Clinic Of General Hospital Research Articles

Endoscopic versus Histopathological Diagnosis of Pan-gastritis in Patients with Chronic Gastric Dyspepsia

Abstract Background One of the most prevalent, severe, and sneaky chronic disorders in people is chronic gastritis. Numerous hundreds of millions of individuals worldwide may have chronic gastritis in one way or another, according to estimates that more than half of the world's population has this disease to some degree or extent. Despite the clear role of gastritis in the etiology of common peptic ulcers and stomach malignancies, the relevance of chronic gastritis as a dangerous disease is vastly overestimated in clinical practice. Aim of the Work to compare the endoscopic diagnosis and histopathologic diagnosis of pan gastritis in patients presented with chronic gastric dyspepsia. Patients and Methods This study is a Randomized study conducted at Gastroenterology Medicine outpatient clinic and endoscopy unit in Air Force General Hospital and Benha teaching hospital included 100 patients presented by dyspepsia for more than 8 weeks Results In this study we demonstrated that RBCs ranged from 3.8 to 5.9 x1012/L with a mean ± SD of 4.86 ± 0.64 x1012/L. WBCs ranged from 4 to 9.5 x109/L with a mean ± SD of 6.62 ± 1.55 x109/L. Platelets ranged from 120 to 348 x103/µL with a mean ± SD of 224.71 ± 63.94 x103/µL. Hb ranged from 9.5 to 14.5 g/dL with a mean ± SD of 11.83 ± 1.55 g/dL. ALT ranged from 5.9 to 45 U/L with a mean ± SD of 24.34 ± 11.46 U/L. AST ranged from 10.7 to 49 U/L with a mean ± SD of 29.28 ± 10.33 U/L. Urea ranged from 6.5 to 44.7 mg/dL with a mean ± SD of 24.77 ± 10.39 mg/dL. Creatinine ranged from 0.2 to 2.1 mg/dL with a mean ± SD of 1.1 ± 0.6 mg/dL. In this study we illustrated that regarding endoscopic results, 25 (25%) patients were normal, 56 (56%) had gastritis and 19 (19%) had other lesions. regarding patients with gastritis, 7 (12.5%) of them had atrophy, 8 (14.29%) had mucosal nodularity, 24 (42.86%) had edema and 17 (30.36%) had erythema while the location of gastritis varied as 41 (73.21%) patients had pan-gastritis, 9 (16.07%) had antrum predominant gastritis and 6 (10.71%) had corpus predominant gastritis. regarding patients with other lesions, 7 (36.84%) of them had esophagitis, 9 (47.37%) had duodenal ulcer and 3 (15.79%) had hiatal hernia. In this study we illustrated that there was a statistically significant difference among endoscopic and histopathological findings of the studied patients (P value <0.001). Conclusion Pan-gastritis is a common finding in early dyspeptic patients and endoscopy has high sensitivity in diagnosis of pangastritis and normal endoscopic appearance did not rule it out, and the histopathology was still the gold standard method.

Isolation and Diagnosis of Dermatophytes of the Hand Tinea and Sensitivity Study to the Antifungals Griseofulvin

