scholarly journals Evaluation of Antibiotics Activity among Hospitalized Patients in Iraq

2021 ◽  
pp. 30-43
Author(s):  
Qayssar Joudah Fadheel ◽  
Rana Talib Naser
Keyword(s):  
Teaching Hospital ◽  
Medical Condition ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hospitalized Patients ◽  
Medical Ward ◽  
P Value ◽  
Surgical Ward ◽  
Significant Difference ◽  
Medical City

Objectives: The study was conducted to evaluate the activity of different antibiotics used for various diseases and compare between their different effects among hospitalized patients. Study Design: Randomized prospected clinical study. Place and Duration of Study: It was carried out in Al-Zahraa Teaching Hospital and Al-Sader medical city, Iraq/Al-Najaf Town. The present study began at November 2017 and end  at December 2018.                                                        Methodology:  Sample of 100 patients in Al-Zahraa teaching Hospital and al-Sader Medical City, was randomly collected 90 cases in Al Sader Medical City ( 35 cases of medical ward and 55 cases from Surgical ward). We collected 10 medical condition in Al-Zahra Teaching Hospital from Gynecological and obstetric ward in random manner. Results: The results of present study reveal a significant difference between ceftriaxone and ceftazidime  and meropenem in treatment intraabdominal operations infection (appendectomy and cholycystectomy) , the results of present study show that 70% of patient used ceftriaxone for treatment of appendectomy and only 30%of patients used ceftazidime for this condition  so there is a significant difference between these two antibiotics (P-value less than 0.05) and only 10% of patients used meropenem (P-value less than 0.02). Other result of present study show significant difference in use meropenem over ceftriaxone in treatment diabetic foot ulcer(60% rate use meropenem over ceftriaxone 40%), in acute kidney injury, there's very high difference in use meropenem 80% versus 10% of vancomycin use (P-value 0.1). Conclusions: From current study we concluded that the antibiotics used greatly in surgical ward of Hospital followed  by medical ward , in addition to that antibiotics used in postoperation are  more effective than those used in medical ward , so there are a significant differences obtained among antibiotics used in surgical ward.

Frequency of Chronic Kidney Disease in Type 2 Diabetic Patients Presenting with Diabetic Foot Ulcer

2020 ◽  
Author(s):  
Ghazala Usman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Significant Difference

Background: Recent evidence states that about a quarter of all diabetic patients will experience an ulcer on foot at some point in their lifetime and 15-25% of these will require foot amputation. In the present study, we aimed to evaluate the incidence of chronic kidney disease (CKD) in Type 2 diabetes mellitus (T2DM) patients presenting with Diabetic foot ulcer. Methods: The present study was carried out at Jinnah Postgraduate Medical Center (JPMC), Sindh from February-August 2017. Over 100 Type 2 - DM patients, aged between 35-60 years who presented with diabetic foot ulcer took part in this study. Data was collected and documented in pre-approved pro-forma, subsequently, entered and analyzed via SPSS version 19. Chi-square was applied to test any significant difference between the categories with a p-value of ≤0.05 considered as significant. Results: The mean serum creatinine (mg/dl) value was reported to be 1.17 ± 0.45. Frequency of CKD in Type 2 - DM patients presenting with diabetic foot ulcer was 31%. Male gender was affected more from CKD. Frequency distribution of chronic kidney disease among duration of DM groups 10-15 years = 35.5% and >15 years = 64.5%. The characteristics of HbA1c (g/dl) of study population was 8.34 ± 0.59. Conclusion: Occurrence of CKD in Type 2 - DM patients presenting with diabetic foot ulcer was much higher as compared to national and international studies. Therefore, special attention should be given on regular screening of diabetic patients with a complaint of a foot ulcer.

