Influence of body mass index and antibiotic dose on the risk of surgical site infections in pediatric clean orthopedic surgery.

OBJECTIVE: To evaluate body mass index (BMI) and antimicrobial dose as risk factors for surgical site infections in pediatric patients. PATIENTS AND METHODS: Children between 2 and 19 years of age undergoing clean orthopedic procedures and receiving at least one dose of perioperative antibiotics (cefazolin, vancomycin, or clindamycin) were studied. The retrospective case-controlled study was conducted at the Alfred I. duPont Hospital for Children, a 180-bed tertiary-care academic pediatric hospital in Wilmington, DE. Data were collected from January 1, 2002, to December 31, 2005. RESULTS: Underweight children had a higher risk for SSIs than overweight and normal-weight children. American Society of Anesthesiologists classes II and greater were associated with a greater risk of SSI. Longer procedures were also associated with a higher risk of SSI, specifically, duration of surgery \u3e2 h. Children weighing ≥70 kg who received a standard dose of cefazolin (maximum of 1 g) had a higher risk of SSI caused by methicillin-sensitive Staphylococcus aureus (MSSA). CONCLUSIONS: Being underweight and undergoing an operation lasting \u3e2 h created significant risks for SSI. Children weighing ≥70 kg receiving a standard 1-g dose of cefazolin had a greater risk of MSSA SSIs than children weighingantibiotic

Characterization of Pediatric Acute Lymphoblastic Leukemia Survival Patterns by Age at Diagnosis

Age at diagnosis is a key prognostic factor in pediatric acute lymphoblastic leukemia (ALL) survivorship. However, literature providing adequate assessment of the survival variability by age at diagnosis is scarce. The aim of this study is to assess the impact of this prognostic factor in pediatric ALL survival. We estimated incidence rate of mortality, 5-year survival rate, Kaplan-Meier survival function, and hazard ratio using the Surveillance Epidemiology and End Results (SEER) data during 1973–2009. There was significant variability in pediatric ALL survival by age at diagnosis. Survival peaked among children diagnosed at 1–4 years and steadily declined among those diagnosed at older ages. Infants (<1 year) had the lowest survivorship. In a multivariable Cox proportional hazard model stratified by year of diagnosis, those diagnosed in age groups 1–4, 5–9, 10–14, and 15–19 years were 82%, 75%, 57%, and 32% less likely to die compared to children diagnosed in infancy, respectively. Age at diagnosis remained to be a crucial determinant of the survival variability of pediatric ALL patients, after adjusting for sex, race, radiation therapy, primary tumor sites, immunophenotype, and year of diagnosis. Further research is warranted to disentangle the effects of age-dependent biological and environmental processes on this association

A Review on Ship Recycling Industry in Bangladesh from Global Perspective

At present, the global center of the ship breaking and recycling industry is in South Asia, specifically Bangladesh, India, and Pakistan. These three countries account for 70–80 percent of the international recycling market for ocean-going vessels, with China and Turkey covering most of the remaining market. Only about 5 percent of global volume is scrapped outside these five countries. Bangladesh has environmentally beneficial coastal region and affordable labor that make the shipbreaking and recycling business as a potential sector for the country. In addition, ship recycling and its related businesses are helping to solve our nation’s unemployment issues at all levels of the population. This study provides a statistical overview of ship recycling industries and the difficulties of this sector with feasible solutions. Firstly, this article tries to demonstrate the statistical analysis of Bangladesh\u27s ship recycling sector from a worldwide viewpoint as well as its contribution to the country\u27s economy. The graphical representation of the number of scrapped ships yearly and their GRT/LDT value shows a good comparison of the development of this industry in Bangladesh as well as other countries. Besides, the average number of breaking ships and their GRT /LDT values for a few years (2012-2021) also represents the growth of the ship breaking and recycling industry. The data in this study is based on public online journal articles, conference papers, reports from organizations (NGOs), reports from the steel and other industries, daily newspaper articles, etc. All of these data have been sorted according to country-wise, number of the scrapped ship, GRT value, etc., and represented by different graphical analyses. Despite the fact that this industry has helped the nation to gain a lot of reputation, it also has some challenges that need to be addressed immediately. The later part of this study discusses those challenges of these industries and finally, certain propositions have been proposed in order to overcome those challenges

Spectrum of valvular lesions in newly diagnosed rheumatic heart disease

Background: Rheumatic heart disease (RHD) is the most common acquired heart disease among young adults and an important health problem in developing countries. There is much scarcity of information about echocardiographic evaluation of valvular involvement of RHD in Bangladesh. Objective of this study was to analyze the clinical spectrum and pattern of cardiac valvular lesions in newly diagnosed RHD patients. Methods: This cross-sectional study was conducted from April 2019 to May 2021 in National Center for Control of Rheumatic Fever and Heart Diseases (NCCRF and HD), Dhaka, Bangladesh.  Newly diagnosed 160 RHD patients irrespective of age and sex were enrolled. Medical history was obtained, physical examination was carried out, several investigations were done and standard color Doppler echocardiography was performed. Diagnosis of RHD was made following 2012 World Heart Federation criteria. Results: More than 60% of newly diagnosed patients of RHD were female; mean age of patients was 24.29±9.17 years and 77.5% of patients were between 15-34 years of age. Detected valvular lesions were mostly isolated (65%) and mitral valve involvement was 88.7%. Isolated mitral regurgitation was detected among 56.3% patients and was higher in female. Combination of mitral regurgitation and mitral stenosis were reported in 12.5% cases whereas mitral regurgitation with aortic regurgitation was present in 10.6% cases. Overall, 14 (6.4%) of the newly diagnosed patients were detected with severe forms of cardiac valvular lesion. Conclusions: RHD were common in young adults. Mitral valve was predominantly involved, particularly presenting as isolated mitral regurgitation

