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Article
Case Fatality Rate, Determination and Causes of Death in Al Nassiriay Burn Center at 2015 and 2016
نسبة ومحددات الوفيات واسبابها للمرضى الراقدين في ردهة الحروق لمستشفى الحسين التعليمي لعامي 2015 & 2016

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Abstract

; A cross sectional study had been extended through 2 years to envolve 611 burn patients from whom 103has been diedfrom they were admitted in AL-Hussain teaching hospital burn center through 2 years February 2015- January 2017which representcase fatality of (16.85%), in different age group between less than one year to more than 67 years old with different percentage of total body surface area burn,we were found that increase rate of death with increasing total body surface area regardless the age of the patients. about 63% of patients were die who had burn of more than 60%of total body surface area in all different ages.while only 3.4% were died with burn of 10—15% and about 30.3% were die who had between 46—59% of burn. about 23% if patients were died who had 36 to 45% of TBSA burn while 7% died who had 26 to 35 % of burn of TBSA .there were increase rate of death in ALNassiryia burn center in young age group between less than 1 year to 5 years were have the same percentage of burn compare with older age group between 40—45 years old in percentage of 22.6% vs 10.2 % respectively , while 20.2% of cases were die in age between less than 1 and 2 years. And 19.04% patients died who have age more 60 years old. The main cause of death was septicemia in AL-Hussen burn center in 61.1% then electrolyte disturbance26.2% and renal failure in 12.62%.the main organism that cause septicemia is mixed bacteria in 35.92% then pseudomonas in 28.15% then proteus 22.33%.researcher were found that the main type of electrolyte disturbance were companied electrolyte in 42.71% then hyponateremia in 28.15%.researcher found that in this study that the most common death patients occur in 2rd degree burn in 47.57% while in 4th degree about 18.4% that is because most of cases with 4th degree burn reach dead or at end stage to the burn unit .and death occur even with first degree burn if there were large percentage of burn with bad managements

Keywords

Burn --- Death rate --- Age --- TBSA


Article
Death rates and causes among admitted neonates in Children Welfare Teaching Hospital – Medical city –Baghdad (2000- 2004)

Author: Numan N. Hameed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 114-117
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The neonatal deaths account for two-third of all deaths in the first year of life, and 40% of under-five mortality. Extreme prematurity, respiratory distress syndrome , neonatal infections , and congenital malformations are among the common causes of neonatal deaths. Methods: We retrospectively studied 668 neonates who died over 5 years period from first of Jan. 2000 to the end of Dec. 2004 in neonatal care unit of children Welfare Teaching Hospital-medical city, by obtaining data from reviewing their medical records and death certificates.
Results: The death rate in neonates admitted to SCBU (special Care baby Unit) during the period of study was (10.7%), male constituted 432 (64.7%) and female 236 (35.3%) with male to female ratio 1.8:1. The major causes of death were congenital malformations (41.6%), neonatal infections (33.4%),and prematurity (10.3%).
Conclusions: There was no decline in the neonatal death rate in our hospital especially from sepsis and prematurity and low birth weight. Death due to late onset sepsis was lower than that due to early onset sepsis .There was a significant increase in the death from congenital malformations.


Article
Identification of bacterial agentsand antimicrobial susceptibility of neonatal sepsis with patient,s outcome

Authors: Abdul-Kareem Mohammed Ali عبد الكريم محمد --- Lamia Abdul-Kareem لمى عبد الكريم --- Emad Japur Rashed عماد جبر رشيد
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2014 Volume: 10 Issue: 17 Pages: 148-161
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background : Sepsis neonataroum is an important factor for morbidity and mortality in neonates. The incidence of neonatal bacterial sepsis depends on geographic area and may vary from country to country as well as within the same country. Objective: To identify the percentage of neonatal septicemia confirmed by positive blood cultures among 664 neonates admitted in neonatal care unit, and to identify the bacterial agents causing early and late neonatal sepsis and their antimicrobial susceptibility, and the outcome from neonatal septicemia. Patients and methods: The total number of patients(with clinical signs and symptoms suggesting sepsis) collected from neonatal care unit of AL-Kadimiya Teaching hospital from the 1st of January to the end of october 2011 were 664 neonates, and only 105 neonates who show signs and symptoms suggestive of septicemia that were confirmed by a positive blood culture were enrolled in this study. Data were collected include :Gestational age, Birth weight , Gender, Onset of sepsis, Place of delivery and also we followed up the subjects and recorded the outcome till discharge. Results: In this prospective study and from 664 neonate were admitted (total number of admission), positive blood cultures were obtained for 105 neonates (15.8%). Gram negative bacteria were the commonest causative agent in both early (66.7%) and late (56.9%) onset sepsis. Among neonates with sepsis, 33 patients (31.4%) had early onset and 72 patient (68.6%) had late-onset neonatal sepsis. The susceptibility of the isolated causative agent to selected antibiotics were the same in early and late onset sepsis. Over 70% of gram negative bacilli were resistant to both ampicillin and cloxacillin but show variable sensitivity to gentamicine and cefotaxime. Most of the isolated gram positive bacteria were sensitive to ampicillin, cloxacillin and cefotaxime but highly resistant to gentamicin. The death rate was 20.9%. Early onset sepsis, male gender, gestational age less than 37 weeks and birth weight less than 2500 gm were found to be significantly associated with death. Conclusions: Gram negative bacteria were the main cause of early and late-onset neonatal sepsis in our center and many of these isolated bacteria were resistant to the used antibiotics. Low birth weight neonates <2500 gm, gestational age < 37weeks, male gender and early onset sepsis were significantly associated with death. The death rate due to neonatal sepsis was higher compared with the other studies. Recommendations: Proper antenatal care and optimal obstetric management in early detection and treatment of mothers at risks together with minimizing invasive procedures of infants as much as possible and ideal nursery setup which includes adequate space for care of infants and aseptic equipments for monitoring.

