scholarly journals Spectrum of Severe Sepsis in Critically Ill Adult Patients of Bangladesh: A Prospective Observational study

2015 ◽  
Vol 3 (2) ◽  
pp. 45-48
Author(s):  
Fatema Ahmed ◽  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Md Shah Zaman
Keyword(s):  
Severe Sepsis ◽  
Organ Dysfunction ◽  
Primary Source ◽  
Cross Sectional Study ◽  
Preventive Strategy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Source Of Infection ◽  
Specific Objective ◽  
Organ Dysfunctions

Background: Severe sepsis is the leading cause to Intensive Care Unit (ICU) admission. However few studies have described the primary source of the severe sepsis in Bangladesh.Objectives: General objective was to identify the clinical presentation of infection in severe sepsis patients & specific objective was to determine the primary and commonest source of infection in severe sepsis.Methods: This was a prospective cross sectional study done over seven months period starting from June 1, 2012 to December 31, 2012 in the dept. of Critical Care Medicine of BIRDEM General Hospital. All ICU admissions from the emergency department, medical and surgical in patients who were screened daily for the presence of severe sepsis or septic shock using a screening tool, which included definitions of sepsis and organ dysfunctions. All consecutive patients with severe sepsis were enrolled as study subjects.Results: A total of 228 patients were admitted in ICU and among them, 95 patients of severe sepsis were included . The mean age of the patients was 59.56 years & male to female ratio being 3:2. Ninety two (92% ) patients had any kind of comorbidity. Commonest comorbidity was diabetes mellitus (77%). Respiratory, renal dysfunction, and cardiovascular, were the most frequent organ dysfunctions (87% , 64%, 58%, respectively). In severesepsis patients single organ dysfunction was 30 %, double organ dysfunction was also 30% & triple organ dysfunction was 35% of patients. The most common primary source of infection were the respiratory system 70%, followed by urinary tract11% , intravascular catheter related infection 7% and abdomen 5%.Conclusion: Severe sepsis is a significant & common health problem in ICU Patients of Bangladesh. An understanding of the primary sources of severe sepsis is vital for treatment and these information will allow us to make preventive strategy for severe sepsis.Bangladesh Crit Care J September 2015; 3 (2): 45-48

scholarly journals Epidemiology, Clinico-Pathological Characteristics, and Comorbidities of SARS-CoV-2 infected Pakistani Patients

2021 ◽  
Author(s):  
Saadia Omer ◽  
Muhammad Bilal Sarwar ◽  
Muhammad Roman ◽  
Muhammad Usman ◽  
Muhammad Alam ◽  
...  
Keyword(s):  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Response To Treatment ◽  
Future Research ◽  
Cross Sectional ◽  
Icu Patients ◽  
Female Ratio ◽  
Source Of Infection ◽  
Control And Prevention ◽  
Complete Blood Counts

AbstractSARS-CoV-2 is a causative agent for COVI-19 disease, initially reported from Wuhan, China. Infected Patients experienced mild to severe symptoms, resulting in several fatalities due to a weak understanding of its pathogenesis, which is the same even to date. This cross-sectional study has been designed on four hundred and fifty-two symptomatic, mild-to-moderate, and severe/critical patients to understand the epidemiology and clinical characteristics of COVID-19 patients with their comorbidities and response to treatment. The mean age of studied patients was (58±14.42) years, and the overall male to female ratio was 61.7 to 38.2%, respectively. 27.3% of the patients had a history of exposure, 11.9% travel history, while for 60% of patients, the source of infection was unknown. The most prevalent signs and symptoms in ICU patients were dry coughs, myalgias, shortness of breath, gastrointestinal discomfort, and abnormal Chest X-ray (p<0.001), along with the high percentage of hypertension (p=0.007) and COPD (p=0.029) as leading comorbidities. Complete Blood Counts indicators were significantly increased in severe patients, while the Coagulation Profile and D-dimer values were significantly higher in mild-to-moderate (non-ICU) patients (p < 0.001). Serum Creatinine (1.22 umole L-1; p = 0.016) and LDH (619 umol L-1; p < 0.001) indicators were significantly high in non-ICU patients while, raised values of Total Bilirubin (0.91 umol L-1; p = 0.054), CRP (84.68 mg L-1; p = 0.001) and Ferritin (996.81 mg L-1; p < 0.001) were found in ICU patients. Drug Dexamethasone was the leading prescribed and administrated medicine to the COVID-19 patients, followed by Remdesivir, Meropenem, Heparin, and Tocilizumab, respectively. A characteristic pattern of Ground glass opacities (GGO), consolidation, and interlobular septal thickening were prominent in severely infected patients. These findings could be used for future research, control, and prevention of SARS-CoV-2 infected patients.

