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Analysis of drug utilization pattern of antimicrobials used as surgical prophylaxis for general surgical procedures in a Tertiary Care Hospital of North Karnataka: An observational study 北卡纳塔克邦三级医院普通外科手术预防使用抗菌药物的药物使用模式分析:一项观察性研究
Pub Date : 2019-01-01 DOI: 10.4103/JHRR.JHRR_44_18
B. Patil, A. Khot, A. Patil, A. Naikwadi
Background: Surgical site infection (SSI) is an infection presenting within 30 days after the surgical procedure if no prosthetic is placed and up to 1 year if prosthetic is implanted in the patient. Despite standard protocols for preoperative preparation and antimicrobial prophylaxis, the rate of SSI varies from 2.5% to 41.9%. Reasons could be multifactorial, but one among them is lack of adherence to any of the antibiotic policy. To review the drug utilization pattern of antimicrobials in the perioperative period and to study its impact on SSI, the above study has been carried out. Materials and Methods: A cross-sectional, observational study has been carried out in the Department of General surgery of SBM Patil Medical College Hospital. Patients of either sex who underwent surgical procedures such as appendectomy and hernioplasty have been included in the study. Data were collected using a predesigned pro forma. The study was approved by the institutional ethics committee. Results: A total of 140 patients underwent surgical procedures, of which 70 were male and 70 were female. Open appendectomy was the most common procedure performed, followed by hernioplasty in 18 patients. Ceftriaxone–sulbactam was the frequently prescribed antibiotic and six patients developed SSI. Conclusion: Despite use of antibiotics, six patients developed SSI. Hence, auditing of the antimicrobial usage as surgical prophylaxis is need of the hour. Because prescriber's worldwide running out of antibiotic options, it is mandatory for each hospital to have formulary for antibiotic use depending on the pattern of organisms isolated.
背景:手术部位感染(SSI)是指在手术后30天内出现的感染,如果没有放置假体,如果植入假体,最长可达1年。尽管术前准备和抗菌预防的标准方案,SSI的发生率从2.5%到41.9%不等。原因可能是多方面的,但其中之一是缺乏对任何抗生素政策的遵守。为了回顾围手术期抗菌药物的使用模式,并研究其对SSI的影响,我们进行了上述研究。材料与方法:在上海医科大学附属医院普外科进行横断面观察性研究。接受过阑尾切除术和疝成形术等手术的患者不论男女都被纳入研究。使用预先设计的表格收集数据。该研究得到了机构伦理委员会的批准。结果:共140例患者接受手术治疗,其中男性70例,女性70例。开放阑尾切除术是最常见的手术,其次是18例疝成形术。头孢曲松舒巴坦是常用的抗生素,6例患者发生SSI。结论:尽管使用了抗生素,仍有6例患者发生了SSI。因此,审计抗菌药物的使用作为外科预防是需要的时间。由于世界范围内处方者的抗生素选择越来越少,每家医院都必须根据分离的生物体的模式制定抗生素使用处方。
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引用次数: 2
Mixed adenoneuroendocrine carcinoma: A report of four cases from South India 混合性腺神经内分泌癌:印度南部4例报告
Pub Date : 2019-01-01 DOI: 10.4103/JHRR.JHRR_39_18
S. Vijayakumar, S. Jacob, B. Badhe, B. Srinivas
Neuroendocrine tumors (NET) are rare. Common sites of NETs are the gastrointestinal tract and pancreas. In 2010, the World Health Organization classified NETs into mixed adenoneuroendocrine carcinoma, neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma (MANEC), tumors that have both exocrine and endocrine components of at least 30% each. Since it is relatively a new entity, only case reports and case series are available. In the past 7 years, there were only eight reports from India. We report a further four cases of this nascent disorder from a single institution, obtained retrospectively. The first includes an elderly man with upper gastrointestinal symptoms and underwent subtotal gastrectomy for antropyloric growth, which was a low-grade MANEC. The second was a female patient with chronic pancreatitis and presented with obstructive jaundice due to an ampullary growth. Whipple's specimen showed an intermediate-grade MANEC. The third case was a 40-year-old female with caecal growth and ovarian mass and was found to have a low-grade MANEC. The fourth, also in a female, was a case of abdominal wall abscess with an intraabdominal connection to the intestine and she had omental deposits and high-grade MANEC. The pathological findings are discussed and compared other reports from the country.
