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A rare case of malakoplakia of the urinary bladder 罕见的膀胱斑疹病例
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_26_22
P. Yadav, Piyush Singhania, P. Sahu
Malakoplakia (from Greek Malako “soft” + Plako “plaque”) is a rare inflammatory condition that presents as a papule, plaque, or ulceration that usually affects the genitourinary tract. The most frequently affected organ is the urinary bladder. This condition has features of granulomatous inflammation. The pathogenesis of the disease is not completely understood. It is often misdiagnosed as malignancy. In this case report, we present a case of urinary bladder malakoplakia which presented with obstructive uropathy and acute kidney injury (AKI).
Malakoplakia(源自希腊语Malako“soft”+Plako“plack”)是一种罕见的炎症性疾病,表现为丘疹、斑块或溃疡,通常影响泌尿生殖道。最常受影响的器官是膀胱。这种情况具有肉芽肿性炎症的特点。这种疾病的发病机制尚不完全清楚。它经常被误诊为恶性肿瘤。在本病例报告中,我们报告了一例膀胱malakoplakia,其表现为梗阻性尿路病和急性肾损伤(AKI)。
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引用次数: 0
From the desk of the Editor-in-Chief responding to the author 在总编辑的办公桌上回复作者
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_221_22
Sushil Kumar
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引用次数: 0
Primary assessment of patients admitted to the emergency ward using arterial blood gas 使用动脉血气对急诊病房患者的初步评估
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_222_22
S. Mulay, Rajesh Ursekar, J. Mathew, Krista Pinto
Background: Arterial blood gas study (ABG) is a point-of-care testing (POCT) diagnostic tool that can furnish metabolic and respiratory aberrations. This study was conducted systematically, to assess the metabolic and respiratory aberrations quickly and the scope for corrective treatment so that metabolic and respiratory abnormalities get corrected. Materials and Methods: A prospective cross-sectional study was done among 150 cases admitted to the Department of Emergency Medicine during a three-month period where the study on ABG was done. Data was collected in the prescribed format and a stepwise interpretation of the ABG was done. The four primary disorders taken into consideration are metabolic acidosis, metabolic alkalosis, respiratory alkalosis, and respiratory acidosis Results: Out of 150 cases 82 had respiratory alkalosis, 51 had metabolic acidosis, ten had respiratory acidosis, and seven had metabolic alkalosis as a primary disorder. Conclusion: ABG analysis is a POCT diagnostic tool for analyzing various metabolic and respiratory aberrations and can also guide us in the scope for correction of the disorder.
背景:动脉血气研究(ABG)是一种护理点测试(POCT)诊断工具,可以提供代谢和呼吸异常。这项研究是系统地进行的,以快速评估代谢和呼吸异常以及纠正治疗的范围,从而纠正代谢和呼吸畸形。材料和方法:在为期三个月的ABG研究期间,对急诊医学科收治的150例患者进行了前瞻性横断面研究。以规定的格式收集数据,并对ABG进行逐步解释。考虑的四种原发性疾病是代谢性酸中毒、代谢性碱中毒、呼吸性碱中毒和呼吸性酸中毒。结论:ABG分析是一种分析各种代谢和呼吸异常的POCT诊断工具,也可以指导我们纠正该疾病的范围。
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引用次数: 0
Extensive atherosclerosis associated with mobile thrombus in the left carotid bulb in an elderly 老年人广泛动脉粥样硬化与左颈动脉球内可移动血栓相关
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_189_22
S. Dwivedi, S. Ashfaq, T. Riyaz
A case of extensive atherosclerosis in an 88-year-old, chronic heavy smoker, associated with mobile thrombus in the left carotid bulb is presented. This patient also suffered from chronic obstructive pulmonary disease (COPD) and hypertension. He was fully worked up and confirmed as a case of the mobile thrombus attached to the plaque in the left carotid bulb by echocardiography and carotid Doppler. Thrombolysis of a large, mobile clot poses a theoretical risk of stroke worsening from incomplete fibrinolysis. He was prescribed anticoagulants and has been doing fine till the last follow-up. The importance of preventing premature atherosclerosis in the next generations is also discussed. We report this case to create awareness about this preventable malady and treatment options.
