scholarly journals Effects of introducing Type&Screen system on rational use of transfusions

2021 ◽  
Vol 8 (2) ◽  
pp. 1051-1057
Author(s):  
Aleksandar Stefanović ◽  
Emina Čolak ◽  
Gordana Stanojević ◽  
Ljubinka Nikolić
Keyword(s):  
Economic Effect ◽  
Transfusion Practice ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Total Blood ◽  
Exact Test ◽  
Packed Red Blood Cells ◽  
Age Related ◽  
Number Of Patients ◽  
Screen System

Introduction: The number of blood donors at the global level has decreased primarily due to ethical and age-related changes in the structure of the planet's population. In addition, there is over ordering of blood for surgical patients. Accordingly, there is a need for rationalizing the testing i.e. reducing the number of cross-matchings and decrease in the use of blood. A type and screen (T&S) upon admission is sufficient for most patients. Determination of ABO blood group and Rh type, and screens for clinically significant alloantibodies is denoted as type and screen (T&S). Aim: Comparison of pharmaco-economic effect using transfusion indices on the number of performed cross-matches and the amount of packed red blood cells issued. Material and Methods: The authors present the comparison between the year 2010 before the introduction of the Type and Screen (T&S) system and the year 2019 when the T&S system and restrictive policy in transfusion practice, were introduced. Data for 2010 were collected from written transfusion protocols of the clinic, and for 2019 were obtained from the hospital information system (Heliant) and written transfusion protocols. The difference between two groups of data was examine with Chi-square test and Fisher exact test, with the reliability level set at p<0.05. Results: With the introduction of the T&S system, the number of cross-matches was reduced from 0.63 to 0.49 and the number of blood units was reduced from 0.21 to 0.11 per hospitalized patient, which at the level of one clinic represents a significant pharmacoeconomic contribution of approximately 50%. In our study, after processing T&S in ordering of blood, the indices (CTR, %T, TI) failed to improve. Despite of unsatisfactory transfusion indices, the application of restrictive indication policies in accordance with national and international guidelines has led to highly significant reduction in the consumption of total blood from 3243 to 1867 blood units. The BOQ as an overall assessment of the results after the introduction of the T&S procedure indicated improvement. Conclusions: The introduction of validation in blood transfusion indirectly draws the attention of prescribing physicians to take into account the significance of blood therapy. The effects of the introduction of the T&S method and restrictive transfusion policy are savings in blood consumption, decreased number of patients tested, a significant reduction in used blood units, and the number of performed cross-matches, despite the increased number of patients.

Frequency of the Audiometric Notch Following Excessive Noise Exposure

2015 ◽  
Vol 40 (2) ◽  
pp. 213-221 ◽  
Author(s):  
Lidija Ristovska ◽  
Zora Jachova ◽  
Nikica Atanasova
Keyword(s):  
Noise Exposure ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Age Related ◽  
Chi Square Test ◽  
History Of ◽  
Level Of Significance ◽  
Age Related Hearing Loss ◽  
Excessive Noise

Abstract The aim of the study was to determine the configuration of pathologic audiograms in patients with excessive noise exposure, and to calculate the frequency of notches in the audiogram in patients with and without excessive noise exposure by avoiding the effect of age-related hearing loss. We have analyzed 514 audiograms of 257 patients aged between 20 to 50 years: 240 patients (mean age of 38.7 years) with excessive noise exposure and 17 patients (mean age of 41.2 years) with notches in the audiogram, but without a history of excessive noise exposure. For statistical data analysis we have used the Chi-square test and Fisher exact test with the level of significance p < 0.05. Pathologic audiograms were classified into five different types: Slope at 4000 Hz (0.8%), Slope at 2000 Hz (15.1%), Notch at 4000 Hz (67.4%), Notch at 2000 Hz (0.8%), Flat (8.9%), and 7% were out of this classification. A total of 190 (79.2%) patients with excessive noise exposure had a notch in the audiogram. Left ear notches were the most common. Among the patients with notched audiograms, 91.8% had a history of excessive noise exposure, either occupational or nonoccupational, and 8.2% did not report any excessive noise exposure.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Electronic cigarettes: How confident and effective are allergists, pulmonologists, and primary care physicians in their practice behavior?

