Background Acinetobacter baumannii (AB), an opportunistic pathogen, could develop into serious infections with high mortality and financial burden. The debate surrounding the selection of effective antibiotic treatment necessitates studies to define the optimal approach. This study aims to compare the clinical outcomes of commonly used treatment regimens in hospitalized patients
G6PD deficiency is a genetic disease that weakens the immune system and renders affected individuals susceptible to infections. In the Sultanate of Oman resides a high number of recorded G6PD cases due to widespread consanguineous marriage, which may reach 25% of the population. We studied the infection patterns and risk factors for mortality to provide antimicrobial stewardship recommendations for these patients. After obtaining ethical approval, a registry of recorded cases was consulted retrospectively to include G6PD-deficient adult patients admitted to Suhar hospital over 5 years with microbiologically confirmed infections. Patient demographics, health-related information, infection causes, treatment, and clinical outcomes were studied. Data were analyzed to describe infection patterns and risk factors. Several variables, including underlying comorbidities and hospitalization details, such as length of stay, admission to critical care unit, blood transfusion, or exposure to an invasive procedure, were statistically associated with the acquisition of multidrug-resistant and hospital-acquired infections. Meanwhile, these infections were associated with a high mortality rate (28%), significantly associated with the patient’s health status and earlier exposure to antimicrobial treatment due to previous bacterial infection. The high prevalence of G6PD deficiency among the Omani population should alert practitioners to take early action when dealing with such cases during infection that requires hospitalization. Strict infection control measures, Gram-negative empiric coverage, hospital discharge as early as possible, and potent targeted antimicrobial therapy in this patient population can ameliorate the treatment outcomes and should be emphasized by the antimicrobial stewardship team.
Background and study aims: Gastric varices (GV) are less frequent than esophageal varices (EV) and have a lower risk of bleeding. However, they are more prone to serious bleeding, often requiring more blood transfusions, and have a higher mortality rate. Our study assessed the comparative effectiveness of three modalities: endoscopic cyanoacrylate injection, non-selective beta-blockade and no primary prophylactic treatment. Patients and Method: Forty-eight cirrhotic patients with cardio-fundal varices were classified into three groups of16 patients each: group I: cyanoacrylate injected patients, group II: propranolol treated patients and group III: untreated patients. Upper gastrointestinal endoscopy was performed to establish the variceal status and repeated at 6-month intervals for 24 months to record of size of GV, appearance of EV, portal hypertensive Gastropathy (PHG) and occurrence of gastric variceal bleeding. Mortality rate was also recorded. Results: Gastric variceal bleeding and mortality rates in group I, II and III were 6.2% and 18.8%; 31.2% and 6.2%, 6.2% and 12.5% (p= 0.194 and p= 0.761 respectively). All patients in group I had obliterated GV. The percentage of patients with large GV increased from 18.8 to 37.5% (p=0.055) in group II and from 25 to 56.2% (p=0.002) in group III. During follow up, EV appeared in 25% of patients in group I, 6%in group II and12% in group III (p=0.509). Conclusion: No significant difference in occurrence of gastric variceal bleeding or mortality rates among the three groups managed with cyanoacrylate injection, propranolol administration and observation without treatment .
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