Clinical Departments Research Articles

Pregnancy and delivery in an advanced cancer survivor with immune checkpoint inhibitor-induced type 1 diabetes: a case report

PurposeGiven the rarity and elderly onset of immune checkpoint inhibitor (ICI)-induced type 1 diabetes (ICI-T1DM), cases leading to delivery are rare.MethodTo our knowledge, this is the first case report of childbirth in a patient with ICI-T1DM after cancer survival. A 32-year-old woman was started on Nivolumab for metastatic parotid cancers one year after total parotidectomy.ResultThe patient developed ICI-T1DM after 43 cycles and started multiple daily insulin therapy and self-monitoring of blood glucose. Complete response was maintained for 2 years by nivolumab, and she finished nivolumab in 77 cycles to attempt pregnancy. During the follow-up period, she began using a sensor-augmented pump (SAP). She had undetectable serum and urinary C-peptide when she started SAP. Her HbA1c level decreased from 7.8 to 6.6% without increasing hypoglycemia in one year. The patient remained in complete response after ICI discontinuation, and embryo transfer was initiated. Pregnancy was confirmed after a second embryo transfer (21 months after ICI discontinuation). At 36 weeks and 6 days, an emergency cesarean section was performed due to the onset of preeclampsia. The baby had hypospadias and bifid scrotum but no other complications or neonatal intensive care unit admission.ConclusionBecause ICI discontinuation and ICI-T1DM carry risks for the patient and child, the decision regarding pregnancy warrants careful consideration. Diabetologists should collaborate with patients and other clinical departments to develop a treatment plan for childbirth.

ECMS-NET:A multi-task model for early endometrial cancer MRI sequences classification and segmentation of key tumor structures

Endometrial cancer, one of the three major malignant tumors of the female genitalia, has seen an increase in incidence in recent years. The 5-year survival rate for early endometrial cancer is approximately 80% to 90%. In clinical practice, the accurate segmentation of endometrial cancer tumors is crucial for assessing the extent of hyperplasia and guiding treatment decisions. Developing a deep learning (DL)-based tumor segmentation method for Magnetic Resonance Imaging (MRI) sequences in cases of Endometrial Cancer (EC) can significantly improve the accuracy and efficiency of this process. We proposed an multi-task framework: ECMS-Net. We established a classification model based on the Transformer algorithm to discern images containing tumors within the sequence and U2-Net segmentation model was trained to perform automated and precise segmentation of early endometrial cancer tumor regions. Our results show that we have firstly proposed a sequence classification method and achieved an accuracy of 0.985 and this is the best result of the study so far, followed by a tumor segmentation maxF1 value of 0.970, which highlights the excellent performance of our proposed method. The entire experimental process aligns closely with the demands of the clinical imaging department, promising to enhance the efficiency of medical professionals, alleviate workload stress, and better cater to the requirements of the medical field.

Differences in the treatment needs of patients with dementia with Lewy bodies and their caregivers and differences in their physicians’ awareness of those treatment needs according to the clinical department visited by the patients: a subanalysis of an observational survey study

BackgroundWe investigated whether the treatment needs of patients with dementia with Lewy bodies (DLB) and their caregivers, along with their attending physicians’ perception of those treatment needs, differ according to the clinical department visited by the patients.MethodsThis was a subanalysis of a multicenter, cross-sectional, observational survey study. Data from the main study were classified according to the clinical department visited by the patient: psychiatric group (P-group), geriatric internal medicine group (G-group), and neurology group (N-group). The treatment needs of patients and caregivers were defined as “the symptom that causes them the most distress”, and the frequency of each answer was tabulated.ResultsThis subanalysis included 134, 65, and 49 patient–caregiver pairs in the P-, G-, and N-groups, respectively. Statistically significant differences in patient background characteristics such as patient age; initial symptom domains; use of cholinesterase inhibitors, levodopa, antipsychotics, and Yokukansan; and total scores of the Mini-Mental State Examination, Neuropsychiatric Inventory-12, and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale Parts II and III were shown among the three subgroups. While there were no differences in patients’ treatment needs among the subgroups, residual analysis showed that in the N-group, parkinsonism was more of a problem than other symptom domains (p = 0.001). There were significant differences in caregivers’ treatment needs among the three subgroups (p < 0.001). The patient–physician concordance rates for the symptom domains that caused patients the most distress were: P-group, 42.9% (kappa coefficient [κ] = 0.264); G-group, 33.3% (κ = 0.135), and N-group, 67.6% (κ = 0.484). The caregiver–physician concordance rates for the symptom domains that caused the caregivers the most distress were: P-group, 54.8% (κ = 0.351), G-group, 50.0% (κ = 0.244), and N-group, 47.4% (κ = 0.170).ConclusionThis subanalysis revealed differences in the treatment needs of patients with DLB and their caregivers according to the clinical department they attended. There might be a lack of awareness of those treatment needs by the attending physicians, regardless of their specialty.Trial registrationUMIN Clinical Trials Registry UMIN000041844.