一例广泛的动脉粥样硬化在一个88岁,慢性重度吸烟者,与移动血栓在左颈动脉球提出。该患者还患有慢性阻塞性肺疾病(COPD)和高血压。经超声心动图和颈动脉多普勒检查,确诊为左颈球茎斑块上有移动血栓。一个大的,可移动的凝块的溶栓造成不完全纤维蛋白溶解导致中风恶化的理论风险。医生给他开了抗凝剂,直到最后一次随访,他的情况都很好。还讨论了预防下一代过早动脉粥样硬化的重要性。我们报告这个病例是为了提高人们对这种可预防的疾病和治疗方案的认识。
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引用次数: 0
Voluntary blood donations in Navi Mumbai, India: Experience in coronavirus disease pandemic 印度孟买纳维市的自愿献血:在冠状病毒疾病大流行中的经验
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_70_22
Sumedha P Shinde, A. Shende, Renuka Chawla, A. Vatkar
Introduction: In India, voluntary blood donation camps (VBDCs) are a key supply of blood and its products. Conducting blood donation drives was challenging in Navi Mumbai due to the widespread lockdown during the coronavirus disease (COVID) outbreak. Study Type: This was a retrospective study. Materials and Methods: To relieve the anxieties and apprehensions of the blood donor population, extensive confidence-building efforts were required. Various safety measures and standard operating procedures were also included, as well as training for VBDC organizers and medical personnel. We studied the blood donations done at our institute on a retrospective basis from blood bank records. Results: Our study showed a 7% increase in outdoor VBDC donations in 2021 over the previous year 2020. However, according to the advice of the local transfusion council, promoting in-house donations raised their number by a stunning 33% in 2021. Conclusion: Even during the COVID pandemic, confidence-building methods and precautions helped restore VBDC’s legitimacy and increase donation numbers by a marginal extent.
导言:在印度,自愿献血营是血液及其制品的主要供应来源。由于新冠肺炎疫情爆发期间大范围的封锁,在新孟买开展献血活动具有挑战性。研究类型:这是一项回顾性研究。材料和方法:为了减轻献血者的焦虑和忧虑,需要广泛的建立信任的努力。此外,还包括各种安全措施和标准作业程序,以及对VBDC组织者和医务人员的培训。我们从血库记录中回顾性地研究了我院的献血情况。结果:我们的研究显示,2021年户外VBDC捐款比前一年(2020年)增加了7%。然而,根据当地输血委员会的建议,促进内部捐赠在2021年将其数量提高了惊人的33%。结论:即使在COVID大流行期间,建立信任的方法和预防措施也有助于恢复VBDC的合法性,并在一定程度上增加捐赠数量。
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引用次数: 0
Seroprevalence of acute leptospirosis in a tertiary care hospital of western India 印度西部一家三级医院急性钩端螺旋体病的血清流行率
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_33_22
Bhumika Baveja, M. Palewar, Suverna Joshi, R. Karyakarte
Background: Leptospirosis is a widespread re-emerging zoonotic disease, especially in developing countries. According to World Health Organization, despite being severe, the disease is neglected in most endemic countries because of a lack of information and awareness about the extent of the problem. Objective: The objective was to study the seroprevalence and epidemiology of leptospirosis with its biochemical correlation in the general population in Pune, Maharashtra. Materials and Methods: It is a retrospective observational laboratory-based study over 1 year from January to December 2020 in a tertiary care hospital in western India. A total of 561 blood specimens received during 1 year for the diagnosis of fever were processed for Leptospira IgM antibodies using enzyme-linked immunosorbent assay (ELISA). Results: A total of 111 of 561 blood specimens that were received during the study period tested positive for IgM antibody against Leptospira. The seroprevalence of Leptospira spp. was found to be 19.78%. In seropositive patients, the age ranged from 4 to 77 years. The highest seropositivity was observed in the age group of 21–30 years (42%). There were 34% (n = 38) males and 66% (n = 73) females, among those who tested positive. Seroprevalence in Pune was highest in the months of June–August. Renal function tests were deranged in 44 (39.63%) patients (serum creatinine > 1.5 mL). Hyponatremia and hypokalemia were observed in 37.84% and 21.62% of patients, respectively. In liver function tests, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) both were deranged (SGOT > 40 U/L; SGPT > 56 U/L) in 36 (32.43%) patients, whereas SGOT alone was deranged in additional 18 patients (48.64%). Serum bilirubin was deranged in 65.45%. Coinfection was observed with chikungunya, dengue, and malaria in 7.2%, 6.3%, and 0.90% of patients, respectively. Conclusion: Because morbidity is high in this infection, early diagnosis of leptospirosis is essential because antibiotic therapy provides the greatest benefit when initiated early in the course of illness.
