Medical Card Research Articles

Antibiotic Prescription Pattern, Appropriateness, and Associated Factors in Patients Admitted to Pediatric Wards of Tibebe Ghion Specialized Hospital, Bahir Dar, North West Ethiopia

Irrational prescribing of antibiotics leads to the emergence of resistant bacteria. Despite this fact, antimicrobial agents are commonly prescribed in the inpatient setting, especially in infants and children. The aim of this study was to assess the pattern of antibiotic prescription, appropriateness, and associated factors in pediatric wards of Tibebe Ghion Specialized Hospital (TGSH), Bahir Dar, North West Ethiopia, September 11th, 2021 to October 12th, 2021 GC (Gregorian Calendar). An institution-based cross-sectional study was conducted in the pediatric wards of TGSH from September, 2020 to August, 2021 GC. Data were collected using a structured checklist containing each patient's socio-demographic characteristics, clinical information, list of prescribed drugs, and reason for prescription. A systematic random sampling technique was used to select pediatric patients' medical records containing prescribed antibiotics. The collected data were entered and analyzed using SPSS version 25 software. A total of 279 pediatric patients' medical cards including at least one antibiotic were reviewed. The study revealed that antibiotics were prescribed for most of the patients (88.9%) for empiric treatment purposes. The main medical conditions for which antibiotics were prescribed were pneumonia (16.8%) and early-onset neonatal sepsis (14.0%). Ceftriaxone was the most widely used (84.9%) antibiotic among the monotherapeutic antibiotics, while ceftriaxone plus metronidazole (23.5%) was the most frequently used combination of antibiotics. A high proportion (30.8%) of the pediatric patients was exposed to inappropriate treatment. Residence in rural areas (P=0.046) and being 1 year old or younger (P<0.05) were found to be independent determinants of inappropriate drug use. Antibiotics were the most prescribed class of medications for pediatric patients in TGSH. Ceftriaxone and ampicillin were the most frequently prescribed antibiotics in the pediatric wards of TGSH. A high proportion of patients had been exposed to inappropriate antibiotic treatment. Early age and rural residence were found to be the factors that were significantly associated with inappropriate antibiotic utilization.

Magnitude and its associated factors of teenage pregnancy among antenatal care attendees in Bahir Dar city administration health institutions, northwest, Ethiopia

BackgroundWorldwide teenage pregnancies develop many devastating complications, both the mother and the neonate like developing anemia, nutritional deficiency, pregnancy induced hypertension, preterm baby, inadequate weight gains and obstructed labor, fistula and sepsis. Reproductive health concerns of adolescents the main emphasis area which increasing international attention in recent years. Therefore, we intended to assess the magnitude and its associated factors of teenage pregnancy in Bahir Dar city administration health institutions, northwest, Ethiopia, 2017.MethodsA health institution based a cross-sectional study was conducted among pregnant mothers from February 20-March 27, 2017 in Bahir Dar city administration. Five hundred forty-nine participants were selected by face to face interview and medical card review by using systematic random sampling technique every four intervals for each health institution. Bivariate and multivariate data analysis was performed using Statistical Package for the Social Sciences (SPSS) Windows version 21 and level of significance of association was determined at P- value < 0.05.ResultThe study identified 12.2%with (95%CI (9.5, 14.9)) of pregnant women were teenagers. Multivariable logistic regression analysis showed that: [(AOR (95% CI)) rural residency 3.21(1.234, 9.345), age at first marriage < 18 years 9(7.823, 17.571) and not using contraception prior to this pregnancy 5.22(3.243, 11.675)] were significantly associated with teenage pregnancy.ConclusionThe magnitude of teenage pregnancy was comparable to the 2016 Ethiopian demographic health survey finding. Rural residency, age at first marriage and not using of contraception prior to the current pregnant were significantly associated with teenage pregnancy. As per the findings, awareness creation to the rural population, advocating utilization of contraception, avoid early marriage and put the mindset the effect of teenage pregnancy for those are needed.