scholarly journals Staphylococcus aureus Bacteremia in Hospitalized Patients and Associated Factors: A Cross-sectional Study from Mashhad, Iran

2021 ◽  
Vol 14 (7) ◽  
Author(s):  
Ali Akbar Heydari ◽  
Abas Eslami ◽  
Maliheh Dadgarmoghaddam
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Clinical Characteristics ◽  
Good Condition ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Source Of Infection

Background: Staphylococcus aureus is an important cause of resistant infection with high mortality and morbidity. Objectives: We aimed to evaluate the clinical characteristics and comorbidities of patients with S. aureus infection to define the predictors of adverse outcomes. Methods: In this cross-sectional study, patients (aged ≥ 15 years) with positive S. aureus blood cultures were included. Their demographic and clinical characteristics were recorded, and their association with the main adverse outcomes (methicillin-resistant S. aureus [MRSA], infective endocarditis, source of infection, and the final outcome were analyzed using SPSS software version 16. Results: The male-to-female ratio was 54/51. The mean age was 55.13 years (women: 58.45 ± 20.4 and men: 53.6 ± 17.6). Of 105 cases analyzed, 40% had hospital-, 25.7% community-, and 34.3% healthcare-associated bacteremia. The median duration of hospital admission was 13 days. Thirty-two percent had MRSA, differently based on the source of infection (P = 0.029). Twenty-eight patients had infective endocarditis, differently based on the source of infection, prosthetics, considerable foci of infection, and receipt of blood and its derivatives (P < 0.05). Most patients with neurological and end-stage renal disease (both P = 0.001) did not have infective endocarditis. Finally, 61.9% of the patients were discharged with good condition, 38.1% died, and 9% left the hospital before diagnosis of the foci. Conclusions: Vascular catheters and cardiovascular diseases, including hypertension, are among the most common factors associated with S. aureus bacteremia, and it is necessary to carefully examine the presence of these factors, as well as infective endocarditis in these patients.

scholarly journals Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

2021 ◽  
Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa
Keyword(s):  
Developing Countries ◽  
Head Injury ◽  
Road Traffic ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Incidence And Mortality ◽  
Male Female Ratio ◽  
Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

Nutrient supplementation among pregnant women in China: an observational study

2021 ◽  
pp. 1-19
Author(s):  
Tao Han ◽  
Jingwen Dong ◽  
Jiangtao Zhang ◽  
Chenxiao Zhang ◽  
Yuxuan Wang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Pregnant Women ◽  
Family Members ◽  
Primary Source ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nutrient Supplementation ◽  
Face To Face ◽  
Source Of Information

