Patients In General Hospital Research Articles

Improving the hospital or immunizing its organization? Patient and public involvement at the service of quality

IntroductionThere is a pressing need for the hospitals to improve their quality and become more patient-centered. Over the last decade, several approaches were implemented to meet this demand, such as hospital accreditation or patient surveys. Many studies have addressed the patient involvement systems from the viewpoint of the factors that drive them or the achieved performance. In this study, we examined the patient involvement from the viewpoint of its function and operation rather than its performance. Following Luhmann, we reconsidered quality to be related to the absorption of uncertainty rather than improvement or innovation. The adaptation of an organization to involve patient participation can be regarded as contributing to the immune function of the organizational system.MethodsThree case studies addressing patient and family advisory councils in general hospitals were conducted in Belgium. Qualitative empirical material is retrieved from observation, documentation, and interviews.ResultsOur findings suggest that the immune function of the hospital organization operates in four main phases. First, we assess how the communicative process indicates the relevant difference that needs to be addressed. Role differentiation occurs through the depoliticization and depersonalization of criticism. Second, given the impossible realization of first-order observation of the environment, our material shows how second-order observation is organized through a dual representation. Third, we unveil how the environmental representation requires a specific organizational socialization to overcome the representation paradox. Finally, we analyze how the whole described process must fulfil the preparation of a repertoire of responses to the irritations of its environment.DiscussionThe analysis revealed that patient and family advisory councils complete a crucial immune function for organizations, far beyond the simple discussion of the “nuts and bolts” of organizational structure. These findings permit to discuss implications of the notions of participation and quality regarding to identity work of stakeholders, open organization, and change management.

Long-term effectiveness of SBIRT by outreach visits on subsequent alcohol treatment utilization among inpatients from general hospital: a 36-months follow-up

Aim To investigate the long-term effect of Screening, Brief Intervention, and Referral to Treatment (SBIRT) on alcohol treatment utilization among general hospital inpatients. Methods This 36-month follow-up of a randomized controlled trial included general hospital inpatients who were screened using the Alcohol Use Disorder Identification Test (AUDIT). Patients with an AUDIT score of 8+ were included. Patients were randomized to either SBIRT (Relay) or treatment as-usual (TAU). Outcome was attendance at a specialized outpatient treatment institution or prescription of pharmacological alcohol treatment in general practice. Using the Danish Civil Registration System, patients were followed in the Danish National Patient Registry, Danish National Alcohol Treatment Register, and the Danish National Prescription Registry. Data was collected up to 36 months after discharge. Results The study population consisted of 258 patients in the Relay group and 303 patients in the TAU group. In the Relay group, 36 (14.0%) patients received treatment versus 23 (7.6%) in the TAU group. Patients in the Relay group had higher odds for receiving treatment compared to the TAU group (OR: 1.97, 95% CI: 1.1–3.4, p = 0.01). Significantly more patients in the Relay group scored 16+ on the AUDIT and had already tried to change their alcohol consumption (both p < 0.01). Adjusted for potential confounders, the effect of the Relay intervention was reduced (OR: 1.37, 95%CI: 0.7–2.5, p = 0.31). Conclusions This study did not find evidence that SBIRT is better than TAU at sustaining significant long-term alcohol treatment utilization after discharge among inpatients from general hospital.

A Study of Nurses’ Awareness of the Importance, Educational Needs, and Nursing Competence on Comprehensive Nursing Assessment for Hospitalized Elderly Patients in General Hospital

A Study of Nurses’ Awareness of the Importance, Educational Needs, and Nursing Competence on Comprehensive Nursing Assessment for Hospitalized Elderly Patients in General Hospital

General hospital patients’ attitude towards systematic health risk behavior screening and intervention

BackgroundSystematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval.MethodsAll 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients’ approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses.ResultsThe mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval.ConclusionHigh approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers.Trial registrationClinicalTrials.gov Identifier NCT05365269 on May 9, 2022.

