Annals of Medicine and Surgery最新文献

{"title":"Catatonia associated with seronegative autoimmune encephalitis: a case report.","authors":"Lily Rajbhandari, Prakriti Adhikari, Anil Nepali","doi":"10.1097/MS9.0000000000003665","DOIUrl":"10.1097/MS9.0000000000003665","url":null,"abstract":"<p><strong>Introduction: </strong>Seronegative autoimmune encephalitis is a subgroup of encephalitis with suspected immunologic origin but with no identifiable pathogenic autoantibody in serum or cerebrospinal fluid (CSF).</p><p><strong>Case report: </strong>A 14-year-old girl presented with features suggestive of catatonia and altered mental status without any previous medical or psychiatric history and was subsequently diagnosed with seronegative autoimmune encephalitis. The patient showed notable improvement after immunomodulators (methylprednisolone) and lorazepam were initiated.</p><p><strong>Discussion: </strong>The absence of typical presentation along with absence of detectable serum or cerebrospinal fluid antibodies highlights the diagnostic and therapeutic challenges of autoimmune encephalitis (AE) in pediatric patients.</p><p><strong>Conclusion: </strong>The absence of detectable serum or cerebrospinal fluid antibodies does not exclude an autoimmune etiology when the clinical picture and supportive EEG findings are consistent with autoimmune encephalitis. Hence, autoimmune encephalitis should be suspected when presented with a rapid onset of psychological symptoms, and early and aggressive immunotherapy is crucial for favorable outcomes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6148-6152"},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical variants of nasal cavities and nasal septum in Nepalese patients: a retrospective cross-sectional study at a tertiary care center.","authors":"Prajwal Dahal, Sagar Poudel, Prajina Pradhan, Samjhana Ghimire, Sabina Parajuli, Natasha Dhakal","doi":"10.1097/MS9.0000000000003692","DOIUrl":"10.1097/MS9.0000000000003692","url":null,"abstract":"<p><strong>Background: </strong>Variants of nasal septum and structures of nasal cavity are key in nasal surgeries, with some linked to certain pathologies. This study aims to determine their prevalence in the Nepali population at our hospital.</p><p><strong>Method: </strong>A retrospective, cross section study was conducted at a private hospital in Nepal with 342 adults (aged >13). Two radiologists assessed CT scans for variants of nasal septum, nasal septum deviation angles, and variants of the nasal turbinates and pneumatized uncinate process. Nasal septum deviations were graded from I to IV, and gender-specific prevalences and mean nasal septal deviation (NSD) angle were calculated. Statistical significance was tested using chi-squared test, <i>t</i>-tests, and ANOVA.</p><p><strong>Results: </strong>The prevalences were: nasal septum deviation (76.68%), septal spur (41.98%), septal pneumatization (40.23%), hypertrophied inferior turbinate (38.48%), lamellar concha (34.11%), concha bullosa (CB) (19.83%), supreme turbinate (9.33%), paradoxical middle turbinates (9.33%) and pneumatized uncinate process (8.45%). Nasal septum deviation was right-sided in 34.11%, left-sided in 34.40%, and S-shaped in 8.16%. The prevalences of nasal septum types were: type I (30.9%), type II (48.1%), type III (16.91%), and type IV (4.08%). The mean septal deviation angle was 6.77° (SD 4.52°).The mean septal deviation in deviated septum was 8.64° (SD 3.2°) Significant association were found between deviated septum and septal spur, CB, hypertrophied inferior turbinate, and paradoxical middle turbinate (<i>P</i> < 0.001, 0.012, 0.001, 0.016), as well as between variants of NSD and sides of CB, hypertrophied inferior turbinate, and septal spur (<i>P</i> = 0.006, <0.001, <0.001). The prevalence of CB was significantly high in female (<i>P</i> = 0.001). There was significant association of types of nasal septum with CB (<i>P</i> = 0.003). There was significant difference in deviation angle between variants of deviated nasal septum (<i>P</i> = 0.048), notably between septum deviated to left side and \"S\"-shaped nasal septum (<i>P</i> = 0.024).</p><p><strong>Conclusion: </strong>Recognizing variants of nasal septum and nasal cavities is crucial to prevent surgical complications.