جستجوی مقالات مرتبط با کلیدواژه « infections » در نشریات گروه « پزشکی »

Common parasites that can cause gastrointestinal diseases in humans include Entamoeba histolytica and Giardia lamblia. These parasites are abundant in Iraq’s Southern Governorates, while exact statistics on prevalence rates may be lacking. Inadequate sanitation, contaminated drinking water, and poor personal hygiene all help to transmit these parasites. The aim of the study was to determine the prevalence of E. histolytica and G. lamblia in the Southern Governorates.

From January 2022 to December 2022, this study conducted a retrospective cohort study using the data from patients seeking medical care in hospitals and health centers in Iraq’s Southern Governorates. Microscopic inspection verified the diagnosis. The data were analyzed using the age groups, gender, season, and geographic dispersion.

G. lamblia was significantly outnumbered by E. histolytica across each province. Wasit Governorate has the most E. histolytica at 26.6%, whereas Maysan has 8.4% G. lamblia. All the seasons showed a greater incidence of E. histolytica, while spring showing the biggest variation (27.1%). E. histolytica outnumbered G. lamblia in all age groups, particularly among children aged 1–4 (31.3% vs. 3.6%) years. Males were more likely than females to have E. histolytica (58.96%) and G. lamblia (41.04%).

Through microscopic examination, this study detected G. lamblia and E. histolytica infections in 2000 patients. Geographical location, age, and gender all had an impact on the incidence of those diseases, which differed throughout the Southern Governorates of Iraq.

Given the alterations in definitions and the varied, at times entirely contradictory results, the need for new studies regarding the factors influencing the occurrence of Surgical Site Infections (SSIs) is increasingly felt. This study aims to investigate the role of prophylactic antibiotics in reducing surgical site infections (SSIs) following Laparoscopic Cholecystectomy (LC) in low-risk patients.

In this clinical trial, 120 patients underwent laparoscopic cholecystectomy as per the inclusion criteria. Between September 2021 and May 2022, within the Department of Surgery at Birjand Medical University, candidates slated for elective laparoscopic cholecystectomy were systematically allocated into two distinct groups: one receiving prophylactic antibiotics and the other not. The principal outcome measured was the incidence of postoperative infectious complications. Data were analyzed in SPSS (Version 23) software using Mann-Whitney, t-test, Fisher's Exact, and Chi-square tests. The level of significance was set to P <0.05.

A total of 120 patients underwent laparoscopic cholecystectomy, divided into two groups: 59 received preoperative prophylactic antibiotics (Antibiotic Group, AG) and 61 did not (No Antibiotic Group, NAG), with no significant differences in clinical characteristics like gender, age, body mass index (BMI) and operation times. Surgical site infection (SSI) occurred in two patients (3.4%) in the AG and four patients (6.7%) in the NAG, with no significant overall difference in SSI incidence between the groups (P=0.679). The study found no significant differences in preoperative WBC, hemoglobin, or creatinine levels between patients with and without SSI, indicating similar preoperative conditions across both groups.

The outcomes of our study revealed no substantial disparities between patients administered prophylactic antibiotics and those not during laparoscopic cholecystectomy (LCC). Consequently, the utilization of prophylactic antibiotics in elective LCC is not requisite for low-risk patients.

Microemulsions (MEs) and nanoemulsions (NEs) are dispersions of two immiscible liquids which are usually transparent/translucent. Several reports are available on uses of MEs/NEs to increase efficacy of the loaded active ingredient(s) in topical dosage forms. This review aims to describe brief applications of MEs/NEs in common skin diseases as well as skincare products. Advantages of MEs/NEs in comparison with the traditional bulk form, including their improved efficacy and safety, have been discussed to highlight the importance of use of such delivery systems. The review briefs mechanism of action of MEs/NEs in enhancing delivery of the cargo. Furthermore, applications of MEs/NEs in common skin diseases including infectious rashes, pigmentation disorders (hyperpigmentaion and hypopigmentation), wound healing, skin cancers and scaling patches and plaques/papulosquamous disorders (psoriasis, atopic dermatitis and acne) have been discussed. MEs/NEs in skin care products have also been reviewed here.