Abstract Objective: To clarify nutrient supplementation usage and primary source of information among pregnant women in China. Design: This cross-sectional study used information on nutrient supplementation and primary source of information collected via face-to-face interviews. Data on the usage of folic acid, calcium/vitamin D, iron, vitamins, docosahexaenoic acid, and other dietary supplements were collected. Primary source of information were categorized as family/relatives, friends/co-workers, the Internet, books/magazines, television/radio, doctors, other people, and oneself. Setting: Maternal and Child Health Hospital in Chengdu, China. Participants: 1081 Chinese pregnant women aged ≥ 20 years with singleton pregnancies. Results: In all three trimesters of pregnancy, usage was highest and most stable for folic acid (81.7%), followed by vitamins (vitamin A, B-group vitamins, vitamin C, and multivitamins; 75.0%), whereas calcium/vitamin D (51.4%) and iron (18.1%) usage was low, potentially indicating a deficiency risk. All supplementation usage percentages increased with pregnancy duration (p < 0.05). Notably, approximately 10% of the pregnant women in our study did not use any nutrient supplementation, and this was especially common in early pregnancy. More than 50% of the women reported getting information on nutrient supplementation from family members, and about 30% reported getting this information from doctors. Conclusions: Among pregnant women in China, awareness about nutrient supplementation increases as the pregnancy progresses, but some types of nutrient supplementation (such as calcium/vitamin D and iron) remain at low levels. It is necessary to pay more attention to the health education of pregnant women in China, and the influence of family members should be emphasized.

Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

2021 ◽  
Vol 15 (9) ◽  
pp. 2841-2843
Author(s):  
Muhammad Omer Farooq ◽  
Niaz Ahmed ◽  
Hassan Nadeem ◽  
Kashif Rafi ◽  
Sadia Jabbar ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Cross Sectional Study ◽  
Meld Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Score Study ◽  
Insignificant Difference ◽  
Cirrhotic Patients ◽  
Male To Female

Objective: To determine the frequency of high MELD score in cirrhotic patients undergoing liver resection due to hepatocellular carcinoma also compare the frequency of mortality in patients with high or low MELD score. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. Duration: 6months i.e. 23 12-2017 to 22-06-2018. Methodology: 75 patients were enrolled. Then blood sample was obtained. Reports assessed and MELD score calculated. Scores were labeled as high or low. Patients underwent liver resection according to BCLC. The mortality was noted. All the collected data was entered and analyzed on SPSS version 22. Results: In this study out of total 75 cases 60 were males and 15 females. The mean age of patients was 39.44±9.76 years, male to female ratio was 4:1. Low MELD class was noted in 45 (60%) cases and high MELD class noted in 30(40%) cases. Mortality occurred in 27(36%) cases. Insignificant difference found between the MELD class with mortality. Conclusion: High MELD score was seen in 40% cirrhotic patients undergoing liver resection due to HCC. Post HCC resection, mortality occurred in 36% patients within three months of surgery. No significant association was found between the mortality and MELD score. Keywords: MELD, Hepatocellular Carcinoma, Mortality, Cirrhosis

HIV Prevalence and Frequency of Risk Behavior in Injecting Drug Users Entering Treatment and Out of Treatment: A Cross-Sectional Study in Five Italian Cities

1994 ◽  
Vol 24 (3) ◽  
pp. 527-535 ◽  
Author(s):  
Giovanni Rezza ◽  
Stefania Salmaso ◽  
Damiano Abeni ◽  
Giovanna Brancato ◽  
Alessandra Anemona ◽  
...  
Keyword(s):  
Risk Behavior ◽  
Drug Users ◽  
Injecting Drug Users ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Outreach Programs ◽  
Male To Female

We conducted a study to describe current patterns of drug-related behaviors, and to identify characteristics that may distinguish injecting drug users entering treatment from those out of treatment, in five Italian cities. Overall, 1,180 subjects were recruited — 568 entering treatment and 612 out of treatment. Male to female ratio was 6.6:1. The median age was similar in the two groups. A high proportion of injecting drug users recruited out of treatment had been in treatment at least once. HIV prevalence among injecting drug users entering treatment was not higher than that of those who were out of treatment. Furthermore, a large proportion of injecting drug users who still were out of treatment reported having adopted safe behaviors. The results of the study emphasize the need to implement outreach programs aimed at harm reduction.

