scholarly journals An Assessment of Antimicrobial Prescription Pattern among Surgical Patients: A Hospital Based Cross Sectional Descriptive Study

2021 ◽  
Vol 24 (1) ◽  
pp. 23-27
Author(s):  
Bikash Bahadur Rayamajhi ◽  
Sunil Basukala ◽  
Anjan Khadka ◽  
Narayan Thapa ◽  
Dhirendra Bahadur Ayer
Keyword(s):  
Essential Medicine ◽  
Descriptive Study ◽  
Generation Cephalosporin ◽  
Urinary Stone ◽  
Stone Disease ◽  
Surgical Patients ◽  
National Guidelines ◽  
Cross Sectional ◽  
Health Related ◽  
Effective Group

Introduction: Antimicrobials are used before, during and after surgery to prevent infections to decrease the duration of hospital stay, increase surgical outcomes and reduce health-related costs. There is inadequate evidence to determine the effective group of antimicrobials to be used in surgical prophylaxis in our settings. Methods: A hospital-based cross-sectional descriptive study involving antimicrobial prescriptions pattern among 223 surgical patients was undertaken. Information on patient’s demographic variables, diagnosis, type of surgery and wound, perioperative antimicrobial use, postoperative complications and number of antimicrobials prescribed from the essential medicine list were recorded. The antibiotic prescription patterns were assessed based on a comparison with international and national guidelines. Results: Among 223 patients, males were predominant with an overall mean age of 42.77 years. The total number of diagnoses was 30, the commonest being appendicitis (21.52%), urinary stone disease (15.69%), hernia (13.90%) and cholelithiasis (11.65%). The common surgeries performed were emergency appendectomy, hernioplasty and laparoscopic cholecystectomy. Eighteen types of drugs from seven different antimicrobial groups were used perioperatively, out of which 73% and 83% were prescribed based on international and national guidelines respectively. Conclusion: The most common antimicrobial used was third-generation cephalosporin. The postoperative antimicrobial rate was found higher compared to preoperative and intraoperative prescriptions and for a longer duration compared to national and international guidelines.

Solid Waste Scavenger Community: An Investigation in Bangkok, Thailand

1991 ◽  
Vol 5 (1) ◽  
pp. 54-65 ◽  
Author(s):  
Nipapun Kungskulniti ◽  
Chompusakdi Pulket ◽  
F DeWolfe Miller ◽  
Kirk R Smith
Keyword(s):  
Solid Waste ◽  
Ambient Air ◽  
Respiratory Illness ◽  
Descriptive Study ◽  
Cross Sectional ◽  
Dump Site ◽  
Field Surveys ◽  
The Public ◽  
Protozoan Infection ◽  
Health Related

A solid waste scavenger community at On-Nooch dump site in Bangkok was investigated. The purpose was to identify the dimensions of the public health risk to this group of people and their community due to exposure to hazardous conditions from waste materials. A cross-sectional descriptive study utilizing field surveys and measurements was performed. The demographic, socioeconomic, health related and environmental characteristics of this community were examined. Health complaints and injuries were inventoried among scavengers. Prevalence of childhood respiratory illness was high especially in those households where smoking was present. Intestinal helminthic and protozoan infection in children were detected. Six individuals with possible HIV infection and a number of Hepatitis B antigenemia were found among male respondents. An appreciable proportion of respondents fell below normal when tested for lung function. Air pollution measurements showed acceptable ambient air levels except for particulate matters. Water quality was low for both potable and nonpotable water.

scholarly journals Một số đặc điểm nhiễm khuẩn vết mổ tại Trung tâm Chấn thương chỉnh hình, Bệnh viện Trung ương Huế

2020 ◽  
Author(s):  
Như Phồn Đặng
Keyword(s):  
Laparoscopic Surgery ◽  
Trauma Center ◽  
Open Surgery ◽  
Surgical Site Infections ◽  
Descriptive Study ◽  
Surgical Patients ◽  
Orthopaedic Trauma ◽  
Central Hospital ◽  
Related Factors ◽  
Cross Sectional

