Hospital-based Study Research Articles

Influence of sleep quality and other associated factors on glycemic control among diabetic patients: A hospital-based study

The glycemic control of diabetes patients is influenced by a variety of risk factors, some of which are adjustable and others of which are not. Diabetes and sleep quality are most frequently correlated in both directions. To evaluate the quality of sleep and pinpoint the risk factors for inadequate glycemic control in individuals with diabetes. : This cross-sectional study included seventy consecutive patients who met the inclusion criteria. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the quality of sleep. Siemens- ID 29984, dimension RxL Max, Architect plus ABBOT (ci 4100), completely automatic seven-part cell-counter by Horiba Pentra Dx and Siemens ADVIA Centaur XPT (Immonoassay system) were utilized for the biochemical tests.: Of the 70 participants in the study, 22 patients [31.4%] reported having good sleep quality, while 15 patients [21.4%] had average sleep quality and 33 patients [47.1%] had poor sleep quality. Patients with managed and uncontrolled blood sugar showed varying degrees of sleep quality; 48.4% and 17.9% showed good sleep quality, 29% and 15.4% showed moderate sleep quality, and 22.6% and 66.7% showed poor sleep quality. A statistically significant difference (p<0.001) was seen in the sleep quality of the two groups. : In summary, the results of our study suggested that diabetics with poor sleep quality are more likely to have poor glycemic control. A significant modifiable risk factor for improved glycemic management in diabetic patients is sleep quality.

A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

A study of asymptpmatic hypoglycemia in at risk newborn babies admitted at a tertiary care hospital

: Babies often have blood glucose levels that are 70% of their mothers at birth. Within an hour, it reaches its lowest point, which can be as low as 20 to 25 mg/dl. All healthy newborns experience this low point and have lower than average blood glucose levels. These are just temporary, and they gradually increase in the first few days of a newborn's life. : To determine the proportion of asymptomatic hypoglycemia in at risk newborn babies. To study plasma sugar level at various time, point during first 48hr of life and the effect of risk factor associated with asymptomatic hypoglycemia. : A Hospital-based longitudinal observational study was conducted among 303 patients at Department of Pediatrics of tertiary care Hospital during June 2021 – July 2021. : Total 159 were males and 154 were females. Among the study participants, 203(83%) cases were from Urban area, while 50(17%) were from Rural area. No. of 114(37.6%) babies had asymptomatic hypoglycemia, identified by routine screening. In total various risk factors was found in which among 29% cases had LGA, 41% had preterm and 30% had weight less than 2 kg. : Screening of at risk newborn helps in the early detection of asymptomatic hypoglycemia which will help in the prevention of adverse neurodevelopmental outcome. Routine screening helped to decrease morbidity and mortality due to hypoglycemia. The first 24 hours of life is a crucial part, at - risk babies are more prone to hypoglycemia hence routine screening is recommended in high-risk babies.

Evaluation of Some Liver Enzymes in HIV/AIDS Patients on Antiretroviral Therapy in University of Abuja Teaching Hospital, Nigeria

Background: Hepatoxicity is a major complication and side effect of antiretroviral therapy (ART). Unfortunately, such studies in this area of evaluating the adverse drug reaction of ART on the liver hepatocytes are only few in number in Nigeria.Objective: To determine the levels of some liver enzymes in HIV/AIDS patients on antiretroviral therapy (ART) and as well evaluate their impact on liver hepatocytes.Methods: This is a hospital-based case-control study. A total of 153 subjects were recruited in the study, and they were divided into three groups: the control group (which consist of apparently healthy subjects), the study group 1 (consist of HIV positive subject not on ART), and study group 2 (consist of HIV/AIDS patients on ART). The liver enzymes Alanine amino Transferase (ALT), Asparate amino Transfarase (AST) and Alkaline Phosphatase (ALP) were determined using enzyme linked spectrophotometric assay methods, according to the manufacturer’s specifications.Results: The mean standard deviation (SD) of ALT and AST activity of the study group 1 showed significant differences when compared with that of the control group P<0.001, but the ALP has no significant differences P>0.05. In Study group 2, (HIV/AIDS patients on ART) showed significant differences of P<0.001 in ALT, AST and ALP.Conclusion: Some liver enzymes were elevated in subjects on antiretroviral therapy; this elevation could be due to hepatotoxicity of the (ART) used by the HIV/AIDS patients on the liver hepatocytes.International Journal of Human and Health Sciences Vol. 08 No. 02 Apr’24 Page: 126-131

Clinical Characteristics and Fatality Risk Factors for Patients with Listeria monocytogenes Infection: A 12-Year Hospital-Based Study in Xi'an, China.