Potential drug-drug interactions and associated factors among hospitalized pediatric patients in Adigrat general hospital, Tigrai, north Ethiopia: a retrospective cross-sectional study

BackgroundDrug-drug interactions (DDIs) are associated with increased or decreased adverse effects and decreased or decreased therapeutic effects. Hospitalized pediatric patients are exposed to a number of potential DDIs (pDDIs). There are limited studies on pDDIs among pediatric patients in Ethiopia. This study was aimed to evaluate the pDDIs and associated factors among hospitalized pediatric patients in Adigrat general hospital, Tigrai, northern Ethiopia.MethodsA retrospective cross-sectional study was carried out among hospitalized pediatric patients in Adigrat general hospital from 01 July 2020 to 31 August 2020. A simple random sampling technique was used to select medical charts. Micromedex 2.0 database was used to screen pDDIs. Data was analyzed using statistical package for social science version 21 and a P-value of ≤ 0.05 was considered statistically significant.ResultsOf the total 146 patients studied, 100 (68.5%) were exposed for at least one pDDI. A total of 158 pDDIs consisting of 33 distinct interacting drug pairs were identified. About 19.3% of the patients had at least one major pDDI, 6.7% at least one moderate and 68.9% at least one minor pDDIs. On the other hand, 63.3% of the total pDDIs were minor and 25.9% major while 3. 8% were contraindicated pDDIs with 15.2% fair and 81.6% good level of documentation. The overall mean duration of pDDIs exposure was about 4.9 (1-23) days. The frequently occurring potential clinical consequences of pDDIs comprised increased risk of QT-interval prolongation (10.1%), theophylline toxicity (5.1%), antiepileptic toxicity (5.1%) and formation of ceftriaxone calcium precipitates (3.8%). Infant/toddler age group (adjusted odds ratio [AOR] = 31.961, 95% CI: 1.117-914.528), number of diseases (AOR = 0.255, 95% CI: 0.069-0.939) and polypharmacy (AOR = 0.276, 95% CI: 0.091-0.838) were associated with pDDIs exposures.ConclusionsA large number of pediatric patients were exposed to a various pDDIs. Age, number of diseases and polypharmacy predicted for the occurrence of pDDIs. Besides, the major severity pDDIs encounted frequently in the current study can potentially lead to a life threatening cardio-vascular toxicicty from QT-interval prolongation. Clinicians should be vigilant to pDDIs to prevent potential clinical consequences of pDDIs. Moreover, computerized drug interaction screening and clincal pharmacy services should be practiced to improve patients’ safety.

Association of preoperative red blood cell width and postoperative 30-day mortality in patients undergoing non-cardiac surgery: a retrospective cohort study using propensity-score matching

BackgroundIn terms of predicting surgery mortality, it is controversial whether red blood cell width works independently. In non-cardiac surgery patients older than 18 years, we intend to examine the relationship between red blood cell width and postoperative 30-day mortality.MethodsIn this retrospective cohort study, 90,785 Singapore General Hospital patients were matched by propensity score between January 1, 2012 and October 31, 2016. It was determined that red blood cell width at baseline and mortality within 30 days after surgery were the independent and dependent variables. We used a non-parametric multivariate logistic regression to balance the confounders among 7807 patients with high RDW and 7807 patients with non-high RDW in the propensity score matching. We investigated the association between RDW and 30-day mortality after surgery using the doubly robust estimation method.ResultsCohorts matched according to propensity score, the risk of 30-day mortality after surgery increased by 114.6.0% among the high RDW group (OR = 2.146, 95% CI 1.645–2.799, P < 0.00001). In the crude model, there was a significant association between RDW and 30-day mortality after surgery (OR = 1.877, 95% CI 1.476–2.388, P < 0.00001). In the propensity-score adjusted model, the risk of 30-day mortality after surgery in the high RDW group compared to the control group was not as high as in the non-adjusted model (OR = 1.867, 95% CI 1.467–2.376, P < 0.00001). Compared to non-high RDW group, the risk of 30-day mortality after surgery increased by 117.0% and 127.7% among high RDW group in the original cohort (OR 2.170, 95% CI 1.754–2.683, P < 0.00001) and the weighted cohort (OR 2.272, 95% CI 2.009–2.580, P < 0.00001), respectively.ConclusionsAccording to the results of this observational, propensity score-matched cohort study, uncontrolled high RDW before surgery is associated with an increased risk of death within 30 days after surgery, that is to say, patients over the age of 18 with high preoperative RDW who undergo non-cardiac surgery have a worse postoperative prognosis than those with normal RDW.

