scholarly journals Some Clinical Features and Supportive Therapies in Covid-19 Patients Died in Hajar Hospital, Tehran, Iran

2021 ◽  
Vol 11 (2) ◽  
pp. 154-165
Author(s):  
Hamed Maleki ◽  
◽  
Fatemeh Tabatabaie ◽  
Mosayeb Bagherinik ◽  
Sosan Azizmohamadi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Significant Relationship ◽  
Clinical Manifestations ◽  
Recovery Process ◽  
Definitive Treatment ◽  
Blood Products ◽  
Definite Effect ◽  
And Gender ◽  
Underlying Diseases

Objective: Due to the spread of Coronavirus Disease 2019 (COVID-19) worldwide and the resulting mortality as well as the lack of definitive treatment for this disease, various non-invasive and invasive drugs and treatments have been used around the world for reducing the effects of this disease or accelerating the treatment process, but the positive and definite effect of none of these methods has been confirmed and they have been effective only in some cases. This study aims to investigate some clinical features and supportive therapies in deceased COVID-19 patients in Iran. Methods: This descriptive-analytical retrospective study was conducted on 100 Covid-19 patients died in Hajar Hospital in Tehran, Iran from February to September 2020. They were divided into two groups of with and without underlying diseases. After coordination and obtaining the necessary permission and informed consent, information was collected from the medical files of samples. Results: Mechanical ventilation, vasoconstrictor injection and blood products had been used as supportive therapies in deceased patients, where ventilation use (n=62, 62%) was significantly higher (P=0.01) compared to vasoconstrictor injection (n=28, 28%) and blood products (n=13, 13%). Most of deceased patients had an underlying diseases (79%). Hypertension, diabetes and heart problems were the most common underlying diseases. The disease severity, clinical manifestations, and mortality rate of deceased patients with cardiovascular diseases, diabetes and hypertension were significantly different compared to those with other underlying diseases (P= 0.01). The age and gender of deceased patients had no significant relationship with the use of any supportive therapies (P≥0.01), but had a significant relationship with the underlying diseases (P≤0.01). Conclusion: The treatment methods that are the definite needs of the patient and have more favorable effects on the recovery process have a high value in the treatment of COVID-19 patients. These patients need to use supportive therapies for purposeful and effective treatment. Mechanical ventilation is more important than injecting vasoconstrictors or using blood products.

scholarly journals Retrospective analysis of clinical features in 134 coronavirus disease 2019 cases

2020 ◽  
Vol 148 ◽  
Author(s):  
Lin Zhang ◽  
Bin Huang ◽  
Hongzhen Xia ◽  
Hua Fan ◽  
Muxin Zhu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Test Results ◽  
Reactive Protein ◽  
Type Ab ◽  
Therapy Strategies ◽  
Underlying Diseases ◽  
To Receive ◽  
Group Distribution

Abstract We aimed to describe the clinical features in coronavirus disease 2019 (COVID-19) cases. We studied 134 critically ill COVID-19 cases from 30 December 2019 to 20 February 2020 in an intensive care unit (ICU) at Wuhan Jinyintan Hospital. Demographics, underlying diseases, therapy strategies and test results were collected and analysed from patients on admission, admission to the ICU and 48 h before death. The non-survivors were older (65.46 (s.d. 9.74) vs. 46.45 (s.d. 11.09)) and were more likely to have underlying diseases. The blood group distribution of the COVID-19 cases differed from that of the Han population in Wuhan, with type A being 43.85%; type B, 26.92%; type AB, 10% and type O, 19.23%. Non-survivors tend to develop more severe lymphopaenia, with higher C-reactive protein, interleukin-6, procalcitonin, D-dimer levels and gradually increased with time. The clinical manifestations were non-specific. Compared with survivors, non-survivors more likely to have organ function injury, and to receive mechanical ventilation, either invasively or noninvasively. Multiple organ failure and secondary bacterial infection in the later period is worthy of attention.

scholarly journals Foreign Body Ingestion in Children: Epidemiological, Clinical Features and Outcome in a Third Level Emergency Department

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1182
Author(s):  
Antonio Gatto ◽  
Lavinia Capossela ◽  
Serena Ferretti ◽  
Michela Orlandi ◽  
Valeria Pansini ◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Clinical Features ◽  
Foreign Bodies ◽  
Pediatric Patients ◽  
Invasive Procedure ◽  
Foreign Body Ingestion ◽  
X Rays ◽  
And Gender ◽  
Underlying Diseases

Ingestion of foreign bodies is a frequent pediatric cause of access to the Emergency Department (ED). The aim of this study was to determine the epidemiological and clinical features of pediatric patients with a diagnosis of foreign body ingestion and to identify the factors associated with an urgent invasive procedure or hospitalization. This is a retrospective study conducted on a population of 286 pediatric patients (0–17 years) evaluated for foreign body ingestion at the Pediatric ED of “Fondazione Policlinico Universitario A. Gemelli, IRCSS” between October 2014 and June 2019. Data concerning age and gender, underlying diseases, type of foreign body, symptoms and signs, instrumental tests, specialist visits, treatment and outcome were analyzed. The majority of foreign bodies were coins (23%). Symptoms recurred in 50% of the foreign bodies with esophageal localization and between the 92 (32%) patients with symptoms the most common was vomiting (7%). X-rays was performed in 61% of patients. Among all patients, 253 patients (88.8%) had been discharged, 21 (7%) had been hospitalized, and four (1.4%) were sent to an outpatient facility. Besides, 17 (5.9%) patients had been transferred to the Observation Unit. Of the hospitalized patients (21 (7.3%)), clinical observation was performed for 57% and endoscopic procedure for 45%. Our data confirm that the ESPGHAN-ESGE guidelines application prevents interventions that are not necessary, avoiding diagnostic and therapeutic delays.

