Context:Acinetobacter infections are a major nosocomial infection causing epidemics of infection in the Intensive Care Units (ICU).Aims:This study estimates the clinical and economic outcomes of Acinetobacter infections and compares them with those of non-Acinetobacter bacterial infections.Settings and Design:Prospective cross-sectional observational study carried out for 6 months in the medicine ICU of a tertiary care hospital.Materials and Methods:Patients were divided in two groups, one group with Acinetobacter infections and the other with non-Acinetobacter infections. The data was collected for infection, length of stay (LOS), mortality and cost along with patient demographics from the hospital records for analysis.Statistical Analysis Used:The data was analyzed using Statistical Package for the Social Sciences Version 15.0. The LOS and cost of treatment (COT) for the two groups were compared using the nonparametric Mann–Whitney U-test.Results:A total of 220 patients were studied out of which 91 had Acinetobacter infections. The median LOS was 20 days in Group-A and 12 days in Group-B (P < 0.0001). The median COT was INR 125,862 in Group-A and INR 68,228 in the Group-B (P < 0.0001). Mortality in Group-A and Group-B was 32.97 and 32.56 (P = 0.949) respectively.Conclusion:The burden of Acinetobacter infections in ICUs is increasing with the increase in LOS and COT for the patients. The infection control team has to play a major role in reducing the rate of nosocomial infections.
Alpha-1 antitrypsin deficiency (AATD) is a rare genetic disorder characterised by reduced levels of circulating alpha-1 antitrypsin and an increased risk of lung and liver disease. Recent reviews of AATD have focused on diagnosis, epidemiology and clinical management; comprehensive reviews examining disease burden are lacking. Therefore, we conducted literature reviews to investigate the AATD disease burden for patients, caregivers and healthcare systems. Embase, PubMed and Cochrane libraries were searched for AATD publications from database inception to June 2021, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Most published AATD studies were small and short in duration, with variations in populations, designs, measures and outcomes, complicating cross-study comparisons. AATD was associated with significant pulmonary and hepatic morbidity. COPD, emphysema and bronchiectasis were common lung morbidities, where smoking was a key risk factor. Fibrosis and steatosis were the most common liver complications reported in patients with a PiZ allele. Health status analyses suggested a poorer quality of life for AATD patients diagnosed with COPD versus those with non-AATD-associated COPD. The burden for caregivers included loss of personal time due to caring responsibilities, stress and anxiety. AATD was also associated with high direct medical costs and healthcare resource utilisation.
Organophosphorus poisoning (OPP) is a major concern for developing countries. There are no guidelines for the prophylactic use of antibiotics in the management of OPP which in such critical cases might add to the economic burden of the patients as well as antibiotic resistance. We compared the health and economic outcomes in patients prescribed with prophylactic antibiotics with respect to the patients not prescribed with any antibiotics. A retrospective observational study was carried out for two years for patients admitted to ICU with OPP. Patients were graded for severity of OPP, and divided into two groups based on prophylactic prescription and no prescription of antibiotics. The length of stay (LOS), hospitalization cost and outcomes were measured and compared between the two groups using statistical tests. Out of the 254 patients observed, 108 were prescribed with prophylactic antibiotics and 94 were not prescribed with any antibiotic. There was a significant difference between LOS, cost of treatment and outcomes in the two groups ( < 0.001). When antibiotics were not prescribed, the odds of improvement was 1.854 times higher compared to those who received prophylactic antibiotics although after adjusting for severity of poisoning, significance was lost. On an average, 2-3 antibiotics were prescribed to every patient in the first group. OPP is an important health concern where issues of antibiotic misuse and overuse are practiced. Our study suggested that systemic antibiotic prophylaxis did not offer any advantage over non-use of any antibiotics in patients with OPP.
OBJECTIVES: Knowledge and practice of disposal of date expired and unused drugs among college students and people having a health science background and to find the most widely used method of drug disposal for the expired drugs in the study group. METHODS: A pilot study questionnaire was prepared and a survey was done among students with Health Science background to understand the appropriateness of content. Further 500 University students and people having a health science background were interviewed personally using the validated questionnaire prepared. Results were presented percentage responses and interpretation of the results helped in the derivation of the final conclusion. RESULTS: When asked about the awareness of the existing guidelines for the safe disposal of drugs in various countries 56% of the respondents knew about it while 44% were unaware. A total of 52.2% of the respondents agreed that the wrong drug disposal methods can lead to adverse environmental effects while 25.6% strongly agreed to it. A mere 4.8% disagreed to the statement while another 17.4% somewhat agreed to it; 56.8% strongly agreed to the fact that there was a need of a drug take back system in their place of residence. A total of 57.2% opined that there was a need of public awareness programs to increase the awareness about drug disposal in the general public. A majority 91.2% of the respondents admitted that they simply throw the expired drugs into the dustbins. 46.8% of the people said there was no work being done in this context by any organization. CONCLUSIONS: The study clearly indicates lack of awareness and good practices of date expired drugs among surveyed population. There is a need to create awareness regarding disposal of drugs among the population which should be done either by the government or any organization.
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