Outcome Measures with COPM of Children using a Wilmington Robotic Exoskeleton

Background: The Wilmington Robotic Exoskeleton (WREX) is a body-powered, four degrees of freedom orthosis that allows gravity-minimized movement of the arm at the shoulder and elbow. We sought to measure patient satisfaction and performance with use of the WREX during activities of daily living, play, and at school. Method: Twenty-five families completed a phone interview based on the Canadian Occupational Performance Measure (COPM). These families all had a child, aged 2 to 21years, who had a neuromuscular disorder and who had used the WREX for at least eight months. The parents rated their child’s performance of and satisfaction with important activities both with and without the WREX. The scores were assessed for change between the two conditions. Results: Twenty-four out of the 25 parents reported that their child had greater levels of performance and satisfaction when they were wearing the WREX. The mean change in performance score was 3.61 points, and the mean change in satisfaction score was 4.44 points. Conclusion: Families who have a child diagnosed with a neuromuscular disorder and who uses the WREX perceived improved performance and satisfaction with the WREX during self-chosen meaningful activities

Detailed Performance Loss Analysis of Silicon Solar Cells using High-Throughput Metrology Methods

In this work, novel, high-throughput metrology methods are used to perform a detailed performance loss analysis of approximately 400 industrial crystalline silicon solar cells, all coming from the same production line. The characterization sequence includes a non-destructive transfer length method (TLM) measurement technique featuring circular TLM structures hidden within the busbar region of the cells. It also includes a very fast external quantum efficiency and reflectance measurement technique. More traditional measurements, like illuminated current-voltage, Suns-VOC, and photoluminescence imaging are also used to carry out the loss analysis. The variance of the individual loss parameters and their impact on cell performance are investigated and quantified for this large group of industrial solar cells. Some important correlations between the measured loss parameters are found. The nature of these distributions and correlations provide important insights about loss mechanisms in a cell and help prioritize efforts to optimize the performance of the production line.Comment: 5 pages, 6 figures, conferenc

Factors Associated with Klebsiella

Although Klebsiella bacteremia in children is perceived to be associated with fatal consequences, data are scarce on those children presenting with diarrhea. We evaluated the factors associated with Klebsiella bacteremia in such children. In this retrospective chart analysis, data of all diarrheal children was retrieved from electronic medical record system (named as SHEBA) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), from January 1, 2010, to December 31, 2012, who had their blood culture done. This was a study having a case-control design where comparison of clinical and laboratory characteristics was done among children with Klebsiella bacteremia (cases = 30) and those without any bacteraemia (controls = 90). Controls were selected randomly. The cases more often had fatal outcome (p<0.001). In logistic regression analysis, after adjusting for potential confounders such as young age, severe dehydration, severe wasting, abnormal mentation, hypotension, and fast breathing, the cases were independently associated with hospital-acquired infection and positive stool growth (for all, p<0.05). The study highlights the importance of obtaining blood cultures in hospitalized children under five years old with diarrheal illness in the presence of either hospital-acquired infection or positive stool culture to have better outcome

Pneumonia mortality and healthcare utilization in young children in rural Bangladesh: a prospective verbal autopsy study

BackgroundThe present study aimed to examine the risk factors for death due to pneumonia in young children and healthcare behaviors of the guardians for children in rural Bangladesh. A prospective autopsy study was conducted among guardians of children aged 4 weeks to 59 months in Mirzapur, Bangladesh, from 2008 to 2012.ResultsPneumonia was the primary cause of death, accounting for 26.4% (n = 81) of all 307 deaths. Of the pneumonia deaths, 58% (n = 47) deaths occurred in younger infants (aged 4 weeks to < 6 months) and 24.7% (n = 20) in older infants (aged 6–11 months). The median duration of illness before pneumonia death was 8 days (interquartile range [IQR] 3–20 days). Prior to death, 91.4% (n = 74) children with pneumonia sought treatment, and of those who sought treatment, 52.7% (n = 39) sought treatment ≥ 2 days after the onset of disease. Younger infants of 4 weeks to < 6 months old were at 5.5-time (95% confidence interval [CI] 2.5, 12.0) and older infants aged 6–11 months were at 3-time (1.2, 7.5) greater risk of dying from pneumonia than older children aged 12–59 months. Children with a prolonged duration of illness (2–10 days) prior to death were at more risk for death by pneumonia than those who died from other causes (5.8 [2.1, 16.1]). Children who died from pneumonia sought treatment 3.4-time more than children who died from other causes. Delayed treatment seeking (≥ 2 days) behavior was 4.9-time more common in children who died from pneumonia than those who died from other causes. Children who died from pneumonia more often had access to care from multiple sources (5.7-time) than children who died from other causes.ConclusionsDelay in seeking appropriate care and access to multiple sources for treatment are the underlying risk factors for pneumonia death in young children in Bangladesh. These results indicate the perplexity in guardians’ decisions to secure appropriate treatment for children with pneumonia. Therefore, it further underscores the importance of focusing on mass media coverage that can outline the benefits of seeking care early in the progression of pneumonia and the potential negative consequences of seeking care late