Résumé
Background: Sepsis is still one of the most leading cause of death in world. 19 million sepsis (formerly severe sepsis) cases and 5 million sepsis-related deaths are estimated to occur annually. Sepsis is also one of the most common cause of patients getting critically ill and getting admission in intensive care unit. The main focus of this study is to identify the culture isolate from the critically ill patients and to check for the antibiotic sensitivity and resistance and identify if the report has changed the course of treatment and outcome of the patients. Critical illness is a life-threatening multisystem process that can result in significant morbidity or mortality. Critically ill patients are those who have dysfunction or failure of one or more organs/system and depend on survival from advanced instruments of monitoring and therapy. The aim of the study was to identify the causative organism causing sepsis in critically ill patients.Methods: It will be multi central retrospective study which included patients of critical illness of Rohilkhand Medical college, Bareilly, Uttar Pradesh and Varun Arjun Medical college, Shahjanpur, A total of 468 patients were taken for the analysis during period of from August 2018 to November 2019 among of which 324 samples came positive. Samples were taken on day one of the patient’s presentation to the hospital and were analysed in BD BACTEC culture medium. Patient’s data were taken from records available at both the hospitals. Sensitivity was performed using disk diffusion method and the results were compared with the records of patients.Results: Among of samples taken that is 324; 194 were male and 130 were female. Maximum patients which were tested positive for Staphylococcus aureus (n=198). Others included Streptococcus pneumococcus (n=25), Escherichia coli (n=50), Klebsiella oxytoca (n=13), Klebsiella pneumoniae (n=15), Pseudomonas aeruginosa (n=20), and Acinetobacter (n=3). In retrospective analysis of the patients of all 324 cases treatment in approximately 148 patients was changed due to change in the sensitivity of antibiotics.Conclusions: Staphylococcus still dominates the sepsis. It is advisable to add an antibiotic with gram negative if patients count does not improve in first 24 hour.
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Background: Latest studies have shown effective clinical outcomes after arthroscopic Bankart repair [ABR] but have shown some risk factors for re-dislocation after surgery. We assessed whether patients are at a risk for re-dislocation during the first year after ABR, examined the recurrence rate after ABR, and sought to recognize new risk factors
Materials and Methods: We performed ABR utilizing bioabsorbable suture anchors in 51 consecutive shoulders [50 patients] with traumatic anterior shoulder instability. Average patient age was 26.5 [range, 15-40] years. We assessed re-dislocation after ABR using patient telephone interviews [follow-up rate, 100%] and correlated re-dislocation with several risk factors
Results: Re-dislocation after ABR occurred in five shoulders [9.8%], of which 4 sustained re-injuries within the first year with the arm elevated at 90° and externally rotated at 90°. Of the remaining 46 shoulders without re-dislocation, 4 had re-injury under the same conditions within the first year. Consequently, re-injury within the first year was a risk for re-dislocation after ABR [P < 0.001, chi-squared test]. Using multivariate analysis, large Hill-Sachs lesions [odds ratio, 6.75; 95% CI, 1.35-64.5] and <4 suture anchors [odds ratio, 9.45; 95% CI, 1.88-72.5] were significant risk factors for re-dislocation after ABR
Conclusion: The recurrence rate after ABR was not associated with the time elapsed and that repair strategies should augment the large humeral bone defect and use >3 anchors during ABR
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Background: prophylactic antibiotics are effective in preventing surgical-wound infections. However, the clarity about the compelling need for antibiotic administration and the risk associated with their use is missing. The use of antimicrobial prophylaxis against surgical site infection [SSI] is common in plastic surgery, while results from prospective randomized controlled trials are scarce
Aim of the Study: was to evaluate the need for antibiotic prophylaxis in the field of plastic surgery
Methods: Electronic search of available Literatures in the scientific database of recent randomized controlled trials evaluating the indications for and use of antibiotics to reduce and treat SSIs for patients undergoing plastic surgery from 1960 to 2017- [Medline, Embase, the Cochrane Library as well as NHS centre websites were searched for English Publications from both reprint requests and by searching the database. Data extracted included antibiotic dosage, duration and incidence of surgical site infection
Conclusion: surgical procedures must be distinguished based on the risk of infection and the need for antibiotic prophylaxis should be determined accordingly, i.e. on a case by case basis.No prophylaxis is required for superficial skin's and clean surgeries such as mucosal excisions, nevertheless, Antibiotic prophylaxis is recommended microsurgical operations, prosthetic surgery, incisional hernias, clean non-prosthetic osteoarticular surgery, oral cavity and genitourinary system procedures. Still, antibiotic use should be prescribed with caution to avoid profound side effects such as developing resistant bacterial strains, severe allergies and other accompanied comorbidities
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Objective: The aim of the study is to assess the effect of tobacco smoking on the risk of nonfatal acute myocardial infarction in young adults less than years
Materials and methods: We conducted a population-based case-control study with 164 occurrence acute myocardial infarction cases [21 women; 143 men], consecutively visited King Abdulaziz hospital, KSA, and 227 controls [81 women; 146 men], From February 2016 till February 2017. All women are non-Saudi women. Odds ratios [OR] and 95% confidence intervals [95%CI] were calculated using unconditional logistic regression
Results: The commonness of present smoking was 81% in male cases and 54% in male controls [OR = 3.59, 95%CI: 2.49, 5.31] and 60% of female cases were smokers compared with 36% of controls [OR = 2.65, 95%CI: 1.40, 4.98]. No interaction was found between current smoking and gender on myocardial infarction risk [P = 0.399]. A dose-effect response was present, the odds favoring myocardial infarction reaching an eight-fold increase for those who smoked >25 cigarettes/day compared with never smokers. The risk estimate for former smokers was similar to never smokers
Conclusions: Tobacco smoking is an important independent risk factor for acute myocardial infarction in young adults, with similar strength of association for both genders