New Genetic Markers of Skin T-Cell Lymphoma Treatment.

Cutaneous T-cell lymphomas (CTCL) can be described as chronic skin inflammation lesions with the content of malignant T cells and they are considered to be T-cell-mediated skin diseases. CD147 is recognized as a 58-kDa cell surface glycoprotein of the immunoglobulin superfamily; it can induce the synthesis of MMPs (matrix metalloproteinases) on the surface of tumor cells where it was originally identified. It can also function in adjacent tumor fibroblasts using CD147-CD147 interactions. The polymorphism rs8259 T/A is situated in the untranslated region (3'UTR) of the CD147 gene. HLA DRB1*1501 takes part in the process of presentation and recognition of different antigens to T cells. It can be expressed by antigen-presenting cells-macrophages, dendritic cells, and B cells. The aim of the study is to test genotype-phenotype associations of both polymorphisms including therapy in a large cohort of CTCL patients. A final total of 104 CTCL patients were enrolled in the study. For the first remission at the clinic department, they were treated by means of local skin-directed therapy, phototherapy, and systemic therapy. Genomic DNA was isolated from peripheral blood leukocytes. A standard technique using proteinase K was applied. The polymorphisms rs8259 T/A (CD147 gene) and rs3135388 (HLA DRB1*1501) were detected through standard PCR-restriction fragment length polymorphism methods. The severity of the disease (patients with parapsoriasis, stages IA and IB, vs patients with stages IIB, IIIA, and IIIB) was associated with the CD147 genotype: the AA variant was 3.38 times more frequent in more severe cases, which reflects the decision on systemic therapy (p = 0.02, specificity 0.965). The AA genotype in the CD147 polymorphism was 12 times more frequent in patients who underwent systemic therapy of CTCL compared to those not treated with this therapy (p = 0.009, specificity 0.976). The same genotype was also associated with radiotherapy-it was observed 14 times more frequently in patients treated with radiotherapy (p = 0.009, specificity 0.959). In patients treated with interferon α therapy, the AA genotype was observed to be 5.85 times more frequent compared to the patients not treated with interferon therapy (p = 0.03, specificity 0.963). The HLA DRB1*1501 polymorphism was associated with local skin-directed therapy of CTCL. The CC genotype of the polymorphism was observed to be 3.57 times more frequent in patients treated with local therapy (p = 0.008, specificity 0.948). When both polymorphisms had been calculated together, even better results were obtained: the AACC double genotype was 11 times more frequent in patients with severe CTCL (p = 0.009, specificity 0.977). The TACT double genotype was associated with local skin-directed therapy (0.09 times lower frequency, p = 0.007, sensitivity 0.982). The AACC genotype was 8.9 times more frequent in patients treated by means of systemic therapy (p = 0.02, specificity 0.976) and as many as 18.8 times more frequent in patients treated with radiotherapy (p = 0.005, specificity 0.969). Thus, the AACC double genotype of CD147 and DRB1*1501 polymorphisms seems to be a clinically highly specific marker of severity, systemic therapy and radiotherapy of patients with T-cell lymphoma. Although genotyping results were not known during the treatment decision and could not modify it, the clinical decision on severity and therapy reflected some aspects of the genetic background of this complicated T-cell-associated disease very well.

Status of recording inpatient medical records by nurses at Hai Duong General Hospital in 2024

Objectives: To describe the current status of medical records by nurses in select clinical departments at Hai Duong General Hospital in 2024. Methods: A cross-sectional study was conducted among 402 medical records from 4 internal medicine departments and 4 surgical departments at Hai Duong General Hospital in April 2022. Results: The percentage of satisfactory medical records was found to be 84.1%. Conclusion: The current status of medical records in certain clinical departments at Hai Duong General Hospital was quite good. Further research and improvements in documentation forms and practices are necessary to enhance the quality of medical records.

Experience of correction of enzyme therapy in children with cystic fibrosis using computer systems and means of network communication

