scholarly journals Mortality Rate and Causing Factors in Ventilator Associated Pneumonia in Children

2021 ◽  
Vol 15 (6) ◽  
pp. 1917-1920
Author(s):  
Riffat Farrukh ◽  
Amber Naseer ◽  
Shaheen Masood ◽  
Ibrahim Shakoor ◽  
Farhina Nasir ◽  
...  

Aim: To estimate the incidence of ventilator-associated pneumonia (VAP) and to identify causing microbiological organismsand VAP related mortality rate in children admitted to the ICU. Study design: This was a Cross-sectional and an observational study. Study place and duration: In the Pediatric department of Abbasi Shaheed Hospital, Karachi, for one-year duration from May 2020 to May 2021. Methodology: All admitted children to the pediatric ICU (PICU) and ventilated were selected and observed for any features suggestive of VAP. All suspected children have Partial septic signs. A VAP will be categorized ifchild remains on ventilator for more than 48 hours and when a patient had 2 of these signs of nosocomial infection - TLC <4,000 or> 15,000 mm3 , fever> 101 ° F, CRP> 48 mg / L, neutrophils> 85% or a new chest X-rayexhibited pneumonia withradiological sign of progressive, persistent or new infiltrates. The chi-square test was used for comparison of percentages with a value of Less than 0.05 p. Results: Of all the cases admitted, the average length of ICU stay was 8.65 ± 6.45 per day. Children who needed VAP required 14.2 ±9.5 days of ventilation and 7.5± 5.2 days for children who have not VAP progression. Of 100 cohort of children necessitating ventilation, 22 died and 2 were left without advice or serious illness, with a total mortality of 22%. Conclusion: The VAP incidence in this study was 22%. Features related with a higher incidence of ventilator-associated pneumonia include age <1-year, continuous intravenous sedation and unplanned intubation in emergency situation. Features suggestive of underlying VAP encompassed, CRP> 48 mg / L, purulent tracheal secretions, positive tracheal culture of aspirate and positive X-ray results. Key words: Ventilator-associated pneumonia (VAP), Nosocomial infections,PICU and Children.

Author(s):  
Ricky Indra Alfaray ◽  
Muhammad Iqbal Mahfud ◽  
Rafiqy Sa'adiy Faizun

Introduction: Ventilator-Associated pneumonia (VAP) is pneumonia that occurs in patients who have been mechanically ventilated for a duration of more than 48 hours. The duration of ventilator use was identified as a risk factor which is a trigger of VAP. Objective: This study aimed to determine the association between the duration of ventilator use and the incidence of VAP in patients in the Intensive Care Unit of Dr. Mohammad Hoesin General Hospital, Palembang. Method and Material: This study was an observational analytic study using a cross-sectional design. The samples were all patients who use a ventilator for more than 48 hours at the ICU room period of July 1, 2014, to June 30, 2015. Data were obtained from the patient’s medical records of a total of 146 patients, but the number of patients who comply with the criteria was 106 patients. Result and Discussion: Out of the 106 samples, 41 patients (38.7%) developed VAP and 65 patients (61.3%) did not develop VAP. The analysis using Chi-Square test showed that patients who used ventilator for >5 days had an OR = 3.273 compared to patients using ventilator 2-5 days (p-value = 0.016; 95% CI = 1.223 to 8.754). Conclusion: There is a significant association between the duration of ventilator use and the incidence of VAP in patients at the ICU of Dr. Mohammad Hoesin General Hospital, Palembang. Patients using ventilators for more than 5 days 3,386 times more at risk of developing VAP compared to patients using ventilators 2-5 days. The riskiest time for the patient using ventilator was more than 5 days of usage. And, the mortality rate of VAP patients was 63.4% from 41 patients while the mortality rate of whole ICU patients was 50.9%.


