Nickel Perfluoroalkyl Complexes Supported by Simple Acetate Coligands.

The interaction of tetramethylammonium acetate with [(MeCN)2Ni(CF3)2], [(MeCN)2Ni(C2F5)2], and [NMe4][(MeCN)Ni(CF3)3] was explored by 19F NMR spectroscopy. We show that depending on the nature of the nickel complex, one or two acetate ligands can add to the metal center and replace the nickel-bound MeCN ligands, depending on the acetate concentration. The number of acetates that could bind to nickel, and whether the resulting complex exists as a monomer or dimer, was determined to be dependent on the nature of the fluoroalkyl ligand. Moreover, we observe that oxidation of the nickel center of [(MeCN)2Ni(CF3)2] in the presence of two equivalents of acetate leads cleanly to the octahedral, paramagnetic (EPR spectroscopy), and anionic Ni(III) complex [NMe4][Ni(CF3)2(OAc)2].

SARS-CoV-2 and Dengue Coinfection in Filipino Children: Epidemiology Profile, Clinical Presentation and Outcomes.

BACKGROUND: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dengue-endemic regions has raised concern on the possibility of coinfection, especially in children who bear the highest burden of illness. This study determined the incidence and described the profile of Filipino children with SARS-CoV-2 and dengue coinfection, and compared disease severity and outcome in children with coinfection to a matched group of children with SARS-CoV-2 monoinfection. METHODS: This was a retrospective matched cohort study of pediatric patients 0-18 years old diagnosed with SARS-CoV-2 and dengue coinfection or SARS-CoV-2 monoinfection in the Philippines and reported to the Surveillance and Analysis of Coronavirus disease 2019 (COVID-19) in Children Nationwide registry from March 01, 2020 to June 30, 2022. RESULTS: A total of 3,341 SARS-CoV-2 infections in children were reported. The SARS-CoV-2 and dengue coinfection incidence is 4.34% (n = 145). We matched 120 coinfections to monoinfections according to age, gender and timing of infection. More coinfection cases were classified as mild or moderate COVID-19, whereas more asymptomatic cases were seen in those with monoinfection. Rates were similar for severe and critical COVID-19 in both groups. Coinfections predominantly presented with typical dengue symptoms rather than COVID-19 symptoms and laboratory parameters. No differences in outcomes were observed between coinfection and monoinfection. The case fatality rates are 6.7% for coinfection and 5.0% for monoinfection. CONCLUSIONS: One in every 25 SARS-CoV-2 infections had a dengue coinfection. Continued surveillance is needed to establish the interaction of SARS-CoV-2 and dengue virus, evaluate the impact of COVID-19 and/or dengue vaccination on coinfection and monitor complications of coinfection.

Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures.

This study investigated the long-term survival and incidence of secondary fractures after fragility hip fractures. The 5-year survival rate was 62%, and the mortality risk was seen in patients with GNRI < 92. The 5-year incidence of secondary fracture was 22%, which was significantly higher in patients with a BMI < 20. BACKGROUND: Malnutrition negatively influences the postoperative survival of patients with fragility hip fractures (FHFs); however, little is known about their association over the long term. OBJECTIVE: This study evaluated the ability of the geriatric nutritional risk index (GNRI) as a risk factor for long-term mortality after FHFs. METHODS: This study included 623 Japanese patients with FHFs over the age of 60 years. We prospectively collected data on admission and during hospitalization and assessed the patients' conditions after discharge through a questionnaire. We examined the long-term mortality and the incidence of secondary FHFs and assessed the prognostic factors. RESULTS: The mean observation period was 4.0 years (range 0-7 years). The average age at the time of admission was 82 years (range 60-101 years). The overall survival after FHFs (1 year, 91%; 5 years, 62%) and the incidence of secondary FHFs were high (1 year, 4%; 5 years, 22%). The multivariate Cox proportional hazard analysis revealed the risk factors for mortality as older age (hazard ratio [HR] 1.04), male sex (HR 1.96), lower GNRI score (HR 0.96), comorbidities (malignancy, HR 2.51; ischemic heart disease, HR 2.24; revised Hasegawa dementia scale ≤ 20, HR 1.64), no use of active vitamin D3 on admission (HR 0.46), and a lower Barthel index (BI) (on admission, HR 1.00; at discharge, HR 0.99). The GNRI scores were divided into four risk categories: major risk (GNRI, < 82), moderate risk (82-91), low risk (92-98), and no risk (> 98). Patients at major and moderate risks of GNRI had a significantly lower overall survival rate (p < 0.001). Lower body mass index (BMI) was also identified as a prognostic factor for secondary FHFs (HR 0.88 [p = 0.004]). CONCLUSIONS: We showed that older age, male sex, a lower GNRI score, comorbidities, and a lower BI are risk factors for mortality following FHFs. GNRI is a novel and simple predictor of long-term survival after FHFs.

