No abstract

Background: Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia associated with increased morbidity and mortality. Awareness about the risk factors can be used to implement simple and effective preventive measures. Objectives: To determine the factors associated with development of VAP and its microbial profile among patients admitted to ICUs. Methods: A nested case-cohort study was conducted at Al-Hussein university hospital in Cairo city, Egypt for a period of 6 months from the 1 st of March 2013 to the end of August 2013. Patients who were on mechanical ventilation (MV) for more than 48 hours were monitored at frequent intervals for development of VAP. Samples obtained by endotracheal aspiration were ccultured on Blood agar-Chocolate agar-MacConkey agar, plates of which were incubated at 37c for 24 hours. The isolated organism was identified by morphological and biochemical identification. Results: Of the 73 samples which were taken from endotracheal tubes of the patients, 42 cases were diagnosed as VAP with an incidence rate of 57.5%. Early onset VAP occurred in 36 (85.7%), while late onset VAP was observed in the remaining 6 patients(14.3%). Escherichia coli (40.5%) followed by Klebsiella pneumoniae (23.8%) were the most commonly isolated pathogens. Univariate analysis showed that the duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness, steroids use and H2 blocker use were the risk factors associated with VAP (p < 0.05). Logistic regression revealed duration of MV as an independent risk factor for VAP. Conclusion: The incidence of ventilator pneumonia is high in our study. VAP was significantly related to duration of MV and ICU stay, re-intubation, supine head position, impaired consciousness, steroids use and H2 blocker use.

Introduction: Neonatal Sepsis is a significant leading cause of infant death around the world, particularly in developing nations. The study aimed to identify maternal and neonatal risk factors linked to neonatal sepsis. Methods: A hospital-based case-control study was conducted in the ICU. Cases were neonates diagnosed as having sepsis by clinical criteria and laboratory findings. Controls were admitted neonates who were neither suspected nor diagnosed with sepsis. Data on mothers and babies, as well as laboratory findings, were gathered and analyzed. Results: A total of 174 cases and 348 controls were included in the study. Maternal age, parity, route of delivery, PROM, prematurity, birth weight, neonatal gender and age were significantly associated with the risk of sepsis ( p < 0.05). However, the bivariate logistic model revealed that the most influential predictors of neonatal sepsis were premature rupture of membranes, Gestational age, Neonatal age, birth weight, and mode of delivery. Conclusion: Both maternal and neonatal variables were found to have a significant association with the risk of neonatal sepsis; thus, empowering mothers to pursue antenatal care may allow the detection of risk factors for undesirable delivery consequences such as neonatal sepsis, as well as appropriate management to mitigate those risks.

Introduction: Psoriasis is a chronic non-contagious inflammatory skin disorder, which might impair patient’s social relationships, limit leisure activities, and lower self-esteem. Psoriasis patients might be stigmatized leading to psychological disorders such as anxiety and depression. Objectives: This study aimed to outline the clinical features of psoriasis and its effects on quality of life, and the feeling of stigmatization among psoriasis patients. Methods: This cross-sectional questionnaire-based study was conducted on 109 adult psoriasis patients in Arar City, Saudi Arabia. The study collected data on socio-demographic and clinical characteristics of psoriasis patients, self-reported psoriasis severity using the self-assessment Simplified Psoriasis Index (sa-SPI-s), patients’ quality of life using the dermatological life quality index (DLQI), and the feeling of stigmatization using the six-items stigmatization scale. Results: The mean age of psoriasis onset in studied patients was 20 (±7.65) years, females represented 58.72%, and 22% were unemployed. Joint and nail affection were reported in 46.79% and 51.38%, respectively. One third of patients had positive family history of psoriasis. Seasonal variation, life stressors, smoking and skin injuries were frequent provocative factors for psoriasis lesions. The average sa-SPI-s was 10.08 (±10.41), which was correlated with patients’ ages, disease duration, obesity, and pruritis. The average DLQI and six-items stigmatization scale for psoriasis patients were 8.95 (±5.77) and 7.61 (±4.5), respectively that were correlated with sa-SPI-s. Conclusion: The clinical manifestations and chronicity of psoriasis impaired patients’ quality of life and accompanied with social stigma due to skin disfigurement. These effects need to be addressed for better care of patients.