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5482-5493"},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two skin closure techniques in open carpal tunnel release: a randomized controlled trial on postoperative pillar pain and scar quality.","authors":"Aidin Arabzadeh, Mohammadreza Guity, Mohammad Ayati Firoozabadi, Omid Salkhori, Seyyed Saeed Khabiri, Hamed Naghizadeh","doi":"10.1097/MS9.0000000000003672","DOIUrl":"10.1097/MS9.0000000000003672","url":null,"abstract":"<p><strong>Background: </strong>Pillar pain and scar-related discomfort are common complications following open carpal tunnel release (CTR). While surgical approaches have been widely studied, the influence of skin closure techniques on postoperative pillar pain remains unclear. This study aimed to compare the effect of two different skin closure methods, subcuticular absorbable monocryl sutures versus interrupted non-absorbable nylon sutures, on postoperative pillar pain and scar quality.</p><p><strong>Methods: </strong>In this randomized controlled trial, 128 patients who underwent open carpal tunnel release by a single surgeon were randomly assigned to one of the two groups using a computer-generated randomization sequence. Group 1 received subcuticular monocryl closure, while Group 2 received interrupted nylon sutures. Patients were evaluated at 2, 6, and 12 weeks postoperatively using the Visual Analog Scale (VAS) for pillar pain and the Patient and Observer Scar Assessment Scale (POSAS) for scar evaluation.</p><p><strong>Results: </strong>Patients in the monocryl group reported significantly lower VAS scores for pillar pain at 6 weeks (<i>P</i> < 0.05), with differences narrowing by week 12. POSAS scores also favored monocryl at early follow-up, particularly in parameters such as itching and stiffness. No major complications were observed in either group.</p><p><strong>Conclusion: </strong>Skin closure techniques may significantly affect early postoperative outcomes in CTR. Subcuticular monocryl sutures were associated with reduced pillar pain and improved scar quality in the early recovery phase, suggesting their potential advantage over conventional nylon sutures.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5542-5550"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the body roundness index and chronic pain among adults in the United States: a cross-sectional study.","authors":"Weiai Jia, Hemei Wang, Fangfang Yong, Wei Liu, Jingpu Shi, Huiqun Jia","doi":"10.1097/MS9.0000000000003683","DOIUrl":"10.1097/MS9.0000000000003683","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a significant public health concern in the United States. Obesity is associated with chronic pain. The body mass index may not accurately assess the health risks of obesity, and the body roundness index (BRI), a novel anthropometric indicator, may be more appropriate. However, the association between the BRI and chronic pain has not been validated. Therefore, this study examined the association between the BRI and chronic pain among adults in the United States.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from adult participants in the 1999-2004 National Health and Nutrition Examination Survey. Chronic pain was defined as self-reported pain lasting 3 months or more in the past year. The BRI was calculated using height and waist circumference. Multivariable logistic regression models and restricted cubic splines were used to assess the association between the BRI and chronic pain. Subgroup analyses were performed to explore confounder effects.</p><p><strong>Results: </strong>Of the 11,599 participants aged 20 years or older, 1690 (15.92%) had chronic pain. In fully adjusted models, the BRI was positively associated with chronic pain [odds ratio (OR) = 1.05, 95% confidence interval (CI) = 1.02-1.09]. Compared with participants in the lowest BRI quintile (Q1), those in the highest quintile (Q5) had an adjusted OR of 1.28 (95% CI = 1.07-1.54) for chronic pain. The multivariable restricted cubic spline showed a nonlinear association between the BRI and chronic pain. In two piecewise regression models, participants with BRI ≥ 4.63 had an adjusted OR of 1.07 (95% CI = 1.00-1.13) for chronic pain; however, no correlation was observed for participants with the BRI < 4.63. Further subgroup analyses revealed no significant interactions between these variables.