A FEW CHARACTERISTICS OF SURGICAL SITE INFECTIONS IN ORTHOPAEDIC TRAUMA CENTER OF HUE CENTRAL HOSPITAL Background: Currently, in addition to the advancement of surgical and anesthesia techniques has relieved the risks of surgery, however, the surgical site infections remains a challenge for both patients and physicians. Surgical site infections is unwanted medical incident that increasing aggravate illness, prolonged hospitalization and increased mortality in surgical patients. Objectives: 1. Identify the rate of surgical site infections and a few of the characteristics of surgical site infections.; 2. Determines related factors and bacteria causing surgical site infections in Orthopaedic Trauma Center of Hue Central Hospital. Subjects and Methods: A cross-sectional descriptive study. Hospitalized patients, post- operative 48 hours, from 3- 7/2019. Results: The rate of surgical site infections was 5.4%. The rate of SSIs in contaminated surgery was highest (22.0%) compared with other types. The rate of SSIs in open surgery and laparoscopic surgery, surgery with drainage had the rate of SSIs higher that not set. Patients with emergency surgery or plan surgery, methods of anesthesia had not the rate of SSIs in difference. The characteristics of SSI are usually fluid stagnant 47.0%, pus stagnant 31.4%. The ways to deal with this problem is to change the dressing daily (52.9 and 84.0%), remove the fluid and pus 19.6%. Solutions used to wash the incision are 0.9% Sodium Chlorua and Iode / Betadine alcohol. In 51 cases of SSIs, there were 31 cases of positive bacteria by 60,8%. Bacteria identified most of S.aureus, accounted for 32,3%. Conclusions: We found that the rate of surgical site infections in Orthopaedic Trauma Center of Hue Central Hospital of this study was low and the leading bacteria causing ISS was S.aureus. Keywords: surgical site infections (SSIs), bacteria, surgery

scholarly journals Cross-sectional and prospective data on urinary calcium and urinary stone disease

2003 ◽  
Vol 63 (6) ◽  
pp. 2200-2206 ◽  
Author(s):  
Massimo Cirillo ◽  
Davide Stellato ◽  
Paolo Panarelli ◽  
Martino Laurenzi ◽  
Natale G. De Santo ◽  
...  
Keyword(s):  
Urinary Stone ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Cross Sectional ◽  
Prospective Data ◽  
Urinary Stone Disease

scholarly journals Defining Dysbiosis for a Cluster of Chronic Diseases

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Lamont J. Wilkins ◽  
Manoj Monga ◽  
Aaron W. Miller
Keyword(s):  
Chronic Disease ◽  
Microbial Diversity ◽  
Chronic Diseases ◽  
Disease Risk ◽  
Antibiotic Use ◽  
Urinary Stone ◽  
Stone Disease ◽  
Cross Sectional ◽  
Disease States ◽  
Causative Effect

Abstract The prevalence of many chronic diseases has increased over the last decades. It has been postulated that dysbiosis driven by environmental factors such as antibiotic use is shifting the microbiome in ways that increase inflammation and the onset of chronic disease. Dysbiosis can be defined through the loss or gain of bacteria that either promote health or disease, respectively. Here we use multiple independent datasets to determine the nature of dysbiosis for a cluster of chronic diseases that includes urinary stone disease (USD), obesity, diabetes, cardiovascular disease, and kidney disease, which often exist as co-morbidities. For all disease states, individuals exhibited a statistically significant association with antibiotics in the last year compared to healthy counterparts. There was also a statistically significant association between antibiotic use and gut microbiota composition. Furthermore, each disease state was associated with a loss of microbial diversity in the gut. Three genera, Bacteroides, Prevotella, and Ruminococcus, were the most common dysbiotic taxa in terms of being enriched or depleted in disease populations and was driven in part by the diversity of operational taxonomic units (OTUs) within these genera. Results of the cross-sectional analysis suggest that antibiotic-driven loss of microbial diversity may increase the risk for chronic disease. However, longitudinal studies are needed to confirm the causative effect of diversity loss for chronic disease risk.

