(43.48%) out of 46 scalp shaven babies as compared to 118(35.11%) out of 336 non scalp shaven babies. The commonest organism in babies with scalp shaving was found to be methicillin resistant Staphylococcus aureus(MRSA), whereas the most common organism in non scalp shaven babies was Klebsiella pnuemoniae.Conclusion Scalp shaving appears to be an independent variable associated with community acquired Late Onset Neonatal Sepsis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 35-44

scholarly journals Survival Status and Predictors of Mortality among Newborns Admitted with Neonatal Sepsis at Public Hospitals in Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Samuel Dessu ◽  
Aklilu Habte ◽  
Tamirat Melis ◽  
Mesfin Gebremedhin
Keyword(s):  
Neonatal Sepsis ◽  
Late Onset ◽  
Survival Curve ◽  
Multivariable Analysis ◽  
Public Hospitals ◽  
Rank Test ◽  
Cumulative Proportion ◽  
Predictors Of Mortality ◽  
Survival Status ◽  
History Of

Background. One-fourth of neonatal death is due to neonatal sepsis and nearly 98% of these deaths are occurring at low- and middle-income countries. In Ethiopia, forty percent of under-five mortality occurs during the neonatal period, of which neonatal sepsis accounts for 30-35% of neonatal deaths next to prematurity and its complications. On the other side, among the survived neonates with neonatal sepsis, there exist as vulnerable to short and long-term neurological and developmental morbidity impacting the overall productivity of the child as adult. Methods. A longitudinal prospective cohort study was conducted among selected 289 neonates with neonatal sepsis who were admitted in the neonatal intensive care unit at public hospitals in Ethiopia from 1st March 2018 to 31st December 2019. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. The Kaplan-Meier survival curve together with log-rank test was used to estimate the survival time of the neonates. Variables which had p value < 0.05 in multivariable analysis using the cox proportional hazard model were declared as statistically significant predictors of mortality. Results. The study was conducted with a total of 289 neonates admitted with neonatal sepsis. The cumulative proportion of surviving at the end of the fourth day was 99.5%, and it was 98.2% at the end of the fifth day. In addition, it was 96.6%, 93.5%, and 91.1% at the end of the sixth, seventh, and eighth day, respectively. The incidence of mortality was 8.65 per 100 neonates admitted with neonatal sepsis. Having a history of intrapartum fever (AHR: 14.5; 95% CI: 4.25, 49.5), history of chorioamnionitis (AHR: 5.7; 95% CI: 2.29, 13.98), induced labor (AHR: 7; 95% CI: 2.32, 21.08), and not initiating exclusive breastfeeding within one hour (AHR: 3.4; 95% CI: 1.34, 12.63) were the independent predictors of mortality. Conclusion. The survival status of neonates among neonates admitted with neonatal sepsis was high at the early admission days and high cumulative proportion of death as the admission period increased. The risk of mortality was high among the neonates with early onset of neonatal sepsis as compared with late onset of neonatal sepsis and history of intrapartum fever, history of diagnosed chorioamnionitis, onset of labor, and EBF initiation within one hour were the independent predictors of mortality among neonates admitted with neonatal sepsis.

scholarly journals Outcome of Type 1 tympanoplasty: An experience at Biratnagar eye hospital in Eastern Nepal

2015 ◽  
Vol 7 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Sanjeev Kumar Thakur ◽  
Sanjay Kumar Singh ◽  
Anwar Afaque ◽  
Nisha Ghimire
Keyword(s):  
Medical Sciences ◽  
Hearing Improvement ◽  
Hearing Outcome ◽  
Type 1 Tympanoplasty ◽  
Younger Age ◽  
History Of ◽  
The Mean ◽  
The Difference ◽  
Graft Success

Background: The history of tympanoplasty is well over a century. Type 1 tympanoplasty is an established procedure worldwide with a variation in the outcome.Aims and Objectives: To analyze the outcome of Type 1 tympanoplasty surgeries in terms of graft success and hearing improvement done at the Ear Department of Biratnagar eye hospital in eastern Nepal and discuss the various factors that might have influenced it.Materials and Methods: Retrospective analysis of records of the cases that underwent Type 1 tympanoplasty from August 2013 to January 2015 was done. The factors analysed were age, gender, the side of the affected ear and the perforation size. Appropriate Statistical test was applied and the results were discussed.Results: A total of 151 cases of type 1 Tympanoplasty were analysed were females had higher frequency than males, with higher incidence at younger age. The mean age of successful cases was 28.53. Females had a better success rate in terms of graft success compared to males. Moderate size perforations had the best outcome of graft success and least were of small size perforations. Of all cases analyzed, hearing improvement was observed in maximum cases.Conclusion: There was no significant influence of age or gender on the hearing outcome. The difference of hearing improvement according to size of perforation was also not significant.Asian Journal of Medical Sciences Vol.7(2) 2015 55-60

scholarly journals Comparative study of sonohysterosalpingography with hysterosalpingography for determination of tubal patency in infertile women