PREDICTIVE FACTORS FOR SPONTANEOUS REGRESSION OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE INSTITUTE IN CENTRAL INDIA

Aim: The aim of this study is to identify the factors affecting spontaneous regression of Retinopathy of prematurity. Methods and Material: All the neonates with gestational age of &lt;37 weeks and/or &lt;2kgs birth weight were screened and demographic data and data regarding the risk factors were noted at the start of study from their birth cards and medical cards they carried with them and was noted in a proforma. In those neonates in whom the Retinopathy of Prematurity presented or progressed to type 1 ROP were treated. Rest of them were followed as per ICROP (2005) guidelines till complete vascularisation. Risk factors were compared between the two groups. The Statistical analysis was performed by SPSS 23.0 version. In the study 426 neonates were screened of them 183 eyes of 94 n Results: eonates had ROP. Sixty three neonates had spontaneous regression and 31 were treated as per ETROP guidelines. Mean gestational age in spontaneous regression group was 32.24±2.14 weeks, and that of treatment group was 29.9 ±2.44 weeks. This difference was statistically significant (P&lt;0.001). Mean birth weight in spontaneous regression group was 1449.84±288 grams, and that of treatment group was 1309.93 ±291.06 grams. This difference was statistically significant (P=0.023). Oxygenation and NICU hospitalisation &lt;1 week, anemia and blood transfusion, lesser weight gain in the initial 6 weeks were found to significantly affect spontaneous regression of ROP (P&lt;0.005). Higher gestational age, Oxygenation and NICU hospitalisation &lt;1week were found to independently influence spontaneous regression of ROP. Conclusions: The gestational age of infant is an important predicting factor in spontaneous regression of ROP. Longer duration of oxygenation and NICU hospitalisation are important factors affecting spontaneous regression of ROP inversely.

FORENSIC MEDICAL DETERMINATION OF THE SEVERITY OF CHEST INJURIES WITH RIB CAGE TRAUMA

Background. Closed chest trauma with rib fractures is a common injury to the external respiratory system. Victims with such an injury may be subject to forensic examination. Purpose. The aim of the study was to determine the severity of injuries in patients with closed chest trauma with violation of the integrity of the costal skeleton, treated in a specialized surgical hospital, to establish additional criteria for forensic diagnosis of such trauma. Subjects and Methods. 71 medical cards of inpatients, patients with chest injuries who were treated at the Kharkiv Institute of General and Emergency Surgery named after V.T. Zaitseva. A forensic medical evaluation of closed chest injuries with rib fractures was performed according to the severity of injuries according to clinical observations. Morphological and clinical approach was used to determine the severity of injuries. Results. Severe injuries were found in 14 (19.7%) cases of injuries, mainly with the occurrence of a life-threatening phenomenon, namely acute respiratory failure. Moderate injuries were found in 57 (80.3%) cases of chest injuries with rib fractures in the absence of danger to life. Conclusions. It is established that in the available scientific and methodological literature there are no diagnostic morpho-clinical signs for qualitative forensic assessment and prediction of the final results of closed chest injuries, there are different views on forensic assessment. It is determined that when applying the morphological and clinical approach of forensic assessment, additional diagnostic criteria for closed chest injuries, should be considered when determining the severity of injuries: dynamics and duration of recovery of post-traumatic morphological and functional changes of injured organs. or the entire respiratory system (lungs), the occurrence of life-threatening phenomena. The ways of further improvement of forensic diagnostics in the assessment of these injuries by the degree of their severity are identified.

Do adult patients with congenital colorectal conditions know their diagnosis?