神经内分泌肿瘤(NET)是罕见的。NETs的常见部位是胃肠道和胰腺。2010年,世界卫生组织将NETs分为混合性腺神经内分泌癌、神经内分泌癌和混合性腺神经内分泌癌(MANEC),即外分泌成分和内分泌成分各占30%以上的肿瘤。由于它是一个相对较新的实体,因此只提供病例报告和病例系列。在过去的7年里,只有8份来自印度的报告。我们报告另外四例这种新生障碍从单一机构,回顾性获得。第一例患者为上消化道症状的老年男性,因幽门生长(低度MANEC)而行胃大部切除术。第二例是慢性胰腺炎的女性患者,由于壶腹生长而表现为梗阻性黄疸。Whipple的标本显示为中等程度的MANEC。第三例为40岁女性,伴有盲肠生长和卵巢肿块,发现为低度MANEC。第四例患者为女性,腹壁脓肿伴腹腔内肠连接,伴有大网膜沉积和高度MANEC。对病理结果进行了讨论,并与国内其他报告进行了比较。
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引用次数: 3
A comparative study of the hazards management system associated with laundry operations in secondary and Tertiary Health Facilities in Nigeria 尼日利亚二级和三级卫生机构洗衣业务相关危害管理系统的比较研究
Pub Date : 2019-01-01 DOI: 10.4103/JHRR.JHRR_48_18
E. Omoijiade
Background: Occupational safety and health hazards in health-care facilities (HCFs) can be grouped according to location or service offered. Contaminated laundry, noise, heat, lifting, sharps, slips, trips, falls, and fire hazards are among those located in the laundry department. Aims: This study sought to assess the measures to reduce workplace hazards, thereby providing information on the hazard management system in various HCFs, as this would prove useful to establish appropriate interventions to further ensure the health and safety of workers in hospital laundries. Materials and Methods: The study was conducted in six hospitals with a laundry department in Benin city, composed of one available tertiary HCF and five secondary HCFs. Data were collected through the hazard identification checklist, which was used to determine the safe/unsafe acts and conditions of the workplaces. Results: The percentage rating for the assessment of the hazard management system in the hospital laundry between the health facility types was 39.57% ± 7.12% for the secondary health facilities, while that of the tertiary health facility was 51.85%. A comparison of the means showed that there was no statistically significant difference in the average rating between secondary and tertiary health facility (P = 0.191), (95% confidence interval = −0.339–0.094). Conclusion: Adverse health and safety effects can be avoided or minimized drastically if the associated hazards are properly managed; however, the hazards management system in the health-care laundries was adjudged to be substandard, in both the tertiary and secondary health facilities.
背景:卫生保健设施中的职业安全和健康危害可根据地点或提供的服务进行分组。被污染的衣物、噪音、热量、升降、尖锐物、滑倒、绊倒、跌倒和火灾危险都位于洗衣部。目的:本研究旨在评估减少工作场所危害的措施,从而提供关于各种氟氯烃危害管理系统的信息,因为这将有助于制定适当的干预措施,进一步确保医院洗衣房工人的健康和安全。材料和方法:本研究在贝宁市设有洗衣科的6家医院进行,由1家可用的三级HCF和5家二级HCF组成。数据是通过危险识别清单收集的,该清单用于确定工作场所的安全/不安全行为和条件。结果:二级卫生机构对医院洗衣房危害管理体系的评价百分比为39.57%±7.12%,三级卫生机构为51.85%;平均数比较显示,二级和三级卫生机构的平均评分没有统计学上的显著差异(P = 0.191)(95%可信区间= - 0.339-0.094)。结论:如果相关危害管理得当,可大大避免或减少对健康和安全的不良影响;然而,在三级和二级卫生设施中,卫生洗衣房的危害管理系统被判定为不合格。
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引用次数: 0
Emerging and current trend in the investigation of obesity in clinical practice 肥胖症临床研究的新趋势及发展趋势
Pub Date : 2018-09-01 DOI: 10.4103/jhrr.jhrr_15_18
O. Fasipe, P. Akhideno, A. Adelosoye, P. Osho, O. Ibiyemi-Fasipe, E. Osho
Obesity is a medical condition in which excess body fat has accumulated to the extent that it could produce a negative adverse health effect. The various emerging and current investigational methods or techniques for the analysis and determination of total body fat composition and body fat percentage are the theoretical gold standard method of underwater weighing which has its foundation on Archimedes' principle, Bioelectrical Impedance Analysis (BIA), Whole-body Air Displacement Plethysmography (ADP), Dual-Energy X-ray Absorptiometry (DEXA), Near Infrared interactance (NIR), Body Average Density (BAD) Measurement, Ultrasound Sonography Technique (UST) and Anthropometric Measurements (AM) such as triceps skinfold thickness (TSF), Mid-upper arm circumference (MAC), Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Stature ratio (WSR or WHtR), Waist-to-thigh ratio (WTR) and/or Obesity Determinant Indices (ODI). We the authors of this research work currently propose and recommend the Obesity Determinant Indices (ODI) as novel anthropometric measurements that will serve as a more reliable predictor and accurate indicator of cardiovascular disease risk factors, including body fat redistribution, hypertension, dyslipidemia, stroke, ischemic heart diseases, heart failure, chronic kidney disease, sleep apnea and type 2 diabetes mellitus in obese patients. Furthermore, We also jointly propose and recommend the diagnostic and interventional criteria for obesity treatment which are the First Criteria (Criteria-I) and Second Criteria (Criteria-II). These criteria take into consideration the presence of an individual body mass index (BMI), presence of at least one waist circumference (WC) dependent parameters (such as WC or WHR or WHtR or WTR or any of the ODI) that fall into the obesity reference range, and/or presence of at least one obesity-related comorbid conditions/risk factors such as hypertension, type 2 diabetes mellitus, dyslipidemia, osteoarthritis, rheumatoid arthritis, polycystic ovarian syndrome, heart failure, ischemic heart diseases, sleep apnea, depression disorders, anorexia nervosa, bulimia nervosa or any other obesity-associated neuropsychiatric disorders. In conclusion, initiation of appropriate treatment in the form of High-Intensity Lifestyle Interventions alone or a combination of pharmacotherapy with Low-to-Moderate-Intensity Lifestyle Interventions should be commenced for any patient that meet these stipulated criteria guidelines.
肥胖是一种医学状况,其中过量的身体脂肪积累到了可能对健康产生负面影响的程度。分析和测定全身脂肪组成和体脂百分比的各种新兴和现有的研究方法或技术是水下称重的理论金标准方法,其基础是阿基米德原理、生物电阻抗分析(BIA)、全身空气置换体积脉搏图(ADP)、双能x射线吸收仪(DEXA)、近红外相互作用(NIR)、身体平均密度(BAD)测量、超声技术(UST)和人体测量(AM),如三头肌皮褶厚度(TSF)、中上臂围(MAC)、身体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WSR或WHtR)、腰大腿比(WTR)和/或肥胖决定指数(ODI)。我们的研究工作的作者目前提出并推荐肥胖决定指数(ODI)作为一种新的人体测量指标,将作为一个更可靠的预测和准确的指标心血管疾病的危险因素,包括体脂肪再分配,高血压,血脂异常,中风,缺血性心脏病,心力衰竭,慢性肾脏疾病,睡眠呼吸暂停和2型糖尿病的肥胖患者。此外,我们还共同提出并推荐了肥胖治疗的诊断和介入标准,即第一标准(标准- i)和第二标准(标准- ii)。这些标准考虑到是否存在个体体重指数(BMI),是否存在至少一个腰围(WC)相关参数(如WC或WHR或WHtR或WTR或任何ODI)落入肥胖参考范围,和/或是否存在至少一种肥胖相关的合并症/危险因素,如高血压,2型糖尿病,血脂异常,骨关节炎,类风湿性关节炎,多囊卵巢综合征,心力衰竭。缺血性心脏病、睡眠呼吸暂停、抑郁症、神经性厌食症、神经性贪食症或任何其他与肥胖相关的神经精神疾病。总之,对于符合这些规定的标准指南的任何患者,应开始适当的治疗,以单独的高强度生活方式干预或药物治疗与低至中等强度生活方式干预的组合形式。
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引用次数: 1
Primary fallopian tube carcinoma: A case of rare malignancy 原发性输卵管癌:罕见恶性肿瘤1例
Pub Date : 2018-09-01 DOI: 10.4103/jhrr.jhrr_29_18
P. Chakrabarti, S. Bera, S. Rana
Primary fallopian tube carcinoma is an extremely uncommon tumor of female genital tract origin with the incidence of 0.1%–1.8% of all genital malignancies. Due to its nonspecific symptomatology and rarity of this neoplasm, correct preoperative diagnosis is made only in 4% of the cases and is usually first recognized by pathologist. Our case was a 39-year-old patient who presented with intermittent vaginal bleeding, lower abdominal pain, and pelvic mass. On physical examination, lower abdominal tenderness was found. Ultrasound examination revealed bilateral hydrosalpinx. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination confirmed features of papillary serous adenocarcinoma of the left fallopian tube. The patient was referred to oncologist for chemotherapy. Six months following initial surgery, the patient is in good condition. This case is being reported due to the scarcity of data published from the Indian population and rarity of this neoplasm.
