Prospective Descriptive Study Research Articles

Profile of renal conditions among pediatric emergency patients

BackgroundRenal diseases are frequently seen in the pediatric emergency department (ED), and usually, they are associated with morbidity and mortality if not early detected and properly managed. While acute kidney injury (AKI) can result from intrinsic kidney disease, many acute (nonrenal) conditions may be associated with AKI. In addition, children with chronic kidney disease (CKD) may also present to the ED with acute symptoms or complications.AimTo evaluate patients presenting to the ED with renal affection, their etiology, management, and outcome.Patients and methodsThis is a prospective descriptive study on 100 patients presented to Cairo University Pediatric ED with renal affection, from Jan to June 2023. Clinical data were collected including presenting manifestations, vital signs, clinical assessment, laboratory and radiological investigations, and also their plan of management or interventions needed and their outcome.ResultsSeventy-three percent of the patients had underlying CKD, and they presented mostly with acute complications as urinary tract infections (20%), severe anemia (25%), disturbed conscious level (10%), convulsions (12%), and hypertensive emergency (18%). Of the AKI patients (27%), 18% had underlying renal diseases, and 9% had multisystem affection. All of our patients received conservative management, 74 patients were admitted at the hospital, 24 patients needed ICU admission, 14 patients did peritoneal dialysis, 6 did hemodialysis, and only 1 patient needed continuous renal replacement therapy. Mortality was observed in only 2% of our patients.ConclusionPatients with renal conditions either AKI or CKD present to the ED with various acute conditions. Proper identification and provision of required services is important for a satisfactory outcome.

Clinical Profile and Pediatric Patterns in Predicting Sepsis Among Febrile Inpatients at an Indian Hospital: A Prospective Observational Study

Background: Sepsis is a global perpetrator of pediatric morbidity and mortality. This research aims to analyze the clinical profile of febrile pediatric patients with a risk of sepsis to study underlying patterns involved and understand clinician perspectives to ensure diagnostic accuracy and assess the management and outcomes. Methods: In this prospective cross sectional descriptive study 300 febrile inpatients of 1 month to 13 years of age with one or more sepsis warning signs were examined. Patient factors affecting progression towards sepsis were analyzed, along with age-related patterns of tachycardia and tachypnea. Risk of developing sepsis was compared with degree of elevation in TLC, patient admission and outcome on discharge. The study also extended towards segregating most relied markers of sepsis by comparing prevalence among various risk groups. Results: Factors such as male gender, infancy, and incomplete vaccination status were found to increase the chances of developing sepsis. Diverse diagnoses heightened sepsis likelihood to varying extents. Tachycardia and tachypnea followed a pattern of manifesting most among infants. The study demonstrated a direct link between rising sepsis risk and elevating TLC levels. Quantification of PS6 interventions demonstrated that adrenaline was the most commonly used ionotrope and IVF DNS was the most used isotonic fluid. Conclusion: The unpredictable nature of pediatric sepsis can be tackled by an effective understanding of the patterns by which it manifests. Early detection of sepsis relies on pediatric patterns and established symptomatology approved commonly among clinicians which demands constant evaluation to ensure appropriateness and diagnostic consistency. Keywords: Biomarkers, Acute febrile illness, Pediatric Intensive care Unit (PICU), Neonatal intensive care unit (NICU), SIRS

49. ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT GÃY KÍN CỔ PHẪU THUẬT XƯƠNG CÁNH TAY BẰNG NẸP VÍT KHÓA TRÊN BỆNH NHÂN LỚN TUỔI TẠI BỆNH VIỆN THỐNG NHẤT

Objectives: To describe the clinical characteristics, X-ray images and results of treatment of proximal humerus fractures by the method of combining the locking plate at Thống Nhất Hospital. Subjects and Methods: Retrospective and prospective cross-sectional descriptive study on 19 patients between 2021 and 2024. Result: Mean age of study patients is 70,5. The results of post-surgery correction without displacement accounted for a high rate with 94,7%. The humerus neck angle after surgery achieved good results, accounting for 100%. The rate of patients without pain after surgery accounted for 81.3%. The percentage of patients with good overall results accounted for 63,3%.

The Effect of Genital Aesthetic Surgery on Body Image Cathexis and Sexual Function in Women.