Listeriosis is a severe food-borne disease caused by Listeria monocytogenes infection. The data of listeriosis in Xi'an population are limited. The aim of this study is to evaluate the clinical features and fatality risk factors for listeriosis in three tertiary-care hospitals in Xi'an, China METHODS: The characteristics of demographic data, underlying diseases, clinical manifestations, laboratory indicators, cranial imaging examination, antibiotics therapeutic schemes, and clinical outcomes were collected between 2011 and 2023. Logistic regression analysis was performed. Seventy-one etiologically confirmed listeriosis patients were enrolled, including 12 neonatal and 59 non-neonatal cases. The majority of neonatal listeriosis presented as preterm (50%) and fetal distress (75%). The main clinical manifestations of non-neonatal listeriosis included fever (88%), headache (32%), disorder of consciousness (25%), vomiting (17%), abdominal pain (12%), and convulsions (8%). The fatality rate in neonatal cases was higher than in non-neonatal listeriosis (42 vs. 17%). Although no deaths were reported in maternal listeriosis, only two of 23 patients had an uneventful obstetrical outcome. Five maternal listeriosis delivered culture-positive neonates, three of whom decreased within 1week post-gestation due to severe complications. Twenty-eight cases were neurolisteriosis and 43 cases were bacteremia. Neurolisteriosis had a higher fatality rate compared with bacteremia listeriosis (36 vs. 12%). The main neuroradiological images were cerebral edema/hydrocephalus, intracranial infection, and cerebral hernia. Listeria monocytogenes showed extremely low resistance to ampicillin (two isolates) and penicillin (one isolate). The fatality risk factors were the involvement of the central nervous system, hyperbilirubinemia, and hyponatremia for all enrolled subjects. Hyperuricemia contributed to the elevation of fatality risk in non-neonatal listeriosis. When the patients suffered with symptoms of fever and central nervous system infection, they should be alert to the possibility of listeriosis. Early administration of ampicillin- or penicillin-based therapy might be beneficial for recovery of listeriosis.

Epidemiological observations and management challenges in extrapedal mycetoma: A three-decade review of 420 cases.

Mycetoma is a serious, destructive, disfiguring chronic granulomatous inflammatory disease affecting the subcutaneous tissues that spread to involve the skin, deep tissues and bone. The disease predominately affects the limbs, and extrapedal mycetoma is rarely reported. The reported extrapedal ones are characterised by high morbidity and mortality. This communication reports on 420 patients with extrapedal mycetoma seen and managed at the Mycetoma Research Centre (MRC), University of Khartoum, between January 1991 and December 2021. In this descriptive, cross-sectional, hospital-based study, the electronic records of all mycetoma-confirmed patients seen during the study period were carefully and meticulously reviewed. The confirmed patients with extrapedal mycetoma were included in this study. The study included 420 patients with extrapedal mycetoma, 298 (70.7%) had eumycetoma, and 122 (29.3%) had actinomycetoma. There were 343 male patients (81.7%) and 77 (18.3%) females, with a male-to-female ratio of 4:1. Their ages ranged between 1.5 and 95 years, with a median of 28 years. Most of the patients were students and farmers. The majority of patients were from El Gezira, North Kordofan, and the White Nile States. Mycetoma was painful in 21%, and a family history of mycetoma was recorded in 11.5% of patients. The buttocks (37.9%) and head and neck (16.9%) were affected most. Less frequently affected sites were the trunk and back (12%) each, abdominal and chest walls (4.5%) each and loin (1%). The prominent clinical presentation findings were multiple sinuses discharging grains (55%), massive swellings (46%), and lymphadenopathy (11.5%). Less commonly observed clinical findings were local hyperhidrosis (5.3%) and dilated tortuous veins close to mycetoma lesions (0.5%). The study showed that 204 patients (48.6%) had clinical improvement in terms of decreased lesion size and healing of sinuses following medical therapy. Sixty-six patients (15.7%) had no noticeable improvement. The lesion continued progressing despite treatment in 44 patients (10.5%). In the study, 118 patients were on regular follow-up, and in this group, a cure was documented in 25 patients (21.1%) with eumycetoma and 23 (19.4%) with actinomycetoma. Post-operative recurrence among eumycetoma patients was 40%, with a 1% mortality rate. The treatment outcome was unsatisfactory, characterised by a low cure rate, high recurrence (40%) and follow-up dropout (57%) rates. This emphasises the importance of early case detection and management, objective health education programmes and thorough patient counselling to urge people to seek treatment early and reduce dropouts.

