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Abstract Objective To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Methods Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). Results From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. Conclusion The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.
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Fat embolism syndrome (FES) is an emergency fatal condition, if not diagnosed early and timely managed. Careful observation of patients with multiple bone fractures aids in early diagnosis. Rehydration is an important factor in preventing FES. Most often the syndrome is self-limiting. High risk cases are treated with steroids and with respirator assistance.
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Background: By 2050, United Nations projects that one in five Indians would be 60 years of age or older. This demographic transition is likely to be accompanied by substantial rise in prevalence of cognitive problems, which will have an impact on quality of life among elderly people. Effective screening at primary level would help in identification of burden of diseases and better planning at secondary and tertiary level. Methods: A community-based cross-sectional study over a period of three months was conducted at Pulipakkam in Chengalpattu district. The estimated sample size was 215, and simple random sampling method was used. Elderly people aged 60 years and above who consented to participate were included in the study. After obtaining informed consent, they were screened using the Mini-Cog tool which combines a short memory test with a simple clock- drawing test followed by a recall component. Results: The 215 participants in total were screened. The mean age of participants was 66.02±3.83 years. The prevalence of cognitive impairment (CI) based on Mini-Cog scale was 44.2%. Females (44.8%) had marginally higher prevalence than males (43.8%). CI was more prevalent among people over 65 years (57.6%). The likelihood of experiencing CI was higher among those who lived without their spouse (59.4%), were unemployed (53.7%), and who were smokers / alcoholics (63.7%). Conclusions: Considering the high burden of CI, there is need for long term prospective research for a comprehensive profile of mental disorders at community level. Early assessment and detection of CI could help in improving quality of life of elderly. Implementing initiatives aimed at increasing awareness, reducing stigma, and conducting widespread screening using reliable tools.
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Ceftaroline fosamil, a cephalosporin approved by the FDA for treating infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Staphylococcus aureus, particularly MRSA strains, poses a significant health risk due to antibiotic resistance. Ceftaroline fosamil is unique in its ability to bind to penicillin-binding protein 2a (PBP2a) found in MRSA, inhibiting bacterial cell wall synthesis and causing bacterial death. The pharmacokinetics of ceftaroline involve rapid conversion to its active form, primarily excretion through the kidneys, and a plasma protein binding rate of approximately 20%. Ceftaroline is effective against complex skin and soft tissue infections (cSSTIs) and community-acquired pneumonia (CAP), especially when MRSA is suspected. However, its efficacy against gram-negative bacteria is limited. The safety profile of ceftaroline fosamil is generally good, with reported adverse events comparable to other comparator agents in clinical trials. It is contraindicated in individuals with hypersensitivity to cephalosporins. Comparative efficacy with other antibiotics like vancomycin and daptomycin is discussed, emphasizing the importance of considering individual patient characteristics and local prevalence of resistant bacteria. The use of ceftaroline fosamil in special populations, such as pediatric and adult patients. While its efficacy in pediatric MRSA infections is explored, the lack of large-scale clinical trials for certain conditions like MRSA bacteremia is acknowledged. Clinical outcomes, including successful treatment of MRSA bacteremia, infective endocarditis, central nervous system infections, and nosocomial pneumonia, are discussed, suggesting ceftaroline fosamil's potential as a valuable therapeutic option. The conclusion underscores its breakthrough status, offering hope in addressing MRSA infections and improving patient outcomes.