Assessment of attitude and practices toward breaking the bad news among physicians in a national tertiary government hospital for infectious diseases from October 2020 to October 2021

Background@#Delivering bad news to patients is one of the most difficult tasks of physicians that play a big role in the process of treatment and cooperation of patients. Patients generally have the right to be informed of their condition, but the debate over the importance of the attitude of telling the truth is still an issue. @*Objective@#This study aimed to understand the attitude and practices toward breaking the bad news among physicians in a National Tertiary Government Hospital for infectious Diseases from October 2020 to October 2021.@*Methods@#This cross-sectional study was conducted at the San Lazaro Hospital from October 2020 to October 2021. A self-administered questionnaire was adapted to elicit information on physicians’ knowledge and practices about breaking bad news to patients and their families. Inclusion criteria included all the practicing physicians assigned in the clinical areas either full time or part time medical specialists, residents and fellows and hospitalist in San Lazaro Hospital. Physicians who were assigned in the non-clinical areas and did not see or handle patients and non-employees of the institution and who refused to sign the informed consent were excluded. Total Purposive Sampling was utilized. Data were gathered using a validated 3-part 34 item personally administered questionnaire and was presented in Descriptive Statistics Frequency distribution for the demographics, ANOVA, Linear regression analysis.@*Results@#A total of 100 participants was included and based on socio-demographic characteristics of respondents toward breaking the bad news. Majority of the respondents were aged 35 – 54 years old with 52 or 52%, female with 69 or 69%, were fellows with 41 or 41%, specialty was Family Medicine with 36 or 36%, and majority of the respondent’s qualification was GP with training with 46 or 46%. The study revealed that sex (t = -2.070, p = 0.042) had significant association to the attitude and practices toward breaking the bad news among practicing physicians at 0.05 level of significance. Thus, male respondents has had higher attitude and practices toward breaking the bad news as compare to female respondents. @*Conclusion@#According to the findings of this study, clinicians at San Lazaro Hospital demonstrated a good attitude and practice regarding breaking the bad news between October 2020 and October 2021. The researcher believed want to help their patients, and most of them have the necessary knowledge and skills for breaking bad news.

A cross-sectional study on the association between social media addiction, body image, and social comparison among young adult Filipino women aged 18-25 years old in Metro Manila / The Health Sciences Journal

INTRODUCTION@#The Philippines tops globally for time spent on social media. This study aimed to explore the association between social media addiction, body image, and social comparison among young adult Filipino women aged 18-25 years old in Metro Manila.@*METHODS@#The Social Media Addiction Scale (SMAS), Body Image Questionnaire (BIQ), and Iowa-Netherlands Comparison Orientation Measure (INCOM) were used to assess social media addiction, body image, and social comparison, respectively. PRR (CI 95%) assessed the association between SMA and BI, and SMA and SC.@*RESULTS@#Majority of participants had social media addiction (91.11%), while most reported a neutral body image (87.64%). Additionally, more than half of the participants exhibited a high tendency towards social comparison (53.15%). The study found a positive association between social media addiction and negative body image, as well as a significant positive association between social media addiction and social comparison. Obesity showed a significant positive association with negative body image perception, while being overweight was significantly associated with a lower likelihood of having a positive body image. Spending at least 4 hours per day on social media was significantly associated with a higher tendency towards social comparison.@*CONCLUSION@#These findings suggest the presence of social media addiction among young adult Filipino women and its association with body image and social comparison. Awareness of these associations can contribute to the development of targeted interventions and educational programs to promote healthier social media use and positive body image among young adults.

Household survey on owned dog population and rabies knowledge in selected municipalities in Bulacan, Philippines: A cross-sectional study.

