Outcome and early complications of Endoscopic Retrograde Cholangio-Pancreatography (ERCP): a cross-sectional study on 626 Patients

2021 ◽  
Vol 43 (5) ◽  
pp. 410-423
Author(s):  
Yousef Bafandeh
Keyword(s):  
Epigastric Pain ◽  
Standard Procedure ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Duodenal Perforation ◽  
Success Rates ◽  
Cross Sectional ◽  
Pancreatic Cancers ◽  
Referral Hospitals ◽  
Cbd Stone

Background. ERCP is the gold standard procedure for diagnosis and potential treatment of biliary-pancreatic disorders with various distributions in different areas of the world. The study aimed to evaluate the findings, outcome, complications and technical experiences of ERCP, also by considering the correlation of findings with liver function tests (LFT) and imaging. Methods. In this descriptive – cross sectional data-based study for 12 years from 2007, 626 (43.9% male and 56.1%female; mean age 60 Ys) consecutive patients were subjected with therapeutic purpose at two referral hospitals. Results. Epigastric pain (40%), jaundice (39.4%) and pruritus (38.1%) were the most common indications. CBD was cannulated by optimal wire- guided sphincterotomy in 486(77.6%) patients. Precut was performed in 65(10.6%) with successful cannulation in 61 cases (93.8%) and 7.7% of complications, including perforation. A total success rate of 98% was obtained. The most common diagnoses were CBD stone(s) in 322 (51.4%) and biliary-pancreatic cancers in 114 (18.2%) of cases. No LFT (ALT, ALP and Bilirubin) predicted the diagnoses. The higher concordance rate of imaging studies in comparison with ERCP was 75% for stone(s) and the lower rate of 11.1% for tumors. Metallic stents were used in 15(2.4%) of inoperable malignant cases with life expectancy of more than 6 months. Complications occurred in 29 cases (4.6%) including duodenal perforation (0.8%), pancreatitis (1.6%) and bleeding (1.2%). Mortality rate was 0.4%. Conclusion. Although no single laboratory or imaging can exactly predict the finding or outcome, but by considering judicious case selection, appropriate use of available tools and standard techniques, the procedure could be safe with a few complications and higher success rates.

scholarly journals 732. Evaulation of Micafungin Treatment at Pediatric Patients: A cross-sectional Study from Tertiary Pediatric Centre

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S416-S417
Author(s):  
Kamile Arıkan ◽  
Nuri Bayram ◽  
İlker devrim ◽  
Ayküke Akaslan-Kara
Keyword(s):  
Amphotericin B ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Resistance Rate ◽  
Sectional Study ◽  
Candida Spp ◽  
Cross Sectional ◽  
Median Serum ◽  
Before And After ◽  
Resistance Patterns

Abstract Background Micafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia. Methods Children who were treated for micafungin for possible or proven invasive Candidia infection between May 2017 and October 2019 were included. Results In this cross-sectional study, totally 78 children with a median age of 3 months (8 days -17 years), 50 (64.1%, F/M: 0.56) male were included. Thirty four (43.6%) patients were neonate, 26 (76 %) of them were premature. Thirty seven patients (47.4%) received micafungin for candidemia and 41 (52.6%) patients received micafungin empirically for IC. Twelve (32.4%) Candida spp cultured were C. albicans, the rest twenty five (67.6%) Candida spp were non-albicans Candida spp. The most commonly cultured Candida spp was Candida parapsilosis (C. parapsilosis) (n=13) followed by C. albicans (n=12), C. glabrata (n=3), C. tropicalis (n=3), C. guilliermondii (n=3), C. krusei (n=2) respectively. Resistance rate of C. parapsilosis (n=13) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 66.7%, 100%, 69.2%, 90.9%, 37.5% respectively. Resistance rate of C. albicans (n=11) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 50%, 50%, 12.5%, 42.9%, 0% respectively. None of the C. tropicalis, C. guilliermondii and C. krusei isolates were resistant to micafungin. Culture negativity could not be achieved at the end of 14th day of micafungin treatment in the 15 (16.9%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=7), the other species were; C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=1) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. Median serum AST, ALT and creatinin levels didn’t increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to micafungin usage. Characteristics of patients who received micafungin.and cultured Candida spp Antifungal resistance patterns of Candida spp. Laboratory change before and after micafungin treatment Conclusion Increase in fluconazole resistant Candida spp makes micafungin a reasonable and effective choice for suspected or proven invasive candidiasis Disclosures All Authors: No reported disclosures

scholarly journals Bacteriological Safety of Blood Collected for Transfusion at University of Gondar Hospital Blood Bank, Northwest Ethiopia

