Four-year Retrospective Study Research Articles

Prevalence and Outcome of Snake Bites Among Children Admitted in the Emergency Pediatric Unit, Federal Medical Centre, Birnin Kebbi, Nigeria.

IntroductionSnakebites are common and constitute an important health problem in many countries of the world, with the greatest burden occurring in rural areas of Asia and Sub-Saharan Africa. They were classified by the World Health Organization as category A of neglected tropical diseases. Most studies on snake envenoming in Nigeria were among adult populations with few among children. This study assessed the prevalence and outcome of snakebite among children in Federal Medical Centre, Birnin Kebbi.MethodsThis was a four-year retrospective study in which the medical records of patients with managed snakebite were reviewed. A study proforma was used to obtain information on socio-demographic characteristics, site of the bite, features of envenoming, pre-hospitalization intervention, hospital treatment, length of hospitalization, and outcome of treatment of the patients.ResultsThere were 19 snakebite cases out of 5,195 admissions during the period under review, giving a prevalence of 0.0037 (3.7/1000) with a male:female ratio of 2:1. The majority (66.7%) of the children were aged between 11 and 15 years and the mean (± SD) age of the study population was 10.5 (± 3.3) years. The lower limb was the site of bite in 10 (55.6%) of the patients and clinical features included local pain (100%), local swelling of varying magnitude (16 (88.9%)), spontaneous bleeding eight (44.4%) among others. Ten (55.65%) patients presented after four hours of bite and the mean (±SD) duration of hospitalization was 2.11 (±0.58) days. Most (77.8%) received at least one form of pre-hospital care while only 66.7% received polyvalent anti-snake venin. The case fatality rate was 5.6% while 55.6% of patients signed against medical advice.ConclusionThere was a low hospital prevalence of snakebite in children in the present study location with associated low mortality but a high rate of discharge against medical advice. Most of the patients had a pre-hospital intervention and anti-snake venin is not readily accessible.

English

BACKGROUND Pancytopenia is a relatively common haematological entity with simultaneous presence of anaemia, leucopenia and thrombocytopenia. It is a feature of many medical and haematological disorders like megaloblastic anaemia, drug-induced bone marrow hypoplasia, even fatal leukaemia and bone marrow aplasia. The clinical and haematological studies determine the proper diagnosis and management of patients. Bone marrow examination is an important diagnostic procedure for determining the cause of pancytopenia. This study was conducted to evaluate clinico-haematological findings, identify the causes of pancytopenia, and compare our findings with other similar studies. METHODS The four-year retrospective study was carried out in the Department of Pathology at a tertiary care hospital in western Odisha, India. Data regarding clinical details, peripheral blood and bone marrow aspirations were collected and analyzed using simple statistical methods. RESULTS A total of 131 cases of pancytopenia were studied. The age range of patients was 3 years to 72 years, with a mean of 36.5 years. Male to female ratio was 0.84 : 1. The majority of cases were in the age group of 31 – 40 years (20.61 %). Generalized weakness with pallor (54.96 percent) was the commonest clinical finding, followed by splenomegaly (16.79 %), and hepatomegaly (11.45 %). Aplastic anaemia (43.51 %) was the most common cause found on the bone marrow aspiration followed by megaloblastic anaemia (22.14 %) and haematological malignancies. Among the haematological malignancies, acute myeloid leukaemia was the commonest cause of pancytopenia (10.69 %). CONCLUSIONS Bone marrow aspiration in cytopenic patients helps in understanding the disease process and to diagnose or rule out the causes of cytopenia. Different geographical areas have a different presentation of haematological disorders. KEYWORDS Bone Marrow Aspiration, Pancytopenia, Aplastic Anaemia

Referral pattern of oral and maxillofacial surgery cases in Sudan: A retrospective age-and sex-specific analysis of 3,478 patients over four years.

Oral and maxillofacial surgery (OMFS) is a specialty widening in its scope. An objective analysis of the referral pattern can provide essential information to improve healthcare. This four-year retrospective study was implemented in Khartoum Teaching Dental Hospital. Data (age, sex, diagnosis, and type of treatment) were collected from patient records. Disease frequency, as well as the effect of sex and age, were analyzed for each group. The frequency of treatment types was also assessed. Data were collected from a total of 3,478 patients over the four-year study period. There was a male predominance with the third decade of life being the most common age group. Pathological diseases were the most common (37%) reason for referral, followed by trauma (31%). Temporomandibular joint (TMJ) disorders and dentoalveolar extraction were the least frequently observed. Open reduction and internal fixation (ORIF) was the most commonly performed procedure (28%). These data represent the epidemiology of oral and maxillofacial diseases in Sudan. Given that the third decade of life is the most represented age group, it is beneficial to learn the long-term consequences of these diseases in these young patients and to use modern surgical techniques to improve their lives.