The study was conducted during the month of October 2022 until April 2023, with the aim of isolating and diagnosing the fungi that cause skin diseases from patients visiting the dermatology consultation affiliated with Salah al-Din General Hospital who were diagnosed as infected by dermatologists for the period from 1/6/2022 to 1/ 12/2023 For both sexes, aged between 10 and 60 years, by taking skin samples from the area of infection after wiping them with cotton saturated with 70% alcohol for the purpose of sterilization to get rid of any contaminants. Which was diagnosed clinically by a dermatologist in the dermatology consultation at Salah al-Din General Hospital and outpatient clinics. To evaluate the effectiveness of anti-griseofulvin in inhibiting the isolated fungi, the percentage of dermatophyte infections recorded by positive direct microscopic examination was only (88) patients, representing (88%) of the total number of patients. While the number of negative cases by negative direct microscopic examination was (59), or (59%). As for positive laboratory culture results, there were (79) patients, in the rate of (79%). While the number of negative cases by laboratory culture was (21), in the rate of (21%). The fungal genera that cause skin infections, such as Trychophyton and Microsporum, were isolated, with the genus Trichophyton being the most frequent, with 76 isolates belonging to several species, such as T. mentagrophytes, with a number of 29 isolates, then the fungus T. rubrum, with a number of isolates of 22, then the fungus T. terreste, with a number of isolates of 15, and then fungus T. schoenleinii, with a number of 10 isolates, while only three isolates of the M. canis type were recorded in the genus Microsporum. The results of the susceptibility test of the isolated fungi to Griseofulvin showed that the fungus T. mentagrophytes is more sensitive to the antichrysofulvin, as the average diameter of inhibition reached 32 mm compared to the control, followed by T. rubrum, which had an average diameter of inhibition of 16 mm compared to the control.

Clinical decision support system using hierarchical fuzzy diagnosis model for migraine and tension-type headache based on International Classification of Headache Disorders, 3rd edition.

To determine whether the diagnostic ability of the newly designed hierarchical fuzzy diagnosis method is consistent with that of headache experts for probable migraine (PM) and probable tension-type headache (PTTH). Clinical decision support systems (CDSS) are computer systems designed to help doctors to make clinician decisions by information technology, and have proven to be effective in improving headache diagnosis by making medical knowledge readily available to users in some studies. However, one serious drawback is that the CDSS lacks the ability to deal with some fuzzy boundaries of the headache features utilized in diagnostic criteria, which might be caused by patients' recall bias and subjective bias. A hybrid mechanism of rule-based reasoning and hierarchical fuzzy diagnosis method based on International Classification of Headache Disorders, 3rd edition (ICHD-3) was designed and then validated by a retrospective study with 325 consecutive patients and a prospective study with 380 patients who were clinically diagnosed with migraine and TTH at the headache clinic of Chinese PLA General Hospital. The results of the diagnostic test in the retrospective study indicated that the fuzzy-based CDSS can be used in the diagnosis of migraine without aura (MO) (sensitivity 97.71%, specificity 100%), TTH (sensitivity 98.57%, specificity 100%), PM (sensitivity 91.25%, specificity 98.75%) and PTTH (sensitivity 90.91%, specificity 99.63%). While in the prospective study, the diagnostic performances were MO (sensitivity 91.62%, specificity 96.52%), TTH (sensitivity 92.17%, specificity 95.47%), PM (sensitivity 85.48%, specificity 98.11%) and PTTH (sensitivity 87.50%, specificity 98.60%). Cohen's kappa values for the consistency test were 0.984 ± 0.018 (MO), 0.991 ± 0.018 (TTH), 0.916 ± 0.051 (PM), 0.932 ± 0.059 (PTTH) in the retrospective study and 0.884 ± 0.047 (MO), 0.870 ± 0.055 (TTH), 0.853 ± 0.073 (PM), 0.827 ± 0.118 (PTTH) in the prospective study, which indicated good consistency with the fuzzy-based CDSS and the gold standard (p < 0.001). We developed a fuzzy-based CDSS performs much more similarly to expert diagnosis and performs better than the routine CDSS method in the diagnosis of migraine and TTH, and it could promote the application of artificial intelligence in the area of headache diagnosis.

WP3.9 - Characteristics and outcomes of an emergency hot clinic in a district general hospital - are they still a useful resource?