Justification. In recent years, great progress in the treatment of cystic fibrosis has been associated with the use of pathogenetic therapy (since 2012 - in world practice, since 2020 in the Russian Federation). Against the background of the use of which the nutritional status, the functional state of the lungs improves, but there is no complete restoration of the impaired functions of the organs, in particular, the external secretory function of the pancreas is restored only in young children with the timely appointment of targeted therapy The purpose of the study: to increase the effectiveness of correction of enzyme replacement therapy by an individualized approach. Methods. 140 children (boys - 81, girls - 59) with MV aged from 1 year to 18 years (average age 12.9±4.8 years) were examined. The study was conducted in 2022 in the Department of Cystic Fibrosis Scientific and «Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region» (clinical base of the scientific and clinical Department of Cystic fibrosis Research Center for Medical Genetic). Inclusion criteria - diagnosis of cystic fibrosis, chronic pancreatic insufficiency, severe. Exclusion criteria - short bowel syndrome, exacerbation of the disease. The doses of pancreatin per day were evaluated using the calculation method: units/g of fat in food and intestinal syndrome before and after correction using an algorithm of an individualized approach to calculating enzyme therapy. The observation period is 3 months Design: single-center, prospective, comparative Results. The study showed that the majority of 82 patients (59%) in the general group received less than 2000 U/g of fat, which is less than the reference values (2000-4000 U/g). The median daily dose was 1500 U / g of fat, which can be attributed to the peculiarities of dosing and the need for pancreatin in the Russian pediatric population of patients with cystic fibrosis. The results are consistent with the data of recent studies indicating an acceptable dosage range of pancreatin 1000-4000 units / g of fat in food. In the course of the study, an algorithm for individualized correction of enzyme replacement therapy was developed and the effectiveness of this approach was shown. Conclusion. When calculating pancreatin for the fat content in food, the dose was below the recommended values of 2000-4000 units / g and amounted to 1500 units / g, which indicated that it did not meet the needs of children in enzymes and required individual correction. This served as the basis for the development of an algorithm for individualized correction of enzyme replacement therapy. The effectiveness of this approach using computer technology (inpatient program for doctors and mobile version for patients), in the form of reduction / relief of intestinal syndrome, is shown. To increase compliance and to train parents to control diet and enzyme replacement therapy, it is advisable to use computer programs and mobile applications to calculate the diet and dosage of pancreatin for each meal.

Prevalence of Metabolic Syndrome and Its Risk Factors Influence on Microvascular Complications in Patients With Type 1 and Type 2 Diabetes Mellitus.

Diabetes mellitus (DM) long-term macrovascular and microvascular complications pose significant health risks and increase mortality. In DM patients, metabolic syndrome (MetSy) either precedes or coexists with the condition. Central obesity, poor glycemic control, hypertension, elevated triglycerides (TG), and low high-density lipoproteins (HDL-C) are the components of MetSy. The purpose of this study is to investigate related diabetic microvascular complications in type 1 DM (T1DM) by comparing them with type 2 DM (T2DM), determine potential risk factors, and estimate prevalence based on the diagnosis of MetSy. This study included 160 T1DM and 160 T2DM patients, totaling 320 DM patients. It was carried out from April 20, 2022, to September 31, 2023, at the Sheikh Zayed Hospital, Rahim Yar Khan, in the Outdoor Diabetic Clinic and Medicine Department. A unique questionnaire was utilized to gather socio-demographic, general, clinical, and laboratory data for the MetSy criteria set forth by the International Diabetes Federation (IDF). The blood pressure, BMI, and waist circumference (WC) were measured, while venous fasting blood was used to assess biochemical markers such as HDL-C, TG, and fasting blood sugar. The microvascular diabetes complications were identified using abdominal ultrasound, fundus ophthalmoscopy, and routine laboratory tests.We quantified and analyzed these variables individually for T1DM and T2DM patients with or without MetSy and compared them in the presence or absence of diabetes microvascular complications. MetSy prevalence was 25.62% (41, n=160) for T1DM and 60.62% (97, n=160) for T2DM, totaling 43.12%. Among T1DM patients with MetSy, the majority were married males, aged 36-49 years, with a BMI of 26.69±2.20 kg/m2 and a WC of 85.12±4.23, and 67.5% (108) patients had diabetes microvascular complications. Comparatively, in T2DM with MetSy, the majority were married females aged 50-59 years with a BMI of 29.79 ± 4.65 kg/m² and a large WC of 93.43±4.49, and 75% (123) patients had diabetes microvascular complications. Overall, this study noted significant p-values for hypertension, elevated TG, low HDL-c, high WC, obesity, female gender in T2DM, and above 36 years of age in both groups with MetSy. Diabetic retinopathy (DR) at 32.4% (p<0.001) was the most prevalent T1DM microvascular complication, followed by nephropathy (30.6%), neuropathy (DN) at 28.1%, and gastroparesis (DG) at 22.3%. Whereas in T2DM, the prevalence of DN was 36.3% (p<0.001), followed by DKD (29.3%), DG (28.9%), and DR (24.9%). Nearly a quarter of T1DM patients had MetSy, with increasing percentages of overweight and obese patients who are more likely to have DR, DKD, or DN. MetSy affects two-thirds of T2DM patients, with married obese females aged 50-59 being more susceptible than males, who are more likely to suffer DN, DKD, or DG. Risk factors that contribute to the MetSy burden in T1DM and T2DM include hypertension, poor glycemic management, low HDL-C, high TG, and a higher BMI or WC. Increasing age, female gender in T2DM, longer diabetes duration, and co-morbid hypertension were independent predictors of microvascular complications. DR, DN, DKD, and gastroparesis are the most prevalent diabetic microvascular sequelae. The clinical management of diabetic patients with healthy lifestyle adaptations, good glycemic control, antihypertensives, and statins will contribute greatly to MetSy prevention.

