scholarly journals The risk factor of metastatic status of retinoblastoma patient in Yogyakarta Tertiary Hospital

2020 ◽  
Vol 52 (01) ◽  
Author(s):  
Agus Supartoto ◽  
Sri Nawunghartanti ◽  
Banu Aji Dibyasakti ◽  
Purjanto Tepo Utomo ◽  
Datu Respatika ◽  
...  
Keyword(s):  
Risk Factor ◽  
Tertiary Hospital ◽  
Retinoblastoma Patient

Risk factor analysis for piperacillin-tazobactam-resistant Enterobacter spp. bacteremia at a tertiary hospital

2021 ◽  
pp. 115342
Author(s):  
Kazushi Yamairi ◽  
Koichi Yamada ◽  
Waki Imoto ◽  
Gaku Kuwabara ◽  
Wataru Shibata ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Risk Factor ◽  
Tertiary Hospital ◽  
Risk Factor Analysis

Intra-Abdominal Hypertension is a Risk Factor for Increased VAP Incidence: A Prospective Cohort Study in the ICU of a Tertiary Hospital

2018 ◽  
Vol 35 (7) ◽  
pp. 700-707 ◽  
Author(s):  
Eleni Papakrivou ◽  
Demosthenes Makris ◽  
Efstratios Manoulakas ◽  
Marios Karvouniaris ◽  
Epaminondas Zakynthinos
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis ◽  
Abdominal Hypertension

Background: Ventilator-associated pneumonia (VAP) might be increased in cases with intra-abdominal hypertension (IAH). However, despite animal experimentation and physiological studies on humans in favor of this hypothesis, there is no definitive clinical data that IAH is associated with VAP. We therefore aimed to study whether IAH is a risk factor for increased incidence of VAP in critical care patients. This 1-center prospective observational cohort study was conducted in the intensive care unit of the University Hospital of Larissa, Greece, during 2013 to 2015. Consecutive patients were recruited if they presented risk factors for IAH at admission and were evaluated systematically for IAH and VAP for a 28-day period. Results: Forty-five (36.6%) of 123 patients presented IAH and 45 (36.6%) presented VAP; 24 patients presented VAP following IAH. Cox regression analysis showed that VAP was independently associated with IAH (1.06 [1.01-1.11]; P = .053), while there was an indication for an independent association between VAP and abdominal surgery (1.62 [0.87-3.03]; P = .11] and chronic obstructive pulmonary disease (1.79 [0.96-3.37]; P = .06). Conclusions: Intra-abdominal hypertension is an independent risk factor for increased VAP incidence in critically ill patients who present risk factors for IAH at admission to the ICU.

scholarly journals Gender Differences in Oesophageal Squamous Cell Carcinoma in a South African Tertiary Hospital

2020 ◽  
Vol 17 (19) ◽  
pp. 7086
Author(s):  
Lucien Ferndale ◽  
Colleen Aldous ◽  
Richard Hift ◽  
Sandie Thomson
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Presentation ◽  
Tertiary Hospital ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Males And Females

(1) Oesophageal squamous cell carcinoma is common in Africa and has a male preponderance. The gender-based differences in clinical presentation and risk factor exposure are poorly studied in the African context. Our aim was to compare males and females with this disease. We analyzed the differences in clinical features and risk factor exposure between males and females with oesophageal cancer. (2) Data from patients presenting to a tertiary hospital in South Africa with oesophageal squamous cell carcinoma were analyzed. Data collected included patient demographics, clinical presentation, pathology and risk factor exposure. (3) Three hundred and sixty three patients were included in the study. The male to female ratio was 1.4:1. The mean age was 66 years for females and 61 years for males (p < 0.0001). A significantly larger percentage of males were underweight compared to females (60% vs. 32%, p < 0.001). There were no differences between the genders with regards to performance status, dysphagia grade and duration and tumor length, location and degree of differentiation. There were significant differences between risk factor exposure between the two genders. Smoking and alcohol consumption was an association in more than 70% of males but in less than 10% of females There was no difference survival. (4) Female patients with oesophageal squamous cell carcinoma (OSCC) are older and have a higher body mass index (BMI) than their male counterparts. Traditionally purported risk factors of smoking and alcohol consumption are infrequent associations with OSCC in female patients and other environmental risk factors may be more relevant in this gender.

scholarly journals Prevalence and clinical characteristics of otitis externa among patients attending Otorhinolaryngology Department at Muhimbili National Hospital, Tanzania

2019 ◽  
Vol 5 (4) ◽  
pp. 826
Author(s):  
Zephania Saitabau Abraham ◽  
Onesmo Tarimo ◽  
Aveline Aloyce Kahinga ◽  
Daudi Ntunaguzi ◽  
Kassim Babu Mapondella ◽  
...  
Keyword(s):  
Risk Factor ◽  
Otitis Externa ◽  
Clinical Characteristics ◽  
Public Awareness ◽  
Tertiary Hospital ◽  
Age Group ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Male Predominance