原发性输卵管癌是一种极为罕见的起源于女性生殖道的肿瘤,发病率约占所有生殖系统恶性肿瘤的0.1%-1.8%。由于其非特异性症状和罕见性,只有4%的病例在术前做出正确的诊断,通常是由病理学家首先发现。我们的病例是一名39岁的患者,表现为间歇性阴道出血,下腹部疼痛和盆腔肿块。体格检查发现下腹部压痛。超声检查显示双侧输卵管积水。患者行腹部全子宫切除术及双侧输卵管卵巢切除术。组织病理学检查证实了左输卵管乳头状浆液腺癌的特征。病人被转介到肿瘤科医生那里接受化疗。初次手术后6个月,患者状况良好。由于缺乏从印度人口中发表的数据和这种肿瘤的罕见性,因此报告了这一病例。
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引用次数: 0
Biofilm formation by carbapenem-resistant Enterobacteriaceae strains isolated from surveillance cultures in Intensive Care Unit patients: A significant problem 从重症监护病房患者的监测培养中分离出的耐碳青霉烯肠杆菌科菌株形成的生物膜:一个重要的问题
Pub Date : 2018-09-01 DOI: 10.4103/jhrr.jhrr_26_18
E. Rajni, V. Rajpurohit, P. Rathore, Deep Shikhar, P. Khatri
Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a serious global public health threat. Antibiotic overuse, improper sanitation and unhygienic practices lead to large scale carriage and rapid spread. Biofilm formation by these strains can lead to far reaching consequences. Material and Method: This is a prospective hospital based study planned for a period of 3 months including all patients admitted to 14 bedded Trauma ICU of a tertiary care hospital in Rajasthan. Rectal swabs were collected from admitted patients and carriage of carbapenem resistant enterobacteriaceae looked for as per CDC guidelines. Screening of the Enterobacteriaceae colonies for carbapenemase production was done by Modified Hodge test. Carbapenem-resistant isolates were also tested for Metallobetalactamase production by phenotypic disc confirmatory test. Biofilm formation testing was done by Tissue culture plate method. Results: A total of 73 patients were screened and 27 CRE isolates were obtained, carriage rate being 37%. A high level of resistance was seen to aminoglycosides, fluoroquinolones and cephalosporins. 100% sensitivity was however seen to Colistin, Tigecycline and Fosfomycin. 5 out of 27 strains showed a positive MHT test. Metallo beta lactamase (MBL) production was seen in 21/25 strains as tested by meropenem and meropenem-edta discs. Of the 27 CRE isolates tested for biofilm production, 13 (48.15%) were found positive. Conclusion: The current study finds out the prevalence of CRE carriage and the biofilm forming potential of these strains among critically ill patients and stresses upon urgent need for stringent infection control measures.