scholarly journals Risk Factors that Affect Morbidity and Mortality in Patients with Perforated Peptic Ulcer Diseases in a Teaching Hospital

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Nebyou Seyoum ◽  
Daba Ethicha ◽  
Zelalem Assefa ◽  
Berhanu Nega
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Addis Ababa ◽  
Previous History ◽  
Perforated Peptic Ulcer ◽  
Cross Sectional Study ◽  
Morbidity And Mortality ◽  
Delayed Presentation ◽  
Cross Sectional ◽  
Female Ratio

Background: This study was done to identify risk factors that affect the morbidity and mortality of patients operated for a perforated peptic ulcer in a resource-limited setting.Methods: A two years (January 1, 2016 - December 30, 2018) retrospective cross- sectional study was done on patients admitted and operated for PPU at Yekatit 12 Hospital, Addis Ababa,Ethiopia.Results: A total of 93 patients were operated. The median age affected was 29 years (Range 15-75 years). Male to female ratio was 7.5:1. Chewing chat, smoking and alcohol use were seen in 22 (23.6%), 35(37.6%), and 34(36.5%), cases respectively. Only 23.6% gave previous history of dyspepsia. The median duration of illness was 48hours and the duodenal to gastric ulcer perforation ratio was 6.5:1. In majority of the cases (63.3%) the perforation diameter was <10mm (63.3%). Cellan-Jones repair of the perforations was done in 92.5% of cases. A total of 47 complications were seen in 25 cases. The total complications and mortality rates were 25(26.8%) and 6(6.5%) respectively. The most common postoperative complication was pneumonia (13.97%) followed by superficial surgical site infection (10.8%). Mortality rate was highest among patients >50yrs [AOR (95%CI) =2.4(2-30)]. Delayed presentation of >24 hours [AOR (95%CI) =4.3(1.4-13.5)] and a SBP <90mmhg [AOR (95%CI) =4.8(1-24)] were found to be significantly related with higher complication rate.Conclusions: Patients who presented early and immediate corrective measures were instituted had better outcomes while those seen late developed unfavorable out-come with significantly higher complications. Therefore, early detection and treatment of PPU is essential.

scholarly journals Role of Squash Cytology in Intraoperative Diagnosis of Meningioma

2021 ◽  
Author(s):  
Gowri Prakasam ◽  
K Karkuzhali ◽  
Veeraraghavan Gurusamy
Keyword(s):  
Tamil Nadu ◽  
Frozen Section ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Suspected Case ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College ◽  
Cost Effective Technique

Introduction: Primary Central Nervous System (CNS) tumours constitute less than 2% of overall cancers in adults and are the second most frequently encountered tumours in children. Meningiomas form 24-30% of primary intracranial tumours. Most intrinsic brain tumours are soft and gelatinous in consistency, smear preparation can readily made which gives excellent cytological details when compared to frozen section as the latter produces ice crystal artifacts. Aim: To assess the diagnostic utility of squash cytological evaluation of meningiomas and its comparison with final histopathological diagnosis. Materials and Methods: The cross-sectional study was done at Thanjavur Medical College, Thanjavur, Tamil Nadu, India for period of three years from January 2015 to December 2017. Total of 54 clinically diagnosed and radiologically suspected case of meningiomas were selected. Smears were prepared from the biopsy samples sent in normal saline and stained by Haematoxylin and Eosin (H&E) method. The cytological features were noted and matched with biopsy findings. Descriptive statistics were used to analyse the results. Results: Total of 54 squash smears with male to female ratio was 1:1.5. Maximum number of cases were seen between 41- 50 years followed by 51-60 years. Complete concordance was obtained in 51 cases (94.44%) and partial concordance was noted in a case due to underestimation of malignancy grade in squash cytology. Out of 54 cases, two cases were found to be discordant with final histopathological diagnosis. Conclusion: Intraoperative squash cytology is easy, rapid, reliable and cost-effective technique for neurosurgical consultation with fairly high accuracy in diagnosing meningiomas.

scholarly journals Does Static Intra Access Pressure Monitoring of Arteriovenous Fistulas Predicts Intra Access Stenosis?