BACKGROUND: Despite the effort to eradicate rabies in the Philippines, human rabies cases have not decreased in the past decade. Rabid dogs pose the most significant hazard in the countries with the highest burden of rabies, and 70% rabies vaccine coverage is recommended for dogs in high-risk areas. Ascertaining the owned dog population and community knowledge on rabies can help improve vaccine coverage and information campaigns. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cross-sectional survey in six randomly selected communities (five urban, one rural) in Central Luzon, Philippines. We first conducted the complete mapping of 9,173 households and then randomly selected 727 households. More than half (54.1%) of the households owned dogs (1.21 dogs/household). In the 727 households, we identified 878 owned dogs and 3256 humans. According to these results, the dog-to-human ratio was approximately 1:3.7. Only 8.8% of households reported a history of dog bite in 2019. Among dog-owning households, 31% reported that they allow their dogs to roam freely. Of the recorded dogs, 35.9% have never been vaccinated, and only 3.5% were spayed or castrated. Factors associated with lower rabies knowledge include (1) no education aOR: 0.30 (0.16-0.59), and (2) only primary school education aOR: 0.33 (0.22-0.49). In contrast, factors associated with higher knowledge include (1) owning a dog and not allowing them to roam freely aOR: 2.01 (1.41-2.87) and (2) owning a dog and allowing them to roam freely aOR: 1.84 (1.17-2.92), when compared to those with no dogs. CONCLUSIONS/SIGNIFICANCE: We identified a larger dog population in the community than the usual estimates (1:10), suggesting that annual vaccine needs in the Philippines must be reassessed. Our survey shows a relatively good understanding of rabies; however, awareness of the concept of rabies as a disease, and how animals and humans can acquire it, is lacking.

SARS-CoV-2 Infection in Filipino Children: An interim report from the SALVACION registry

Background@#The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. @*Methods@#This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. @*Results@#As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. @*Conclusion@#Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.

Lateral flow devices for samples collected by straw sampling method for postmortem canine rabies diagnosis.

The direct fluorescent antibody test (dFAT) using brain sample after opening the skull is the standard rabies diagnostic test in animal rabies. However, it is not feasible in many resource-limited settings. Lateral flow devices (LFD) combined with a simple sampling methodology is quicker, simpler, and less hazardous than the standard test and can be a useful tool. We conducted a prospective on-site study to evaluate the diagnostic accuracy of the LFD with the straw sampling method compared with that of the dFAT with the skull opening procedure for post-mortem canine rabies diagnosis. We collected 97 rabies-suspected animals between December 1, 2020 and March 31, 2021. Among the 97 samples, 53 and 50 cases were positive tests for dFAT and LFD, respectively. The sensitivity and specificity of LFD with straw sampling method were 94.3% (95% confidence interval [CI], 84.3-98.8%) and 100% (95% CI, 92.0-100%), respectively. The performance of LFD by the straw sampling method showed relatively high sensitivity and 100% specificity compared with that of dFAT performed on samples collected after opening the skull. This methodology can be beneficial and is a strong tool to overcome limited animal surveillance in remote areas. However, because of our limited sample size, more data using fresh samples on-site and the optimizations are urgently needed for the further implementation in endemic areas.

Background and descriptive features of rabies-suspected animals in Central Luzon, Philippines.

BACKGROUND: The Philippines is one of the major endemic countries for canine rabies in Southeast Asia. However, detailed description and analysis of laboratory-confirmed animal rabies are limited. Highly accurate surveillance requires a thorough understanding of the target area-specific problems and obstacles. Therefore, we aim to describe and analyze the rabies suspect animals in Central Luzon, Philippines, to clarify the characteristics of management and clinical signs by conducting interviews with the owners. METHODS: We prospectively collected information on the rabies suspect animals submitted to the Regional animal laboratory in Central Luzon through passive laboratory-based rabies surveillance between 1st April 2019 and 30th September 2020. We performed active interviews directly or telephonically with the owner. The direct fluorescent antibody test was performed on the hippocampus, brain stem, and cerebellum for laboratory confirmation. Descriptive statistics were used to characterize the number of rabies cases according to management methods and characteristics of suspected animals during the observation period. Clinical symptoms of suspected rabid animals were analyzed by univariate logistic regression analysis. RESULTS: There were 292 sample submissions during the study period. Of these, 160 were positive for dFAT. Samples of pet animals (85.3%) provided by owners or their acquaintances (59.2%) accounted for the majority of laboratory confirmed cases. Case mapping showed that more rabies-suspected cases were sent from areas near the regional laboratory than from those far from the laboratory, despite the incidence of rabies being high in these areas. The management and clinical symptoms of 227 animal cases showed that most owners were managing their animals at home and were allowing them to roam outside (69.6%) and be unvaccinated (78.9%). Rabid animals were more likely to manifest aimless running, restlessness, and agitation. CONCLUSIONS: Our study provided some features of animals with laboratory-confirmed rabies in Central Luzon. However, most of the samples were submitted from areas near the rabies diagnosis laboratory, and the number of samples submitted from remote areas was low. To improve the surveillance capacity, it is necessary to increase sample submissions from remote areas.