Early ward discharge clinic: facilitating discharges and prompt follow-up for medical inpatients in a district general hospital

Early discharge and follow-up for medical admissions could facilitate reduced length of stay and improve patient satisfaction. However, evidence to confirm this is lacking. Peterborough City Hospital (PCH) designed an...

How Shift Nurses' Presenteeism is Related to Insomnia and Care Left Undone: A Cross-Sectional Study Using Generalised Structural Equation Modelling.

To examine the association between nurses' insomnia, presenteeism and care left undone and explore the mediating effect of presenteeism on the relationship between insomnia and care left undone among nurses in acute care hospitals, applying a dynamic model of presenteeism and absenteeism. A cross-sectional design. A secondary data analysis was conducted using online survey data collected in January 2023. Participants were 1154 registered nurses who provided direct nursing care to patients in tertiary or general hospitals (hospitals with 300 or more beds) in South Korea. Poisson regression analysis was used to examine the association between nurses' insomnia, presenteeism and care left undone. Generalised structural equation modelling was performed to examine the mediating effect of presenteeism on the relationship between insomnia and care left undone. The prevalence of insomnia was 15.3%. More than half of the participants (63.7%) reported experiencing presenteeism in the past 4 weeks. All reported at least one nursing care left undone during their last shift. Insomnia and presenteeism were positively associated with care left undone, and presenteeism mediated the relationship between insomnia and care left undone among nurses in acute care hospitals. Nurses experienced insomnia and presenteeism, related to higher rates of care left undone. Nurses' insomnia had a direct effect on care left undone and an indirect effect through presenteeism. Nurse managers and administrators need to make greater efforts to reduce insomnia and presenteeism among nurses, thereby reducing care left undone and improving patient safety in acute care settings. Nurse managers and administrators should consider proactive interventions to address nurses' insomnia and foster a workplace with healthy systems and culture to reduce sleep disturbance and presenteeism, which can effectively decrease care left undone. STROBE guidelines. No patient or public contribution.

Intestinal Parasites Prevalence on Patients Visiting Afgoi General Hospital, in Afgoi District, Somalia

Purpose Intestinal parasitic infection stands as a significant public health concern in developing nations. This study aims to determine the intestinal parasites prevalence on patients visiting Afgoi General Hospital, in Afgoi District, Somalia.  Methods A cross-sectional study design was implemented involving 195 patients at Afgoi General Hospital. Stool samples were obtained to assess intestinal parasite prevalence, while questionnaires were administered to gather and analyze the demographic profiles of the patients.  Results The intestinal parasite prevalence was determined to be 61%. Among the identified species, Giardia lamblia exhibited the highest prevalence at 33.3%, followed by Trichuris trichura at 12.3%, Ascaris lumbricoides at 10.8%, Entamoeba histolytica at 9.2%, Hymenolepis nana at 3.6%, Strongyloides stercoralis at 1.5%, Hookworm at 1%, and both Hymenolepis diminuta and Entamoeba coli at 0.5%.  Conclusion The study revealed a notable prevalence of intestinal parasitic infections among Afgoi General Hospital patients. Thus, enhancing sanitation practices, improving access to clean water, and initiating routine deworming programs are imperative measures.