背景:钩端螺旋体病是一种广泛复发的人畜共患疾病,尤其在发展中国家。根据世界卫生组织的说法,尽管这种疾病很严重,但在大多数流行国家,由于缺乏对问题严重程度的信息和认识,这种疾病被忽视了。目的:研究马哈拉施特拉邦浦那普通人群中钩端螺旋体病的血清流行率和流行病学及其生化相关性。材料和方法:这是一项为期1年的回顾性观察性实验室研究,从2020年1月到12月,在印度西部的一家三级护理医院进行。使用酶联免疫吸附试验(ELISA)对1年内收到的561份用于诊断发烧的血液样本进行了钩端螺旋体IgM抗体处理。结果:在研究期间收到的561份血液样本中,共有111份检测出钩端螺旋体IgM抗体呈阳性。钩端螺旋体的血清流行率为19.78%。在血清阳性患者中,年龄从4岁到77岁不等。血清阳性率最高的是21-30岁年龄组(42%)。在那些检测呈阳性的人中,有34%(n=38)的男性和66%(n=73)的女性。浦那的血清流行率在6月至8月期间最高。44名(39.63%)患者的肾功能测试出现紊乱(血清肌酐>1.5 mL)。低钠血症和低钾血症的发生率分别为37.84%和21.62%。在肝功能测试中,36例(32.43%)患者的血清谷丙转氨酶(SGOT)和血清谷丙氨基转氨酶(SGPT)均出现紊乱(SGOT>40U/L;SGPT>56U/L),另有18例(48.64%)患者单独出现SGOT紊乱。65.45%的患者出现血清胆红素紊乱,和0.90%的患者。结论:由于这种感染的发病率很高,钩端螺旋体病的早期诊断至关重要,因为在疾病早期开始抗生素治疗会带来最大的益处。
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引用次数: 1
Posterior malleolus fracture fixation in ankle injuries: A clinical study 踝关节损伤后踝骨折内固定的临床研究
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_142_22
Rutvik D. Dave, Parag Tank, N. Patel, P. Shah
Introduction: Posterior Malleolar fractures are relatively rare and a part of complex ankle injuries. Trimalleolar fractures affect the stability of the weight-bearing ankle joint. Management of posterior malleolar fractures is a challenge. Aims: This study aimed to examine the radiological and clinical outcomes of the management of posterior malleolar fractures in adults. Settings and Design: This is an original research retrospective studyMaterials and Methods: Eleven patients underwent fixation of ankle fractures with fixation of posterior malleolus as needed using screws or plates. Surgical outcomes were examined in follow-up with an average follow-up of 21 months using the American Orthopedic Foot and Ankle Score (AOFAS) score and with radiological correlation at each follow-up. Results: In our series, 27% of patients had 44B type injury and 73% of patients had 44C type injury as per AO/OTA classification. The average AOFAS score was 90.45 for the series and the score for patients treated with direct reduction of the fragment was better than for those treated with indirect reduction. The average score for patients managed with screws was better than for those treated with plates in our series. 82% of patients showed excellent to good outcomes with one patient having an infection and one patient having moderate to severe pain. Conclusion: Anatomical reduction of posterior malleolar fragment leads to better long-term functional outcomes and a stable ankle joint with early mobilization.