Leishmania spp. protozoa cause leishmaniasis by infecting macrophages. Long non-coding RNAs (lncRNAs), such as H19, Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT), HOX Antisense Intergenic RNA (HOTAIR), and TNF and HNRNPL Related Immuno-regulatory lncRNA (THRIL), play a role in macrophage polarization and gene regulation. Additionally, leukocytes can synthesize and respond to melatonin, yet the regulatory role of melatonin in Leishmania major-infected macrophages is not well understood.

This study aimed to assess the impact of melatonin on the expression of lncRNAs like H19, MALAT, HOTAIR, and THRIL, as well as on nitric oxide synthase (NOS) activity in L. major-infected macrophages.

Leishmania major promastigotes and U937 cell lines were cultured. Macrophages were infected with the promastigotes and subsequently treated with melatonin at concentrations of 3, 10, 30, and 100 nM for durations of 4, 24, and 48 hours. The expression levels of the lncRNAs and NOS activity were measured using quantitative Polymerase Chain Reaction (q-PCR) and spectrophotometry, respectively.

Melatonin treatment (100 nM) significantly increased the expression of H19 compared to the control after 48 hours (P = 0.002). There was also a significant upregulation of MALAT and HOTAIR in macrophages treated with 3 nM melatonin compared to controls after 48 hours (P = 0.02 and P = 0.003, respectively). Additionally, THRIL expression significantly increased in the melatonin group (10 nM) compared to the control after 4 hours of treatment (P = 0.003). An increase in NOS activity was observed in the melatonin group (100 nM) compared to the control at 4 hours, 24 hours, and 48 hours (P = 0.034, P = 0.011, and P = 0.014, respectively).

The findings suggest that melatonin may enhance the expression of H19, THRIL, MALAT, and HOTAIR, as well as NOS activity in macrophages infected with L. major. The upregulation of these lncRNAs by melatonin could potentially improve the macrophages' ability to combat L. major infection.

Candida species can produce a variety of clinical manifestations, and several non-albicans species of Candida, including Candida auris, have been linked to the rise of invasive fungal infections with high rates of treatment failure. Nosocomial outbreaks and high mortality rates in healthcare institutions across the globe have been associated with C. auris, an emerging infectious yeast that was initially discovered in the ear canal of an elderly Japanese patient in 2009. The fact that C. auris has been found on six continents after it was initially isolated has raised serious concerns among scientists and healthcare practitioners.  At present, healthcare facilities lack defined protocols for the effective prevention and control of C. auris infections, as well as appropriate treatment alternatives. This leads to frequent therapeutic failures and complicates the eradication of C. auris infection in healthcare facilities. Studies on C. auris in South India are often limited, and healthcare workers urgently need to be made aware of infections caused by it in order to assess its impact and possible implications for the healthcare system. This study aimed to report seven patients hospitalized in our center who developed C. auris infections with varying clinical manifestations.

 Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP) in children and adolescents. Identifying the incidence and severity of this infection in individuals under the age of 18 can assist in improving the treatment and prevention process.

The present study aimed to evaluate the frequency of M. pneumoniae infection in young patients through a systematic review and meta-analysis.

Three major databases (Medline (via PubMed), Embase, and Web of Science) were searched for research about M. pneumoniae infection in children. STATA (version 14) software was used to interpret the data.

Seventy-seven studies fulfilled the eligibility criteria to evaluate the prevalence of M. pneumoniae infection among children. The prevalence of this infection in young patients was 22.5%. The results revealed that children and adolescents in the age range of 10‒18 years old had the highest prevalence of M. pneumoniae (23.1%, 95% confidence interval [CI]=6.7‒39.4), followed by the 5‒10-year-old age group (21.6%, 95% CI=17.9‒25.3] and the under 5-year group (20.9%, 95% CI=16.7‒25.1).

The global rate of M. pneumoniae infection has been gradually increasing since 2001. Finally, more extensive studies on the prevalence of M. pneumoniae infections in children throughout the world are needed to assess its exact prevalence and antibiotic resistance trend.

Newborns as a vulnerable population are exposed to congenital and acquired infections during and after birth. There are several reports of the isolation and reporting of infectious agents (IAs) in early life of newborns with respiratory manifestations, and the present comprehensive study provides a snapshot of the current global situation of the prevalence of IAs in newborns with respiratory symptoms.