Microplastics in some fish species and their environs in Eastern Visayas, Philippines.

Microplastics are a global concern, and yet, Philippine studies about it are still wanting. This study investigated microplastic ingestion among detritus-feeding mullet versus the herbivorous rabbitfish, and between freshwater and marine fishes. The first part aimed to compare microplastics in fishes' guts differing in feeding guilds, individual sizes, and body weights. The second part compared MPs in fishes' guts and their surrounding waters. Part one revealed that herbivores (58.57%) ingested more MPs than their detritivore-counterparts (30.0%). Pearson correlation, averaging 0.06, suggests a weak correlation between fish weight and MPs amount for both species. Part two showed marine fishes (66.0%) ingested more MPs than its freshwater counterparts (45.0%). A very weak correlation was observed between fish weight and amount of MPs ingested. Fish along the estuary ingested more MPs than those in other stations. No significant differences (p = 0.23) between the MPs in the water samples from each sampling stations was found.

ER doctors' emotions, stressors, stress-reducing factors, coping strategies and motivational factors during the COVID-19 Pandemic

Background@#The presence of COVID-19 has increasingly overwhelmed the Philippine healthcare system, which is affecting the mental and emotional health of healthcare workers in the country. @*Objective@#The study aimed to assess the emotions, stressors, stress-reducing factors, coping mechanisms, and motivational factors of the emergency room (ER) doctors in selected high-risk private hospitals within the National Capital Region (Metro Manila) during the COVID-19 pandemic between March 14, 2020 to November 12, 2020. @*Methodology@#A quantitative, cross-sectional descriptive study was conducted using electronic and/or physical surveys, given to 127 ER doctors in Cardinal Santos Medical Center in San Juan, Makati Medical Center in Makati, and Chinese General Hospital in Manila. @*Results@#Results showed that ER doctors continuously work as it is their professional and ethical duty despite feeling nervous and scared to do so. However, the safety of their colleagues and family increases their stress levels, which were reduced when their family and friends were safe from COVID-19 and when the condition of their colleagues improved. Following strict protocols and chatting with friends and family helped them cope to alleviate stress, and the assurance of adequate personal protective equipment and family support motivated the ER doctors to continue working. @*Conclusion@#The COVID-19 pandemic has had an effect on ER doctors, and all involved parties can improve the experiences of ER doctors during any future outbreaks similar to COVID-19 by providing psychosocial interventions.

Factors associated with the willingness of primary caregivers to avail of a dengue vaccine for their 9 to 14-year-olds in an urban community in the Philippines.

To help address the need for preventive measures against dengue fever, a leading cause of child mortality in the Philippines, vaccine trials are ongoing and a tetravalent vaccine (Dengvaxia™, Sanofi Pasteur) has been developed. It is hypothesized that while acceptability would be high among primary caregivers (i.e., parents/guardians), the willingness to have one's child immunized against dengue would be associated with socio-demographic variables, attitudes and knowledge regarding dengue and vaccination, and past experience with dengue. This study aimed to assess the aforementioned factors' association with primary caregivers' willingness to avail of a dengue vaccine for their 9 to 14-year-old children in an urban community in the Philippines. A cross-sectional study utilizing interviews was conducted to determine which factors were associated with willingness-to-avail assuming a free vaccine, and a case study utilizing a focus group discussion was employed to capture some underlying reasons for their willingness. Data were analyzed using multiple logistic regression and thematic analysis. Among the 202 study participants, 193 (95.54%) were willing to avail of the vaccine. There was a high probability of vaccine acceptance by primary caregivers (95.54%), with good attitude towards vaccination (≥12/15 points) [aOR 10.62, 90% CI (1.73-26.28)] and large household size (>5) [aOR 9.63, 90% CI (2.04-45.58)] being positively associated with willingness-to-avail, and good knowledge regarding dengue fever [aOR 0.10, 90% CI (0.03-0.74)] and older age (>44 years) [aOR 0.14, 90% CI (0.03-0.61)] being negatively associated. Crude analysis showed that household size, knowledge regarding dengue, and attitude towards vaccination were significantly associated with willingness. Multivariate analysis revealed that these factors and the primary caregiver's age were associated with willingness. Thematic analysis showed various perceptions regarding dengue and vaccination. Knowing these factors are associated with willingness-to-avail of the vaccine may help in understanding the audience of health promotion projects aimed at increasing immunization coverage.