The emotions that women generally feel about the appearance of their bodies cause them to turn to aesthetics surgery. This study was conducted to determine the effect of genital aesthetic surgery on body image cathexis and sexual function in women. This descriptive-prospective study was conducted between November 1, 2022, and July 30, 2023, with 50 women who applied to the gynecology service in a training and research hospital. Sociodemographic and descriptive characteristics questionnaire, body image cathexis scale, and female sexual function index were filled out before surgery. The patients whose contact information was obtained were called by phone 2 months after surgery and the body image cathexis scale and the female sexual function index were administered again. Frequency analysis, t-test, and one-way analysis of variance were used to evaluate the data. Significance was accepted as p<0.05. The average age of the women was 39.26±10.28 (22-68) and the mean body mass was 25.39±4.55 (17.6-39.8). The majority of women (44%) underwent perineoplasty. It was observed that the level of body cathexis after genital aesthetics surgery was significantly higher than the preoperative body cathexis, and the general level of sexual function, desire, arousal, orgasm, and satisfaction level increased significantly after surgery. Female genital aesthetics surgery was found to improve body cathexis and increase sexual function in women. In order to reduce unnecessary female genital aesthetic surgery, education should be planned on this subject and public awareness about genital appearance should be increased. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Study Of Unknown Dead Bodies Brought For Post Mortem In Tertiary Hospital

Background: Medico legal autopsies are conducted in India in two circumstances: cases where a person has died because of unnatural circumstances and where the body of the deceased is unidentified. The present study relates to the latter of the two aforementioned circumstances, i.e. where the dead body is not identified. Methodology: In present descriptive prospective study the size and magnitude of problems regarding unidentified bodies. Also the profile of unidentified dead bodies such as age, cause of death, post-mortem interval, manner of death, seasonal trends, area (urban or rural), place from where the body was recovered was studied Results: Total 1919 bodies were brought to us of which 169 cases were selected. The mean age of the patients was 44.82±14.83 years with male predominance. Most of the cases were identified on the basis of the clothes belonging and 16.57% bodies were brought from the rural areas. Majority of the unidentified bodies were found in the autumn season (28.99 %). Maximum unidentified dead bodies were discovered at religious places (n= 64, 37.87 %). In the present study, most deaths were natural, n=114 (67.46 %) and the majority of autopsies were performed between 4 and 6 days (n= 73, 43.20%) Regarding the cause of death according to police records in the present study, it was determined that there were the most cases of illness/ diseased condition (n=55). Conclusion: Unknown/unclaimed should be presented for autopsy forthwith without any delay so that decomposition and other artifacts do not set in and obscure the findings of the postmortem examination

Can Pregnancy Experience Predict Birth Experience, Postpartum Depression and Anxiety? A Prospective Descriptive Study.

A positive pregnancy experience can be a good start for healthy motherhood. This study aimed to investigate Iranian women's pregnancy experience and how self-reported hassles and uplifts influence birth experience, postpartum depression and anxiety, and the association between childbirth experience and postpartum mental health. A prospective descriptive study. A prospective descriptive study was conducted among 228 pregnant women from health centres in Tabriz, Iran. From the 28th to 36th weeks of pregnancy, participants completed the Pregnancy Experience Scale. Then, the mothers were followed up until 4-6 weeks postpartum, and Childbirth Experience Questionnaires version 2.0, Edinburgh Postnatal Depression and the short form of Specific Postpartum Anxiety Scales were completed. The data were analysed using the general linear model. After adjusting for possible confounding variables, there was no statistically significant association between women's pregnancy and childbirth experiences. However, the mean scores of postpartum depression and anxiety were significantly higher in women who felt unhappy about the discomforts that they experienced during pregnancy (β [95% CI] = 0.01 [0.01-0.02]; p < 0.001, 0.22 [0.09-0.35]; p = 0.001, respectively). There was a significant statistical reverse association between childbirth experience and postpartum anxiety and depression. The study demonstrated a significant association between women's pregnancy, birth experiences and postpartum psychological outcomes. Implementing interventions that create a positive pregnancy experience will likely have an impact on reducing the prevalence of postpartum depression and anxiety. Pregnant women participated solely in the data collection by responding to the questionnaires. No participant contributions were required for the study's design, outcome measurement or implementation.

