Acute Kidney Injury in Crush Syndrome and Renal Disaster-Experience in Bangladesh after garment factory collapse

2021 ◽  
Vol 32 (2) ◽  
pp. 107-112
Author(s):  
Ratan Das Gupta ◽  
Nazrul Islam ◽  
Dilip Kumar Debnath ◽  
Syed Mahbub Morshed ◽  
Aminur Rahman
Keyword(s):  
Care Center ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Crush Syndrome ◽  
Patient Questionnaire ◽  
Primary Care Center ◽  
Mortality And Morbidity ◽  
Disaster Experience ◽  
Garment Factory ◽  
Rescue Time

Background: Crush-syndrome usually resulting from earthquake and other natural disaster causes mortality and morbidity. A multistoried garment factory collapsed in Savar, Dhaka, Bangladesh on 24th April 2013 with about 4000 workers. Among the rescued victims, many of them develop crush – syndrome and AKI that led to a man-made renal disaster in Bangladesh. We analyzed outcome of severe AKI patient who required renal replacement therapy. Methods: Victims from accident site were first treated in primarily local hospital and primary care center. Suspected crush syndrome patients were rapidly transferred to tertiary hospital for dialysis and ICU support. We collect data of severe AKI patient by a standard questionnairebased onrenal disaster relief force – crush syndrome patient questionnaire. Results: We had experienced many AKI and crush syndrome after collapsed garment factory with 3500 workers which created a manmade renal disaster. We observed 27 severe AKI due to crush syndrome of Rana plaza with mean age 25.12 years, most of them were female (51.85%). Victims rescued as early as possible, average rescue time was 20.30 hours, 62.96% developed compartment syndrome and required fasciotomy. All of them got dialysis treatment; some of them required ICU support. Among all, 67% recovered completely and 26% died. Main causes of death were infection and DIC with MOF. Conclusions: Crush injury victims who developed severe AKI, required dialysis. Severe AKI patients who required dialysis had high mortality and morbidity. Early intervention to prevent AKI and complications may reduce mortality and morbidity. Bangladesh J Medicine July 2021; 32(2) : 107-112

scholarly journals Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ashraf O. Oweis ◽  
Sameeha A. Alshelleh ◽  
Suleiman M. Momany ◽  
Shaher M. Samrah ◽  
Basheer Y. Khassawneh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Acute Kidney Injury Network ◽  
Apache Ii Score ◽  
Mortality And Morbidity ◽  
Incidence Risk

Background. Acute kidney injury (AKI) is a common serious problem affecting critically ill patients in intensive care unit (ICU). It increases their morbidity, mortality, length of ICU stay, and long-term risk of chronic kidney disease (CKD). Methods. A retrospective study was carried out in a tertiary hospital in Jordan. Medical records of patients admitted to the medical ICU between 2013 and 2015 were reviewed. We aimed to identify the incidence, risk factors, and outcomes of AKI. Acute kidney injury network (AKIN) classification was used to define and stage AKI. Results. 2530 patients were admitted to medical ICU, and the incidence of AKI was 31.6%, mainly in stage 1 (59.4%). In multivariate analysis, increasing age (odds ratio (OR) = 1.2 (95% CI 1.1–1.3), P = 0.0001) and higher APACHE II score (OR = 1.5 (95% CI 1.2–1.7), P = 0.001) were predictors of AKI, with 20.4% of patients started on hemodialysis. At the time of discharge, 58% of patients with AKI died compared to 51.3% of patients without AKI (P = 0.05). 88% of patients with AKIN 3 died by the time of discharge compared to patients with AKIN 2 and 1 (75.3% and 61.2% respectively, P = 0.001). Conclusion. AKI is common in ICU patients, and it increases mortality and morbidity. Close attention for earlier detection and addressing risk factors for AKI is needed to decrease incidence, complications, and mortality.

scholarly journals Severe preeclampsia leads to higher prevalence of mortality and morbidity affecting maternal outcomes in single tertiary hospital

2020 ◽  
Vol 28 (3) ◽  
pp. 99
Author(s):  
Khonsa’ Tsabitah ◽  
Budi Wicaksono ◽  
Samsriyaningsih Handayani
Keyword(s):  
Placenta Previa ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Severe Preeclampsia ◽  
Sectio Caesarea ◽  
Maternal Outcomes ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Maternal Characteristics ◽  
Cross Sectional Design

Objective: The purpose of this study was to determine the maternal outcomes of severe preeclampsia at RSUD Dr. Soetomo Surabaya in January 2013-December 2014.Materials and Methods: This research was a descriptive study with cross-sectional design to observe maternal characteristics and maternal outcomesof severe preeclampsia. Data were retrieved from medical records of severe preeclampsia patients admitted to Obstetric Ward of Dr Soetomo Hospital, from January 2013 to December 2014. This study used total sampling for collecting its data. These data were proccessed descriptively and presented in graphic, tables, and short description.Results: From January 2013 to December 2014 there were 386 (44.2%) cases of severe preeclampsia that were included in this study from a total of 874 cases available. The maternal outcomes of severe preeclampsia consisted of 42 cases (10.9%) of HELLP syndrome, 36 cases (9.3%) of pulmonary edema, 225 cases (58.3%) of sectio caesarea, 7 cases(1.8%) of antepartum bleeding with 5 cases (1.3%) of placenta previa and 2 cases (0.5%) of solutio placenta, 2 cases (0.5%) of postpartum bleeding, 8 cases (2.1%) of eclampsia, 31 cases (8%) of impending eclampsia, 5 cases (1.3%) of acute kidney injury, and 2 cases (0.5%) of maternal death.Conclusion: In conclusion, this study shows that severe pre-eclampsia patients have high prevalence of mortality and morbidities that affects maternal outcomes. It also reccommends that all patients with severe preeclampsia need to receive intensive maternal and fetal care. It is necessary to do careful complication examination, prevention of seizures using magnesium sulfate, and continous fetal and maternal monitoring.

