Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
Neonatal sepsis is one of the most important causes of mortality and morbidity especially in developing countries. Management of such cases is difficult, costly and need expert centers in many cases. Therefore, identification of the risk factors and their predictive values may help optimizing its management. With the above idea this case-control study was done to see the effects of maternal and neonatal risk factors and to find their predictive values in the development of neonatal sepsis. Fifty cases and fifty suitably matched controls were enrolled in the study and different maternal, natal and newborn factors were compared. Many risk factors were found to have influence in the development of neonatal sepsis. Among them the maternal intrapartum fever, foul smelling liquor, young mother (< 20 yrs), poor income group, prolonged labor, unclean vaginal examination (UVE) and primi mother were much associated with the occurrence of sepsis. Also the neonatal factors, like prematurity, resuscitation at birth and low APGAR score carried the significant risk of developing sepsis. But when relative influence of these risk factors were analyzed over neonatal sepsis in detecting their predictive values, it was found that irregular antenatal check up, prematurity, resuscitation at birth, and maternal intrapartum fever had influenced most in the development of neonatal sepsis in chronological order. DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11324 J Bangladesh Coll Phys Surg 2011; 29: 187-195
Background Typhoid and paratyphoid remain the most common bloodstream infections in many resource-poor settings. The World Health Organization recommends typhoid conjugate vaccines for country-specific introduction, but questions regarding typhoid and paratyphoid epidemiology persist, especially regarding their severity in young children. Methods We conducted enteric fever surveillance in Bangladesh from 2004 through 2016 in the inpatient departments of 2 pediatric hospitals and the outpatient departments of 1 pediatric hospital and 1 private consultation clinic. Blood cultures were conducted at the discretion of the treating physicians; cases of culture-confirmed typhoid/paratyphoid were included. Hospitalizations and durations of hospitalizations were used as proxies for severity in children <12 years old. Results We identified 7072 typhoid and 1810 paratyphoid culture-confirmed cases. There was no increasing trend in the proportion of paratyphoid over the 13 years. The median age in the typhoid cases was 60 months, and 15% of the cases occurred in children <24 months old. The median age of the paratyphoid cases was significantly higher, at 90 months ( P < .001); 9.4% were in children <24 months old. The proportion of children (<12 years old) hospitalized with typhoid and paratyphoid (32% and 21%, respectively) decreased with age; there was no significant difference in durations of hospitalizations between age groups. However, children with typhoid were hospitalized for longer than those with paratyphoid. Conclusions Typhoid and paratyphoid fever are common in Dhaka, including among children under 2 years old, who have equivalent disease severity as older children. Early immunization with typhoid conjugate vaccines could avert substantial morbidity, but broader efforts are required to reduce the paratyphoid burden.
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