scholarly journals Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

2019 ◽  
Vol 54 (1) ◽  
pp. 1802256 ◽  
Author(s):  
Phuong T.K. Nguyen ◽  
Hoang T. Tran ◽  
Dominic A. Fitzgerald ◽  
Thach S. Tran ◽  
Stephen M. Graham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Admissions ◽  
Adverse Outcome ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Severe Pneumonia ◽  
Careful Consideration ◽  
World Health ◽  
Management Approach ◽  
Who Criteria

Pneumonia is the most common reason for paediatric hospital admission in Vietnam. The potential value of using the World Health Organization (WHO) case management approach in Vietnam has not been documented.We performed a prospective descriptive study of all children (2–59 months) admitted with “pneumonia” (as assessed by the admitting clinician) to the Da Nang Hospital for Women and Children to characterise their disease profiles and assess risk factors for an adverse outcome. The disease profile was classified using WHO pneumonia criteria, with tachypnoea or chest indrawing as defining clinical signs. Adverse outcome was defined as death, intensive care unit admission, tertiary care transfer or hospital stay >10 days.Of 4206 admissions, 1758 (41.8%) were classified as “no pneumonia” using WHO criteria and only 252 (6.0%) met revised criteria for “severe pneumonia”. The inpatient death rate was low (0.4% of admissions) with most deaths (11 out of 16; 68.8%) occurring in the “severe pneumonia” group. An adverse outcome was recorded in 18.7% of all admissions and 60.7% of the “severe pneumonia” group. Children were hospitalised for a median of 7 days at an average cost of 253 USD per admission. Risk factors for adverse outcome included WHO-classified “severe pneumonia”, age <1 year, low birth weight, previous recent admission with an acute respiratory infection and recent tuberculosis exposure. Breastfeeding, day-care attendance and pre-admission antibiotic use were associated with reduced risk.Few hospital admissions met WHO criteria for “severe pneumonia”, suggesting potential unnecessary hospitalisation and use of intravenous antibiotics. Better characterisation of the underlying diagnosis requires careful consideration.

scholarly journals The Impact of Risk Factors and More Stringent Diagnostic Criteria of Gestational Diabetes on Outcomes in Central European Women

2008 ◽  
Vol 93 (5) ◽  
pp. 1689-1695 ◽  
Author(s):  
A. Kautzky-Willer ◽  
D. Bancher-Todesca ◽  
R. Weitgasser ◽  
T. Prikoszovich ◽  
H. Steiner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Tertiary Care ◽  
World Health ◽  
Large For Gestational Age ◽  
Oral Glucose ◽  
Who Criteria ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Objectives: In the face of the ongoing discussion on the criteria for the diagnosis of gestational diabetes (GDM), we aimed to examine whether the criteria of the Fourth International Workshop Conference of GDM (WC) select women and children at risk better than the World Health Organization (WHO) criteria. Design and Setting: This was a prospective longitudinal open study in five tertiary care centers in Austria. Patients and Outcome Measures: The impact of risk factors, different thresholds (WC vs. WHO), and numbers of abnormal glucose values (WC) during the 2-h, 75-g oral glucose tolerance test on fetal/neonatal complications and maternal postpartum glucose tolerance was studied in 1466 pregnant women. Women were treated if at least one value according to the WC (GDM-WC1) was met or exceeded. Results: Forty-six percent of all women had GDM-WC1, whereas 29% had GDM-WHO, and 21% of all women had two or three abnormal values according to WC criteria (GDM-WC2). Eighty-five percent of the GDM-WHO were also identified by GDM-WC1. Previous GDM [odds ratio (OR) 2.9], glucosuria (OR 2.4), preconceptual overweight/obesity (OR 2.3), age 30 yr or older (OR 1.9), and large-for-gestational age (LGA) fetus (OR 1.8) were the best independent predictors of the occurrence of GDM. Previous GDM (OR 4.4) and overweight/obesity (OR 4.0) also independently predicted diabetes postpartum. GDM-WC1 had a higher rate of obstetrical complications (LGA neonates, neonatal hypoglycemia, cesarean sections; P &lt; 0.001) and impaired postpartum glucose tolerance (P &lt; 0.0001) than GDM-WHO. Conclusion: These results suggest the use of more stringent WC criteria for the diagnosis of GDM with the initiation of therapy in case of one fasting or stimulated abnormal glucose value because these criteria detected more LGA neonates with hypoglycemia and mothers with impaired postpartum glucose metabolism than the WHO criteria.