2018 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Nila Eza Fitria

<p><em>Maternal Mortality Rate (MMR) is one indicator of the success of health services in a country. Maternal deaths occur for several reasons, including anemia The purpose of this research is to know the relationship of knowledge of pregnant women with Fe tablet with anemia occurrence in jorong Koto Malintang Puskesmas Agam District 2014. This research is cross sectional research design conducted in Jorong Koto Malintang Puskesmas Kamih Agam on 23 s / d 29 August 2014. The sample in this study pregnant women in Jorong Koto Malintang 30 people. Univariate analysis has been done descriptive and bivariate analysis using chi-square test. The results showed 30 respondents classified as less knowledgeable (36.7%) and more than half of pregnant women (63.3%) suffered from anemia. The result of bivariate analysis with trust level 0,05 indicates a significant relationship between the existence of Knowledge about Tablet Fe Pregnancy with Genesis Anemia where value p = 0,002 (p = &lt;0,05). Can be concluded in this research there is a significant relationship between mother's knowledge about Fe tablet with anemia. It is expected to improve the knowledge of pregnant women about the importance of Fe tablets consumed by pregnant women during pregnancy to prevent anemia</em></p><p><em><br /></em></p><p>Angka Kematian Ibu (Maternal Mortality Rate / MMR) merupakan salah satu indikator keberhasilan pelayanan kesehatan di suatu negara. Kematian ibu terjadi karena beberapa alasan, termasuk anemia. Tujuan penelitian ini adalah mengetahui hubungan pengetahuan ibu hamil dengan tablet Fe dengan kejadian anemia di jorong Koto Malintang Puskesmas Kabupaten Agam tahun 2014. Penelitian ini adalah rancangan penelitian cross sectional yang dilakukan di Jorong Koto Malintang Puskesmas Kamih Agam pada 23 s/d 29Agustus 2014. Sampel dalam penelitian ini ibu hamil di Jorong Koto Malintang 30 orang. Analisis univariat telah dilakukan analisis deskriptif dan bivariat menggunakan uji chi-square. Hasilnya menunjukkan 30 responden tergolong kurang berpengetahuan (36,7%) dan lebih dari setengah ibu hamil (63,3%) menderita anemia. Hasil analisis bivariat dengan tingkat kepercayaan 0,05 menunjukkan adanya hubungan yang signifikan antara adanya Pengetahuan Tentang Tablet Fe Hamil dengan Anemia Genesis dimana nilai p = 0,002 (p = &lt;0,05). Dapat disimpulkan dalam penelitian ini ada hubungan yang signifikan antara pengetahuan ibu tentang tablet Fe dengan anemia. Diharapkandapat meningkatkan pengetahuan ibu hamil tentang pentingnya tablet Fe dikonsumsi oleh ibu hamil selama kehamilan untuk mencegah anemia. </p><p><em><br /></em></p>


Author(s):  
Yuni Romalita ◽  
Yusriani Yusriani ◽  
Muhammad Khidri Alwi ◽  
Serawati Serawati

Implementasi Prinsip Keterbukaan dalam Pemberdayaan Terhadap Keaktifan Kader Kesehatan untuk Mencegah Risiko Kematian Ibu Yuni Romalita Program Studi Magister Kesehatan, Pascasarjana Universitas Muslim Indonesia; [email protected] Yusriani Fakultas Kesehatan Masyarakat, Universitas Muslim Indonesia; [email protected] (koresponden) Muhammad Khidri Alwi Fakultas Kesehatan Masyarakat, Universitas Muslim Indonesia; [email protected] Serawati Program Studi Magister Kesehatan, Pascasarjana Universitas Muslim Indonesia; [email protected] ABSTRACT Maternal Mortality Rate (MMR) is one of the important indicators of the degree of public health. One of the government's programs in suppressing MMR is the empowerment of health cadres. Cadres have a big role to play in the smooth process of health services, one of which is posyandu activities. The principle of openness is very important in empowerment to increase the activeness of cadres in reducing MMR. The research objective is to find out the implementation of the principle of openness in empowering the activeness of health cadres in preventing the risk of maternal death in Gowa Regency. This type of research was cross sectional study with a sample size of 120 people, selectied by accidental sampling. Data collection was done by interview using a questionnaire, data analysis using the Chi square test. The results showed that 89.2% of cadres met the principle of openness in empowerment and 10.8% did not meet the principle of openness. There is a relationship between the implementation of the principle of openness in empowerment to the activeness of health cadres in preventing the risk of maternal death in Gowa Regency. It is expected that all relevant parties can work together to increase the activity of health cadres in preventing the risk of maternal death, especially in applying the principle of openness in empowerment. Keywords: the principle of openness; cadre empowerment; maternal death; cadre activity ABSTRAK Angka Kematian Ibu (AKI) menjadi salah satu indikator penting dari derajat kesehatan masyarakat. Salah satu program pemerintah dalam menekan AKI adalah pemberdayaan kader kesehatan. Kader memiliki peran besar terhadap lancarnya proses pelayanan kesehatan salah satunya kegiatan posyandu. Prinsip keterbukaan sangat penting dalam pemberdayaan untuk meningkatkan keaktifan kader dalam menurunkan AKI. Tujuan penelitian yaitu dalam untuk mengetahui implementasi prinsip keterbukaan dalam pemberdayaan terhadap keaktifan kader kesehatan dalam mencegah risiko kematian ibu di Kabupaten Gowa. Jenis penelitian yang digunakan yaitu Cross Sectiona Study dengan jumlah sampel sebanyak 120 orang, pemilihan sampel dengan cara accidental sampling. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, analisis data menggunakan uji chi square. Hasil penelitian menunjukkan bahwa 89.2% kader memenuhi prinsip keterbukaan dalam pemberdayaan dan 10.8% yang tidak memenuhi prinsip keterbukaan. Ada hubungan antara implementasi prinsip keterbukaan dalam pemberdayaan terhadap keaktifan kader kesehatan dalam mencegah risiko kematian ibu di Kabupaten Gowa. Diharapkan kepada semua pihak yang terkait dapat bekerja sama untuk meningkatkan keaktifan kader kesehatan dalam mencegah risiko kematian ibu, khususnya dalam menerapkan prinsip keterbukaan dalam pemberdayaan. Kata kunci: prinsip keterbukaan; pemberdayaan kader; kematian ibu; keaktifan kader