3D intraoral scanning techniques support the effects of crown morphology on dental caries

BackgroundWith the development and utilization of three-dimensional (3D) intraoral scanning (IOS) technology, the morphological characteristics of teeth were quantitatively assessed. In this research, we aimed to explore the prevalence of dental caries in relation to each measurable morphological indicator of the tooth body via 3D intraoral scanning techniques.MethodsA hospital-based single-centre study was conducted at our hospital from Dec. 2021 to Apr. 2023. A total of 53 patients were involved in the study, providing complete morphological data for 79 teeth. Each patient completed an oral hygiene routine questionnaire and underwent examination by an experienced dentist to evaluate caries conditions before undergoing 3D intraoral scanning to obtain a digital dental model. Geomagic Studio 2014 was used to extract oral morphological data from the models. The acquired data were entered, cleaned and edited using Excel 2016 and subsequently exported to SPSS version 25.0 for analysis. Chi-square analysis and logistic regression analyses were employed to test the associations.ResultsAmong the participants, 33 (61.1%) were female, with a mean age of 26.52 ± 10.83 years. Significant associations were found between dental caries and the vertical distance between the distal tip and the gum (OR 14.02; 95% CI 1.80-109.07; P = 0.012), the distal lateral horizontal distance of occlusion (OR 0.40; 95% CI 0.18–0.90; P = 0.026), and the mesial horizontal distance of occlusion (OR 2.20; 95% CI 1.12–4.31; P = 0.021). The Hosmer–Lemeshow test indicated a P value of 0.33.ConclusionsThe vertical distance between the distal tip and the gum, the distal lateral horizontal distance of the occlusion and the mesial horizontal distance of the occlusion were the influencing factors for dental caries (identified as independent risk factors). We hypothesize that these factors may be associated with the physiological curvature of teeth and the role of chewing grooves in plaque formation over time. However, further studies involving larger population samples and more detailed age stratification are still needed.

Evaluation of increased posterior tibial slope as a risk factor for anterior cruciate ligament injury

Individuals who sustain anterior cruciate ligament (ACL) injury have an increased risk of developing early onset post traumatic osteoarthritis of the knee despite treatment received [1]. An increase in the posterior tibial slope is postulated to increase the risk of ACL rupture [2]. Measurement of the posterior tibial slope in individuals would serve as a means of screening and identifying those at increased risk of developing ACL injuries to take measures towards prevention. The aim was to measure and compare the mean value of the posterior tibial slope in adult patients with or without ACL injury. This was a hospital-based case-control study comprising 80 patients divided into two matched groups. Posterior tibial slope was measured on the plain lateral radiograph of the knee using the proximal tibial anatomic axis measurement protocol in all participants. Independent sample t-test was used to compare the means of the measured posterior tibial lope between cases and controls. The difference in the measured mean posterior tibial slope between the ACL injured group and the non-ACL injured group was found to be statistically significant with those in the ACL injured group having higher mean values (12.71 ± 1.2° vs 10.25 ± 1.1°) with a P value of < 0.001. Individuals with ACL injury have a significantly greater posterior tibial slope than those without ACL injury when measured on the lateral plain radiograph of the knee using the proximal tibial anatomic axis measurement protocol.