Lung Cancer in Women-Sociodemographic, Clinical and Psychological Characteristics with Comparison to Men.

(1) Background: There is a difference in the course of lung cancer between women and men. Therefore, there is a need to evaluate various factors in the patient population treated in daily practice. The purpose of this study was to analyze the clinical, sociodemographic and psychological aspects of female lung cancer. To better express the results, we compared women and men. (2) Methods: Consecutive patients with a history of lung cancer treatment admitted to the outpatient oncology clinic (Department of Lung Cancer and Chest Tumours, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw) and the Department of Internal Medicine, Pulmonary Diseases and Allergy, were enrolled. We conducted analyses of the clinical, psychological and socioeconomic factors of women with lung cancer treated in everyday practice, including a comparison with a group of men. Demographic data were collected from a self-administered questionnaire. We used the Perceived Stress Scale (PSS-10) and Acceptance of Illness Scale (AIS) questionnaires for psychological evaluation. (3) Results: A total of 100 patients with confirmed primary lung cancer with a history of treatment were enrolled in the study (50 women and 50 men). We found a significantly shorter history of smoking in the group of women; at the same time, there were no differences in the reported incidence of COPD. Despite comparable results to men on the psychological questionnaire (PSS-10, AIS), women more often reported a willingness to be supported by a psychologist or psychiatrist due to lung cancer. However, they did not decide to consult them more often than men. Immunotherapy was a significantly less frequently used method in women. (4) Conclusions: We should be more active in finding out the willingness to consult a psychologist or psychiatrist among women with lung cancer. The diagnosis of COPD should be considered more often among women due to the lack of differences in the reported incidence of COPD between men and women, despite a clear contrast in the number of pack-years.

Risk factor analysis and prediction model construction for surgical patients with venous thromboembolism: A prospective study

Abstract Objective: Patients undergoing surgery are at high risk of developing venous thromboembolism (VTE). This study aimed to determine the predictive value of risk factors for VTE in surgical patients and to develop a prediction model by integrating independent predictors. Methods: A total of 1111 patients who underwent surgery at clinical departments in a tertiary general hospital were recruited between May and July 2021. Clinical data, including patient-related, surgery-related, and laboratory parameters, were extracted from the hospital information system and electronic medical records. A VTE prediction model incorporating ten risk variables was constructed using artificial neural networks (ANNs). Results: Ten independent factors (X1: age, X2: alcohol consumption, X3: hypertension, X4: bleeding, X5: blood transfusions, X6: general anesthesia, X7: intrathecal anesthesia, X8: D-dimer, X9: C-reactive protein, and X10: lymphocyte percentage) were identified as associated with an increased risk of VTE. Ten-fold cross-validation results showed that the ANN model was capable of predicting VTE in surgical patients, with an area under the curve (AUC) of 0.89, a Brier score of 0.01, an accuracy of 0.96, and a F1 score of 0.92. The ANN model slightly outperformed the logistic regression model and the Caprini model, but a DeLong test showed that the statistical difference in the AUCs of the ANN and logistic regression models was insignificant (P&gt;0.05). Conclusion: Ten statistical indicators relevant to VTE risk prediction for surgical patients were identified, and ANN and logistic regression both showed promising results as decision-supporting tools for VTE prediction.

Coagulation Function Testing Clinical Demand and Current Status in China

Diseases or symptoms related to coagulation function are widely present in clinical daily work, as coagulation function plays a central role in maintaining homeostasis in the internal environment. Therefore, coagulation dysfunction often leads to serious harm to patients. At the same time, coagulation related treatments such as the use of anticoagulants or transfusion therapy have potential serious side effects, even leading to patient death. For many years, balancing the bleeding or embolism caused by anticoagulants has been a challenge that clinical workers have to face, which poses great challenges to clinical work. Therefore, monitoring coagulation function is very important for clinical diagnosis and treatment. The rapid and accurate completion of coagulation function diagnosis conclusions and early transmission to clinical workers are important guarantees for patient life. However, at present, due to technical limitations and the complexity of the detection process, this demand cannot be met. At present, in China, coagulation function testing is mostly concentrated in laboratory departments, and the limitation of distance may affect the timeliness of coagulation function testing. Therefore, many clinical departments of institutions tend to conduct coagulation function testing themselves, which has led to many new demands for coagulation function testing, such as fast and convenient POCT coagulation function testing and coagulation function testing of cell models that are more in line with clinical needs, More joint detection of coagulation markers and so on, of course, these needs must be established on the premise that clinical testing equipment and laboratory testing results are consistent. However, in order to meet the needs of miniaturization and rapid testing, the coagulation function testing equipment used in clinical departments often has significant methodological differences from laboratory testing equipment, which further leads to differences in testing results. Based on this situation, many new technologies, including microfluidic technology, as well as more detection techniques, have been widely and deeply applied to clinical coagulation function testing, which has brought a lot of good news to clinical coagulation function diagnosis to a large extent.