Limited research exists about the knowledge that adult patients have about their congenital colorectal diagnosis. This was an IRB approved, prospective study of patients in the Adult Colorectal Research Registry who completed surveys between October 2019 and March 2022. Surveys were administered through REDCap after patients consented to being contacted for research purposes. Patients provided demographic data, which was linked to surgical records, and the diagnoses provided by patients were compared with diagnoses recorded by the original surgeons. One hundred and thirty-one questionnaires were collected, 115 patients had anorectal malformations (ARM) and 16 had Hirschsprung disease (HD). Seven patients who had ARM were unaware that they had an ARM or HD. The type of ARM recorded by the surgeon was unavailable for comparison with the patient's reported diagnosis in four cases. Of the 111 remaining patients with ARM, only 32 of them (29%) knew what their own type of anomaly was. Female patients recalled their diagnosis more often than male patients (42.4% vs 13.5%). All 16 participants with HD correctly identified their diagnosis severity as HD with or without total colonic aganglionosis. The results of this study demonstrate patient's limited understanding of their type of ARM and highlight the urgent need to enhance communication and education strategies, such as issuing patients with medical diagnosis identification cards. It is critical for clinicians to better communicate with patients to ensure that they and their relatives truly understand their precise diagnosis. Adequately informed patients can better advocate for themselves, adhere to treatments and precautionary recommendationsand navigate the complexities of transitional care. Consequently they canmore effectively manage theirlifelong complications.

Clinical-epidemiologic and serologic characteristics of Lyme disease in the Zaporizhzhia region (a retrospective analysis for 2015–2019 according to the Municipal Institution “Regional Infectious Hospital” of Zaporizhzhia Regional Council)

The aim of the work is to clarify the clinical and laboratory features of Lyme disease in the Zaporizhzhia region on the basis of a retrospective clinical, epidemiological and serological analysis of this disease cases in the period from 2015 to 2019. Materials and methods. A retrospective analysis of 62 medical cards of stationary patients with Lyme disease for the period from 2015 to 2019 was carried out. The age of the patients ranged from 18 to 79 years. There were 38 men and 24 women. All the patients were given a traditional complex clinical-laboratory examination; ELISA was used to defined serum IgM and IgG to Borrelia burgdorferi. Results. According to the study results it was found that Lyme disease in the Zaporizhzhia region had a clear seasonal prevalence in summer (56.5 %) and spring (25.8 %). The vast majority of patients (80.6 %) clearly indicated the tick bite. The disease was mostly acute (90.3 %) with a predominance of erythema (94.6 %). In the acute course of the disease, patients were seropositive in 75.0 % of cases with simultaneous detection of both IgM and IgG to Borrelia burgdorferi, and positive IgM in the absence of IgG. Seronegative 25.0 % of patients required clear clinical and epidemiological data to confirm the diagnosis. Under prolonged and chronic conditions, patients had positive IgG to Borrelia burgdorferi (100 %) and IgM (50.0 %). Certain clinical and laboratory features at different course of Lyme disease were revealed. So, the acute course was characterized by the predominance of erythema (94.6 %), mild or no manifestations of general intoxication syndrome, lack of pathological changes in the hemogram in most patients (80.4 %). In the prolonged and chronic course, there was no history of erythema, clinical symptoms were polymorphic, half of the patients had increased erythrocyte sedimentation rate in the absence of changes in blood count, mild cytolytic syndrome and hyperbilirubinemia. Conclusions. As a result of the retrospective analysis of Lyme disease cases in the period from 2015 to 2019, certain patterns of epidemiological, clinical and serological changes in different courses of this infection in the Zaporizhzhia region were revealed, namely the clear seasonality of the disease, in the acute course – the predominance of erythema and different variants of serological profile in patients, and in prolonged and chronic course – polymorphism of all clinical symptoms and no history of erythema.