Prognostic Factors of Acute Intestinal Obstruction in the General Surgery Department of the Ignace Deen National Hospital

Introduction: The aim of this work was to highlight the prognostic factors of acute intestinal obstruction in the general surgery department of the Ignace Deen National Hospital, Conakry University Hospital. Methods: This was a prospective descriptive study of six months from January to June 2021 on patients admitted and operated on in the general surgery department of the Ignace Deen National Hospital for acute intestinal obstruction. Results: Acute intestinal obstructions represented 10.1% (n = 102) of abdominal surgical emergencies (n = 1005). The mean age was 47.64 ± 19.16 years with extremes of 1 and 86 years. The sex ratio was 1.37 in favor of men. The location of the obstacle was high (58.8%), low (33.3%) and mixed in 7.8%. The strangulation mechanism was the most frequent 92.3%. Necrosis 27.5%. An intestinal resection was performed in 37.3%. Septic complications were 14.1% including parietal suppuration 7.6%. The average hospital stay was 13.25 days. Overall mortality was 15.6% (n = 16). This was statistically correlated with strangulation (p = 0.015), intestinal necrosis (p = 0.004), delay in consultation (p = 0.000), age (p = 0.008) and delay in treatment (p = 0.021). Conclusion: Acute intestinal occlusions are a common medical and surgical emergency. Morbidity and mortality remain high and often linked to age, delay in consultation, mechanism, and the occurrence of necrosis, which are prognostic factors that are mostly modifiable. Management requires multidisciplinary collaboration or resuscitation plays a prominent role.

Endometrial extracellular vesicles regulate processes related to embryo development and implantation in human blastocysts.

What is the transcriptomic response of human blastocysts following internalization of extracellular vesicles (EVs) secreted by the human endometrium? EVs secreted by the maternal endometrium induce a transcriptomic response in human embryos that modulates molecular mechanisms related to embryo development and implantation. EVs mediate intercellular communication by transporting various molecules, and endometrial EVs have been postulated to be involved in the molecular regulation of embryo implantation. Our previous studies showed that endometrial EVs carry miRNAs and proteins associated with implantation events that can be taken up by human blastocysts; however, no studies have yet investigated the transcriptomic response of human embryos to this EV uptake, which is crucial to demonstrate the functional significance of this communication system. A prospective descriptive study was performed. Primary human endometrial epithelial cells (pHEECs), derived from endometrial biopsies collected from fertile oocyte donors (n = 20), were cultured in vitro to isolate secreted EVs. Following EV characterization, Day 5 human blastocysts (n = 24) were cultured in the presence or absence of the EVs for 24 h and evaluated by RNA-sequencing. EVs were isolated from the conditioned culture media using ultracentrifugation, and characterization was performed using western blot, nanoparticle tracking analysis, and transmission electron microscopy. Human blastocysts were devitrified, divided into two groups (n = 12/group), and cultured in vitro for 24 h with or without previously isolated EVs. RNA-sequencing analysis was performed, and DESeq2 was used to identify differentially expressed genes (DEGs) (FDR < 0.05). QIAGEN Ingenuity Pathway Analysis was used to perform the functional enrichment analysis and integration with our recently published data from the pHEECs' EV-miRNA cargo. Characterization confirmed the isolation of EVs from pHEECs' conditioned culture media. Among the DEGs in blastocysts co-cultured with EVs, we found 519 were significantly upregulated and 395 were significantly downregulated. These DEGs were significantly enriched in upregulated functions related to embryonic development, cellular invasion and migration, cell cycle, cellular organization and assembly, gene expression, and cell viability; and downregulated functions related to cell death and DNA fragmentation. Further, the intracellular signaling pathways regulated by the internalization of endometrial EVs were previously related to early embryo development and implantation potential, for their role in pluripotency, cellular homeostasis, early embryogenesis, and implantation-related processes. Finally, integrating data from miRNA cargo of EVs, we found that the miRNAs carried by endometrial EVs targeted nearly 80% of the DEGs in human blastocysts. This is an in vitro study in which conditions of endometrial cell culture could not mimic the intrauterine environment. This study provides novel insights into the functional relevance of EVs secreted by the human endometrium, and particularly the role of EV-miRNA regulation on global transcriptome behavior of human blastocysts during early embryogenesis and embryo implantation. It provides potential biomarkers that could become useful diagnostic targets for predicting implantation success. This study was supported by the Spanish Ministry of Education through FPU awarded to M.S.-B. (FPU18/03735), Generalitat Valenciana through VALi+d Programme awarded to M.C.C.-G. (ACIF/2019/139), and Instituto de Salud Carlos III and cofounded by the European Social Fund (ESF) "Investing in your future" through the Miguel Servet Program (CP20/00120 [H.F.]; CP19/00149 [I.C.]). The authors have no conflicts of interest to disclose. N/A.