<p class="abstract"><strong>Background:</strong> Otitis externa is among the otological diseases with significant impact on the quality of life of sufferers. Little is known in Sub Saharan countries despite being the focus of such disease. The study aimed to determine the prevalence and clinical characteristics of otitis externa at Muhimbili National Hospital, Tanzania’s largest tertiary hospital.</p><p class="abstract"><strong>Methods:</strong> This was a hospital based descriptive cross sectional study where 1200 participants were recruited from June 2016 to January 2017. Data was analyzed using SPSS program version 20.  </p><p class="abstract"><strong>Results:</strong> A total of 1200 patients were recruited in this study and majority 601(50.1%) were females. Majority 672(56%) were in age group 0–10 years. Among 1200 patients, 138 (11.5%) were diagnosed to have otitis externa and male predominance (55.1%) was found. Majority 120 (87%) had diffuse otitis externa and with 0-10 years (25.83%) being the commonly affected age group by variant. The commonest risk factor was self-ear cleansing 87(53.7%) and only 2.9% were found to have complications of otitis externa.</p><p class="abstract"><strong>Conclusions:</strong> Otitis externa was found to be prevalent and with male predominance. Self-ear cleansing was the commonest risk factor. Complications of otitis externa were found to be rare. Public awareness on otitis externa should be advocated in our country.</p>

Urine Incontinence Before and After Delivery in Primipara

2020 ◽  
Vol 2 (2) ◽  
pp. 67-72
Author(s):  
Prezma Shrestha
Keyword(s):  
Risk Factor ◽  
Urinary Incontinence ◽  
Vaginal Delivery ◽  
Muscle Tone ◽  
Mode Of Delivery ◽  
Study Finding ◽  
Antenatal Clinic ◽  
Tertiary Hospital ◽  
Pregnancy And Postpartum ◽  
Perineal Muscle

Introduction: Urinary incontinence is a common condition in pregnancy and postpartum period. It causes discomfort, embarrassment, loss of confidence and self esteem. This study aimed to determine the occurrence of urinary incontinence in pregnant attending antenatal clinic in a tertiary hospital. Methods: A descriptive observational study was conducted to find out occurrence of urinary incontinence in primiparous attending department of obstetrics and gynecology from August 2014 to August 2015 at B.P. Koirala Institute of Health Sciences. Results: The total of 100 primigravida were enrolled in the study. Out of which six had urinary incontinence with mean age of 23 years. Most of them were in the period of gestation group 38–40 weeks. 22% of total were obese with mean BMI of 26.69 kg/m2. Seventy nine patients had vaginal delivery, four had vacuum assisted vaginal delivery and 17 had cesarean section. Age and Body Mass Index (BMI) was not found to be associated with urinary incontinence. Oxford grading for assessment of perineal muscle after delivery showed decline in pelvic muscle tone which was significantly associated with urinary incontinence. However, the mode of delivery, and birth weight of baby was not found to be significant. Conclusion: The study finding suggested that pregnancy acts a risk factor for development of UI although no preference could be drawn regarding the mode of delivery. Our study also concluded antepartum UI as a risk factor for postpartum UI.

scholarly journals Prevalence of Anaemia in Children Diagnosed with Pneumonia in a Tertiary Hospital in Quito, Ecuador: Correspondence

2019 ◽  
Vol 39 (1) ◽  
pp. 63-64
Author(s):  
Nagendra Chaudhary ◽  
Sandeep Shrestha ◽  
Santosh Pathak
Keyword(s):  
Risk Factor ◽  
Iron Deficiency ◽  
Respiratory Diseases ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Nutritional Deficiencies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Physical Findings ◽  
Prevalence Of Anemia