العفن الولادي هو سبب مهم من أسباب الوفيات للأطفال حديثي الولاده.أن نسبة حدوث العفن الولادي البكتيري تعتمد على المنطقه الجغرافيه وقد تختلف من بلد ألى بلد وأيظا في البلد الواحد.الهدف من الدراسه لمعرفة نسبة حدوث العفن الولادي , البكتيريا المسببه للعفن الولادي المبكر والمسببه للعفن الولادي المتأخر وأيضا معرفة مدى أستجابتها للمظادات الحيويه ومعرفة نسبة حدوث الوفيات الناتجه من العفن الولادي في وحدة حديثي الولاده. لقد تم جمع المرضى من وحده حديثي الولاده في مستشفى الكاظميه التعليمي للفتره من الاول من كانون الثاني الى نهاية تشرين الاول لسنة 2011 م. كل المرضى الدين أدخلوا الى وحدة حديثي الولاده والذين لديهم العلامات والاعراض التي تدل على العفن الولادي والتي تم تأكيدها بواسطة زرع الدم الموجب تم أدراجها في هده الدراسه. المعلومات التي جمعت تشمل:عمر الجنين عند الولاده , الوزن عند الولاده , جنس المولود , تأريخ حدوث العفن الولادي , مكان الولاده , وكدلك تم متابعة المرضى وتسجيل النتيجه النهائيه للمرض. في هذه الدراسه ومن 664 مريض تم أدخالهم, كانت نتيجة زرع الدم موجبه ل105 حاله (15,8%). البكتيريا السالبه لصبغة الكرام كانت اكثر انواع البكتيريا المسببه لكل من العفن الولادي المبكر(66,7%) والعفن الولادي المتأخر(56,9%). أن من بين هؤلاء المرضى كانت هناك 33 حاله (31,4%) من عفن الدم المبكر و 72 حاله (68,6%) من عفن الدم المتاخر. أن استجابة البكتيريا للمضادات الحيويه التي جربت كانت متشابهه في حالتي العفن المبكر والعفن المتأخر في هذه الدراسه. أن أكثر من 70% من البكتيريا السالبه لصبغة الكرام كانت مقاومه لكل من الامبسيلين والكلوكساسيلين ولكن اظهرت استجابات متفاوته لكل من الجينتامايسين والسيفوتاكسايم. أن معظم البكتيريا الموجبه لصبغة الكرام اظهرت استجابه لكل من الامبيسيلين والكلوكساسيلين والسيفوتاكسايم بينما اظهرت مقاومه عاليه للجينتامايسين. أن نسبة الوفيات كانت 20,9%. أن العفن المبكر, الذكور, الولاده المبكره الاقل من 37 اسبوع و الوزن الاقل من 2500غرام عند الولاده كانت عوامل مصاحبه للوفاة . البكتيريا السالبه لصبغة الكرام كانت السبب الرئيسي للعفن الولادي المبكر والمتاخر في مركزنا وان العديد من البكتيريا المسببه كانت مقاومه للمظادات الحيويه المستخدمه. نوصي بالعنايه الجيده خلال اللحظات الاولى للولاده والمتابعه الافضل اثناء التداخلات الولاديه والكشف المبكر والعلاج اللازم للأم المصابه بالألتهابات مع تقليل التداخلات الجراحيه المساعده للولاده قدر المستطاع مع مراعاة ترك مسافات مناسبه بين الاطفال الحديثي الولادة واستخدام الادوات المعقمه عند المراقبه

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