The Impact of Covid-19 on Ophthalmological Emergency Department Visits at King Khaled Eye Specialist Hospital in Riyadh City, Saudi Arabia

Purpose: This study aimed to assess the impact of COVID-19 on ophthalmological emergency department visits at King Khaled eye specialist hospital in Riyadh city, Saudi Arabia. Method: A Retrospective Record Review was conducted at KKESH in Riyadh city during a pandemic period from 2 March to 30 June of 2019 and same period in 2020. Data include all patients who visited the ophthalmology emergency department with all age groups.

Risk factors and Compliance of surviving sepsis campaign: A retrospective cohort study at tertiary care hospital

Background and Objective: Sepsis is one of the leading causes of direct maternal mortality in Pakistan. It is recommended that the first three hours after the presentation are crucial. During this time implementation of surviving sepsis campaign resuscitation bundles reduces maternal mortality. Our objective was to assess the factors contributing to puerperal sepsis and the compliance of “surviving sepsis campaign resuscitation bundles in puerperal sepsis” for the management of puerperal sepsis. Methods: This was a retrospective record review for five years from January 2011-December 2015. All women who fulfilled the inclusion criteria of puerperal sepsis were included and data from their files were collected and entered in SPSS version 19.0. Mean and standard deviations were calculated for continuous variables while for categorical variable proportion and percentages were used. Results: This retrospective record review in five years showed the 396 patients had P-sepsis, among them 44 patients had severe sepsis with organ dysfunction. The culture was positive in 26(59%) with trend of E-coli in 9(20%) Among them 12(27%) had serum lactate more than ≥4mmol/L. Central venous pressure monitoring with fluid resuscitation was done as per protocol of survival bundle given to all 12(100%), Vasopressin was needed in half of these patients 6(50%). Amid 44 patients of severe sepsis 29(66%) were admitted to special care, while 15(34%) required intensive care admissions. Our 7(16%) patients failed to survive. All of them had multi-organ failure. Conclusion: There was moderate adherence of modified surviving sepsis campaign resuscitation bundles. Further improvement in compliance is warranted. doi: https://doi.org/10.12669/pjms.38.1.3992 How to cite this:Yousuf F, Malik A, Saba A, Sheikh S. Risk factors and Compliance of surviving sepsis campaign: A retrospective cohort study at tertiary care hospital. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.3992 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Survival of Patients with Floor of Mouth Squamous Cell Carcinoma Treated with Surgical Resection and Reconstruction

Objective. To identify predictors of survival in patients with floor of mouth SCC in order to improve patient selection for resource intensive resection and reconstruction procedures.Study design and setting. A retrospective record review of patients who underwent resection and reconstruction for floor of mouth SCC at Charlotte Maxeke Johannesburg Academic Hospital. Methods. Patient data were collected and analyzed with respect to age, sex, race, tobacco usage, alcohol usage, tumour stage and postoperative chemo-radiation. One- and five-year recurrence and survival rates were also evaluated.Conclusion. The use of alcohol as well as disease stage appear to be significant variables in the risk of recurrence and five-year survival of patients.

Effectiveness of Shorter Treatment Regimen in Multidrug-Resistant Tuberculosis Patients in Pakistan: A Multicenter Retrospective Record Review

In Pakistan, the treatment of multidrug-resistant tuberculosis (MDR-TB) with a shorter treatment regimen (STR), that is, 4–6 months of amikacin, moxifloxacin (Mfx), ethionamide, clofazimine (Cfz), pyrazinamide (Z), ethambutol (E), and high-dose isoniazid, followed by 5 months of Mfx, Cfz, Z, and E, was initiated in 2018. However, there is a lack of information about its effectiveness in Pakistani healthcare settings. Therefore, this retrospective record review of MDR-TB patients treated with STR at eight treatment sites in Pakistan aimed to fill this gap. Data were analyzed using SPSS 23. Multivariate binary logistic regression (MVBLR) analysis was conducted to find factors associated with death and treatment failure, and lost to follow-up (LTFU). A P-value < 0.05 was considered statistically significant. Of 912 MDR-TB patients enrolled at the study sites, only 313 (34.3%) eligible patients were treated with STR and included in the current study. Of them, a total of 250 (79.9%) were cured, 12 (3.8%) completed treated, 31 (9.9%) died, 16 (5.1%) were LTFU, and four (1.3%) were declared as treatment failures. The overall treatment success rate was 83.7%. In MVBLR analysis, patients’ age of 41–60 (odds ratio [OR] = 4.9, P-value = 0.020) and > 60 years (OR = 3.6, P-value = 0.035), being underweight (OR = 2.7, P-value = 0.042), and previous TB treatment (OR = 0.4, P-value = 0.042) had statistically significant association with death and treatment failure, whereas patients’ age of > 60 years (OR = 5.4, P-value = 0.040) and previous TB treatment (OR = 0.2, P-value = 0.008) had statistically significant association with LTFU. The treatment success rate of STR was encouraging. However, to further improve the treatment outcomes, special attention should be paid to the patients with identified risk factors.

