Purpose of the study. To analyze the influence of comorbid pathology and age on the duration of inpatient treatment of adult patients with respiratory syncytial virus infection.Materials and methods. An observational retrospective cross-sectional study was conducted of 3821 patients who were treated at the St. Petersburg State Budgetary Institution “Clinical Infectious Diseases Hospital named after. S.P. Botkin” with the main diagnosis B97.4 “Respiratory syncytial virus infection” for the period from January to December 20023. The influence of comorbid pathology and patient age on the duration of hospitalization was analyzed.Results. A significant increase in the length of hospitalization in patients with respiratory syncytial virus was observed when combined with the following comorbid conditions: J12 “Viral pneumonia, not elsewhere classified”; J15 “Bacterial pneumonia, not elsewhere classified”; G40 “Epilepsy”; K75 “Other inflammatory diseases of the liver”; G62 “Other polyneuropathies”; B27 “Infectious mononucleosis.” In all cases p < 0.001. A relationship was found between the duration of hospitalization and the age of the patients – an increase in age by 2.718 times was accompanied by an increase in the duration of hospitalization by 10.60%.Conclusion. The results obtained indicate age and comorbid pathology as significant predictors of increasing the duration of hospital treatment for respiratory syncytial infection.
Objective: To compare the efficacy of clomiphene and Letrozole in the induction of ovulation in patients with primary ovarian sub-fertility. Methodology: This was a Randomized control trial study carried out at Dow University Hospital Karachi, Ojha Campus, Karachi after approval of synopsis from February 2016 to January 2017. The required sample size was 164 (82 in the Letrozole group and 82 in the CC group). Non-probability consecutive sampling technique was used. Females of 18-40 years irrespective of weight, years of marriage, and duration of sub-fertility with primary ovarian sub-fertility were included in the study. SPSS was used for data analysis. Results: Total of 164 women were enrolled in the study. 82 women were given Clomiphene Citrate and 82 were treated with Letrozole. The mean age was found to be 28.48±4.12 in the clomiphene citrate group whereas 28.45±3.01 in the Letrozole group. The results showed improved results among the group with Letrozole drug compared to Clomiphene Citrate. Efficacy was positively found with 1st cycle, 2nd cycle & 3rd cycle in 2 (2.4%), 23 (28.05%) & 32 (39.02%) respondents respectively with Clomiphene Citrate. Whereas efficacy was positive with 1st cycle, 2nd cycle & 3rd cycle in 18 (21.9%), 34 (41.4%) & 24 (29.2%) respondents respectively with Letrozole. Conclusion: Letrozole appeared to be the effective drug of choice in ovulation induction among patients who failed to conceive, however, the clomiphene citrate was found to be most effective in women. The dosage of Letrozole is much lower mg with effective pregnancy results compared to Clomiphene Citrate clomiphene citrate.
Introduction The COVID‑19 pandemic has raised multiple psychological challenges among most healthcare workers, from anxiety to depression, burnout, sleep disorders, and substance use disorders. Thus, the burden caused by this prolonged medical crisis has inevitably drastically lowered the quality of life of the medical staff. In order to mitigate the negative effects of the pandemic, healthcare workers resorted to various coping strategies, with better or worse outcomes. Objectives The present study aims to identify Romanian physicians’ main coping mechanisms and evaluate the role of positive and negative stress-reducing strategies on quality of life. Methods A cross‑sectional national survey was conducted using a web-based questionnaire among physicians practicing in Romania (n=265). In addition to socio-demographic and professional information, the questionnaire addressed participants’ coping mechanisms using the COPE inventory and quality of life with the WHOQOL-Brief scale. Descriptive statistics, Pearson correlations, and multiple linear regressions were used in the statistical analysis. Results In total, 265 physicians consented to their participation in the survey. Of those who responded, 84.5% identified as female, 92.1% had a permanent residence in a urban setting, 63.8% were married and 55.1% attained a master’s degree, a PhD diploma or equivalent level of education. The results showed that optimism was higher in male professionals, while avoidance coping was higher in female health professionals. The mean values of QoL subscales were: 74.7± 18.3 for the general quality of life, 70.8± 20.7 for health satisfaction, 64.0± 14.2 for the physical area, 61.7± 16.2 for the psychological area, 61.2± 20.3 for the social relationships area and 64.7± 12.7 for the environment