引言:后踝骨折相对罕见,是复杂踝关节损伤的一部分。三踝骨折影响负重踝关节的稳定性。后踝骨折的治疗是一项挑战。目的:本研究旨在检查成人后踝骨折治疗的放射学和临床结果。设置和设计:这是一项原始研究回顾性研究材料和方法:11名患者根据需要使用螺钉或钢板进行踝关节骨折固定和后踝固定。在随访中检查了手术结果,平均随访21个月,使用美国骨科足部和踝关节评分(AOFAS)评分,并在每次随访中进行放射学相关性检查。结果:在我们的系列中,根据AO/OTA分类,27%的患者有44B型损伤,73%的患者有44 C型损伤。该系列的平均AOFAS评分为90.45,直接还原片段治疗的患者的评分优于间接还原治疗的患者。在我们的系列中,使用螺钉治疗的患者的平均得分高于使用钢板治疗的患者。82%的患者表现出良好至良好的结果,其中一名患者感染,一名患者中度至重度疼痛。结论:解剖复位后踝骨折可获得更好的长期功能结果和稳定的踝关节早期活动。
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引用次数: 0
Assessment of anti-inflammatory activity of Tridax procumbens in wistar rats 雷公藤对wistar大鼠抗炎活性的评价
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_45_22
S. Prakash, R. Suman, G. Chandra, P. Yadav, M. Kumar
Background: Tridax procumbens Linn. is a spreading herb found throughout India. Tridax procumbens is known for several potential therapeutic effects like antiviral, antioxidant, anti-infective, wound healing, insecticidal and anti-inflammatory, hepatoprotective, and antidiabetic. Novel therapies for inflammation are essential to overcome the adverse effects of existing anti-inflammatory drugs. Thus, this study was designed to evaluate anti-inflammatory activity in the experimental animal. Objective: To evaluate anti-inflammatory efficacy in experimental animalMaterials and Methods: Tridax procumbens plant leaves were taken for the study. The Plant extraction was prepared by using the Soxhlet apparatus. The ethanolic extract was used as a test drug. Indomethacin and Dexamethasone were used as control drugs. Wistar rats weighing 150g to -200g were used in the study. Results: At dosages of 200 and 400 mg kg-1, the ethanolic leaf extracts of Tridax Procumbens demonstrated substantial anti-inflammatory activity against Irish Moss-triggered inflammation. After 3 hours, 400 mgkg-1 showed a significant reduction in inflammation (48 percent), with the impact increasing after 3 hours (52 percent). The anti-inflammatory efficacy of Tridax Procumbens ethanol (EtOH) extracts was substantial and comparable to that of indomethacin (10 mg/kg). Tridax procumbens ‘s Ethanol (EtOH) leaf extract at a dose of 200 and 400 mgkg-1, demonstrated considerable anti-inflammatory action. The average weight of granulomatous surrounding tissue in the threading was considerably smaller in the Tridax procumbens extraction group after 7 days than in the comparison group. The 400 mg kg-1 dose was shown to be the most effective of the two. the greatest reduction in the production of granuloma tissue. Tridax procumbens at doses of 200 mg/kg and 400 mg/kg resulted in substantial reductions in granuloma weights of 38.16 ± 0.04 (7.4 percent inhibition) and 34.58 ± 0.04 (16.1 percent inhibition), respectively. The lower dose of 400 mg/kg resulted in a little lesser reduction in granumola weight than the conventional medication dexamethasone (28.92 ± 0.04). (29.8 percent inhibition). Conclusion: The present study concludes that Tridax Procumbens possess anti-inflammatory effects in animal models.