Author(s):  
Hamzullah Khan ◽  
Faridullah Shah ◽  
Khalid Khan ◽  
. Abuzar

Objectives: To determine the case fatality rate of COVID-19 by evaluating the data of Patients died due to COVID-19. Materials and Methods: A total of 243 patients with PCR done from the government designated Public health research laboratory of Khyber Medical University were included in a cross sectional comparative study. Chi-square test, risk analysis, probability testing and survival analysis using Kaplan Meir test was done on data sheet prepared in SPPS version 25 in accordance with the objectives of the study. Results: Out of total 243 patients, 165 (67.90%) were negative by PCR testing and 78 (32.09%) were COVID-19 positive. The Mean age with SD was 36+17 years. Out of total 178 (73.3%) were males and 65 (26.7%) were females. 34 (13.99%) had age more than 55 years, where 4/5 (80%) of the deaths were recorded. The relationship of an increase in age with rate of mortality was statistically significant (p=0.001). The over all probability of death in our population in age more than 55 years is 24 times higher (OR=24,95CI: 2.6-221.24) with relative risk of 1.1 (rr=1.11, 95CI:1-1.24). Mortality rate was 6.41%. A significant correlation of mortality with case positivity (p=0.003) with relative risk of 1.06 (rr=1.06, 95CI: 1.008-1.13). Three out of 5 of the COVID-19 positive deceased had cardiac diseases and 2/5 had respiratory disease/viral pneumonia. Using Kaplan Meir test, the survival graphs of COVID positive vs COVID negative cases had similar pattern that shows the mortality rate in the positive cases was not solely due to COVID-19, but has aggravated the pre-existing illness to cause death. Conclusion: The mortality rate was 6.41%, more in age>55 years (80%) and almost all the deceased had chronic co-morbid conditions like CAD, CCF and COPD at time of presentation. COVID-19 is not the sole killer, it contributes killing in immune-deficient patients.


Author(s):  
Prakash Dudhani ◽  
Sanjay Khandekar

Background: There was a strong correlation between increase in hypertension and changing lifestyle factors. The problem which lies with the hypertension is that it cannot be cured completely. And its management requires lifelong medication with some life-style modifications. Decreased physical activities coupled with increased mental tension are important contributors of hypertension. They are usually seen amongst employees of the profession where working is typically sedentary.  The main objectives were to study on prevalence of hypertension and risk factors among Government Gazetted officers of Maharashtra, India.Methods: A cross sectional study was carried among gazetted officers working in various departments of state Government for a period of one year in Solapur district. 355 Gazetted Government officers of class I & class II cadre were studied. Blood pressure was measured with a standard mercury sphygmomanometer. Chi-square test was applied to assess risk factors.Results: In present study, the prevalence of hypertension among Gazetted officers was observed 20.28%. There was significant positive association was found between age and prevalence of hypertension. And also it was found significantly higher in men than women. The association between education and hypertension found to be statistically significant (P<0.001), while there was no association between socioeconomic status and hypertension was found (P=0.33). Prevalence of hypertension was noted higher at every level of BMI. Prevalence of hypertension was significantly higher in smokers, alcoholic and had significant association (P<0.05).Conclusions: We conclude that, because of high prevalence of hypertension in Gazetted officers, periodically they should be screened for the same.


