scholarly journals Pediatric Septic Shock: Early Recognition and Aggressive Fluid Therapy Improves Outcome

Author(s):  
Shahzad Najeeb ◽  
Shabana Sarwar ◽  
Rafayat Ullah ◽  
Asfandyar . ◽  
Khurram Saleem ◽  
...  

Objective: To establish the effect of aggressive fluid resuscitation in reversing the pediatric septic shock at 1 hour in children younger than 5 years of age presenting in the emergency unit of the hospital. Methods:  This was a descriptive, case series study, done for six months, from December 2015 to May 2016, at Pediatric Department of Ayub Medical College Abbottabad. Patients with age range of 1 month to 5 years, presenting in the emergency department with the diagnosis of septic shock having clinical features of tachycardia, tachypnea or hyperthermia along with hypotension and poor capillary refill time were included. All patients received aggressive fluid management. Clinical examination was repeated at the end of one hour for assessment of reversal of shock. Data was collected by self-made Performa. Results: Mean age of study participants was 22.4 ± 17.6 months. Majority of participants 42(57%) were male. Mean weight was 10.3±4.3 kilograms. Mean heart rate was 173.9±17.8 beats per minutes. 67.6% were treated with a third-generation cephalosporin. At the end of one hour of treatment 51 (68.9%) showed the reversal of shock. Conclusion: Majority of childrens who presented with septic shock showed the reversal of shock at one hour of management with weight-based fluid bolus therapy.

2010 ◽  
Vol 17 (01) ◽  
pp. 101-104
Author(s):  
HAJI KHAN KHOHARO ◽  
F ATI MA QURESHI ◽  
SHUAIB ANSARI ◽  
Rizwan Javed

Objective: The study was conducted to determine the frequency of Chloroquine-resistant Plasmodium falciparum. Subjects& Methods: This was a descriptive case series study conducted at Muhammad Medical College Mirpurkhas & Liaquat University HospitalHyderabad/ Jamshoro, from January 2007 to December 2007. Total 160 patients with acute attack of fever were selected & studied who fulfilledthe inclusion criteria. The WHO extended test was done by giving 25 mg/kg body weight of Chloroquine base over 3 days. The interpretationof the test was done as per criteria laid down by WHO. Results: Out of one hundred sixty, 110 (68.75%) were males and 50 (31.25%) werefemales with ratio of 2.2:1. The age range 16-45 years with mean 28±12 years. Seventy one patients (44.375%) were Chloroquine sensitive.Chloroquine-resistance (CQR) Rl, Rll & both Rl Rll noted were 28.125%, 15.645% & 43.75% respectively. The CQR- R III was not observedin our study. Conclusions: In view of this situation, more organized and thorough studies must be conducted to elucidate the epidemiology,geographic-distribution & degree of Chloroquine resistance. And the local strategies be made to overcome this problem and to assess the needfor changing the first line drug.


2010 ◽  
Vol 17 (04) ◽  
pp. 715-720
Author(s):  
NIAZ MAQSOOD ◽  
BUSHRA AKRAM ◽  
WAJID ALI

Objectives: To assess the frequency of the various psychosocial stressors and stressful life events in patients presenting with conversion disorder. Study Design: Case series study. Place & Duration of Study: The study was conducted in the Department of Psychiatry & Behavioural Sciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College, Bahawalpur from January, 2009 to March, 2009. Subjects & Methods: The sample consisted of 100 in-patients (89 Female, 11 Male) with Conversion Disorder. They were interviewed andresults were analysed from the entries in a Performa. Results: Stressors were clearly identified in 100 patients. In all patients, we found more than one stressor. Among patients, there were (24%) In-laws problems, (23%) Love problems, (21%) Relationship problems with family, (20%) exam/study stress, (15%) marriage against will, (13%) demanding and pampered child, (11%) Issue less, (10%) sexual abuse, (8%) demand of marriage, (6%) overage in wait of marriage, (4%) death of partner, (3%) husband abroad and (3%) patient’s engagement break. Conclusions: We concluded that stressors and life events were present in all conversion disorder’s patients and these stressful life events are important causal factors for Conversion Disorder. Conversion Disorder has strong relationship with psychosocial stressors. 


