Clinico-Epidemioogical and Radiological Profile of Broncholitis at Sher-E-Bangla Medical College Hospital in Barishal, Bangladesh

Background: Bronchiolitis, caused mostly by Respiratory syncytial virus (RSV) virus is the leading cause of lower respiratory tract infection in infants. The disease is mostly presents with cough runny nose, fever, breathing difficulties and respiratory failure This infection usually affects children up to age of 24 months, with younger infants often more severely affected and is the most prevalent cause of hospitalization in infants under the age of 12 months. The treatment is supportive; therefore, epidemiology, clinical, laboratory, and radiologic findings can help to ensure appropriate diagnosis and proper treatment.Methods:This descriptive cross-sectional observation study was conducted at Paediatrics department of Sher-E-Bangla Medical College & Hospital (SBMCH), Barishal, Bangladesh between October 2018 to March 2019To find out the clinico-epidemiological and radiological profile of Bronchiolitis. Children below 24 months of age diagnosed as bronchiolitis were studied.Results:200 children were evaluated, including 150 boys and 50 girls; Infants below 6 months accounted for the highest proportion (60%). All the bronchiolitis patients had cough or cold with respiratory distress. Other symptoms were fever (98.0%), restlessness (63.0%), poor feeding (60%) and fast breathing. On examination lower chest indrawing and rhonchi were found in all cases. Hyperinflation was the most prevalent radiological finding (60%) and more than half (55%) patients had lymphocytosis on CBC.Conclusion:Most children present with typical clinical and radiological feature of bronchiolitis which can help the clinicians to clinically identify this disease more efficiently.

Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage – A multicentre subanalysis of the German PBM Network Registry

Purpose Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period. Methods This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 until 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH. Results A total of n = 9,081 patients were analysed (aSAH n = 5,008; ICH n = 4,073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR= 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR= 1.48 in aSAH, OR= 1.53 in ICH, p < 0.001) and for several postoperative complications. Conclusions Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH. Trial registration: ClinicalTrials.gov, NCT02147795, https://clinicaltrials.gov/ct2/show/NCT02147795

Strategi Komunikasi Program KBKM 2021 dalam Upaya Pemajuan Kebudayaan oleh KEMDIKBUD-RISTEK

One of the causes of the lack of cultural existence today is not because the level of awareness of the younger generation for culture is low or irrelevant, but because of the low level of communication between generations. The purpose of this study was to find out the communication strategy of the KBKM program in an effort to promote culture by KEMDIBUD-RISTEK RI to the younger generation. This research uses descriptive qualitative method with sample determination using purposive sampling technique and case study approach. Data collection techniques using interview and observation study methods and documentation using data validity triangulation techniques. The results of this study indicate that KEMDIKBUD-RISTEK RI has made efforts to promote culture through villages by attracting the role of young people using communication strategies from Onong Uchjana Effendy in the form of planning, management and implementation of communication. The planning includes the timeline and the publication process, communication management includes redundancy (repetition), canalizing, informative, persuasive, educative and also coercive. Then carry out the analysis of issues and the role of communication, selecting targets, determining targets, developing strategies and selecting partners, determining messages, determining communication tools, managing communication and conducting partner directions, planning activities, communication budgets, as well as monitoring and evaluation.

Executive dysfunction following SARS-CoV-2 infection: A cross-sectional examination in a population-representative sample

Objective: To determine whether SRS-CoV-2 infection and COVID-19 symptom severity are associated with executive dysfunction among members of the general population, including those not hospitalized or exposed to intubation. Design: Cross-sectional observation study with data from an ongoing national cohort study of young and middle-aged adults. The Canadian COVID-19 Experiences Project (CCEP) survey involves 1,958 adults with equal representation of vaccinated and vaccine hesitant adults between the ages of 18 and 54 years. Setting: Population-based survey of community dwelling adults, representative of the broader Canadian population. Participants: Men and women between 18 and 54 years of age from English and French speaking provinces. The sample comprised 1,958 adults with a mean age of 37 years (SD=10.4); 60.8% were female. Exposures: SARS-CoV-2 infection with COVID-19 symptoms of any severity, ranging from negligeable to life-threatening infection requiring hospitalization. Primary Outcome: Symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS). Results: Those who reported a prior SARS-CoV-2 infection regardless of COVID-19 symptom severity (Madj=1.89, SE=0.08, CI: 1.74, 2.04; n=175) reported a significantly higher number of symptoms of executive dysfunction than their non-infected counterparts (Madj=1.63, SE=0.08, CI: 1.47,1.80; n=1,599; β=0.26, p=.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of executive dysfunction, with moderate (β=0.23, CI: 0.003-0.46) and very/extremely severe (β= 0.69, CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater dysfunction, compared to asymptomatic. These effects remained reliable and of similar magnitude after removing those who had been received intubation and when controlling for vaccination status. Conclusions: Positive SARS-CoV-2 infection history and COVID-19 symptom severity are associated with executive dysfunction among young and middle-aged adults with no history of medically induced coma.

