Impact of Donor Inflow in COVID 19 Pandemic: A Tertiary Care Hospitals Blood Service Experience

Background: The severe acute respiratory syndrome (SARS) causing the COVID 19 pandemic infection has affected one and all across the world and halting mosthuman activities. During the disease outbreak and country lockdown, Blood Transfusion Services faced numerous challenges to maintain the sustainability in service provision. We intend to identify the challenges faced during COVID-19 outbreak and the following imposed national lockdown. Methods: This retrospective study was done during the lockdown period from26/03/2020 to 30/05/2020 comprising 66 days to detect donor inflow declination and to compare the donor inflow with pre lockdown and post lockdown period of same duration. The periods were divided into six equal intervals to compare donor distribution patterns in lockdown, pre lockdown and post lockdown period. Mean and standard deviation was calculated for continuous variables and chi square test was done for categorical variables. Results: The donations collected during the lockdown period and post lockdown period were almost 71.37% and 62.82% less respectively when compared with the pre lockdown collection (211and 274 versus 737).While in interval periods, donor inflow was declined substantially in lockdown period and in post lockdown period, inflow was declined as of lockdown period initially but it increases as time passed. But the increment was not as such of pre lockdown period. Donor inflow in age group and time interval of donation frequency were statistically significant (p <0.00005 and p< 0.0037 respectively). Conclusion: Concerns of being infected through hospital contact, lack of public transport facilities, travel restrictions imposed by the police department, and no availability of medical student donors in the hospital setting were the main attributing factors for donor inflow. Bangladesh J Medicine July 2022; 33(1) : 70-75

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350. Neurocysticercosis – Gender Differences in Clinical Presentations

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.545 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S244-S244

Author(s):

Bharath Pendyala ◽

Prasanth Lingamaneni ◽

Patricia DeMarais ◽

Lakshmi Warrior ◽

Gregory Huhn

Keyword(s):

Gender Differences ◽

Categorical Variables ◽

Public Health Issue ◽

Diagnostic Code ◽

Continuous Variables ◽

Chi Square ◽

Generalized Seizures ◽

Icd 10 ◽

Chi Square Test ◽

Reported Data

Abstract Background Neurocysticercosis is a Neglected Tropical Disease and an important public health issue. Our goal was to collect and analyze data regarding clinically significant gender differences among our Neurocysticercosis patients. Methods A retrospective chart search with ICD 9/ ICD 10 diagnostic code for Neurocysticercosis and neuroimaging suggestive of Neurocysticercosis was performed for clinical encounters in the hospital or affiliated clinics between years 2013–2018. After a careful chart review, patients who were clinically diagnosed with Neurocysticercosis were included in the study. T-test was used to compare means of continuous variables and chi-square test to compare proportions of categorical variables. Results Among 90 total patients included, male (49.4%) and female (50.6%) distribution were nearly identical. The mean age in females was found to be higher than males (52.5 vs 42.0, P < 0.0001). Almost an equal number of males and females presented with either seizures (63.6% vs 57.8%, P= 0.85), headaches (25.0% vs 28.9%, p= 0.85), or other symptoms (11.4% vs 13.3%, p= 0.85). Males had more generalized seizures compared to females (60% vs 38%, P= 0.37), although this result was not statistically significant. Females were more likely to present with > 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P < 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P < 0.001). Male patients were more likely to have contrast enhancement or edema surrounding the lesions (61.4% vs 33.3%, P= 0.01) and were more likely to require treatment with Albendazole/Praziquantel (75.8% vs 31.7%, P < 0.001). Conclusion Although previously reported data is limited, there is a suggestion that there are gender differences in host immune response and that inflammation surrounding parenchymal lesions is more intense in females. This study suggests that men either present early in the disease phase or have different immune responses than women and require anti-parasitic therapy more frequently. More research in this aspect is needed. Disclosures All Authors: No reported disclosures

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Non-Prescription Antibiotic Use For People Aged 15 Years Or Older For Cough In China: A Community-Based Survey