Evaluation of Serological Tests for Different Disease Stages of Leptospirosis Infection in Humans.

Leptospirosis is a zoonotic disease that is widely distributed around the world and presents symptoms similar to other febrile illnesses in tropical regions, which complicates clinical diagnosis. This study aimed to evaluate the performance and agreement between serological diagnostic tests for detecting both acute and convalescent human leptospirosis, using the micro agglutination test (MAT) as a reference in an endemic region of the Colombian Caribbean. A prospective descriptive study was conducted on 275 participants with suspected leptospirosis. Paired serum samples were obtained, and an epidemiological survey was conducted. Using the MAT as the gold standard, we calculated positive and negative predictive values, sensitivity, specificity, and kappa index. A Bayesian latent class model was also used to compare the diagnostic tests. In 223 paired serum samples, the sensitivity values for various stages of the disease ranged between 10.8% to 54.1% in the acute and 6.1% to 66.7% during the convalescent phase compared to the MAT. According to the Bayesian model, sensitivity was 9.5% to 75.3% in the acute phase and 5.7% to 85.3% in the convalescent phase. The Kappa value, an indicator of agreement, was moderate for the IgM ELISA in the acute phase (0.553) and substantial in the convalescent phase (0.692). The MAT was the best confirmatory test in both acute and convalescent phases of leptospirosis. Despite the high specificity of ELISA, 21.62% of participants identified as negative by IgM-ELISA in both phases were subsequently confirmed as positive by the MAT. It is necessary to re-evaluate diagnostic guidelines that do not employ the MAT for confirmation and to enhance the diagnostic and clinical identification of leptospirosis within healthcare institutions and public health laboratories while providing a rapid and reliable test for its implementation.

QLTI-01. ASSESSING THE EFFECTIVENESS OF SUPPORT FROM ST. JUDE CHILDREN’S RESEARCH HOSPITAL TO VIETNAMESE TEAM IN TREATMENT FOR CHILDREN WITH BRAIN TUMORS

Abstract BACKGROUND Treatment for children with brain tumors requires multidisciplinary team (MDT) which is lacking in Vietnam which negatively impacts outcome. This study aims to describe the implementation and promotion of MDT approach in Vietnam with the support of St. Jude Children’s Research Hospital. METHODS We conducted a prospective descriptive study of St. Jude Children’s Research Hospital’s activities with the Vietnamese team between August 2023 and March 2024 and its impact on education, patient care and disseminating of MDC approach in Vietnam. RESULTS Onsite and online training were provided for the Vietnamese team during this time. The onsite training included exchange visits for both teams and St. Jude support for Vietnamese colleagues to attend regional and international neuro-oncology conferences. Online case discussions have been held every month from January 2024 and there are 40-60 participants each meeting from 5 main oncology centers in Vietnam. There are 3- 4 complex case discussions each meeting. A zalo group (a social media platform) for Vietnamese doctors (92 doctors) with multidisciplinary team members was established. After discussion, references and summaries of each case were distributed to the zalo group. For emergency cases, email consults are requested directly for timely input. In addition, key educational textbooks covering different disciplines of neuro-oncology (pathology, radiology and medical) were provided to different Vietnamese teams. All participants (92 doctors) found the online discussion (100.0%) benefical to further their knowledge in different fields (chemotherapy, radiation, pathology and surgery) and the outcome of consultations which guided teams to manage difficult cases. For some cases, pathology samples with local reports are sent to St. Jude to review the diagnosis and classification. CONCLUSIONS Training plays an important role in bringing knowledge and building team-based experience for Vietnamese clinicians in the treatment for children with brain tumor.

