The cause of death for Covid-19 patients is still controversial, some say that the age of children under five and the elderly has a high risk of death, some report a high risk of co-morbid mortality, such as hypertension, diabetes mellitus, asthma, pneumonia Until now, there is no definite cure for the corona virus disease 19, while transmission from person to person through droplets makes it very easily transmitted The morbidity rate is high, and also the mortality rate is around 7% The aim of the study was to prove the etiology of the death of Covid-19 patients at Jakarta Hospital Research Method: Applied research method with case control design Samples of 41 patients died and control of 41 live Covid-19 patients Sampling for patients who died from March to June 2020 a total of 41 people and 41 living Covid-19 patients were taken by random sampling, data collection was using the Eijkman Institute standard questionnaire Frequency distribution analysis, chi square and multiple logistic regression Result: The descriptive results of male gender are 56 1%, minimum age 0 5 years, maximum 92 years, and average 54 years Young people 0 5-59 years, 63 4%, and 60-92 years 36 6% Religion of Islam 68 3%, Non-Muslim 31 7% Clinical symptoms of fever 22%, no fever 78%;shortness of breath 64 6%, pain 8 5%, cough 43 9%, lethargy 20 7%, headache 13 4%, diarrhea 12 2%, nausea 24 4%, pneumonia 74 4%, sore throat 2 4%, cold 1 2%, large stomach 1 2%, swollen legs 1 2%, oxygen saturation was up normal 38 46% Co morbidity: Hypertension 35 4%, Diabetes Mellitus 23 2%, HD/CKD 12 2% X-ray almost of them pneumonia (98 8%) PCR laboratory positive 34 1%, Rapid Anti Body reactive test 25 6 Whole blood test: Hb 4 9% up normal, up normal erythrocytes 42 7% , Hematocrit up normal 42 7%, up normal thrombocytes 28%, up normal leukocytes 54 9%, up normal lymphocytes 74 4%, up normal CRP 35 4%, GDS up normal 7 3%, up normal SGOT 45 1%, up normal SGPT 45 1% Urea up normal 43 9%, creatinine up normal 56 5%, sodium up normal 59 8%, potassium up normal 58 5%, calcium up normal 63 4%, chloride up normal 53 7% Medical Care: ICU 18 2%;ventilator 23 2%, IVFD 52 4%, Oxygen 32 9%, Diet 4 9% TB drugs 6 1%, Azithromycin 3 7% Asering 2 4%, OMZ 11%, Menden 11%, Cefrocidine 41 5%, Lasix 11%, Aspilet 3 7%, Milos 46 3%, Coagulant 3 7%, Dopamine 3 7%, Alloclamide 1 2%, Hazania 1 2%, Tamiflu 1 2%, Lefloxine 2 4%, Oseltamivir 26 8% Hedonic 4 9%, Paracetamol 2 4%, Kalmix 18 3% Amlodipine 14 6% Carnefit 8 5% Renovit 2 4%, Vit C 25 6% Vit E 18 3%, Vit D 1 2%, Vit A 1 2%, Vit B Complex 1 2%, Zinc 7 3%, Vit K 7 3%, Curcuma 8 5% Significant factors associated with death: pneumonia, cough, hypertension, O2 saturation Hb, erythrocyte, Vit A, milos and IVFD The end of the multiple logistic regression model only pneumonia and IVFD were significant Detail final research for pneumonia p value 0 001, Odd Ratio 33 904, 95% CI 3,965-299,906;IVFD p value 0 001 with OR 6 654, 95% CI 2 151-20 580 were contributed 50 5% (R2) while the remaining factors are not examined Conclusion pneumonia was influenced cause of death Covid-19 © 2021, Scientific Publishers of India All rights reserved
Introduction: Lymphatic malformations of abdomen include mesenteric, omental and retroperitoneal cysts. These are benign malformations with variable presentation. These malformations may present as abdominal distension, abdominal pain, features of intestinal obstruction and rarely acute abdomen. Ultrasonography, CT scan and MRI provide characteristics of malformations like size, composition and may at times help in determining the origin of the lesion. Surgical exploration confirms the diagnosis besides being therapeutic. The mesenteric and omental cysts are either enucleated or need bowel resection or sometimes, partial cyst excision with marsupliazation. Intraoperative injection of the sclerosing agent is an option in instances when excision is not possible or feasible. We analysed the clinical characteristics, management and follow-up of these cases in our study. Methods: We analysed 26 cases of abdominal lymphatic malformations. The data regarding epidemiological and clinical characteristics were reviewed and