Clinical and pathological features of upper limb nerve tumors - four years retrospective study.

Benign peripheral nerve tumors and malignant peripheral nerve tumors are rarely found in patients with upper limb tumors. A four-year retrospective study was conducted on patients with tumors in the upper limb area admitted to the Emergency Clinical Hospital, Bucharest, Romania. Seventeen patients were admitted within this time range, 15 of which were benign and two malignant. All patients required surgical intervention after thorough clinical and imaging evaluation. Benign masses were removed, follow-up examination revealing no local recurrent, as well as good function recovery. On the other hand, malignant tumors due to their highly aggressive features, both determined local recurrence, one requiring upper limb amputation, the other presenting metastases.

Tuberculosis and Human Immunodeficiency Virus Co-Infection and Associated Factors at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia: A Four-Year Retrospective Study.

BackgroundHuman immunodeficiency virus (HIV) and tuberculosis (TB) are the principal global causes of death among patients with communicable diseases. Because of shared immune defense mechanisms, they are the primary cause of morbidity worldwide. However, little information was found regarding the magnitude of TB/HIV co-infection in the study area, in Northwest Ethiopia.ObjectiveThe main aim of this study was to assess the prevalence of TB and HIV co-infection and associated factors among TB patients.MethodsAll TB patients at Debre Markos Comprehensive Specialized Hospital were included from September 11, 2012 to September 10, 2016. Data were analyzed using SPSS version 22. Logistic regression was used to determine the associations between independent and outcome variables.ResultsA total of 180 TB patients were enrolled. Pulmonary tuberculosis (PTB) accounted for 97/180 (53.9%), followed by extrapulmonary tuberculosis (EPTB) in 83/180 (46.1%). There were 164/180 (91.1%) new TB cases and 16/180 (8.9%) treatment failures, but no relapsing or defaulting cases were observed. Forty percent (72/180) of patients were co-infected with TB and HIV. The likelihoods of having TB/HIV co-infection were 3.2 and 2.1 times higher in PTB smear-positive and PTB smear-negative patients (AOR=3.2, 95% CI 1.4–8.1, p=0.006; and AOR=2.1, 95% CI 1.0–4.3, respectively, p=0.05), in comparison to EPTB. The rate of TB/HIV co-infection was 28/66 (42.4%) in 2013, 18/38 (47.4%) in 2014, 13/32 (40.6%) in 2015, and 13/44 (29.5%) in 2016.ConclusionTB/HIV co-infection showed a decreasing trend in the past 2 years in the study area. TB/HIV co-infection is one of the most serious community health concerns in the study area. Therefore, TB/HIV collaborative activities should be implemented to reduce co-infection and its impact on the community.

Clinical Profile and Outcomes of Guillain-Barre Syndrome: A Four-Year Retrospective Study at a Tertiary Hospital in the Philippines

Guillain-Barre syndrome (GBS) is the leading cause of acute neuromuscular weakness in the developed world. In this retrospective study, a total of 34 patients were identified and diagnosed with GBS from January 2016 to December 2019. The Brighton criteria was used to classify the certainty and diagnosis of GBS. The clinical profile and outcomes were then determined. GBS was seen in all age groups with a mean age at 47.9 with a slightly male predominance. The majority(47%) of patients had a history of respiratory infection although almost 30% had no known triggering event. The most common presenting symptom was ascending paralysis followed by complaints of cranial nerve involvement. Younger age and less severe disease presentation at onset correlate with a more favorable outcome. Patients who presented earlier after the triggering event were noted to have a faster rate of progression of symptoms and a worse outcome. The common GBS variants in this study according to nerve conduction studies were AMSAN and MFS. Methylprednisolone and IVIG were both effective with no statistical significance noted. The in-hospital mortality rate was at 3%. Majority of patients had a good functional outcome.

Intraoperative hypotension and perioperative acute ischemic stroke in patients having major elective non-cardiovascular non-neurological surgery.