Các yếu tố tiên lượng của bệnh nhân chảy máu não cấp vùng trên lều do tăng huyết áp

Objectives: Comments on the relationship of prognostic factors in patients with acute supratentorial cerebral hemorrhage due to hypertension. Subjects and method: A cross-sectional, prospective descriptive study was conducted on 150 patients diagnosed with acute supratentorial cerebral hemorrhage due to hypertension, admitted for inpatient treatment at the Neurology Center, Bach Mai Hospital from August 1, 2023 to July 31, 2024. Results: The rate of patients with good outcome after 3 months (73.3%). In terms of prognostic factors, the study showed that in the age group ≤ 60 years old, the rate of poor outcome was 18.1%, the group &gt; 60 years old had a rate of poor outcome of 34.6%. Thus, in the age group &gt; 60 years old, the outcome was worse, this difference was statistically significant with p&lt;0.05. In our study, there was no statistically significant difference in outcome at day 90 between patients with a history of hypertension, diabetes, coronary artery disease, antiplatelet drugs, smoking, alcohol consumption and patients without this history. In the group without cerebral hemorrhage, the rate of patients with poor outcome was 18.8%; while in the group with cerebral hemorrhage, this rate was 36.9%, this difference was statistically significant with p&lt;0.05. In the group with no hematoma volume &lt; 30 ml, the rate of patients with poor outcome was 14.1%; meanwhile, in the group with hematoma volume ≥ 30 ml, this rate was 100%, this difference was statistically significant with p &lt; 0.01. In the group with Glasgow score at admission ≥ 14 points, the rate of patients with poor outcome was 14.4%; meanwhile, in the group with Glasgow score at admission &lt; 14 points, the rate of patients with poor outcome was 71.9%, this difference was statistically significant with p &lt; 0.01. Conclusion: Studying 150 patients with acute supratentorial cerebral hemorrhage due to hypertension treated at the Neurology Center - Bach Mai Hospital from August 1, 2023 to July 31, 2024, we drew the following conclusions: factors leading to poor outcomes for patients with acute cerebral hemorrhage due to hypertension include age &gt; 60, hematoma volume ≥ 30 ml, Glasgow score at admission below 14 points, and intraventricular hemorrhage.

Viêm tĩnh mạch tại vị trí lưu kim luồn tĩnh mạch ngoại biên và một số yếu tố liên quan tại Trung tâm Thần kinh, Bệnh viện Bạch Mai

Introduction: Peripheral venous catheter-related phlebitis is a common complication in healthcare facilities, causing pain, disrupting treatment, and potentially leading to severe complications.Objective: This study investigates the incidence and risk factors associated with peripheral intravenous catheter-related phlebitis. Method: A prospective cross-sectional descriptive study was conducted using a self-designed questionnaire and the Visual Infusion Phlebitis (VIP) Scale to assess the degree of phlebitis. The study included 347 inpatients treated in the Emergency and Intensive Care Unit, Neurology Center, at Bach Mai Hospital. Data were collected from medical records and clinical observation. Results: Among the studied patients, the incidence of phlebitis was 17.6%, and 4.3% of catheter insertion sites exhibited signs of inflammation. Grade 1 and 2 were the most common phlebitis (43.1% and 54.2%), with a small number of grade 3 cases (2.8%) and no cases of grade 4 or 5. Factors such as catheter insertion sites in the forearm, elbow, or ankle; underlying conditions like hypertension, cerebral hemorrhage, pneumonia; paralysis; continuous fluid infusion; and certain intravenous medications were identified as being associated with an increased risk of phlebitis. Conclusion: Phlebitis at the PVC site is a significant concern during treatment in ICU and Neurology centers. Proper catheter site selection and effective management of underlying conditions can help reduce the risk of phlebitis. These findings may assist in developing clinical guidelines to improve patient care quality.