2021 ◽  
Vol 39 ◽  
Author(s):  
Michelli Christina Magalhães Novais ◽  
Deusiane Santos Victor ◽  
Danielle da Silva Rodrigues ◽  
Bruno Oliveira Freitas ◽  
Nilo Manoel Pereira Vieira Barreto ◽  
...  

ABSTRACT Objective: To assess the factors associated with the de-hospitalization of children and adolescents with complex chronic condition. Methods: This cross-sectional and retrospective study investigated a sample of children and adolescents admitted to the Dehospitalization Training Unit, from January 2012 to December 2017. Data were collected by consulting medical records and patient record books, from November 2018 to June 2019. The length of stay in the unit, de-hospitalization, readmissions, frequency and cause of death, age, sex, diagnosis, place of residence, number of caregivers and kinship, and use of devices were studied. The chi-square test was used to verify the association between the dependent variable (de-hospitalization) and the independent variables (age, sex, place of residence, use of devices, and clinical diagnosis). Results: A total of 93 patient records were analyzed, 37.6% aged between 7 months and 2 years old, 58.1% boys, 95.7% used tracheostomy, 92.5% gastrostomy, and 71% invasive mechanical ventilation. Hypoxic-ischemic encephalopathy was the diagnosis of 40.3% of the sample. Average hospitalization time was 288 ± 265 days; 60.2% were hospitalized between 31 days and one year, representing 50% of deaths. Of those de-hospitalized, 76.3% were discharged to the Ventilatory Assistance Homecare Program. De-hospitalization was associated with the child or adolescent's place of residence (p=0.027) and use of ventriculoperitoneal shunt (p=0.021). Conclusions: This study identified that de-hospitalization may be associated with the place of residence of the child or adolescent, with the highest number of discharges to the state capital, and non-dehospitalization when using ventricular-peritoneal shunt.


2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Yoma Kristiani Tarukbua’ ◽  
Lucia Panda ◽  
Ventje Kawengian

Abstract: Coronary heart disease (CHD) is a disease with a high mortality rate in both developed and developing countries. Blood type is a particular feature of human in an individual's blood, such as ABO and Rhesus groups. The purpose of this study to determine the relate of blood type and CHD. Methods Cross sectional study using a study by the number of respondents in this study were 42 patients CHD checks from November to December 2012 at poliklinik Jantung BLU RSUP Prof. Dr. R. D Kandou, Manado. Based on Chi Square test showed the value of Pearson Chi Square, which obtained significance value is 1.000 (significant value <0.05), so it was concluded that there is no significant relate between blood type and CHD. Keywords: CAD, Blood Group, Cross Sectional     Abstrak: Penyakit jantung koroner (PJK) merupakan penyakit dengan angka mortalitas yang tinggi baik di negara maju maupun berkembang. Golongan darah merupakan ciri khusus darah dari suatu individu, seperti golongan ABO maupun Rhesus. Tujuan penelitian ini untuk mengetahui hubungan golongan darah dan PJK. Metode penelitian menggunakan studi Cross Sectional dengan jumlah responden dalam penelitian ini adalah 42 pasien PJK yang melakukan pemeriksaan mulai bulan November hingga Desember 2012 di poliklinik Jantung BLU RSUP Prof. Dr. R. D Kandou, Manado. Berdasarkan uji Chi Square menunjukkan nilai Pearson Chi Square, yang didapatkan nilai signifikansinya adalah 1,000 (nilai signifikan <0,05), sehingga disimpulkan bahwa tidak terdapat hubungan bermakna antara golongan darah dan PJK. Kata kunci: PJK, Golongan Darah, Cross Sectional