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Abstract Sarcopenia is a pathology resulting from a progressive and severe loss of muscle mass, strength, and function in the course of aging, which has deleterious consequences on quality of life. Among the most widespread studies on the issue are those focused on the effect of different types of physical exercise on patients with sarcopenia. This randomized controlled study aimed to compare the effects of a whole-body vibration exercise (WBV) session on the inflammatory parameters of non-sarcopenic (NSG, n=22) and sarcopenic elderly (SG, n=22). NSG and SG participants were randomly divided into two protocols: intervention (squat with WBV) and control (squat without WBV). After a one-week washout period, participants switched protocols, so that everyone performed both protocols. Body composition was assessed by dual-energy radiological absorptiometry (DXA) and function through the six-minute walk test (6MWD) and Short Physical Performance Battery (SPPB). Plasma soluble tumor necrosis factor receptors (sTNFR) were determined by enzyme-linked immunosorbent assay (ELISA) and measured before and immediately after each protocol. After exercise with WBV, there was an increase in sTNFR2 levels in the NSG (P<0.01; d=-0.69 (-1.30; -0.08) and SG (P<0.01, d=-0.95 (-1.57; -0.32) groups. In conclusion, an acute session of WBV influenced sTNFr2 levels, with sarcopenic individuals showing a greater effect. This suggested that WBV had a more pronounced impact on sTNFr2 in those with loss of muscle strength and/or physical performance. Additionally, WBV is gaining recognition as an efficient strategy for those with persistent health issues.
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Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.
A leishmaniose visceral é uma doença tropical negligenciada. Foram avaliadas a distribuição espacial dos casos de leishmaniose visceral no estado de Alagoas. Todos os casos de LV, registrados pela secretaria de saúde, foram analisados e georreferenciados. Entre 2008 e 2017, 97,1% dos municípios apresentaram classificação esporádica de transmissão. Com a evolução temporal, a incidência de casos de leishmaniose visceral se concentrou na maioria dos municípios da microrregião de Santana do Ipanema-AL. A análise espaço-tempo, se considerada, pode promover o aprimoramento das ações de vigilância e controle da leishmaniose visceral.
Sujet(s)
Humains , Médecine tropicale , Analyse spatio-temporelle , Leishmaniose viscérale , BrésilRÉSUMÉ
Abstract Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.
Resumo A leishmaniose visceral é uma doença tropical negligenciada. Foram avaliadas a distribuição espacial dos casos de leishmaniose visceral no estado de Alagoas. Todos os casos de LV, registrados pela secretaria de saúde, foram analisados e georreferenciados. Entre 2008 e 2017, 97,1% dos municípios apresentaram classificação esporádica de transmissão. Com a evolução temporal, a incidência de casos de leishmaniose visceral se concentrou na maioria dos municípios da microrregião de Santana do Ipanema-AL. A análise espaço-tempo, se considerada, pode promover o aprimoramento das ações de vigilância e controle da leishmaniose visceral.
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Background: The cultural diversity has influenced the beliefs of people regarding health and illness. An aim of the study was to assess the role of faith healers in the treatment of severe mental illness. Methods: It is a retrospective cross-sectional study with convenience sampling technique was used, on 123 caregivers of patients with severe mental illnesses using standardized tools like MINI, BPRS, and YMRS. Results: 41.5% participants firstly contacted faith healer while 86% visited faith healer anytime during the course of illness. 47.2% took treatment from faith healer for <6 months, 21.1% took 6-12 months and 17.9% more than 13 months. 22.8% circulated between faith healer to faith healer, 18.7% from psychiatrist to faith healer and 27.6% from medical professional to faith healer. Conclusions: There is an immense need to create awareness regarding mental illness and treatment options available.
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The use of social media in healthcare communication has expanded, public dissemination of health-related information is less common. Objective of the study was to compare the number of tweets received by public health campaigns with trending tweet and likes in twitter on those specific days. Recent posts with hashtags of nine general health and five dental public health related campaigns between 01 January 2022 to 31 December 2022 were selected from Twitter based on public health importance. We looked for top trending campaigns that had the most global reach. Descriptive statistical analysis was performed. Among the nine general health campaigns, no likes were received for five campaigns and three campaigns got likes which were greater than the trending campaigns. Among the oral health related tweets, only National tooth brushing day campaign garnered 76000 likes and none of the other oral health related tweet garnered likes. Future Twitter-based health campaigns should emphasize image-based information endorsed by a reputable organization. Further support for this message from well-known twitter users could expand the information's reach.