The association between intraoperative hypotension and perioperative acute ischemic stroke is not well described. We hypothesized that intraoperative hypotension would be associated with perioperative acute ischemic stroke. Four-year retrospective cohort study of elective non-cardiovascular, non-neurological surgical patients. Characteristics of patients who had perioperative acute ischemic stroke were compared against those of patients who did not have acute ischemic stroke. Multivariable logistic regression was used to determine whether hypotension was independently associated with increased odds of perioperative acute ischemic stroke. Thirty-four of 9816 patients (0.3%) who met study inclusion criteria had perioperative acute ischemic stroke. Stroke patients were older and had more comorbidities including hypertension, coronary artery disease, diabetes mellitus, active tobacco use, chronic obstructive pulmonary disease, cerebral vascular disease, atrial fibrillation, and peripheral vascular disease (all P < 0.05). MAP < 65mmHg was not associated with increased odds of acute ischemic stroke when modeled as a continuous or categorical variable. MAP < 60mmHg for more than 20min was independently associated with increased odds of acute ischemic stroke, OR = 2.67 [95% CI = 1.21 to 5.88, P = 0.02]. Our analysis suggests that when MAP is less than 60mmHg for more than 20min, there is increased odds of acute ischemic stroke. Further studies are needed to determine what MAP should be targeted during surgery to optimize cerebral perfusion and limit ischemic stroke risk.

Trends in per-operative parameters and postoperative complications associated with coronary artery bypass graft surgery (CABG); A four-year retrospective study

Objective:To determine the patterns of per-operative parameters and early outcomes of patients that underwent CABG surgery during a four-year period.Methods:This is a cross-sectional descriptive study conducted in a tertiary care of hospital from November 2020 to January 2021. All the patients that underwent the isolated coronary artery bypass grafting (CABG) procedure were included in the study from June 2017 till June 2020. Data was collected on a data extraction form and stored in SPSS format which was analyzed for qualitative statistics keeping p<0.05 as significant. All the results were represented in the form of tables.Results:A total of 1,613 patients were operated upon for Coronary Artery Bypass Grafting (CABG) procedure during the study period with 1,222 (75.8%) males and 391 (24.2%) females. Dyslipidemia (71.8%) was the most common risk factor. The average perfusion time decreased only slightly (~1 minute) from 96.01 minutes to 95.07 minutes (2017 to 2020). This change however was not significant (p=0.301). The rate of Left Internal Mammary Artery (LIMA) use stayed relatively stable over the 4-year period fluctuating between 88.7% and 92.9% (p=0.360). The average initial ICU stay (in hours), drain at 12 hours and 24 hours stays almost the same. The rate of mortality peaked in 2018 (4.76%) and subsequently fell to 3.57% by 2020.Conclusion:More males underwent CABG surgery at this tertiary care hospital and the overall complication rate and per-operative parameters improved over the years. The non-risk stratified mortality in this study was found to be higher than developed nations.

Effectiveness of histopathological examination in medicolegal autopsies – A four-yearretrospective study from a tertiary level medical college hospital from South India

Histopathological examination (HPE) in medicolegal autopsies (MLA) is essential when gross examination is not sufficient to confirm or exclude morphological changes at cellular level. This study aims to evaluate the histopathological findings in medicolegal autopsies and determine the efficacy and effectiveness of HPE in MLA. A four years retrospective study was done from July 2015 to June 2019 and all cases of MLA which were sent for HPE to department of pathology were included in the study and clinical autopsies were excluded from the study. There were total of 364 cases with age range was between 0 to 86 years, with male female ratio of 1:1.09. Majority of the cases sent for HPE were for suicidal deaths by hanging which accounted 80.4% (293 out of 364 cases). Of autopsies done for cases other than suicidal hanging and strangulation, which were 63 cases, the most frequent organ submitted was heart (38 cases), followed by lungs (22 cases), liver(18 cases), kidneys (17 cases), brain (14 cases), spleen (13 cases), uterus (8 cases), intestine (6 cases), testes (2cases), pancreas and gall bladder (one case each). Overall significant findings were noted in any of the organs in 41 cases, did not show significant changes on microscopy in 7 cases, and showed autolysis in 15 cases. In our study HPE was more efficient in Lung (72.9%), followed by heart (36.3%). HPE plays an important role in establishing cause of death in MLA. It will be more fruitful when autopsy surgeon and histopathologist work together and autopsy surgeon clearly specifies what he is expecting or what he wants to exclude.

Clinical value of serology for the diagnosis of strongyloidiasis in travelers and migrants: A 4-year retrospective study using the Bordier IVD® Strongyloides ratti ELISA assay.