scholarly journals Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

2020 ◽  
Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
World Health ◽  
Respiratory Pattern ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
History Of ◽  
Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having &ldquo;some dehydration&rdquo; and &ldquo;dehydration&rdquo; according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean &plusmn; standard deviation age of 25.62 &plusmn; 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p&lt;0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p&lt;0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p&lt;0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

scholarly journals Incidence and Risk Factors for Severe Pneumonia in Children Hospitalized with Pneumonia in Ujjain, India

2020 ◽  
Vol 17 (13) ◽  
pp. 4637
Author(s):  
Sunil Kumar Kasundriya ◽  
Mamta Dhaneria ◽  
Aditya Mathur ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Public Health Problem ◽  
Severe Pneumonia ◽  
World Health ◽  
Major Public Health Problem ◽  
Open Defecation ◽  
History Of ◽  
Poor Ventilation ◽  
Acyanotic Congenital Heart Disease ◽  
Health Organization

Childhood pneumonia is a major public health problem. The aim of this prospective hospital-based study is to determine the incidence and risk factors for community-acquired severe pneumonia in children in Ujjain, India. The study includes 270 children, 161 (60%) boys and 109 (40%) girls, aged between 2 months and 5 years with World Health Organization defined and radiologically confirmed severe pneumonia. Considering the 270 children, 64% (95% confidence interval (CI) 57.9–69.4) have severe pneumonia. The following are identified as risk factors for severe pneumonia from the generalized logistic regression model: Born premature (adjusted odds ratio (AOR) 7.50; 95% CI 2.22–25.31; p = 0.001); history of measles (AOR 6.35; 95% CI 1.73–23.30; p = 0.005); incomplete vaccination (AOR 2.66; 95% CI 1.09–6.48; p = 0.031); acyanotic congenital heart disease (AOR 9.21; 95% CI 2.29–36.99; p = 0.002); home treatment tried (AOR 3.84; 95% CI 1.42–10.39; p = 0.008); living in a kuchha house (AOR 3.89; 95% CI 1.51–10.01; p = 0.027); overcrowding (AOR 4.50; 95% CI 1.75–11.51; p = 0.002);poor ventilation in living area (AOR 16.37; 95% CI 4.67–57.38; p < 0.001); and practicing open defecation (AOR 16.92; 95% CI 4.95–57.85; p < 0.001). Awareness of these risk factors can reduce mortality due to severe pneumonia.

scholarly journals Recurrent Emergency Department Users: Two Categories with Different Risk Profiles

2019 ◽  
Vol 8 (3) ◽  
pp. 333 ◽  
Author(s):  
Ksenija Slankamenac ◽  
Meret Zehnder ◽  
Tim Langner ◽  
Kathrin Krähenmann ◽  
Dagmar Keller
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Emergency Services ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Co Morbidity ◽  
Ed Visits ◽  
Morbidity Index

Recurrent emergency department (ED) visits are responsible for an increasing proportion of overcrowding. Therefore, our aim was to investigate the characteristics and prevalence of recurrent ED visitors as well as to determine risk factors associated with multiple ED visits. ED patients visiting the ED of a tertiary care hospital at least four times consecutively in 2015 were enrolled. Of 33,335 primary ED visits, 1921 ED visits (5.8%) were performed by 372 ED patients who presented in the ED at least four times within the one-year period. Two different categories of recurrent ED patients were identified: repeated ED users presenting always with the same symptoms and frequent ED visitors who were suffering from different symptoms on each ED visit. Repeated ED users had more ED visits (p < 0.001) and needed more hospital admissions (p < 0.010) compared to frequent ED users. Repeated ED users visited the ED more likely due to symptoms from chronic obstructive pulmonary diseases (p < 0.001) and mental disorders (p < 0.001). In contrast, frequent ED patients showed to be at risk for multiple ED visits when being disabled (p = 0.001), had an increased Charlson co-morbidity index (p = 0.004) or suffering from rheumatic diseases (p < 0.001). A small number of recurrent ED visitors determines a relevant number of ED visits with a relevance for and impact on patient centred care and emergency services. There are two categories of recurrent ED users with different risk factors for multiple ED visits: repeated and frequent. Therefore, multi-professional follow-up care models for recurrent ED patients are needed to improve patients’ needs, quality of life as well as emergency services.