A systematic search was conducted in main databases, including PubMed, Scopus, Web of science, and Google scholar. The pooled prevalence of infectious agents (IAs) in newborns was estimated using comprehensive me- ta-analysis software based on random effects model.

Out of 44 inclusive studies (50 datasets) for IAs in newborns, the pooled prevalence was estimated to be 12.2% (95% CI: 6.40-22.0%) and the highest and lowest prevalence of IAs was related to the Brazil (78.2%, 95% CI: 31.0-96.6%), and UK (0.01%, 95% CI 0.01-0.01%) respectively.

The high prevalence of IAs in newborns emphasizes considers the necessary measures to prevent respiratory infections.

Based on reported evidence of an outbreak incidence of highly pathogenic avian influenza (HPAI) in Qom province, this study aimed to evaluate the environmental risk factors in the outbreak of avian influenza infection in this province to provide essential data for developing effective interventions in infection control.

The cross-sectional method was predicted and implemented in two specific phases. In the primary phase of the study, the necessary criteria were extracted using a questionnaire. In another part of the study, the characteristics and spread of the infection in Qom province were evaluated by DotMapper software.

From a total of 175 investigated farms, 95 farm units (54%) were infected and were positive for AI. The results showed that at least one of the environmental risk factors was not controlled in 86% of laying poultry farms and 66% of broiler poultry farms, according to the questionnaire. The findings of statistical analyses for the evaluation of environmental risk factors affecting AI infection in poultry farm units indicate that sanitary land disposal of infected poultry carcasses, waste and manure of birds (odds ratio [OR] = 1.02), complete quarantine and installation of warning signs in contaminated areas (OR = 0.55), the existence of facilities and performance decontamination, as well as the use of effective disinfectants for the disinfection of ventilators, disinfection of poultry vehicles, and equipment and manure of birds (OR = 0.33) have a considerable association with AI infection on poultry farms in Qom province.

Our findings revealed that control and monitoring of environmental risk factors as part of an effective surveillance system for the AI virus are key processes for the propagation and contribute to the spread of the infection.

 Coronavirus disease 2019 (COVID-19) manifestations are highly diverse, potentially affecting nearly all organ systems during or after infection. Given the importance of a thorough assessment of COVID-19.

 Our study aimed to investigate any new onset or worsening lower urinary tract symptoms (LUTS) in patients infected with COVID-19.

 In this cross-sectional study, 88 COVID-19 patients completed the International Consultation on Incontinence Questionnaire-Overactive Bladder and the Overactive Bladder Symptom Score Questionnaires (OABSS). The patients assessed stress urinary incontinence (SUI) and difficulty voiding.

 Our study revealed that urinary symptoms were the only initial symptom for 28 (31.8%) of the patients or part of the initial symptoms. Furthermore, new onset of OAB symptoms was noted in 35 (39.8%) patients; worsening of pre-diagnosed OAB symptoms was noted in 4 (4.5%) patients; new onset SUI was reported in 17 (32.7%) women, and voiding dysfunction was reported in one woman and two men. There was no significant difference in demographic characteristics, laboratory tests, and lung involvement between patients with and without LUTS (P > 0.05). However, new onset or worsening LUTS significantly (P < 0.001) affected the quality of life.

 This study demonstrated that LUTS could be the only symptom or one of the initial symptoms of COVID-19. Therefore, physicians should consider COVID-19 as a differential diagnosis in patients presenting with these symptoms.

With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, many people were affected worldwide.This study evaluated patients’ characteristics and skin diseases at a Dermatology Emergency Unit (DEU) of a university skin hospital in Tehran, Iran, during the COVID-19 pandemic. We also compared the results with those of a previous study performed at the same DEU in 2017. The data of all patients presented to the DEU during the first four months of the pandemic in Iran (February to June 2020) were studied, and variables such as age, sex, complaints, and finaldiagnosis were collected. A total of 3,745 patients (50.3% male) were studied. Infections (32.4%), dermatitis (20.5%), and urticaria (16.8%) were the most prevalent diagnoses in both genders. Infections were significantly more frequent in males (P < 0.001), while urticaria was more common in females (P < 0.001). The highest number of visits occurred between 12:00–18:00 (34.0%) and most patients were between 18–44 years old (48.8%). With the growing number of COVID-19 cases, the DEU of our skin hospital was involved as part of the medical community in screening COVID-19 patients. Compared to the previous study, the general framework of common causes of DEU visits was very similar to that of the non-pandemic era, although a significant increase in the proportion of dermatitis cases was observed. Likewise, the proportion of non-skin complaints was significantly higher, reflecting the public concern about the COVID-19 pandemic.

