scholarly journals Incidence and risk factors of oroantral perforation following tooth ex- traction among Nigerian population in a tertiary hospital: a ten- year retrospective study

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Ekaniyere Benlance ◽  
Birch Dauda SAHEEB

Oro-antral perforation (OAP) could be misdiagnosed if the incidence and risk factors are unknown and its consequence could be worrisome. We aimed to determine the incidence and risk factors of oro-antral perforations after teeth extraction. A retrospective study of forceps extracted upper posterior teeth over a ten-year period from September 2008 to November 2018 was done at our hospital in Nigeria. In univariate analysis, the predictors were age, gender, experience of surgeon, site of tooth, side of surgery, use of elevators while the outcome variable was oroantral perforations. Logistic regression was also done to determine the risk factors associated OAP. We used SPSS Version 17(SPSS Inc, Chicago, USA) to perform descriptive and inferential statistical analysis. P-Value less than 0.05 was considered statistically significant. Out of the total 26,372 dental extractions during the ten-year period, 54 (0.2%) extraction cases (33 males, 21 females) had oro-antral perforations. Their mean age was 54.8± 10.6years (ranging from 21 to78 years). The highest incidence occurred in the sixth decade of life. Only the location of teeth had a significant association with oro-antral perforations. The location of upper first molar was (OR = 1.85, P=0.00) identified as a significant risk factor. The incidence of OAP is significantly lower in Nigerians and was 0.2% although there could be a population variability. The position of the upper first molar was a factor found to be associated and predictive of the OAP but age, gender, number of extractions per visit, side of operation and the surgeon’s experience were not. The findings will help surgeons to predict occurrence of OAP knowing its risk factors.

2021 ◽  
pp. 1-6

OBJECTIVE The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA. METHODS Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography. Univariate and multivariate analyses were executed to reveal the associations between rupture status and VADA characteristics. RESULTS The rate of ruptured VADAs was 29.1% (34 of 117) and the stagnation sign was observed in 39.3% (46 of 117). Fusiform shape (OR 5.105, 95% CI 1.591–16.383, p = 0.006), irregular surface (OR 4.200, 95% CI 1.412–12.495, p = 0.010), posterior inferior cerebellar artery (PICA) involvement (OR 3.788, 95% CI 1.288–11.136, p = 0.016), and the stagnation sign (OR = 3.317, 95% CI 1.131–9.732, p = 0.029) were significantly related to rupture of VADA in multivariate logistic regression analysis. CONCLUSIONS This study showed that fusiform shape, irregular surface, PICA involvement, and the stagnation sign may be independent risk factors for the rupture of VADA. Therefore, when the potential risk factors are observed in unruptured VADA, more aggressive treatment rather than follow-up or medical therapy may be considered.


2016 ◽  
Vol 56 (2) ◽  
pp. 101
Author(s):  
Sherly Yuniarchan ◽  
Risky Vitria Prasetyo ◽  
Ninik Asmaningsih Soemyarso ◽  
Mohammad Sjaifullah Noer

Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN). Some factors have been suggested to affect blood pressure (BP) in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age); and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years). We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17) years), with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6%) children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5%) and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021). Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Khaled Gomaa ◽  
Ahmed R. Abdelraheim ◽  
Saad El Gelany ◽  
Eissa M. Khalifa ◽  
Ayman M. Yousef ◽  
...  