area. Specific coping mechanisms (emotional venting, behavioral and mental disengagement) were associated with lower quality of life. In contrast, emotion-focused (positive reinterpretation and acceptance), problem-focused strategies (planning, active coping, suppression of competing activities) and humor were associated positively with most QoL subscales scores. Conclusions Our data points to specific protective characteristics and some detrimental factors on physicians’ quality of life during the pandemic, with the implication that these factors may be important considerations for mitigating distress and psychiatric disorders for healthcare workers during times of high stress. Concerted initiatives to improve wellness in healthcare workers ought to develop targeted programs to ensure adequate psychological support. Disclosure of Interest None Declared
The aim: to determine the impact of a new coronavirus infection on the course of pneumocystis pneumonia in patients with HIV infection.Materials and methods. A retrospective analysis of 45 medical records of patients who died in the intensive care unit of the S. P. Botkin Clinical Infectious Diseases Hospital between March 2020 and January 2023 was conducted. Of the 45 patients with Pneumocystis pneumonia, the new coronavirus infection was also verified in 26 patients. Anamnestic and clinical data, laboratory and instrumental research results, pathological findings were compared in groups of patients with Pneumocystis pneumonia with/without co-infection with COVID-19.Results and discussion. The patient groups were comparable in terms of gender, age, duration of HIV infection, severity of immunodeficiency, and intensity of HIV viremia. The main clinical manifestations (fever level, cough, signs of respiratory failure, auscultatory picture in the lungs), as well as the indicators of routine laboratory tests (hemogram, concentration of LDH, CRP, ferritin, D-dimer) did not differ statistically in the groups. The radiological picture of changes in the lungs was similar, as well as the duration of hospital stay (bed days) in the groups did not differ. Analysis of the results of pathological reports showed that in most cases (2⁄3of patients), COVID-19 did not have a significant impact on the course and outcome of the disease, being a concomitant pathology. However, in every third patient, signs of viral pneumonia were postmortem along with specific Pneumocystis cystic lung damage.Conclusion. COVID-19 coronavirus infection in patients with pneumocystosis does not significantly change the clinical picture, laboratory and radiological manifestations of pneumonia and in most cases does not affect its course and outcome. However, in a third of cases, coronavirus pneumonia was the cause of death along with pneumocystis.
Aim of the study. Genetic analysis of Streptococcus pneumoniae serogroups 15 and 11 circulating in Russia according to the following parameters: serotype affiliation; clonal complex (CC); presence of resistance and virulence determinants; relatedness to genetic lineages circulating in the world, and justification of inclusion of the actual serotypes of serogroups 15 and 11 in the future conjugate vaccine composition. Materials and methods. The study included whole genome data of S. pneumoniae serogroups 11 and 15. Results. Genomes of serogroup 15 strains from Russia are represented mainly by serotypes 15B and 15C, the majority of which belong to CC-1025 and CC-1262. CC-1025 is characterized by a more frequent association with invasive diseases. Representatives of CC-1025 and CC-1262 contain virulence determinants unique to these genetic lineages within the studied population of serogroup 15: oligopeptide transporters, fructose-specific PTS system, unique hydrolase variants, additional iron ion transporters, the gene of zinc metalloprotease ZmpC (activating human MMP9). The genomes of serogroup 11 are represented mainly by serotype 11A, the majority belong to CC-62 and CC-1012. The virulence determinants unique to CC-62 (within the studied serogroup 11) include bacteriocins, components of oligopeptide transport, flavin reductase-like protein (adhesin, also protects bacteria from oxidative stress), fucose processing operon, PsaA (adhesin, also a component of the ATP-binding cassette transporter that imports manganese ions). Conclusion. In the Russian Federation, serogroups 15 and 11 are the most common non-vaccine serogroups. No antimicrobial resistance determinants have been identified in the genomes of representatives of these serogroups. For each of the genetic lineages prevalent in Russia and associated with serogroups 15 and 11, unique virulence determinants within the studied serogroup have been identified, which may contribute to the success of these lineages. It is advisable to include serotypes 15B and 11A in vaccines promising for the Russian Federation.
