NEONATAL BACTERIAL CONJUNCTIVITIS IN TERTIARY HOSPITALS IN SANA'A CITY, YEMEN

Background: Ophthalmia neonatorum (ON) is the most widespread eye infection occurring in the first 28 days of life. Although most of these cases are benign, some may progress to systemic complications or blindness if left untreated. Objectives: The current study was conducted with the aim of revealing the bacteriological causes of conjunctivitis in neonates and the antibiotic sensitivity pattern of these bacteria. Subjects and methods: The study included all neonates at the age of 1 to 28 days presenting at the neonatal nurseries with Neonatal Intensive Care Unit (NICU) and level II care beds in three hospitals; Authority of Al-Thawra General Hospital, Al-Kuwait University Hospital and Al-Sabeen Maternity and Child Hospital in Sana’a city, Yemen. A full history was taken from each nurse and mothers of the neonates included in the study in which the findings were recorded in a predesigned questionnaire including socio demographic, maternal clinical information and therapeutic interventions. To isolate the causative agent, the conjunctival swabs were inoculated on proper media and bacteria were identified by standard microbiological methods and antibiotic resistance was done for the isolates. Results: 203 swabs were collected from newborns with eye discharge over a nine-month period. Positive growth rate was 51.7%, males were more affected (57.1%), 80% of affected neonates had low birth weight, 71.4% of preterm infants were most affected (p <0.01). There was a significant relationship between invasive and non-invasive mechanical ventilation with neonatal conjunctivitis (p<0.05). Gentamicin showed good in vitro sensitivity to all bacteria isolated, Staphylococcus aureus (83%), Escherichia coli 84.6%, with P. aeruginosa it was 60%. Conclusion: The vast majority of cases of neonatal conjunctivitis were mild with a high level of occurrence, Staphylococcus aureus and Klebsiella pneumoniae were the major bacterial agents, neonatal conjunctivitis most likely to be a hospital-acquired infection. There was a significant association between phototherapy, non-invasive ventilation and incidence of neonatal conjunctivitis . Gentamicin had high activity against the bacteria isolated in this study. Peer Review History: Received: 9 November 2021; Revised: 11 December; Accepted: 27 December, Available online: 15 January 2022 Academic Editor: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, [email protected] Dr. Jucimary Vieira dos Santos, Hemonorte Dalton Barbosa Cunha, Brazil, [email protected] Similar Articles: BACTERIAL CONJUNCTIVITIS OF ADULTS: CAUSES AND OPHTHALMIC ANTIBIOTIC RESISTANCE PATTERNS FOR THE COMMON BACTERIAL ISOLATES BACTERIAL CAUSES AND ANTIMICROBIAL SENSITIVITY PATTERN OF EXTERNAL OCULAR INFECTIONS IN SELECTED OPHTHALMOLOGY CLINICS IN SANA’A CITY

Comparison of the effects of remifentanil and dexmedetomidine on surgeon satisfaction with surgical field visualization and intraoperative bleeding during rhinoplasty

Objective We aimed to compare the effect of dexmedetomidine with remifentanil on hemodynamic stability, surgical field quality, and surgeon satisfaction during rhinoplasty. Methods and materials In this double-blind randomized controlled-trial, 60 participants scheduled for rhinoplasty at the Mother and Child Hospital, Shiraz, Iran, was randomely divided into the dexmedetomidine group (IV infusion of 1 μg/kg dexmedetomidine over 20 min before induction of anesthesia then 0.6 μg/kg/hr. dexmedetomidine from the time of induction until the end of the operation) or in the the remifentanil group (an infusion rate of 0.25 μg/kg/min from the time of anesthesia induction until the end of the operation). Bleeding volume, surgeon satisfaction, postoperative pain (visual analog scale (VAS)), Level of sedation (Richmond Agitation Sedation Scale (RASS)), Patient satisfaction, Vital signs & recovery, and the Aldrete Score (used to discharge the patients from recovery) were measured for all participants. Results The patients in the dexmedetomidine group had less bleeding (p = 0.047) and shorter time to return of respiration, extubation, and the postoperative recovery time (p < 0.001). The surgeon satisfaction was higher in the dexmedetomidine group (p < 0.001). Patient satisfaction was significantly different between the two groups (p < 0.001). VAS scores, intaking paracetamol, and RASS score were significantly lower in the remifentanil group (p < 0.001). SBP, DBP, MAP, and heart rate were lower in dexmedetomidine group. Conclusion Dexmedetomidine was associated with relatively stable hemodynamics, leading to decreased intraoperative bleeding, recovery time, and greater surgeon satisfaction and the level of consciousness in the recovery ward. However, painlessness and patient satisfaction were greater with the use of remifentanil. Trial registration IRCT20141009019470N112.