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Hailegebriel Wondimu ◽  
Zelalem Addis ◽  
Feleke Moges ◽  
Yitayal Shiferaw
Keyword(s):  
Risk Factors ◽  
Bacterial Contamination ◽  
Standard Procedure ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Blood Bank ◽  
Bacterial Isolation ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background. Transfusion associated bacterial infection has remained more frequent with a sever risk of morbidity and mortality. This study assessed the bacteriological safety of blood collected for transfusion. Method. A cross-sectional study was conducted at University of Gondar hospital blood bank from December 2011 to June 2012. Bacterial isolation, identification, and antimicrobial susceptibility tests were done as per the standard procedure. Chi-square test and P value were used to assess associations between risk factors and the bacterial isolation rate. Results. Twenty-one (15.33%) blood units were found contaminated with bacteria, and 95.24% contamination was due to external sources. The commonly isolated bacteria were Staphylococcus aureus, Coagulase negative Staphylococci, Escherichia coli, Klebsiella species, Streptococci species, Enterobacter species, and Citrobacter species. All of the bacteria isolated were 100% sensitive to Gentamicin, Chloramphenicol, Amoxicillin, and Doxycycline. Multiple antimicrobial resistances were observed in 66.7% of the isolates. Not using glove by phlebotomist, touching disinfected phlebotomy site and double puncture at the same hand or both hands of a donor were found to be risk factors for bacterial contamination. Conclusion. Bacterial contamination of blood to be transfused is a common problem in the hospital. So attention should be given to activities performed at the blood bank for safe transfusion practices.

scholarly journals Relationship between Ratio of Second and Fourth Digit and Obesity Traits among Different Ethnic Groups in Ilorin, North Central Nigeria

2016 ◽  
Vol 8 (4) ◽  
pp. 396-400 ◽  
Author(s):  
Bolaji Fatai OYEYEMI ◽  
John Oluwafemi ADEBAYO ◽  
Abass Toba ANIFOWOSHE ◽  
Oluyinka Ajibola IYIOLA
Keyword(s):  
Ethnic Groups ◽  
Pearson Correlation ◽  
Standard Procedure ◽  
Surrogate Marker ◽  
Relative Length ◽  
Cross Sectional Study ◽  
Digit Ratio ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Digit ratio (2D:4D) denotes the relative length of the second and fourth digits. There are contradicting reports on its relationship with ethnicity/race, whereas convincing studies show it is related to obesity. This cross-sectional study was undertaken to demystify ethnic difference in 2D:4D ratio and to analyze its relationship with obesity among adults in Ilorin Nigeria. The cross-sectional study included 701 individuals. Finger lengths were measured with electronic calipers and other anthropometric traits were measured with standard procedure. Student t test and one-way ANOVA were used to detect differences among groups and relationship was computed with Pearson correlation. The receiver operator characteristic curves were used to detect the diagnostic effect of 2D:4D for obesity. The obtained results showed sexual dimorphism in 2D:4D ratio and other anthropometrics at p < 0.01. Obesity was associated with significantly higher mean of 2D:4D in both genders (female 0.9814 ± 0.012:0.9700 ± 0.012; male 0.9700 ± 0.010:0.9592 ± 0.010 at p < 0.001). The area under the curve was 0.753 (95% CI 0.677-0.829, p < 0.01) and 0.798 (95% CI 0.756-0.804, p < 0.01) in female and male R2D:4D respectively for obesity, implying that 2D:4D might be a surrogate marker for obesity in future.  No significant difference was found in 2D:4D among different ethnic groups studied (p >0.05); this result proved that there was no ethnic specificity in 2D:4D ratio among study’ participants. Thus, it can be reported that the digit ratio was related to high 2D:4D, but this cannot be said for different ethnic groups. The results imply that 2D:4D might be a good surrogate indicator for obesity, but not ethnicity.  

scholarly journals Suggestive changes of human papillomavirus infection in students at a public university

2021 ◽  
Vol 106 (106(812)) ◽  
pp. 30-37
Author(s):  
J. Núñez ◽  
A. Romano ◽  
M. Medina ◽  
R.A. Cardozo
Keyword(s):  
Human Papillomavirus ◽  
Standard Procedure ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Health Sciences ◽  
Low Grade ◽  
Global Public Health ◽  
Cross Sectional ◽  
Human Papillomavirus Infection ◽  
Papillomavirus Infection