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Abaid ur Rehman ◽  
Muhammad Imran Khan ◽  
Omer Sabir ◽  
Muhammad Mohsin Riaz ◽  
Mubashar Dilawar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Vascular Access ◽  
Doppler Ultrasonography ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Arteriovenous Fistulas ◽  
Doppler Us ◽  
Sensitivity Specificity ◽  
Male To Female

The initiation of hemodialysis in patients with chronic kidney disease (CKD) requires vascular access formation. The choice of vascular access for individual patient depends on various factors however arteriovenous fistula (AVF) is conventionally considered to be the vascular access of choice. Once hemodialysis is initiated through a mature AVF, there is an ongoing need for surveillance of the AVF to ensure adequate function and prevent vascular access issues among which flow obstruction (both inflow and outflow) remains the most important. AVF stenosis can potentially lead to inadequate dialysis delivery and thrombosis thus leading to access loss. Physical examination and AVF Doppler ultrasonography (DUS) are useful for evaluation of stenosis in the  arteriovenous connection and the outflow tract. Periodic assessment of the AVF with Static Intra access Pressure (SIAPR) determination may be a reliable means of predicting vascular access stenosis. Material & Methods  A cross sectional study carried out at Department of Nephrology, Fatima Memorial Hospital, Lahore from July 2018 to December 2018. In total 113 patients were included, and all patients underwent SIAPR assessment and Doppler Ultrasound of AVF. Results Mean age of the patients was 56.81±9.38 years, male to female ratio of the patients was 1.8:1. In this study the SIAPR was suggestive of  stenosis in 87(76.99%) patients. The sensitivity, specificity and diagnostic accuracy of SIAPR against Doppler US of the AVF for detection of stenosis was 75.86%, 22.62% & 36.28% respectively Conclusion SIAPR has low specificity and diagnostic accuracy compared to Doppler US for detection of AVF stenosis.

scholarly journals Evaluation of hearing status after type I tympanoplasty

2020 ◽  
Vol 24 (1) ◽  
pp. 50-55
Author(s):  
Mashuque Mahamud ◽  
Mani Lal Aich ◽  
Abdullah Al Mamun ◽  
Rafiul Alam
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Female Ratio ◽  
The Mean ◽  
Type I Tympanoplasty ◽  
Air Conduction

Objective: To evaluate hearing outcome after type I tympanoplasty in inactive mucous type of chronic otitis media. Methods: It was a cross-sectional study conducted in the department of Otolaryngology & Head Neck Surgery, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from July 2014 to June 2016. 50 cases were selected by matching inclusion and exclusion criteria. Paired t-test and Z test was used to analyze the variables. P values <0.05 was considered as statistically significant. Results: The mean age was found 28.5 years with range from 15 to 41 years and male female ratio was 1.3:1. All patients had intermittent otorrhoea and varying degree of hearing loss. The mean air conduction threshold was 40.2 dB preoperatively and 27.1 dB post-operatively. Air-bone gap was found 26.9 dB in preoperative and 16.1 dB in post-operative group. The differences were statistically significant between preoperative and post-operative group. Thus mean improvement of air conduction threshold was 13.1 dB and air-bone gap was 10.8 dB. Two third (66.%) patients improved <15 db air conduction thresholds and 17(34%) improved ≥15 db air conduction thresholds. Using the proportion of patients with a postoperative hearing within 40 dB as the criterion, this study showed 46(92%) patients achieving this and 40(80%) patients achieving AB gap within 20 db postoperatively. Conclusion: Improvement of air conduction threshold and AB gap after type I tympanoplasty was statistically significant. Thus from this study it can be concluded that type I tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 50-55

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