Identification of risk factors and outcome of VAP in PICUs may help in reducing the incidence and improving patients' outcomes. The incidence of VAP in this study was relatively high. The most prominent risk factors for occurrence of VAP were MOSF, prior antibiotic use for > 48 h before MV, reintubation, coma and age. Proper use of antibiotics before MV in PICUs is essential. Also, adequate training of nurses and strict supervision of infection control protocols are crucial. Lack of a gold standard for the diagnosis of VAP and difficulty in sampling procedures were among the study limitations.
Objectives: Childhood malnutrition is a major concern in developing countries. Therefore, the present study aimed to determine the nutritional status and dietary habits of school children. Methods: This is a community based cross-sectional survey designed to evaluate nutritional status of students aged (5 -19 years) in Beni-Suef Governorate, Egypt, during September-December 2013. A two-stage sampling technique was done; 22 government schools were selected in the first stage. In the second stage, 1100 students were selected from the target population of the study. Weight, height, and age data were used to calculate z-scores of the three different nutritional indicators. Dietary habits were studied using a food frequency questionnaire. Results: Underweight (WAZ < −2) and stunting (HAZ < −2) occurred in 10% and 53.2%, respectively. WAZ and HAZ mean scores of the children were −0.22 (SD = 1.39) and −2.09 (SD = 2.03), respectively. The malnourished children were classified on the basis of (WHO/NCHS) reference population BMI z-scores as being: 2.8% underweight (<−2SD) and 34.4% obese (>+2SD). Boys were more underweight (3%) than girls (2.2%). Conversely, girls tend to be more stunted (65.3%) compared to boys (59.9%) in the age group 10 -14 years. Identified risk factors associated with malnutrition for those aged more than 10 years were: mother education (P-value = 0.03), father education (P-value = 0.04) and family size (P-value = 0.014). Conclusıon and Recommendatıons: Child's nutritional status is strongly associated with the literacy of both parents and family size. The prevalence of malnutrition can be reduced by implementation of school intervention programs for the socioeconomic development.
Monitoring the levels of cellular and humoral immunological parameters together with assessing PELOD and PRISM III scores can significantly affect prognosis and survival of septic children.
Falls, traffic accidents, and direct head trauma were the most frequent etiologies for TBI in emergency admitted pediatric patients. Child neglect and abuse were the most prominent predisposing factors. GCS and D-dimer were the most important clinical and laboratory markers predicting mortality. Further large-scale studies are needed to determine the prevalence of TBIs and to prove the prognostic role of the D-dimer.
The perspectives of healthcare professionals on antibiotic stewardship programs (ASPs) should be explored. Any antibiotic stewardship strategy must be individualized based on patient needs, prescription habits, and local resources. The current study aimed to explore the perspectives of healthcare providers on antibiotics stewardship and their awareness of these perspectives. Furthermore, potential barriers to the application of ASPs should be identified and addressed. This exploratory cross-sectional study utilized a qualitative method to evaluate critical care physicians, pediatricians, and clinical pharmacists (n = 43). The mean age of the physicians was 32 ± 1.5 years. Among them, approximately two-thirds (66%) were women. A thematic content analysis was performed to examine the responses of the participants and to prioritize the recommendations for and barriers to the implementation of ASPs from the perspective of healthcare providers. According to the interviewees, the primary obstacles include lack of time in implementation and monitoring and lack of awareness of the need for ASPs. All respondents recommended the implementation of supervised and continuous trainings. In conclusion, the abovementioned barriers must be adequately addressed to facilitate the implementation of ASPs.
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