10.21203/rs.3.rs-539716/v1 ◽

2021 ◽

Author(s):

Yan Luo ◽

Xuewen Tang ◽

Lingling Ding ◽

Zhujun Shao ◽

Jianxing Yu ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Univariate Analysis ◽

Antibiotic Use ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Main Driver ◽

Antibiotics Use ◽

Chi Square Test ◽

Use Behavior

Abstract Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all communities, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities.Methods A probability-proportionate-to-size (PPS) sampling method was adopted to survey from all 14 communities in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices (PADs). The continuous variables were presented by mean and standard deviation (SD) or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios (ORs) and 95% confidence intervals (CIs), respectively.Results A total of 3034 respondents across the 14 communities and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26-49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30-39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). As for antibiotic knowledge in 3034 participants, 61.8% participants had minimal knowledge on broad-spectrum antibiotic and 53.76% were not familiar about the effects of joint use.Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

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Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

Advances in Virology ◽

10.1155/2021/6689669 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Víctor O. Costa ◽

Eveline M. Nicolini ◽

Bruna M. A. da Costa ◽

Fabrício M. Teixeira ◽

Júlia P. Ferreira ◽

...

Keyword(s):

Clinical Laboratory ◽

Lung Parenchyma ◽

Clinical Deterioration ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Exact Test ◽

Laboratory Confirmation ◽

Chi Square Test ◽

Imaging Markers

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p = <0.001) and increases in serum creatinine ( p = 0.009), LDH ( p = 0.057), troponin ( p = 0.018), IL-6 ( p = 0.053), complement C4 ( p = 0.040), and CRP ( p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p = 0.001). Hypertension ( p = 0.064), heart disease ( p = 0.048), and COPD ( p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p = 0.027), as well as bilateral opacifications ( p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.

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Predictors of 30-day readmission rate after total gastrectomy in patients with gastric malignancy.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16109 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16109-e16109

Author(s):

Miguel Salazar ◽

Estefania Gauto ◽

Shristi Upadhyay Upadhyay Banskota ◽

Pedro Palacios ◽

Trilok Shrivastava ◽

...

Keyword(s):

Total Gastrectomy ◽

Economic Burden ◽

Readmission Rate ◽

Hospital Costs ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Prolonged Length ◽

Chi Square Test ◽

Gastric Malignancy

e16109 Background: Total gastrectomy with lymph node dissection is curative for early gastric malignancy which accounts for 1.5% of cancer cases in the U.S. Readmissions are common postoperatively, and are associated with increased morbidity, mortality, hospital costs and decreased quality of life. We hence aim to identify incidence, impact and independent predictors for readmission in patients who underwent total gastrectomy in gastric malignancy. Methods: We conducted a retrospective cohort study of the 2017 National Readmission Database (NRD) of adult patients readmitted within 30 days after an index admission for total gastrectomy with a concomitant diagnosis of gastric malignancy. T-test was used for continuous variables and chi square test was used for categorical variables. Multivariate regression was used to identify predictors for unplanned readmissions. ICD 10 codes were used to identify diagnoses and procedures. Results: A total of 1,779 patients with gastric malignancy underwent total gastrectomy. The 30-day readmission rate was 18.5%. Main causes for readmission were sepsis, ventricular fibrillation, recurrent STEMI. Readmitted patients were more likely to be on chemotherapy. (40.1% vs 27.2%; P<0.01) and more likely to be discharged to a skilled facility (13.5% vs 17.9%; P<0.01). The total health care in-hospital economic burden of readmission was $6.5 million in total charges and $25 million in total costs. Independent predictors of readmission were major bleeding, respiratory failure requiring mechanical ventilation, peripheral parenteral nutrition, history of non-alcoholic hepato-steatosis, and prolonged length of stay. Conclusions: Readmissions after gastrectomy in patients with gastric malignancies are associated with lower in-hospital mortality yet pose a substantial economic burden on healthcare. The lower mortality might be explained by the relatively stable course and lower comorbidities of patients who become eligible for discharge after surgery. Further studies are suggested. Modifiable risk factors like malnutrition and sepsis warrant special attention to decrease readmissions and improve overall outcomes.[Table: see text]