Evaluating the Impact of Interventions and Improvements in Outpatient Intravenous Infusion Therapy at a Hospital in China: A Comprehensive Analysis of Prescription Patterns and Safety Measures.

The excessive use of intravenous infusion in China was once a serious problem, but in recent years, attention has been paid to the phenomenon, and the government has implemented several policies to solve the problem, which has been gradually improved. This study focuses on evaluating the impact of ongoing interventions and improvements in outpatient intravenous infusion therapy. From January 2016 to December 2022, we conducted a study to gather annual data on intravenous infusion prescriptions. A data questionnaire, encompassing information on departments, clinical diagnosis, and infusion drugs, was developed for this purpose. We analyzed the changing trends of Top 10 clinical departments with higher intravenous infusion usage rates and Top 10 drugs used. We also evaluated the compliance of intravenous infusion prescriptions with management regulations and drug instructions, for further intervention in the future. The analysis of intravenous infusion prescription rates revealed a gradual decrease from 10.89% to 5.63%. This reduction was statistically significant (P < 0.05). High levels of intravenous infusion use were consistently observed in emergency surgery and emergency medicine. Commonly administered drugs via infusion included antibacterial drugs, tumor medications, proton pump inhibitors, and injections of traditional Chinese medicine. Inappropriate prescriptions are often characterized by issues related to drug dosage, usage, indication, and selection. Trend analysis of unreasonable types revealed significant improvements in "Diagnosis incomplete/unwritten", "Solvent selection", "Dosing frequency", and "Treatment without indication" (P < 0.05). The findings of this study indicate a gradual improvement in the situation regarding intravenous infusion. However, there are still prevalent instances of unreasonable practices that need to be addressed.

Prevalence of Extended-spectrum Beta-lactamase (ESBL), Metallo Beta-lactamase (MBL) and Carbapenemase Producing Acinetobacter Species Isolated from Various Clinical Samples in Tertiary Care Hospital

Acinetobacter is an important nosocomial pathogen causing health care associated infections. It is highly antibiotic resistant gram-negative bacilli. The study was done to determine the prevalence of Acinetobacter species isolated from various clinical samples with their antibiotic susceptibility pattern. To determine the antimicrobial susceptibility pattern of the isolated Acinetobacter species and also the multidrug resistant mechanisms by phenotypic characterization. The retrospective study was carried out in patients diagnosed with Acinetobacter infection in the Microbiology Department, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth, Deemed To Be University, Karad, a tertiary care hospital, including the clinical departments, during the period of two years from November 2020 till November 2022. Organism identification, biochemical test, antibiotic resistance pattern and phenotypic tests such as ESBL, MBL and Carbapenemase production were performed as per the Clinical and Laboratory Standards Institute (CLSI). The Modified Hodge test (MHT) was performed for Carbapenemase production detection in Acinetobacter species. A total of 150 Acinetobacter species were isolated from clinical samples. Acinetobacter baumannii was the most prevalent species 138 (92%), followed by Acinetobacter lwoffii 10 (7%) and Acinetobacter hemolyticus 2 (1%). The isolates showed highest resistance to Ampicillin 130 (87%) and sensitive to Colistin 113 (75.3%). Most of the isolates of of Acinetobacter baumannii showed maximum ESBL 21(14%) and MBL 75 (93%) production. Modified Hodge test showed positive results in Acinetobacter baumannii, only 11 (7%). The study showed that Acinetobacter baumannii was the most prevalent species showing drug resistance by phenotypic detection methods. At present Acinetobacter is a frequent pathogen in hospital acquired infections in critically ill patients admitted to ICU. The isolates of Acinetobacter species in our study showed resistant to most commonly used antibiotics. The study showed that ESBL production in Acinetobacter was 22 (15%) and MBL 80 (53%). Most Acinetobacter isolates were Multi Drug Resistant (MDR). MDR Acinetobacter is widely increasing due to inappropriate use of antibiotics in healthcare hospital. In our study, detection of carbapenemase by Modified Hodge test was positive in 11 (7%) isolates.

