Factors Affecting the Duration of Hospitalization in Urology and Nephrology Patients in the Intensive Care Unit.

Introduction Prolonged stays in the intensive care unit (ICU) are known to increase the risk of adverse outcomes following severe conditions. This study focuses on the factors affecting ICU length of stay, particularly in Urology and Nephrology patients who require intensive monitoring and specialized care, and their impact on patient outcomes. Methods A descriptive cross-sectional study was conducted with a sample size of 45 patients. Data was collected using a validated closed-ended questionnaire and analyzed with IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States). Results The study found positive associations between prolonged ICU stay and several factors, including elevated total bilirubin levels, deranged creatinine, urea, sodium, and calcium levels, as well as abnormal C-reactive protein levels. Higher bilirubin levels and positive blood and culture results were linked to extended ICU stays. Additionally, the use of contrast CT and MRI was associated with longer ICU durations. Conversely, broad-spectrum antibiotics showed a negative association with ICU stay length, while transfusion of blood products was positively associated with longer stays. Conclusion Understanding these factors can help improve the management of ICU patients and enhance outcomes in future cases.

A Case Report of Necrotizing Fasciitis Managed With the Application of Negative Pressure Wound Therapy to Achieve Better Wound Closure.

Necrotizing fasciitis is a severe and potentially life-threatening infection of the soft tissues that involves the skin, subcutaneous fat, fascia, and muscle. It can rapidly spread and lead to tissue death, sepsis, toxic shock syndrome, cardiopulmonary failure, and even death, especially in patients with chronic diseases, immunocompromised status, or immobility. To control the spread of necrosis, prompt diagnosis and aggressive surgical intervention with radical debridement of the affected tissues are essential, along with the administration of broad-spectrum antibiotics and intensive care support, when required. The application of negative pressure wound therapy has been utilized in the management of acute and complicated wounds with good outcomes. Here, we present a case of an 82-year-old female who presented with fever, tachycardia, and hypotension with underlying comorbid conditions of diabetes mellitus, hypertension, and spinal stenosis. On further exploration, she was found to have necrotizing fasciitis involving the left gluteal region. The present article describes the use of a vacuum-assisted closure dressing as an adjunct to serial debridement in the treatment of severe necrotizing fasciitis.

Factors contributing to distress among school and college-going adolescents during COVID-19 Lockdown: A cross-sectional study conducted in Sibi Balochistan, Pakistan.

BACKGROUND: Due to the COVID-19 pandemic, many countries have implemented nationwide lockdowns. While this leads to a decrease in disease transmission, there is a concurrent increase in the levels of psychological distress. To estimate the levels of psychological distress in school- and college-going adolescents currently under lockdown and to determine the factors associated with this psychological distress. MATERIALS AND METHODS: A cross-sectional study conducted in Army Public School and College (APSAC) Sibi, Balochistan province of Pakistan between March and May 2020. Students of APSAC Sibi were enrolled in this research. Modified Kuppuswamy Socioeconomic Scale, Godin Leisure-Time Exercise Questionnaire, and Kessler-10 were used for data acquisition. Chi-square and t-tests and univariate analysis (nonparametric test) were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, US). RESULTS: Out of 225 participants, 57.4% were studying at school. Sixty-four percent of the participants were likely to be suffering from psychological distress. There is a significant effect of physical activity, sleep duration, bedtime at night, screen-time duration, and COVID-19 positive family member on the levels of distress. A moderate positive correlation was between psychological distress and bed-time at night (rho[223] = 0.328, P < 0.001) and screen time duration (rho[223] = 0.541, P < 0.001). A moderate negative correlation of physical activity (rho[223] = -0.340, P < 0.001) and a weak negative correlation of sleep duration hours (rho[225] = -0.158, P = 0.018) was found with psychological distress levels. CONCLUSIONS: The COVID-19 lockdown and pandemic have had a considerable psychological impact on both school-going and college-going students, showing increased level of stress. A strong public health campaign along with mental and physical and social support programs are the need of the hour.