The outcome of nontransecting anastomotic urethroplasty in recurrent bulbar urethral stricture and its impact on sexual functions: A prospective observational study

Purpose: The management of recurrent bulbar urethral stricture had no consensus and faced many challenges such as the risk of failure, ischemia, and sexual dysfunction. Therefore, this study aimed to assess the outcome of nontransecting anastomotic urethroplasty in recurrent bulbar urethral stricture disease (USD) less than 3 cm and its impact on sexual functions. Material and methods: This is a prospective descriptive study that included patients with recurrent bulbar USD ≤ 3 cm. Full history taking and clinical examination, including International Prostate Symptoms Score (IPSS) and International Index of Erectile Function (IIEF-5), were documented. Moreover, retrograde urethrogram, uroflowmetry, and penile Doppler were undergone. The nontransecting urethroplasty techniques were performed: Heineke-Mikulicz principle stricturoplasty for stricture ≤1 cm without excision of the stricture and nontransecting excision and primary anastomosis without transecting the corpus spongiosum for stricture 1 to 3 cm. Each patient was routinely evaluated through a 12-month follow-up using IPSS and IIEF, uroflowmetry, and postvoiding residual urine. Results: Thirty-three patients were included in the study with a mean stricture length of 1.45 ± 0.7 cm. Twelve patients had failed previous urethroplasty, while 21 patients had previous visual internal urethrotomy. Nontransecting excision and primary anastomosis in 14 patients and Heineke-Mikulicz principle stricturoplasty in 19 patients were performed. There was no recurrence of stricture urethra, except for one patient, who required visual internal urethrotomy at a 3-month follow-up, with mean postoperative IPSS of 3.04 ± 2.745, Qmax 23.89 ± 2.714 mL/s, and postvoiding residual urine 26 ± 33 cc. No significant differences were reported between pre- and postoperative IIEF (18.61 ± 5.448 versus 19.33 ± 5.599, respectively, P = 0.236). Conclusion: Nontransecting urethroplasty can achieve a high success rate in short recurrent bulbar USD without the potential sexual morbidity.

FREQUENCY OF SQUAMOUS CELL CARCINOMA IN POST BURN PATIENTS

Burn injuries, particularly those leading to chronic scars, can predispose individuals to the development of squamous cell carcinoma (SCC). The risk of malignant transformation increases with burn severity and long-term scarring. Understanding the prevalence of SCC in post-burn patients is crucial for implementing preventive and management strategies. Objective: To assess the frequency of squamous cell carcinoma (SCC) in patients with post-burn scars and evaluate associations between demographic and burn-related factors with the development of SCC. Methods: A prospective descriptive study was conducted on 70 patients with a history of burn injuries and resulting scars. The study was carried out over a defined period at a tertiary care hospital. Patient demographic variables such as age, gender, socioeconomic background, and education level were collected. The severity of burns was categorized as partial-thickness or full-thickness, and the aetiology of burns was classified as thermal, chemical, or electrical. Burn locations were also documented. Histopathological examination of biopsy specimens from suspicious scars confirmed SCC diagnosis. Statistical analysis using chi-square tests was employed to identify associations between categorical variables and SCC occurrence. Results: Of the 70 patients included, 53 were males (75.7%) and 17 females (24.3%), with a mean age of 53.97 ± 4.91 years. Full-thickness burns were observed in 57.1% of the patients, while 42.9% had partial-thickness burns. The most common burn cause was thermal (45.7%), with the lower extremities being the most affected region (57.1%). SCC developed in 8.6% (6 out of 70) of the patients. The latency period for SCC ranged between 28 and 37 years, with an average of 31.5 years. Full-thickness burns were more commonly associated with SCC development compared to partial-thickness burns. Conclusion: The study reported a frequency of 8.6% for squamous cell carcinoma in patients with post-burn scars. Full-thickness burns were associated with a higher risk of SCC development. Long-term surveillance and proactive management of burn scars are critical in preventing malignant transformations.

Strokes at the Maradi Referral Hospital: Clinical Presentation, Treatment and Evolution