Introduction: Sexually transmitted infections are a global public health problem. Objective: to analyze the results of cervical-vaginal cytologies with suggestive changes of Human Papillomavirus infection in students of the Faculty of Health Sciences of the University of Carabobo, who was attended the gynecology consultation of the Ambulatory “Nuestra Seora de la Luz” in 2016-2017. Method: descriptive, cross-sectional study. Population consisting of all students of the Faculty of Health Sciences who was attended the Gynecology Consultation at the Ambulatory mentioned above during the period under study. Non-probabilistic and intentional sample, inclusion criteria: age, acceptance to belong to the study by signing informed consent, and not suffering pathologies at the time of sampling or being pregnant. The collection of the information was carried out through the interview and subsequent cytological examination, and the cytological study was expressed according to the BETHESDA 2001 system. The sample for cervical-vaginal cytology was performed according to standard procedure. Results: average age of 21.43-2.47 years, 40.2% belonging to the low mean stratum, 9.2% smokers, sexarquia in ages 18-20 years in 52.6% of cases, 70% with 2 or 3 pairs. As for the cytology result, 9.2% was suggestive for Human Papillomavirus infection, while with the BETHESDA 2001 System, in the epithelial cell abnormalities section, 63.6% showed low-grade Human Papillomavirus -associated. Conclusions: in the sample, the suggestive changes to Human Papillomavirus infection, was higher than that found in other countries, whereas most interviewees presented risk factors to contract it, so emphasis on education is recommended conducting annual cytology to the at-risk population.

scholarly journals Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Habtamu Demelash Enyew ◽  
Maru Mekie Dagnew
Keyword(s):  
Antenatal Care ◽  
Health Care Access ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Sectional Study ◽  
Cross Sectional ◽  
Near Misses ◽  
Care Access ◽  
Referral Hospitals

Abstract Objectives This study was aimed to assess the magnitude of maternal near misses and the role of delays including other risk factors. A Hospital based cross sectional study was conducted at three referral hospitals of Amhara region on 572 mothers who came to obtain obstetrics care services from February 01 to July 30, 2018. Results The magnitude of maternal near miss was 26.6% (95% CI 23, 30). With regards to delays, 83 (14.5%), 226 (39.5%), and 154 (26.9%) of women delayed in the decision to seek care, in reaching care, and in receiving care respectively. Women who had no antenatal care [AOR = 3.16; CI (1.96, 5.10)], who stayed in hospital 7 days or more [AOR = 2.20; CI (1.33, 3.63)] and those who had delay in reaching health facility [AOR = 1.99; CI (1.10, 3.61)] were more likely to be near miss. While, women whose husband was able to read and write [AOR = 0.29; CI (0.09, 0.96)] and those with monthly household income between 2001 and 3000 ETB [AOR = 0.35; CI (0.18, 0.70)] were 71% and 65% less likely to be near misses respectively. Promoting antenatal care and increasing maternal health care access could have significant impact in reducing maternal near misses.

scholarly journals Trends in misoprostol use and abortion complications: A cross-sectional study from nine referral hospitals in Nigeria

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0209415 ◽  
Author(s):  
Folasade Adenike Bello ◽  
Bukola Fawole ◽  
Babawale Oluborode ◽  
Ibraheem Awowole ◽  
Theresa Irinyenikan ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Abortion Complications ◽  
Referral Hospitals

scholarly journals Geographical variation in musculoskeletal surgical care in public hospitals in Ireland: a repeated cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028037 ◽  
Author(s):  
Mary E Walsh ◽  
Fiona Boland ◽  
John M O’Byrne ◽  
Tom Fahey
Keyword(s):  
Hip Fracture ◽  
Hip Replacement ◽  
Geographical Variation ◽  
Private Health Insurance ◽  
Knee Arthroscopy ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Referral Hospitals

ObjectiveTo examine the extent of geographical variation across musculoskeletal surgical procedures and associated factors in Ireland.DesignRepeated cross-sectional study.Setting36 public hospitals in Ireland.ParticipantsAdult admissions for hip fracture, hip and knee replacement, knee arthroscopy and lumbar spine interventions over 5 years (2012–2016).Primary outcome measureStandardised discharge rate (SDR).AnalysisAge and sex SDRs were calculated for 21 geographical areas. Extremal quotients, coefficients of variation and systematic components of variance were calculated. Linear regression analyses were conducted exploring the relationship between SDRs and year, unemployment, % urban population, number of referral hospitals, % on waiting lists>6 months and % with private health insurance for each procedure.ResultsAcross 36 public hospitals, n=102 756 admissions were included. Hip fracture repair showed very low variation. Elective hip and knee procedures showed high variation in particular years, while variation for lumbar interventions was very high. Knee arthroscopy rates decreased over time. Higher unemployment was associated with knee and hip replacement rates and urban areas had lower hip replacement rates. Spinal procedure rates were associated with a lower number of referral hospitals in a region and spinal injection rates were associated with shorter waiting lists. A higher proportion of patients having private health insurance was associated with higher rates of hip and knee replacement and lumbar spinal procedures.ConclusionsVariation and factors associated with SDRs for publicly funded hip and knee procedures are consistent with similar international research in this field. Further research should explore reasons for high rates of spinal injections and the impact of private practice on musculoskeletal procedure variation.

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

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