EVALUASI RASIONALITAS PENGGUNAAN ANTIBIOTIK ISPA PADA PASIEN RAWAT JALAN DI PUSKESMAS KECAMATAN GUNUNG SITOLI

URTI (Upper Respiratory Tract Infection) is a major disease in children in outpatient installation. Antibiotics are the most widely used class of drugs to treat infections. Antibiotics must be used rationally. Because the bad impact that occurs is the emergence of bacterial resistance. This study aims to obtain an overview of the rationality of the use of antibiotics in URTI patients, especially in children aged 5 to 11 years. The method used is a retrospective descriptive method, using medical record cards and prescription sheets for patients diagnosed with URTI and receiving antibiotics at the Gunungsitoli District Health Center during the period January to December 2020. Sampling used the purposive sampling method. Data that met the inclusion criteria were children aged 5-11 years and receiving antibiotic therapy. Then a table is made which includes the patient's identity, diagnosis, antibiotics, and the dose used. Then presented in the form of percentages, average values ​​and tables. The results showed that of the 64 patients who suffered the most URTI by age were patients aged 5 years (26.56%), the antibiotic group that was most often prescribed was the penicillin group, namely amoxicillin. (54.69%). Evaluation of rational use of antibiotics based on the 2011 Ministry of Health guidelines includes the right patient criteria (100%), right indication (100%), right frequency (100%), right drug (100%), right duration (98.44%), and right dose (93.75%).

Clinico-pathological analysis of a rare case of pulmonary nocardiosis under the mask of disseminated tuberculosis

Nocardiosis is a rare infectious disease caused by bacteria of the genus Nocardia and characterized by the development of foci of purulent-necrotic inflammation of the lungs, brain, and internal organs. Clinical diagnosis of nocardiosis has objective difficulties. The aim of the study is to highlight a rare clinical case of pulmonary nocardiosis, to analyze mistakes in the clinical diagnostics of the main disease, to discuss the differential diagnosis of nocardiosis. Materials and methods. A clinico-pathological analysis of an inpatient and outpatient medical record card, and the results of an autopsy of a 58-year-old patient who died in an anti-tuberculosis institution from pulmonary nocardiosis has been carried out. Results. According to the anamnesis, the patient suffered from COPD and chronic polyposis rhinitis with hypertrophy of the nasal turbinates for many years. Polypectomy and submucosal resection of the nasal septum were performed in the otolaryngology department. Wegener's granulomatosis was suspected during the intravital pathomorphological examination of nasal polyps, and glucocorticoids were prescribed in the hospital. Histological preparations and biological material of the patient were examined in clinics in Berlin, the diagnosis of “Wegener's granulomatosis” was not confirmed, however, domestic doctors recommended Medrol, which the patient received continuously for 5 years at a dose of 12 mg/day. After 5 years, the patient was admitted to the hospital of a specialized anti-tuberculosis institution in serious condition with a clinical diagnosis: newly diagnosed disseminated tuberculosis of both lungs with disintegration, right-sided spontaneous tension pneumothorax, respiratory insufficiency of the III degree. According to urgent indications, thoracentesis and drainage of both pleural cavities were performed. Despite intensive therapy, the condition worsened, and biological death occurred 11 days after hospitalization. During the post-mortem pathological examination, signs of tuberculosis of both lungs were not detected, nocardiosis of both lungs was diagnosed, which pathomorphologically manifested as multiple foci of purulent-necrotic bronchopneumonia with disintegration. Pathological diagnosis was confirmed by bacteriological and PCR examination of the post-mortem material. The disease developed on the background of wrongly prescribed long-term glucocorticosteroid therapy, which was carried out for the misdiagnosis “Wegener's granulomatosis”. No signs of Wegener's granulomatosis were found at autopsy. The direct cause of death was acute respiratory failure. Conclusion. Thus, pulmonary nocardiosis was not diagnosed in the hospital, the reason for the misdiagnosis was the rarity of the disease and the objective difficulties of diagnostics. A decisive role in the development of nocardiosis was played by erroneously prescribed long-term glucocorticosteroid therapy, which should be considered as a pathology of the therapy

Quality of medical records in public health facilities: A case of Southern Ethiopia, resource limited setting.

Facility based retrospective study was conducted in three regions in southern Ethiopia to assess quality of medical records. A total of 2,145 medical records were reviewed from 73 public health facilities. Minimum standards of medical records were considered to assess completeness and legibility of records. The completeness of medical records were judged systematically according to national HMIS formats. From total of 2,145 medical cards reviewed, only 394 (18.4%) records had all complete and readable data. Gaps observed include 29.0% missed at least one of identification data, 14.3% lack chief compliant, 20.1% lack diagnosis, 12.5% lack medication and 60.3% records had no date and/or signature. Moreover, 9.5% cards had at least one non-readable component. Records at health centers were 56.8% less likely to be quality record as compared to records in hospitals. Even though completeness of every single record is must, only less than one fifth of records met quality of national medical record standard. Ministry of health should consider rules and regulation to maintain data quality and switching to electronic record, and finally progress in data quality should be monitored routinely.