Dear editor, We read with interest the article “Prevalence of Anaemia in Children Diagnosed with Pneumonia in a Tertiary Hospital in Quito, Ecuador” in the recent issue of your esteemed journal and found it very useful and informative1. This article presents the prevalence of anemia in children with pneumonia. However, there are certain points we would like to comment and highlight which might bring more clarity to this issue and will be useful to the readers of JNPS. In the abstract (conclusion section), the authors have mentioned that “anaemia or nutritional deficiencies could be a risk factor for respiratory diseases”. The authors seem to draw a conclusion on “nutritional deficiencies” as a risk factor for respiratory disease without any evidence or data provided in the results. We feel that it should better be omitted from the conclusion. The authors have mentioned that they used physical findings such as: fever, tachypnea, breathing difficulties, rhonchi, crackles, and wheezing to diagnose pneumonia and them again have mentioned using WHO tachypnea threshold to diagnose pneumonia. It is very unlikely for all the 80 cases to have all the above listed physical findings. Diagnosis of pneumonia in children remains an important yet difficult clinical problem. WHO criteria which uses the presence of cough, fast breathing and chest indrawing to diagnose pneumonia may over-estimate the diagnosis of actual pneumonia2. Chest radiograph remains a diagnostic test of choice in hospitals3. The readers would be keen to know which diagnostic criteria the authors had used to diagnose pneumonia (either clinical or radiological?). If they had used the clinical criteria, what were the exact parameters used to diagnose pneumonia needs further clarification. The authors also need to reply the reason of not including cough and retractions in the inclusion criteria to diagnose pneumonia. The readers would also be keen to know that if any attempt was made to exclude pneumonia like illnesses e.g., bronchiolitis, asthma or cardiac diseases which can mimic pneumonia. The authors have mentioned that diagnosis of concomitant conditions that could affect anthropometric or haemoglobin parameters, or that could predispose to pneumonia were excluded. The readers would be interested to know (a) what anthropometric parameters or hemoglobin parameters were excluded and (b) what factors predisposing to pneumonia were excluded which is missing in the material and methods. The authors have concluded that anaemia is a frequent condition in paediatric pneumonia and could be a risk factor for respiratory diseases. The study done by the authors was a cross-sectional study which has always a chance of selection bias4. The increased prevalence of anemia in pneumonia patients could have been due to chance, we do not know. Therefore, it is very difficult to answer (in a cross-sectional study) either anemia is prevalent in children with pneumonia or not unless we have some cohort studies on the same. This should have been mentioned as one of the limitations of the study. The readers would be interested to know regarding any iron supplements in children aged more than 3 years which might be the cause of decrease prevalence of anemia in this age group. In the discussion section, the authors have tried to convince that anemia in the study groups was most likely due to iron deficiency. They have used hemoglobin, MCV and RDW to support the diagnosis of iron deficiency anemia. The sensitivity and specificity of MCV to diagnose IDA is 61.7% and 59.1% respectively with a positive predictive value of 70% 5 whereas using RDW as a criteria to diagnose IDA has a sensitivity of 81% and specificity of 53.4%6. In the discussion, the authors have emphasized iron deficiency as the cause of anemia in the cases. The authors need to explain that how can they be sure that all the cases of anemia in their study was due to iron deficiency without undergoing iron profile (serum ferritin, % saturation, TIBC). It is well known that with subclinical infection, serum iron concentrations are reduced, altering the synthesis of hemoglobin, the main indicator of anemia7. The readers would be interested to know if any attempts were made to exclude those subclinical infections from the enrolled cases with pneumonia.

scholarly journals The 12-month period prevalence and cardiac manifestations of HIV in patients with acute coronary syndrome at a tertiary hospital in Cape Town, South Africa: a retrospective cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Camilla Pennefather ◽  
Tonya Esterhuizen ◽  
Anton Doubell ◽  
Eric H. Decloedt
Keyword(s):  
South Africa ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Tertiary Hospital ◽  
Hiv Positive ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Cardiac Manifestations ◽  
Single Vessel Disease ◽  
Hiv Negative

Abstract Background HIV-positive patients are increasingly being affected by non-communicable diseases such as coronary artery disease (CAD). Data from high-income countries (HICs) indicate that HIV-positive patients have different risk-factor profiles for acute coronary syndrome (ACS) as well as different cardiac manifestations of this syndrome compared to HIV-negative patients. There is limited data from Sub-Saharan Africa (SSA), and particularly from South Africa with the biggest HIV epidemic in the world. The objective of this study was to determine the 12-month period prevalence of HIV in patients with ACS and to compare the risk-factor profile, ACS presentation and management between HIV-positive and HIV-negative adults. Methods We included all patients hospitalised with ACS from 01 January to 31 December 2018 in a tertiary hospital, Tygerberg Hospital, in Cape Town, South Africa. The HIV-status of all patients was determined using routine clinical records. We performed multiple conditional logistic regression on HIV-positive and HIV-negative patients (1:3 ratio) to compare the risk factor profile, ACS presentation and management between the groups. Results Among 889 patients, 30 (3.4%) were HIV-positive (95% confidence interval (CI): 2.3–4.8). HIV-positive patients were younger, more frequently men, and had a lower prevalence of medical comorbidities and a family history of CAD. They were more likely to present with ST-elevation myocardial infarction (STEMI) [odd’s ratio (OR) (95% CI): 3.12 (1.2–8.4)], and have single-vessel disease [OR (95% CI): 3.03 (1.2–8.0)]. Angiographic and echocardiographic data, as well as management, did not differ between the groups. Among HIV-positive patients, 17 (65%) were virally suppressed (HIV viral load < 200 copies/mL) with a median CD4+ count of 271 cells/mm3. The majority (20, 67%) of HIV-positive patients were receiving antiretroviral therapy at the time of the ACS. Conclusions We found an HIV-prevalence of 3.4% (95% CI 2.3–4.8) in adults with ACS in a high endemic HIV region. HIV-positive patients were younger and more likely to present with STEMIs and single-vessel disease, but had fewer CAD risk factors, suggesting additional mechanisms for the development of ACS.

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