Introduction: Strokes, with their increasing frequency in sub-Saharan Africa, are on the verge of becoming an epidemic and constitute a real development problem. The aim of our work was to determine the sociodemographic aspects and risk factors of stroke at the Maradi referral hospital. Patients and methods: This was a prospective descriptive study from February 15, 2023 to August 15, 2023. Patients hospitalized in the Cardio-Neurology Department and those attending neurological consultations for stroke were included in the study. Results: A total of 106 patients were included, including 72.64% (n=72) ischemic stroke and 27.36% (n=29) haemorrhagic stroke. Men accounted for 56.60% (n=60) of cases; mean patient age was 58.10 years; patients aged 50-60 years made up 27.37% (n=29) of cases. Hemiplegia was the most frequent cause (98.11%) (n=104); language disorders were observed in 88.68% (n=94) of cases; headache 62.26%(n=66); balance disorders 83.96% (n=89) and consciousness disorders were rare in 28.30% (n=30) of cases. Stroke risk factors were dominated by: hypertension in 83.01% (n=88) of cases, dyslipidemia in: (Total = 50.57% (n=45), TG = 31.03% (n=27), HDL = 23.25% (n=20) and LDL = 67.82%(n=59) and overweight/obesity present in 68.87% (n=75) of our patients. Indeed, these risk factors for stroke are now fairly well identified; it is currently possible to influence most of them effectively, within the framework of primary prevention. Conclusion: In our countries where the technical platform remains limited, especially in terms of the management of these pathologies, it is more than necessary to strengthen primary prevention.

Factors influencing emergency medicine worker shift satisfaction: A rapid assessment of wellness in the emergency department.

In emergency medicine (EM), the interplay of wellbeing and burnout impacts not only patient care, but the health, productivity, and job satisfaction of EM healthcare workers. The study objective was to use a rapid assessment tool to identify factors that impact EM worker satisfaction, or "wellness," while on shift in the emergency department (ED) and the association with role and level of satisfaction. This prospective descriptive study utilized a QR-code-based electronic survey instrument that included a 7-point Likert shift satisfaction score. A voluntary response sampling was obtained from EM workers at five EDs. Respondents self-reported role and work site. Association and logistic regression analysis were performed. Of 755 responses, 467 were dissatisfied (score≤5) and 288 were satisfied (score≥6) with their shifts. Physicians reported higher satisfaction on shift than nurses (OR 2.77, 95% CL 2.01-3.81, p<0.01). Factors associated with dissatisfied responses included: admission or transfer process (OR 0.40, CL 0.21-0.77, p<0.01), boarding patients (OR 0.13, CL 0.06-0.27, p<0.01), tools to do my job (OR 0.65, CL 0.46-0.90, p=0.01), and patient flow (OR 0.72, CL 0.53-0.98, p=0.04). Factors linked to a satisfied response included: teaching/learning (OR 2.85, CL 1.86-4.37, p<0.01) and team/coworker interaction (OR 8.92, CL 6.14-12.96, p<0.01). Satisfaction on shift for EM physicians, nurses, and staff differ and are associated with multiple identifiable factors. Focused attention to work environment and operations could help mitigate on-shift dissatisfaction. Endeavors aimed at cultivating and enhancing a supportive teaching and learning environment with an emphasis on team member and coworker interaction could positively impact and improve wellness.

Impact of EUCAST Rapid Antimicrobial Susceptibility Testing (RAST) on optimal antimicrobial therapy in gram-negative bloodstream infections

ObjectivesTo evaluate the possible impact of RAST on optimal antimicrobial therapy via de-escalation or escalation, and to determine the reduction in antibiotic susceptibility reporting time with RAST. MethodsIn this single-center, prospective descriptive study, RAST was performed on clinical blood cultures containing E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii isolates. Very major error, major error, and categorical agreements with VITEK 2 were analyzed. ResultsOne hundred and three isolates were included in the study, out of which 29.1 % were carbapenem-resistant and 36.9 % were multidrug-resistant according to VITEK 2. Categorical agreement of the RAST method with standard antimicrobial susceptibility test (AST) was > 90 % at 6 h, except for piperacillin/tazobactam. Antibiotic revision could be carried out in 79.6 % of the patients either by de-escalation (61.2 %) or escalation (18.4 %) for optimal therapy based on the RAST 6 h result. RAST could provide carbapenem-sparing therapy in 24 % of patients. Reduction in antibiotic susceptibility reporting time was 41.5 h (38.8 to 63.2, median (IQR)). ConclusionsRAST can provide early antibiotic revision in a majority of patients with significantly reduced antibiotic susceptibility reporting time. Six hours is the shortest optimal time for antibiotic revision with RAST. In countries where empirical broad-spectrum antibiotics are prevalent due to high antibiotic resistance pressure, RAST should be proposed primarily in de-escalation and carbapenem-sparing strategies.