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Validation of a Breastfeeding History Questionnaire for the Risk of In-Hospital Formula Supplementation Among Multiparous Women

Journal of Human Lactation ◽

10.1177/0890334419868157 ◽

2019 ◽

Vol 35 (4) ◽

pp. 665-671

Author(s):

Whitney R. Bender ◽

Nathanael C. Koelper ◽

Mary D. Sammel ◽

Celeste Durnwald

Keyword(s):

Hospital Stay ◽

Care Center ◽

Tertiary Care ◽

Categorical Variables ◽

Chi Square ◽

Multiparous Women ◽

Chi Square Test ◽

Student’S T ◽

Relationship Of ◽

The Relationship

Background: A woman’s prior breastfeeding history may influence future decisions regarding infant feeding. Few quantitative tools utilizing this information have been demonstrated to predict breastfeeding success. Research aim: To evaluate the efficacy of a prenatal breastfeeding history (BAP) questionnaire administered in prenatal care to predict in-hospital formula supplementation among multiparous women. Methods: This is a prospective observational study of multiparous women with singleton pregnancies who presented to a Baby-Friendly urban tertiary care center for 1st prenatal visit at < 20 weeks’ gestation. The BAP tool generates a numerical score, with higher score (≥ 2) indicating prior successful breastfeeding experiences. The primary outcome was occurrence of non-medically indicated formula supplementation during the postpartum hospital stay. Student’s t test and Pearson’s chi-square test were used to compare continuous and categorical variables. A multivariable logistic regression was performed to assess the relationship of BAP score to formula supplementation. Of 587 women screened, 433 (73.8%) mother–infant dyads were analyzed. Results: Rates of formula supplementation in women with BAP scores ≤ 1 were 67% (156/234) compared with 37% (73/199) in women with higher scores ( p < 0.0001). After controlling for race/ethnicity, insurance, and obesity, women with BAP scores of ≤ 1 were 2.6 times more likely to supplement formula than women with higher scores (a OR 2.62, 95% CI [1.70, 4.04], p < .0001). Conclusion: In this prospective validation study, women with negative prior breastfeeding experiences, as evidenced by a lower BAP score, were more likely to supplement formula during the postpartum hospital stay.

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Can racial and financial disparities be overcome in the surgical treatment of NSCLC?

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.208 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 208-208

Author(s):

Jordan R. Sasson ◽

Gary Schwartz ◽

Sadiq Rehmani ◽

Hassan S Moghaddas ◽

Sarah Almubarak ◽

...

Keyword(s):

