Epidemiology and Outcome of Candidemia in ICU, Mashhad, a 6-Year Multi-Center Study

Background and aim: candidemia is a state that usually happens in immunocompromised patients. Thus it is more prevalent in ICU patients. This status brings mortality and morbidity; however, the outcome is various in different ICU care settings. The aim of this study is to assess epidemiology of outcome of candidemia in ICU in Mashhad during a 6-year period. Method: in a cross-sectional study between 2012 and 2018 in different ICU centers affiliating with Mashhad University of Medical Sciences, data of candidemia patients were extracted from hospital information system. These data were demographic, past medical history, result of the culture, and antifungal treatment. Result: totally, 55 patients (22 men and 33 women) were included in the study. The mean age of the patients was 45.9±1.9 years. Furthermore, the mean duration of hospitalization and the mean duration of ICU care were 43 and 37 days, respectively. Five patients had a history of immunosuppressive treatment and four patients were prescribed antifungal treatment in their past medical history (all with fluconazole and none with Itraconazole). Eighteen patients received caspofungin, eleven Amphotericin B treatment, and two fluconazole with no significant difference in outcome of the patients regarding antifungal type. In case of coincident antibiotic treatment, Carbapenems were prescribed in 43 patients, Glycopeptides in 48 patients, 25 patients had Cephalosporin treatment, and 13 patients had Fluoroquinolone treatment with no significant difference regarding the antibiotic type. Conclusion: The mortality percent of candidemia in ICU was 69.1 within mean time of 37 days. Furthermore, there was no significant difference in outcome of the patients regarding using Caspofungin or Amphotericin. Timely initiation of antifungal regarding to the culture result may bring better outcomes.

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Better Late Than Never - An Analysis of Last-Minute Travelers Attending a Specialist Travel Medicine Clinic in Ireland

International Journal of Travel Medicine and Global Health ◽

10.15171/ijtmgh.2019.26 ◽

2019 ◽

Vol 7 (4) ◽

pp. 123-128

Author(s):

Gerard Thomas Flaherty ◽

Muhammad Haziq Hasnol ◽

Lokman Hakim Sulaiman

Keyword(s):

Medical History ◽

Travel Medicine ◽

Cross Sectional Study ◽

Health Clinic ◽

Past Medical History ◽

Cross Sectional ◽

Travel Health ◽

Vaccination History ◽

The Mean ◽

Travel Vaccines

Introduction: Last-minute travelers (LMTs) are a vulnerable group, because it may not be possible to adequately vaccinate them against exposure to infectious diseases. The purpose of this retrospective cross-sectional study was to describe the characteristics of LMTs attending a travel health clinic. Methods: The following data was extracted from records of travelers attending the Tropical Medical Bureau (Galway, Ireland) over a 6-year period with less than 2 weeks remaining before their departure: gender, age, occupation, destination(s), purpose of travel, departure date, travel duration, travel group size, accommodation, past medical history, medications, and vaccination history. Results: Of 7555 traveler records, 1296 (17.2%) were of LMTs, of whom 45 (3.5%) were recurrent LMTs. LMTs were equally likely to be male or female. The mean age of this cohort was 32.2 years. The most common travel destination was Asia, and holiday was the most frequent purpose of travel. The mean interval before departure was 7.54 ± 3.65 days, and the mean travel duration was 7.36 ± 2.3 weeks. The majority (n=454, 35.1%) of LMTs traveled in pairs. Approximately 2 in 5 (n=497, 38.4%) travelers reported a past medical history; over half (n=674, 52.0%) had previously received travel vaccinations. The majority (n=1202, 92.8%) of LMTs were unable to complete a scheduled course of pre-travel vaccines. Conclusion: This study provides insight into the characteristics and travel patterns of LMTs. A large proportion of LMTs have pre-existing medical conditions. Further research should focus on the travel health risk-taking behavior of these individuals.

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Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0041-1727578 ◽

2021 ◽

Author(s):

Vanajakshamma Velam ◽

Vyshnavi Kancherla ◽

Latheef Kasala ◽

Anusha Kancherla ◽

Mounica Reddy Pillaram

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Well Being ◽

Care Hospital ◽

Cross Sectional ◽

Significant Difference ◽

Female Employees ◽

The Mean ◽

Lifestyle Patterns ◽

Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

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Retinal microvascular signs in COVID-19

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318236 ◽

2021 ◽

pp. bjophthalmol-2020-318236

Author(s):

Ralene Sim ◽

Gemmy Cheung ◽

Daniel Ting ◽

Edmund Wong ◽

Tien Yin Wong ◽

...

