Differences between the Incident and Prevalent Hemodialysis Patients in Egypt

Background and Aim: The number of patients on hemodialysis (HD) increases continuously. The HD population is usually divided into early and late HD patients according to the duration of HD, that are known as incident and prevalent groups. Still, there is a debate about the exact definition of both the incident and prevalent groups. Furthermore, predictors of death of both of these groups are not yet identified, especially in Egyptian HD patients. We aimed to compare between the incident and prevalent HD patients as well as to define predictors of mortality among each of these groups. Study Design and Methodology: This prospective multicenter study was started in June 2016, comprising 2123 HD patients recruited from twenty-five Egyptian HD centers. Patients were classified according to HD duration into two groups: Incident group including patients with HD duration equals to or less than 6 months, and a prevalent group including patients who had been maintained on HD for more than 6 months. All patients were observed for one and half years and their demographic data, laboratory findings and mortality events were recorded. Results: In comparison to the prevalent group, the incident HD patients showed significantly lower hemoglobin, serum albumin, urea reduction ratio, serum phosphorus, and serum ferritin but higher average erythropoiesis stimulating agents (ESA) dose. There was significantly a higher number of patients with hypertension in the incident group, while there was no significant difference in diabetes mellitus or ischemic heart disease in both groups. There were a higher number of patients with positive hepatitis C virus antibodies and hyperparathyroidism in the prevalent group. By the end of the study, the mortality frequency was found to be significantly higher in the incident than the prevalent groups. Older age and corrected serum calcium were significant predictors of mortality in the total studied group as well as the prevalent group. However, no significant predictors of mortality could be detected among the incident group. Conclusion: The incident HD group tends to show higher frequency of hypertension, laboratory findings suggestive of malnutrition as well as higher frequency of mortality with different pattern of mortality predictors compared to the prevalent group.

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The Impact of COVID-19 on Hospitalised COPD Exacerbations in Malta

Pulmonary Medicine ◽

10.1155/2021/5533123 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Yvette Farrugia ◽

Bernard Paul Spiteri Meilak ◽

Neil Grech ◽

Rachelle Asciak ◽

Liberato Camilleri ◽

...

Keyword(s):

Length Of Hospital Stay ◽

Chronic Obstructive ◽

Inpatient Mortality ◽

Obstructive Pulmonary Disease ◽

Predictors Of Mortality ◽

Copd Exacerbations ◽

Number Of Patients ◽

Significant Difference ◽

The Difference ◽

The Impact

Introduction and Aims. The first COVID-19 case in Malta was confirmed on the 7th of March 2020. This study is aimed at investigating a significant difference between the number of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) admissions and their inpatient outcome at Mater Dei Hospital during the COVID-19 pandemic when compared to the same period in 2019. Furthermore, we aim to determine predictors of mortality in AECOPD inpatients. Method. Data was collected retrospectively from electronic hospital records during the periods 1st March until 10th May in 2019 and 2020. Results. There was a marked decrease in AECOPD admissions in 2020, with a 54.2% drop in admissions ( n = 119 in 2020 vs. n = 259 in 2019). There was no significant difference in patient demographics or medical comorbidities. In 2020, there was a significantly lower number of patients with AECOPD who received nebulised medications during admission (60.4% in 2020 vs. 84.9% in 2019; p ≤ 0.001 ). There were also significantly lower numbers of AECOPD patients admitted in 2020 who received controlled oxygen via venturi masks (69.0% in 2020 vs. 84.5% in 2019; p = 0.006 ). There was a significant increase in inpatient mortality in 2020 (19.3% [ n = 23 ] and 8.4% [ n = 22 ] for 2020 and 2019, respectively, p = 0.003 ). Year was found to be the best predictor of mortality outcome ( p = 0.001 ). The lack of use of SABA pre-admission treatment ( p = 0.002 ), active malignancy ( p = 0.003 ), and increased length of hospital stay ( p = 0.046 ) were also found to be predictors of mortality for AECOPD patients; however, these parameters were unchanged between 2019 and 2020 and therefore could not account for the increase in mortality. Conclusions. There was a decrease in the number of admissions with AECOPD in 2020 during the COVID-19 pandemic, when compared to 2019. The year 2020 proved to be a significant predictor for inpatient mortality, with a significant increase in mortality in 2020. The decrease in nebuliser and controlled oxygen treatment noted in the study period did not prove to be a significant predictor of mortality when corrected for other variables. Therefore, the difference in mortality cannot be explained with certainty in this retrospective cohort study.

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What Do Our Nurses Know about Managing Patient with Permanent Pacemakers?