2018 ◽  
Vol 7 (8) ◽  
pp. 3117
Author(s):  
Renuka Kumari ◽  
Priti Bala Sahay
Keyword(s):  
Menstrual Cycle ◽  
Reproductive Tract ◽  
Social Stigma ◽  
Medical Sciences ◽  
Reproductive Tract Infections ◽  
Secondary Infertility ◽  
Tubal Patency ◽  
History Of ◽  
The Difference ◽  
Tract Infections

Background: Ever since the history of mankind, human infertility has been a source of personal misery and social stigma. The aim of this study was to evaluate the tubal factors of infertility, especially the tubal patency by SSG and HSG and study the advantages of both.Methods: The present work was undertaken in the Department of Obstetrics and Gynecology and Department of Radiodiagnosis of Rajendra Institute of Medical Sciences, Ranchi. 60 patients with primary or secondary infertility attending the OPD were selected over a period of 15 months (July 2008 to September 2009). Inclusion criteria: women of age 20-35 years with regular menstrual cycle whose male partners had no faults. Exclusion criteria: women with PID or other proven causes of infertility. All the patients were subjected to both SSG and HSG (interval period being 1 menstrual cycle) and the results compared in terms of tubal occlusion detection rate, detection of pelvic pathologies and complications of both the procedures.Results: Out of 60 cases, 70% (42) were of primary infertility and 30% (18) were of secondary infertility. History of reproductive tract infections was higher in secondary infertility group (44%). SSG appeared to be more sensitive in detection of tubal obstruction (35%) than HSG (30%), but the difference was statistically insignificant (p>0.05). HSG could locate the exact site of tubal obstruction which was not evident in SSG. SSG was more sensitive in detection of associated pelvic pathologies (p = 0.05) like ovarian cyst, endometriosis and fibroid uterus. However, HSG was better in diagnosis of genital tuberculosis. 20% of patients complained of pelvic pain, bleeding, infection or allergic reaction during or after HSG, while only 7% of patients reported the same with SSG. Thus, SSG was superior to HSG in this respect (p = 0.02).Conclusions: SSG, though not a substitute, can be used as an alternative to HSG for assessment of tubal factors of infertility.

Hidradenitis Suppurativa and the Association With Hematological Malignancies

2016 ◽  
Vol 21 (2) ◽  
pp. 158-161
Author(s):  
Bahman Sotoodian ◽  
Mariam Abbas ◽  
Alain Brassard
Keyword(s):  
Risk Factor ◽  
Male Patient ◽  
Hidradenitis Suppurativa ◽  
Late Onset ◽  
Chronic Inflammatory Disease ◽  
Epidemiologic Studies ◽  
Lymphocytic Leukemia ◽  
Apocrine Glands ◽  
History Of ◽  
Underlying Risk

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting skin sites with a high density of apocrine glands. HS commonly presents after puberty, with most patients diagnosed in the second decade of their life. Several studies have investigated smoking, obesity, hypertension, diabetes, and dyslipidemia as possible underlying risk factors for HS. However, we encountered 2 patients with a long-standing history of untreated leukemia who developed late-onset HS. Objective: To investigate the presence of malignancy as an underlying risk factor for development of HS. Method: The PubMed and Scopus databases were searched for keywords such as hidradenitis suppurativa, malignancy, cancer, and epidemiology. Observation: Only 1 retrospective Swedish study with 2119 patients investigated the prevalence of cancer, including 6 hematopoietic malignancies, in HS patients. However, the study did not assess the timeline of developing HS in relation to the cancer diagnosis. We report 2 patients with a long-standing history of hematopoietic cancers who received no continuous treatments for their malignancies and developed late-onset HS: a 60-year-old male patient with hairy cell leukemia and a 68-year-old male patient with chronic lymphocytic leukemia who developed HS later in life. Conclusion: Multiple epidemiologic studies found the average age of HS diagnosis to be well prior to the fourth decade of life. The latency of the HS diagnosis as well as the presence of long-standing leukemia in both of our patients raises the necessity for assessing the possibility of malignancy, especially hematopoietic cancer, as a risk factor for HS. Limitation: This is a small retrospective analysis including only 2 patients. Larger studies would better assess the role of malignancy, leukemia in particular, as a possible risk factor for development of HS.

scholarly journals The Comparison of the Global Surgery Fees and the Actual Cost in Two Educational Hospitals Affiliated to Tehran University of Medical Sciences