Correlation of alanine aminotransferase levels and a histological diagnosis of steatohepatitis with ultrasound-diagnosed metabolic-associated fatty liver disease in patients from a centre in Nigeria

BackgroundMetabolic-associated fatty liver disease (MAFLD) is defined as the occurrence of hepatic fat accumulation in patients with negligible alcohol consumption or any other cause of hepatic steatosis. This study aimed to correlate the ultrasound-based diagnosis of MAFLD with the histological diagnosis of nonalcoholic steatohepatitis (NASH) and alanine aminotransferase (ALT) levels in patients with MAFLD.MethodsThis was a hospital-based cross-sectional study of 71 patients with MAFLD diagnosed by ultrasound. Percutaneous liver biopsy was performed for histological evidence of NASH in all patients, regardless of liver function test (LFT) values, provided that they had no contraindications. Liver histology was graded using the NASH Clinical Research Network MAFLD Activity Score. The data obtained were entered into SPSS version 21 and analysed using descriptive and inferential statistics. The significance level was set at < 0.05.ResultsA total of 71 patients (26 males and 45 females) with MAFLD were included. Thirty-nine (76.5%) patients with MAFLD and normal ALT levels had NASH, while 14 (82.4%) had elevated ALT levels. There was no statistically significant difference in the histological grade of NASH between patients with normal and elevated ALT levels. A weak correlation was found between the severity of steatosis on ultrasound scan and NASH incidence (p = 0.026). The sensitivity and specificity of ALT levels for predicting NASH according to the area under the receiver operating characteristics (AUROC 0.590) at an ALT cut-off value of 27.5 IU/L were 55.8% and 64.7%, respectively.ConclusionNASH can occur in patients with MAFLD, irrespective of alanine transaminase (ALT) levels, and ultrasound grading of the severity of steatosis cannot accurately predict NASH. Liver biopsy remains the investigation of choice.

Association of Risk Factors with Female Pattern Hair Loss

Introduction: Female Pattern Hair Loss (FPHL) is one of the main causes of hair loss in adult women and has a major impact on individual’s quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal, and environmental factors. Objective: To evaluate etiological factors associated with female pattern hair loss. Materials &amp; Methods: This was a hospital-based case control study, conducted in the Department of Dermatology &amp; Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March, 2021 to August, 2022. In this study, total 100 females aged 18 to 45 years were enrolled. Among them, 30 females had history of hair loss &gt;6 months, presented to outpatient department, BSMMU were included as case &amp; 70 healthy females who had no history of hair loss included as control according to inclusion &amp; exclusion criteria. Diagnosis of FPHL was made clinically &amp; Ludwig classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. Result: The mean age of the patients with FPHL was 41.0±7.77 years with majority belongs to &gt;40 years of age group &amp; their mean duration of hair loss was 26.3±12.0 months. Among the patients of FPHL, 36.7% had history of inadequate intake of iron containing food, 66.7% had family history of alopecia, 36.7% had history of increased bleeding during their menstruation, 20.0% had multiple (&gt;3) childbirth &amp; 23.3% had hypertension. About 86.7% patients with FPHL had low serum ferritin (&lt;30ng/ml) with mean serum ferritin level was 20.25±16.07ng/ml and 66.7% patients of FPHL had low Hb (&lt;12 µg/l) with mean Hb was 11.47±1.52 µg/l. In the multivariate logistic regression analysis significant association found with FPHL were age (OR 2.013, 95% CI 0.672-3.714), family history of alopecia (OR1.231, 95% CI 0.162-1.991) and lower serum ferritin level (OR1.090, 95% CI 1.043-1.139). Conclusion: Age, family history of alopecia, lower serum ferritin may be implicated as risk factors for female pattern hair loss. Medicine Today 2023 Vol.36 (1): 7-11

Prevalence of Vitamin D Deficiency among Patients Attending Tertiary Level Hospitals in Bangladesh: Hospital-Based Cross-Sectional Study