recorded. Operative record and imaging findings were noted. The long and short term results of the surgical treatment were analysed. Results: Twenty six cases (18 Male:8 Female) were included in this study. The most common presentation was chronic abdominal symptoms like pain, vomiting or distension. Three patients had antenatal diagnosis while eleven patients had symptoms three months before being diagnosed. The average age of presentation was 48.64 months. Twelve (46.15%) patients had solitary cyst. Fifteen (57.69%) patients had mesenteric cyst, 6(23.07%) had omental cyst and five (19.23%) patients had cyst extending to the retro peritoneum. Twelve patients underwent enucleation. Serous fluid was the content in ten (38.48%) patients. Two patients needed emergency surgery for intestinal obstruction. The average follow-up was 46 months. Two patients required re-exploration after initial incomplete resection. Overall recurrence rate was seen in four cases (15.38%). Conclusion: Lymphatic malformations of abdomen can have varied presentation. Ultrasonography and CT scan or MRI is useful diagnostic tools. Mesenteric cysts need resection anastomosis. Omental cysts are amenable to resection. Multi-loculated and retroperitoneal cyst may need partial excision or sclerotherapy. Long term outcome is excellent.
Background: Childhood obesity is a serious public health issues worldwide in the 21st century and the prevalence has been increasing in all countries. Objectives: To estimate the prevalence of overweight and obesity among primary school students in AL-Nasiriya city and their correlation with the eating habits, socioeconomic and lifestyle factors. Methods: A cross-sectional study conducted on 357 (177 girls and 180 boys) sample of pupils aged 6-12 years selected randomly from students who attended public primary schools during the period from1st of December 2018 to the end of May 2019 in AL-Nasiriya city. The Body Mass Index (BMI) was measured and used as indicator for overweight/obesity. Results: The overall prevalence of obesity and overweight among primary school children in ALNasiriya city was 28% (17.9% were obese and 10.1% were overweight). A significant positive association between excessive body weight and snacks No./day (p-value=0.004, odd ratio=3.112), and fruits intake (p-value=0.014, odd ratio=2.767) was found in this study. While, there was a significant negative association of student's BMI with the physical activities (p-value=0.049, odd ratio=0.566). Conclusion: The prevalence of overweight and obesity is relatively high among primary school students in AL-Nasiriya city. Preventive approaches by the families and the schools should be considered. Keywords: Overweight,
Background: Prematurity is one of the leading causes of morbidity and mortality among newborns. The incidence of preterm deliveries especially the late preterm births have unfortunately gone up in the last decade. Late preterm births are associated with increased neonatal complications compared to term births. This study makes an effort to find out the relevant maternal and fetal factors associated with late preterm births. This study also assesses the maternal and neonatal outcomes associated with late preterm births. Methods: This prospective observational study was conducted at Maternal and Child Health Unit of Shri B M Patil Medical College Hospital Vijayapur, Karnataka over a period of 1 year. 200 late preterm births and 200 term births were enrolled in the study. During the study period, all neonates delivered in the hospital were divided into two groups as late preterm group and term group. Maternal and neonatal data was collected in predefined structured proforma. Results: The mother's mean age in the late preterm group was 24.34 ± 4.07 years, and among the term group was 25.24 ± 4.54 years, which was not statistically significant (P=0.857). The obstetric risk factors observed for late preterm births were inadequate antenatal care (39%), premature rupture of membranes (31%), hypertensive disease of pregnancy (24.5%), previous preterm delivery (21%), and maternal anemia (13%). When two or more factors were found, late preterm labor incidence was 32.6% in this study. 