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A 13-year-old boy was admitted with complaints of abdominal pain and loose stools. Abdomen was distended. Laboratory tests on admission revealed neutrophilic leukocytosis and a peripheral smear done showed severe eosinophilia (33%) and leukocytosis. CT abdomen revealed ascites. Ascitic fluid tapping was done and 1.5 L of straw colored ascitic fluid drained. Ascitic fluid study was suggestive of high protein low SAAG ascites. The possibility of eosinophilic enterocolitis was considered. For confirmation endoscopy and sigmoidoscopy were done and a segmental biopsy was taken. Biopsy was suggestive of significant mucosal eosinophilia of duodenum, stomach, rectum, and eosinophilic abscess in the muscularis layer in the duodenum, stomach, and descending colon.
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Background- Osteoarthritis hip and femoral neck fractures in old age can be treated by total hip arthroplasty using dual mobility cup designs. The posterior approach (Kocher-Langenbeck) was used earlier however, lateral (Harding) and anterior approach (Smith-Petersen) are more often used. Evaluation of functional outcomes of total h Aim- ip arthroplasty using dual mobility cups in patients with osteoarthritis hip and femur neck fractures in terms of time of surgery, re-operation rate and mortality in 1 year, length of hospital stay and post-operative complications, using Harris Hip Score (HHS). Study Design- Hospital based prospective cohort study. Material and Methods- 40 cases were include in the study of which, 20 cases are of osteoarthritis hip and 20 cases are of femur neck fracture managed by dual mobility total hip arthroplasty. Clinical and functional outcome was graded using HHS. Anatomical reduction was assessed at 8 weeks, 3months, 6 months and 9 months. The mean HHS at 8 weeks, 3months, 6 months and 9 mont Result- hs in osteoarthritis hip was 56.40, 69.80, 80.90 and 91.50 and in femur neck fractures was 51.10, 63.50, 74.60 and 84.50, achieved. Better result was found in osteoarthritis hip. Conclusion- We concluded that using dual mobility total hip arthroplasty in osteoarthritis hip is far better than femur neck fractures due to better clinical and functional outcome, better anatomical reduction.
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Donating blood is an essential practice that can help save lives. Effective strategies are necessary to attract and keep blood donors to meet the demand for safe blood. To evaluate the experience of voluntary blood donors in Zanzibar, a survey was conducted, and purposive sampling was used to select participants who had donated blood multiple times. The study involved interviewing 15 repeat blood donors, and the data collected was analyzed thematically. Two main themes emerged from the analysis: motivators and barriers. Despite a few negative effects, most participants had positive experiences with repeat blood donation, and only few experienced physical reactions during or after the process. The study concludesthat blood donors in Zanzibar generally have good experience towards repeat blood donation, although community participation, education, and sensitization are needed to recruit and maintain more donors.
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Background: Breast cancer tops the global cancer incidence rates, having the highest rate of death among women. The primary objective of this study was to assess the impact of standard chemotherapy treatment dose adjusted for the Sri Lankan population, on hepatic and kidney function of breast cancer patients. Methods: The study conducted a cross-sectional, retrospective and prospective analysis of 75 breast cancer patients who received doxorubicin, cyclophosphamide, and paclitaxel chemotherapy regimen with normal liver and renal function at baseline at UHKDU oncology clinic. The study population had a mean age and BMI of 54.04±11.33 years and 26.7±3.89, respectively. Prior to starting the 16-cycle chemotherapy treatment, mean serum SGOT, SGPT, Creatinine, and eGFR values were 27.57 U/l, 31.32 U/l, 0.71 mg/dl, and 99.07 ml/minute/1.73 m2 respectively. Results: During the treatment, there was a statistically significant increase in the mean values of SGOT and SGPT (p<0.05), whereas there was no significant variation in the mean values of creatinine and eGFR (p>0.05) compared to the baseline results. The study identified a significant positive correlation in SGOT (r=0.793) and SGPT (r=0.872) values, while there was a noteworthy negative correlation (r=-0.757) between eGFR and chemotherapy cycle. Furthermore, there was a positive significant correlation between serum creatinine levels and chemotherapy cycle (r=0.579). Conclusions: The dosed adjusted chemotherapy regimen had a significant impact on hepatic function but had no statistically significant impact on renal function among the study population. Further research is recommended to evaluate the long-term effects of standard chemotherapy treatment on liver and kidney functions.