Jurnal NERS ◽

10.20473/jn.v15i2.18925 ◽

2020 ◽

Vol 15 (2) ◽

pp. 157

Author(s):

Muhamad Al Muizz Ismail ◽

Nor Marini Ibrahim ◽

Muhammad Kamil Che Hasan

Keyword(s):

Clinical Laboratory ◽

Pearson Correlation ◽

Demographic Data ◽

Descriptive Analysis ◽

Pacemaker Implantation ◽

Cross Sectional Study ◽

Cross Sectional ◽

Number Of Patients ◽

Significant Difference ◽

Level Of Knowledge

Introduction: The number of patients with pacemaker implant is increasing in the health services sector in Malaysia, which requires nurses to have expertise in patient care with pacemaker implantation. Therefore, this study was conducted to analyse the level of knowledge among nurses regarding the management of patients with pacemaker implantation.Methods: A cross-sectional study was conducted through purposive sampling among all nurses working at the critical care unit, intensive care unit, cardiac rehabilitation ward, investigation clinical laboratory, and non-invasive clinical laboratory in a public hospital in Kelantan. A questionnaire consisted of demographic data and nurses’ knowledge was distributed. Data were analysed for descriptive analysis and using Pearson correlation test.Results: Results from all respondents (n=70), show 48.6 % of the respondents had moderate knowledge about patient management with pacemaker implantation, 32.9 % had a low level of knowledge and only 13.6% had high knowledge regarding management of patient with pacemaker implantation. There is a significant difference between the level of knowledge and demographic data, that is between the level of education (p=0.027), age (p=0.011) and length of service (p=0.015). There is no significant relationship between knowledge and demographic data, such as gender (p=0.481), marital status (p=0.315), and post-basic (p=0.067).Conclusion: Level of knowledge among nurses about the management of patient with pacemaker implantation is low to moderate. Additional education and exposure among nurses are needed to enhance the knowledge of nurses and improve the quality of care among patients with pacemaker implant.

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Patients’ perceptions and experiences about the root canal treatment: An exploratory study among Saudi population

Asian Journal of Oral Health and Allied Sciences ◽

10.25259/ajohas_8_2021 ◽

2021 ◽

Vol 11 ◽

pp. 5

Author(s):

Abdulaziz Abdulrahman Aleid

Keyword(s):

Root Canal ◽

Statistical Significance ◽

Demographic Data ◽

Post Treatment ◽

Root Canal Treatment ◽

Saudi Population ◽

Dental Patients ◽

Number Of Patients ◽

Significant Difference ◽

Pre Treatment

Objectives: Root canal treatment (RCT) is one of the most popular treatments at dental setting and pain and anxiety is a great source of concern for dental patients and dentist. However, in Saudi Arabia the current literature containing data on endodontic pain with clear comparisons of pre-treatment and post-treatment is extremely rare. The aim of this study was to investigate the perception of Saudi population about RCT and its relation with pain and anxiety. Material and Methods: A sample of 76 patients were selected for this questionnaire based survey. Participants were asked to provide their response toward the endodontic treatment before and after the treatment. Pre-validated questionnaires consisted of demographic data, questions on anxiety, pain, and concerned about RCT. Descriptive statistics, independent, and paired t-tests were used to compare between pre-test and post-test score. The level of statistical significance was set at 5%. Results: In the present study, patient’s anxiety score was assessed which was found to be significantly decreased from pre-treatment 31.47 ± 28.90 to post-treatment 23.28 ± 25.95. Likewise, mean anticipated and experience of pain score were also significantly reduced pre-treatment 41.07 ± 29.35 to post-treatment 21.90 ± 24.50. Conclusion: Current study reported a significant difference in reduction of mean anxiety for RCT post-treatment. Moreover, there was significant difference found between anticipated pain and experienced pain for the treatment. Before the treatment significant number of patients was not concerned for RCT and majority of the patients were concerned for pain associated to RCT.

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Comparison of the AN69ST Membrane versus Citrate-Enriched Dialysate on Clotting Events during Hemodialysis without Systemic Anticoagulation

Blood Purification ◽

10.1159/000456532 ◽

2017 ◽

Vol 44 (1) ◽

pp. 60-65 ◽

Cited By ~ 1

Author(s):

Vanessa Nseir ◽

Antoine Rachas ◽

Michelle Elias ◽

Hélène Francois ◽

Erika Nnang Obada ◽

...