背景:碳青霉烯耐药肠杆菌科(CRE)是严重的全球公共卫生威胁。抗生素的过度使用、不适当的环境卫生和不卫生的做法导致大规模传播和迅速传播。这些菌株形成的生物膜可能导致深远的后果。材料和方法:这是一项基于医院的前瞻性研究,计划为期3个月,包括拉贾斯坦邦一家三级护理医院14张床位的创伤ICU收治的所有患者。收集住院患者的直肠拭子,并根据CDC指南寻找碳青霉烯类耐药肠杆菌科。采用改良霍奇法筛选产碳青霉烯酶的肠杆菌科菌落。对耐碳青霉烯菌株进行了金属β -内酰胺酶产生的表型盘验证试验。生物膜的形成测试是由细胞培养板的方法。结果:共筛选73例患者,分离CRE菌株27株,携带率为37%。高水平的阻力是氨基糖甙类、氟喹诺酮类原料药、头孢菌素。对粘菌素、替加环素和磷霉素的敏感性为100%,27株中有5株MHT试验阳性。用美罗培南和美罗培南-edta圆盘检测,21/25株菌株产生金属β -内酰胺酶(MBL)。27株CRE分离株生物膜检测阳性13株(48.15%)。结论:本研究发现了危重患者中CRE携带的流行情况和这些菌株的生物膜形成潜力,并强调迫切需要采取严格的感染控制措施。
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引用次数: 0
Obesogenic factors influencing overweight among Asian children and youth 影响亚洲儿童和青少年超重的致肥因素
Pub Date : 2018-09-01 DOI: 10.4103/JHRR.JHRR_27_18
IzaDonna Ramos Togbo
Obesity is a public health dilemma worldwide. The prevalence of childhood obesity is increasing tremendously in the world. Overweight children and youth are probable to develop diseases in the later years. This study described the obesogenic factors influencing overweight among Asian children and youth. The study also determined the association of these factors to children and youth weight status. This narrative review obtained thirty-four pertinent articles published between 2010 and 2018. The data were extracted from Google Scholar, EBSCO, and PubMed. Numerous reviewed articles identified obesogenic factors influencing overweight among Asian children and youth as follows: familial factors, food retail environment, Westernization, food advertisement, and unhealthy food choices in school. Familial factors comprise parenting style and socioeconomic status. Food retail environment results were gathered from Thailand, China, Philippines, Saudi Arabia, and Korea. The effect of Westernization was seen in four cities of India and China. Influences of food advertisement were studied in Korea, Thailand, Singapore, and Malaysia. Unhealthy food choices in school were evident in South Asia, China, India, and Malaysia. These five factors are considered and an appropriate health program must be established to address this health problem.
肥胖是世界范围内的公共卫生难题。世界上儿童肥胖的发病率正在急剧上升。超重的儿童和青少年很可能在晚年患上疾病。本研究描述了影响亚洲儿童和青少年超重的致肥因素。该研究还确定了这些因素与儿童和青少年体重状况的关系。本叙述性综述获得了2010年至2018年间发表的34篇相关文章。数据摘自Google Scholar、EBSCO和PubMed。许多综述文章指出了影响亚洲儿童和青少年超重的致肥因素:家庭因素、食品零售环境、西方化、食品广告和学校的不健康食品选择。家庭因素包括父母教养方式和社会经济地位。食品零售环境调查结果来自泰国、中国、菲律宾、沙特阿拉伯和韩国。在印度和中国的四个城市可以看到西化的影响。在韩国、泰国、新加坡和马来西亚研究了食品广告的影响。在南亚、中国、印度和马来西亚,学校里不健康的食物选择很明显。考虑到这五个因素,必须建立一个适当的健康方案来解决这一健康问题。
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引用次数: 3
Application of proportional odds model in identifying contributing factor of under-five child malnutrition in Bangladesh: A case study in Tangail district 比例优势模型在确定孟加拉国五岁以下儿童营养不良影响因素中的应用:以坦盖尔地区为例
Pub Date : 2018-09-01 DOI: 10.4103/JHRR.JHRR_38_18
Gowranga Kumar Paul, Mossamet Kamrun Nesa, S. K. Mondal, Sifat Ar Salan, F. Mim
Background: Children malnutrition is one of the major public health-related concerns in all over the world, especially in developing countries like Bangladesh. Several socioeconomic and demographic factors are responsible for this situation. Aims: The purpose of this research was to identify the contributing factors of malnutrition in Tangail district using primary data collected from rural Tangail. Materials and Methods: The sample was collected using the cluster sampling techniques. Villages were considered as a cluster, and the sample from cluster are selected using probability proportional to size method. In our study, we have categorized the child nutritional status as, “severely malnourished,” “moderately malnourished,” and “nourished” based on Weight-for-age z-score. Bivariate analysis was conducted by examining the gamma measurement for ordinal variables and to check the association between child nutrition status and selected individual variables; we have used the contingency table and Chi-square test. Statistical Analysis: Both univariate, bivariate, and multivariate analysis was conducted to meet the objectives of the study. The proportional odds model was selected to understand the stable effects of covariates influencing the child malnutrition. Results: Bivariate analysis shows significant (P < 0.01) associations for almost all of the selected covariates and the multivariate analysis describes the relationship between education and occupation, mother's (body mass index were found highly statistically significant (P < 0.01) and for child malnutrition. Conclusions: The findings of this study suggest the necessity of improving the mother's education level, nutritional status, and the job facilities for women to achieve the optimum nutrition for children under 5 years of age.