2019 ◽  
Author(s):  
Arash Rashidian ◽  
Maryam Radinmanesh ◽  
Mahnaz Afshari ◽  
Mohammad Arab ◽  
Zahra Shahinfar
Keyword(s):  
Time Management ◽  
Global Surgery ◽  
Insurance Companies ◽  
Teaching Hospitals ◽  
Affecting Factors ◽  
Medical Sciences ◽  
Referral Hospitals ◽  
The Common ◽  
The Difference ◽  
The Cost

Background: Global surgeries include ninety operations in the common surgical procedures, with the annual fixed fees; which the insurance companies pay hospitals accordingly. The aim of this study was to compare the global fees to these surgeries’ real costs and to investigate the affecting factors in two teaching hospitals affiliated to Tehran University of Medical Sciences. Methods: This longitudinal retrospective descriptive-analytic study was conducted on all hospital records with global surgeries in three months in 2012 to 2013in two educational hospitals affiliated to Tehran University of Medical Sciences.Data were collected using the researcher’s –made checklist and extracted from the HIS (Hospital Information System). SPSS, EXCEL, and STATA software were used to analyze the data and to obtain the difference between the recorded costs and global fees. Results: The global fees were less than the recorded costs in both hospitals. The recorded costs in hospital B were much less than hospital A for the same surgeries. In hospital B, costs have been reduced for some surgeries in 2013comparedto 2012 by reducing the patients’ length of stay and time management. Conclusion: Fees in the referral hospitals of Tehran University, which usually involve complicated patients, should be determined more accurately. However, this study suggested that hospitals can greatly reduce the cost of global surgeries throughclinical and cost management.   Keywords: Global surgery, Hospital, Fee

Clinical features and bacteriological profile of late onset sepsis

2017 ◽  
Vol 4 (2) ◽  
pp. 361
Author(s):  
Purnima Samayam ◽  
Ravichander B.
Keyword(s):  
Staphylococcus Aureus ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Birth Asphyxia ◽  
Hospital Environment ◽  
Preterm Neonates ◽  
Causative Organism ◽  
Coagulase Negative Staphylococcus ◽  
Bacteriological Profile ◽  
Late Onset Sepsis

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the neonatal period. Late onset sepsis (LOS) is associated with community environment or postnatal exposure to hospital environment. It's incidence is rising due to greater survival of preterm neonates and very low birth weight babies. The bacterial isolates of neonatal sepsis especially that in LOS are changing. An understanding of the changing epidemiology of neonatal LOS will help to reduce the associated mortality and morbidity. The objective was to study the clinical symptoms and signs of late onset sepsis, to study the bacteriological profile of LOS.Methods: A prospective observational study. All neonates presenting with signs and symptoms of sepsis after 72 hours of life up to day 28 were included. Babies with birth asphyxia and congenital anomalies were excluded from the study.Results: A total of 120 newborns with LOS were included in the study. Of this 42.5% had blood culture positive sepsis. Lethargy, refusal of feeds and apnoea were seen in 61.66%, 55.0% and 34.17% of babies respectively. Klebsiella (25.49%), Staphylococcus aureus (23.53%) and coagulase negative Staphylococcus (21.57%) were the predominant organisms isolated in LOS.Conclusions: Prompt diagnosis of neonatal sepsis is a challenge. The incidence of LOS in neonates is rising. Klebsiella is the most common gram negative organism; Staphylococcus aureus and CONS are the predominant gram positive organisms. CONS is emerging as an important causative organism in LOS.

Clinical and Epidemiological Features of Hospitalized Patients with COVID-19 in Hospitals of Tehran University of Medical Sciences

2021 ◽  
Author(s):  
Vali Baigi ◽  
Saharnaz Nedjat ◽  
Masud Yunesian ◽  
Ali Akbari Sari ◽  
Mahboobeh Mirzaee ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Case Fatality Rate ◽  
Past History ◽  
Case Fatality ◽  
Teaching Hospitals ◽  
Hospital Death ◽  
Fatality Rate ◽  
Medical Sciences ◽  
History Of ◽  
Epidemiological Characteristics

Introduction: Since the start of COVID-19 pandemic in December 2019, until mid-April 2020 the total number of cases worldwide exceeded two millions and the death toll exceeded 130000 cases. Objective: The current study conducted to explore the clinical and epidemiological characteristics of COVID-19 patients, fatality of this disease and its mortality risk factors in major hospitals affiliated with Tehran University of Medical Sciences (TUMS). Methods: The data were collected in four major teaching hospitals affiliated with TUMS for all the patients that were admitted between Feb 19th and Apr 15th 2020 and were diagnosed as COVID-19 using reverse transcription polymerase chain reaction (RT-PCR), clinical diagnosis and/or lung computed tomography (CT) scan. The case fatality rate of the disease was estimated by age, sex, symptoms, comorbidities, and type of diagnosis. Logistic regression model was used to examine the associations between different factors and in-hospital deaths. Results: By Apr 15th 2020, a total of 4377 patients were admitted with COVID-19 diagnosis in four selected hospitals and 496 (11.3%) of these patients died in hospital. The case fatality rate of this disease was 28.8% in the ≥80-year age group, which was the highest compared to the other age groups. The case fatality rates were 12.5% and 9.8% among men and women, respectively. The results of multiple logistic regression on the outcome of death indicated that age, sex, cough, myalgia, reduced consciousness at arrival and past history of cancer were significantly associated with in-hospital death. Adjusting the effect of other variables, for each 10-year increase in age, the odds of death due to COVID-19 was 1.61 times greater (adjusted OR 1.61, 95% CI: 1.51 to 1.72, p<0.001). Conclusions: Older age, the male gender, past history of comorbidities (particularly cancer) and reduced consciousness at arrival are among the factors that can significantly increase the odds of in-hospital death in COVID 19 patients. These factors might be helpful in detecting and managing patients with poorer prognosis.