14.5% late preterm's needed resuscitation (P=0.003), 45% late preterm neonates had difficulty establishing feeding at birth (P<0.001), 34% late preterm’s had respiratory distress at birth (P<0.001), 12% had hypoxic-ischemic encephalopathy (Stage2/3) (0.003), 35% had early-onset sepsis (P<0.001), 28% had jaundice (P<0.001), 24% had hypoglycemia (P<0.001), 41% had hypothermia (P<0.001), 13.5% had HSPDA (P<0.006). The duration of hospital stay was significantly more in late preterm neonates (8.7 ± 1.6 days) as compared to term neonates (3.9 ± 1.1 days) with a pvalue of <0.05. Most important is the mortality, which was significantly more among late preterm neonates (18%) than term neonates (6%) with a p-value of 0.011. Conclusion: Maternal risk factors such as preterm premature rupture of membrane, inadequate antenatal care, hypertensive disorders of pregnancy, and maternal anemia were associated with late preterm births. Since late preterm birth is an independent risk factor for neonatal morbidity and mortality compared to term neonates, knowing maternal and perinatal risk factors is essential. Early identification and management of these risk factors reduces the neonatal morbidities and mortalities.
Urinary Tract Infections (UTI) affect mostly females. The infection and possible consequent ascent of bacteria is enhanced by various risk factors. Sex hormones regulate gene transcription implicated in immune cell development and maturation, in regulation of immune responses and immune signaling pathways. This study was designed to determine the relationship between UTI and some sex hormones and role of them in cytokines related to immune response in pre and post-menopausal women during bacterial infection. The study included 90 urine samples from females age (18-69) years: forty five were pre-menopause group subdivided into two groups includes (25 infected with UTI and 20 control subjects) , while others forty five post- menopause group includes (25 infected with UTI and 20 control subjects) were attending to clinic of urology at Salahaldeen hospital and private medical clinic in Tikrit City. Blood samples were collected from these women to determine the concentrations of sex hormones (Estrogen (E2), Progesterone)and cytokines includes (Interleukin10 (IL-10),Transforming Growth Factor-β (TGF-β), Human β-Defensin 2 (HBD2) and Toll-Like Receptor4 (TLR-4) in those Sera, they assaying using ELISA technique assay . The positive isolates were selected for infected females of pre and post-menopausal. Fifty bacterial isolated were isolated from infected women with UTI, and the most frequently isolated microorganisms 27(54%) were Gram-negative bacteria; 15(60%) and 12(48%) pre and post-menopausal respectively, Followed by Gram-positive bacteria 23(46%) isolated; 10(40%) and 13(52%) pre and post-menopausal respectively. According to current research results of urine culture bacterial isolation, the most commonly isolated microorganisms were: Escherichia coli 15(30%) 8(32%), 7(28%) pre and post-menopausal respectively; and Enterobacter fecales in 10(20%) 5(20%), 5(20%) pre and post-menopausal respectively. The most effective antimicrobial agents were Amikacin, Gentamicin and Amoxicillin but the less effective were Ceftriaxone, Norfloxacin, and Nitrofurantoin. The results showed that the concentration of estrogen and progesterone hormones were higher in pre and post-menopausal without UTI (414.0 ± 34.2 pg/ml; 1.589 ± 0.460) pg/ml (406.1 ± 30.71 pg/ml; 1.894 ± 0.292) while decreased in pre and post-menopausal with UTI respectively; and decreased in the levels of IL-10, TGF-β, HBD2 and TLR-4 in a females with UTI pre and post-menopausal when compared without UTI females. The interaction between sex hormones and the incidence, progression and morbidity of UTI may be due to effective role of them at the levels of some cytokines like of IL-10, TGF-β, HBD2 and TLR-4. The ability of sex hormones to increase production of antimicrobial peptides, combined with the effect on epithelial integrity or distribution of proteins associated with cell-cell contact, to mention a few, place them as possible candidates for supportive treatment of UTI.