Induction Therapy ◽

Categorical Variables ◽

Continuous Variables ◽

Urban Hospital ◽

Chi Square ◽

Black Patients ◽

Diverse Patient Population ◽

Chi Square Test ◽

Student’S T ◽

Nsclc Patients

208 Background: Considerable data exists examining disparities in the treatment of non-small cell lung cancer (NSCLC) patients. Black patients, in particular those of lower socioeconomic status (SES), are less likely to receive appropriate care, including induction therapy and resection of surgically treatable lesions. We analyzed the outcomes of resection of NSCLC among a racially and financially diverse patient population at a large urban hospital network with a comprehensive thoracic oncology program. In this system, a patient navigation support team helped overcome barriers to preoperative preparation and multidisciplinary referral. Methods: A retrospective review of 345 patients who underwent lobectomy at our institution from 2002 - 2011 was performed. Data was retrieved from the Society of Thoracic Surgeons (STS) database and patient charts. Patient demographics, payor information and preoperative characteristics were noted. Postoperative complications, 30-day survival and 3-year survival were compared. Statistical analysis was performed using SPSS 17.0 (SPSS Inc, Chicago, IL). Chi-square test was used to compare categorical variables and Student's t-test was used to compare continuous variables. Results: Demographics of black and non-black patients were similar. There were more black patients within the Medicaid group than non-Medicaid (48.9% and 25.3%, p=0.001). Physiologic characteristics, risk factors and use of pre-operative RT and chemotherapy were similar. Post-operative complications were comparable in Medicaid vs. non-Medicaid (11.1% and 14.7%, p=0.524), however black patients had a lower rate of complications vs. non-black (6.1% and 17.4%, p=0.007). 3-year survival was similar in the black vs. non-black (82.3% and 78.6%, p=0.879) and Medicaid vs. non-Medicaid (66.7% and 78.8%, p=0.342) groups. Conclusions: We demonstrated equivalent surgical outcomes for NSCLC in addition to the similar use of induction therapy. Surprisingly, complications were lower in the black cohort. Our results reveal that appropriate treatment is being provided regardless of race or SES, and postulate that our system of preoperative patient support eliminates potential barriers to care.

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Predictive Factors For Three Pronuclear Zygote In Ivf Cycle

KnE Medicine ◽

10.18502/kme.v1i1.531 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Budi Wiweko

Keyword(s):

Strong Predictor ◽

Multivariate Logistic Regression Analysis ◽

Controlled Ovarian Hyperstimulation ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Preimplantation Genetic Testing ◽

Vitro Fertilization ◽

Chi Square Test

Introduction: Preimplantation Genetic Testing is one of the methods to screen genetic defects in embryos created through In Vitro Fertilization. In developing country this technique is still new and expensive method. Thus, knowing several factors in predicting the occurrence of three-pronuclear zygote can help much.Method: 472 cycles in 449 subjects who underwent controlled ovarian hyperstimulation in IVF cycles between January 2013 and August 2014 were included in the study. Categorical variables were compared using Chi Square test and continuous variables were analyzed using Independent t-test, and statistically significant was considered when p < 0.05. Multivariate logistic regression analysis was performed in order to correlate clinical variables and the occurrence of three-pronuclear zygote (3pn). Results: There were 38 3pn was identified in this study (8.05%). No correlation was found between age of the women, number of mature follicles, which are less than six with the incidence of 3pn. However, level of Anti Mullerian Hormones (AMH) found to be the strongest predictor with the incidence of 3PN (p < 0,01, RR 2.5, CI95% 1,55; 4.16).Conclusion: level of AMH is known to be strong predictor of thee pronuclear zygote after IVF cycle.

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Identification of two HCC phenotypes based on thrombocytopenia.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e14720 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e14720-e14720

Author(s):

Brian I. Carr

Keyword(s):

Categorical Variables ◽

Tumor Diameter ◽

Continuous Variables ◽

Chi Square ◽

Platelet Counts ◽

Elevated Bilirubin ◽

Size Groups ◽

Chi Square Test ◽

Small Hccs ◽

Maximum Tumor Diameter

e14720 Background: Clinical phenotypes of small and larger HCCs are not well characterized. Aims. To characterize small HCC phenotypes. Methods: A cohort of 430 small HCCs that were diagnosed through screening, were dichotomized by size of < 3cm or > 3cm maximum tumor diameter and compared for radiologic and blood test parameters and analyzed by Chi-square test for categorical variables and Mann-Whitney test for continuous variables. Results: Significant differences between the tumor size groups included AFP values and platelet counts, with thrombocytopenia and elevated bilirubin levels being associated with smaller tumors. In comparing PVT+ and PVT- patients, AFP levels and platelet counts were also significantly different between the 2 groups. Conclusions: Larger tumors were associated with normal platelets and bilirubin levels, compared to smaller tumors that were more typically found in the presence of thrombocytopenia, suggesting that smaller and larger HCCs might have different developmental pathways.