Strongyloides stercoralis serology is a sensitive method for strongyloidiasis diagnosis, but it is prone to cross-reactions with other helminthiases. This four-year retrospective study aimed at estimating the performance of the Bordier IVD® Strongyloides ratti ELISA assay in a non-endemic country (France). The study included all patients tested for strongyloidiasis in our center between 2015 and 2019, by both serology and stool examination. Cases were defined using an algorithm considering serological results, microscopic examination of stools, and other biological, clinical or epidemiological data. The study included 805 stools from 341 patients (70% migrants, 20% travelers, 10% without travel to a highly endemic area). Thirty patients (8.8%) had positive serology, 9 had microscopically proven strongyloidiasis, and 11 and 10 were classified as probable and possible strongyloidiasis, respectively. Performances of microscopy and serology were compared, considering proven and probable strongyloidiasis as true infections. The sensitivity, specificity, positive predictive value and negative predictive value of serology were 100%, 97%, 67% and 100%, respectively, and those of microscopic examination of stools were 45% (p < 0.01), 100% (p < 0.01), 100% (p = 0.079) and 96% (p < 0.001), respectively. Eosinophilia did not help in discriminating true-positive from false-positive results. Overall, these results underline the high value of the S. stercoralis serologic assay, compared to stool examination. The systematic use of this technique for screening purposes in travelers or migrants, or before onset of immunosuppressive therapy, could help to improve patient management and epidemiological knowledge.

Can Individual Attitudes toward Aging Predict Subsequent Physical Disabilities in Older Taiwanese Individuals? A Four-Year Retrospective Cohort Study

Individual attitudes toward aging have been regarded as a modifiable risk for physical disability. However, longitudinal cohort studies have not been carried out in countries in Asia. In the present study, we aimed to explore the association between individual attitudes toward aging and subsequent physical disabilities using a nationwide representative cohort, the Taiwan Longitudinal Study on Aging (TLSA), over a 4-year follow-up period. In 2003, a baseline survey for 10-item attitudes toward aging scale consisting of widely different domains across financial relationships with children, grandparenting, living arrangements, and remarriage was conducted. Later, physical disabilities, including mobility and activities of daily living (ADL) limitations, were evaluated in 2007. A total of 1635 participants aged 57 and over were analyzed. Older age, self-rated poor health, and those suffering from pain were found to be more likely to have higher risk of physical disabilities. The older adults who expressed a willingness to receive financial support from their adult children were reported to have a lower risk of mobility limitations (adjusted odds ratio (aOR): 0.67, 95% confidence interval (CI): 0.50–0.90), while those who did not want to assist with child care as grandparents had a higher risk of ADL difficulties (aOR: 2.46, 95% CI: 1.31–4.60). Our work shed light on the importance of individual attitudes toward aging in predicting long-term physical disabilities and illuminated the intimate role of grandparents, both financial and participatory, in Chinese families. In the future, culturally adapted attitudes toward aging scale should be developed to identify older Chinese adults at risk of physical disabilities.

The incidence of toxic shock syndrome due to nosocomial methicillin-resistant Staphylococcus aureus infection in burn patients: A four-year retrospective cohort study

Among adult and pediatric patients, concern is growing in regard to toxic shock syndrome (TSS) resulting from methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infection. We investigated the incidence and characteristics of this form of TSS in patients with burn injury who were admitted to our burn care units from January 2008 to December 2011. Of the 244 patients with nosocomial MRSA infection admitted during the study period, TSS occurred in 20 (8.2%) patients whose average age was 42.9 years, average total burn surface area (TBSA) was 31.7%, and average day of TSS appearance was 9.5 days after injury. There were no particular characteristics associated with age, TBSA or day of TSS appearance in these patients. All but 1 patient recovered from TSS within an average of 9.4 days. The incidence of TSS due to nosocomial MRSA infection in these burn patients was higher than expected. TSS due to nosocomial MRSA infection should be considered in burn care.

Congenital malformations among newborns in Morocco: A retrospective study.