Efektivitas pencucian luka menggunakan daun jambu biji terhadap tingkat malodor klien luka kaki diabetik

2019 ◽  
Vol 8 (2) ◽  
pp. 152
Author(s):  
Adi Antoni ◽  
Yanna Wari Harahap
Keyword(s):  
Diabetic Foot ◽  
Rating Scale ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Numeric Rating Scale ◽  
P Value ◽  
Consecutive Sampling ◽  
Guava Leaves ◽  
Guava Leaf ◽  
Numeric Rating

Abstrak   Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronik dan menjadi masalah global. Salah satu komplikasi yang ditimbulkan dari DM adalah luka kaki diabetic. Langkah awal dalam perawatan luka kaki diabetic adalah mencuci luka. Tujuan penelitian ini adalah mengetahui keefektifan dari rebusan daun jambu biji sebagai cairan pencuci luka terhadap tingkat malodor pada luka kaki diabetic. Metode: Desain penelitian yang digunakan adalah quasy experiment dengan rancangan one group pretests-posttest only. Teknik sampling yang digunakan adalah consecutive sampling dengan jumlah sampel 16 orang. Kriteria sampel yang digunakan adalah klien luka kaki diabetic, tingkat malodor 1-10 dengan NRS. Alat ukur yang digunakan adalah Numeric Rating Scale (NRS). Analisa data yang digunakan dalam penelitian ini menggunakan uji paired t test. Hasil: tingkat malodor sebelum intervensi pencucuan luka menggunakan rebusan daun jambu biji rata-rata sebesar 4.40 dan sesudah intervensi sebesart 2.44 dengan p value < 0.001. Selisih tingkat malodor antara sebelum dan sesudah intervensi sebesar 1.96. Hasil penelitian ini menunjukkan bahwa daun jambu dapat digunakan sebagai cairan pencuci luka dalam mengatasi tingkat malodor pada luka kaki diabetik. Kesimpulan : daun jambu biji dapat digunakan sebagai cairan pencuci luka pada luka kaki diabetic. Perawat diharapkan dapat memanfaatkan daun jambu biji sebagai salah satu alternatif dalam pencucian luka kronik khususnya luka kaki diabetik.   Kata kunci: Daun Jambu Biji, Tingkat Malodor, Luka Kaki Diabetik   Abstract   Background: Diabetes mellitus (DM) is a chronic disease and a global problem. One of the complications that arise from DM is diabetic foot ulcer. The first step in treating diabetic foot ulcer is washing the wound. The purpose of this study was to determine the effectiveness of guava leaf decoction as a washing fluid for malodor levels in diabetic foot ulcer. Method: The research design used was quasy experiment with one group pretests-posttest only design. The sampling technique used was consecutive sampling with a sample of 16 people. Sample criteria used were diabetic foot ulcer clients, malodor level 1-10 with NRS. The measuring instrument used is the Numeric Rating Scale (NRS). Analysis of the data used in this study used paired t test. Results: the level of malodor before intervening in wound washing using guava leaf decoctions on average was 4.40 and after the intervention was 2.44 with p value <0.001. The difference in the level of malodor between before and after the intervention was 1.96. The results of this study indicate that guava leaves can be used as a washing fluid in dealing with malodor levels in diabetic foot ulcer. Conclusion: Guava leaves can be used as a washing fluid for diabetic foot wounds. Nurses are expected to be able to use guava leaves as an alternative in washing chronic wounds, especially diabetic foot injuries.   Key words: Guava Leaf, Malodor Level, Diabetic foot ulcer.

Efficacy of Aloe vera/ Plantago Major Gel in Diabetic Foot Ulcer: A Randomized Double-Blind Clinical Trial

2019 ◽  
Vol 16 (2) ◽  
pp. 223-231 ◽  
Author(s):  
Younes Najafian ◽  
Zahra M. Khorasani ◽  
Mona N. Najafi ◽  
Shokouh S. Hamedi ◽  
Marjan Mahjour ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Foot ◽  
Intervention Group ◽  
Aloe Vera ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Plantago Major ◽  
Double Blind ◽  
Significant Difference