To determine the outcomes of transurethral nephroscope for the treatment of large vesical stone with using pneumatic lithoclast

In this study, our aim is “to study the determine the outcomes of transurethral nephroscope for the treatment of vesical stones using pneumatic lithoclast”. Material and Methods: The detailed study was conducted in Department of Urology, Islam Medical &amp; Dental College/ Islam teaching/Central hospital Sialkot, from March 2019-March 2020 where we included 25 Male and 5 female who with vesical stones greater then 4 cm that was fragmented using the through transurethral use of a nephroscope via 26F amlplatz sheath. We took history from medical cards and conducted physical examinations, lab tests, urine culture and ultrasonagraphy of urinary tract. Then using the x-ray KUB film for stone clearance. We noted the mean age, operation time, presenting symptoms, complications and the post operative status of the stone clearane, and conducted our analysis using SPSS version 20. Result: The mean age ± SD was noted to be 48.79±12.499 years and male to female percentage being 89% to 11%. The mean stone size was 4.53±0.38 cm and mean operation time was 48.79±8.73 minutes. Thirty-one patients (31%) developed retention of urine and straining during micturition in (17%), dribbling of urine (15%) , hematuria (10%), frequent urination(10%) and abdominal pain was reported in 15% patients. Ninety-six (96%) patients achieved the stone-free status and had no complications while only 1 patient had an intravesical bleeding. Conclusion: We conclude that treatment of large stone using a nephroscope via a transurethral amplatz sheath is an effective procedure and quick too.We also noticed that the Amplatz sheath helps in pneumatic lithotripsy is indeed an effective and safe procedure to be carry out in patients with large bladder stones.

Клинико-статистическая характеристика и факторы риска у детей с бронхиальной астмой, имеющих коморбидную патологию

INTRODUCTION: The existence of combined pathology in children with such a common chronic disease as bronchial asthma requires special organizational approaches to providing them with medical care, taking into account not only clinical, but also medical and social characteristics. AIM: To study social and hygienic risk factors in children with bronchial asthma and comorbid pathology. MATERIALS AND METHODS: To study medical and social risk factors in children with bronchial asthma with comorbid pathology, a sociological survey of their parents was conducted. The survey involved the parents of 368 children diagnosed with bronchial asthma. To obtain clinical and statistical characteristics of children, primary medical documentation was selected and analyzed — medical histories and outpatient cards. This is a single-center, non-randomized and uncontrolled study. RESULTS: It was found that in children of the early age with comorbid pathology, diagnosed with bronchial asthma, the latter mostly takes uncontrolled and partially controlled course. The most common comorbid diseases are diseases of the respiratory organs (except for bronchial asthma), digestive organs, endocrine system, eating disorders, metabolic disorders, a combination of several diseases of allergic origin. Among the socio-hygienic factors potentially affecting the health of children, the most common were smoking in the family, low income, and poor housing conditions. CONCLUSIONS: The information obtained can serve as the basis for the development of measures for primary and secondary prevention of bronchial asthma in childhood.

