1.Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
Mohamad SHIEB ; Rand HASANAIN ; Zara ARSHAD ; Faisal A. NAWAZ ; Rahul KASHYAP ; Eric J. STERN
Clinical and Experimental Pediatrics 2024;67(9):427-434
Bacterial bloodstream infections (BSI) are the leading cause of mortality and morbidity in pediatric solid organ transplant recipients. This systematic review aimed to pool global data from leading transplant institutions and identify the overall incidence, risk factors, and causative organisms of BSI in pediatric liver transplant recipients. A systematic review of the PubMed and OVID databases was conducted from 2000 to 2022. The initial search yielded 252 unique articles, which were independently reviewed by 2 authors. Articles that reported pediatric-specific data on BSI in isolated liver transplant patients were included, including the incidence of BSI, isolated organisms, and involved risk factors involved. This systematic review was registered with PROSPERO (ID: CRD42023403206). Fourteen articles from the United States, France, Iran, Japan, Korea, South Africa, Thailand, and Turkey were included. A total of 4,812 liver transplants were included in the final analysis. The mean patient age was 25 months (age range, 0–18 years), and 50.9% were male. The overall incidence of BSI was 23.5% (range, 14.7%–55%). The most commonly reported organisms were Staphylococcus epidermidis, Enterococcus, Klebsiella spp., and Escherichia coli. Among the risk factors studied, postope rative biliary complications, a medical history of biliary atresia, and younger age were the risk factors most commonly associated with BSI. Bacterial BSI after pediatric liver transplantation occur at a high incidence, with a unique organism profile notable for a higher percentage of gram-negative organisms. Further studies are required to determine the most appropriate prophylactic and empirical antibiotic management strategies for this population.
2.Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
Mohamad SHIEB ; Rand HASANAIN ; Zara ARSHAD ; Faisal A. NAWAZ ; Rahul KASHYAP ; Eric J. STERN
Clinical and Experimental Pediatrics 2024;67(9):427-434
Bacterial bloodstream infections (BSI) are the leading cause of mortality and morbidity in pediatric solid organ transplant recipients. This systematic review aimed to pool global data from leading transplant institutions and identify the overall incidence, risk factors, and causative organisms of BSI in pediatric liver transplant recipients. A systematic review of the PubMed and OVID databases was conducted from 2000 to 2022. The initial search yielded 252 unique articles, which were independently reviewed by 2 authors. Articles that reported pediatric-specific data on BSI in isolated liver transplant patients were included, including the incidence of BSI, isolated organisms, and involved risk factors involved. This systematic review was registered with PROSPERO (ID: CRD42023403206). Fourteen articles from the United States, France, Iran, Japan, Korea, South Africa, Thailand, and Turkey were included. A total of 4,812 liver transplants were included in the final analysis. The mean patient age was 25 months (age range, 0–18 years), and 50.9% were male. The overall incidence of BSI was 23.5% (range, 14.7%–55%). The most commonly reported organisms were Staphylococcus epidermidis, Enterococcus, Klebsiella spp., and Escherichia coli. Among the risk factors studied, postope rative biliary complications, a medical history of biliary atresia, and younger age were the risk factors most commonly associated with BSI. Bacterial BSI after pediatric liver transplantation occur at a high incidence, with a unique organism profile notable for a higher percentage of gram-negative organisms. Further studies are required to determine the most appropriate prophylactic and empirical antibiotic management strategies for this population.
3.Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
Mohamad SHIEB ; Rand HASANAIN ; Zara ARSHAD ; Faisal A. NAWAZ ; Rahul KASHYAP ; Eric J. STERN
Clinical and Experimental Pediatrics 2024;67(9):427-434
Bacterial bloodstream infections (BSI) are the leading cause of mortality and morbidity in pediatric solid organ transplant recipients. This systematic review aimed to pool global data from leading transplant institutions and identify the overall incidence, risk factors, and causative organisms of BSI in pediatric liver transplant recipients. A systematic review of the PubMed and OVID databases was conducted from 2000 to 2022. The initial search yielded 252 unique articles, which were independently reviewed by 2 authors. Articles that reported pediatric-specific data on BSI in isolated liver transplant patients were included, including the incidence of BSI, isolated organisms, and involved risk factors involved. This systematic review was registered with PROSPERO (ID: CRD42023403206). Fourteen articles from the United States, France, Iran, Japan, Korea, South Africa, Thailand, and Turkey were included. A total of 4,812 liver transplants were included in the final analysis. The mean patient age was 25 months (age range, 0–18 years), and 50.9% were male. The overall incidence of BSI was 23.5% (range, 14.7%–55%). The most commonly reported organisms were Staphylococcus epidermidis, Enterococcus, Klebsiella spp., and Escherichia coli. Among the risk factors studied, postope rative biliary complications, a medical history of biliary atresia, and younger age were the risk factors most commonly associated with BSI. Bacterial BSI after pediatric liver transplantation occur at a high incidence, with a unique organism profile notable for a higher percentage of gram-negative organisms. Further studies are required to determine the most appropriate prophylactic and empirical antibiotic management strategies for this population.