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Background: Breast cancer tops the global cancer incidence rates, having the highest rate of death among women. The primary objective of this study was to assess the impact of standard chemotherapy treatment dose adjusted for the Sri Lankan population, on hepatic and kidney function of breast cancer patients. Methods: The study conducted a cross-sectional, retrospective and prospective analysis of 75 breast cancer patients who received doxorubicin, cyclophosphamide, and paclitaxel chemotherapy regimen with normal liver and renal function at baseline at UHKDU oncology clinic. The study population had a mean age and BMI of 54.04±11.33 years and 26.7±3.89, respectively. Prior to starting the 16-cycle chemotherapy treatment, mean serum SGOT, SGPT, Creatinine, and eGFR values were 27.57 U/l, 31.32 U/l, 0.71 mg/dl, and 99.07 ml/minute/1.73 m2 respectively. Results: During the treatment, there was a statistically significant increase in the mean values of SGOT and SGPT (p<0.05), whereas there was no significant variation in the mean values of creatinine and eGFR (p>0.05) compared to the baseline results. The study identified a significant positive correlation in SGOT (r=0.793) and SGPT (r=0.872) values, while there was a noteworthy negative correlation (r=-0.757) between eGFR and chemotherapy cycle. Furthermore, there was a positive significant correlation between serum creatinine levels and chemotherapy cycle (r=0.579). Conclusions: The dosed adjusted chemotherapy regimen had a significant impact on hepatic function but had no statistically significant impact on renal function among the study population. Further research is recommended to evaluate the long-term effects of standard chemotherapy treatment on liver and kidney functions.
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RESUMO A limitação, disponibilidade irregular e elevado custo de alguns alimentos que são produzidos em outras regiões e transportados para o semiárido brasileiro para serem fornecidos aos animais são alguns dos principais entraves para a atividade pecuária nessa região, resultando na necessidade de alternativas alimentares, especialmente volumosos com qualidade que possam ser utilizados para os rebanhos. Nessa condição, a melancia forrageira (Citrullus lanatus var. citroides) é um recurso forrageiro em potencial, já que se trata de uma planta de cultivo com ciclo rápido, propagação por sementes e que, além de ofertar nutrientes, é fonte de água aos animais, característica muito apreciada em regiões áridas e semiáridas. Assim, o objetivo desta revisão é traçar um quadro teórico de aspectos relacionados à morfologia, produção e potencialidades de uso da melancia forrageira na alimentação de pequenos ruminantes. Uma busca criteriosa de artigos científicos sobre características morfoagronômicas, produtividade e aplicações da melancia forrageira em dietas para ruminantes foi realizada. Embora se tenham poucos estudos que utilizem a melancia forrageira, os conhecimentos empíricos e científicos obtidos através dos anos indicam o seu uso como uma opção viável para uma complementação alimentar dos rebanhos nas épocas secas. Sua rusticidade aliada à sua resistência no período de pós-colheita são qualidades que lhe confere a qualificação de um recurso forrageiro com grande potencial.