Introduction: Vitamin D (Vit D) is essential for calcium and phosphate homeostasis, critical for bone growth and remodeling. Its deficiency leads to conditions like osteomalacia and rickets, with adverse effects on osteoporosis, growth, and skeletal health. This study aimed to assess Vitamin D Deficiency prevalence among patients in Bangladeshi tertiary-level hospitals. Materials and Methods: A prospective cross-sectional study was conducted from January to December 2019 at Cumilla Medical College Hospital and Central Medical College Hospital. We enrolled 1250 patients meeting inclusion criteria and collected data via a pre-designed questionnaire. Results: Most participants (31.8%) were aged 31-40, with a mean age of 37.31±13.37. Male patients constituted 53.3%, and 46.7% were female. Rural residents accounted for 52.6%, while 25.8% lived in urban areas, and the rest abroad, mainly the Middle East. The majority (88.5%) belonged to middle-class families, and only 1.5% reported sufficient sun exposure. Strikingly, 54.2% were Vitamin D deficient, 40% had insufficient levels, and only 6.4% had adequate Vit D. Conclusion: This study highlights a significant prevalence of Vitamin D deficiency among patients in Bangladeshi tertiary hospitals. The data underscore the urgent need for healthcare authorities to address this public health concern. Policymakers and healthcare providers should be aware of the potential long-term health consequences of Vitamin D deficiency, emphasizing the importance of strategies to promote adequate Vit D levels in the population. Medicine Today 2023 Vol.36 (1): 17-22

Interplay between leadership and patient safety in dentistry: a dental hospital-based cross-sectional study

ObjectivesThe study aimed to study the association of leadership practices and patient safety culture in a dental hospital.DesignHospital-based, cross-sectional studySettingRiphah Dental Hospital (RDH), Islamabad, Pakistan.ParticipantsAll dentists working at RDH were...

Prevalence of multidrug resistance Salmonella species isolated from clinical specimens at University of Gondar comprehensive specialized hospital Northwest Ethiopia: A retrospective study.

Multidrug resistance Salmonellosis remains an important public health problem globally. The disease is among the leading causes of morbidity and mortality in developing countries, but there have been limited recent studies about the prevalence, antimicrobial resistance, and multidrug resistance patterns of Salmonella isolates from various clinical specimens. Aimed to assess the prevalence, antimicrobial resistance, and multidrug resistance patterns of Salmonella isolates from clinical specimens at the University of Gondar Comprehensive Specialised Hospital, northwestern Ethiopia. A retrospective hospital-based cross-sectional study was conducted to determine the prevalence, antimicrobial resistance, and multidrug resistance patterns of isolated from all clinical specimens at the University of Gondar Salmonella Comprehensive Specialised Hospital from June 1st, 2017 to June 3rd, 2022. A total of 26,154 data points were collected using a checklist of records of laboratory registration. Clinical specimens were collected, inoculated, and incubated for about a week with visual inspection for growth and gram staining. The isolates were grown on MacConkey agar and Xylose Lysine Deoxycholate agar. Pure colonies were identified with a conventional biochemical test, and those unidentified at the species level were further identified by the analytical profile index-20E. Then, antimicrobial susceptibility was determined by the Kirby-Bauer disc diffusion technique. The multidrug resistance Salmonella isolates was identified using the criteria set by Magiorakos. Finally, the data was cleaned and checked for completeness and then entered into SPSS version 26 for analysis. Then the results were displayed using tables and figures. Of the total 26,154 Salmonella suspected clinical samples, 41 (0.16%) Salmonella species were isolated. Most of the Salmonella isolates, 19 (46.3%), were in the age group of less than 18 years, followed by the age group of 19-44 years, 11 (26.8%). In this study, S. enterica subsp. arizonae accounts for the highest 21 (51%), followed by S. paratyphi A 9 (22%). Of the Salmonella isolates, S. typhi were highly resistant to ampicillin (100%), followed by tetracycline and trimethoprim-sulfamethoxazole, each accounting for 83.3%. Furthermore, S. paratyphi A was resistant to ampicillin (100%), tetracycline (88.9%), and chloramphenicol (88.9%). The overall multi-drug resistance prevalence was 22 (53.7%; 95% CI: 39.7-61). Accordingly, S. paratyphi A was 100% multidrug-resistant, followed by S. typhi (66.6%). A low prevalence of Salmonella species was observed in the past six years. Moreover, most S. typhi and S. paratyphi strains in the study area were found to be resistant to routinely recommended antibiotics like ciprofloxacin and ceftriaxone, compared to what was reported earlier. In addition, all isolates of S. paratyphi A and the majority of S. typhi were multidrug resistant. Therefore, health professionals should consider antimicrobial susceptibility tests and use antibiotics with caution for Salmonellosis management.