Transitioning From Consult-Based to Automatic Pharmacy-Driven Vancomycin Management: Results From a Single, Primary Care Center

2021 ◽  
pp. 089719002110041
Author(s):  
Jennifer L. Cole ◽  
Russell O’Glee ◽  
Michael Clark ◽  
Meredith White
Keyword(s):  
Primary Outcome ◽  
Care Center ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Management Policy ◽  
Primary Care Center ◽  
Safety And Efficacy ◽  
Policies And Procedures ◽  
Collaborative Agreement ◽  
Secondary Outcomes

Objective: The transition to area under the curve (AUC) vancomycin monitoring requires substantial updates in pharmacy policies and procedures. The study facility was tasked with transitioning from a consult-based collaborative agreement to an automatic pharmacist management policy on all intravenous (IV) vancomycin orders. The purpose of this quality assessment (QA) study was to evaluate the effectiveness of this transition. Methods: The primary outcome was the proportion of patients with pharmacist assessment of pharmacokinetics and dosing with documentation in IV vancomycin treated patients from January-June 2020. Secondary outcomes included the proportion of AUC24 levels within therapeutic range, the incidence of acute kidney injury (AKI) and treatment failures in patients treated ≥72 hours compared to a historical, trough-based cohort. Results: There were 88 patients in the QA analysis with 100% having a pharmacist assessment with documentation. There were 34 patients treated ≥72 hours in the AUC group, 36 in the trough-based group. AUC24 fell within desired range in 45% of monitored patients. Rates of AKI (9% vs 11%, p = 0.75) and treatment failures were similar (3% vs 0%, p = 0.3). Conclusion: The transition from consult-based to an automatic pharmacy management agreement was successful with similar safety and efficacy compared to a historical trough-based cohort.

Clinical profile of acute kidney injury in a tertiary hospital

2019 ◽  
Vol 10 (2) ◽  
pp. 59-61
Author(s):  
M Rama Subba Reddy ◽  
◽  
S Senthil Kumar ◽  
A Nasreen Begum ◽  
A Shanmuga Priya ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Clinical Profile

A Retrospective Cohort Study of SARS-CoV-2 Infection in Hypertenses Patients in a Primary Care Center

2020 ◽  
Author(s):  
Esther Hernandez Castilla ◽  
Lucia Vallejo Serrano ◽  
Monica Saenz Ausejo ◽  
Beatriz Pax Sanchez ◽  
Katharina Ramrath ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Center ◽  
Primary Care Center

KNOWLEDGE, ATTITUDE, AND PRACTICE OF PHARMACISTS ABOUT PHARMACEUTICAL CARE FOR DIABETES MELLITUS PATIENTS IN A PRIMARY CARE CENTER IN SAUDI ARABIA

2020 ◽  
Vol 76 (3) ◽  
Author(s):  
Maha Aldraimly ◽  
Sayed Azhar Suliman ◽  
Ahmed Ibrahim Nouri ◽  
Manahel Mohammed Alshaer ◽  
Norah Mohammed Almaghrabi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Saudi Arabia ◽  
Pharmaceutical Care ◽  
Care Center ◽  
Primary Care Center ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

scholarly journals European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fausto Biancari ◽  
Giovanni Mariscalco ◽  
Hakeem Yusuff ◽  
Geoffrey Tsang ◽  
Suvitesh Luthra ◽  
...  
Keyword(s):  
Adverse Events ◽  
Aortic Dissection ◽  
Treatment Strategies ◽  
Kidney Injury ◽  
Type A ◽  
Salvage Procedure ◽  
Type A Aortic Dissection ◽  
Mortality And Morbidity ◽  
Link Type ◽  
The Impact

Abstract Background Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient’s conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient’s comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD. Trial registration ClinicalTrials.gov Identifier: NCT04831073.

Fifteen-minute consultation: how to identify and treat children with acute kidney injury

2021 ◽  
pp. edpract-2020-319928
Author(s):  
Maura Scott ◽  
Grace McCall
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Management ◽  
Kidney Injury ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Fluid Status ◽  
Close Observation ◽  
Long Term Follow Up

Acute kidney injury (AKI) is under-recognised in children and neonates. It is associated with increased mortality and morbidity along with an increased incidence of chronic kidney disease in adulthood. It is important that paediatricians are able to recognise AKI quickly, enabling prompt treatment of reversible causes. In this article, we demonstrate an approach to recognising paediatric AKI, cessation of nephrotoxic medication, appropriate investigations and the importance of accurately assessing fluid status. The mainstay of treatment is attempting to mimic the kidneys ability to provide electrolyte and fluid homeostasis; this requires close observation and careful fluid management. We discuss referral to paediatric nephrology and the importance of long-term follow-up. We present an approach to AKI through case-presentation.

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