Fluctuations in willingness to communicate of an EFL lecturer: An observation study in Indonesia

Despite the growing number of research on Willingness to Communicate (WTC) in English students, research of teachers’ WTC in English is still scarce. At the same time, the fluctuations of WTC in English in authentic classroom interactions are still under research. This study aims to observe the fluctuations in WTC of the English lecturer in the Indonesian context. The data were collected through video recordings during an online classroom learning session where participants were teaching their students. The data were then transcribed, coded, and analyzed thematically by drawing from MacIntyre et al.’s (1998) Heuristic Model. From the results of the analysis, WTC fluctuations in English are divided into four factors: (1) modeling the use of English in the classroom, (2) the power of affirmation, (3) focusing on the message, and (4) showing language similarity. The implication of this study is also discussed. DOI: 10.26905/enjourme.v6i2.5983

P-EGS24 Surgical case series of incarcerated diaphragmatic hernias following oesophagectomy for oesophageal cancer. Single centre experience

Background Incarcerated post-oesophagectomy diaphragmatic hernia (IPODH) is a recognised surgical emergency and potentially hazardous event. Information regarding the natural course for this emergency and guidelines regarding the management were not described clearly in literature. This case series aim to review patients who presented as emergency with IPODH Methods This observation study is conducted at Salford Royal Hospital that has one of the largest oesophago-gastric unit in United Kingdom. A 7-year period (April 2013 - April 2020) retrospective data collection is performed using prospectively maintained database. We reviewed the presentation and management course for all patients who presented as emergency with IPODH. Results We identified 341 patients who underwent oesophagectomies over the seven-year period. Seven patients (2%) developed IPODH which required emergency surgery. All these patients underwent 2 stage oesophagectomies. Out of these, 5 patients had laparoscopic assisted procedure (hybrid), 1 patient had minimally invasive procedure and another patient had open operation. Mean time interval from esophagectomy to the acute incarcerated hernia presentation was 23 months. Only 1 patient developed acute diaphragmatic hernia on day 4 post-oesophagectomy. The incarcerated hernia contents were reported as small bowels (4 patients), gastric conduit (2 patients) and colon (1 patient). Dealing with these acute emergency cases can be difficult as the hernia contents are threatened. Therefore, most of these patients underwent emergency laparotomy, only 1 patient had laparoscopic procedure to repair the incarcerated hernia. Collagen mesh used to repair the defect only in 2 patients, whereas the rest of the patients had the defect repaired with primary sutures only. Conclusions Minimally invasive techniques were associated with a higher incidence of post-oesophagectomy diaphragmatic hernia compared with open techniques. These hernias can lead to a significant and serious risk when they present with incarceration. The risk of the acute manifestation and significant post-repair morbidity support long-term surveillance for post-oesophagectomy diaphragmatic hernia and elective surgical treatment. Laparoscopic repair of non-complicated diaphragmatic hernia is feasible and effective in high-volume centres.