ABSTRACT The limitation, irregular availability, and high cost of some foods that are produced in other regions and transported to the Brazilian semi-arid region for animal feeding are some of the main obstacles to the livestock activity in this region, resulting in the need to seek food alternatives, especially voluminous that can be used for cattle herds. In this context, the forage watermelon (Citrullus lanatus var. citroides) is a potential forage resource, as it is a crop plant with a fast cycle, outstanding seed propagation, and a good source of nutrients and water for animals, a feature highly appreciated in arid and semi-arid regions. Consequently, this review sought to outline a theoretical framework of the aspects related to the morphology, production, and potential use of forage watermelon (Citrullus lanatus var. citroides) in feeding small ruminants. For this purpose, we conducted a thorough search of scientific articles on morpho-agronomic characteristics, productivity, and applications of forage watermelon in diets for ruminants. Although few studies report the use of forage watermelon, the empirical and scientific knowledge obtained over the years indicates it is a viable option for supplementary feeding of herds during dry seasons. Its rusticity, combined with its resistance in the post-harvest period, are qualities that give forage watermelon the qualification of a forage resource with great potential.
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Objective: Design a proposal of educational intervention for both, people who live with Diabetes Mellitus type 2 and their family caregiver. Methodology: Methodology. A case series study was conducted with the participation of 12 people living with type 2 diabetes mellitus and attending a Mutual Help Group in Pachuquilla, Hidalgo. Sociodemographic data, somatometric measurements (weight, height, BMI, waist circumference), blood pressure, and capillary blood samples for glycosylated hemoglobin were collected. Results: The mean age was 64 and range of 39-79 years, O.D. of 12; 67% women; 25% finished secondary school, 50% worked at home, 17% in commerce, 33% unemployed; 58% married, 25% widowed, and 17% divorced and in common law; 33.% with less than 5 years diagnosed, 67% have been diagnosed for more than 5 years; 75% depend economically; 67% have complications, 75% with family support, in diabetes knowledge 33% obtained intermediate score and 67% inadequate score; the weight average was of 77 kg and range of 57-116.5 kg, and O.D. 17 kg; in waist circumference, 100% exceed the recommended limit, in BMI, 50% is classified as overweight and 50% as obese; in blood pressure 50% > 130/80 mmHg and in glycosylated hemoglobin 75% > 7% mg/dl. Conclusion: The currently implemented strategy does not reflect good knowledge and control of the disease. This study invites us to continue with research where an educational intervention is implemented in which family caregivers are included and active participation is encouraged, in addition to implementing the IEP as a theoretical basis for the intervention.
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Aim of the Study: The phytoconstituent 6-heptadecylcyclohex 3-ene-1 carboxylic acid isolated from the methanol extract of Dichrotachys cinerea Wight. stem bark was evaluated for hepatoprotective activity against CCl4 induced toxicity. Materials and Methods: The constituent 6-heptadecylcyclohex 3-ene-1 carboxylic acid isolated from the methanolic extract of D. cinerea and the structure was confirmed by spectroscopic studies. Hepatoprotective property was screened in male wistar strain rats. The parameters studied were estimation of liver function serum markers such as serum total bilirubin, total protein, alanine transaminase, aspartate transaminase, alkaline phosphatase and histological profile of the liver tissue. Results: The LD50 of methanolic extract and constituent, 6-Heptadecylcyclohex -3-ene-1 carboxylic acid were evaluated and found to be 500 and 100 mg/kg body weight respectively. The hepatoprotective activity of constituent was more significant as similar to the standard hepatoprotective drug silymarin. The histological profile of the liver tissue showed the presence of normal hepatic cords, absence of necrosis and fatty infiltration as similar to the controls. Conclusion: The methanolic extract of D. cinerea stem bark and the phytoconstituent 6-heptadecylcyclohex-3-ene-1 carboxylic acid showed significant protection from CCl4 induced liver damage.