Abstract Introduction Hot clinics with ambulatory imaging have become integral to service provision in emergency general surgery, reducing admissions and expediting diagnoses. However they can come under criticism over a lack of senior decision making and perceived unnecessary reviews. Aims We aimed to evaluate the service in our department, by characterising the seniority level of the decision makers and assessors in the hot clinic, and outcomes of patients seen. Methods Retrospective analysis over a 3 month period of patients seen in the hot clinic of a district general hospital was performed. Results Total number of patients seen was 128. Median time from referral to appointment was 1 day. Abdominal pain formed 70.3% original presenting complaints. Over half of patients (52.3%, n=67) had review arranged by a registrar, and 46.9% (n=60) of patients were seen by a registrar at their appointment. 7% (n=9) had their hot clinic review arranged by a consultant. 63.3% (n=81) of patients had imaging performed as part of their review, and 53.1% (n =43) of these patients had pathology identified. 13.3% (n=17) of patients seen at the clinic required admission, and 43.0% (n=55) were discharged. 21.4% (n=3) of those brought back for a further hot clinic review had been seen by a consultant, versus 64.3% (n=9) seen by a registrar. Discussion Hot clinics are a valuable resource, and in our department a senior decision maker at a registrar level is involved in majority of decision making. The admission rate is low, demonstrating that the service is effective in helping to avoid admissions. Consultant input can help avoid repeated reviews.

Self-reported immune status and COVID-19 associated subjective cognitive functioning in post-COVID-19 syndrome: Examination of an Irish cohort.

Cognitive changes are very frequently reported by people with post-COVID-19 syndrome (PCS), but there is limited understanding of the underpinning mechanisms leading to these difficulties. It is possible that cognitive difficulties are related to immune status and/or low mood. The aim of the present study was to examine the relationship between immune status and cognitive functioning in PCS, while considering whether depression symptoms also influence this association. Participants were recruited in an online study of cognitive and psychological consequences of PCS, involving individuals attending a post-COVID clinic in an acute general hospital in Ireland, and a comparison sample of age- and sex-matched community controls who had also been infected with COVID-19 but had not experienced PCS. Participants with PCS (n=71) and community controls (n=50) completed the immune status questionnaire, Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F). Significant differences were observed between groups in terms of perceived immune status, perceived cognitive function, depression scores, and fatigue, with the "PCS" group reporting lower immune status, more cognitive difficulties, and higher levels of depression and fatigue. Regression analysis in the PCS group indicated that immune status and depression significantly contributed to variance in subjective cognitive functioning, with immune status remaining a significant predictor of cognitive functioning scores even when accounting for depression, fatigue, and other covariates related to PCS, such as Body Mass Index(BMI). Our findings suggest that subjective cognitive functioning is influenced by self-reported immune status in PCS, emphasising the importance of immune status, cognitive, and mood screening as part of routine clinical care in PCS.

Impact of VO 2peak on the Clinical Outcomes of Older Patients With Coronary Heart Disease in China.

The aim of this study was to explore the role of cardiopulmonary exercise test parameters, especially peak oxygen uptake (VO 2peak ), in predicting the incidence of adverse cardiovascular events in older Chinese patients with coronary heart disease (CHD). Older patients with CHD who underwent cycle ergometer cardiopulmonary exercise test at the Cardiac Rehabilitation Clinic of Chinese PLA General Hospital from July 1, 2015 to January 31, 2020 were enrolled. The follow-up intervals were 6mo. Cox regression was used to analyze the relationship between VO 2peak and adverse cardiovascular events. Restricted cubic splines and subgroup analyses were used to observe the relationship between VO 2peak and the hazard ratio (HR) of the primary end point event (PEE), which included a composite of all-cause death, nonfatal recurrent myocardial infarction, unscheduled revascularization, and stroke. The composite end point event was the PEE combined with cardiac rehospitalization. A total of 1223 participants (mean age 68±5yr) were included. Median follow-up was 68mo. Mean VO 2peak was 16.5±4.0 mL/kg/min, and VO 2peak was an independent predictor of the PEE (HR=0.929; 95% CI, 0.891-0.970; P =.001). This association was further validated by restricted cubic spline and subgroup analyses. Peak oxygen uptake was also an independent risk factor for the composite end point event (HR=0.968; 95% CI, 0.941-0.996; P =.025). In conclusion, VO 2peak is an independent risk factor for adverse cardiovascular events in older Chinese patients with CHD, and more optimal therapy should be recommended to patients with lower VO 2peak .