Keyword(s):

Medical History ◽

Vital Signs ◽

Plexiform Layer ◽

Nasopharyngeal Swab ◽

Inner Plexiform Layer ◽

Cross Sectional ◽

Imaging Device ◽

Asymptomatic Patients ◽

Significant Difference ◽

Retinal Microvascular Signs

Background/aimsTo explore if retinal findings are associated with COVID-19 infection.MethodsIn this prospective cross-sectional study, we recruited participants positive for COVID-19 by nasopharyngeal swab, with no medical history. Subjects underwent retinal imaging with an automated imaging device (3D OCT-1 Maestro, Topcon, Tokyo, Japan) to obtain colour fundus photographs (CFP) and optical coherence tomographic (OCT) scans of the macula. Data on personal biodata, medical history and vital signs were collected from electronic medical records.Results108 patients were recruited. Mean age was 36.0±5.4 years. 41 (38.0%) had symptoms of acute respiratory infection (ARI) at presentation. Of 216 eyes, 25 (11.6%) had retinal signs—eight (3.7%) with microhaemorrhages, six (2.8%) with retinal vascular tortuosity and two (0.93%) with cotton wool spots (CWS). 11 eyes (5.1%) had hyper-reflective plaques in the ganglion cell-inner plexiform layer layer on OCT, of which two also had retinal signs visible on CFP (CWS and microhaemorrhage, respectively). There was no significant difference in the prevalence of retinal signs in symptomatic versus asymptomatic patients (12 (15.0%) vs 13 (9.6%), p=0.227). Patients with retinal signs were significantly more likely to have transiently elevated blood pressure than those without (p=0.03).ConclusionOne in nine had retinal microvascular signs on ocular imaging. These signs were observed even in asymptomatic patients with normal vital signs. These retinal microvascular signs may be related to underlying cardiovascular and thrombotic alternations associated with COVID-19 infection.

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Emotional Bonding and Sexual Activity During COVID-19 Lockdown: A Cross-National Pilot Study

Journal of Psychosexual Health ◽

10.1177/26318318211027482 ◽

2021 ◽

pp. 263183182110274

Author(s):

Deblina Roy ◽

Sujita Kumar Kar ◽

SM Yasir Arafat ◽

Pawan Sharma ◽

Russell Kabir

Keyword(s):

Online Survey ◽

Sampling Technique ◽

Sexual Relationships ◽

Sexually Active ◽

Online Questionnaire ◽

Cross Sectional ◽

Emotional Bonding ◽

Significant Difference ◽

The Mean ◽

Study Participants

Background: The COVID-19 pandemic and lockdown measures have affected the sexuality and emotional bonding among the couple across the world. Objectives: We aimed to assess the effects of the COVID-19 pandemic and lockdown on the married people’s emotional bonding and sexual relationships in 3 south Asian counties (Bangladesh, India, and Nepal). Methods: A cross-sectional online survey was conducted among Bangladesh, India, and Nepal residents from April 3 to April 15, 2020. The survey was designed in English. The participants were selected through convenience sampling technique, the link of the online questionnaire was shared with the participants. Only participants older than 18 years and above, married, and living with their spouses were included in the study. Results: A total number of 120 respondents were included finally for analysis from the participating countries (India, Nepal, and Bangladesh). The mean age of the participants was 35.42 (±5.73) years; the majority were males under the age of 40 years and had completed postgraduation as their qualification. Among the study participants, more than half (53.8%) of the women reported being sexually active during the lockdown, whereas 41% of the men reported being sexually active. Among the sexually active participants, most women (57.7%) reported that they perceived positive emotional bonding with their partners. Nevertheless, there was no significant difference observed when compared with men. There are variations in responses. However, no significant association was identified. Conclusion: There are a few insights from the study, that is, there was no significant difference found in almost 3 countries in emotional intimacy. There had been a trend that there is improved emotional bonding with their partners, although no significant difference was observed.

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Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?

Egyptian Rheumatology and Rehabilitation ◽

10.1186/s43166-021-00065-2 ◽

2021 ◽

Vol 48 (1) ◽

Author(s):

Eman A. Baraka ◽

Mona G. Balata ◽

Shereen H. Ahmed ◽

Afaf F. Khamis ◽

Enas A. Elattar

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Cross Sectional Study ◽

Healthy Controls ◽

Tender Joint ◽

Cross Sectional ◽

Reactive Protein ◽

Significant Difference ◽

The Mean ◽

Anti Inflammatory

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.