What Parents have to Say: Content and Actionability of Narrative Comments from Child HCAHPS Survey

OBJECTIVE: To examine the content and actionability of written comments from parents and guardians on the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) survey. METHODS: We coded 548 narrative text comments linked to demographic information from the Child HCAHPS survey from July 2017 to December 2020 about inpatient pediatric care at an urban children’s hospital-within-a-hospital at an academic medical center. We developed initial codes based on research findings and the content of the Child HCAHPS survey, and also added codes that emerged from the comments. We performed directed and conventional content analysis. RESULTS: Most comments were positive and provided by the child’s mother. About half referred to content on the Child HCAHPS survey, primarily on being treated with courtesy and respect or explaining care at discharge. Comments about other topics most frequently provided a narrative rating of the provider or described whether providers were caring and friendly. Thirty-nine percent of comments were deemed sufficiently specific to make improvements (ie, actionable) in inpatient pediatric care; negative comments or comments about care for sicker patients were more often actionable. CONCLUSIONS: Child HCAHPS comments provided rich detail and a large portion were deemed actionable. Comments also provided insights into topics both on the survey itself and on many other inpatient pediatric issues raised by parents and guardians. More research is needed on the value of Child HCAHPS comments, the association between Child HCAHPS open-ended and closed-ended responses, and how quality leaders and frontline staff use comments to improve inpatient pediatric care.

ANALISIS PENYEBAB OBAT KADALUARSA DI INSTALASI FARMASI RUMAH SAKIT IBU DAN ANAK ERIA BUNDA PEKANBARU TAHUN 2020

Pelayanan kefarmasian merupakan pelayanan penunjang serta pusat pendapatan utama bagi rumah sakit. Instalasi farmasi merupakan salah satu unit pelaksanaan fungsional yang menyelenggarakan seluruh kegiatan pelayanan kefarmasian. Di instalasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru berpotensi menghasilkan obat kadaluarsa yang dapat menimbulkan kerugian bagi rumah sakit. Tujuan dari penelitian ini adalah untuk mengetahui penyebab obat kadaluarsa di instalasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru. Penelitian ini merupakan penelitian kualitatif deskriptif. Subjek penelitian ini terdiri dari Kepala Instalasi Farmasi, Penanggung Jawab Farmasi Rawat Inap, Koordinator Perbekalan Farmasi dan Alkes, Staf Farmasi Rawat Jalan, dan Staf Gudang Farmasi. Dengan metode pengumpulan data menggunakan observasi dan wawancara. Dari hasil penelitian dapat disimpulkan bahwa penyebab obat kadaluarsa di instalasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru disebabkan oleh perencanaan obat yang terlalu berlebih dari konsumsi pemakaian rata-rata rumah sakit, pengadaan obat yang tidak memperkirakan berapa banyak obat yang mau dipesan, serta penyimpanan obat dikarenakan human error dimana kesalahan pada saat penyimpanan yang tidak FIFO dan FEFO. Saran bagi instlasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru yaitu dengan mengadakan pelatihan dan sosialisasi terhadap perencanaan dan pengadaan obat, serta meningkatkan pengawasan dalam melakukan penyimpanan obat. Pharmaceutical services are support services as well as the main revenue center for hospitals. The pharmacy installation is one of the functional implementation units that organize all pharmaceutical service activities. The pharmacy installation at the Eria Bunda Mother and Child Hospital in Pekanbaru has the potential to produce expired drugs that can cause harm to the hospital. The purpose of this study was to determine the causes of drug expiration in the pharmacy installation of Eria Bunda Mother and Child Hospital Pekanbaru. This research is descriptive qualitative research. The subjects of this study consisted of the Head of the Pharmacy Installation, the Person in Charge of Inpatient Pharmacy, the Coordinator of Pharmacy and Medical Devices, the Outpatient Pharmacy Staff, and the Pharmacy Warehouse Staff. With the data collection method using observation and interviews. From the results of the study, it can be concluded that the cause of expired drugs in the pharmacy installation of Eria Bunda Mother and Child Hospital Pekanbaru is caused by excessive drug planning than the average hospital consumption, drug procurement that does not predict how many drugs to order, and storage. medicine due to human error where the error during storage is not FIFO and FEFO. Suggestions for the pharmacy installation of Eria Bunda Mother and Child Hospital Pekanbaru, namely by holding training and socialization of drug planning and procurement, as well as increasing supervision in carrying out drug storage.