</p><p><strong>Conclusion: </strong>Higher BRI was associated with an increased risk of chronic pain, indicating that the BRI was a significant risk factor. Therefore, regular monitoring and preventive measures are required to maintain optimal BRI levels and prevent chronic pain.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5454-5461"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic juvenile idiopathic arthritis, with tinea capitis and peripheral eosinophilia: a case report.","authors":"Albraa Babiker Mohammed Alameen, Anas Babiker Mohammed Elamin, Mohammedalmujtaba Gamar Abdallah Imamaldin, Mohammed Elhassan","doi":"10.1097/MS9.0000000000003660","DOIUrl":"10.1097/MS9.0000000000003660","url":null,"abstract":"<p><strong>Background: </strong>Systemic juvenile idiopathic arthritis (SJIA) is a unique subtype of juvenile idiopathic arthritis (JIA) with very special clinical manifestations, complications, and management options. The simultaneous presentation of tinea capitis and eosinophilia has not been reported in the context of Systemic Juvenile Idiopathic Arthritis before.</p><p><strong>Case presentation: </strong>A 5-year-old Sudanese boy presented with fever and bilateral ankle arthritis in a background of extensive scalp lesions, which were scaly, itchy, and associated with hair loss. On examination: his weight was on the fifth percentile. There was cervical lymphadenopathy, hepatomegaly, and signs of bilateral ankle arthritis. Complete blood counts revealed leucocytosis, thrombocytosis, mild eosinophilia, and microcytic hypochromic anemia. Anti-dsDNA was positive with equivocal ANA profile, CRP was 34.4 mg/l, and LDH was very high. The patient received antibiotics, systemic antifungal, corticosteroids, hydroxychloroquine for which he achieved good results.</p><p><strong>Discussion: </strong>These results support the diagnosis of SJIA in a background of a tinea capitis with mild eosinophilia. Several case reports described extensive dermatophytosis in the background of other autoimmune diseases. The etiology of the eosinophilia was mysterious.</p><p><strong>Conclusion: </strong>Physicians should be alert to the presentation of systemic JIA. The association between SJIA, tinea capitis, and eosinophilia remained largely mysterious, and multicenter studies are needed to explore this further.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6181-6185"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory blood markers in breast cancer: a narrative review from early detection to therapy response.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003687","DOIUrl":"10.1097/MS9.0000000000003687","url":null,"abstract":"<p><p>Breast cancer remains the most frequently diagnosed malignancy among women worldwide, with early detection and accurate prognostication crucial for improving survival outcomes. While imaging and histopathological analyses are standard diagnostic tools, there is growing interest in cost-effective, minimally invasive biomarkers that can complement existing modalities - particularly in resource-limited settings. This narrative review explores the role of inflammatory blood markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII), in breast cancer detection, prognosis, and monitoring of therapeutic response. These markers, derived from routine complete blood counts, reflect the systemic immune landscape and are increasingly associated with tumor progression, treatment resistance, and survival. We also highlight the limitations of these markers, particularly their non-specificity, and compare their utility with established diagnostic and molecular techniques. While not diagnostic alone, these inflammatory indices may serve as adjuncts in clinical decision-making and merit further validation in prospective studies.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5906-5911"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emphasizing the role of cardiothoracic surgeons within the global health context: a call to action.","authors":"Achanga Bill Smith Anyinkeng, Abdullah K Alassiri, Jonas L Ibekwe, Efuetlateh John Paul Nchonganyi, Samuel G Junior Fodop, Effiom Victory Bassey, Kelechi E Okonta","doi":"10.1097/MS9.0000000000003678","DOIUrl":"10.1097/MS9.0000000000003678","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, cardiovascular thoracic diseases (ischemic heart diseases) are the second most common global cause of disability-adjusted life years (DALYs. Globally, 17 million lives are lost annually, and 80% occur in LMICs as a result of CVD, and 75% of the world lacks access to cardiac surgery with some regions (Sub-Saharan Africa) having 0.07 pediatric cardiac surgeons and 0.12 adult cardiac surgeons per million population. This is a global cause for concern and needs immediate attention.