Association Between Thyroid Cancer and Cardiovascular Disease Risk: A Nationwide Observation Study

BackgroundResearch findings on the long-term cardiovascular risk associated with thyroid cancer and treatment are unclear. This study aimed to investigate the standardized incidence rate (SIR) of coronary heart disease (CHD), ischemic stroke (IS), and atrial fibrillation (AF) among thyroid cancer patients in comparison with the general population across different age groups. MethodsDesign, setting, and participantsThis observational cohort study enrolled patients between January 1, 2011 and December 31, 2016 with follow-up until December 31, 2018. This study analyzed the data of Taiwanese thyroid cancer patients registered on the National Taiwan Cancer Registry Database, with CHD and IS. Main outcomes and measuresSIR models were used to evaluate the association between thyroid cancer and CHD, IS, AF, and cardiovascular disease outcome, stratified by age and sex. SIR analyses were also conducted for both sexes, age groups (<60, ≥60 years), and different follow-up years.ResultsAfter excluding 128 individuals <20 years or >85 years and with missing index data, 4274 eligible thyroid cancer patients without CHD history, 4343 patients without IS history, and 4247 patients without AF history were included for analysis. During the median follow-up of 3.5 (1.2) years, CHD incidence was 70; IS, 30; and AF, 20. Compared with the general population, thyroid cancer patients had higher CHD risk throughout the age spectrum (SIR, 1.33; 95% confidence interval [CI], 1.02 to 1.65). The overall CHD risk gradually declined, but it was persistent for more than 5 years after thyroid cancer diagnosis. CHD risk was observed in both males and females, especially in young thyroid cancer patients <65 years. However, lower SIRs for IS (SIR, 0.74; 95% CI, 0.47 to 1), AF (SIR, 0.74; 95% CI, 0.42 to 1.06), and cardiovascular disease (SIR, 0.88; 95% CI, 0.7 to 1.05) were observed among thyroid cancer patients (not significant). ConclusionsThyroid cancer survivors have a substantial CHD risk even at long-term follow-up, especially in those patients <65 years. Further research on the association between thyroid cancer and CHD risk is warranted.

Plasma Levels of Decorin Increased in Patients during the Progression of Breast Cancer

Decorin (DCN), an extracellular matrix proteoglycan found in tumor surrounding tissues, is a natural inhibitor of tumor cell proliferation and invasion. We conducted a cross-sectional observation study to evaluate the association of the pathological stage with the levels of DCN in plasma or tumor surrounding tissue. Among 118 patients who underwent breast surgery, 35 were designated as carcinoma in situ (Stage 0), 39 were Stage I, and 44 were Stage II or III. The stromal expression of DCN was quantified using a semiquantitative digital image analysis after immunohistochemical staining. The concentration of DCN was evaluated with a specific ELISA. As we have previously shown, stromal DCN expression was attenuated in the patients with Stage I, whereas stromal and plasma DCN was elevated paradoxically in those with Stage II/III. The elevated plasma DCN is an independent predictive factor of Stage II/III by the multivariate logistic regression analysis. The plasma level of DCN was negatively correlated with stromal DCN expression only in patients with advanced disease (Stage II/III). The plasma level of DCN could become a useful biomarker for patients in the advanced stages. Extensive studies and further assessments are warranted for evaluating the prognostic significance and tumor characteristics to understand the clinical significances of stromal and systemic DCN.

Hand hygiene compliance of health care workers in a neonatal intensive care unit: a prospective observation study

Background: We aimed to determine hand hygiene (HH) compliance of the healthcare workers (HCW’s) and evaluate if there is an epidemiological relation between the microorganisms isolated from the hands of HCWs and patients clinical materials in the neonatal intensive care unit (NICU).Methods: HH compliance was observed in two unannounced phases in March and in August within the scope of 5 indications determined by WHO. Between two phases personnel was trained to improve HH by educational sessions and introduction of Semmelweis system hand in scan (HIS, Sysmex) in the unit. A total of 22 nurses, 11 physicians and 5 staff was working in the NICU. Hand samples taken from HCW by glove juice method were inoculated quantitatively in culture plates and colonies were identified by MALDI-TOF MS. Epidemiological relation between clinical isolates and hand samples was investigated with arbitrary primed PCR.Results: Although overall compliance remained only 50%, a significant increase in compliance was detected in August prior to aseptic procedures and after contact with patients and body fluids. Alcohol scrub was preferred as 60.4% in March and 75.2% in August. HH efficacy reached to 72% by implementing HIS. During this period, 10.7% of 607 patient’s samples revealed clinically significant growth. Potential pathogens were isolated in 5.2% of 144 hand samples, but any epidemiological correlation with patient isolates was detected.Conclusions: HH compliance observations should be done at regular intervals and current technology could be utilized in trainings to overcome hospital related infections.