Objective: Bacterial co-infections in cases of coronavirus disease 2019 (COVID-19) can lead to less favourable outcomes. The aim of this study was to determine the prevalence of primary bacterial co-infections among patients with COVID-19 in Brunei Darussalam. Methods: Seventy-one of 180 patients admitted to the National Isolation Centre between 9 March 2020 and 4 February 2021 were screened for primary bacterial co-infection (infection occurring <48 h from admission). We compared patients with a primary bacterial co-infection to those without. Results: Of the 71 screened patients, 8 (11.2%) had a primary bacterial co-infection (sputum 37.5% [6/16], blood 2.8% [1/36], urine 1.7% [1/60]), for a period prevalence rate of 4.4% (respiratory tract infection 3.3% [6/180], bloodstream 0.6% [1/180], urine 0.6% [1/180]) among all COVID-19 patients. Older age, presence of comorbidity, symptoms at admission (fever, dyspnoea, nausea/vomiting), abnormal chest X-ray (CXR) and more severe COVID-19 (P < 0.05) were associated with primary bacterial co-infection. Primary bacterial co-infection was also associated with development of secondary infection and death (all P < 0.05). Only one patient with primary bacterial co-infection died (methicillin-sensitive Staphylococcus aureus septicaemia and multiorgan failure). Conclusions: Our study showed that primary bacterial co-infection affected 4.4% of patients with COVID-19 in Brunei Darussalam. Older age, presence of comorbidity, symptoms and abnormal CXR at admission and more severe disease were associated with a primary bacterial co-infection. Lower respiratory tract infection was the most common co-infection.
Introduction: Oral misoprostol as a labor inducing agent (IOL) is quickly attaining popularity under resource constraints due to its cheapness, stability at room temperature, and logistically easier administration in comparison to oxytocin and dinoprostone. We purpose to inspect the effectiveness and safety of a regimen of oral misoprostol in in the Gynae/Obs unit at Rehman Medical Institute, Peshawar Pakistan. Material and Methods: This was Randomized Controlled Trial conducted at department of Gynecology & Obstetrics, Rehman Medical Institute, Hayatabad, Peshawar, from December, 2016 to May, 2017.In this study a total of 200 (100 in each group) patients were observed. After the drug administration, per vaginal examination was done at 4 hourly intervals to see for labor induction/pains. Data was collected by means of proforma. Results: In this study, the mean age was 31.2 with SD ± 3.51 in group B and the mean age was 32.80 with SD ± 4.02 in Group A. Oral route (Misoprostol, 50μg) (Group A) was operative in 80% patients and was not effective in 20% patients. While Vaginal route (Misoprostol, 25μg) (Group B) was effective in 88% patients and was not effective in 12% patients. Conclusion: The oral misoprostol IOL regimen designated in this analysis is effective, safe and logistically practicable to direct with limited resources. Keywords: Vaginal misoprostol, oral misoprostol, induction of labour.
Background: Cardiomyopathy constitutes a group of diseases that directly affect the structural or functional ability of myocardium. They are the most common form of heart diseases that are inherited in children and responsible for sudden deaths in healthy young adults. The Aim of our study was to provide a detailed description of clinical profile, epidemiology and etiology of cardiomyopathies in children.Methods: This was a hospital based prospective observational study, conducted over a period of two and half years from September 2017 to March 2020 in the Post Graduate Department of Pediatrics Government Medical College Srinagar. Study group included all patients aged between 1 month and 18 years diagnosed with cardiomyopathy. They were subjected to a detailed clinical history and physical examination. All the patients underwent echocardiography.Results: During the study period 37 patients were diagnosed with different types of cardiomyopathies. Dilated cardiomyopathy was commonest seen in 19 (51.35%), followed by hypertrophic cardiomyopathy 13 (35%) cases. Fast breathing was most common presenting complaint in dilated cardiomyopathy while most of cases with hypertrophic cardiomyopathy were asymptomatic. There was one case of distinct form of cardiomyopathy isolated left ventricular hypoplasia. Males were more involved 21 (56.76%) cases. Majority of patients 18 (48.64%) were less than one year at time of diagnosis. Parental consanguity was seen in 6 (16.22%) cases. Underlying cause was identified in 10 (27.02%) cases with myocarditis being the commonest cause.Conclusions: Pediatric cardiomyopathy represents a considerable percentage of children with cardiac disorders. Dilated cardiomyopathy is the most common type usually presented with congestive heart failure, majority of cases of hypertrophic CMP were asymptomatic. Male preponderance was seen in dilated and hypertrophic cardiomyopathy. Parental consanguinity was seen in significant number of patients. Myocarditis and inborn error of metabolism was seen in significant number of patients.
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