Inpatient experience and influencing factors at Ho Chi Minh city Blood Transfusion and Hematology hospital in 2022

Objective: Policymakers and healthcare managers globally are increasingly focused on collecting Patient Experience (PE) Data to identify information and issues that require improvement for enhancing service quality. For several years, the Ho Chi Minh City Blood Transfusion and Hematology Hospital has prioritized improving patient experience and satisfaction with its services. Methods: A cross-sectional study incorporating both quantitative and qualitative approaches. Quantitative data were gathered from 250 patients or their main caregivers in six inpatient departments. Quantitative data analysis employed descriptive statistics and non-parametric tests. Qualitative information was obtained through six in-depth interviews with customers (patients and their family members) and seven in-depth interviews with medical staff (hospital leader, 02 clinical department leaders, 02 doctors, and 02 nurses). Results: The overall Patient Experience (PE) score was 8.5 (median) on a 10-point scale. PED at admission: the waiting time for admission to the inpatient department had the lowest rate of positive experiences (48.8%). Internal Audit on Facilities and Utilities serving patients: the criterion for positive experiences regarding hospital quietness had the lowest rate (65.2%). Internal Audit on the attitude and spirit of service by medical staff, medical examination and treatment activities, and hospital fee payment: all criteria received a fairly high positive evaluation rate of over 86%. Internal accounts before discharge: over 12% of respondents reported difficulties in hospital discharge payment. Factors influencing Internal Revenue Service: Positive factors included the correct application of medical examination and treatment regulations according to the Ministry of Health, administrative procedure reform, new facilities and equipment, training on codes of conduct, and appropriate treatment method selection according to the diagnosis. Negative factors included an incomplete call center for medical examination and treatment, long waiting times for admission to the inpatient department and medical examination, and a lack of methods for patients to pay hospital fees directly in the department or treatment room. Conclusions: The hospital's overall PED score is 8.5 points. Develop a plan to adjust the process to reduce waiting time for admission from the medical examination department and discharge time; Increase medical human resources to support patient fee collection directly in the treatment department/room. Keywords: Patient experience, inpatients, patients, hematology blood transfusion.

Pattern of E. histolytica infection and its correlates among patients in a general practice clinic: A four-year retrospective evaluation

Background: Overcrowding, poor hygiene and scarcity of portable water are common features of population growth in a resource poor nation especially with rising cost of living from inflation. This is the often the state of many underdeveloped nations such as Nigeria. Such environments encourage the spread of communicable diseases. This study assess the pattern, trend, and at-risk population of Entamoeba histolytica (E. histolytica), implicated in intestinal Amoebiasis in South-South Nigeria. Method: This retrospective study was conducted using hospital data obtained from the laboratory department of a general hospital clinic in Warri and covered a period of four years from January 2015 - December 2018. The record of 4,169 laboratory results of stool samples examined by direct smear and concentration technique, were recovered from a designed computer database. Trend of infection over the period as well as variations in distribution patterns between sex, age and seasons were determined using appropriate statistical tools. Results: Out of the 4,169 stool samples 365 (8.8%) had E. histolytica with decreasing trend of infection from 2015 – 2018 as 135 of 1210 (11%); 118 of 1114 (10.6%); 57 of 792 (7.2%); 55 of 1053 (5.2%) respectively. Prevalence of infections was higher in females, 57.5% (95CI%, 51.7-59.7, n= 210) than males (n=155, 42.5%, 95%CI, 40.3-48.6). The prevalence of infections was highest among Age brackets 1-5years, 6-15 years and 35+ years; but lowest in the 26-35 years with peak season of infections at first and last quarters of each year. Conclusions: Children are more vulnerable to E. histolytica infestation and the dry seasons of the year place them at risk. This information underscores the need for local surveillance to evaluate the effectiveness of control and preventive health measures with a view of reducing the prevalence and morbidity of parasitic infections in our locality.

Incidence versus treatment outcomes and survival in patients before age 40 with colorectal cancer

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Colorectal cancer (CRC) was the third most common cancer and the second cause of cancer deaths worldwide in 2020. Its incidence has increased dramatically in people under 50 years of age (early-onset colorectal cancer; EOCRC).&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to compare two age groups of patients with colorectal cancer in terms of stage, prognostic factors, survival and incidence of recurrence.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Materials and methods:&lt;/b&gt; The study group consisted of 588 patients operated on between 1995 and 2005 at the University Hospital in Krakow in the Clinical Department of General, Oncological and Gastroenterological Surgery. A method of retrospective documentation analysis was used. Patients were divided into two age groups: up to forty years of age and between 45 and 65 years of age.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; Up to 40 years of age, stage IV colorectal cancer was diagnosed in 33.3% of patients, while between 45 and 65 years of age, it was diagnosed in 26.1%. Five-year survival differed according to tumour stage. In the two groups analysed, there was a significant difference between the survival curves (P = 0.00000). Also, comparing recurrence times in the paired group excluding cancer-independent deaths revealed a statistically significant difference between the groups (P = 0.006).&lt;/br&gt; &lt;b&gt;&lt;br&gt;Discussion:&lt;/b&gt; The incidence of colorectal cancer has increased worldwide in young people under 50 years of age, and it is therefore recommended that the research presented here be studied, and that prognostic factors be analysed and multicentre prophylactic studies combined with health education of those at risk be encouraged. Cancer occurring in younger patients is characterized by advanced stage at diagnosis and five-year survival is lower and has a poorer prognosis. The availability is very important of early diagnosis to detect pre-cancerous and considered pre-cancerous conditions is important. This involves detecting lesions at a lower stage of the disease.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; The availability of early diagnosis to detect precancerous and considered pre-cancerous conditions is very important. This involves detecting lesions at a lower stage of the disease. Diagnosing colorectal cancer at an early stage and treating the pre-cancerous lesions will improve treatment outcomes, resulting in fewer metastases and longer survival and recurrence times.&lt;/br&gt;