scholarly journals Doxycycline Usage for Prevention of Leptospirosis among Farmers and Reasons for Failure to Use Chemoprophylaxis: A Descriptive Study from Southern Sri Lanka

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
C. L. Fonseka ◽  
B. N. Vidanapathirana ◽  
C. M. de Silva ◽  
A. A. B. B. Athukorala ◽  
P. R. Goonawardena ◽  
...  
Keyword(s):  
Sri Lanka ◽  
General Population ◽  
Community Setting ◽  
Descriptive Study ◽  
Cluster Sampling ◽  
Preventive Strategy ◽  
National Guidelines ◽  
Cross Sectional ◽  
Health Authorities ◽  
Multi Stage

Background. Leptospirosis causes substantial morbidity and mortality in Sri Lanka. Health authorities have implemented a chemoprophylaxis programme for prevention of disease for farmers who are at a high risk of leptospirosis. Only 39% of general population is aware of chemoprophylaxis. Awareness on chemoprophylaxis and its usage among the risk population and the reasons for non-usage was uncertain. Our aim was to assess the chemoprophylaxis usage for prevention of leptospirosis among farmers and reasons for failure to use such preventive strategy. Methods. Cross-sectional descriptive study was conducted on farmers in community setting in Galle District. Multi-stage cluster sampling method was used. Out of the seventeen “Ministry of Health” (MOH) divisions within the Galle district, nine divisions were randomly selected and, subsequently, two subdivisions (“Public Health Midwife” divisions) were randomly selected from each MOH division. From each PHM division (total of 18), a cluster who does farming as the main source of income was selected. From these farmers, details on demographics, knowledge on leptospirosis and knowledge and practice on chemoprophylaxis usage were obtained through an interviewer administered open-ended questionnaire. From those who have not properly taken chemoprophylaxis, the reasons for non-usage were explored by semistructured interviews. Results. We recruited 319 (77%-males) farmers to the study. Eighteen (5.6%) have already had leptospirosis. Majority (86.8%) of farmers were aware that doxycycline can be used to prevent the disease occurrence. Only 31% knew about correct recommendations of chemoprophylaxis usage adopted by the national guidelines. Only 28.5% (91) used doxycycline prophylaxis. Out of those, only 60 farmers (65.9%) continued the prophylaxis throughout the contact and followed national recommendations. Themes responsible for non-usage were elicited such as lack of awareness of chemoprophylaxis usage, false sense of security from the disease by perceived “immunity” due to prolong exposure or due to low prevalence of disease, lack of motivation, lack of availability of medication, and fear of side effects. Conclusions. Awareness of leptospirosis is better among farmers compared to the general population. Usage of chemoprophylaxis among farmers was highly inadequate. Individual and health system related hypotheses and myths exist for non-usage of chemoprophylaxis. Thus, an urgent concerted campaign aimed at increasing awareness within the target group through education and making medicines effectively distributed is essential for better prevention of the disease.

scholarly journals 147. Antibiotic Prescribing: Shorter is Also Better in the Emergency Department

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S185-S186
Author(s):  
Lisa Vuong ◽  
Darius Faison ◽  
Julie Thomson ◽  
Rachel Kenney ◽  
Susan L Davis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Infection Type ◽  
Inappropriate Prescribing ◽  
Generation Cephalosporin ◽  
Cross Sectional Study ◽  
Drug Event ◽  
Antibiotic Prescribing ◽  
Beta Lactam ◽  
National Guidelines ◽  
Cross Sectional