Abstract Background Surgical site infection (SSI) is one of the commonest complications following cesarean section (CS) with a reported incidence of 3–20%. SSI causes massive burdens on both the mother and the health care system. Moreover, it is associated with high maternal morbidity and mortality rate of up to 3%. This study aims to determine the incidence, risk factors and management of SSI following CS in a tertiary hospital. Methods This was an observational case control retrospective study which was conducted at Minia maternity university hospital, Egypt during the period from January 2013 to December 2017 (Five years). A total of 15,502 CSs were performed during the studied period, of these, 828 cases developed SSI following CS (SSI group). The control group included 1500 women underwent cesarean section without developing SSI. The medical records of both groups were reviewed regarding the sociodemographic and the clinical characteristics. Results The incidence of SSI post-cesarean section was 5.34%. Significant risk factors for SSI were; chorioamnionitis (adjusted odds ratio (AOR) 4.51; 95% CI =3.12–6.18), premature rupture of membranes (PROM) (AOR 3.99; 95% CI =3.11–4.74), blood loss of > 1000 ml (AOR 2.21; 95% CI =1.62–3.09), emergency CS (AOR 2.16; 95% CI =1.61–2.51), duration of CS of > 1 h (AOR 2.12; 95% CI =1.67–2.79), no antenatal care (ANC) visits (AOR 2.05; 95% CI =1.66–2.37), duration of labor of ≥24 h (AOR 1.45; 95% CI =1.06–2.01), diabetes mellitus (DM) (AOR 1.37; 95% CI =1.02–2.1 3), obesity (AOR 1.34; 95% CI =0.95–1.84), high parity (AOR 1.27; 95% CI = 1.03–1.88), hypertension (AOR 1.19; 95% CI = 0.92–2.11) and gestational age of < 37 wks (AOR 1.12; 95% CI = 0.94–1.66). The mortality rate due to SSI was 1.33%. Conclusions The obtained incidence of SSI post CS in our study is relatively lower than other previous studies from developing countries. The development of SSI is associated with many factors rather than one factor. Management of SSI is maninly medical but surgical approach may be needed in some cases. Registration Local ethical committee (Registration number: MOBGYN0040).


2018 ◽  
Vol 5 (2) ◽  
pp. 334 ◽  
Author(s):  
Leelakrishna P. ◽  
Karthik Rao B.

Background: Catheter associated urinary tract infections (CAUTIs) are the most common causes of UTIs in postoperative cases. Many risk factors are associated with its incidence. The present study was conducted with the aim to determine the related risk factors and to identify the causative agents contributing to the urinary tract infection.Methods: This prospective study was conducted on 210 patients meeting the requirements of inclusion criteria during September 2012 to February 2014. Detailed history of the patients was recorded. Urine culture was done at different time intervals to identify the causative agent suggestive to CAUTI. Univariate analyses of the association of each variable with CAUTI and multivariable logistic regression were done to predict CAUTI outcome.Results: The mean age of study participants was 51.61 years. Among them 141 were males and 69 were female patients. On univariate analysis purpose for urine catheterization, place of catheterization, breach in the closed system of drainage, duration of catheterization, hemoglobin value less than 10, raised renal parameters with serum creatinine more than 1.5 were all significantly associated with development of CAUTI (p value 0.000). Sex of the patient (p value 0.279) and catheter size (p value 0.279) was not found to have a significant correlation with increased risk of CAUTI. On multivariate analysis, age, catheter size, diabetes, duration of catheterization, a breach in the closed system of catheter drainage  and sex were found to be the significant risk factors associated with CAUTI (p<0.05).Conclusion: An understanding of the risk factors in development of CAUTI, significantly helps in reducing the additional burden on the health care system. Measures such as shortening the duration of catheterization, strict control of diabetes and sterile precautions in insertion and maintenance of indwelling catheters can help in prevention CAUTI.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 216-216
Author(s):  
Hiroyuki Fujii ◽  
Taizo Hirata ◽  
Takuya Mura ◽  
Yuko Okada ◽  
Takuo Ito ◽  
...  