The Effect of Murottal Al-Quran Therapy on Pain in Post Cesarean Surgery Patients at Abby Mother and Child Hospital, Lhokseumawe City

Pain is an unpleasant sensory and emotional experience resulting from actual or potential tissue damage or described in terms of the damage. Murottal is a recording of the voice of the Qur'an sung by a qori (reader of the Qur'an). In this study, the degree of pain before murottal therapy was obtained based on the NRS (numeric rating scale) pain measuring instrument by the respondents, it was found that 8 patients (18.6%) had normal pain levels, 23 people (53.5%) experienced mild pain. ), and 12 people (27.9%) experienced moderate pain. Meanwhile, after murottal therapy based on the NRS pain measuring instrument (Numeric Rating Scale) by the respondents, it was found that patients with normal pain levels increased to 28 people (65.1%), and those who experienced mild pain became 15 people (34.9%). There is an effect of murottal Al-Qur'an therapy in lowering the pain intensity in post-cesarean patients at RSIA Abby, Lhokseumawe City

Gestational Diabetes Mellitus: Knowledge and Awareness

Gestational diabetes mellitus is a disorder of glucose intolerance which occurs for the first time during pregnancy. Gestational diabetes mellitus is major public health issue which is increasing day by day all over the world. It leads to the risk of obesity, type 2 diabetes and possibly adult cardiovascular disease in infant and increases rate of caesarean delivery and prenatal injury. This preliminary study is done to analyse the knowledge and awareness about GDM in antenatal women. Data were collected from government and private hospitals like Amrit Kaur Hospital, Shree maternity Child Hospital, Jain fertility Child ICU Hospital etc. Questionnaires were given to pregnant women who Visited hospitals for antenatal check up. A total no of 250 respondents were included in this study. Of total number of women only 52% were known to GDM. So the knowledge about GDM is average in women and most of the women gain this knowledge from their own experience. The study reveals that health program and camps should be organized to increase the knowledge about GDM. Key words: Gestational Diabetes Mellitus, Awareness, cardiovascular disease.

Distribution of Pfmdr 1 and Kelch 13 Genes Among the Children 5 Years and Below Attending a Secondary Health Facility, South-West, Nigeria.

Background: Malaria is a major public health concern in some part of the world especially in the tropical Africa where children are more vulnerable. The occurrence of resistant gene in Plasmodium falciparum to some antimalarial drugs could increase the malaria morbidity and mortality among the children. The study evaluates the distribution of P. falciparum resistant kelch protein gene on chromosome 13 (PfKelch 13) and multidrug resistant (Pfmdr1) mutant genes among children aged five years and below who attended Mother and Child Hospital, Akure, Nigeria. Methods: Thin and thick smears were prepared from the blood collected aseptically through venepuncture from five hundred (500) children (age 5years and below). Two hundred (200) malaria positive samples were randomly selected from the 500 samples for PCR analysis to detect Pfmdr1 and Kelch 13 mutant genes from the positive samples. Discussion: The results showed that of the 500 respondents who gave their consent to participate in the study, 288 (57.6%) were males while 212 (42.4%) were females. The distribution of Pfmdr1 are; mixed group (mutant/wild) 38.5% (77/200), mutant gene 35.5% (71/200), wild gene 20.5% (41/200) and the resistant genes were absent in 5.5% (11/200) of the infected children. The mixed group of Pfmdr1 gene was higher among infants (51.9%), male (44.3%), children with birth order 4 (60.0%) and children that have blood group B (51.3%), however, there is no significant difference in the distribution of Pfmdr1 between gender (χ2 = 0.634, df = 1, p>0.05). There was a point mutation in the codon position 557 where the amino acid Alanine was replaced by Serine in the PfK13. The research revealed high prevalence of Pfmdr1 mutant genes and point mutation in the PfK13 gene of P. falciparum among children which may be as a result of treatment of malaria with different antimalarial drugs which the parasite has developed resistance against. It is therefore important to administer other malaria drugs apart from the drugs the parasite has developed resistance against.

P074 Prolonged fever in children: Epidemiological and etiological profile in the eastern region of Morocco—about 119 cases