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Background: The vital use of data and information for successful policy-making, planning, monitoring of operations, and decision-making is essential to the administration of today’s health systems. Vital health choices typically rely on political expediency, donor pressure, and rarely replicated countrywide studies that are insensitive to changes unfolding over shorter timescales because data utilization has been constrained and is inadequate. Methods: A descriptive cross-sectional research study was conducted where quantitative technique was used for a minimum of 216 respondents. The results were presented in form of tables and charts. Results: The results show that access to routine data (p=0.0001), having a working computer (p=0.023), having access to the internet (p=0.030), having a high level of education (p=0.025), the gender of the health worker (p=0.010), the cadre (p=0.001), participating in data discussion forums (p=0.013), receiving training on data use (p=0.036), collecting data (p=0.041), analysing data (p=0.032), and data management (p=0.007) were substantially correlated with the use of health information data. Conclusions: The level of education, gender of the health worker, cadre, involvement in data discussion forums, training on data utilization, data collection, data analysis, data management, overall levels of competency, access to routine data, access to functional computer and access to internet significantly influenced the utilization of health information data.
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Bites of Bitis Rhinoceros (Viperidae) usually cause a hemorrhagic syndrome in the victims. This is a medical emergency. Antivenom immunotherapy remains effective. However, its availability and cost still limiting its use in Africa in general and in Côte d'Ivoire particularly. The roots of a plant of the Annonaceae family (Annona senegalensis) are used in Côte d'Ivoire to treat cases of envenomations by Viperidae. The objective of this work is to study the modulation of the effect of Bitis rhinoceros venom on coagulation parameters by the hydroethanol extract of Annona senegalensis leaves. The phytochemical study of the plant was carried out by monitoring effect of the venom on three blood coagulation parameters (PT, APTT, Fibrinogen) from healthy individuals in the presence and absence of the hydro-ethanolic extract. Phytochemistry revealed the presence of saponins, tannins, and polyphenolic compounds including flavonoids in this plant. The study of the effect of the venom showed that at the concentration of 10-2 mg/mL the venom of Bitis rhinoceros modifies some coagulation parameters by the decrease of half of the prothrombin rate, the increase of the coagulation time. It has no effect on the fibrinogen level. The effect of this venom is inhibited by 1 mg/mL of the hydroethanol extract. The leaves of Annona senegalensis contain molecules that could neutralize the action of the venom in the coagulation disorder.
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Antimicrobial resistance remains a threat to patient safety and healthcare outcomes and largely arises from inappropriate antimicrobial prescriptions. This study aimed to determine the pattern of antibiotic prescriptions in the Paediatrics department of Rivers State University Teaching Hospital, Port Harcourt.Method:A point prevalence survey was conducted in the Paediatric wards and Special Care Baby Unit (SCBU) on 13 November 2021. Records of all children admitted before or at 8:00a.m. on the day of the survey were descriptively analysed using the protocol and web-based management system of the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance, University of Antwerp.Results: The antibiotic prevalence in this study was 77.4%. The most common indication(s) for antibiotic use in SCBU was infection prophylaxis (81.3%) and in paediatric wards: Pneumonia, Ear Nose Throat and Soft tissue infections accounted for (23.1%) each. Third-generation cephalosporins and aminoglycosides were predominantly used in all wards and were empirical-based prescriptions. Regarding antibiotic quality indicators of prescriptions: In SCBU: 19 (90.5%) had indication(s) for antibiotics documented, 10 (46.7%) were guideline compliant, and 1 (4.8%) had documented review/stop date. In the paediatric medical and surgical wards, 17(85.0%) vs. 4(100%) had indication(s) for antibiotics documented, 6(30.0%) vs. 0(0%) were guideline compliant, and 1(5.0%) vs. 4(100.0%) had a review/ stop date.Conclusion:High prevalence of antibiotic use, suboptimal antibiotic quality indicators and absence of laboratory evidence for antibiotic prescriptions were observed in the paediatric units. There is a need to reorientate prescribers and institute strategic measures to improve antimicrobial stewardship