SATISFACTION OF INPATIENTS ABOUT HEALTH EDUCATION AT CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Background: Health education for patients is one of the essential tasks of physicians in patient care and treatment. To improve the effectiveness of health care and treatment, physicians must spend more time with patients. The interaction of physicians in performing health education for patients must be really enthusiastic, dynamic and responsive to the needs of each patient. Objectives: This study aims to describe the satisfaction of inpatients about the health education communication activities of physicians in clinical departments of university hospitals at Can Tho University of Medicine and Pharmacy Hospital in June and July - 2023. Materials and methods: A convenience sample of 210 inpatients in 07 clinical departments at the time of discharge from the hospital was surveyed in this descriptive, cross – sectional study. Prepared questionnaires for faceto-face interviews with 37 questions (built by referencing documents related to health education communication for patients, and at the same time proposing some new elements for further study). Descriptive statistics were used to analyze data. Results: The majority of the patients were female, accounting for 57.14 %, the average age was 52.01 ± 2.3. Patients had a positive attitude toward thehealth educati on communication methods of physicians, with a score of 69.59 ± 15.73. Most patients received health education in the form of individual consultations, accounting for 95.71 %. The percentage of doctors providing health education consultation to patients was 59.62 %. Patients had a positive attitude toward the health education communication methods of physicians (69.59 ± 15.73), the mean score of patients' evaluation of health education communication activities was 28.89 ± 4.66 and the content of medical education communication was 32.17 ± 10.18. Conclusion: This study shows that patients have positive attitudes toward health education at clinical departments, but patients mainly expect doctors to be the ones to provide information and conduct health education for them. Therefore, it is necessary to develop a health education program for patients that pays attention to the central role of doctors.

General Ultrasound Examination Volumes per Sonographer 8-Hour Workday

&#x0D; The average number of general ultrasound examinations performed by a sonographer in an 8-hour workday is not well reported in the literature. Through an informal survey, we estimate that the average general ultrasound examination volume across Canada per 8-hour workday is 11.25, with a range of 9 to 14.&#x0D; Understanding ultrasound examination data volumes provides information to help understand productivity. Decision-makers can also use the examination volume data and factors affecting sonographer examination throughput to create strategies to enhance efficiency in clinic and hospital departments.&#x0D; Factors that may influence the average examination rate include examination time, the age of equipment, resource availability, staffing shortages, and sonographer’s work-related musculoskeletal disorders and stress.&#x0D;

Designing the Empowerment Model of Patients Hospitalized in the Hospitals Affiliated to Shahid Sadoughi University of Medical Sciences, Yazd

Introduction: Identifying factors that influence the patient experience are critical to implementing strategies that support patient engagement and ultimately achieve better health outcomes. The present study was conducted with the aim of presenting a model of empowerment of hospitalized patients.&#x0D; Methods: The current research was a qualitative-quantitative study that was cross-sectional by stratified sampling method with proper allocation in hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran, on 230 heads, managers, matrons, supervisors, heads of clinical and paraclinical departments and hospital headquarters units, nurses and doctors were done. The data were collected using the demographic information tool and the questionnaire made by the researcher to design a model of empowering patients admitted to the hospital. Determining the ability of the designed model by fitting the data was done with the confirmatory factor analysis method. Data were analyzed by SPSS version 16 software and Amos.v 24 software.&#x0D; Results: Questionnaire for designing a model of empowering patients in the hospital has 8 areas and 61 items or components. In the present study, the Chi-square ratio to the degree of freedom was significant (p&lt;0.001), which indicated the appropriate fit of the model. The value of the GFI index was estimated at 0.93, which indicated that the model fits well. The values of GFI and AGFI for the empowerment model of hospitalized patients were higher than 0.8.&#x0D; Conclusion: Organizations and medical institutions have the opportunity to utilize this model to empower patients. The universities of medical sciences and affiliated hospitals should create an enabling environment for enhancing patient empowerment.

The Impact of the Emotional Disposition of Healthcare Workers on the Expression of Adverse Events after Primary Vaccination against SARS-CoV-2.

