METHODS: A total of 168 CRE strains isolated from a tertiary teaching hospital from 2014-2015 were included in this study. The presence of carbapenemase genes and minimum inhibitory concentration of imipenem, meropenem and colistin were investigated. All carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) strains were characterised by PFGE. The risk factors of patients infected by CRE associated with in-hospital mortality were determined statistically.
RESULTS: The predominant CRE species isolated was K. pneumoniae. The carbapenemases detected were blaOXA-48, blaOXA-232, blaVIM and blaNDM of which blaOXA-48 was the predominant carbapenemase detected among 168 CRE strains. A total of 40 CRE strains harboured two different carbapenemase genes. A total of seven clusters and 48 pulsotypes were identified among 140 CRKp strains. A predominant pulsotype responsible for the transmission from 2014 to 2015 was identified. Univariate statistical analysis identified that the period between CRE isolation and start of appropriate therapy of more than 3 days was statistically associated with in-hospital mortality.
MATERIALS AND METHODS: This was a retrospective descriptive study. All medical records of conjoined twins who were admitted to Hasan Sadikin Bandung General Hospital from January 1st, 2015, to June 30th, 2023, were reviewed for gender, conjoined type, birth order, risk factor and treatment.
RESULTS: Of the 28 conjoined twins, 21 were girls (75%), and 7 were boys (25%); 19 (67,85%) were of the thoracoomphalopagus type; 11 (39,28%) were born as first children; 18 (64,28%) were born at 37 weeks of gestational age; and 22 twins' (78,57%) parents were aged between 21 and 35 years. None of the mothers had used medication, 13 (46,42%) took folic acid on occasion, five (17,85%) used traditional herbs, nine (32,14%) smoked and none drank alcohol. Parents who live in industrial areas were 18 (64.28%). There was no history of conjoined twins in previous pregnancies or deliveries or in the parent's family. Liver separation had been done in four (14.28%). Emergency separation in one twin. Nine (21.42%) patients died before surgery due to a worsening condition.
CONCLUSION: The conjoined twins were more common in girls, predominantly of the thoracoomphalopagus type. Risk factors that were commonly found were the first child, a gestational age of less than 37 weeks, and living in an industrial area.
MATERIALS AND METHODS: The study included Hirschsprung patients aged ≥3 and <18 years who underwent Yancey- Soave surgery at our hospital. The functional outcomes were evaluated using the Krickenbeck classification to determine voluntary bowel movement (VBM), constipation and soiling.
RESULTS: Most (82.6%) patients showed VBM, 26.1% had constipation and 4.3% suffered from soiling. Among 23 patients who received Yancey-Soave surgery, 8 (34.8%) had eosinophilia and 5 (21.7%) had lymphocytosis. However, no significant differences were observed between eosinophilia and non-eosinophilia groups for VBM (p=1.0), constipation (p= 0.621) or soiling (p=0.738). Similarly, no significant differences were found between lymphocytosis and nonlymphocytosis groups for VBM (p=1.0), constipation (p=0.545) or soiling (p=0.973). Moreover, no other prognostic factors affected the functional outcomes after Yancey- Soave surgery (p>0.05).
CONCLUSION: Our study shows that eosinophilia and lymphocytosis might not affect the functional outcome of patients with HSCR following Yancey-Soave surgery. In addition, sex, aganglionosis type, age at definitive surgery and nutritional status might not influence the functional outcome after definitive surgery. Further, a more extensive study is essential to clarify our findings.
METHODS: A retrospective cohort study was conducted at Hospital Pulau Pinang in Malaysia. Medical records of active TB patients from 2014-2018 were reviewed. Cox regression was used to identify the factors associated with MDR-TB development and mortality among TB patients.
RESULTS: The patients had a mean age of 48.84 ± 16.713 years, and a majority of the Chinese race (46.4%). Out of 351 TB patients, 325 (92.6%) were drug-susceptible TB, and 26 (7.4%) were diagnosed with MDR-TB. Among drug-susceptible TB patients, 245 (75.4%) achieved successful outcomes, and 73 (22.5%) passed away. In multivariable Cox regression, drug addiction, levels of white blood cells, urea, platelets, and albumin were significantly associated with death. Relapsed TB, alcohol consumption, and being single were significant risk factors for MDR-TB development.
CONCLUSION: Patients achieved a success rate of 75.4%, which is encouraging but still far below the WHO target (at least an 85% success rate) and has room for further improvement.
METHODS: We searched Ovid MEDLINE, Ovid Embase, medRxiv and bioRxiv between January 2020 to October 2021 to identify studies that reported on the rates of screening mammography and breast cancer diagnosis before and during the pandemic. The effects of 'lockdown' measures, age and ethnicity on outcomes were also examined. All studies were assessed for risk of bias using the Newcastle-Ottawa Scale (NOS). Rate ratios were calculated for all outcomes and pooled using standard inverse-variance random effects meta-analysis.
RESULTS: We identified 994 articles, of which 7 registry-based and 24 non-registry-based retrospective cohort studies, including data on 4,860,786 and 629,823 patients respectively across 18 different countries, were identified. Overall, breast cancer screening and diagnosis rates dropped by an estimated 41-53% and 18-29% respectively between 2019 and 2020. No differences in mammogram screening rates depending on patient age or ethnicity were observed. However, countries that implemented lockdown measures were associated with a significantly greater reduction in mammogram and diagnosis rates between 2019 and 2020 in comparison to those that did not.
CONCLUSION: The pandemic has caused a substantial reduction in the screening and diagnosis of breast cancer, with reductions more pronounced in countries under lockdown restrictions. It is early yet to know if delayed screening during the pandemic translates into higher breast cancer mortality.
METHODS: This is a multi-center observational study using secondary hospital data collected retrospectively from February 1, 2020, until May 30, 2020. Clinical records of all real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases with smoking status, co-morbidities, clinical features, and disease management were retrieved. Severity was assessed by the presence of complications and outcomes of COVID-19 infection. Logistic regression was used to determine the association between COVID-19 disease severity and smoking status.
RESULTS: A total of 5,889 COVID-19 cases were included in the analysis. Ever smokers had a higher risk of having COVID-19 complications, such as acute respiratory distress syndrome (odds ratio [OR] 1.69; 95% confidence interval [CI] 1.09-2.55), renal injury (OR 1.55; 95% CI 1.10-2.14), and acute liver injury (OR 1.33; 95% CI 1.01-1.74), compared with never smokers. However, in terms of disease outcomes, there were no differences between the two groups.
CONCLUSION: Although no significant association was found in terms of disease outcomes, smoking is associated with a higher risk of having complications owing to COVID-19 infection.