背景:平菇。是一种分布在印度各地的草本植物。三叶草具有抗病毒、抗氧化、抗感染、伤口愈合、杀虫和抗炎、护肝和抗糖尿病等潜在治疗作用。针对炎症的新疗法对于克服现有抗炎药的不良影响至关重要。因此,本研究旨在评估实验动物的抗炎活性。目的:评价实验动物的抗炎作用。材料与方法:以平菇属植物叶片为研究对象。植物提取物是通过使用Soxhlet装置制备的。乙醇提取物被用作试验药物。对照药物分别为吲哚美辛和地塞米松。本研究选用体重150g~-200g的Wistar大鼠。结果:剂量为200和400 mg kg-1,Tridax Procumbens的乙醇叶提取物对爱尔兰苔藓引发的炎症表现出显著的抗炎活性。3小时后,400 mgkg-1显示炎症显著减轻(48%),3小时后影响增加(52%)。Tridax Procumbens乙醇(EtOH)提取物的抗炎功效显著,与吲哚美辛(10 mg/kg)。Tridax平菇的乙醇(EtOH)叶提取物在剂量为200和400 mgkg-1时,表现出相当大的抗炎作用。Tridax平卧位提取组7天后,穿线过程中肉芽肿性周围组织的平均重量明显小于对照组。400 mg·kg~(-1)剂量被证明是两种剂量中最有效的。肉芽肿组织产生的最大减少。剂量为200的Tridax平卧 mg/kg和400 mg/kg导致肉芽肿重量显著减少38.16 ± 0.04(7.4%抑制)和34.58 ± 抑制率分别为0.04(16.1%)。400的较低剂量 与传统药物地塞米松相比,mg/kg的颗粒瘤重量减少幅度较小(28.92 ± 0.04)(抑制率为29.8%)。结论:本研究得出结论:原伞形花提取物在动物模型中具有抗炎作用。
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引用次数: 0
Pattern of comorbidities and clinical profile of young adults who died due to severe coronavirus disease: A descriptive study 因严重冠状病毒病死亡的年轻人的合并症模式和临床特征:一项描述性研究
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_169_22
N. Mary Grace, Shinas Babu, Anoop Joseph, Dayan Jacob, Allen Benjamin, V. Anaghajyothi, Sanjay Pulpandi, C. Jacob
Introduction: Mortality due to coronavirus disease (COVID-19) is a significant problem among the non-elderly population. Aims: The primary objective was to estimate the prevalence of comorbidities among the deceased in the age group of 18–64 years and the secondary objective, was to describe their clinical profile. Settings and Design: The study setting was a tertiary care center catering to COVID-19 patients. This was a record-based descriptive study. Materials and Methods: Sampling strategy and Sample size: The formula used for sample size calculation is Z2 FNx01 P(1 – P) / d2. The sample size required was 97. The study period was from July 1 to November 30, 2021. Data collection: Demographic data including comorbidities, and clinical and laboratory features were studied. The laboratory investigations were done on the day of admission, and either on the last day or one day before death were taken for analysis. Statistical analysis used: Statistical analysis was carried out in IBM SPSS Version 26. Chi-square and Fisher’s exact tests, Mann–Whitney U and Kruskal–Wallis tests, Wilcoxon signed rank test, and Correlation tests were used for analysis. Results: The majority of the patients had more than one comorbid condition. The parameters which showed significant variation as the illness progressed were lymphocyte count, total protein, and albumin. Conclusion: Special vigilance should be kept while managing young patients with comorbidities. Lymphocyte count and serum albumin can be helpful in prognostication.