</p><p><strong>Method: </strong>Through literature review, we elaborate on key points such as the global burden of cardiothoracic surgical diseases, the current status of cardiothoracic surgical care around the world, and the inherent benefits of building a strong cardiothoracic surgical care capability for health systems globally. Search engines used were: PUBMED, SCOPUS, MEDLINE, Cochrane, and Google Scholar.</p><p><strong>Results: </strong>Cardiothoracic diseases make up an important part of the global health burden of diseases as cardiothoracic care can be linked to over 15 of the 17 Sustainable Development Goals, giving the tremendous part played by cardiothoracic surgeons in the Health System Surgical Initiatives.</p><p><strong>Conclusion: </strong>We, therefore, recommend policymakers and global health actors: increase the involvement of cardiothoracic surgeons within the global health systems and dialogues; integrate and enforce cardiothoracic surgical care within the global surgery movement; and most importantly promote the training and education of cardiothoracic surgeons in LMICs in the field of global public health and as well involve cardiothoracic surgeons in the national surgical system strengthening process.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5887-5891"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac tamponade with scleroderma renal crisis in systemic sclerosis: a case report.","authors":"Suraj Shrestha, Roshan Aryal, Suman Acharya, Khagendra Shrestha, Anuradha Twayana","doi":"10.1097/MS9.0000000000003646","DOIUrl":"10.1097/MS9.0000000000003646","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibrosis of internal organs and vasculopathy. It commonly involves the skin and multiple organs, including the kidneys and cardiovascular system. Cardiac tamponade in SSc is an uncommon manifestation, often occurring alongside scleroderma renal crisis (SRC).</p><p><strong>Case presentation: </strong>A 50-year-old woman presented with sudden shortness of breath, chest pain, and reduced urine output. Diagnostic tests revealed a large pericardial effusion leading to cardiac tamponade, acute kidney injury, and microangiopathic hemolytic anemia. Clinical assessment and immunological testing confirmed the diagnosis of systemic sclerosis. The patient received pericardiocentesis, hemodialysis, and was treated with diuretics and angiotensin-converting enzyme inhibitors (ACEIs).</p><p><strong>Discussion: </strong>Pericardial effusion is frequently seen in SSc, but it is difficult to determine whether it directly contributes to or results from SRC. Early diagnosis and the use of ACEIs have shown promising benefits in managing SRC.</p><p><strong>Conclusion: </strong>This case underscores the rare yet critical presentation of SSc with concurrent cardiac tamponade and SRC, emphasizing the importance of early diagnosis and multidisciplinary management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6163-6167"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial hemorrhage in posterior reversible encephalopathy syndrome: a systematic review and meta-analysis.","authors":"Bahadar S Srichawla, Mihnea-Alexandru Găman, Hande Can, Vincent Kipkorir, Maria A Garcia-Dominguez","doi":"10.1097/MS9.0000000000003676","DOIUrl":"10.1097/MS9.0000000000003676","url":null,"abstract":"<p><strong>Background: </strong>Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiographic phenomenon characterized by vasogenic edema, predominantly affecting the posterior regions of the brain. The hemorrhagic variant of PRES has been increasingly recognized, complicating the clinical picture and prognosis.</p><p><strong>Methods: </strong>This meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Observational studies and case reports/series were included. Extracted data included demographics, clinical presentations, imaging findings, and outcomes. A random-effects model to pool the incidence rate of hemorrhagic PRES and heterogeneity was assessed using the I² statistic. The Joanna Briggs Institute scale for case reports/series and the Newcastle-Ottawa scale for cohort studies were used for quality and risk of bias assessment.