Molecular Biology for Diagnosis of Congenital and Neonatal Infections in the Cerebrospinal Fluid of Newborns from a Brazilian Tertiary Hospital.

This was a prospective descriptive study involving the molecular analysis of 151 CSF samples from neonates, collected for cytological and biochemical diagnosis from 2017 to 2021. After the results and consent from the participants' caregivers were obtained, the leftover material was sent to the University's Virology Laboratory and submitted for DNA/RNA extraction and Nested-PCR/RT-PCR. A review of the patients' medical records and descriptive statistics was performed. This work was approved by the Ethics Committee (CAAE: 86760218.3.0000.5404). A total of 151 CSF samples were obtained, 16 of which were positive (10.6% [95% CI%: 6.18-16.63%]). Two of these were PCR-positive for HSV-1 (1.3%), four for VZV (2.6%), one for CMV (0.67%), two for Toxoplasmosis (1.3%), four for Parvovirus B-19 (2.6%), and four for Zika (2.6%). The proportion of positive PCR results was higher in the group that presented with malformations (25.0% vs. 8.4%, p = 0.040). The pathogens identified by PCR were mostly Zika virus, VZV, and B-19, and these were mainly found in newborns with malformations.

Can Timed Up and Go Test discriminate the risk of falling in patients with Multiple Sclerosis with low to moderate impairment?

Purpose The aim of the study was to discriminate the risk of falling in patients with Multiple Sclerosis with low to moderate impairment who do not use walking aid using the Timed Up and Go (TUG) Test. Methods This study was planned as a prospective descriptive study with 204 patients. Falls were recorded in three-month prospective diaries, and the balance was evaluated using the TUG Test. Results By using three-month prospective diaries, the mean age of 109 faller patients and 95 non-faller patients was 35.87 ± 8.35 and 35.35 ± 9.39 years, respectively. The faller group’s mean TUG Test score was 9.46 ± 4.14, whereas the non-faller group’s was 7.74 ± 2.02 s. The TUG Test has an area under the receiver operating characteristic curve value of 0.666 in discriminating fallers from non-fallers (0.592–0.740, %95 Cl). To identify fallers, the TUG Test score of ≥7.85 s has a sensitivity of 0.65 and a specificity of 0.65. Conclusion As a result of the present study, the TUG Test was found to have moderate sensitivity and specificity in predicting the risk of falling. It is not a sufficient stand-alone measure for fall risk prediction, so it is recommended that this test be included as part of a comprehensive falls screening programme.

Study of the Association Between Socioeconomic Determinants and Pregnancy Follow-Up Indicators of Mothers of Low-Birth-Weight Infants: Insights for Achieving Sustainable Development Goals

Aims: This study investigates the association between socioeconomic determinants and pregnancy follow-up among 200 mothers of low-birth-weight newborns. By identifying factors influencing maternal care and birth outcomes, the study contributes to achieving Sustainable Development Goals (SDG) 3, 8, and 10, focusing on improving maternal and child health, reducing socioeconomic disparities, and ensuring equitable healthcare access. Methods: A prospective descriptive study was conducted over 12 months (June 2020–July 2021) at the neonatology and nutrition reference center of Rabat Children's Hospital. The study recruited 206 mother-child pairs, focusing on those with low-birth-weight infants. Results: Among the 200 mothers, 92% followed their pregnancies. Distribution of prenatal consultations was as follows: 0.54% had one visit, 5.98% two visits, 33.7% three, 41.85% four, and 17.93% more than four. Analysis revealed significant associations between pregnancy follow-up and socioeconomic factors. Maternal age (p &lt; 0.001), education level (p &lt; 0.001), and place of residence significantly influenced pregnancy monitoring, with urban mothers more likely to receive follow-up care. Single mothers had a 100% non-tracking rate, while married mothers predominantly monitored their pregnancies. Conclusions: This study demonstrates the strong influence of sociodemographic factors on antenatal care use, aligning with findings from other contexts. It contributes new insights into the specific characteristics of our study population and has practical implications for shaping maternal and child health policies, addressing the unique needs of diverse sub-populations. Achieving SDG 3 (Good Health and Well-being), SDG 8 (Decent Work and Economic Growth), and SDG 10 (Reduced Inequalities) requires targeted interventions that improve equitable access to quality maternal care.