4.Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
Mohamad SHIEB ; Rand HASANAIN ; Zara ARSHAD ; Faisal A. NAWAZ ; Rahul KASHYAP ; Eric J. STERN
Clinical and Experimental Pediatrics 2024;67(9):427-434
Bacterial bloodstream infections (BSI) are the leading cause of mortality and morbidity in pediatric solid organ transplant recipients. This systematic review aimed to pool global data from leading transplant institutions and identify the overall incidence, risk factors, and causative organisms of BSI in pediatric liver transplant recipients. A systematic review of the PubMed and OVID databases was conducted from 2000 to 2022. The initial search yielded 252 unique articles, which were independently reviewed by 2 authors. Articles that reported pediatric-specific data on BSI in isolated liver transplant patients were included, including the incidence of BSI, isolated organisms, and involved risk factors involved. This systematic review was registered with PROSPERO (ID: CRD42023403206). Fourteen articles from the United States, France, Iran, Japan, Korea, South Africa, Thailand, and Turkey were included. A total of 4,812 liver transplants were included in the final analysis. The mean patient age was 25 months (age range, 0–18 years), and 50.9% were male. The overall incidence of BSI was 23.5% (range, 14.7%–55%). The most commonly reported organisms were Staphylococcus epidermidis, Enterococcus, Klebsiella spp., and Escherichia coli. Among the risk factors studied, postope rative biliary complications, a medical history of biliary atresia, and younger age were the risk factors most commonly associated with BSI. Bacterial BSI after pediatric liver transplantation occur at a high incidence, with a unique organism profile notable for a higher percentage of gram-negative organisms. Further studies are required to determine the most appropriate prophylactic and empirical antibiotic management strategies for this population.
5.Results of a Standard versus an Accelerated Ponseti Protocol for Clubfoot: A Prospective Randomized Study
Mir Shahidul ISLAM ; Qazi Manaan MASOOD ; Arshad BASHIR ; Faisal Y SHAH ; Manzoor A HALWAI
Clinics in Orthopedic Surgery 2020;12(1):100-106
BACKGROUND:
The aim of this study was to compare the results of the standard once-weekly Ponseti casting technique to an accelerated twice-weekly regimen in our population cohort.
METHODS:
A prospective randomized controlled study was conducted with a total of 100 consecutive patients (158 feet) being enrolled for the study. Fifty patients were randomized to each group and followed up for at least one year.
RESULTS:
Initial mean Pirani score was 4.67 ± 0.73 in the standard group and 4.35 ± 0.76 in the accelerated group, and the score decreased to 0.34 ± 0.38 and 0.35 ± 0.31, respectively. Initial mean Dimeglio score was 11.75 ± 2.75 in the standard group and 10.51 ± 2.57 in the accelerated group, and the score decreased to 0.79 ± 0.77 and 0.79 ± 0.71, respectively, immediately after casting. The average number of casts required to correct all the deformities was 6.3 ± 1.2 in the standard group and 6.1 ± 1.4 in the accelerated group (p = 0.45). Average time spent in cast was 58.2 ± 8.3 days in the standard group and 39.5 ± 5.2 days in the accelerated group (p < 0.001). Percutaneous Achilles tendon tenotomy was done in 86.42% in the standard group and in 84.41% in the accelerated group (p = 0.72). Final results were assessed by using a modified functional rating scoring system: 55.55% clubfeet had excellent results and 44.45% had good results in the standard group, whereas 66.23% clubfeet had excellent results and 33.77% had good results in the accelerated group. None amongst the two groups had fair or poor results.
CONCLUSIONS
These results suggest that the accelerated Ponseti technique significantly reduces the correction time without affecting the final results and that it is as safe and effective as the traditional Ponseti technique.
6.Orbital Metastasis as The Initial Presentation of Breast Cancer
Hayatulrizal Muhd ; Hanis Zuhaimy ; Mohamad Fathi Ismail ; Faisal Arshad ; Siti Norhafiza Mohamad Azmi ; Norren Haneezah Sahak
Malaysian Family Physician 2020;15(3):74-78
Breast cancer is the most common cancer
among the female population of Malaysia, with
an average lifetime risk of 31.1%.1
Typical sites
for metastasis of the breast carcinoma include
the bones, liver, lungs, skin, and brain. In most
cases, breast cancer is diagnosed first, but in 12-
31% of the cases like in this case, the metastasis
appear first as the initial presentation. In this
case, we reported a case of a healthy young
woman who presented with orbital metastasis as
the initial presentation of breast cancer.