ОЦЕНКА КАЧЕСТВА ЖИЗНИ ЭВЕНКОВ ПО ОПРОСНИКУ SF–36

The study used the SF-36 questionnaire, suitable for use in the general and clinical populations, to compare health status between populations and between diseases. In the world literature, data on the quality of life of the Evenks according to the SF-36 questionnaire were not found. The quality of life of the Evenks associated with the state of health has been studied. To conduct a survey of the adult population of the village of Zhilinda, a sample representative of gender and age was formed in the amount of 150 people, of which 69 were men (46 %) and 81 were women (54 %). The average age of the surveyed women was 43.3 ± 16.6 years, men - 41.1 ± 16.4 years. Gender comparisons were made. The questionnaire contained the following sections: general information, family income, living conditions, employment, nature of work, satisfaction with medical care and a medical examination card, consisting of sections: physical activity, smoking status, consumption of alcoholic beverages, Rose questionnaire, frequency of consumption of certain foods, quality of life questionnaire. To compare the quality of life of the inhabitants of the village of Zhilinda, the base of population values of the transformed indicators of the SF-36 questionnaire from the city of Yakutsk was used. The inhabitants of Zhilinda revealed low levels of physical functioning. The following factors were associated with decreased physical functioning: female gender, increased age, college education, increased body mass index, low income, and presence of joint/spine pain. Social functioning decreased with dissatisfaction with housing, vitality with low income, general health with an increase in the number of cigarettes smoked. Evenki quality of life can be significantly improved by reducing body weight, quitting smoking, treating diseases of the musculoskeletal system, increasing income and improving living conditions.

Rancang Bangun Sistem Informasi Berobat Jalan di Klinik Cikijing Rancaekek

Information technology provides benefits for human life. Utilization of technology in the service sector is needed because it can provide optimal service to clients. Meanwhile, currently the outpatient data processing at the Cikijing Rancaekek Clinic is still manual, causing several obstacles, namely difficulty in finding patient data because they are still looking through medical record cards, difficulty in making reports quickly and accurately and difficulty in calculating treatment costs.The purpose of this study is to make it easier to find patient data, make reports quickly, and make the calculation of patient treatment costs more effective. The method used is SDLC with a waterfall model and data collection techniques. System analysis and design tools used for this final project are Flow Map, Data Flow Diagram (DFD), Entity Relationship Diagram (ERD), Data Dictionary (Data Dictionary), and Structure Chart. For program implementation using Microsoft Visual Foxpro9.0 programming language. In this system, it is concluded to overcome the problems that have occurred in the old system, so that it can assist in the process of searching for patient data, making reports and calculating treatment costs.

Mobile app and digital system for patients after myocardial infarction (afterAMI): study protocol for a randomized controlled trial

BackgroundTreatment of acute myocardial infarction has been the subject of studies over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient’s prognosis. It is extremely important to take care of all cardiovascular risk factors and undergo a full rehabilitation program. Telemedical solutions are becoming more and more relevant in everyday practice. We describe a protocol of a study evaluating the use of the mobile application “afterAMI” in patients after myocardial infarction. The app offers an educational mode, calendar, vital signs diary, medication reminders, medical history card, and healthcare professional contact panel. It offers several solutions, which individually proved to be effective and improve a patient’s prognosis. Despite general promising results from previous studies regarding telemedical tools, there is a paucity of evidence when it comes to prospective randomized trials. Our aim was to perform a comprehensive evaluation of a newly developed mobile application in the clinical setting.MethodsA group of 100 patients with myocardial infarction on admission at the 1st Chair and Department of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analyzed, along with rehospitalizations, the patients’ knowledge regarding cardiovascular risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1 and 6 months after inclusion into the study.DiscussionThis project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients.Trial registrationClinicalTrials.govNCT04793425. Registered on 11 March 2021.