Correlation between incidence of dengue and climatic factors in the Philippines: An ecological study / The Health Sciences Journal

INTRODUCTION@#Dengue continues to be a major health concern in the Philippines. This study aimed to establish trends and correlations between the incidence of dengue and rainfall, humidity and temperature, respectively, in the different regions.@*METHODS@#Using 2018 records obtained from DOH and PAGASA, correlations were made between monthly measurements of climatic factors and the incidence of dengue using Pearson’s r, while maps and interpolations were generated using quantum geographical information system software.@*RESULTS@#There was a significant positive but weak correlation between the incidence of dengue and rainfall (r = 0.379, 95% CI 0.255, 0.491; p < 0.001) and humidity (r = 0.215, 95% CI 0.080, 0.342; p = 0.002). There was a significant negative but weak correlation between the incidence of dengue and temperature (r = -0.145, 95% CI -0.277, -0.008; p = 0.039). A strong positive correlation was noted between the incidence of dengue, and rainfall and humidity, respectively, in several regions. Multiple regression indicates that rainfall, humidity and temperature are poor predictors of the incidence of dengue (R2 = 0.1436, 0.0461 and 0.0209, respectively).@*CONCLUSION@#This study showed overall a significant but weak correlation between an increased incidence of dengue and heavy rainfalls and high relative humidity, and a weak negative correlation for temperature. A high positive correlation of an increased incidence of dengue and heavy rainfalls and high relative humidity was observed in several regions.

Cartilage wear patterns in severe osteoarthritis of the trapeziometacarpal joint: a quantitative analysis.

OBJECTIVE: The present quantitative study aimed to assess the three-dimensional (3-D) cartilage wear patterns of the first metacarpal and trapezium in the advanced stage of osteoarthritis (OA) and compare cartilage measurements with radiographic severity. DESIGN: Using 19 cadaveric trapeziometacarpal (TMC) joints, 3-D cartilage surface models of the first metacarpal and trapezium were created with a laser scanner, and 3-D bone surface model counterparts were similarly created after dissolving the cartilage. These two models were superimposed, and the interval distance on the articular surface as the cartilage thickness was measured. All measurements were obtained in categorized anatomic regions on the articular surface of the respective bone, and we analyzed the 3-D wear patterns on the entire cartilage surface. Furthermore, we compared measurements of cartilage thickness with radiographic OA severity according to the Eaton grading system using Pearson correlation coefficients (r). RESULTS: In the first metacarpal, the cartilage thickness declined volarly (the mean cartilage thickness of the volar region was 0.32 ± 0.16 mm, whereas that of the dorsal region was 0.53 ± 0.18 mm). Conversely, the cartilage evenly degenerated throughout the articular surface of the trapezium. Measurements of the categorized regions where cartilage thinning was remarkable exhibited statistical correlations with radiographic staging (r = -0.48 to -0.72). CONCLUSIONS: Our findings indicate that cartilage wear patterns differ between the first metacarpal and trapezium in the late stage of OA. There is a need for further studies on cartilage degeneration leading to symptomatic OA in the TMC joint.

Quality of public school toilets and the frequency of changing sanitary napkins among students in public secondary schools in the City of Manila, Philippines.

BACKGROUND: In sub-tropical countries, poor menstrual hygiene management has been reported. One cause of poor menstrual hygiene management can be poor quality toilets. However, associations between poor quality toilets and menstrual-related behaviors have been poorly understood. The present study aimed to assess the association between the quality of school toilets and the frequency of changing sanitary napkins in school toilet among Filipino students. METHODS: A cross-sectional study was conducted in six secondary schools of the City of Manila, Philippines, in 2017. A self-administered survey questionnaire with female students collected data on the outcome variable, self-reported daily frequency of changing sanitary napkins in school toilet, and other predictor variables. An observational survey collected data on the main predictor variable, surveyor-rated toilet quality variables. A total of 526 students were included in the analyses. Logistic regression with generalized estimating equation model was used to assess the association between the outcome and predictor variables. RESULTS: No significant association was found both between toilet quality and the outcome. Although the association was not significant, the odds ratio (OR) of "sanitary bin is available in toilet" was 2.54 compared to "sanitary bin is not available in toilet." The results of multivariate analysis showed that participants who reported stronger perceived behavioral control or stronger subjective norm were significantly more likely to change sanitary napkins, compared to those with lower perceived control score or lower subjective norm score, respectively (adjusted OR 2.29, 95% confidence interval 1.24 to 4.25; adjusted OR 2.63, 95% confidence interval 1.45 to 4.76). CONCLUSIONS: The present study showed that the quality of school toilets was not associated with the frequency of changing sanitary napkins among the studied population. However, it does not mean that the cause-effect relationship was rejected. Further studies involving more schools are necessary to confirm this relationship. Improving subjective norm and perceived behavior control might improve menstrual hygiene behavior.