scholarly journals Relationship between Radiological Findings with Bacterial Etiology of Community Acquired Pneumonia in Pediatric Population

2021 ◽  
Author(s):  
Nidhi Pandey ◽  
Garima Mittal ◽  
Nitika Agarwal ◽  
Barnali Kakati ◽  
R.K. Agarwal
Keyword(s):  
Sample Size ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Clinical Signs ◽  
Lower Lobe ◽  
Community Acquired Pneumonia ◽  
World Health ◽  
Care Hospital ◽  
Number Of Patients ◽  
The Right

Pneumonia continues to be a major cause of morbidity and mortality in children. Pneumonia is the leading killer of children worldwide. For the diagnosis of pneumonia, the World Health Organization has introduced guidelines for the management of cases to reduce the mortality of these diseases on the basis of simple clinical signs followed by the empirical treatment with antibiotics. More than 99% of deaths related to pneumonia among children occur in countries having a low and middle income. To study the Radiological finding of Community-Acquired Pneumonia (CAP) in children. Across sectional study was conducted in which the sample size for the study was calculated from the expected prevalence of CAP based on other studies (74%). The sample size calculated by the required criterion for this study is 96. I was able to cover 118 patients as per the inclusion criteria in this study. The Patients of pediatric age groups and either sex attending tertiary care hospital with complaints suggestive of CAP. In this study total number of patients are 118 included who presented with the signs and symptoms suggestive of pneumonia. The findings of chest X-Ray of Right Lung with respect to different bacterial agents. Consolidation of the Right upper lobe is found to be statistically significant with respect to Streptococcus pneumonia and consolidation of the right lower lobe is found to be statistically significant with respect to bacteria Staphylococcus aureus whereas there is no statistically significant association with respect to other bacteria. The radiological finding of CAP in children attending pediatric OPD was observed that there was no association with any other bacteria.

scholarly journals Clinical characteristics and factors influencing the outcome of hospitalised COVID-19 patients in a semi-urban primary healthcare center

2021 ◽  
Vol 14 (2) ◽  
pp. 42-54
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Chinmay Saha Podder ◽  
Nandini Chowdhury ◽  
Md Mohim Ibne Sina ◽  
SKM Shameem Kawser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Outcome ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Rt Pcr ◽  
District Health ◽  
Factors Associated ◽  
Negative Outcome

Background and objectives: Various new manifestations and risk factors for COVID-19 have been unveiled in the course of the current pandemic. Understanding the clinical spectrums as well as the risk factors associated with the adverse outcome of the disease is critical to combat this pandemic. This study was conducted to identify the clinical features, overall outcome and the factors associated with adverse outcome of the hospitalised COVID-19 patients in a semi-urban healthcare setting. Methods: This study was conducted at Debidwar Upazila (sub-district) Health Complex under the Cumilla district from April 2020 to October 2020. Reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients, aged 18 years and above, admitted at the Health Complex were enrolled in the study. All patients were followed till their recovery, referral or death. The data were collected in a pre-designed semi-structured questionnaire that included demographic, epidemiological, clinical and laboratory parameters. Result: Out of 50 RT-PCR positiveCOVID-19 adult participants, 30 (60%) were males and 20 (40%) were females. Twenty-four percent, 36%, and 40% of the patients had mild, moderate and severe disease respectively. The most common clinical symptom was fever (96%), followed by cough (86%) and shortness of breath (60%). Hypertension (54%), diabetes mellitus (40%), bronchial asthma (20%) and chronic obstructive pulmonary disease (COPD, 14%) were the major co-morbid conditions. Of the total cases, 2 (4%) died and 8 (16%) required referral to tertiary care hospital while 40 (80%) recovered. COPD was associated with poor outcome (OR 19; 95% CI: 2.88, 125.31; p < 0.05). Smokers were 7 times more likely to exhibit the negative outcome than non-smokers (95% CI: 1.52, 32.33; p < 0.05). Conclusion: In this study, COPD was associated with a negative outcome. Further study with larger sample should be carried out to determine the spectrum of risk factors. Ibrahim Med. Coll. J. 2020; 14(2): 42-54

scholarly journals Occurrence of Cardiovascular Complications Associated with SARS-CoV-2 Infection: A Systematic Review