Keyword(s):

High Risk ◽

Venous Pressure ◽

Dialysis Session ◽

Optimal Management ◽

Risk Of Bleeding ◽

Short Summary ◽

Number Of Patients ◽

Significant Difference ◽

Systemic Anticoagulation ◽

Urea Reduction Ratio

Background: The optimal management of anticoagulation in hemodialyzed patients with a high risk of bleeding is controversial. Methods: We compared premature termination of dialysis caused by clotting events between AN69ST membranes (G1) and 0.8 mmol/L citrate-enriched dialysate (G2). The number of sessions that had increased venous pressure (VP) and variations in urea-reduction ratio (URR) were analyzed. Results: Six hundred and two sessions were analyzed in 259 patients: 22.4% had sessions that ended prematurely (25% in G1 and 19.1% in G2, p = ns, OR 0.60 [0.34-1.08], p = 0.08). The increase in VP was lower in G2 (23 vs. 70, p < 0.001). URR was higher in G2 (0.56 vs. 0.60, p < 0.001). Conclusion: Clotting events that led to the termination of dialysis were comparable in the 2 groups. However, UUR was better in G2, and the number of patients with increased VP in the sessions was lower in G2. Short Summary: Our study compared the effects of the AN69ST membrane and citrate-enriched dialysate on clotting events during the dialysis of 259 patients with a high risk of bleeding. URR was significantly better and fewer cases of increased VP occurred in the citrate group compared to the AN69 ST group. No significant difference was observed regarding the need to prematurely terminate a dialysis session.

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Study of pregnancy outcome of threatened abortion and its correlation with risk factors in a tertiary care hospital of Mumbai, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184514 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4598

Author(s):

Dipali S. Sivasane ◽

Rekha G. Daver

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Pregnancy Loss ◽

Demographic Data ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Number Of Patients ◽

Significant Difference ◽

Threatened Abortion

Background: Early pregnancy loss is very common and, in most cases, it can be considered as nature’s method to select for a genetically normal offspring. Threatened abortion is a relatively common complication during pregnancy, occurring in approximately 20% of all pregnancies. Maternal age, Outcome of previous pregnancies, health of mother, any infection etc can be decisive factors in the risk of pregnancy loss.Methods: The present study was a cross sectional study where patients admitted with threatened abortion were interviewed using pretested semi-structured questionnaire after the treatment. Outcome of pregnancy was recorded. Their basic socio-demographic data along with possible risk factors were recorded. TORCH Ig M and Ig G were done in all patients.Results: Out of 95 patients admitted with threatened abortion, 42 (44%) patients undergone abortion whereas in 53 (56%) patients, pregnancy was continued. Out of total 60 patients admitted with the complain of only vaginal spotting, in 39 pregnancy continued and in 21 patients pregnancy was aborted. (p-value<0.05). 50.52% were from age group of 21 to 25 years of age. It was also seen that after 35 years of age, significant number of patients aborted. Out of these 11 patients with high BMI, pregnancy was continued only one patient. Out of total 20 patients positive for IgM of toxoplasma infection, pregnancy was aborted in 13 (65%) patients. Out of total 15 patients positive for IgM of cytomegalo virus infection, pregnancy was continued in 11 (73.3%) patients.Conclusions: Patients of threatened abortion with only symptom of spotting per vagina have good chances of continuation of the pregnancy. Increased maternal age above 35, Overweight and bad obstetric history are also associated with pregnancy loss. Though there was no statistically significant difference it was evident that among all TORCH infections, IgM toxoplasma and Rubella are associated more with pregnancy loss.

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Comparison of Laboratory and Radiological Findings of Pregnant and Non-Pregnant Women with Covid-19

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1726054 ◽

2021 ◽

Vol 43 (03) ◽

pp. 200-206

Author(s):

Kadir Burak Ozer ◽

Onder Sakin ◽

Kazibe Koyuncu ◽

Berk Cimenoglu ◽

Recep Demirhan

Keyword(s):