2020 ◽  
Vol 41 (3) ◽  
pp. 192-197
Author(s):  
Sherry S. Zhou ◽  
Alan P. Baptist
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Electronic Cigarettes ◽  
The United States ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Knowledge And Beliefs ◽  
Tobacco Cigarette ◽  
Number Of Patients ◽  
Personal Use

Background: There has been a striking increase in electronic cigarette (EC) use in the United States. The beliefs and practices toward ECs among physicians are unknown. Objective: The purpose of this study was to investigate EC practice patterns among allergists, pulmonologists, and primary care physicians. Methods: An anonymous survey was sent to physicians. The survey contained 32 questions and addressed issues related to demographics, cessation counseling behaviors, personal use, and knowledge and beliefs about ECs. Statistical analysis was performed by using analysis of variance, the Pearson χ2 test, Fisher exact test, and logistic regression. Results: A total of 291 physicians completed the survey (222 primary care physicians, 33 pulmonologists, and 36 allergists) for a response rate of 46%. The allergists asked about tobacco cigarette use as frequently as did the pulmonologists and more than the primary care physicians (p < 0.001), but they rarely asked about EC use. The pulmonologists scored highest on self-reported knowledge on ECs, although all the groups answered <40% of the questions correctly. The allergists did not feel as comfortable about providing EC cessation counseling as did the pulmonologists and primary care physicians (p < 0.001). All three groups were equally unlikely to recommend ECs as a cessation tool for tobacco cigarette users. Conclusion: Allergists lacked knowledge and confidence in providing education and cessation counseling for EC users. As the number of patients who use these products continues to increase, there is an urgent need for all physicians to be comfortable and knowledgeable with counseling about ECs.

A year of hepatocellular carcinoma at a glance. Demographics, biochemical and radiological characteristics and treatment modalities from a specialized facility of Pakistan

2021 ◽  
pp. 1-6
Author(s):  
Laima Alam
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cross Sectional Study ◽  
Treatment Modalities ◽  
Fisher Exact Test ◽  
Tumour Staging ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Team Meetings ◽  
Contrast Enhanced Ct

Objectives:Relation of demographics of hepatocellular-carcinoma with the aetiology.Tumour characteristics in relation to anti-viral therapy and presence of viral-DNA/RNATreatment modalities offeredMethods: This cross-sectional study enrolled all the patients aged 18-70 years with diagnosed hepatocellular carcinoma either through Triphasic Contrast-Enhanced-CT scan and/or Magnetic Resonance Imaging or biopsy presenting to the Outpatient-Department or multi-disciplinary-team meetings for the year 2019. Demographic variables, biochemical analysis including liver profile and stage of cirrhosis, viral-status, tumour staging and the treatment modalities offered were all noted. ANOVA (normal) and Kruskal-Wallis (non-normal) tests were used to compare quantitative data whereas chi-square-test and fisher-exact-test were used to compare qualitative-data.Results: Out of 195 patients with hepatocellular carcinoma, 76% were males in their fifth to sixth decades of life, 96% had cirrhosis, 94% corresponded to viral hepatocellular-carcinoma (82% Hepatitis-C-Virus, 9% Hepatitis-B-Virus and 3% coinfection), 60% of the cirrhotics landed in Child-Pugh A category with tumour staging BCLC-B being the predominant one (43.6%) and single and multiple bilateral nodules were the commonest lesions encountered. Platelets and Alanine-Transaminase had a significant relation across aetiological groups. Lymph-nodes were the most common extra-hepatic organs for metastasis and the presence of viral PCR had a significant impact on the tumour aggressiveness. Thirty-two percent of the patients were amenable to curative treatment.Conclusion: Viral infection is the main cause of rising prevalence of this tumour in Pakistan. Treatment modalities are expensive and expertise are lacking. A nationwide cancer registry is required for the exact disease burden and tumour behaviour for our population. Continuous....

scholarly journals Phlebitis associated with peripheral intravenous catheters in adults admitted to hospital in the Western Brazilian Amazon

2016 ◽  
Vol 50 (2) ◽  
pp. 263-271 ◽  
Author(s):  
Sandra Maria Sampaio Enes ◽  
Simone Perufo Opitz ◽  
André Ricardo Maia da Costa de Faro ◽  
Mavilde de Luz Gonçalves Pedreira
Keyword(s):  
Intermittent Infusion ◽  
Brazilian Amazon ◽  
Fisher Exact Test ◽  
Intravenous Therapy ◽  
Chi Square ◽  
Significance Level ◽  
Exact Test ◽  
Dorsal Hand Vein ◽  
Mean Time ◽  
Intravenous Catheters