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The relationship between workload and adherence to professional codes of ethics among a sample of Iranian nurses

Clinical Ethics ◽

10.1177/14777509211040183 ◽

2021 ◽

pp. 147775092110401

Author(s):

Mahsa Dadkhah-Tehrani ◽

Mohsen Adib-Hajbaghery

Keyword(s):

Personal Characteristics ◽

Codes Of Ethics ◽

Spearman Correlation ◽

Cross Sectional ◽

Significant Difference ◽

Perceived Workload ◽

Professional Codes ◽

The Mean ◽

Professional Codes Of Ethics ◽

The Relationship

Background Many studies have investigated the adherence to professional codes of ethics by nurses. However, no study has explicitly examined the relationship between workload and adherence to professional codes of ethics among Iranian nurses. Objective This study aimed to explore the relationships between workload and adherence to professional codes of ethics among a sample of Iranian nurses. Materials and Methods A cross-sectional descriptive study was conducted on 213 nurses who were randomly selected from the different wards of Shahid Beheshti Hospital of Kashan, Iran. Data collection instruments included a personal characteristics questionnaire, the Nursing Ethics Questionnaire, and the National Aeronautics and Space Administration Task Load Index. The Chi-square, the Spearman correlation coefficient, the Kruskal–Wallis, and Mann–Whitney U tests were used to analyze the data. Results A majority of nurses were females (77.5%), married (79.3%), and permanently employed (55.4%). The mean of the overall perceived workload and adherence to professional codes of ethics were 76.36 ± 13.64 and 13.98 ± 2.58, that were at high and moderated level, respectively. Spearman correlation test showed no significant correlation between perceived workload and adherence to professional codes of ethics ( r = 0.03, P = 0.6). A significant difference was found between the mean scores of adherence to professional codes of ethics in nurses working in different departments ( P < 0.001). Conclusion Participating nurses perceived high levels of workload but their mean adherence to professional codes of ethics was at a moderate level. The perceived workload was indirectly correlated with adherence to professional codes of ethics.

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Differences in phosphatemia and frequency of consumption of dietary sources of phosphorus in hemodialysis patients in southern and northern Brazil

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2018-0063 ◽

2019 ◽

Vol 41 (1) ◽

pp. 83-88 ◽

Cited By ~ 2

Author(s):

Fabiana Baggio Nerbass ◽

Edcléia Regina Canzi ◽

Renata dos Anjos Araujo ◽

Dyane Corrêa ◽

Rafaela Gonzaga dos Santos ◽

...

Keyword(s):

Total Sample ◽

Inorganic Phosphorus ◽

Cross Sectional Study ◽

The State ◽

Cross Sectional ◽

Significant Difference ◽

Phosphorus Sources ◽

Northern Brazil ◽

The Mean ◽

Pork Sausages

Abstract Introduction: Hyperphosphatemia is associated with unfavorable outcomes, and the percentage of patients presenting with this condition in hemodialysis (HD) in kidney foundation units in the state of Santa Catarina (SC) is historically higher than that of patients in the state of Tocantins (TO). Objective: To assess the frequency of consumption of the main dietary sources of phosphorus and to compare them between the two states. Methodology: A cross-sectional study was carried out involving 123 patients, 66 of SC and 57 of TO: 52% were men, average age was 46.9 ± 15.7 years, and mean HD time 48 (57-71) months. A food frequency questionnaire (FFQ) with 33 items that are dietary sources of phosphorus was applied. A consumption score was calculated for sources of organic, inorganic, and total phosphorus, and the six-month average of phosphatemia was obtained. Results: The mean phosphatemia of SC patients was higher (6.2 ± 1.5 vs 4.7 ± 1.3 mg/dL, p <0001) than TO patients, as well as the prevalence of hyperphosphatemia (62% vs 28%; p <10001). In the total sample, the foods most frequently consumed were milk and beans. Comparing the frequency of consumption between the two states, a significant difference was found in 17 items. In TO, beef and beans were the foods most frequently consumed, and in SC, fourteen other items of the FFQ (pork, sausages, dairy products, etc.) were the most frequently consumed. Phosphatemia correlated with the frequency of consumption of inorganic phosphorus sources. Conclusion: the frequency of consumption of several items was different between the states, and this explains the differences in phosphatemia between the two regions.