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Abstract TP69: Safety and Outcomes of IV Thrombolysis with Alteplase for Acute Ischemic Stroke Patients with Thrombocytopenia

Stroke ◽

10.1161/str.48.suppl_1.tp69 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Haris Kamal ◽

Nour Abdelhamid ◽

Liang Zhu ◽

Sean Savitz ◽

James Grotta ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Strong Evidence ◽

Demographic Data ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Exact Test ◽

Chi Square Test ◽

Iv Tpa

Background: Intravenous tPA (IV tPA) has been the mainstay for reperfusion therapies for acute ischemic stroke (AIS) patients for 2 decades. Many contraindications from the initial NINDS trial were derived from experts’ consensus and not tested in the trial. Many AIS patients present with thrombocytopenia (< 100,000) and may be excluded from treatment in spite of lack of strong evidence. Some clinicians opt to treat these patients weighing the benefits and risks along with the lack of strong evidence behind this exclusion. We sought to evaluate the safety in AIS patients with low platelets receiving IV tPA as compared to those who do not. Methods: Restrospective chart review of all patients presenting with AIS between 1/2006 to 7/2016 at our center. We analyzed patients who had platelets <100,000 among this cohort and stratified them into those who were treated with IV tPA and those who received antiplatelet therapy only. Demographic data, medical history, medications, presence of sICH after treatment, presenting NIHSS were collected. Two sample Wilcoxon rank sum test was used to compare continuous variables between the two groups, and chi-square test or Fisher’s exact test used to compare categorical variables. Results: 21 patients were treated with IV tPA while 122 patients were treated with antiplatelets. Table 1 lists the demographic variables of the two groups with and without IV tPA. Patients included had moderate thrombocytopenia with very few <50,000. No significant differences were found in presenting NIHSS, race, gender, and history of atrial fibrillation between the two groups except platelets (p=0.0128), age (p=0.0462) and glucose (p=0.0279). Table 2 lists the outcome variables of mRS and symptomatic ICH. There was no petechial or sICH among 21 treated patients. Conclusion: While limited by small numbers and lack of randomization, our data suggest that IV tPA is safe in patients with moderately reduced platelet counts.

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Nonattendance of adult otolaryngology patients for scheduled appointments

The Journal of Laryngology & Otology ◽

10.1017/s0022215106003653 ◽

2006 ◽

Vol 121 (3) ◽

pp. 258-261 ◽

Cited By ~ 22

Author(s):

A D Cohen ◽

D M Kaplan ◽

M Kraus ◽

E Rubinshtein ◽

D A Vardy

Keyword(s):

Logistic Regression ◽

Waiting Time ◽

Female Gender ◽

Categorical Variables ◽

Multivariate Logistic Regression Model ◽

Patient Scheduling ◽

Continuous Variables ◽

Chi Square ◽

Related Factors ◽

Chi Square Test

Background: Nonattendance for appointments is an impediment to otolaryngology patient care worldwide. In a previous study of children attending an otolaryngology clinic, we observed that attendance was determined by the waiting time for an appointment and the timing of the appointment within the day. However, the factors that affect nonattendance in adults have not been well studied.Objective: We aimed to investigate factors associated with nonattendance in adults visiting an otolaryngology clinic.Methods: Nonattendance was observed for a period of one year in adult patients visiting an ambulatory otolaryngology clinic. The following parameters were also noted: age, gender, treating physician, waiting time and timing of the appointment. The chi-square test was used to analyse differences between categorical variables. The t-test was used to analyse differences between continuous variables. Logistic regression was used for multivariate analyses.Results: The study assessed 8071 visits to the otolaryngology clinic. The overall proportion of nonattendance was 27.7 per cent. A multivariate logistic regression model demonstrated that nonattendance was significantly associated with the following factors: female gender, younger age, long waiting time for an appointment, timing of the appointment within the day and the treating physician.Conclusion: In adult otolaryngology patients, nonattendance was associated with patient-related factors and healthcare systems related factors alike. It is suggested that managed overbooking could be carefully introduced into otolaryngology patient scheduling.

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