Delirium management and current practice among Intensive Care Units Doctors, Khartoum

Delirium is a brain dysfunction characterized by attention and cognitive disturbances in a fluctuating manner. The international guidelines recommend daily screening for delirium. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) are the most commonly used methods for assessing delirium. This study aimed to identify barriers and gaps in knowledge and practice. This was a hospital-based Cross-Sectional study. Stratified random sampling was used in this study. 72 ICU doctors were randomly selected. Statistical analyses were performed using IBM SPSS version 23. Descriptive data were presented, and the chi-squared test was used to determine the associations among variables. Statistical significance was set at p &lt; 0.05. More than 70% of the doctors were ≤ 30 years of age and female. A total of 69.4% of the participants had &lt; 1year of experience. In total, 94.4% of the participants worked in medical ICUs. Less than 20% of the doctors used delirium assessment tools, with a statistically significant difference based on experience (p=0.012). Delirium was not regularly assessed in 13.9% of the patients. Non-pharmacological management was applied by 76.4% of doctors, and communication with patients was the most frequent (75%). Haloperidol was the most commonly used drug (83.3%). A total of 40.3% of doctors did not stop delirium medication on ICU discharge. A regular delirium assessment was performed. However, the use of validated assessment tools is uncommon. Nonpharmacological management of delirium is important and is mostly performed. Our doctors prescribed antipsychotics for the treatment of both forms of delirium, and almost half of them did not stop the medications on ICU discharge. Medication reconciliation and contact with the next in-charge of the patients are important.

Bacterial etiologies, antimicrobial susceptibility pattern and associated factors among patients suspected sterile body site infections at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia

BackgroundSterile body locations are usually associated with clinical urgency and life-threatening illnesses, and they are typically contaminated with diverse bacterial etiologies. If the bacteria acquire resistance to antimicrobial drugs, the public health crisis will only worsen. In developing countries, drug-resistant bacteria are common because of poor surveillance, diagnostic capacity, and control measures. Early diagnosis, and assessing the drug resistance and factors associated with infection are important to combat the drug resistance and treatment. This study aimed to assess the bacterial etiologies, antimicrobial susceptibility pattern, and possible associated factors among patients suspected of sterile body sites.MethodsA hospital-based cross-sectional study was conducted from June 2022 to August 2022 at Debre Markos Comprehensive Specialized Hospital in Amhara regional state, Ethiopia. One hundred seven study participants were selected using consecutive convenient sampling techniques. A structured questionnaire was used to collect socio-demographic and clinical data. Gram stain was done for a preliminary report and inoculated into blood agar, MacConkey agar, and chocolate agar and incubated aerobically and micro aerobically at 37°C for 24 h. Antimicrobial susceptibility testing was done by the modified Kirby Bauer’s disk diffusion method. Data were analyzed using bivariate and multivariate logistic regression was used. A p-value less than 0.05 is considered as statistically significant.ResultsThe overall magnitude of sterile body site infection among study participants was 7.5% (14/187). The majority of the isolates were Gram-negative bacteria with the predominant species Enterobacter cloacae accounting for 28.57% (4/14). Among isolates 78.57%(11/14) of them were multidrug-resistant isolates. Being inpatient, co-morbidity, and alcohol consumption were significantly associated with sterile body site infection.ConclusionIn our study, Gram-negative bacteria were the predominant bacteria that infects sterile body fluid. The prevalence of multi-drug resistance bacteria isolates was significantly high. Therefore, before prescribing an empirical treatment, a medical professional should identify the bacterial etiology of sterile body fluids and the susceptibility of microbes to the drug.