背景:儿童营养不良是全世界主要的公共卫生问题之一,特别是在孟加拉国等发展中国家。造成这种情况的几个社会经济和人口因素。目的:本研究的目的是利用从坦盖尔农村收集的原始数据,确定坦盖尔地区营养不良的影响因素。材料与方法:采用整群抽样技术采集样本。将村庄视为一个聚类,采用概率比例法从聚类中选取样本。在我们的研究中,我们根据年龄体重z-score将儿童营养状况分为“严重营养不良”、“中度营养不良”和“营养不良”。通过对有序变量的伽马测量进行双变量分析,并检查儿童营养状况与选定个体变量之间的关联;我们使用了列联表和卡方检验。统计分析:进行单因素、双因素和多因素分析以达到研究目的。选择比例优势模型来了解影响儿童营养不良的协变量的稳定效应。结果:双因素分析显示,几乎所有选定的协变量都有显著(P < 0.01)的相关性,多因素分析显示,教育程度与职业、母亲体重指数和儿童营养不良之间的关系具有高度统计学意义(P < 0.01)。结论:提高母亲的受教育程度、营养状况和工作条件是实现5岁以下儿童最佳营养的必要条件。
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引用次数: 4
Catheterization-associated urinary tract infections: Epidemiology and incidence from tertiary care hospital in Haryana 导尿相关尿路感染:哈里亚纳邦三级医院的流行病学和发病率
Pub Date : 2018-09-01 DOI: 10.4103/JHRR.JHRR_19_18
R. Sandhu, P. Sayal, Ruchi Jakkhar, G. Sharma
Background: Urinary tract infections (UTIs) attributed to the use of an indwelling catheter is one of the most common infections acquired by patients in health-care facilities. This infection is associated with varied microbiological etiology. This along with existing underlying condition increases hospitalization, medication, morbidity, and also adds to the financial burden. Aims and Objectives: The aim of the study was to provide a baseline information in the context of incidence of catheter-associated UTI (CAUTI), to identify the associated microbial, and to determine their susceptibility pattern to commonly used antimicrobial agents for prophylactic and empiric therapy in this group of patients. Materials and Methods: This prospective study was done on nonrepetitive urine samples from catheterized patients. Semi-quantitative bacterial culture was performed, and isolates were identified by standard biochemical tests. Antimicrobial sensitivity tests were carried out by disc diffusion technique using Mueller-Hinton Agar as recommended by Clinical Laboratory Standard Institute. Results: Significant bacteriuria was observed among 17/161 (10.55%) urine samples. Among bacterial isolates, Gram-negative bacilli predominates. Escherichia coli 7/17 (41.17%) being the most common isolate. The incidence of UTI/1000 catheter days and urinary catheter utilization ratio observed in our study was 4.41 and 18.05, 0.673 and 0.066 for intensive care unit and wards, respectively. Conclusion: Burden of CAUTIs is vast with regards to incidence, patient outcomes, cost, reimbursement, and suffering. Our study underscores the pressing need for the development of antimicrobial urinary catheters and also we strove to minimize the effect of exogenous factors on the incidences of CAUTI and regarding the development of protocols and checklists on the insertion and management of indwelling urinary catheters based on the UTI prevention guideline.