Bronchoscopy with and without needle-based confocal laser endomicroscopy for peripheral lung nodule diagnosis: protocol for a multicentre randomised controlled trial (CLEVER trial)

IntroductionDespite many technological advances, the diagnostic yield of bronchoscopic peripheral lung nodule analysis remains limited due to frequent mispositioning. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic feedback on needle...

#2657 Evaluation of the impact of a nephrologist led acute kidney Injury clinic in a large district general hospital

Abstract Background and Aims Acute kidney injury (AKI) has a significant impact on inpatient hospital admissions costing the NHS in the UK an estimated £1bn. Hospitalisation complicated by AKI results in increased length of stay and mortality and up to a fifth of discharged patients are readmitted to hospital within 30 days. Traditionally district general hospitals in the UK have limited nephrology cover. In our large district general hospital, a new nephrologist led AKI clinic was established to review patients whose inpatient admissions were complicated by a stage 2 or 3 AKI. Over a 7-month period the aim was to evaluate this new clinic and its impact for local patients and the hospital trust. Method Inpatients with stage 2 and 3 AKI were identified by a specialist AKI nurse and nephrologist as suitable for the clinic. A discharge summary was generated with the stage and cause of AKI. Patients were seen within 6 weeks of discharge by either a nephrologist or a specialist AKI nurse. Data was retrospectively collected, and this included diagnosis, causes of AKI, highest stage of AKI, progression of chronic kidney disease (CKD) and referral to tertiary chronic kidney disease services. Using the hospital's own AKI dashboard, we looked at 30-day readmission rates of all AKIs and overall hospital length of stay over this period. Results Retrospective data was collected for 245 patients who attended the clinic over 7 months. 43.9% had a stage 3 AKI, 41.4% had a stage 2 AKI, the remainder of patients were CKD patients with progression or had an underlying glomerular pathology. The most common cause for AKI was hypovolaemia (41.8%) followed by infection/sepsis (37.7%). Most AKIs fully resolved (58.1%), 7% of patients had not resolved and 27% partially resolved. 12.3% of patients were referred onto nephrology tertiary services. Over the course of the 7 months, the trend of 30-day readmission rates dropped from 18.2% to 10.1% (Fig. 1). There was no significant change in hospital length of stay. Conclusion The nephrology led AKI clinic has had a meaningful impact in our post discharge patient care. We have been able to review patients in a timely manner providing them with a holistic approach. A significant number of patients were identified and referred early for specialist tertiary CKD management. Over the 7-month period there was a reduction in 30-day readmission rates however it has not yet affected overall length of stay. This study supports a nephrologist led AKI clinic in a district general hospital.

Prevalence and Causes of Stigmatization Among Patients With Chronic Skin Diseases in Saudi Arabia.

Skin diseases can lead to stigmatization with negative consequences for patients' quality of life and mental health. The aim of this study was to estimate the prevalence of stigmatization experienced by patients with vitiligo, psoriasis, acne, rosacea, or atopic dermatitis and to assess the relationships between the level of stigmatization and patient characteristics. This cross-sectional study included adult patients with vitiligo, psoriasis, acne, rosacea, or atopic dermatitis attending the dermatology clinics of various general hospitals in Saudi Arabia. Stigma levels were assessed using the six-item Stigma Scale. The prevalence of stigmatization was 90.4% among the 280 patients included. Multiple regression analyses revealed the factors that independently and significantly increased the level of stigmatization. These included male gender (B = 4.300, 95%CI 3.407-5.192, P <0.001), positive family history of skin conditions (B = 2.267, 95%CI 1.139-3.395, P <0.001), number of skin diseases (B = 2.357, 95%CI 0.998-3.716, P = 0.001), and presence of facial lesions (B = 2.455, 95%CI 1.206-3.705, P<0.001). The prevalence of stigmatization is high among patients with chronic skin diseases in Saudi Arabia. Identifying patients at risk for high levels of stigmatization may allow them to be provided with appropriate social and psychological support.