Background Prolonged fevers (PF) are defined as a thermal shift &gt;38 ° C without any immediately obvious cause (fever of unknown origin). The fever is considered as prolonged when it lasts at least 7 days in children and 5 days in infants. PF constitute a frequent reason for consultation. Our Objective is to highlight the epidemiological and etiological profile of prolonged fevers in children in the eastern region of Morocco. Material and methods Our work is a retrospective study of 119 cases, conducted from January 1, 2015 to July 31, 2018 in the pediatric department of the C.H.U Mohammed VI Mother-Child Hospital in Oujda, Morocco. Results The hospital incidence of PF in this study was 2.8%. The patients average age was 49 months. A male predominance was noted (63 boys). The patients were living in urban zone in 76% of cases. The symptom duration before first consultation was 18 days. Children with a history of suspected but not confirmed infection with notion of taking antibiotics and antipyretics were noted in 30% of cases. The functional signs were dominated by digestive symptoms in 34 patients, followed by mucocutaneous signs in 26% of cases, and cardiorespiratory manifestations in 12% of cases. The main physical signs were represented by a tumor syndrome in 34 patients, and 31 cases of cutaneous involvement. The etiologic diagnosis was confirmed by an abdominal ultrasound in 48% of cases, a myelogram in 19% of cases, a chest X-ray in 17% of cases, and a cardiac ultrasound in 14.5% of cases. At the end of the etiological investigation, the infectious causes were in 52 cases, inflammatory diseases in 32 cases, neoplasia in 27 cases, and undetermined causes 8 cases. Discussion The hospital incidence of prolonged fevers is difficult to estimate because of the nosological problem they pose. However, FP constitutes 0.4% to3% of the reasons for pediatric hospitalization. In our study, it was 2.8%. Regarding age, almost half of the children hospitalized for FP exploration are under the age of six. This can be explained by the high frequency of febrile diseases, in particular infectious diseases, at this age the male predominance was marked in most studies with a sex ratio ranging from 1.1–1.8. The clinical signs on admission did not allow a clear etiological orientation, and it was the repeated questioning and physical examination during hospitalization that guided the etiological investigation. The most common feature is infectious causes. There is a high percentage of neoplastic causes compared with the literature. Indeterminate causes constitute only 6.7% compared with higher figures in the literature which can be explained by the progress of examinations in the field of etiological research. Conclusion Prolonged fevers in children therefore remains a complex condition to handle despite advances in diagnostic means. Careful clinical examination is necessary for the management of children with PF. In fact, the patient should be regularly reassessed in search of new symptoms and other investigation leads. The reasoned prescription of additional workups and critical analysis of clinical signs are also essential steps in the etiological investigation.

Epidemiologic Characteristics of and Prognostic Factors for COVID-19 Among Hospitalized Patients: Updated Implications From Hubei Province, China

Introduction: The roles of some indicators in the prognosis of patients with coronavirus disease-19 (COVID-19) remain unclear and controversial. This study aimed to explore the epidemiologic characteristics of and prognostic factors for COVID-19 to provide updated recommendations for its prevention, diagnosis, and treatment.Methods: For this retrospective study, demographic, epidemiologic, and clinical data were extracted from the medical records of patients admitted to the Maternal and Child Hospital of Hubei Province (Optical Valley) with COVID-19 between February 19, 2020, and March 19, 2020. The primary outcome was the prognosis that was determined at discharge as mentioned in the medical records. Descriptive statistics, univariate analyses, and stepwise logistic regression analysis were used for data analysis.Results: Of the 1,765 patients included, 93.1% were cured and the mortality was 1.8%. Univariate analyses identified 63 factors significantly associated with COVID-19 prognosis. Logistic regression analysis revealed that a poorer prognosis was associated with undergoing resuscitation, complex disease manifestations, consultation with outside specialists, elevated basophil or lymphocyte counts, an albumin (ALB)/globulin (A/G) ratio &gt; 2.4, and elevated levels of serum aspartate aminotransferase (AST) or creatinine. Patients had a better prognosis if the following conditions were met: dry cough reported as an initial symptom, fatigue as a clinical manifestation, and a diagnosis based on laboratory testing.Conclusion: To prevent clinical deterioration, clinicians should provide special care to patients who underwent resuscitation, with a critical disease, or requiring consultation with outside specialists. Extra attention should be paid to patients with high basophil or lymphocyte counts, a high A/G ratio, and elevated AST or creatinine levels.

PLAN OF ORTHOPEDIC AND TRAUMATOLOGY SPECIALIST HOSPITAL

<p>Along with the times, the quality and quantity of hospitals in Indonesia also continue to grow. According to Statistics in Indonesia, the number of births in Indonesia is still high, as well as the mortality rate shown by the 2012 medical survey which is also still high. So that improving the quantity and quality of maternal and child is still needed. Based on data from the Ministry of Health of the Republic of Indonesia, pregnant women do not have access to go to midwives or doctors in the regions. Suburban communities, especially in the Medan Sunggal area, do not get adequate services and facilities in terms of health, especially maternal and child health. So with that, the Mother and Child Hospital will be established in the Medan Sunggal area is expected to fullfill the necessities of the community in the suburbs of Medan. The Mother and Child Hospital was designed with the theme of Green Architecture so that the resulting building design is comfortable with an environmentally friendly atmosphere so that it can be considered to be the main destination for everyone who is pregnant and giving birth.</p>