Outcomes of preterm neonates with patent ductus arteriosus: a retrospective review from a tertiary care hospital

Abstract

The management of patent ductus arteriosus (PDA) in preterm neonates remains controversial. A retrospective review was conducted to determine the outcomes in preterm neonates with PDA. Data of neonates admitted to the Aga Khan University Hospital from January 2012 to December 2016 were retrieved from patient records. Of the 208 neonates included in the study, 143 (68.7%) received no treatment, while 65 (31.2%) underwent pharmacotherapy and/or surgical ligation for PDA closure. PDA closure was spontaneous in 109 (52.4%) neonates. The mean ±SD gestational age (GA) of neonates with spontaneous ductal closure was greater as compared to those who required some form of treatment [33±3.3 vs 29.7±3.1weeks, p=0.001]. Apnoea (OR:4.47; 95% CI:1.21-16.44), sepsis (OR:3.81; 95% CI:1.33-10.87), pulmonary haemorrhage (OR:4.88; 95% CI:1.24-19.19), and lower APGAR (OR:0.69; 95% CI:0.54-0.90) were associated with higher odds of mortality in our cohort. Our findings demonstrate that PDA resolves spontaneously in most preterm neonates and provide evidence that conservative treatment is not associated with mortality. Keywords: Conservative treatment; ligation; mortality; patent ductus arteriosus; premature.

Non-adherence to self-monitoring of blood glucose (SMBG) in poorly controlled type 1 and type 2 diabetes mellitus.

“…Nonadherence to SMBG practice amongst type 1 diabetic patients was 40% where as it 48% in case of type 2 Diabetic patients. 19 This finding correlates well with observation done k.Khowja at all, Yaqoob at 14 all and Farhan at all. 20 They Also found that Nonadherence to SMBG practice was low than SMBG adherence practice.…”

Perceived barriers to the effective management of diabetes mellitus among the Wakhi people: A qualitative study

“…It is consistent with a previous study that showed that feelings of social exclusion and embarrassment influence diabetes mellitus self-management practices (18) . Cultural norms and the unaffordability of certain medications, and an unhealthy diet impede healthy eating practices in Pakistani culture (19) . The present study echoes the finding of a study showing that diabetic patients eat whatever is cooked at home (20) .…”

Reporting Case Study Results for Neonatal Tetanus Case Investigations

“…However, the mortality rate associated with tetanus remained high, indicating a need for improved management and prevention efforts. Similarly, Khowaja & Qureshi (2011) in their study of tetanus cases at a tertiary care hospital in Pakistan found that over five years (2011)(2012)(2013)(2014)(2015), the majority of cases were in males, and the highest incidence was in the age group 15-24 years. The study also found a high mortality rate (50%) among tetanus cases, highlighting the need for timely and appropriate management.…”

“…This can be achieved by maintaining proper wound care, including cleaning, and dressing any injuries, and by being vaccinated with the tetanus vaccine. Khowaja & Qureshi (2011) assert that Tetanus toxoid is a chemically modified version of the tetanus toxin that has been inactivated or "killed" allowing it to be used as a vaccine for protection against tetanus without causing illness. When injected into the body, the tetanus toxoid stimulates the immune system to produce antibodies that can recognize and protect against the tetanus toxin in the event of exposure to the bacteria.…”