USE OF STERILE WATER FOR INJECTION IN THE MANAGEMENT OF LABOR PAIN: A RANDOMIZED CONTROLLED TRIAL

Objectives: The objectives of the study are to assess the efficacy of sterile water for injection (SWI) in reducing labor pain, compare it with a saline procedure, and see which one is superior. Parameters assessed were pain relief based on the numeric pain rating scale (NPRS) and duration of labor from intervention to delivery associated with administration of subcutaneous SWI versus normal saline injection (NSI). Methods: This is a prospective randomized interventional hospital-based comparative study of mothers who were in active labor with back pain and undergoing treatment in the labor room of Eden Hospital, Medical College and Hospital, Kolkata. The study was conducted on 66 willing pregnant mothers, divided into two groups of 33 each with one injected with normal saline and the other with sterile water. Results: The NPRS score was almost equal in 2 groups at 15 min, but with an increase in duration, it was seen that the score was low in the sterile water group compared to the normal saline group. The association was statistically significant (p&lt;0.05). Conclusion: This study hypothesized that subcutaneous SWI for relieving labor pain is better than subcutaneous NSI. Based on this study, it is concluded that both the SWI and NSI reduce labor pain, but the SWI produced a significantly greater reduction of pain as measured by the numeric pain rating score and also better satisfaction. Therefore, SWI is a safe, simple, and cost-effective method and can be used as a pain-relieving method, especially in the absence of other pain-relieving options.

Pro- and anti-inflammatory cytokines signatures at different severity of dengue infection

ABSTRACT Context: Dengue disease severity and progression are determined by the host immune response, with both pro- and anti-inflammatory cytokines are key mediators. Aims: To study pro- and anti-inflammatory cytokines across dengue severity and as a biomarker for predicting severe dengue infection. Settings and Design: Hospital-based cross-sectional study was conducted on 125 dengue-positive subjects across the 5-60 years age group of either gender in 2022. Methods and Materials: Haematological parameters and blood samples were drawn to measure cytokines IL6, IL-10 and TNF alpha using the ELISA technique. Statistical Analysis: One-way ANOVA and the Kruskal − Wallis test were used to compare the dependent variables across categories of the dengue spectrum. Receiver operating characteristic curve was drawn to calculate the predictability of the cytokines as a predictor of severe dengue. A P &lt; 0.05 was considered significant. Results: 34.4% of cases had severe dengue infection with 53.2% of severe cases reported in &gt;40 years of age. Only IL-6 levels significantly increased (P &lt; 0.01) across the spectrum of dengue infection across age groups &gt;20 years with a consistent and significant fall in platelet levels (P &lt; 0.01). The accuracy of IL-6 to predict severe dengue was 74.4% and platelet count was 16.2%. Conclusions: Only IL-6 cytokine levels were significantly increased across the spectrum of dengue infection observed in age &gt;20 years and can significantly predict the probability of severe dengue by 74% (sensitivity 81.4%). A significant decrease in platelet values is consistent with the severity but is not a good predictor for severe dengue infection.

Variant-specific Symptoms After COVID-19: A Hospital-based Study in Hiroshima.

Symptoms after novel coronavirus disease 2019 (COVID-19) recovery by severe acute respiratory syndrome coronavirus 2 strains are unspecified. This self-administered questionnaire-based study was conducted to investigate symptoms after COVID-19 recovery at one of the main hospitals for COVID-19 treatment in Hiroshima, Japan, from September 2020 to March 2022 for patients who visited follow-up consultations after COVID-19. Study subjects were divided into four groups (Wild-type, Alpha, Delta, and Omicron periods) according to COVID-19 onset date. Hierarchical cluster analysis was performed to determine symptom clusters and investigate risk factors for each symptom cluster using multivariate analysis. Among 385 patients who enrolled in this study, 249 patients had any persistent symptoms at a median of 23.5 (interquartile range, 20-31) days after COVID-19 onset. Among patients with any persistent symptoms, symptom clusters including olfactory or taste disorders, respiratory symptoms, and cardiac symptoms were found. Respiratory symptoms were more frequent among patients infected in the Omicron period compared to the Wild-type period (adjusted odds ratio [AOR] 3.13; 95% confidence interval [CI], 1.31-7.48). Compared to patients who recovered from mild COVID-19, patients who needed oxygen or ventilation support suffered fewer post-COVID-19 respiratory symptoms (AOR 0.46; 95% CI, 0.22-0.97) but more post-COVID-19 cardiac symptoms among them (AOR 2.67; 95% CI, 1.26-5.65). Olfactory or taste disorders were fewer among patients infected in the Omicron period compared to the Wild-type period (AOR 0.14; 95% CI, 0.04-0.46). This study revealed that symptoms after COVID-19 may vary depending on the infected strain.

