Australasian Medical Journal
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Invasive Pulmonary Aspergillosis
Get PDFAspergillus spp. often colonize the respiratory tract of the critically ill patients in the intensive care units and subsequently cause invasive disease. The risk of developing invasive disease is more in immunocompromised patients. Here we report a case of fatal invasive pulmonary aspergillosis caused by Aspergillus versicolor in a post-operative patient on mechanical ventilation, who did not respond to intravenous itraconazole. We have discussed the challenges involved in accurate diagnosis of this condition and appropriate management
Letter to the Editor
No full textBackground Challenges of 21st century are not only to combat infectious diseases but also to recognize many causes of ill-health that are related to lifestyle, man-made changes in the environment, and disparity and inequality in resources allocation within and between the countries. Now lifestyle diseases are becoming one of the major threat in developing countries apart from communicable diseases, maternal & perinatal diseases. Method Community-based, cross-sectional study Results Overall prevalence in the present study is 21.0% in rural area. Hypertension is higher in male population in (22%) as compared to female population. The prevalence of hypertension is increased with age in both sexes which is statistically highly significant (
Behavioural and Emotional Problems in Adolescents
Get PDFBackgroundAdolescents are highly vulnerable age to psychiatric disorders. This study aimed to explore the prevalence and patterns of behavioural and emotional problems in adolescents. It was also aimed to explore associations between socio-environmental stressors and adverse outcomes.Method A school based cross-sectional study was conducted between January and July 2008. A stratified random sampling was done. 1150 adolescents in 12 to 18 year age group in grades 7 to 12 in 10 co-educational schools (government run and private) were the subjects of the study. Behavioural and emotional problems were assessed using Youth Self-Report (2001) questionnaire. Family stressors were assessed using a pre-tested 23 item questionnaire. Statistical analysis used: Univariate and multivariate analysis was done. Multiple logistic regression analysis was also done. ResultsPrevalence of behavioural and emotional problems in adolescents was found to be 30%, with girls exceeding boys in all age groups. Internalizing syndrome was the most common (28.6%) psychiatric problem. On stepwise regression analysis, a perceived lack of emotional proximity to mother had the highest odds (3.489) followed by addiction in father (2.642) and marital discord in parents (1.402). Type of school, type of family, socioeconomic status, relationship with father, mother's employment and educational status were not found to be significantly associated.ConclusionAn alarming number of our adolescents suffer from emotional and behavioural problems which have their roots in the family environment. These data suggest urgency in establishing a school based mental health service
Morbidity Pattern and Injuries among Iron and Steel workers
No full textBackgroundThe study of illnesses causing absence of workers from work in industries is a practical method to study the health status of industrial workers and to identify occupational health hazards. The iron and steel industries are particularly hazardous places of work. Published data from India on health status of iron and steel workers is limited, therefore this study was undertaken to investigate the sickness absenteeism, morbidity and workplace injuries among this population. MethodWorkers were selected using stratified random sampling. A structured pre-tested interview schedule was used to collect the data. A p value of < 0.05 was considered for statistical significance. ResultsFrom a total of 2525 workers, 353 (mean age 55.1 yrs, male 69.4%) participated in the study. The overall proportion of sickness absenteeism was 66.9% (95% CI: 0.62 – 0.71). Overall 16.4 days were lost per worker per year (male = 16.5 & female = 16.2) due to sickness absence. A blue collar worker lost 21.5 days compared to 11.9 days by a white collar worker (p < 0.01). Among workers, health ailments related to the musculoskeletal system (31.4%), gastrointestinal system (25.8%), hypertension (24.4%), respiratory system (18.1%) and other minor ailments (19.3%) were found to be high. ConclusionSickness absenteeism is significantly higher among iron and steel workers when compared to other occupations in India. Blue collar workers and shift workers loose higher number of days due to sickness absence, and they face problems related to musculoskeletal system, gastrointestinal system and hypertension in higher proportions compared to their counterparts. Women experienced hypertension as the common health problem and higher proportions of injuries outside the work environment
Assessing Hospital Performance in Iran
No full textBackgroundOne of the most important and useful models for assessing hospital performance is the Pabon Lasso Model, a graphical model that determines the relative performance of hospitals using three indicators: 1. Bed Occupancy Rate (BOR); 2. Bed Turnover (BTO); 3) Average Length of Stay (ALS). The aim of this research is to investigate the performance of the hospitals affiliated with Urmia University of Medical Sciences in Iran during the year 2009 based on the Pabon Lasso Model. MethodThis cross-sectional descriptive study was undertaken in 2009. All the 23 hospitals affiliated with Urmia University of Medical Sciences were included. To ensure accuracy and reliability of data, the required data on BOR, BTO, and the ALS were accumulated by referring to the Statistical Year Book of the Urmia University of Medical Sciences. Data analysis was performed using the Pabon Lasso Model and SPSS 16 statistical software. ResultsAcross all hospitals, the following average results for each performance indicator were obtained: ALS = 2.84 days, BOR = 63.55% and BTO = 85.44 times per year. Six hospitals were located in the Pabon Lasso Model zone 1, two hospitals in zone 2, eight hospitals in zone 3, and seven hospitals in zone 4 of the model. ConclusionThe study showed that 60.87% of the studied hospitals had low performance in terms of either BOR or BTO, or both. Thus, the analysis on why that low performance may have occurred, and suggestions to enhance future performance, is provided
Mothers' Knowledge about Childhood Diarrhoea and Management
No full textBackgroundDiarrhoea, a common disease, is one of the major determinants of childhood morbidity and mortality in Nepal. Method This cross-sectional survey used a self-designed and pre-tested structured questionnaire to gather data on mothers’ knowledge about childhood diarrhoea. The study was conducted in the Morang district of Nepal from June to August 2010. Data was analysed using descriptive and inferential statistics. Testing for significant difference and correlation of mothers' knowledge about diarrhoea with demographic factors were performed by using Kruskal-Wallis test and Spearman’s rank correlation at an alpha level of 0.05. ResultsMothers had some basic knowledge about the prevention of diarrhoea, and fluids/foods which can or cannot be given during bouts of diarrhoea. Knowledge about signs of dehydration was poor. None of the mothers were able to mention all the steps for correct and complete preparation of oral rehydration salt (ORS) and salt-sugar-water (SSW) solutions. Only 8.5% of the mothers stated that the purpose of giving ORS solution during diarrhoea is to prevent the child from getting dehydrated.ConclusionKnowledge about signs of dehydration and the management approaches of diarrhoea at home was poor. Thus, there is a need for public health educational interventions
Dopamine versus Noradrenaline in Septic Shock
Get PDFBackgroundThe ‘Surviving Sepsis’ Campaign guidelines recommend the use of dopamine or noradrenaline as the first vasopressor in septic shock. However, information that guides clinicians in choosing between dopamine and noradrenaline as the first vasopressor in patients with septic shock, is limited. Objective This article presents a review of the literature regarding the use of dopamine versus noradrenaline in patients with septic shock.ResultsTwo randomised controlled trials (RCT) and two large prospective cohort studies were analysed. RCT data showed dopamine was associated with increased arrhythmic events. One cohort study found dopamine was associated with higher 30-day mortality. The other cohort study found noradrenaline was associated with higher 28-day mortality.DiscussionData on the use of dopamine versus noradrenaline in patients with septic shock is limited. Following the recent SOAP II study, there is now strong evidence that the use of dopamine in septic shock is associated with significantly more cardiovascular adverse events, compared to noradrenaline. ConclusionNoradrenaline should be used as the initial vasopressor in septic shock to avoid the arrhythmic events associated with dopamine