Relationships Between Age of Onset, Seizure Frequency, And Disease Duration with Cognitive Function in Epilepsy Patients at the Neurology Clinic of H. Adam Malik Central Hospital, Medan

Background: Cognitive function disorders often occur in individuals with epilepsy. The decline in cognitive function in epilepsy patients can be caused by various factors, including age of onset, seizure frequency, and duration of the disease. This study aims to investigate the relationship between the age of onset, seizure frequency, and disease duration on the cognitive function of epilepsy patients at the Neurology Outpatient Clinic of Haji Adam Malik General Hospital in Medan Method: The chosen research design is a cross-sectional analytic. The study was conducted at the neurology outpatient clinic of the Adam Malik Central General Hospital in Medan. The samples used were patients diagnosed with epilepsy at the Neurology Outpatient Clinic of Adam Malik Central General Hospital in Medan, aged 18-65 years, and without any other medical conditions aside from epilepsy. The study involved 35 subjects.Result: The majority of the research subjects are aged 18-45 years (94.3%), with more males (51.4%) than females. Most have a high school education background (48.6%), and the largest group is unemployed (62.9%). The most common age group at onset is 0-18 years (48.6%). The majority of subjects experience seizures in the rare category (less than 1 time per month) at 62.9%. Most subjects have a disease duration of less than 15 years (65.7%). The majority of epilepsy patients at the Neurology Outpatient Clinic of H. Adam Malik Hospital (52.1%) have abnormal cognitive function based on the MoCA-Ina test results. Statistical analysis was conducted using the chi-square test and multivariate analysis with logistic regression. The chi-square test results revealed a significant relationship between age of onset and cognitive function (p=0,008), a significant relationship between seizure frequency and cognitive function (p=0,004), and a significant relationship between disease duration and cognitive function (p=0,012). The multivariate analysis results indicated that disease duration had a significant relationship with cognitive function, with an odds ratio of 0,081 (p-value=0,037, 95% CI 0,008-0,862).Conclusion: There is a relationship between age of onset, seizure frequency, and disease duration with the cognitive function of epilepsy patients at the Neurology Outpatient Clinic of Haji Adam Malik General Hospital in Medan

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.

Distribution and Characteristics of Colonic Diverticula in Northern China.

The prevalence of colonic diverticula is rising in eastern countries, possibly related to aging and the adoption of a western lifestyle. However, limited data exist regarding the distribution and endoscopic features of colonic diverticula in this population. This study aimed to assess the number, size, depth, and location of colonic diverticula in our study cohort. We collected data from patients who underwent colonoscopy at the Endoscopy Center of Tianjin Medical University General Hospital and Bao Di Clinical College of Tianjin Medical University. We thoroughly evaluated and documented any colonic diverticula encountered during the procedures. Logistic regression analysis was employed to explore associations between participant characteristics and the presence of colonic diverticula. Our study included a total of 27,021 eligible patients from our colonoscopy database, among whom 1529 individuals (5.67%) exhibited one or more diverticulosis. Patients with colonic diverticula (mean age: 58.6) were significantly older and exhibited a male predominance compared with those without diverticula. Cases of right-sided, left-sided, and bilateral diverticulosis were recorded in 1161 (76.0%), 170 (11.1%), and 198 patients (12.9%), respectively. Patients with right-sided diverticula (mean age: 55.2), more common in males, were younger than those with left-sided diverticula (mean age: 67.1, P < 0.05), which were more frequent in females (P < 0.001). Individuals aged 60 years or older (odds ratio: 4.32, P < 0.001) and those with bilateral diverticulosis (odds ratio: 21.2, P < 0.001) had a higher likelihood of having a greater burden of diverticula. Colonic diverticula in Northern China predominantly manifests as right-sided, more common in males, and associated with older age. Notably, patients with right-sided diverticulosis tend to be younger than those with left-sided diverticula. In addition, a higher burden of diverticula is more prevalent in individuals aged 60 years or older and those with a bilateral distribution pattern.