Prevalence and correlates of suicidal ideation in chronic patients with schizophrenia: a hospital-based cross-sectional study

ABSTRACT Background Prior studies seeking to identify factors associated with suicide in patients with schizophrenia have reported important, though limited, and controversial findings. Our aims were to examine the prevalence of suicidal ideation (SI) and investigate the relationship between SI and a variety of factors (such as insomnia, religious coping, previous life experiences, dependency in daily living activities, positivity) in patients with schizophrenia. Method This was a cross-sectional study carried out among Lebanese patients with schizophrenia during January 2022. Results Out of 196 patients, 17.3% had SI. Multivariable logistic regression found that more loneliness (aOR = 1.43) and more severe insomnia (aOR = 1.08) were substantially related with increased odds of reporting SI, whereas having more positive life experiences (aOR = 0.83) was associated with lower odds of occurrence of SI. Positive/negative religious coping, activities of daily living and positivity showed no significant association with SI in our sample and context. Conclusion Findings showed that SI is highly prevalent in chronic patients with schizophrenia. The study identified three important factors (insomnia, loneliness, and positive experiences in life) associated with SI in schizophrenia, which could be targeted in prevention and intervention strategies.

Preference and Associated Factors for Cesarean Delivery Among Pregnant Women: A Cross-Sectional Study

Objective: A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its frequency has risen in both industrialized and developing nations. Maternal request for cesarean delivery has been explained for the escalating rate along with other factors like anxiety, fear of childbirth, previous cesarean delivery, previous negative vaginal birth experience, maternal age, maternal education, and socioeconomic factors. Hence, this study was undertaken to assess pregnant women's tendency to have a cesarean birth and to investigate the factors associated with the inclination for cesarean delivery. Materials and methods: A hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, a systematic sampling procedure was utilized, and 368 antenatal mothers after 36 weeks of gestation, who do not have any specific medical reasons against vaginal delivery were included in the study. Data collection was done by questionnaire. The information regarding socio-demographic factors, preexisting comorbidities, current obstetric risk factors, emotional factors, previous delivery experience, and their information preference toward the mode of delivery were collected. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery. Results: The preference for cesarean delivery and non-preference for cesarean delivery was 114 (30.9%) and 201 (54.6%), respectively whereas 53 (14.4%) participants remained neutral. The Chi-square analysis revealed a notable connection between the inclination towards a preference for cesarean delivery and factors such as obstetric score, parity, comorbidities, and among obstetric risk factors such as pregnancy after in-vitro fertilization (IVF), with a history of abortion, and having a prior history of cesarean delivery. Nevertheless, no meaningful association was observed between the preference for cesarean delivery and the remaining variables. On multivariate logistic analysis, independent variables like preexisting anxiety or depression, pregnancy through IVF, and having a history of previous cesarean delivery have increased the odds of preferring cesarean delivery. The independent variables like increasing gestational age, graduates, and unemployed have decreased the odds of preferring a cesarean delivery. Conclusion: In conclusion, the prevalence of cesarean delivery is influenced by a complex interplay of medical, cultural, socioeconomic, and healthcare system factors. While cesarean delivery is essential in cases of medical necessity, efforts should be made to avoid unnecessary cesarean delivery that does not provide clear benefits over vaginal delivery. Balancing the risks and benefits of cesarean delivery and promoting evidence-based obstetric practices are crucial for ensuring optimal maternal and infant outcomes.