Background:Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFUMethods:Forty patients with DFU enrolled in a double-blind randomized clinical trial. The patients who were randomly assigned into the intervention group (n = 20), received topical Plantavera gel in addition to the routine cares, whereas the patients in the control group (n = 20), received topical Placebo gel in addition to the routine cares. Intervention was done twice a day for 4 weeks in the both groups. Photography and an evaluation of DFU healing were conducted by a checklist and then were scored at baseline and at the end of each week. The collected data was analyzed by SPSS software.Results:At the end of the study, there was a significant difference between the two groups in terms of total ulcer score (P<0.001) and Plantavera gel significantly reduced the ulcer surface comparing with the control group (P=0.039). However, there was not a significant difference between the two groups (P=0.263) in terms of the ulcer depth. During this study, no side effect was observed for Plantavera gel in the intervention group.Conclusion:Topical Plantavera gel seems to be an effective, cheap and safe treatment. Of course, further studies are required to confirm the properties of the wound healing of this gel.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Serum potassium disorders predict subsequent kidney injury: a retrospective observational cohort study of hospitalized patients

2022 ◽  
Author(s):  
Gianmarco Lombardi ◽  
Giovanni Gambaro ◽  
Pietro Manuel Ferraro
Keyword(s):  
Cohort Study ◽  
Serum Potassium ◽  
Hospital Admissions ◽  
Kidney Injury ◽  
Observational Cohort Study ◽  
Hospitalized Patients ◽  
P Value ◽  
Significant Difference ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Introduction Electrolytes disorders are common findings in kidney diseases and might represent a useful biomarker preceding kidney injury. Serum potassium [K+] imbalance is still poorly investigated for association with acute kidney injury (AKI) and most evidence come from intensive care units (ICU). The aim of our study was to comprehensively investigate this association in a large, unselected cohort of hospitalized patients. Methods: We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 1, 2010 and December 31, 2014 with inclusion of adult patients with at least 2 [K+] and 3 serum creatinine (sCr) measurements who did not develop AKI during an initial 10-day window. The outcome of interest was in-hospital AKI. The exposures of interest were [K+] fluctuations and hypo (HoK) and hyperkalemia (HerK). [K+] variability was evaluated using the coefficient of variation (CV). Cox proportional hazards regression models were used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between the exposures of interest and development of AKI. Results: 21,830 hospital admissions from 18,836 patients were included in our study. During a median follow-up of 5 (interquartile range [IQR] 7) days, AKI was observed in 555 hospital admissions (2.9%); median time for AKI development was 5 (IQR 7) days. Higher [K+] variability was independently associated with increased risk of AKI with a statistically significant linear trend across groups (p-value = 0.012). A significantly higher incidence of AKI was documented in patients with HerK compared with normokalemia. No statistically significant difference was observed between HoK and HerK (p-value = 0.92). Conclusion: [K+] abnormalities including fluctuations even within the normal range are associated with development of AKI.

scholarly journals THE RELATIONSHIP OF THE INITIAL WOUND WITH THE WOUNDS LONG TREATMENT IN DIABETICUM PATIENTS AT CIBINONG HOSPITAL BOGOR

2020 ◽  
Vol 11 (2) ◽  
pp. 35-40
Author(s):  
Ranti Ranti
Keyword(s):  
General Hospital ◽  
Diabetic Foot ◽  
Wound Care ◽  
Day Treatment ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Stage I ◽  
Stage Iii ◽  
P Value ◽  
Early Wound

According to the survey data of American Diabetes Association (ADA) in 2014, the global prevalence rate of DM patients in 2014 was 8,3% out of total population of the world, and it has increased to 387 cases in 2014. Sulistyowati, D. A. stated that in 2015 for the prevalence of the patients suffering from diabetic foot ulcer was 15% with the risk of amputation of 30%, mortality rate of 32%, and in Indonesia, diabetic foot ulcer is the disease whose probability to be hospitalized is 80%. This research aims at finding out the relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum at Cibinong General hospital in 2018. This study is a quantitative analytic research with the approach of cross sectional. The population of this research is 40 respondents, and the research sample is 40 respondents by taking the technique of Total Sampling. The data collection is derived from the observation sheet. Based on the research findings, it is known that 14 respondents (77.8%) who suffered from the stage I-II wound needed 3-5 day treatment. Moreover, 19 respondents (86,4%) who suffered from stage III-IV wound needed 6-8 day treatment. The result of statistical test by taking cremer von mises test derived the value p=0,000 meaning that p value <0,05 signifies Ha received. This indicates that there is a significant relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum. Result analysis also obtains the value OR of 22.167 meaning that the wound stage III-IV will have the possibility of influencing the length of wound care of 22.167 times compared to the stage I-II. There is a relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum at Cibinong General Hospital. This research finding is expected to be a recommendation for the patients suffering from ulcus diabeticum, particularly those who suffer from stage III-IV with a long wound care.