2021 ◽  
pp. 8-20
Author(s):  
Daniele Melo Sardinha ◽  
Karla Valéria Batista Lima ◽  
Thalyta Mariany Rêgo Lopes Ueno ◽  
Yan Correa Rodrigues ◽  
Juliana Conceição Dias Garcez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Systematic Review ◽  
Cardiac Injury ◽  
Severe Pneumonia ◽  
Cardiovascular Complications ◽  
World Health ◽  
The World ◽  
Health Organization ◽  
Cardiopulmonary System

Cardiovascular Diseases represent the main cause of death in the world, and are associated with risk factors that cause serious complications in cases of infections, such as those of the respiratory tract. In March 2020 the World Health Organization declared a pandemic for SARS-CoV-2, a new coronavirus causing severe pneumonia, which emerged in December 2019 in Wuhan, China. The objective is to investigate the occurrence of cardiovascular complications associated with SARS-CoV-2 infection. It is a systematic review, quantitative, in the databases, PubMed and Science direct, including primary studies with hospitalized patients confirmed for COVID-19 and who presented cardiovascular complications, the form used tools for evaluation of quality and evidence, following the PRISMA recommendations. Results: 12 studies were included. The occurrence of cardiovascular complications was: 27.35% of the sample of 3,316 patients. Types: Acute cardiac injury 17.09%; Thromboembolism 4.73%; Heart failure 3.43%; Arrhythmias 1.77%; stroke 0.33%. Mean age 61 years. Conclusions: This study showed that there are several cardiovascular complications associated with SARS-CoV-2, that the main one is acute cardiac injury, which causes several instabilities in the cardiopulmonary system, and that it is associated with mortality.

scholarly journals Malnutrition Precipitated Measles Outbreak in Gewane District, Afar Regional State, Northeastern Ethiopia, 2016

2020 ◽  
Author(s):  
Wolde Melese Ayele
Keyword(s):  
Risk Factors ◽  
Multivariable Analysis ◽  
Clinical Signs ◽  
Immunization Coverage ◽  
Public Health Problem ◽  
Binary Logistic Regression ◽  
Developed Countries ◽  
High Rate ◽  
World Health ◽  
Vaccination History

Abstract Background: Measles is a contagious viral and vaccine-preventable disease that is continuing a public health problem. It is occurring as an outbreak not only in developing but also in developed countries.Methods: A 1:2 ratios, unmatched case-control study was conducted from September 19/2016- October 08/2016 in Undufo Kebele, Gewane district, Northeastern Ethiopia. Both confirmed by laboratory and epidemiologically linked measles cases were involved. Controls were those who had no clinical signs of measles during the data collection period and residents of the same community where cases were identified. An interviewer-administered questionnaire was used to collect data. Nutritional status was measured using MUAC and the result decided based on the world health organization's nutritional categorization of children by MUAC. Data were entered into Epi-info 7 and analyzed using SPSS-21. Binary logistic regression was done to identify risk factors for measles infection with 95% confident level of Odds ratio.Result: Fifty cases and 100 controls have participated in this investigation. Four out of five samples collected were positive for measles IgM antibody. There were three deaths reported. There was no vaccination history of cases and controls. The majority of cases were female and between 6–15 years of age. In multivariable analysis, malnutrition (AOR = 3.21; 95%CI 1.871,6.334), and contact history (AOR = 12.24; 95%CI 6.992,28.121) increased the risk of contracting measles infection.Conclusion: children under 15-year age were more affected groups. The absence of vaccination in the area precipitated by a high rate of malnutrition was the main cause that aggravates the number of new infections. Contact history and malnutrition were the identified risk factors for measles infection. Therefore, increasing immunization coverage of more than 80%, and securing food security decrease the susceptibility of outbreak occurrence.