FP7.10 - An audit assessing the documentation of antibiotic indication and course length on an acute surgical unit

Abstract Aims Documenting antibiotic indications and course lengths on drug charts at the time of prescription is recommended in numerous publications. A closed loop audit was therefore performed to assess the documentation of this information for acute general surgery patients in a district general hospital. Methods During the first cycle, drug charts from acute general surgery patients were reviewed and the rates of documentation for antibiotic indication and course length were assessed. To improve these measures, the results from this cycle were presented to junior doctors and cards reminding doctors to complete antibiotic documentation were made and attached to drug charts when necessary. The impact of these measures was examined during a re-audit. Results 50 patients were assessed during cycle one and antibiotic indication and course length were documented in 54.0% and 42.0% of cases respectively. Data from a further 50 patients were collected following the presentation to junior doctors working in general surgery and the introduction of the reminder cards. Following these interventions, antibiotic indication and course length were documented in 74.0% and 68.0% of cases respectively. Co-amoxiclav and Tazocin were the most common agents prescribed across cycle 1 (64.0% and 14.0% respectively) and cycle 2 (60.0% and 16.0% respectively). Conclusions The documentation of antibiotic indication and course length on drug charts needed improving in this cohort. Although the presentation of the data from cycle 1 and reminder cards achieved this outcome, further improvements are required and should be assessed during future re-audits.

In-hospital mortality and its associated factors among hospitalized stroke patients at public hospitals of Eastern Ethiopia

BackgroundStroke is rapidly developing clinical signs of focal/ global disturbance of cerebral function, with symptoms lasting more than 24 h and leading to death. Data showed that stroke deaths in Ethiopia reached nearly seven percent of total deaths. Despite this report, there is a paucity of investigations about the problem.ObjectiveTo determine in-hospital mortality and its associated factors among hospitalized stroke patients in Hiwot Fana Comprehensive Specialized University Hospital and Jugal General Hospital, eastern Ethiopia from September 2016–August 2022 G.C.MethodsA retrospective cohort study was conducted among hospitalized stroke patients. A sample size of 395 medical records was selected from a total of 564 stroke patients by a simple random sampling technique. The data was analyzed by SPSS version 26 using bivariable and multivariable cox-regression models. A p-value of 0.05 and less at a 95% confidence interval was used to establish a statistically significant association.ResultsOf the total, 109 (27.6%) died in the hospital while 57.2% and 15.2% of them were discharged with improvement and against medical advice, respectively. Age greater than 65 (AHR = 4.71, 95% CI = 1.11–19.96), creatinine level > 1.2 mg/dl (AHR = 1.54, 95% CI = 1.0-2.39), and co-morbidity with atrial fibrillation (AHR = 1.48, 95% CI = 1.0-2.21) were significantly associated with in-hospital mortality.ConclusionIn-hospital mortality was found in more than a quarter of stroke patients. Mortality was more likely increased among the patients with age > 65, serum creatinine level > 1.2 mg/dl, and atrial fibrillation. Hence, these high-risk patients need to be monitored.

Effectiveness of Video Assisted Teaching on Knowledge and Pre-procedure Anxiety Level of Patients Undergoing Upper GI Endoscopy