Congenital malformations are one of the leading causes of neonates and infants’ mortality and morbidity. The frequency of these congenital malformations varies in different populations. The objective of this study was to find out the prevalence and pattern of congenital malformations in a tertiary teaching hospital in Rabat, Morocco. This four-year retrospective descriptive study was conducted from January 2011 to December 2014. All newborns with congenital malformations diagnosed at birth were included. Mothers and newborn characteristics were analyzed using SPSS 13.0. A total of 706 newborns were noted to have congenital malformation. The prevalence rate was 1.02%. The mean maternal age was 28.8±7.2 years. The mean maternal body mass index was 28.1±6.9 kg/m2. 13.3% of the mothers had a history of abortion. The nervous system was the most affected system (19.4%) followed by the musculoskeletal system (14.2%), the chromosomal abnormalities (12.3%) and the genito-urinary system (10.8%). Males newborns (57.9%) had more congenital malformations than females (40.5%). The rates for live-births, fetal asphyxia and stillbirths were 75.2%, 7.2% and 17.3%, respectively. This retrospective study provides recent and detailed data about congenital malformations in a Moroccan region. The result from this study will contribute to the knowledge of congenital malformations in this particular area and hence the supportive preventive policy.

Are Chest Radiographs Routinely Indicated After Chest Tubes Placed for Non-Surgical Reasons Are Removed?

BackgroundThe insertion and subsequent removal of chest tubes are frequently performed procedures for the management of pneumothoraces, pleural effusions, and cardio-thoracic surgical interventions. A chest radiograph is commonly obtained after the removal of a chest tube to rule out the interval development of a pneumothorax. This practice has been questioned in various retrospective and prospective studies conducted on surgical patient populations, showing little to no benefits in performing routine chest X-rays (CXRs) after chest tube removal unless clinical symptoms such as worsening respiratory status and hemodynamic compromise are present.Material and MethodsA four-year retrospective study was conducted using the Cleveland Clinic Foundation database. A chart review was performed, and 1,032 patients were screened, with 200 patients meeting inclusion criteria. The inclusion criteria included patients who underwent chest tube insertion for non-surgical reasons. The primary outcome was the percentage of clinically significant pneumothoraces detected by routine CXR after chest tube removal.ResultsOut of the 200 patients included in the study, 53 had a CXR after chest tube removal showing a residual pneumothorax. Out of the 53 patients, 50 ended up not needing chest tube re-insertion, as the patients were asymptomatic and hemodynamically stable. Only three patients required chest tube re-insertion due to respiratory symptoms and significant hemodynamic changes after the chest tubes were removed. In all three cases, the symptoms manifested prior to the CXRs being obtained; therefore, the decision to reinsert each chest tubes was made based on clinical signs rather than imaging. As expected, the practice of repeating CXRs after removal of the chest tubes resulted in delayed discharges despite patients reporting no symptoms and being hemodynamically stable.ConclusionsOur study findings correlate with prior smaller studies on surgical patients. Symptoms and hemodynamic data seem to be a better predictor of whether a patient will require chest tube re-insertion or not. Routine CXR after chest tube removal also leads to prolonged hospital stay.

Yanık Merkezinde Konsültasyon İstenen Hastalardaki Psikiyatrik Bozukluklar, Deliryum ve Mortalite: Dört Yıllık Bir Retrospektif Çalışma

Yanık Merkezinde Konsültasyon İstenen Hastalardaki Psikiyatrik Bozukluklar, Deliryum ve Mortalite: Dört Yıllık Bir Retrospektif Çalışma

Alemtuzumab for relapsing multiple sclerosis in clinical practice: A four-year retrospective one-center study

Disease-modifying therapies for multiple sclerosis have been developed tremendously over the last two decades. The aim of this study was to review the short-, medium-, and long-term safety of alemtuzumab in relapsing remitting multiple sclerosis (RRMS). This retrospective observational study (2015-2019) included all patients with highly active or rapidly progressing and aggressive RRMS who were treated with alemtuzumab at the Cabueñes University Hospital. The short-, medium-, and long-term adverse effects were evaluated following the risk management program of the European Medicines Agency. 39 patients were included, 23 of them received at least two cycles of treatment. Most patients showed at least one adverse event. The following adverse reactions were reported: infusional reactions (17), urinary tract infections (six), thrombopenia (five), and thyroid dysfunction (six). In clinical practice alemtuzumab showed an acceptable safety profile in selected patients even if all of them suffered at least one adverse effect. Thorough and prolonged follow-up is required to further confirm the safety of this drug.

Prevalence of Intestinal Parasitic Infections in the Southwest of Iran: A Four-year Retrospective Study.