2021 ◽  
Vol 25 (1) ◽  
pp. 48-52
Author(s):  
Sajid Rashid

Objectives: To determine the change in the trend of burn patient epidemiology after the COVID-19 pandemic in terms of frequency of burn injury and mortality rate.Material and Methods: This cross-sectional descriptive study was carried out at Rawalian burn center, Plastic Surgery Department, Holy Family Hospital RMU Rawalpindi from 1st March to 31st July over a period of 05 months. All burn patients reporting to the Rawalian burn center during the specified period were included in this study by consecutive sampling. Patients were mainly admitted from emergency and some from OPD following the standard admission, inclusion, and exclusion criteriaResults: Mean age of patients in the pre-COVID (Control) period March to July 2019 was 28.84 years with an SD of ±3.73. There were 63% females and 37% males. The total burn surface area range was 8-65% during this period. Whereas in the post-COVID period, March to July 2020 mean age of patients was 29.13 years with an SD of ±4.06. There were 60% females and 40% males. Whereas the total burn surface area range was 10-61% during this period. Frequency per month of burn injury progressively reduced to 58 patients and mortality rate to 1 in July 2020 (post-COVID period). The overall frequency of burn injury (n) during the control period was 367 patients whereas in the post-COVID period is reduced to 326 patients. So there was an 11.17% reduction as compared to the control period. A Chi-square test was applied and was found significant.Conclusion: Based on the current study it can be concluded that there is a progressive fall in frequency of burn injury and mortality rate during the ongoing COVID-19 pandemic as compared to the PRE-COVID period however further studies are needed to explore the cause of this falling trend.  


2011 ◽  
Vol 51 (4) ◽  
pp. 213
Author(s):  
Syamsir Alam ◽  
Hakimi Hakimi ◽  
Tiangsa Sembiring ◽  
Melda Deliana ◽  
Siska Mayasari Lubis

Background Dysmenorrhea is a common gynecological symptom reported in adolescent girls. Prevalence of the condition has been reported to be 45 - 75%. Absenteeism from work and school as a result of dysmenorrhea is common (13 - 51% of women have been absent at least once, and 5 - 14% are often absent due to the severity of symptoms).Objective To compare school performance in pubertal adolescent girls with and without dysmenorrhea.Methods This cross-sectional study was conducted in June 2010 in adolescent females aged 12 - 18 years from the Musthafawiyah School, Mandailing Natal district, North Sumatera. Adolescent females with and without dysmenorrhea were recruited for this study. All participants completed questionnaires including age of menarche, length of menstrual cycle, length of bleeding, number of sanitary napkins used daily and school absences. School reports from two consecutive semesters in one year were used to evaluate subjects’ academic performance. An academic score of higher than 7.5 was considered good performance while scores of less than 7.5 were considered poor. We used the chi-square test to analyze differences in school performance between girls with and without dysmenorrhea.Results One hundred and sixteen participants were divided into 2 groups, those with and without dysmenorrhea, of 58 subjects each. We found no significant difference in school performance between the two groups, P=0.176 (95% CI -0.009 to -0.048 and P=0.08 (95%CI -0.052 to 0.024).Conclusion There was no significant difference in school performance of girls with and without dysmenorrhea.


Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 28-34
Author(s):  
Saurabh Kashyap ◽  
Mohammad Suhail Khan ◽  
Anas Ahmad Khan ◽  
Syed Esam Mahmood ◽  
M Z Idris ◽  
...  

Introduction: Diabetes and hypertension are among the most common non-communicable diseases affecting our population. They are the important risk factors for cardiovascular morbidity and mortality. Objective: The study was performed to estimate the association of hypertension and dyslipidaemia with increasing body weight and obesity in Type II diabetics. Methods: This one year cross sectional study was conducted by enrolling 677 diabetics subjects from rural health training centre of integral institute of medical sciences, Lucknow, India. MS excel was used for data analysis. Descriptive statistics were used for number and percentages and associations were estimated using chi-square test. Results: Most of the subjects belonged to overweight category (36.91%) followed by obese (32.3%). Majority of subjects (38.4%), were within 40 – 50 years of age in which most of them belonged to overweight category (39.2%) followed by obese (31.5%). Out of total study subjects, 62% were males and 38% were females. Means of HbA1C, lipid parameters, blood pressure were found significantly associated with dyslipidemia and hypertension Conclusion: Association of hypertension and dyslipidemia in obese diabetics signifies that these patients may be at a higher risk of developing cardiovascular diseases and a precise action or self-care management is required.


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