Empirical Antibiotic Treatment in Diabetic Foot Infection: A Study Focusing on the Culture and Antibiotic Sensitivity in a Population From Southern China

2017 ◽  
Vol 16 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Wen-xia Wu ◽  
Dan Liu ◽  
Yi-wen Wang ◽  
Chuan Wang ◽  
Chuan Yang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Southern China ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Severe Infection ◽  
Third Generation ◽  
Diabetic Ulcer ◽  
Significant Difference

Diabetic foot and subsequent diabetic ulcer infections are the most devastating complication of diabetes. This study was conducted to explore the bacterial spectrum, sensitivity of microbials, and analysis of the empirical antibiotic regimens in our health center. The study included patients with diabetic foot ulcer infection (DFI) seen from 2009 to 2014. The patients included had all information covering the physical examination, laboratory tests, and image examinations. We sent appropriately obtained specimens for culture prior to starting empirical antibiotic therapy in all participants. A total of 312 patients were included: 52, 112, 95 and 53 patients within uninfected, mild, moderate, and severe infection groups. The total percentages of Gram-positive cocci (GPCs) and Gram-negative rods (GNRs) were 54% and 48.8% ( P = 0.63). The most common GPC was Staphylococcus aureus (22.4%) and GNR was Pseudomonas aeruginosa (11.9%). Methicillin-resistant Staphylococcus aureus was isolated from 21 patients (6.7%). Even in the mild infection group, there was no significant difference between GPC and GNR infection, irrespective of recent antibiotic use ( P = 0.053). The most frequently used empirical antibiotics in our center were second-/third-generation cephalosporin ± clindamycin, both in the mild and moderate/severe infection groups. In our center, the amoxicillin/clavulanate or ampicillin/sulbactam (β-L-ase 1) and second-/third-generation cephalosporins were highly resistant to the common GNR (30%-60%). The ticarcillin/clavulanate, piperacillin/tazuobactam (β-L-ase 2), fluoroquinolone, and group 2 carbapenem had good sensitivity. This study presents a comprehensive microbiological survey of diabetic foot ulcers in inpatients and provides reliable evidence of the local microbial epidemiology and sensitivity of antibiotics, which may help us improve clinical outcomes in DFI patients.

scholarly journals EFFECTIVENESS OF CITRIC ACID DRESSING ON HEALING PROCESS OF DIABETIC FOOT ULCER AMONG PATIENTS ADMITTED IN SURGICAL WARD AT GOVERNMENT RAJAJI HOSPITAL, MADURAI

2020 ◽  
Vol 8 (8) ◽  
pp. 939-944
Author(s):  
S. Rajamani M.Sc (N). , M.B.A (HM). , M.Sc (Psy). , Ph.D. ◽  
◽  
S. Muniammal , M.Sc (N). , MBA (HM). ◽  
Abinaya. B , Msc (N). ◽  
◽  
...  
Keyword(s):  
Citric Acid ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Surgical Ward

scholarly journals A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#

2022 ◽  
Vol 30 (Suppl.) ◽  
pp. 48-59
Author(s):  
Fatimah Baqer Alqubbanchi ◽  
Fadya Yaqoob Al-Hamadani
Keyword(s):  
Cost Effectiveness ◽  
Mortality Rate ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Hospitalized Patients ◽  
P Value ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
The Cost ◽  
D Dimer

Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.

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