Pregnant Women ◽

Health Care Professionals ◽

Treatment Algorithm ◽

Reproductive Age ◽

Radiological Findings ◽

Laboratory Findings ◽

Number Of Patients ◽

Significant Difference ◽

The Mean ◽

The Difference

Abstract Objective Covid-19 became a pandemic, and researchers have not been able to establish a treatment algorithm. The pregnant population is also another concern for health care professionals. There are physiological changes related to pregnancy that result in different laboratory levels, radiological findings and disease progression. The goal of the present article is to determine whether the laboratory results and radiological findings were different in non-pregnant women (NPWs) of reproductive age and pregnant women (PWs) diagnosed with the Covid-19 infection. Methods Out of 34 patients, 15 (44.11%) PWs and 19 (55.8%) NPWs were included in the study. Age, comorbidities, complaints, vitals, respiratory rates, computed tomography (CT) findings and stages, as well as laboratory parameters, were recorded from the hospital database. Results The mean age of the PWs was of 27.6 ± 0.99 years, and that of the NPWs was of 37.63 ± 2.00; when age was compared between the groups, a statistically significant difference (p = 0.001) was found. The mean systolic blood pressure of the PWs was of 116.53 ± 11.35, and that of the NPWs was of 125.53 ± 13.00, and their difference was statistically significant (p = 0.05). The difference in the minimum respiratory rates of the patients was also statistically significant (p = 0.05). The platelet levels observed among the PWs with Covid-19 were lower than those of the NPWs (185.40 ± 39.09 × 109/mcL and 232.00 ± 71.04 × 109/mcL respectively; p = 0.05). The mean D-dimer value of the PWs was lower in comparison to that of the NPWs (p < 0.05). Conclusion The laboratory findings and imaging studies may differ between pregnant and non-pregnant populations. It is important to properly interpret these studies. Future studies with a higher number of patients are required to confirm these preliminary data.

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Immunophenotype Study in Children with Leukemia and Its Relationship with Relapse in Ahvaz Shafa Hospital from 2013 to 2018

Journal of Molecular Biology Research ◽

10.5539/jmbr.v9n1p61 ◽

2019 ◽

Vol 9 (1) ◽

pp. 61

Author(s):

Arash Alghasi ◽

Jamshid Safdarian

Keyword(s):

Acute Lymphoblastic Leukemia ◽

B Cell ◽

Leukocyte Count ◽

Lymphoblastic Leukemia ◽

Demographic Data ◽

Laboratory Findings ◽

Khuzestan Province ◽

Significant Difference ◽

Male Patients ◽

The Mean

Introduction: Acute lymphoblastic leukemia (ALL) is one of the most common cancers in children. Since the identification of patients immunophenotypes is effective for disease diagnose and prognosis, and due to very few studies in Iran, especially Khuzestan province, the aim of this study was to investigate the immunophenotype of children with leukemia and its association with recurrence in Ahvaz Shafa Hospital from 2013 to 2019. Methods: This is a retrospective study that was conducted in patients referring to Ahvaz Shafa Hospital during the years 2013 to 2019. Demographic data including age, gender, height, weight, leukocyte count, flow cytometry and other laboratory findings were collected and analyzed by version 22 SPSS statistical software. Results: The mean age of the patients was 7.59 ± 3.94 years and the sex of 51 (52%) were female. Immunophenotype of 81 patients (82.7%) was Pre B cell, 4 patients (4.1%) was Pro-B Cell, 5 patients (5.1%) was Pro-T Cell, and 8 patients (8.2%) was T Cells. 87 patients (88.8%) recovered and 11 patients (11.2%) had recurrence. Only 11 patients with Pre B cell (13.6%) had recurrence, but in other immunophenotypes, 100% of patients had remission, but this difference was not statistically significant (p = 0.46). There was no statistically significant difference between the prevalence of phenotypes in female and male sexes (p = 0.76). The incidence of recurrence was 9.8% in female patients and 12.8% in male patients, which was not statistically significant (p = 0.64). Conclusion: The results of this study showed that preB cell immunophenotypes with the prevalence of 82.7% had the highest frequency in acute lymphoblastic leukemia, and the incidence of recurrence in patients was 11.2%. Also, patients with other immunophenotypes did not recurrence, so his finding may have been because of insufficent patients to study and compare.

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Is Caesarean Myomectomy a Safe Procedure? A Comparative Study

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2016.86 ◽

2016 ◽

Vol 22 (1) ◽

Cited By ~ 2

Author(s):

Serdar Başaranoğlu ◽

Elif Ağaçayak ◽

Ayşegül Deregözü ◽

İlknur İnegöl Gümüş ◽

Mustafa Acet ◽

...

Keyword(s):