Failure of labor induction in Tigray region, Ethiopia: a retrospective record review study

Background: Failed induction of labour is defined as when there is failure to generate regular contractions (i.e, every 3 minute) and cervical change after artificial membrane rupture and at least 24 hour of oxytocin use However, the magnitude of failed induction labor in Tigray is not well documented. Therefore, the objective of this study was to assess the magnitude and factors associated with failed induction of labor in the study area. Methods: We conducted institution-based- retrospective record review study of all inductions of labor conducted from April 9, 2017- April 8, 2018(n=380) in Axum St.Mary hospital, Tigray, Ethiopia. Data were entered and analyzed using SPSS version 21 software. The data were cleaned before analysis. Descriptive statistics such as frequency and mean were used to describe the study participants. For the multivariable logistic, binary logistic regression a two tailed p-value <0.05 was performed to show statistical significant. Results: The magnitude of failure of labor induction was found 11.8% (95% CI: 8.7-15.3%). The multivariable binary logistic regression analysis showed that primi-parity (AOR=4.31, 95% CI; 1.22-15.18) and poor Bishop Score (AOR=10.67, 95%CI: 1.31-86.87) were significantly associated with failed induction of labor. Conclusion and recommendation: The failed of labor induction was found high in the study area. The health care providers should assess and document the status of the cervix (using the Bishop score) to determine the probability of success and to select the appropriate method of induction. In addition, they need to consider induction of women with an unfavorable cervix is associated with high failure and a higher caesarean section.

Pregnancy outcomes amongst adolescents/young adults at tertiary-care hospital in low-middle-income country: ten-year retrospective record-review

Objective: Adolescent pregnancies are known to be associated with adverse outcomes. Our objective was to compare pregnancy outcomes amongst adolescents (young adolescents YA: 15-17 years; older adolescents OA: 18-19 years) and young adults (20 to 25 years) Methods: Study was conducted at Aga Khan University Hospital, Karachi. Ten-year retrospective record review was done through convenience sampling. Data was collected on predesigned proforma. Participants were 396 primiparous adolescents (15-19 years) with singleton low-risk pregnancy. Reference-group included 410 primiparous, low-risk, young adults. Pregnancies complicated with preexisting diabetes mellitus, chronic hypertension, renal disorders or cardiac diseases were excluded. Maternal /neonatal outcomes were compared amongst groups. Results: Out of 806 charts reviewed, 75 (9.3%) were YA, 321 (39.8%) were OA and 410 (50.9%) were 20-25 years old young adults. Most of the un-booked cases were in young adolescents; 17 (22.7% YA), 41 (12.8% OA) and 33 (8.0% reference -group) (p-value 0.001). This group also booked at a later gestational age; YA (19.6±10.4 weeks), OA (17.2±9.3 weeks) and controls (15.5n±8.8 weeks) (p-value 0.002). Gestational age at delivery was not significantly different among the groups. Adolescents had a decreased likelihood of cesarean section with youngest group having 29% less chance of cesarean delivery (OR 95% CI 0.41, 0.2) compared to women of 20-25 years of age. Difference in maternal/neonatal outcomes remained insignificant between groups at univariate and multivariate analysis. .............................................................

Implementing universal rifampicin testing for TB in Pakistan: results and implications for the TB response

SETTING: A large specialised chest hospital in Pakistan.OBJECTIVE: To study outcomes of comprehensive Xpert® MTB/RIF and universal rifampicin testing.DESIGN: A hospital-based, 3-year retrospective record review of registered TB patients.RESULTS: During the study, 11 744 TB patients were registered when the number of annual notifications remained stagnant. Xpert use increased dramatically in adults with pulmonary TB (PTB) from less than 1% tested with Xpert alone in 2016, to 81.6% by 2018. Significant increases were seen in bacteriologically confirmed PTB in adults from 64% to 77.3% (P < 0.001). No remarkable changes were seen in testing and confirmation of PTB in children or extrapulmonary TB. Significantly lower (P < 0.001) rifampicin resistance (RR) was observed among those with smear-negative compared to those with smear-positive results among new (1.0% vs. 5.1%) and previously treated PTB cases (2.0% vs. 14.4%). Most importantly, a significant decline in RR was observed among previously treated individuals, from 15.4% (95%CI 12.2–19.0) to 8.6% (95%CI 6.6–11.0) during the study. A decrease in RR was also documented in newly diagnosed PTB patients, but this was not statistically significant.CONCLUSION: Universal rifampicin testing is feasible in adult PTB patients; a decline in RR was seen among previously treated individuals with PTB.