简介:冠状病毒疾病(新冠肺炎)导致的死亡率是非老年人群中的一个重大问题。目的:主要目的是估计18-64岁年龄组死者合并症的患病率,次要目的是描述他们的临床特征。设置和设计:研究环境是一个为新冠肺炎患者提供服务的三级护理中心。这是一项基于记录的描述性研究。材料和方法:采样策略和样本量:用于计算样本量的公式为Z2 FNx01 P(1–P)/d2。所需样本量为97。研究期间为2021年7月1日至11月30日。数据收集:研究人口统计学数据,包括合并症、临床和实验室特征。实验室调查在入院当天进行,在死亡前最后一天或一天进行分析。使用的统计分析:统计分析在IBM SPSS Version 26中进行。采用卡方和Fisher精确检验、Mann–Whitney U和Kruskal–Wallis检验、Wilcoxon符号秩检验和相关检验进行分析。结果:大多数患者有一种以上的合并症。随着病情的发展,淋巴细胞计数、总蛋白和白蛋白等参数表现出显著变化。结论:在管理年轻合并症患者时应保持特别警惕。淋巴细胞计数和血清白蛋白有助于预测。
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引用次数: 0
Etiological profile, prescribing pattern of antibiotics and clinical outcomes of pneumonia patients in a tertiary care hospital in South India during 5-year period 南印度一家三级护理医院5年期间肺炎患者的病因、抗生素处方模式和临床结果
Pub Date : 2022-10-01 DOI: 10.4103/mgmj.mgmj_205_22
J. Mathew, Shiyona Noyal, S.T. Biju, Siby Joseph, Amit Jose
Background: Pneumonia is one of the most important and serious lower respiratory tract infections, which requires implacable attention. This work aimed to document the causative organisms, antibiotics used, and outcome of pneumonia patients hospitalized in a tertiary care hospital. Materials and Methods: A retrospective study was conducted in the medical departments of a tertiary care teaching hospital for 5 years. Demographic details and clinical details including pertinent laboratory values of patients diagnosed with pneumonia were documented and analyzed using a specifically designed data collection form. Results: The study was conducted on 190 patients. The average age of the study population was 56.7 ± 22.6 years and there was a male preponderance of 111(58.4%) patients. Klebsiella pneumonia was found to be the most frequently isolated pathogen in 12.5% of the sputum culture, followed by Acinetobacter baumannii in 10.22% and Pseudomonas aeruginosa in 9.09%. The most commonly prescribed empirical antibiotics were beta-lactam antibiotics mostly in combination with macrolides for synergy irrespective of Pneumonia Severity Index (PSI) classes. Definitive therapy was classified based on World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) classification of antibiotics, watch category antibiotics were prescribed according to culture report and reserve antibiotics were prescribed only in those cases where watch category antibiotics were resistant. On analyzing PSI of community-acquired pneumonia (176 patients), most of the patients in the study belong to class 4: 61 patients (34.7%) and class 5: 44 patients (25%). For the high-risk patients (PSI class 4 and 5), mortality was approximately 3.8% (4 of 105) and for low-risk patients, there was zero mortality reported within 30 days. Conclusion: Gram-negative bacteria were the major pathogens causing Pneumonia in the study site contradictory to the data from developed countries. Identifications of pathogens and appropriate antibiotic therapy based on PSI score can bring down the duration of hospital stay and mortality of patients with pneumonia.
背景:肺炎是最重要、最严重的下呼吸道感染之一,需要高度重视。这项工作旨在记录在三级护理医院住院的肺炎患者的病原体、使用的抗生素和结果。材料与方法:对某三级护理教学医院内科进行了为期5年的回顾性研究。使用专门设计的数据收集表记录和分析了被诊断为肺炎的患者的人口统计学细节和临床细节,包括相关的实验室值。结果:该研究对190名患者进行了研究。研究人群的平均年龄为56.7岁 ± 22.6岁,男性占多数的患者有111人(58.4%)。肺炎克雷伯菌在12.5%的痰培养中被发现是最常见的分离病原体,其次是鲍曼不动杆菌10.22%和铜绿假单胞菌9.09%。最常见的经验抗生素是β-内酰胺类抗生素,主要与大环内酯类抗生素联合使用,无论肺炎严重程度指数(PSI)类别如何,都具有协同作用。根据世界卫生组织(世界卫生组织)的抗生素获取、观察和储备(AWaRe)分类对最终治疗进行分类,根据培养报告开具观察类抗生素处方,仅在观察类抗生素耐药的情况下开具储备抗生素处方。在分析社区获得性肺炎(176名患者)的PSI时,研究中的大多数患者属于4类:61名患者(34.7%)和5类:44名患者(25%)。对于高危患者(PSI 4级和5级),死亡率约为3.8%(105例中有4例),而对于低风险患者,30天内报告的死亡率为零。结论:革兰阴性菌是研究区引起肺炎的主要病原体,与发达国家的数据相矛盾。基于PSI评分的病原体识别和适当的抗生素治疗可以降低肺炎患者的住院时间和死亡率。
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引用次数: 0
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MGM Journal of Medical Sciences
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