216 Background: Irinotecan Induced Cholinergic Syndrome (IICS), manifesting in such events as early diarrhea and diaphoresis, is well-known adverse effect of irinotecan. These symptoms occur within the first 24 hours of irinotecan administration and can be ameliorated with anticholinergic agents. Although IICS is transient and tends to be underestimated, diarrhea and abdominal pain during drug infusion are inflictive and make patients reluctant to undergo anticancer therapy. Methods: First, to identify the risk factors that are associated with IICS, 132 consecutive patients who were treated with a chemotherapeutic regimen that included irinotecan at Kure Medical Center between 2012 and 2017 were retrospectively analyzed from the aspect of sex, age, dose, cancer type, regimen, kidney function, and renal function. Secondly, to determine the response rate of butylscopolamine bromide for IICS, we injected butylscopolamine bromide 20mg into the irinotecan infusion bag and administered both agents through the intravenous line together to patients who experienced IICS. Results: IICS occurred 14 of 132 patients (10.6%); these 14 patients were given butylscopolamine bromide by coinjection for total 119 cycles. Univariate analysis indicated that dose (p = 0.0029), cancer type (p = 0.0023) and regimen (p = 0.0005) was associated with IICS. Patients with symptoms tended to be administered a higher irinotecan dose than those without symptoms (127.9±20.4mg/m2 and 99.6±34.1mg/m2). By logistic regression analysis, a higher dose (dose > 105mg/m2) was identified a significant risk factor for IICS (Odds Ratio = 10.9; 95% Confidence Interval: 2.0 to 96.7; p = 0.0121). 13 patients (105 cycles) of 14 patients (119 cycles) who were administered butylscopolamine bromide, experienced complete or partial improvement of IICS. The response rate was nearly 90%. Conclusions: A higher dose of irinotecan is a significant risk factor for IICS. To avoid creating a disincentive for patients to undergo anticancer therapy, the prevention of IICS is paramount. As prophylaxis of IICS, mixing butylscopolamine bromide into the irinotecan infusion bag was remarkably effective.


2009 ◽  
Vol 49 (6) ◽  
pp. 379
Author(s):  
Made Lndah Nastiti Utami Budha ◽  
Roni Naning ◽  
Ketut Dewi Kumara Wati

Background Data suggesting history of direct or indirect contactto cats are either protective, has no effect or increase risk ofsensitization and asthma development.Objective To determine the relationship between childhoodcontact to cat and the development of asthma in children.Methods A case control study was conducted in Denpasar sinceDecember 2006 until Juli 2008. In this study, subjects withasthma (cases group) were selected for comparisons to a series of healthy subjects without asthma (controls group). Forty-sevensubjects (3-12 years) with asthma were recruited and matched(age and sex) with 4 7 healthy and non asthma controls. Data were collected using two kinds of questionnaires, i.e: ISAAC, ATS 78, and Robertson modification questionnaire from Medical School, University of Indonesia, which had been validated to determine asthma and asthma risk factors questionnaire. Data were analyzed as univariate by using chi-square or Fisher's exact test, and multivariate analysis by stepwise logistic regression model.Results Result of univariate analysis showed that there were seven significant risk factors of asthma. Using multivariate analysis, contact to cat was significant risk factor for asthma [OR: 4.5 (95% CI 1.3 to 16.0), P= 0.020]. Other significant risk factors were; contact to cockroach [OR: 11.7 (95% CI 2.6 to 51.6), P= 0.001], use of kapok mattress [OR: 6.4 (95% CI 1.4 to 29.0), P= 0.015], passive smoker [OR: 4.7 (95% CI 1.3 to 17.0), P= 0.018], and atopic history [OR: 9.2 (95% CI 2.3 to 36.7), P= 0.002].Conclusions There was a relationship between childhood contactto cat and the development of asthma in children. Risk factors that statistically significant were; contact to cockroach, use of kapok mattress, passive smoker, and history of allergy in study subject.