The present study aimed to compare the clinical outcome as well as laboratory and clinical profiles of Coronavirus disease 2019 (COVID-19) patients with and without diabetes.

The present study is a retrospective study that included 266 non-diabetic and 259 diabetic patients who were admitted to a tertiary healthcare center in South India between March 2021 to April 2021.The objective of the study was to compare the clinical outcome and laboratory profiles of COVID-19 patients with and without diabetes. Patients aged 18 years or above, diagnosed with COVID-19 by either RT-PCR and/or HRCT chest as well as diagnosed to be diabetic or non-diabetic were included in the study. After observing inclusion and exclusion criteria, the study included patients whose medical records were scrutinized, and data was analyzed using SPSS v 28.0 and the continuous variables were expressed in mean, standard deviation, minimum and maximum value. The categorical variables are expressed in frequency and percentage. Comparison was done using binomial test and Mann-Whitney U test while association was tested using Fischer exact test.

Primary outcomes show that higher number of patients with diabetes (84.94%) presented with abnormal Interleukin-6 (IL-6) levels and this difference was found to a statistically significant (p<0.001). Hypertension was the most common comorbidity among both diabetic (46.72%) and non-diabetic (33.52%) patients and it was shown to be associated with clinical outcome and oxygen requirement (p<0.001). A significant difference was observed in the mean score of age, total count, IL-6 and number of days admitted between COVID-19 subjects of both groups with the mean being higher in the group of patients with diabetes (p<0.001).

The results of the present study reinforce available evidence that IL-6 levels can be used to ascertain progression, morbidity, and mortality to ensure proper management of COVID-19 patients and that diabetes state results in higher total count, IL-6 and number of days admitted.

The ongoing global health crisis caused by the infectious coronavirus disease, known as COVID-19, is attributed to the SARS-CoV-2 virus. The pandemic has significantly impacted people of all ages and nationalities and has spread across all continents, with an initial focus on Asia and subsequently reaching Europe. The objective of this study was to analyze the progression of COVID-19 in Europe in contrast to other continents around the world by examining the pandemic's trajectory across different geographic areas, allowing us to gain insights into the effectiveness of containment measures, and identifying potential patterns of virus spread.

The data source was a curated dataset provided by Our World in Data (OWD), regularly updated during the COVID-19 pandemic. The dataset consisted of 207,316 records with 67 attributes, covering 244 locations, including countries from six continents. These attributes encompassed a wide range of COVID-19-related metrics, such as cases, deaths, testing, vaccinations, and demographic indicators. This comprehensive comparative study specifically focused on the European continent data from January 01, 2020, to August 08, 2022.

The analysis revealed distinct groups of European countries with different experiences with the virus. First, some countries were found to be severely affected by the virus, grappling with higher case numbers and mortality rates. On the other hand, some countries were able to successfully manage the virus spread. Additionally, there was a group with significant case numbers but relatively lower mortality rates. Finally, certain countries effectively limited the virus transmission while maintaining low mortality rates.

As the pandemic continues, it is essential to emphasize the significance of international data to develop comprehensive strategies against severe health crises. Evaluating different outcomes across continents and within specific regions could provide crucial insights to guide future control measures. However, the fight against COVID-19 is far from over, necessitating ongoing research and cooperation on a global scale.

COVID-19 is a respiratory disease pandemic and a major global health problem that can cause acute respiratory distress syndrome (ARDS). Previous studies have shown an inverse link between toxoplasmosis and COVID-19. This study aimed to evaluate the association between COVID-19 and toxoplasmosis infection.

In this cross-sectional descriptive study, samples were taken from 360 patients, 50% of whom were men and 50% were women. Of the patients, 180 were determined to be COVID-19-positive by the ELISA kit, and 180 were in the control group. Some demographic characteristics, such as sex, age range, and occupation, were also recorded.