Symphysiopathy during pregnancy, assessment of risk factors

Objective: to assess the significance of clinical and anamnestic characteristics of women as risk factors for the development of symphysiopathy during pregnancy. Materials and methods: a retrospective analysis of 26 birth histories of patients with a diagnosis of symphysiopathy/symphysitis delivered in the GUZ «Clinical Maternity Hospital No. 2» in Volgograd at 38–39 weeks of pregnancy from 2016 to 2020. All patients diagnosed symphysiopathy was made at the management of pregnancy in the antenatal clinic on the basis of complaints, the data of physical examination and by ultrasound. The data of all pregnant women were ordered, encoded and entered into tables in the program MS Excel. Statistical analysis was performed with the SPSS program for windows 16.0. Results: clinically, symphysiopathy was manifested by pain in the area of the pubic in 100% of cases. According to the medical cards, only two cases (7.7%) were treated with physical therapy. The conducted statistical analysis showed that such risk factors for the development of symphysiopathy as age, parity and body mass index (BMI) do not have statistical significance as possible factors affecting the course of symphysiopathy. A statistical analysis of the possible effect of weight gain on the width of the diastasis was carried out, according to which the compared groups have a statistical difference in the width of the diastasis (p=0.007). Conclusion: the study shows that there is no significance of such clinical and anamnestic factors as age, parity, BMI for the manifestation of symphysiopathy during pregnancy. In this study, the only statistically significant criterion affecting the course of symphysiopathy is increased overall weight gain during pregnancy.

SEX AND COVID-19 IN HOSPITALIZED PATIENTS IN DNIPRO (UKRAINE)

TYPE: Abstract TOPIC: Chest Infections PURPOSE: To study the gender impact on the course of COVID-19 in Dnipro (Ukraine). METHODS: The retrospective study included medical cards of patients with Covid-19 hospitalized to the Clinical hospital#4 in Dnipro in October,2020.Were investigated patient complaints,concomitant diseases, oxygen saturation and the degree of lung damage(chest computer tomography).Statistica 10.0 was used. RESULTS: Totally 68 in-patients cards (28 men (M) and 40 women (W) were included).Patients had moderate COVID-19.Groups of M and W were comparable by age, severity and duration of disease and medications. Strong headache and cognitive impairments were in 40% of M and 24% of W(p=0,02). High blood pressure was in 30% of M and 5,2% of W (р=0,004).Fever 38 0 C was in 35,7% of M and 60% of W (p=0,049).Severe dyspnea was in 42% of M and 39% of W(p=0,4).COPD had 18% of M and 2,5% of W (р=0,03),previously diagnosed hypertension was in 43% of M and 45% of W (p=0,4), chronic kidney disease was in 3,5% of M and wasn’t diagnosed in women(p=0,2).Diabetes mellitus was in 15,2% of M and in 18,5% of W (p=0,07).Oxygen saturation in M was 93,0 (3,8)%,in W - 95,0 (3,5)% (p=0,06).% of damage of the lung on a CT was 36 (0,8)% in M and 31,2 (0,9)% in W(p=0,04). CONCLUSIONS: Men with moderate COVID-19 had more headache,cognitive impairment high blood pressure and higher percentage of lung impairment and the rate of comorbid COPD.Women more often suffer from fever and had comorbid hypertension. CLINICAL IMPLICATIONS: Patients underwent treatment in the city clinical hospital 4 into a covid department. DISCLOSURE: Nothing to declare. KEYWORD: COVID-19

CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF COVID-19 ASSOCIATED MYOCARDITIS

The article is devoted to the actual problem in the case of ongoing COVID-19 pandemic – the clinical and morphological characteristics of СOVID-19 associated myocarditis in conditions of non-widespread of this topic. The aim of the study is to study the clinical and morphological features of COVID-19 associated heart damage in deceased patients. The study included data from medical cards of inpatients of Almaty City cardiological center, as well as postmortem data of 12 patients (9 men and 3 women, average of age 65,6±13,8, 51–80 years), dead patients with a diagnosis of atherosclerosis-associated diseases. Pathological anatomical autopsy was performed at the Central Pathological Anatomical Department of Federal Health Institution “Central Medical and Sanitary Unit No. 1 of the Federal Medical and Biological Agency Hospital №1 Russia. Extrapolating data from the pathomorphological study of deceased patients, who had a history of coronavirus infection and died from circulatory system diseases, on autopsy it was found that SARS-Cov-2 infection led to the development of subacute/chronic myocarditis. Its clinical manifestations develop within 4-6 months or more than a year after acute COVID-19 in the form of myocardial infarction or progressive heart failure. The researchers also emphasize the extreme importance of performing autopsy studies of any nosology in combination with COVID-19, for subsequent clinical and morphological analysis, which provide invaluable opportunities to summarize each morphological manifestation of this infection to be further compared to clinical manifestations. Thus, at present, any unclear myocardial dysfunction requires serodiagnosis of a new coronavirus infection. SARS-Cov-2 infection can cause chronic nonbacterial lymphocytic thromboendocarditis with an autoimmune mechanism; as well as its combination with lymphocytic myocarditis. Research in this field still needs to be continued.