A Cross-Sectional Study about Demographic and Medical Characteristics of Hypertensive Pregnant Women in Two Secondary Healthcare Facilities, in Ilorin, Nigeria

Background Hypertension is one of the major causes of related maternal deaths worldwide and it is one of the most common medical disorders encountered during pregnancy. Aim This study aimed at assessing the demographic and medical characteristics of hypertensive pregnant women in two secondary healthcare facilities, in Ilorin, Nigeria Method This was a cross-sectional study among 104 pregnant women with hypertension attending the outpatient department of General Hospital and Civil Service Clinic, Ilorin between March and May 2021. A validated self-administered questionnaire was used to obtain information on sociodemographics. Data on the medical characteristics of the respondents and their medications were extracted from the respondent's medical files. Ethical approval was obtained from the Ministry of Health and General Hospital, Ilorin. For statistical analysis for categorical measurements, the frequencies and percentages were computed. Results Seventy-five percent of the correspondents were below 36 years old, 97% were married, 79% had tertiary education, and 74% were above 24 weeks of gestation. About 68% of the correspondents had blood pressure more than or equal to 140/90 and 10% had blood pressure more than 160 mm Hg systolic or more than 100 mm Hg diastolic. About 78.8% of the correspondents had a family history of hypertension, 13.5% had a family history of diabetes mellitus, and 22.1% had a family history of obesity. About 27.9% had pre-existing hypertension, 61.5% developed hypertension before the end of 20 weeks of gestation, and 10.6% developed hypertension after 20 weeks of gestation. About 24% had their antihypertensive medication changed during pregnancy, 38.5% were treated with methyldopa, 31.7% with nifedipine, and 27% with nifedipine and methyldopa. Majority (83.6%) of the respondents were not adherent to their medications. Conclusion Two-third of the patients had poor blood pressure control irrespective of the fact that all were under drug therapy. Family history and large body mass index are the main risk factors for the development of hypertension during pregnancy. Noncompliance may play a significant role in no drug response.

Effective prediction of somatic symptom disorder–B criteria in China: A case report

According to the diagnostic criteria for somatic symptom disorder (SSD) outlined in the Diagnostic and Statistical Manual of Mental Disorders-5th (DSM-5), there is a necessity for a rapid, simple, and effective diagnostic tool in the outpatient setting to predict the SSD&amp;ndash;B criteria. This study aims to evaluate the screening diagnostic value of combining the duration of concern about physical discomfort per day with the Whiteley Index-8 (WI-8) scale. In a previous multicenter cross-sectional study, patients were recruited from outpatient clinics in general hospitals (n = 699). In this comparative study, we recruited an additional 100 patients from a psychosomatic outpatient unit. Receiver operating curve (ROC) analysis was applied to obtain the optimal cutoff value for the time spent worrying about physical discomfort per day and the WI-8 scale. The analysis of both datasets reveals significant differences in the amount of time spent on symptoms per day between the groups. In the previous multicenter study, patients in the high-score group expressed more concern about physical discomfort than those in the low-score group (4.5 &amp;plusmn; 4.8 h/day [h/d] vs. 0.9 &amp;plusmn; 1.9 h/d; t = 13.943; P &lt; 0.01). In the current comparative study (n = 100), the high-score group spent 5.3 &amp;plusmn; 4.2 h/d worrying about physical symptoms, while the low-score group spent 2.3 &amp;plusmn; 3.7 h/d. ROC curve analysis indicated that the cutoff value for time in the previous multicenter study was 1.25 h (area under the ROC curve [AUC] = 0.839), and the WI-8 scale score was 19 (AUC = 0.907). Combining the two increased the AUC&amp;ndash;0.921 (P &lt; 0.001). The cutoff value for time in the comparative study was 1.9 h (AUC = 0.801), and the WI-8 scale score was 11 (AUC = 0.925). Combining the two increased the AUC to 0.935 (P &lt; 0.001). The combination of time and the WI-8 scale offers a simple, cost-effective, rapid, and direct method for clinical doctors to screen for somatic symptom disorders&amp;ndash;B criteria.