2018 ◽  
Vol 12 (02) ◽  
pp. 67-72
Author(s):  
Salih Hosoglu ◽  
Eyup Arslan ◽  
Emel Aslan ◽  
Özcan Deveci

Introduction: Multi-drug resistant Acinetobacter baumannii (MDR-Ab) infections are an important healthcare problem globally. The aim of this study was to evaluate risk factors associated with MDR-Ab infections in hospitalized patients in Turkey. Methodology: A case-control study was performed in a tertiary care 1,303-bed university hospital, among case patients with MDR-Ab infections. The hospital records of case and control patients were retrospectively evaluated over a year. Patients who were hospitalized in the same department and in the same time interval as the case patients, without MDR-Ab infection or colonization, were chosen for control group. Demographic characteristics, Acute Physiology And Chronic Health Evaluation II (APACHE II) scores, comorbid diseases, use of invasive tools and duration of usage, and duration of use of antibiotics were recorded for all patients. Comparisons between case and control groups for possible risk factors were performed. Results: In total, 95 cases and 95 controls were included in the study. Univariate analysis highlighted several variables as risk factors for MDR-Ab infections. Multivariate analysis showed that only antibiotic usage over seven days (OR = 2.38, CI = 1.18-4.83, p = 0.016) was found to be a significant risk factor. When antibiotic treatment patterns in both groups were compared, the use of carbapenems (p = 0.001) and glycopeptide antibiotics (p=0.001) in patient treatment were found significantly higher in the MDR-Ab case group. Conclusion: This study showed us that previous antibiotic use is a significant risk factor for MDR-Ab infections. The use of carbapenems and glycopeptides should be considered as primary risk factors for developing MDR-Ab infection.


Stroke ◽  
2021 ◽  
Author(s):  
Toshiaki Hayashi ◽  
Tomomi Kimiwada ◽  
Hiroshi Karibe ◽  
Reizo Shirane ◽  
Tatsuya Sasaki ◽  
...  

Background and Purpose: In pediatric moyamoya disease, there have been few reports of the risk factors for preoperative cerebral infarction, especially during the waiting period before surgery. The clinical and radiological findings of surgically treated pediatric moyamoya patients were evaluated to analyze the risk factors for cerebral infarction seen from onset to surgery. Methods: Between August 2003 and September 2019, 120 hemispheres of 71 patients under 18 years of age with moyamoya disease were surgically treated by direct and indirect bypass procedures. The mean age of all surgical hemispheres at diagnosis was 6.7±3.9 years (6 months–17 years). The potential risk factors for preoperative infarction were examined statistically. Results: Multivariate logistic regression analysis showed that risk factors for infarction at the time of diagnosis were age at diagnosis (odds ratio [OR], 0.68 [95% CI, 0.57–0.82]; P <0.0001) and the magnetic resonance angiography (MRA) score (OR, 2.29 [95% CI, 1.40–3.75]; P =0.001). Univariate analysis showed that risk factors for infarction while waiting for surgery were age at diagnosis (OR, 0.61 [95% CI, 0.46–0.80]; P <0.0001), the MRA score (OR, 1.75 [95% CI, 1.26–2.41]; P =0.0003), and onset of infarction (OR, 40.4 [95% CI, 5.08–322.3]; P <0.0001). Multiple comparisons showed that patients under 4 years of age were at a significantly high risk of infarction at the time of diagnosis and while waiting for surgery. Time from diagnosis to surgery of >2 months was a significant risk factor for infarction while waiting for surgery in patients under 6 years of age. Conclusions: Young age at diagnosis and a high MRA score may be associated with rapid disease progression and result in preoperative infarction. We recommend that surgery be performed within 2 months of diagnosis for the patients under 4 years of age with a high MRA score (>5) and cerebral infarction. Further study is needed to define the optimal timing of surgery.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Arai ◽  
Jun Kato ◽  
Nobuo Toda ◽  
Ken Kurokawa ◽  
Chikako Shibata ◽  
...  

Abstract Background Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. Methods In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. Results Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44–8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08–16.2), and heart disease (OR 3.05; 95% CI 1.11–8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36–28.7). Conclusion In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 420
Author(s):  
Claudia Ioana Borțea ◽  
Florina Stoica ◽  
Marioara Boia ◽  
Emil Radu Iacob ◽  
Mihai Dinu ◽  
...  

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.


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