</p><p><strong>Results: </strong>A total of 63 individual records and 12 cohort studies were reviewed. Hypertension at arrival was seen in > 90% of cases. Overall, 60.3% of cases occurred in women and the average age was 39.3, with a 12.7% mortality rate. The incidence rate of hemorrhagic PRES was found to be approximately 17%, with significant heterogeneity among the included studies (I² = 67%). Seizures (31.7%), headaches (33.3%), and altered mental status (30.1%) were the most reported symptoms. Hypertension (31.7%), immunosuppressive therapy (23.8%), and coagulopathy (11.1%) were identified as the most common risk factors. Hemorrhagic findings included intraparenchymal hemorrhage (77.7%), subarachnoid hemorrhage (15.8%), and microhemorrhages (6.3%).</p><p><strong>Conclusions: </strong>Hemorrhagic PRES is a significant clinical concern, occurring in approximately 17% of PRES cases, and is often associated with poorer outcomes. We highlight the importance of early recognition, aggressive blood pressure control, and careful monitoring in high-risk patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"6023-6032"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of current practice of antimicrobial use and clinical outcome in the management of pneumonia among pediatric patients admitted to Jimma Medical Center, Southwest Ethiopia: a prospective observational study.","authors":"Abduba Wariyo Guyo, Berhanu Teshome Derese","doi":"10.1097/MS9.0000000000003690","DOIUrl":"10.1097/MS9.0000000000003690","url":null,"abstract":"<p><strong>Background: </strong>Inappropriate use of antibiotics is one of the major contributing factors for the development of antibiotic resistance, threatening the effective prevention and treatment of common infections. Appropriate antimicrobial use is the cornerstone for curbing antimicrobial resistance and achieving good clinical and economic outcomes. The issues of appropriate antimicrobial use are of critical importance to the global community.</p><p><strong>Objectives: </strong>To evaluate the current practices of antimicrobial utilization and outcomes in the management of Pneumonia among pediatric patients admitted to the hospital.</p><p><strong>Method: </strong>A prospective observational study design was conducted on children admitted to the pediatric wards of the hospital. The study was conducted from 3 February 2022 to 3 June 2022, and patients aged <18 years and diagnosed with pneumonia were included. A chart review supplemented by a self-administered questionnaire was used to collect data. Descriptive statistics and binary logistic regressions were performed for data analyses.</p><p><strong>Results: </strong>Among the total of 146 patients, 61.6% were male, and the mean age was 40.95 (+47.61) months. Treatment approaches in all were empirical and no de-escalation therapy was made even after culture results. Ceftriaxone was the most commonly prescribed antimicrobial. Patients' outcomes included a clinical cure rate of 65.1%, an in-hospital mortality rate of 7.5%, and a complication rate of 27.3%. Poor clinical outcome was associated with recent antimicrobial use (AOR = 3.87; 95% CI:1.34-11.16; <i>P</i> = 0.012), antimicrobial changed (AOR = 3.74; 95% CI: 1.522-9.22; <i>P</i> = 0.004), and longer hospital stay (>10 days) (AOR = 6.00; 95% CI: 2.53-14.22; <i>P</i> = 0.029) were all independent predictors of poor clinical outcome in treatment of pneumonia.</p><p><strong>Conclusion: </strong>Antimicrobials were prescribed empirically without sufficient evidence of indication such as microbiological and radiologic findings. The practice also is not based on local guidelines and has no multidisciplinary approach in management. These factors likely contributed to higher rates of poor outcomes (more than one-fourth of the patients) when compared with similar studies in other countries. Therefore, these observations need the hospital's establishment of an antimicrobial stewardship program centered on fundamental strategies in pediatrics, including preauthorization, prospective audits with feedback, and pharmacist-led interventions that are feasible and accepted in the inpatient setting as soon as possible.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 9","pages":"5470-5481"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}