The current study was aimed to assess the prevalence of intestinal parasitic infections (IPIs) in persons who were referred to selected hospitals of Abadan and Khorramshahr cities, in the southwest of Iran. In this descriptive cross-sectional study, 43200 and 28821 stool specimens were gathered from Abadan and Khorramshahr cities, respectively, during four consecutive years (2014-2017). A decreasing trend was seen in the prevalence rate of IPIs in Abadan and Khorramshahr cities. The overall prevalence of IPIs was estimated to be 5.82% and 6.11% in Abadan and Khorramshahr cities, respectively. In Abadan city, the proportion of IPIs in male persons with 56% was higher than females 44%, while in Khorramshahr city, more prevalence was observed in females (54% vs. 46%). Moreover, according to the season, the highest prevalence was recorded in Spring (30.4%) and Summer (31.1%) in Abadan and Khorramshahr cities, respectively. We found Giardia lamblia, as the most frequent parasite in studied individuals of both cities (Abadan: 2.92%; 1261/43200 and Khorramshahr: 3.15%; 908/28821). Other parasites were as follows: Entamoeba histolytica/dispar, E. coli, E. hartmanni, Blastocystis hominis, Hymenolepis nana, Enterobius vermicularis, Strongyloides stercoralis, and Taenia spp. This was the first study on the prevalence of IPIs in Abadan and Khorramshahr cities, southwest of Iran. Intestinal parasites are still the main public health concern in these regions. Health education, improving sanitary conditions, screening and treatment of infected people, particularly in rural and semi-urban areas can be helpful.

Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study

BackgroundSecondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis.MethodsA four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively.ResultsA total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 ± 1.87 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival analysis and Log-rank test revealed that secondary infection group had worse survival between day 15 and day 90.ConclusionsUrinary and deep venous catheterization increased the risk of secondary infection, in which underlying immunosuppression might also play a role. Secondary infection affected the prognosis of septic patients and prolonged in-hospital length of stay.

Is anticoagulation reversal necessary prior to surgical treatment of geriatric hip fractures?

ObjectiveHip fracture surgery in geriatric patients on anticoagulants may increase the risk for blood loss. Anticoagulation reversal may lower these risks; however, data on blood loss and transfusions are limited. The study purpose was to compare outcomes between hip fracture patients 1) not on anticoagulants 2) whose anticoagulants were reversed, and 3) whose anticoagulants were not reversed. MethodsThis four-year retrospective cohort study at six Level 1 Trauma Centers enrolled geriatric patients (≥65) with isolated hip fractures. The primary outcome was total hospital blood loss (ml). Secondary outcomes: hospital length of stay (HLOS) and volume of packed red blood cells (pRBC) transfusions (ml). Statistical analyses included: Fisher’s, chi-squared, Kruskal-Wallis, linear mixed-effect and logistic regression. Bonferroni adjusted alpha = 0.025. ResultsOf the 459 patients, 189 (41%) were not on anticoagulants, 186 (41%) were reversed, and 84 (18%) were not reversed. The LS mean (SE) blood loss was 134 ml (12) for not reversed patients and 159 (17) for reversed patients; no significant difference compared to those not on anticoagulants [138 (12)], p-diff = 0.14 and 0.83, respectively. The LS mean (SE) HLOS was significantly longer for the reversed patients, 7.7 (0.4) days, when compared to those not on anticoagulants, 6.8 (0.4), p = 0.02, and when compared to those not reversed, 6.3 (0.6), p = 0.01. There was no significant difference in pRBC transfusions. ConclusionNot reversing anticoagulants for geriatric hip fractures was not associated with increased volume of blood loss or transfusions when compared to those reversed. Delayed surgery for anticoagulant reversal may be unnecessary and contributing to an increased HLOS.

Bacterial Isolates and Drug Susceptibility Pattern of Sterile Body Fluids from Tertiary Hospital, Northern Ethiopia: A Four-Year Retrospective Study.

This study was conducted in Ayder comprehensive specialized Hospital, Mekelle, Northern Ethiopia, to determine the bacterial profiles and drug susceptibility pattern from body fluids. A total of 218 patients were investigated, of which 146 (67%) were males. The age of the study subjects ranged from 2 days to 80 years with 96(44%) in the age group of 15 years and above. The overall bacterial infection was 44 (20.2 %) of which gram positive bacteria were prevalent, 23 (52.3%) than gram negative bacteria 21 (47.7%). The predominantly isolated bacteria were S. pneumonia, followed by K.pneumoniae, S. aureus, and E coli. Multidrug resistance was observed in 12 (100%) of the isolated gram positive bacteria and in 6 (75%) of the isolated gram negative bacteria.