Intraventricular Antimicrobial Therapy in children with Multi-Drug Resistant Ventriculitis: A tertiary hospital experience and literature review

Background@#Intraventricular antimicrobial therapy (IVT), defined as the direct installation of antimicrobial agents into the lateral ventricles has been utilized as the last therapeutic option for the treatment of multidrug-resistant ventriculitis. The aim of this case series is to report our institution’s experience with IVT in pediatric patients with ventriculitis. @*Material and Methods@#Retrospective chart review was done. The demographic data, cerebrospinal fluid (CSF) culture isolates, treatment regimens, and clinical outcomes of these patients were collected and described. @*Results@#Between 2016 to 2018, seven (7) pediatric patients diagnosed with ventriculitis caused by multidrug-resistant organisms underwent intraventricular antimicrobial therapy in combination with intravenous therapy. The median age was 1 year (range 1 month to 17 years old, mean: 4.4 years). Fifty-seven (57) percent of the patients were females. The isolated pathogens were Acinetobacter baumannii MDRO (n = 3), Klebsiella pneumoniae MDRO (n = 2), Methicillin-resistant Staphylococcus aureus (n = 1), and Methicillin-resistant Staphylococcus epidermidis (n = 2).One patient had mixed isolates on CSF culture (Acinetobacter baumannii and MRSE). The antimicrobial agents for IVT used were colistin (n = 4), vancomycin (n = 2), and gentamicin (n = 1). The mean time to initiation of intraventricular therapy from the diagnosis of ventriculitis was 19 days. The mean duration of IVT therapy was 15 days. The survival rate was 57%. @*Conclusion@#Ventriculitis caused by drug-resistant organisms is an emerging concern. Optimal therapy is not yet established and experience with IVT is limited. This series showed that there were no adverse effects related to IVT thus it may be considered an option for MDRO ventriculitis. Gram negative organisms are more common causes of ventriculitis in our institution.

Comparison of various methods of detection of Hypoxemia and Correlation of Hypoxemia with clinical features among pediatric patients 3 months to 5 years old with community-acquired Pneumonia at a tertiary hospital emergency room

Introduction@#Pulse oximetry is frequently utilized as a rapid, non-invasive, point-of-care alternative to arterial blood gas analysis in measuring oxygen saturation of children with pneumonia.@*Objectives@#To compare portable fingertip pulse oximetry saturation (SpO2PF), handheld pulse oximetry saturation (SpO2H) and arterial oxygen saturation (SaO2) in detection of hypoxemia, and correlate hypoxemia with clinical features in children with pneumonia.@*Methodology@#This was a prospective, observational, cross-sectional study involving patients 3 months to 5 years old with pneumonia. Oxygen saturation was measured using a portable fingertip pulse oximeter, a handheld pulse oximeter, and arterial blood gas analysis. @*Results@#Eighty-six children were included. SpO2 PF underestimated oxygen levels by 0.126% (95% CI -0.240 to 0.491), while SpO2H underestimated it by 0.323% (95% CI -0.075 to 0.721). Between portable and handheld readings, the mean difference was 0.198% (95% CI -0.089 to 0.484). Across the three methods, limits of agreement ranged from -3.388 to +4.035%. There was no statistically significant difference in variance among the three measurements. Children with tachypnea (cOR 2.623, 95% CI 1.06 – 6.48, p = 0.037), difficulty breathing (cOR 6.316, 95% CI 1.96 – 20.34, p = 0.002), and subcostal retractions (cOR 2.842, 95% CI 1.05 to 7.69, p = 0.040) were more likely to have hypoxemia. @*Conclusion@#Pulse oximetry closely correlates with arterial blood gas analysis within acceptable limits of agreement and with no significant differences in variance among measurements. Difficulty breathing, tachypnea and subcostal retractions were significantly more likely to be observed in hypoxemic children.