An endoscopy is a procedure in which doctor uses specialized instruments to view and operate on the internal organs and vessels.People often found anxious towards hospital environment itself. There no intervention was provided to re-leave from anxiety among the patients. So the researchers aimed to assess the effectiveness of video assisted teaching regarding upper GI endoscopy to improve knowledge and thereby reduce the anxiety among the patients in Government General Hospital, Puducherry.The present study was adopted quantitative quasi experimental research design. The 50 samples were selected by purposive sampling technique with inclusion and exclusion criteria. Pre test data was collected by using self-administered structures questionariesand video assisted teaching programme regarding endoscopy to the samples. The video contains introduction, functions, procedure and visualization of the endoscopy.The researchers accompany each sample during the endoscopy. Post test data was collected after endoscopy with the same questionnaire.The results revealed that, pre and post test mean score of knowledge was 5.26±2.562 and 11.12±0.480. The calculated paired ‘t’ value is 16.421 which was statistically significant at the p level 0.000. The pre and post test mean score of anxiety was 39.64±9.021 and 68.14±3.995. The calculated paired ‘t’ test value was 18.475 which was statically significant at the p level 0.000. The test results infer that, the video assisted programme was effective in improving knowledge and relive in pre procedure anxiety among the clients undergoing endoscopy.The chi-square value reveals that the level of knowledge was significant to gender and educational status at the p level 0.005 respectively and the level of anxiety was significant to educational status at the p level 0.005. The researchers recommended all the therapeutic and diagnostic procedures must be educated among the patients will help to gain complete success.

Overview of Biopsied Tongue Lesions Patients of General Hospitals in Iraq

Overview of Biopsied Tongue Lesions Patients of General Hospitals in Iraq

COVID-19 Inpatient Caseloads in General Hospitals Did Not Affect Quality Indicator Compliance Rates in Israel.

Early in the global COVID-19 pandemic, a concern was raised that potentially high volumes of COVID-19 inpatients in general hospitals might compromise the hospitals' capabilities to maintain high-quality care for routine patients and, thereby, to comply with indicators specifying quality of care. The objective of this study is to evaluate the impact of the surges of COVID-19 inpatients into general hospitals in Israel on the compliance rates for selected quality indicators reported by these hospitals within the Israeli National Program for Quality Indicators (NPQI). Compliance rate data were collected from the quality indicators reports made to the NPQI by participating hospitals. COVID-19 inpatient volume data were obtained from the Ministry of Health Digital Technologies and Data Division. Both datasets were analyzed on a week-by-week basis and plotted one alongside the other on a time scale. Association of each quality indicator's compliance rate with the number of COVID-19 inpatients was tested by Pearson's correlation analysis. The study included data from July 1, 2019 through June 30, 2022, spanning the duration of the COVID-19 pandemic in Israel. Five quality indicators included in the study were: Surgical repair of femoral neck fracture within 48h of admission; Assessment of cerebral ischemic event risk for patients with atrial fibrillation; Duplex carotid ultrasound within 72h of emergency department admission for patients with suspected transient ischemic attack; Antibiotic prophylaxis for caesarean sections; and Percutaneous coronary intervention within 90min for patients presenting with ST-elevation myocardial infarction. Compliance rates for five quality indicators, representing different aspects of routine health care, remained steady - even at times with high volumes of COVID-19 inpatients in general hospitals. This lack of effect was prominent throughout the analyzed period, i.e., general hospitals maintained similar compliance rates for all quality indicators both during the surges of COVID-19 patients and between these periods. Statistical analysis showed no correlation between the quality indicators' compliance rates and the number of COVID-19 inpatients. Our findings indicate that high volumes of COVID-19 inpatients in general hospitals did not affect the hospitals' capability to comply with routine health care quality indicators. The results of our study imply that general hospitals in Israel were able to withstand the challenges associated with the care of COVID-19 inpatients while preserving high quality of care for routine patients.

Measurement of Spiritual Wellbeing in an Australian Hospital Population Using the Functional Assessment of Chronic Illness Therapy: Spiritual Wellbeing Scale (FACIT-Sp-12)

Spiritual wellbeing is known to be a predictor of increased patient coping in hospital settings. Therefore, access to a valid and reliable measure of spiritual wellbeing amongst general hospital patients is highly recommended. The aim of this study was to investigate the dimensionality, reliability, and validity of the Functional Assessment of Chronic Illness Therapy Spiritual Wellbeing scale (FACIT-Sp-12) in a heterogeneous cohort of hospital patients. A cross-sectional survey was administered to 897 adult patients across six hospitals in Sydney, Australia. Confirmatory factor analysis for the three-factor FACIT-12-Sp indicated a poor fit, but after removal of Item 12, the three-factor FACIT-11-Sp presented a good fit to the data. Reliability testing indicated acceptable to good internal consistency. Validity was supported by statistically significant differences between patients who considered themselves ‘both spiritual and religious’ and ‘not religious or spiritual’. While some caution should be taken when using the FACIT-Sp due to several limitations, nevertheless, in a general hospital population in Australia, the three-factor FACIT-11-Sp indicated good dimensionality, reliability, and validity.