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Clinical characteristics of inpatients with coronavirus disease 2019 (COVID-19) in Sichuan province

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Lei Chen ◽  
Qiao He ◽  
Mingqi Wang ◽  
Mei Liu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Sichuan Province ◽  
Chest Ct ◽  
Shortness Of Breath ◽  
Course Of Disease ◽  
West China ◽  
Radiologic Abnormality

Abstract Background The outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients. Methods Patients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared. Results Of the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P <  0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046). Conclusions The symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.

scholarly journals Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ser Hon Puah ◽  
◽  
Barnaby Edward Young ◽  
Po Ying Chia ◽  
Vui Kian Ho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Series ◽  
Plateau Pressure ◽  
Apache Ii Score ◽  
Multivariable Logistic Regression Model ◽  
Reactive Protein ◽  
Ventilatory Management

AbstractWe aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.

scholarly journals Gender Differences in Diabetic Kidney Disease: Focus on Hormonal, Genetic and Clinical Factors

2021 ◽  
Vol 22 (11) ◽  
pp. 5808
Author(s):  
Annalisa Giandalia ◽  
Alfio Edoardo Giuffrida ◽  
Guido Gembillo ◽  
Domenico Cucinotta ◽  
Giovanni Squadrito ◽  
...  
Keyword(s):  
Gender Differences ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Sex And Gender ◽  
Clinical Factors ◽  
Diabetic Kidney ◽  
And Gender ◽  
The Impact

Diabetic kidney disease (DKD) is one of the most serious complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Current guidelines recommend a personalized approach in order to reduce the burden of DM and its complications. Recognizing sex and gender- differences in medicine is considered one of the first steps toward personalized medicine, but the gender issue in DM has been scarcely explored so far. Gender differences have been reported in the incidence and the prevalence of DKD, in its phenotypes and clinical manifestations, as well as in several risk factors, with a different impact in the two genders. Hormonal factors, especially estrogen loss, play a significant role in explaining these differences. Additionally, the impact of sex chromosomes as well as the influence of gene–sex interactions with several susceptibility genes for DKD have been investigated. In spite of the increasing evidence that sex and gender should be included in the evaluation of DKD, several open issues remain uncovered, including the potentially different effects of newly recommended drugs, such as SGLT2i and GLP1Ras. This narrative review explored current evidence on sex/gender differences in DKD, taking into account hormonal, genetic and clinical factors.

Relationship Between Academic Stress and Learning Achievement in Nursing Student

2021 ◽  
Vol 2 (1) ◽  
pp. 222-229
Author(s):  
Yuanita Panma
Keyword(s):  
High School ◽  
Significant Relationship ◽  
Life Stress ◽  
Nursing Student ◽  
Academic Stress ◽  
P Value ◽  
Cross Sectional ◽  
Learning Achievement ◽  
Academic Stressor ◽  
And Gender

The stress experienced by most students is academic stress. This academic stress is closely related to students' academic processes and the environment that affects the academic process. The purpose of this study was to determine the relationship between academic stress and student learning achievement. This study was a cross-sectional design with purposive sampling of 126 respondents. Data were collected at a nursing academy in Jakarta in 2018. The instrument used was the Student Life Stress Inventory (SLSI) questionnaire. Results showed most students were female(88.9%), from Senior High School majoring in science (38.9%), very satisfyinglearning achievement (91.3%), and experience severe academic stress (55.6%). There is no significant relationship between learning achievement and academic stress (p = 0.317) and gender (p-value 0.370). There is a significant relationship between learning achievement and sebior high school majoring (p=value 0.005) and age (p-value 0.007). Institutions should identify sources of the academic stressor and apply appropriate coping mechanisms to reduce academic stress.Keywords:academic stress, learning achievement, nursing student.

