Evaluating the effectiveness of pneumococcal vaccines against hospitalization and intensive care unit admission in adults.

Objective: To evaluate the efficacy of pneumococcal vaccines concerning hospital or intensive care unit (ICU) admissions due to pneumonia after vaccination. Setting: Inpatient and ICUs at Hamad General Hospital. Methods: The retrospective study included adults who were vaccinated between June 2012 and June 2013. Patient records were reviewed for hospital or ICU admissions due to pneumonia 2 years before and after vaccination. Main outcomes measures: The primary outcome was to compare the rates of hospital and ICU admissions for pneumonia 2 years before and after vaccination. The secondary outcome was to evaluate the efficacy of pneumococcal vaccines against different comorbidities. Key findings: One hundred sixty-one patients were included with a dominant age group of 64–85 (52%) years old. Comorbidities reported were hypertension (HTN), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD) and asthma. The rate of hospital admission due to pneumonia was significantly reduced within 2 years after vaccination, 71–39% (P 0.72). In diabetic, hypertensive and COPD/Asthma patients, there was a statistically significant reduction in hospitalization. Although there was a reduction in ICU admission for both commodities, the results did not achieve statistical significance. Conclusion: Adults who received pneumococcal vaccines experienced reduced rates of hospital versus ICU admissions due to pneumonia infection

Peripartum Cardiomyopathy: Facts and Figures

Peripartum cardiomyopathy (PPCM) is a rare clinical entity during pregnancy. PPCM is a diagnosis of exclusion. These patients do not have prior history of heart disease, and there are no other known possible causes of heart failure. It is more common in African countries, may be related to the consumption of kanwa, in the postpartum period. The multiparity, African descent and pregnancy-induced hypertension are a few risk factors for PPCM. The exact etiology of PPCM is not known; possible theories range from myocarditis to the maladaptation to the changes of pregnancy. The clinical manifestation varies from shortness of breath to thromboembolic phenomenon. Echocardiography is essential for diagnosis as well as differential diagnosis of PPCM. These patients preferably are managed in tertiary healthcare facilities. Anticoagulation and antiarrhythmic medications are pillars for the management of PPCM patients. If required, mechanical devices should be used temporarily. PPCM patients may need heart transplant. The beneficial role of bromocriptine and immunosuppression is not clear in PPCM patients. Subsequent pregnancies should be avoided to prevent the PPCM occurrence