背景:留置导尿管引起的尿路感染(uti)是卫生保健机构患者获得的最常见感染之一。这种感染与多种微生物病因有关。这与现有的基础疾病一起增加了住院、用药、发病率,也增加了经济负担。目的和目的:本研究的目的是提供导管相关性尿路感染(CAUTI)发生率的基线信息,确定相关微生物,并确定其对该组患者预防性和经验性治疗常用抗菌药物的敏感性模式。材料和方法:这项前瞻性研究是对导尿患者的非重复尿液样本进行的。进行半定量细菌培养,并通过标准生化试验鉴定分离物。抗菌敏感性试验采用临床实验室标准协会推荐的穆勒-辛顿琼脂光盘扩散技术。结果:161份尿样中有17份(10.55%)存在明显的细菌尿。在分离的细菌中,革兰氏阴性杆菌占主导地位。大肠杆菌7/17(41.17%)是最常见的分离株。重症监护病房的尿路感染率为4.41,尿路使用率为18.05,重症监护病房为0.673,重症监护病房为0.066。结论:CAUTIs在发病率、患者预后、费用、报销和痛苦方面的负担是巨大的。我们的研究强调了开发抗菌导尿管的迫切需要,我们也努力减少外源性因素对caui发病率的影响,并根据尿路感染预防指南制定留置导尿管的插入和管理的方案和清单。
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引用次数: 8
Accuracy of fetal foot length measurement in estimation of gestational age and fetal weight in the third trimester of pregnancy 胎儿足长测量在妊娠晚期估计胎龄和胎儿体重中的准确性
Pub Date : 2018-09-01 DOI: 10.4103/JHRR.JHRR_23_18
Mohamed Ebraheem, B. Malik, Q. Ali, M. Gameraddin, Awadia Gareeballah
Background: Fetal foot length (FFL) is a biometric parameter that has been established for estimating the gestational age (GA). Accurate knowledge of fetal weight (FW) and GA assist Clinicians in the evaluation of fetal growth and predict neonatal outcomes. Aims: This study aims to predict the estimated FW and GA using the FFL in 26–40 weeks' gestation on antenatal ultrasound. Materials and Methods: In a retrospective study, we investigated the fetal measurements of FFL, femoral length (FL), and estimated FW in 100 pregnant women at 26–16 weeks' gestation who attended routine antenatal care. The fetal measurements were examined about the foot length. Results: The foot length was not a significance parameter to determine fetal gender (P = 0.6). There was no correlation of FFL with maternal socioeconomic status, parity, fetal gender, and maternal body mass index, P = 0.26, 0.84, 0.67, and 0.26, respectively. The FFL, FL, and estimated FW were strongly and linearly correlated with GA. The combination of FL, foot length, and estimated FW provide an accurate estimation of GA with minimum (standard error [SE] = 1.75). The combination of FL and foot length provide an accurate prediction of FW with SE of 320.52. The foot length and FL revealed similar values of SEs in estimated FW (R2 = 0.85) for each. Conclusions: The FFL is linearly correlated with GA, FW, and FL. It is an accurate parameter to assess the GA and reliable for predicting the estimated FW. This is useful for assessing fetal growth and skeletal dysplasia.
背景:胎儿足长(FFL)是一种用于估计胎龄(GA)的生物特征参数。胎儿体重(FW)和GA的准确知识有助于临床医生评估胎儿生长和预测新生儿结局。目的:本研究的目的是利用FFL预测妊娠26-40周胎儿的胎心和胎心。材料和方法:在一项回顾性研究中,我们调查了100名妊娠26-16周接受常规产前护理的孕妇的胎儿FFL、股骨长度(FL)和估计FW的测量。对胎儿的测量进行了大约一英尺长的检查。结果:足长对胎儿性别无显著性影响(P = 0.6)。FFL与母亲社会经济地位、胎次、胎儿性别和母亲体重指数无相关性,P值分别为0.26、0.84、0.67和0.26。FFL、FL和估计FW与GA呈强线性相关。FL、脚长和估计的FW的组合提供了最小(标准误差[SE] = 1.75)的GA的准确估计。高度和足长结合可以准确预测FW, SE值为320.52。脚长和FL在估计FW上的se值相似(R2 = 0.85)。结论:FFL与GA、FW和FL呈线性相关,是评估GA的准确参数,也是预测FW的可靠参数。这对评估胎儿生长和骨骼发育不良很有用。
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引用次数: 1
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Journal of Health Research and Reviews
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