Assessing the criteria of somatic symptom disorder in general hospital patients (NCT04269005)

Assessing the criteria of somatic symptom disorder in general hospital patients (NCT04269005)

#1748 The burden of cardiorenal syndrome: epidemiological data and treatment: a one-center experience

Abstract Background and Aims Cardiorenal syndrome (CRS) is an entity combining cardiac and renal dysfunction in a bi-directional way. Six subtypes of CRS have been described, all of which are associated with high morbidity and mortality rates. CRS treatment—no matter the subtype—is until nowadays a field of investigation, aiming to the reduction of fluid overload and venous congestion. The primary endpoint of this study was to estimate the frequency of cardiorenal induced AKI compared to other AKI etiologies in hospitalized patients. We furthermore aimed to determine the burden of the therapeutic regimen in hospitalization duration and renal deterioration. Method This is a retrospective, quantitative analysis of hospitalized adult patients in General Hospital of Athens Hippokration suffering from AKI of various etiologies. No age or sex limitations were used for the purposes of this study. Results A total amount of 1163 patients were enrolled over the course of 18 months. 430 (36.9%) of these patients were hospitalized in the cardiologic department, suffering from either acute or chronic heart failure (66.5% of which were men) with a mean age of 74.4 ± 11.4 years. Mean creatinine level at hospital admission was 2.7 ± 2 mg/dl. Out of these patients, 33.9% were treated using diuretics alone, while 25.5% also needed hemodialysis. Mean number of days of hospitalization was 9.4 ± 5.8 days and 11 ± 8.8 days, while creatinine exit was 2.9 ± 1.5 mg/dl and 4.2 ± 3 mg/dl respectively. Conclusion Cardiorenal syndrome is a quite common cause of AKI in patients being hospitalized. In our study, patients that needed treatment with diuretics compared to those requiring a combination of diuretics and hemodialysis had less days of hospitalization and a better kidney function outcome.

Rescuing the profession we love: general practice training sector recommendations for improving the attractiveness of general practice training. A qualitative analysis.

To investigate the views of the general practice training sector about responding to recruitment challenges, with the aim of identifying effective initiatives and other solutions. Qualitative study; focus group discussion of recommendations from a medical educator workshop. An initial online appreciative enquiry workshop for medical educators followed by focus group discussions by a broader selection of people involved in general practitioner training (Royal Australian College of General Practitioners fellows, supervisors, practice managers, medical educators, registrars). Key overarching themes and major recommendations for increasing recruitment derived from focus group responses to workshop recommendations, based on qualitative descriptive analysis. The 26 medical educators at the workshop made four major recommendations: increase the number of student and junior doctor clinical placements in general practice; increase exposure of students and junior doctors to general practitioner teachers and educators; improve general practitioner trainee pay and entitlements; and improve the integration of general practice and hospital patient care and professional relationships. Thirty-four semi-structured focus group participants broadly supported the recommendations, provided that supervisors and training practices were adequately compensated for the effects on workloads, income, and patient care. Two overarching themes infused participant responses: "rescuing the profession we love" (reflecting participants' passion for general practice and their sense of threat), and "no idea what general practitioners do" (perceptions of being misunderstood and misrepresented by hospital-based practitioners). Clinicians, educators, and policy makers should work together to increase the number of high quality, adequately supported student and junior doctor placements in general practice, improve intra-professional relationships, and trial new models of general practitioner trainee payment and conditions.