Abstract OBJECTIVE To identify the presence of phlebitis and the factors that influence the development of this complication in adult patients admitted to hospital in the western Brazilian Amazon. METHOD Exploratory study with a sample of 122 peripheral intravenous catheters inserted in 122 patients in a medical unit. Variables related to the patient and intravenous therapy were analyzed. For the analysis, we used chi-square tests of Pearson and Fisher exact test, with 5% significance level. RESULTS Complication was the main reason for catheter removal (67.2%), phlebitis was the most frequent complication (31.1%). The mean duration of intravenous therapy use was 8.81 days in continuous and intermittent infusion (61.5%), in 20G catheter (39.3%), inserted in the dorsal hand vein arc (36.9 %), with mean time of usage of 68.4 hours. The type of infusion (p=0.044) and the presence of chronic disease (p=0.005) and infection (p=0.007) affected the development of phlebitis. CONCLUSION There was a high frequency of phlebitis in the sample, being influenced by concomitant use of continuous and intermittent infusion of drugs and solutions, and more frequent in patients with chronic diseases and infection.

scholarly journals FAKTOR-FAKTOR YANG MEMENGARUHI NEUROPATI PERIFER TERKAIT HIV DI MANADO

2018 ◽  
Vol 35 (3) ◽  
Author(s):  
Deivy Cirayow ◽  
Arthur Hendrik Philips Mawuntu ◽  
Herlyani Khosama
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Influencing Factors ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Hiv Dementia ◽  
Chi Square ◽  
Exact Test ◽  
International Hiv Dementia Scale ◽  
Hiv Aids

FACTORS THAT INFLUENCE HIV ASSOCIATED PERIPHERAL NEUROPATHY IN MANADOABSTRACTIntroduction: There are  several sociodemographic and clinical factors that influence the development of HIV associated peripheral  neuropathy (HIV-PN). Manado has different sociodemographic and clinical characteristics  from other regions. However, the percentage of HIV-PN and its influencing factors are unknown.Aims: To know the percentage of HIV-PN and factors that influence this disorder in Manado.Methods: A crosssectional study conducted in HIV/AIDS clinic R.D. Kandou hospital Manado between November2016–January 2017. Neuropathy evaluation was performed using brief peripheral neuropathy screening (BPNS), neuropathic pain diagnostic questionnaire (DN4), and electroneurography. A Chi-square or Fisher exact test was done to analyze categorical variables, independent T or Mann-Whitney test was done for numerical variables, and linear regression was done in multivariate analysis.Results: 50 subjects were included, most were male (70%), and the mean age was 32.98 (±9.726) years, with HIV- NP percentage was 46%. Age >30 years old, low hemoglobin count, CD4, and low international  HIV dementia scale (IHDS) significantly associated with HIV-NP. Working subjects were 13.6 times more likely to have HIV-PN.Discussion: HIV-PN prevalence was relatively high, influenced by age >30 years old an low hemoglobin, CD4, andIHDS. As a factor, working was escalating the likelihood of NP-HIV by 13.9 times.Keywords: HIV/AIDS, influencing factors, peripheral neuropathyABSTRAKPendahuluan: Neuropati perifer terkait human immunodeficiency virus/HIV (NP-HIV) dapat dipengaruhi oleh beberapa faktor klinis dan sosiodemografis. Manado mempunyai karakteristik yang berbeda dengan daerah lain, namun belum diketahui persentase NP-HIV dan faktor-faktor yang memengaruhinya.Tujuan: Mengetahui persentase NP-HIV dan faktor-faktor yang memengaruhinya di Manado.Metode: Penelitian potong lintang terhadap pasien HIV/AIDS di poliklinik HIV/AIDS RSUP Prof. dr. R.D. Kandou, Manado, pada November 2016–Januari 2017.  Evaluasi neuropati dilakukan menggunakan brief peripheral  neuropathy screening (BPNS), neuropathic pain diagnostic questionnaire (DN4), dan elektroneurografi. Digunakan uji Chi-square atau Fisher exact untuk menganalisis variabel kategorik, uji T independen atau Mann-Whitney untuk variabel numerik, dan regresi linear untuk analisis multivariat.Hasil: Didapatkan 50 subjek yang memenuhi kriteria penelitian dengan mayoritas laki-laki (70%), rerata usia32,98±9,726 tahun, dan mengalami NP-HIV sebanyak 46%. Usia >30 tahun, kadar hemoglobin, jumlah CD4, dan skor international  HIV dementia scale (IHDS) yang rendah berhubungan secara bermakna dengan adanya NP-HIV. Adapun subjek yang bekerja berisiko 13,6 kali lebih besar mengalami NP-HIV.Diskusi: Didapatkan prevalensi NP-HIV yang cukup tinggi dengan dipengaruhi oleh usia >30 tahun serta kadar hemoglobin, CD4, dan skor IHDS yang rendah. Faktor bekerja juga meningkatkan kecenderungan 13,9 kali mengalami NP terkait HIV.Kata kunci: Faktor-faktor yang memengaruhi, HIV/AIDS, neuropati perifer