Clinical, Microbial, and Biochemical Aspects of the Exfoliative Toxins Causing Staphylococcal Scalded-Skin Syndrome

1999 ◽  
Vol 12 (2) ◽  
pp. 224-242 ◽  
Author(s):  
Shamez Ladhani ◽  
Christopher L. Joannou ◽  
Denise P. Lochrie ◽  
Robert W. Evans ◽  
Susan M. Poston
Keyword(s):  
Clinical Features ◽  
Treatment Options ◽  
Entire Body ◽  
Secondary Complications ◽  
Staphylococcal Scalded Skin Syndrome ◽  
Treatment And Prevention ◽  
Causative Agents ◽  
Underlying Diseases ◽  
Disease Understanding ◽  
Significant Mortality

SUMMARY The exfoliative (epidermolytic) toxins of Staphylococcus aureus are the causative agents of the staphylococcal scalded-skin syndrome (SSSS), a blistering skin disorder that predominantly affects children. Clinical features of SSSS vary along a spectrum, ranging from a few localized blisters to generalized exfoliation covering almost the entire body. The toxins act specifically at the zona granulosa of the epidermis to produce the characteristic exfoliation, although the mechanism by which this is achieved is still poorly understood. Despite the availability of antibiotics, SSSS carries a significant mortality rate, particularly among neonates with secondary complications of epidermal loss and among adults with underlying diseases. The aim of this article is to provide a comprehensive review of the literature spanning more than a century and to cover all aspects of the disease. The epidemiology, clinical features, potential complications, risk factors, susceptibility, diagnosis, differential diagnoses, investigations currently available, treatment options, and preventive measures are all discussed in detail. Recent crystallographic data on the toxins has provided us with a clearer and more defined approach to studying the disease. Understanding their mode of action has important implications in future treatment and prevention of SSSS and other diseases, and knowledge of their specific site of action may provide a useful tool for physiologists, dermatologists, and pharmacologists.

scholarly journals Revered but Poorly Understood: A Case Report of Dendroaspis polylepis (Black Mamba) Envenomation in Watamu, Malindi Kenya, and a Review of the Literature

2018 ◽  
Vol 3 (3) ◽  
pp. 104 ◽  
Author(s):  
Valentine Erulu ◽  
Mitchel Okumu ◽  
Francis Ochola ◽  
Joseph Gikunju
Keyword(s):  
Mechanical Ventilation ◽  
Oxygen Saturation ◽  
South African ◽  
Artificial Ventilation ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Hemodynamic Instability ◽  
Rapid Onset ◽  
Sub Saharan Africa ◽  
Sub Saharan

The black mamba (Dendroaspis polylepis) ranks consistently as one of the most revered snakes in sub-Saharan Africa. It has potent neurotoxic venom, and envenomation results in rapid onset and severe clinical manifestations. This report describes the clinical course and reversal of effects of black mamba envenomation in a 13-year-old boy in the Jimba area of Malindi. The victim presented to Watamu Hospital, a low resource health facility with labored breathing, frothing at the mouth, severe ptosis and pupils non-responsive to light. His blood pressure was unrecordable, heart rate was 100 beats per minute but thready, his temperature was 35.5 °C, and oxygen saturation was 83%. Management involved suction to clear salivary secretions, several hours of mechanical ventilation via ambu-bagging, oxygen saturation monitoring, and the use of South African Vaccine Producers (SAVP) polyvalent antivenom. Subcutaneous adrenaline was used to stave off anaphylaxis. The victim went into cardiac arrest on two occasions and chest compressions lasting 3–5 min was used to complement artificial ventilation. Hemodynamic instability was corrected using IV infusion of ringers lactate and normal saline (three liters over 24 h). Adequate mechanical ventilation and the use of specific antivenom remain key in the management of black mamba envenomation.

scholarly journals THE EFFECT OF PHYSICIANS’ GENDER AND EXPERIENCE ON PERSIAN MEDICAL INTERACTIONS

2017 ◽  
Vol 10 (1) ◽  
pp. 89-110
Author(s):  
Fariba Ramazani Sarbandi ◽  
Giti Taki ◽  
Pakzad Yousefian ◽  
Mohamad Reza Farangi
Keyword(s):  
Significant Relationship ◽  
Chi Square ◽  
Patient Interactions ◽  
Medical Consultations ◽  
Power Strategies ◽  
Tag Questions ◽  
And Gender ◽  
Physician Patient ◽  
The Relationship ◽  
Chi Square Tests

This study focusing on physician-patient interactions aimed to find out whetherphysicians’ gender and experience influence Persian doctor-patient interactions. Sopower strategies in physician-patient interactions were extracted and categorized toexplore the relationship between physicians’ gender and experience and power strategies.Fieldwork was conducted in clinics and hospitals of Rafsanjan city in Iran. One hundredphysician-patient consultations were audiotaped and transcribed during 2011-2012.Woods’ (2006) view was used to examine four strategies of power and knowledge ontheir talk. The findings pointed out the importance of investigating discourse of medicinein order to improve medical consultations, especially physician-patient interactions.Our study confirmed some previous assertions that physician-patient interactionswere asymmetrical. Physicians controlled and dominated the medical consultations byquestioning, interruptions, directive statements and tag questions. The analysis of the datarevealed that all power strategies were applied in Iranian physician-patient interactions.The results of Chi-Square tests indicated that there was a significant relationship betweenpower strategies and physicians’ experience and gender. It was concluded that the femaleand inexperienced physicians tended to control consultations by questioning, interruption,directives and tag questions more than the male and experienced physicians.

Sign in / Sign up

Export Citation Format

Share Document