scholarly journals Stroke History is an Independent Risk Factor for Poor Prognosis in Ischemic Stroke Patients: Results from a Large Nationwide Stroke Registry

2020 ◽  
Vol 17 (4) ◽  
pp. 487-494
Author(s):  
Haiqiang Qin ◽  
Penglian Wang ◽  
Runhua Zhang ◽  
Miaoxin Yu ◽  
Guitao Zhang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Poor Prognosis ◽  
Independent Risk Factor ◽  
Multivariable Analysis ◽  
Stroke Patients ◽  
Stroke Registry ◽  
Risk Of Death ◽  
History Of ◽  
The Difference

Background: There is some controversy whether stroke history is an independent risk factor for poor prognosis of stroke or not. This study aimed to investigate the difference of mortality, disability and recurrent rate of ischemic stroke patients without and with stroke history, as well as to explore the effect of stroke history on stroke prognosis. Methods: We analyzed patients with ischemic stroke enrolled in the China National Stroke Registry which was a nationwide, multicenter, and prospective registry of consecutive patients with acute cerebrovascular events from 2007 to 2008. Multivariable logistic regression was performed to assess the risk of worse prognosis of stroke history in patients with ischemic stroke. Results: A total of 8181(65.9%) patients without stroke history and 4234(34.1%) patients with stroke history were enrolled in the study. The mortality, recurrence, modified Rankin Scale (mRS) 3-6 rate was 11.4%, 14.7% and 28.5% respectively at 1 year for patients without stroke history, which was significantly lower than that of 17.3%, 23.6%, 42.1% in patients with stroke history, respectively. Multivariable analysis showed that patients with stroke history had higher risk of death [odds ratio (OR) 1.34,95% confidence interval (CI) 1.17-1.54], recurrence (OR 1.47, 95 % CI 1.31-1.65) and mRS 3-6 (OR 1.49,95% CI 1.34-1.66) at 1 year. Conclusion: After adjusting for the potential confounders, stroke history was still an independent risk factor for poor prognosis of ischemic stroke, which further emphasizes the importance of secondary prevention of ischemic stroke. The specific causes of poor prognosis in patients with history of stroke need to be furtherly investigated.

scholarly journals Early- and Late-Onset Preeclampsia at a Tertiary Hospital in 2016

2022 ◽  
Vol 13 (1) ◽  
pp. 6
Author(s):  
Hapsari Kinanti ◽  
Muhammad Ilham Aldika Akbar ◽  
Pudji Lestari
Keyword(s):  
General Hospital ◽  
Early Onset ◽  
Late Onset ◽  
Tertiary Hospital ◽  
Obstetric History ◽  
Significant Difference ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
The Difference ◽  
Early Onset Preeclampsia

Introduction: Preeclampsia is still one of the major causes of maternal morbidity and mortality worldwide. Preeclampsia nowadays has another classification, early-onset preeclampsia and late-onset preeclampsia. This study aimed to evaluate the differences between early-onset and late-onset preeclampsia in Dr. Soetomo General Hospital, Surabaya in 2016.Methods: This was an analytic observational study, evaluating the difference between early- and late-onset preeclampsia in terms of maternal data, medical history, and obstetric history. The samples were taken from the medical record of Dr. Soetomo General Hospital, Surabaya from January until December 2016.Results: In maternal data, early- and late-onset preeclampsia mostly happened in productive age, consisted of 34 patients of early-onset preeclampsia (77.3%) and 31 patients of late-onset preeclampsia (73.8%). Early-onset preeclampsia tended to happen in nullipara (42.2%) and primigravida (35.6%) women, and late-onset preeclampsia usually happened in multipara (43.9%) and multigravida (85.4%) women. In medical and obstetric history, early-onset preeclampsia mostly had a history of hypertension (61.7%), rather than late-onset preeclampsia (32.7%). Moreover, there were no significant differences in other variables.Conclusion: Early-onset and late-onset preeclampsia had a significant difference in parity, gravidity, and hypertension disease.

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