scholarly journals Status Pekerjaan Dan Pengetahuan Ibu Menyusui Terhadap Pemberian ASI Eksklusif

2018 ◽  
Vol 16 (2) ◽  
pp. 236-244
Author(s):  
Happy Marthalena Simanungkalit
Keyword(s):  
Fisher Exact Test ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test

Latar Belakang : Air Susu Ibu (ASI) selain merupakan makanan paling baik untuk bayi, juga terbukti dapat mencegah penyakit pada bayi dan memberi manfaat bagi ibu, keluarga, dan masyarakat. Memberikan ASI selama 6 bulan dapat menyelamatkan 1,3 juta jiwa di seluruh dunia. Tahun 2016 capaian pemberian ASI eksklusif di Wilayah Kerja Puskesmas Jekan Raya masih rendah. Tujuan Penelitian: Penelitian ini merupakan crosssectional study yang bersifat analitik Populasinya adalah seluruh ibu yang memiliki anak usia 6-12 bulan. Metode Penelitian: Penelitian ini menggunakan penelitian observasional analitik dengan metode Cross Sectional. Jumlah sampel yaitu sebanyak 79 responden. Adapun cara pengumpulan data dengan wawancara. Uji statistik yang digunakan adalah uji Chi-square (X2) dan Fisher Exact Test. Hasil penelitian: Variabel yang memiliki hubungan dengan pemberian ASI eksklusif yaitu pengetahuan (p=0,000). Sedangkan untuk variabel lainnya, yaitu umur (Fisher Exact Test = 0,120), pendidikan (p = 0,075) dan pekerjaan (p = 0,976) tidak menunjukkan adanya hubungan dengan pemberian ASI eksklusif. Kesimpulan: Variabel pengetahuan menunjukkan hubungan yang bermakna dengan pemberian ASI eksklusif. Variabel umur, pendidikan dan pekerjaan menunjukkan hubungan yang tidak bermakna dengan pemberian ASI eksklusif.

scholarly journals Evaluation of toxoplasmosis risk on anxiety and perception of cat owner pregnant women

2021 ◽  
Vol 38 (2) ◽  
pp. 154-158
Author(s):  
Nur DOKUZEYLUL GÜNGÖR ◽  
Tuğba GÜRBÜZ ◽  
Selma Bozkurt ZİNCİR ◽  
Banu DOKUZEYLÜL ◽  
Erman OR ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Pregnant Women ◽  
Health Anxiety ◽  
Anxiety Level ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Main Host ◽  
The Difference ◽  
At Home

Cats are the main host of Toxoplasma gondii and pregnant women who own cats at home may be at risk. This condition may cause anxiety and stress in pregnant women. The aim of this study is to evaluate toxoplasmosis risk on anxiety and perception of cat owner pregnant women. The study group consisted of 59 pregnant women feeding cats in the home and 369 pregnant women not feeding cats. A Health Anxiety Inventory (HAI-18) was used to measure the anxiety of all participants. Age and anxiety variables were analyzed using a two-sample independent t-test. Gravida, education, and job status were analyzed using chi-square tests, and live to abort ratio & pregnancy number were analyzed using Fisher exact test. Measurement of the anxiety level between the two groups showed that anxiety is significantly higher among the pregnant women who feed cats in their house with an average of 32.03±8.72. The average anxiety level among the pregnant women who don't have cats in their house was 25.94±8.99. The difference between the Health Anxiety Inventory of the two groups was significant (p= 0.0001) It was shown in the literature that pets can reduce anxiety but not studied in pregnant women, yet. Our results showed that pregnant women who own cats at home had more environmental anxiety than women who don’t feed cats at home which is possibly associated with fear of Toxoplasma gondii transmission. This anxiety may also cause unfavorable pregnancy outcomes like eclampsia, preterm birth, low birth weight and high incidence of cesarean delivery.