Abstract Background Published information suggests room for improvement in antibiotics prescribed on discharge from the emergency department (ED). The objective of this study was to evaluate antibiotic prescribing in the ED for uncomplicated infections of the lower respiratory tract (LRTI), urinary tract (UTI), and skin and skin structure (SSTI). Methods IRB-approved retrospective cross-sectional study of patients discharged from the ED from January to June 2019 at 6 locations. Inclusion: ≥ 18 years old and uncomplicated LRTI, UTI, or SSTI. Exclusion: hospital admission. Appropriate prescribing was defined having all three of the following correct per local and national guidelines: antibiotic selection, dose, and duration. Correct duration: 5 days for LRTI and SSTI; 3 days for trimethoprim-sulfamethoxazole (TMP-SMX), 5 days for nitrofurantoin (NFT), and 7 days for beta-lactams for UTIs. Endpoints within 7 days: antibiotic escalation, readmission to ED or hospital, any outpatient contact, and report of adverse drug event (ADE). Endpoints within 90 days: Clostridioides difficile infection (CDI). Descriptive and bivariable statistics were performed. Results Inappropriate prescribing: 77% (304) vs. appropriate 23% (89). Infection type: 47.8% SSTI, 30% UTI, and 22.1% LRTI. SSTI was associated with the greatest proportion of inappropriate prescribing at 89.4% (Figure 1). Comparisons for inappropriate vs. appropriate groups: 15.8% vs. 22.5% for beta-lactam allergy and 23.4% vs. 19.1% for cultures drawn in ED. Most common antibiotics for inappropriate vs. appropriate: first generation cephalosporin at 70.1% vs. 7.3% (p< 0.05), TMP-SMX at 14.3% vs. 12.2% (p=0.75), and NFT at 7.8% vs. 65.9% (p< 0.05). Prescriptions considered inappropriate were primarily driven by excess duration (Figure 2). Endpoints for inappropriate vs. appropriate groups: antibiotic escalation at 6.6% (2.8% were due to cultures drawn in the ED) vs. 1.1% (p=0.06), readmission at 8.6% vs. 9.0% (p=0.9), any outpatient contact at 18.4% vs. 19.1% (p=0.89), and report of ADE at 1.3% vs. 1.1%. No CDI in either group. Figure 1. Appropriateness of Discharge Prescriptions by Infection Type, N = 393 Figure 2. Subset Analysis: Reasons for Inappropriate Prescribing, n = 304 Conclusion The main reason for inappropriate prescribing in the ED was excess duration of therapy, making this an area of opportunity for future antibiotic stewardship improvement. Disclosures Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder) Susan L. Davis, PharmD, Nothing to disclose

CHARACTERISTICS OF USING 3RD AND 4TH GENERATION CEPHALOSPORIN AT THONG NHAT HOSPITAL

2021 ◽  
Vol 62 (5) ◽  
Author(s):  
Hoang Duc Thai ◽  
Trinh Nhut Minh ◽  
Bui Dang Phuong Chi
Keyword(s):  
Liver Enzyme ◽  
Antibiotic Treatment ◽  
Treatment Efficacy ◽  
Medical Records ◽  
Elevated Liver Enzyme ◽  
Descriptive Study ◽  
Generation Cephalosporin ◽  
Cross Sectional ◽  
Cephalosporin Antibiotics ◽  
Diagnosis Of Infection

Objective: Describing characteristics of using 3rd and 4th generation Cephalosporin antibiotics at Thong Nhat Hospital in the period of 2019 - 2020.Subjects and methods: cross-sectional descriptive study on 158 medical records of patients discharged from hospital from February 20th, 2020 to February 24th, 2020 (5 days) was kept at themedical records store, Department of general planning, Thong Nhat hospital.Results: The majority of patients had no diagnosis of infection but had signs of infection, accounting for 69.92%. Duration of C3G/C4G antibiotic treatment of group with signs of infection was 9.22± 2.79 days. Cefotaxim was used the most, accounting for 26.58%. The majority of indications for the use of antibiotics C3G/C4G for patients were appropriate or partly appropriate, accounting for 74.05%. Efficiency of using appropriate or partially appropriate antibiotics had achieved high results, accounting for 39.24%. Most of the cases diagnosed or showed signs of infection after using antibiotics C3G/C4G obtained treatment efficacy, accounting for 75%. The majority of patients using C3G/C4G antibiotics achieved effectiveness in preventing wound infection in the patient with no signs of infection, accounting for 77.78%. The rate of elevated liver enzyme was 7.59%, the rate of thrombocytopenia was 3.16%.Conclusion: Duration of C3G/C4G antibiotic treatment of group with signs of infection was 9.22 ± 2.79 days. Cefotaxim were used the most. Most of indications to use antibiotics C3G/C4G were appropriate or partially appropriate. Efficiency of using appropriate or partially appropriate antibiotics had achieved high results. The rate of elevated liver enzyme was 7.59%, the rate of thrombocytopenia was 3.16%.