Background and Objectives: Vaccination is one means of SARS-CoV-2 prevention and control. However, despite the effectiveness of vaccination, adverse reactions continue to require vigilance and monitoring. The researchers emphasize the possibility that some of the reported side effects may be psychological in origin. Based on this hypothesis, the main goal of this study was to evaluate the emotional dispositions of healthcare workers who experienced emotions before vaccination and adverse reactions after vaccination. Materials and Methods: This study was conducted between February and May 2021 in the Kaunas Clinics of the University of Health Sciences. A total of 2117 employees of the clinic departments who were vaccinated with two doses of the Pfizer-BioNTech vaccine participated in this study. Statistical analysis was performed on the data using IBM SPSS Statistics®. Results: Most participants (74.5%) experienced systemic (including local) adverse events; 16.5% experienced only local adverse events, and 9.1% experienced no adverse events. The frequency of systemic (including local) adverse events reduced with increasing age (p < 0.05). The main emotions that participants experienced before vaccination were anxiety (37.88%) and happiness (39.02%). Systemic (including local) adverse events occurred 1.26 times more frequently in women than men (77.44% vs. 61.6%, p < 0.05), while local adverse events occurred 1.4 times more often in male participants than in female participants (21.39% vs. 15.27%, p < 0.05). Among the respondents who did not experience adverse events, the most common emotion felt was happiness (25.5%), and most of the participants who experienced systemic (including local) adverse events felt anxiety (42.6%). Conclusions: The information about vaccination and potential adverse events should be targeted at younger persons. It is recommended that women, more than men, should receive professional counseling from psychologists or psychotherapists. The public dissemination of positive messages about the benefits and safety of vaccines prior to a vaccination campaign may alleviate the tension or anxiety felt regarding potential adverse events. Healthcare specialists-both those who work directly with vaccines and those who do not-should maintain a positive psychological attitude towards vaccination, as this can increase patient satisfaction with the benefits of vaccines.

Special aspects of total hip arthroplasty in patients with proximal femur pseudarthrosis

IntroductionThe rate of proximal femur fractures (PFF) in the structure of musculoskeletal system injuries among all fractures of long bones ranges from 3.9 to 18%. According to Russian Ministry of Health 2020 data, the incidence of femoral fractures in Russia was up to 61 cases per 100,000 population (90,000 per year); and femoral neck fractures incidence was 4 times higher among people over 75 years of age. The choice of surgical technique and the fixator used depend on many factors, such as fracture location and its nature, the age of the patient, comorbidities, and the quality of bone tissue. Internal osteosynthesis, is the current treatment method of choice for extra-articular proximal femur fracture, but every treatment method has its limitations. a significant number of complications caused by technical errors, vicious union or nonunion with the subsequent development of false joints, the development of femoral head aseptic necrosis, which leads to coxarthrosis and persistent pain syndrome. To solve the above-described problems, it is necessary to use a conversion surgery - total hip replacement. Objectiveslong-term analysis of the results of total hip replacement in patients with proximal femur pseudarthrosis. MethodsThe study was based on clinical and laboratory data analysis and on the results of total hip arthroplasty (THA) in 45 patients aged 56–84 years (mean age 68.3), including 32 (71.1%) women and 13 (26.1%) men. 12 patients initially received conservative treatment, and 33 patients received initial surgical treatment using various metal osteosynthesis procedures. The time from osteosynthesis or from the moment of injury to admission to the hospital for hip arthroplasty ranged from 12 to 30 months. All patients, before conversion arthroplasty and after discharge, were repeatedly invited to the clinical diagnostic department for a clinical examination and for assessment using rating scales. 3, 6 and 12 months after the surgery, pain syndrome and patient quality of life were assessed using the following questionnaire scales: Harris Hip Score, MOS SF-36, VAS. The maximum follow-up period ranged from 12 to 60 months. ResultsBased on the results obtained, patients of all 4 groups after conversion arthroplasty noted a significant quality of life improvement, a decrease in pain severity and functional results improvement. This was probably due to the presence of a severe limitation of range of movements in the joint, intense pain, absence of support ability of the extremity, as well as low operative efficacy expectations.In 1 (2%) patient, acute PJI was diagnosed in the early postoperative period, followed by sepsis and death.In 4 patients (9%) the result was considered unsatisfactory. At 1 year of follow-up after surgery, they complained of pain and claudication in the operated joint.3 (6%) patients underwent reduction of dislocation. ConclusionsStrict adherence to the recommended treatment algorithm for patients with proximal femur pseudarthrosis made it possible to achieve good treatment results in 90% of surgically treated patients. An important step in the treatment of this patients is a careful preoperative planning with thorough assessment of bone tissue quality and muscles condition in the proximal femur area, allowing to choose the optimal endoprosthesis components.