Postoperative Morbidity ◽

Demographic Data ◽

Safe Procedure ◽

Laboratory Findings ◽

Significant Difference ◽

Maternal Morbidity And Mortality ◽

Gestational Week ◽

The Mean ◽

Group 2 ◽

Group 1

OBJECTIVE: Uterine myomas are the most common benign pelvic tumours observed during the reproductive period.Increased risks of haemorrhage and postoperative morbidity lead professionals to avoid myomectomy at the time of Cesarean (C-section). The present study retrospectively analysed the data of patients who had undergone C-section only and those that had undergone C-section and simultaneous myomectomy.STUDY DESIGN: The data of 42 patients (Group 1) who had underwent caesarean myomectomy and of 50 patients underwent C-section only (Group 2) out of 92 patients that had been taken into C-section on the basis of obstetric indications were retrospectively analysed in this study. The relevant patient data were recorded with the inclusion of demographic data, gestational week, and preoperative and postoperative laboratory findings. Types, locations and sizes (the largest diameter) of individual myomas were identified and noted.RESULTS: The mean diameter of myomas was 66.3±30.2 mm. Ten patients that had underwent caesarean myomectomy (23.8%) developed a need for intensive care. No statistically significant difference was found in laboratory parameters between Group 1 and Group 2.CONCLUSION: Caesarean myomectomy, when performed by experienced obstetricians, does not lead to a significant increase in maternal morbidity and mortality. Although the short-term effects of this procedure are known, there is a need for the conduct of more comprehensive studies to establish its longterm effects on fertility or how it will affect the next pregnancy processes.

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Vitamin D Toxicity in A Pediatric Toxicological Referral Center: A Cross-Sectional Study from Iran

10.21203/rs.3.rs-24130/v1 ◽

2020 ◽

Author(s):

Fariba Farnaghi ◽

Hossein Hassanian-Moghaddam ◽

Nasim Zamani ◽

Narges Gholami ◽

Latif Gachkar ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Pediatric Population ◽

Demographic Data ◽

Essential Element ◽

Laboratory Findings ◽

Cross Sectional ◽

Benign Condition ◽

Significant Difference ◽

Vitamin D Toxicity

Abstract Background: Vitamin D is an essential element for body health whose supplements are generally administered to prevent vitamin D deficiency. Since these supplements are available at homes, vitamin D toxicity may happen in children.Methods: All children younger than 12 years who presented to the pediatric emergency department of Loghman Hakim Hospital, Tehran, Iran with history of ingestion ofvitamin D supplements more than 1500 IU/day were enrolled. Patients’ demographic data, on-presentation signs and symptoms, laboratory findings, treatments given, and outcome were evaluated.Result: Fifteenpatients presented during the study period. Their mean age was 46.53 ±10.14 months and 12 (80%) were girls. All of them had unintentionally ingested vitamin D. Mean ingested dose was 406700.7±227400.1 IU. In eight patients (53.3%), 25 Hydroxyvitamin D level was more than 100 ng/mL. One patient experienced hypercalcemia while all of them were asymptomatic and discharged without complications. There was no significant difference between patients with and without high levels of 25 OH vitamin D regarding lab tests, toxicity course, and outcome.Conclusion: It seems that acute vitamin D toxicity is a benign condition in our pediatric population which may be due to high prevalence of vitamin D deficiency in Iran.

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CT scans in psychiatric patients - an exploratory study at Chris Hani Baragwanath Hospital

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v13i1.7 ◽

2007 ◽

Vol 13 (1) ◽

pp. 4

Author(s):

F Y Jeenah ◽

M Y H Moosa

Keyword(s):

Mentally Ill ◽

Exploratory Study ◽

Psychiatric Patients ◽

Demographic Data ◽

Ct Scanning ◽

First Episode Psychosis ◽

First Episode ◽

Laboratory Findings ◽

Episode Psychosis ◽

Significant Difference

Objective. An exploratory study was undertaken to determine the value of computed tomography (CT) in the assessment of mentally ill patients at Chris Hani Baragwanath Hospital.Method. All mentally ill inpatients aged 18 years and older who presented during the period March - August 2005, were screened for eligibility for CT of the head. The patients’ demographic data, clinical details, special investigations and the results of the CT were recorded. Results. Of approximately 600 admissions, 55 were eligible for CTs during the study period. The mean age of the study population was 38.3 years (standard deviation (SD) 16.3 years). Twenty patients (36.4%) had abnormal CTs; 7 (35%) of these patients were over the age of 60 years. There was a significant correlation between abnormal CTs and advancing age (r = 0.5, p < 0.001). In the group with abnormal CTs the gender distribution was similar, 15 (75%) presented with a first episode of psychosis, 5 (25%) had a concurrent abnormal physical examination, and 7 (35%) had abnormal special investigations. There was no significant difference between this group and the group with normal CTs with regard to gender (χ2 = 0.75, p = 0.385), first-episode psychosis (χ2 = 2.76, p = 0.096), abnormal physical findings (χ2 = 0.51, p = 0.473), or abnormal laboratory findings (χ2 = 0.13, p = 0.714) respectively. Conclusion. In this psychiatric population CT scanning revealed a significant number of abnormalities, especially in patients with first-episode psychosis. The study also suggests that clinical abnormalities (physical and laboratory) may not be reliable predictors of abnormal CTs and therefore the need for further research with bigger sample size.

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