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A Study on Bolton Anterior Tooth Size Discrepancies among Different Malocclusion Groups

Bangladesh Journal of Orthodontics and Dentofacial Orthopedics ◽

10.3329/bjodfo.v1i2.15982 ◽

2013 ◽

Vol 1 (2) ◽

pp. 1-4

Author(s):

AW Ali ◽

MZ Hossain

Keyword(s):

Cross Sectional Study ◽

Normal Group ◽

Anterior Tooth ◽

Tooth Size ◽

Class Iii ◽

Cross Sectional ◽

Normal Occlusion ◽

Significant Difference ◽

The Mean ◽

Bangladeshi Population

Aim: To investigate the correlation between anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion, as well as their prevalence in Bangladeshi population. This study would act as a reference for diagnosis, treatment planning and assessment of prognosis in some orthodontic cases. Methods: This cross sectional study was conducted in the Department of Orthodontics & Dentofacial Orthopedics, Dhaka Dental College & Hospital. A total number of 200 subjects were selected in Angle's Class l, ll, lll and corresponding normal group. Each group had 50 subjects with males and females. A chi-square test was performed to statistically compare the prevalence of anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion and two genders. Analysis of variance was used to compare the mean Bolton anterior tooth size ratios as a function of angle classification and gender. Statistical differences were determined at the 95% confidence level (p< 0.05). Results: No significant difference was observed in the mean Bolton anterior ratio between normal group and class-I malocclusion group (p = 0.343). Significant differences were observed between Class-II malocclusion and normal group (p=0.001), and also between Class-III malocclusion and normal group (p = 0.001). Individuals with Angle Class lll and Class ll malocclusions showed significantly greater prevalence of tooth size discrepancy than Class l malocclusion and corresponding normal group. Conclusion: The great diversity and ethnic mix of Bangladeshi population should alert our orthodontist to use Bolton analysis as an important diagnostic tool and become aware of the moderate variations that may be present and treated. It may somehow guide planning of this type of study in future. DOI: http://dx.doi.org/10.3329/bjodfo.v1i2.15982 Ban J Orthod & Dentofac Orthop, April 2011; Vol-1, No.2, 1-4

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Usefulness of the Non-Contact Tonometry in Out-Patient Screening

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v15i2.232 ◽

2016 ◽

Vol 15 (2) ◽

Author(s):

Satheesh Solomon T Selvin ◽

Chris Elsa Samson Jacob ◽

Thomas Kuriakose

Keyword(s):

Central Corneal Thickness ◽

Care Center ◽

Corneal Thickness ◽

Tertiary Care ◽

Cross Sectional Study ◽

Applanation Tonometry ◽

Cross Sectional ◽

Significant Difference ◽

Iop Measurement ◽

The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg. The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram.

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Comparison of Quality and Lifestyle in Women with and Without Uterine Leiomyoma Referred to Gynecology Clinics of Shiraz University of Medical Sciences in 2018

Shiraz E-Medical Journal ◽

10.5812/semj.100815 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Mahnaz Zarshenas ◽

Mozhgan Sorkhenezhad ◽

Marzieh Akbarzadeh

Keyword(s):

Quality Of Life ◽

Uterine Leiomyoma ◽

Healthy Lifestyle ◽

World Health ◽

Medical Sciences ◽

Cross Sectional ◽

World Health Organization Quality ◽

Significant Difference ◽

The Mean

Background: Uterine leiomyomas are considered as a major source of complications and the most common cause of hysterectomy. Objectives: The aim of this study was to compare the quality of life in women with and without uterine leiomyoma referred to gynecology clinics of Shiraz University of Medical Sciences in 2018. Methods: In this cross-sectional study, a total of 126 patients who referred to the clinics of Shiraz University of Medical Sciences were selected and divided into equal groups according to uterine leiomyoma, 1 - 7 cm uterine leiomyoma group and non-uterine leiomyoma group by convenience sampling. The World Health Organization Quality of Life and Healthy Lifestyle questionnaires were used for data collection. Independent t-test was used to analyze the data. Results: The mean quality of life of women with uterine leiomyoma was 47.20 ± 12.41 and women without uterine leiomyoma had a significant difference (51.11 ± 11.23, t = 3.93, P = 0.041). The mean lifestyle of women with uterine leiomyoma was 114.18 ± 25.48 and women without uterine leiomyoma had 149.11 ± 23.81 (t = 4.01, P = 0.029). Conclusions: The mean score of quality of life and lifestyle were significantly different in women with and without uterine leiomyoma. Therefore, it is necessary to improve the quality of life of women by improving their lifestyle and providing psychological counseling.

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