Prescription pattern of drugs in post-COVID-19 mucormycosis patients in Government General Hospital, Kakinada – A retrospective study

Abstract: INTRODUCTION: Mucormycosis, or zygomycosis, is an aggressive fungal infection caused by Mucorales, posing a significant threat, particularly to immunocompromised individuals. Its incidence has surged in the context of the COVID-19 pandemic, necessitating a deeper understanding of its management strategies. MATERIALS AND METHODS: This retrospective cross-sectional study analyzed prescription patterns for post-COVID-19 mucormycosis in a tertiary care hospital. Medical records of 108 patients diagnosed with post-COVID-19 mucormycosis were reviewed to extract relevant data. RESULTS: The study revealed notable patterns in prescription management, including a male predominance (78.3%) and a mean age of 52.41 years. Diabetes mellitus was prevalent (95%), emphasizing its association with mucormycosis. Antifungal therapy, primarily posaconazole (95%), and adjunctive treatments varied. Surgical intervention, particularly debridement (70%), was crucial. Analgesic therapy, notably diclofenac (52%), and other medications were commonly prescribed, reflecting the complex health-care needs of mucormycosis patients. CONCLUSION: The study provides valuable insights into prescription patterns in post-COVID-19 mucormycosis, emphasizing the need for tailored approaches to optimize outcomes in this vulnerable patient population. Understanding prescription patterns for post-COVID-19 mucormycosis is vital for guiding clinical decision-making and optimizing treatment strategies in this vulnerable patient population. Further research is warranted to address limitations and enhance patient care and outcomes.

Antimicrobial Resistance Profile and Extended Spectrum Beta-lactamase Resistance Genes in Escherichia coli from Patients in General Hospital, Karshi, Abuja, Nigeria

Aims: This study investigated the antimicrobial resistance profile and extended spectrum beta-lactamase resistance genes in Escherichia coli of from urine of patients sourced from General Hospital, Karshi, Abuja, Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between August 2022 and February 2023. Methodology: A total of 120 samples were collected from patients. Escherichia coli was isolated from the samples using standard microbiological methods. Antibiotic susceptibility testing was evaluated as described by the Clinical and Laboratory Standards Institute (CLSI). The detection of ESBL production in E. coli isolates was carried out using double disc synergy test. In addition, molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method. Results: The prevalence of E. coli was 17.5% (21/120), out of which two (2) of the positive isolates (9.5%) were male, and 19 (90.5%) female. Antibiotic resistances in the isolates in decreasing order were as follows: sulphamethoxazole / trimethoprim (SXT: 81.0%), amoxicillin/clavulanic acid (AMC: 61.9%), ofloxacin (OFX: 66.7%), cefotaxime (CTX: 53.4%), gentamicin (CN: 42.9%), ceftriaxone (CRO: 33.3%), imipenem (IPM: 33.3%), meropenem (MOR: 42.4%), nitrofurantoin (NET: 20.3%) and ciprofloxacin (CIP: 23.8%). The commonest antibiotic resistant resistance phenotype was CIP-OFX-SXT (23.8%). Multiple antibiotic resistance (MAR) was observed in 90.5% (19/21) of the isolates, with the common MAR index being 0.3 (23.8%). Six of the twenty one beta-lactam resistant isolates (28.5%) were confirmed ESBL producers. The 6 ESBL positive isolates carried bla genes as follows: blaTEM (1/6, 16.7%) and blaCTX-M (1/6, 16.7%). blaSHV only was not found in any of the isolates. Conclusion: The E. coli isolates from urine of patients in General Hospital, Karshi, Abuja, Nigeria was less resistant to ciprofloxacin, nitrofurantoin, meropenem and imipenem. This implies that the antibiotics are useful in the treatment of infection caused by E. coli. Also, ESBL-positive E. coli isolates harbored ESBL genes, with blaCTX-M and blaTEM as the most common.