scholarly journals A Study of Occupational Exposure to Patient's Blood and Saliva among Dental Students of Shahid Sadoughi Yazd University in 2016-2017

2020 ◽  
Author(s):  
Farzane Vaziri ◽  
Fahimeh Rashidi Maybodi ◽  
Mohammad Hasan Akhavan-Karbassi ◽  
Elahe Mansoori ◽  
Nasrin Faal Rastegar
Keyword(s):  
Occupational Exposure ◽  
High Speed ◽  
Dental Students ◽  
Fisher Exact Test ◽  
Medical Sciences ◽  
Chi Square ◽  
Exact Test ◽  
Skin Contamination ◽  
School Of Dentistry ◽  
Dental Schools

Introduction: Occupational exposure in dentistry is defined as exposing the skin or mucosa to blood, saliva, or infectious discharge of the patient. Dentists are in contact with sharp and high-speed rotary devices that increase the chance of occupational exposure. The purpose of this study was to determine the occupational exposure to blood and saliva of patients in dental students of Shahid Sadoughi University of Medical Sciencesin 2016-2017. Methods: A descriptive analytical study was conducted on 70 senior dental students at the School of Dentistry of Shahid Sadoughi University of Medical Sciences in Yazd, Iran. A standard questionnaire was used for collecting the data. After collecting the data, they were coded and entered into the SPSS 20 software and analyzed using descriptive statistics, Chi-square and Fisher exact test. Results: Based on the results, 49 (70%) of 70 students have been suffered from sharp devices. The skin or mucosa of the 62 students (88.6%) infected with saliva or other body fluids of the patients. Only 15.7% of the injuries were reported with sharp objects and 14.3% of mucosal-skin contamination with blood or saliva. Conclusion: Occupational exposure in dentistry environment is a common problem and many cases, which are related to these subjects were not reported. In order to reduce the risks of this, infection control issues should be taught to dental students. Therefore, occupational exposure management, follow-up centers and guidelines should be established for dental schools.  

Kontribusi Karakteristik Ibu Terhadap kejadian Stunting Pada Anak Usia 24-36 Bulan Di Sleman Yogyakarta

2019 ◽  
Vol 12 (02) ◽  
Author(s):  
Prastiwi Putri Basuki ◽  
Triana Uminingsih
Keyword(s):  
P Value ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Purposive Sampling

Stunting pada masa balita perlu mendapat perhatian khusus termasuk pada anak usia 24-36 bulan. Usia 24-36 bulan merupakan usia anak yang mengalami perkembangan pesat dalam kemampuan kognitif dan motorik. Banyak faktor yang mempengaruhi terjadinya kejadian stunting pada anak, antara lain karakteristik ibu. Tujuan dari penelitian ini adalah mengetahui kontribusi karakteristik ibu terhadap kejadian stunting pada anak usia 24-36 bulan. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional yang dilakukan di Desa Sendang Mulyo Minggir Sleman Yogyakarta. Sampel yang diambil sebanyak 75 anak usia 24-36 bulan dengan teknik purposive sampling. Analisis data  bivariat menggunakan Chi Square dan Fisher Exact Test dan analisis multivariat menggunakan regresi linier. Hasil penelitian menunjukkan bahwa pendidikan ibu (p value=0,000), pengetahuan ibu (p value=0,022) dan pemberian ASI Ekslusif (p value=0,011) yang artinya terdapat hubungan dengan kejadian stunting. Sedangkan status pekerjaan ibu (p value=0,217) tidak signifikan berhubungan dengan kejadian stunting. Berdasarkan analisis multivariat regresi linier menunjukkan hasil bahwa pendidikan ibu, status  pekerjaan ibu, pengetahuan ibu tentang gizi, dan pemberian ASI Ekslusif bersama-sama mempunyai kontribusi terhadap kejadian stunting sebesar 88,2%. Perlu peningkatan program multisektoral dengan melibatkan semua lapisan masyarakat untuk mengurangi kejadian stunting.

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