Analysis of the Clinical Characteristics of Patients with Malignant Neoplasms of the Pancreas Who Received Medical Care in Hospitals in St. Petersburg in the Period from 2015 to 2020

The objective of the study was the analysis of the main clinical characteristics identified in patients with malignant neoplasms of the pancreas, who received medical care in healthcare institutions of St. Petersburg in the period from 2015 to 2020.Methods and materials. A continuous study of clinical and statistical data of patients with pancreatic cancer receiving medical care in healthcare institutions of St. Petersburg (of federal and city subordination) for the period from 01.2015 to 02.2020 was carried out. In total, the study included depersonalized medical cards of 2141 patients diagnosed with pancreatic cancer.Results. During the studied period, more than half of the patients diagnosed with cancer of the pancreas received medical care in specialized oncological institutions of city subordination, a third – in federal institutions, 11.3 % – in multidisciplinary city hospitals. The maximum number of cases was in patients of older age groups: 41.7 % – 70 years and over, including 15.4 % – 80 years and over. The majority (39.7 %) of new patients with pancreatic cancer hospitalized in medical institutions of St. Petersburg were diagnosed with stage IV of the disease. The disease, according to examinations, was represented by stage III in 29.7 % of patients at the time of initial hospitalization. The pancreatic cancer was presented with stage III in 20 % of the patients. The disease was registered in 4.4 % of patients at stage I. Stage 0 or carcinoma in situ was diagnosed at initial presentation in 4.7 % of patients. The stage of the disease was not determined in 1.4 % of patients. The tumor was located in the head of the pancreas in 64.4 % of patients. The most common histological type of pancreatic cancer is ductal adenocarcinoma, which was verified in 72.0 % of patients. Type 2 diabetes mellitus was registered in 37 % of patients as concomitant disease.Conclusion. The results of the analysis of clinical and statistical data of patients with pancreatic cancer may become a background for conducting research on the early detection of this neoplasm.

My Mother's Facelift

My Mother's Facelift

Prevalence and predictors of thrombocytopenia among HAART naive HIV positive patients at Ambo University Referral Hospital

BackgroundDeranged hematological parameters, including thrombocytopenia, are features of human immunodeficiency virus (HIV) infection. Thrombocytopenia is the second most frequent complication of HIV infection. Thus, this study aimed to determine the prevalence and correlates of thrombocytopenia among HAART naive people living with HIV at Ambo University referral hospital. MethodsHospital-based retrospective cross-sectional study was conducted at Ambo university referral hospital from June 2021 to September 2021. The data were gathered retrospectively from the patients' medical cards. The collected data was processed and analyzed using SPSS version 24 and presented as a table and figure, then interpreted based on the findings. Logistic regression was drawn with a p-value of less than 0.05 accepted as statistically significant. ResultsMost of the study participants were females 68(60.7%). The mean ± SD age of the patients was 36.46 ± 9.6 years, ranging from 19 to 67 years. The overall prevalence of thrombocytopenia was 13(11.6%). In terms of CD4 count, study participants with a CD4 count less than 350 were nearly 14 times more likely to have thrombocytopenia than those with a CD4 count greater than 500 (AOR = 13.76, 95% CI) (1.368–138.49). Participants in the study who were treated with AZT containing HAART were 9 times more likely to develop thrombocytopenia than their counterparts (AOR = 9.49, 95% CI (1.732–5202). ConclusionA decreased CD4 number and the presence of other medical co-morbidity showed to have increased risks towards the presence of thrombocytopenia. Therefore, to decrease thrombocytopenic-related mortality and morbidity, there should be continuous screening for HIV-infected patients.