This study was conducted on 180 COVID-19-positive patients, of whom 26.7% were in the 16-30-year age group, 25.1% were self-employed, and 31.7% had anti-Toxoplasma gondii antibodies. Among the 180 control patients, 21.1% had antibodies for T. gondii. Of the 57 patients who were co-infected with both COVID-19 and toxoplasmosis, men had higher infection rates (63.2%) than women (36.8%). There was a significant relationship between co-infections with COVID-19 and toxoplasmosis with occupation, but not with age.

The study found that people with toxoplasmosis infection have a 1.73 times higher risk of contracting COVID-19. The findings suggest that infectious agents could be a predisposing factor, possibly due to changes in cytokine levels.

The management of critically-ill individuals in intensive care units (ICU) is complex. Immobility, pharmacological treatments, and reduced perfusion lead to compromised skin integrity, predisposing to complications like infections and allergies. The presence of dermatological disorders (DDs) may influence management strategies, the patient’s quality of life, duration of ventilation, length of hospitalization, and rate of mortality. Hence, it is critical to analyze the predictors of DDs among ICU inpatients.

To determine the prevalence of DDs in ICUs, classify them, and analyze their associated parameters.

Patients admitted to Medicine/Neonatal/Paediatric ICUs were enrolled in this hospital-based cross-sectional study conducted over two months at a tertiary care hospital. Patients with pre-existing DDs not leading to admission were excluded. The screening was initiated within 48 hours of admission, continued daily throughout the ICU stay, and terminated on discharge from the ICU, in the case of patient death or at the end of the data collection period. Requisite information was recorded using a predesigned proforma.

Out of 688 patients screened, 129 were found to have 136 skin lesions, with an overall prevalence of 18.9%; MICU had the highest prevalence (22.7%), followed by NICU (17.3%) and PICU (12%). Skin lesions were classified into seven major categories. A significant association was found between the type of dermatological disorder and age, the presence of comorbidity, and the route of admission (P-value < 0.05).

This study identified modifiable predictors associated with DDs among ICU inpatients. Infectious disorders constituted the foremost category in children, and iatrogenic disorders were predominant in adults. More comprehensive prospective studies are needed to fully understand the impact of DDs on the prognosis and outcome of ICU patients.

Vaccination against COVID-19 for people with multiple sclerosis (PWMS) has been recommended, but long-term follow-up needs further research.

To follow up PWMS 3 months after vaccination with the Sinopharm vaccine regarding the relapse of MS and infection with COVID-19.

The participants in this prospective study were PWMS over 18 years of age living in Kermanshah Province, Iran, who received two doses of the Sinopharm vaccine between August and November 2021. The information on demographic and clinical characteristics of PWMS, COVID-19 infection, and relapses of MS 3 months after vaccination, were collected. We contacted the patients using the information registered in the MS registry system of Kermanshah Province, and the study data were collected by phone call and using a researcher-made questionnaire.

Overall, 197 MS patients with a Mean±SD age of 41.84±11.0 years, including 155(78.7%) females and 42(21.3%) males were studied. There was no significant difference (P=1.000) in MS relapse frequency between the time points of 3 months before the first dose (15[7.6%]) and 3 months after the second dose (15[7.6%]). The frequency of infection with COVID-19 within 3 months after the second dose (26[13.2%]) was significantly (P=0.017) higher than that in the 3 months before the first dose (12[6.1%]). Within 3 months after the second dose, most PWMS with MS relapse or COVID-19 infection used oral and anti-CD20 therapy.

During the 3 months after the second dose, the frequency of MS relapse was not different, but the frequency of COVID-19 infection was higher.

Listeria is a bacterial genus that is widely distributed in fish and fishery products and is a vehicle for food-borne bacterial infections and intoxications. Listeria innocua, though considered non-pathogenic, is a close relative to L. monocytogenes a known food-borne pathogen. It has been implicated in the transfer of antimicrobial-resistant genes. Therefore, this study investigates the prevalence of Listeria innocua and its antimicrobial susceptibility pattern in seafood found in Badagry, Iyana Ipaja, Liverpool, Makoko and Mushin, Nigeria.  A total of 500 samples comprising of fresh and smoked blue whiting, croaker and shrimps were collected aseptically from retail outlets across Lagos. Culture, biochemical and sugar tests were carried out to identify L. innocua. 16S rRNA gene sequencing was conducted to confirm the isolates as L. innocua. The antimicrobial susceptibility testing was determined by the disk diffusion assay. Out of 500 seafood samples analysed, 36 (7.2%) were positive for Listeria innocua. Raw croaker had the highest occurrence of 13.0%. The antimicrobial susceptibility test revealed that all isolates were resistant to ceftazidime and cloxacillin. However, high sensitivities to ofloxacin (83.3%) and erythromycin (72.2%) were exhibited by the isolates. The recovery of these antimicrobial-resistant Listeria innocua strains in the seafood samples analysed warrants the need for suitable control procedures as this could constitute a great risk to public health.

Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists’ approach to surgical counseling for patients with MS (PwMS).

21 MS specialists were asked about 11 case scenarios with different MS disease statuses, disease-modifying therapies (DMTs), and urgency of the operation. The reasons for refusing surgery or factors that have to be considered before surgery were studied.

Overall, Fleiss Kappa was estimated to be 0.091 [95% confidence interval (CI): 0.090-0.093, P < 0.001] indicating a very poor level of agreement among responders.

PwMS face surgery for various reasons. Risk assessment of surgery, the effect of various drugs such as anesthetics and DMT on patients, as well as many other aspects of MS are issues challenging the practitioners. Clarifying the various dimensions of these issues requires further research.

In clinical practice, bone defects that occur alongside tumors, infections, or other bone diseases present significant challenges in the orthopedic field. Although autologous and allogeneic grafts are introduced as common traditional remedies in this field, their applications have a series of limitations. Various approaches have been attempted to treat large and irregularly shaped bone defects; however, their success has been less than optimal due to a range of issues related to material and design. However , in recent years, additive manufacturing has emerged as a promising solution to the challenge of creating implants that can be perfectly tailored to fit individual defects during surgical procedures. By fabrication of constructs with specific designs using this technique, surgeons are able to achieve much better outcomes for patients. Polymers, ceramics, and metals have been used as biomaterials in Orthopedic Surgery fields. Polymeric scaffolds have been used successfully in total joint replacements, soft tissue reconstruction, joint fusion, and as fracture fixation devices. The use of polymeric biomaterials, either in the form of pre-made solid scaffolds or injectable pastes that can harden in situ, shows great promise as a substitute for commonly used autografts and allografts. Polymethyl methacrylate (PMMA) is one of the most widely used polymer cement in orthopedic surgery. The present paper begins with an introduction and will then provide an overview of the properties, advantages/disadvantages, applications, and modifications of PMMA bone cement. Level of evidence: III

Sepsis is a life-threatening and common cause of Emergency department (ED) referrals. Out-of-hourstaffing is limited in ED, which may potentially affect fluid administration. This study aimed to investigate fluid volumevariation in out-of-hour vs. routine-hour admissions.

The present study is a post-hoc analysis of a multicen-tre, prospective, observational study investigating fluid administration in ED patients with suspected infection, fromJan 20th - March 2nd, 2020. Patient groups were “routine-hours” (RH): weekdays 07:00-18:59 or “out-of-hours” (OOH):weekdays 19:00-06:59 or Friday 19:00-Monday 06:59. Primary outcome was 24-hour total fluid volumes (oral + intra-venous (IV )). Secondary outcomes were total fluids 0-6 hours, oral fluids 0-6 and 0-24 hours, and IV fluids 0-6 and 0-24hours. Linear regression adjusted for site and illness severity was used.

734 patients had suspected infection;449 were admitted during RH and 287 during OOH. Mean (95% CI) total 24-hour fluid volumes were equal in simple in-fection and sepsis regardless of admission time: Simple infection RH: 3640 (3410 - 3871) ml and OOH: 3681 (3451 - 3913)ml. Sepsis RH: 3671 (3443;3898) ml and OOH: 3896 (3542;4250) ml. Oral fluids 0-6h were reduced in simple infectionand sepsis among OOH vs. RH. Sepsis patients received more 0-6-hour IV fluid when admitted OOH vs. RH. There wereno associations between admission time and 0-24-hour oral or IV volumes in simple infection or sepsis.

Admission time did not have an association with 24-hour total fluid volumes. Sepsis patients admitted during OOHreceived more 0-6-hour IV fluids than RH patients, and simple infection and sepsis patients received less oral fluid in0-6 hours if admitted during OOH vs. RH.