Author(s):  
Amir Moeintaghavi ◽  
Negar Azami ◽  
Mohammad Sadegh Zohrevand ◽  
Farid Shiezadeh ◽  
Hamid Jafarzadeh ◽  
...  

2018 ◽  
Vol 45 (4) ◽  
pp. 261-266
Author(s):  
Jorge Luis Alfredo Herrera Ariza ◽  
Mario Alejandro Villabón ◽  
Ángela Carolina Rojas Ruiz ◽  
Iván Fernando Moncada

Objetivo: Determinar los agentes microbianos más frecuentes en pacientes de UCI con diagnóstico de sinusitis nosocomial en el Hospital de San José, período de dos años. Diseño: Estudio observacional tipo serie de casos. Materiales y métodos: Se incluyeron pacientes mayores de 18 años con una estancia hospitalaria mayor a 48 horas, que desarrollaron sinusitis nosocomial de acuerdo a los criterios de los Centers for Disease Control (CDC). Uso de dos técnicas: punción y lavado de seno maxilar. Resultados: 19 pacientes que cumplen los criterios de sinusitis nosocomial. Edad promedio 55 años, predominio sexo masculino. El 94.7% tuvo sonda orogástrica, 89.5% intubación orotraqueal y 89.5% ventilación mecánica. Hubo aislamiento polimicrobiano de gram positivos, gram negativos, anaerobios y hongos. La mortalidad en UCI fue 32%. Conclusiones: Se presenta una adecuada sensibilidad al tratamiento con vancomicina y piperacilina tazobactam en esta patología. El rendimiento diagnóstico es igual al realizar lavado y punción del seno maxilar.Objetive: To determine the microbial agents on UCI patients who have beendiagnosed with nosocomial sinusitis at the San Jose Hospital, (Bogota, Colombia) in a two-year period. Design: Case series study. Materials and methods: Patients who were older than 18-year olds, with a hospitalization longer than 48 hours who developed nosocomial sinusitis, according to the criteria established by the Centers for Disease Control (CDC) were included. Two techniques were employed for data collection: puncture and maxillary sinus wash. Results: 19 patients fulfill the criteria requirements for nosocomial sinusitis. Average age was 55 years old. Population mostly was composed by male individuals. 94.7% had a gastric tube intervention; 89.5% had tracheal intubation 89.5% mechanical ventilation. Polymicrobial isolation with gram positive, gram negative, anaerobic and fungi were identified. Mortality in critical care unites was 32%. Conclusions: An adequate sensitivity to treatment with vancomycin and piperacillin tazobactam was evidenced in this pathology.To perform a washing or maxillary sinus puncture had the same efficiency fordiagnosing this disease.


Hand Therapy ◽  
2021 ◽  
pp. 175899832110078
Author(s):  
Laura Adamson ◽  
Anna Selby

Introduction For some people the appearance of their hands is as important as function. Upper limb scarring can cause some patients distress. Skin camouflage is an intervention that can be used to reduce the visual impact of a scar but there is limited published evidence for its use for hand scarring. Methods This is a case series study with a primary objective to determine whether skin camouflage reduces distress in patients with an upper limb scar and to evaluate this new service. Patients experiencing distress from an upper limb scar were recruited from a hand therapy outpatient clinic. The intervention delivered was a one hour skin camouflage session. Photographs of the upper limb pre and post skin camouflage intervention were taken. The patient-rated Michigan Hand Questionnaire (MHQ) and Derriford Appearance Scale (DAS24) were completed before treatment, at 1 week and 1 month after treatment. Results Six participants reporting distress from an upper limb scar received skin camouflage intervention. Only three out of six participants completed all follow-up. All three showed improvement in at least two domains of the MHQ (function and aesthetics) at one month post treatment. Increased confidence during functional and work-based activities was also reported on the DAS24. Participants reported increased engagement in daily activities as a result of being able to camouflage their scars. Conclusions This small case series shows that skin camouflage intervention may be beneficial for some patients who are experiencing distress related to an upper limb scar by increasing function and self-confidence.


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