scholarly journals Risk Factors Determining the Outcome of 2-12 Months Age Group Infants Hospitalized With Severe Pneumonia

2013 ◽  
Vol 25 (1) ◽  
pp. 9-13 ◽  
Author(s):  
KMF Uddin ◽  
N Jahan ◽  
MA Manan ◽  
SA Ferdousi ◽  
T Farhana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Fatal Outcome ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Pneumonia ◽  
World Health ◽  
Normal Infant ◽  
Age Group ◽  
Health Organization

Pneumonia is one of the leading causes of morbidity and mortality in under fives throughout the world, particularly in developing countries. A case control study was carried out in Bangabandhu Memorial Hospital, University of Science and Technology during the period of January to July 2006. 192 hospitalized infants of 2–12 months age group with World Health Organization(WHO) defined severe pneumonia with radiological confirmation were enrolled in the study, while controls were normal infant of same age group attending EPI center for vaccination. The children were managed using a standard protocol, factors were examined by univariate logistic regression analyasis. The factors whose odds ratio were significantly below 25% and considered as medically important were included in multivariate logistic regression analysis. Out of 192 children, 136(70.8%) were male, 56(29.2%) were female, 2-6 months old infants were 120(62.5%), >6 -12 months infants were 72(37.5%), malnutrition were present in 155( 80.72%), 145(75.5%) lived in slum area, 66(33.7%) were treated by quack, 63% were completely immunized and 3(10.5%) died. On multivariate analysis the following risk factors were found significant i.e. malnutrition, indoor smoke resulting from burning wood and manure used as fuel, non immunization, poor economy , poor housing. Significant risk factors for mortality in severe pneumonia are associated with 3rd degree malnutrition and congenital abnormality of heart with Downs syndrome. Malnutrition, indoor smoke, non-immunization, poor economy, poor housing, and smoking in bed room are important risk factors associated significantly with severe pneumonia and fatal outcome was associated with 3rd degree malnutrition. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15901 Medicine Today 2013 Vol.25(1): 9-13

scholarly journals Clinical Profile and Outcomes in Patients with Acute Intracerebral Haemorrhage Presenting to the Emergency Department at a Tertiary Care Teaching Hospital, South India

2021 ◽  
Vol 10 (21) ◽  
pp. 1575-1582
Author(s):  
Subramanyam Penubaku ◽  
Madhusudhan Mukkara ◽  
Kanchi Mitra Bhargav ◽  
, Ramesh Chandra V.V. ◽  
Sadasiva Raju S. ◽  
...  
Keyword(s):  
Intracerebral Haemorrhage ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Intraventricular Haemorrhage ◽  
World Health ◽  
P Value ◽  
Study Population ◽  
Ich Score ◽  
Gcs Score ◽  
Time Of Admission

BACKGROUND World Health Organisation (WHO) defined stroke as rapidly developing clinical signs of focal disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin. Prognostic factors for predicting functional outcome and mortality play a major role in determining the treatment outcome. We intended to study the clinical charecteristics and outcome of patients with intracerebral bleeding coming to emergency room. METHODS Patients more than 18 years of age who were diagnosed to have intracerebral haemorrhage (ICH) on CT brain plain scan were included in the study. Age < 18 years, patients not willing to participate in the study were excluded from the study. Type of clinical presentation, imaging findings, ICH score, and Glasgow coma scale (GCS) score, were calculated for each patient at the time of admission. The condition of the patient, whether death / discharge (alive) was documented in all study population at the time of discharge. RESULTS Hypertension was the most common risk factor present in 68 % of study population. Most of the patients were between 41 - 70 years of age with a male preponderance. High ICH score, low GCS score at the time of admission, presence of intraventricular haemorrhage, and midline shift (P - value 0.000) were significantly associated with poor clinical outcome. Mortality was high in patients with infratentorial bleed and volume > 40 c.c. CONCLUSION Males in their sixth decade were the most affected in our study on ICH. Cerebellar and brainstem haemorrhages had higher mortality, though putamen is the commonest site of haemorrhage, low Glasgow Coma Scores and high ICH scores were associated with increased mortality. KEY WORDS Stroke, Haemorrhage, Intracerebral, Prognosis, Bleed

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