scholarly journals Cross-sectional descriptive study of management modalities and quality of life of surgical patients in a palliative care unit

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Naing Soe Y ◽  
Amjad NM ◽  
Karim KA
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Palliative Care ◽  
Descriptive Study ◽  
Palliative Care Unit ◽  
Surgical Patients ◽  
Chinese Patients ◽  
Treatment Modalities ◽  
Cross Sectional

Introduction: The goal of palliative care is the provision of the best quality of life (QOL) for terminally ill and dying patients. Advances in medical treatment has seen an increase in overall survival of all stages of malignant diseases. This includes advanced and/or inoperable malignancies where management is mainly palliative involving different modalities. Methods: We designed a cross-sectional descriptive study of surgical patients in a palliative care unit in a 1000-bedded teaching hospital in Kuantan, Malaysia. Objectives of this study are: to study the demographic characteristics and indications for admission of surgical patients in palliative care unit, to study the options of treatment modalities and their complications, to identify the barriers in decision making in surgical treatment and finally to objectively assess the quality of life of these patients by utilizing QUALITY OF LIFE (WHOQOL) –BREF –questionnaire. Results: One hundred and one eligible patients (53%) male, (47%) female of mean age of 54yrs, majority Malay and Chinese patients were included in the study. All patients had malignancies and they were Breast (30%), Lower gastrointestinal (GI) (24%), (18%) upper GI, (15%) hepato-biliary, and (7%) pancreatic cancers. Thirty two percents of patients had emergency treatment while the rest had supportive treatment. Barriers to decision making were mainly due to patient factors in 71%, while 12% was due to the disease presenting at an advanced stage and 15% due to limitation of care. The final results of overall quality of life rating were shown as poor (1%), neither poor nor good (42%), good (52%) and very good (2%). Conclusions: Palliative care and end of life decision making from surgical point of view is a delicate issue. Like all other fields in medicine, palliative care must be evidence-based with specific goal directed therapy. Our study shows that we are able to positively impact the quality of life in more than two thirds of our patients. Our aim is to achieve 100% success. As such, it is imperative to inculcate the goal of palliative care to all grades of health care personnel. ‘To cure sometimes, To relieve often, To comfort always’ should not be mere words.

Socio-Demographic Factors and Health-Related Behaviors Associated with Gerontology

GIS Business ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. 359-370
Author(s):  
Dr. Ravi S. Dalawai
Keyword(s):  
Cross Sectional Study ◽  
Work Culture ◽  
Chi Square ◽  
Cross Sectional ◽  
The Social ◽  
Health Related ◽  
Chi Square Test ◽  
Current Scenario ◽  
Socio Demographic Factors ◽  
Insight Into

Indian population is in growing trend from 942.2 million in 1994 to 1.36 billion in 2019.Among this six per cent of India's population was of the age 65 and above (UNFPA, 2019). Today the work culture is totally changed. Both husband and wife are forced to work in the current scenario and unable to take care of their parents. The changing structure created increased problems for old age people leads to loneliness, psychological, physical health and financial insecurity. The study paper provides insight into the social and demographic factor and health related sickness of the oldest people. This research explained the cross-sectional study included a representative sample (n=116) of adults aged ≥60 years. The sample was chosen using a four-stage stratified random-cluster survey sampling method .The Chi Square test and ANOVA test was analyzed using SPSS20.

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