Organization and Establishment of Scientific Research Management in Environmental Monitoring Departments

Objective: To explore the common problems in the daily nursing management of outpatient clinics in general hospitals and put forward countermeasures. Methods: A total of 20 nurses who were in charge of nursing management in the outpatient clinic from June 2017 to June 2018 were selected as the research subjects, and the problems existing in nursing management in 2017 (before improvement) were summarized, and countermeasures were proposed for improvement in 2018 (after improvement). The results of nursing management quality evaluation, the incidence of outpatient adverse events and patient satisfaction before and after the improvement were compared. Results: After the improvement of outpatient nursing management, the scores of nurses' theoretical knowledge and nursing skills were significantly higher than those before the improvement (P&lt;0.05). After the improvement of outpatient nursing management, the incidence of adverse events was 2.00%, which was significantly lower than that of 10.00% before the improvement (P&lt;0.05). After the improvement, the nursing satisfaction of the patients was 98.00%, which was significantly higher than the 85.00% before the improvement, and the difference was statistically significant (P&lt;0.05). Conclusion: Taking targeted measures to improve the problems in outpatient daily nursing management in general hospitals can significantly improve the quality of nursing management, reduce the occurrence of adverse events in outpatient nursing, and improve patients' satisfaction, which is worthy of promotion.

Factors related to delayed initiation of antiretroviral therapy among patients with clinically eligible HIV-infected

Background: Human Immunodeficiency Virus (HIV), namely a virus that reduces the ability of the human immune system, so that sufferers are susceptible to various diseases, the wider scope of ARV administration certainly has a positive impact in reducing mortality and morbidity, improving the quality of life of patients with HIV and AIDS.Purpose: To determine the factors associated with delayed initiation of antiretroviral therapy in Human Immunodeficiency Virus patients at the VCT (Voluntary Counseling and Testing) Clinic of Pringsewu Hospital in 2022.Method: This type of quantitative research, using a cross sectional design. The population of this study were HIV positive patients at the Pringsewu Regional General Hospital Clinic, Lampung for the year 2022, namely 174 patients, using the side total technique. Univariate data analysis, bivariate with chi square and multivariate with multiple logistic regression tests.Results: The result showed that the factors associated with delayed initiation of antiretroviral therapy in Human Immunodeficiency Virus patients at the VCT Clinic at Pringsewu General Hospital in 2022 were Socioeconomic Status (p value=0.009), education level (p value=0.001, opportunistic infections (p value= 0.001), HIV/AIDS Stigma (p value=0.003), and Access (p value=0.018). The most dominant factor associated with delayed initiation of antiretroviral therapy in patients with Human Immunodeficiency Virus infection was access (95% CI, p=0.027 and OR; 3.738).Conclusion: Antiretroviral therapy (ARV) delays in PLWHA are strongly influenced by low socioeconomic status, low education level, presence of opportunistic infections, positive stigma and remote access to healthcare services.Suggestion: Management at the hospital's VCT clinic is suggested to make guidelines or standardized services, educate about the importance of ARVs, provide motivation, and carry out consistent control of ARV therapy. The management always promotes the importance of awareness and adherence in carrying out ARV therapy which will have many benefits in improving quality of life, healthy behavior, and extending life span.

Comparing the accuracy of positive and negative indocyanine green staining in guiding laparoscopic anatomical liver resection: protocol for a randomised controlled trial

IntroductionKnowledge of the clinical liver anatomy has evolved with advanced imaging modalities and laparoscopic surgery. Therefore, precise anatomical resection knowledge has become the standard treatment for primary and secondary liver...

Relation between Vitamin D Deficiency and Dry Eye

Background Tears are very important to the overall health of the eye and vision. The tear film is mechanically distributed over the ocular surface through a neuronally controlled blinking mechanism. Normal blink reflex, contact between the external ocular surface and the eye lids, and normal corneal epithelium are three factors required for effective resurfacing of the tear film (tear stability). (1) Objective To demonstrate the relation between vitamin D deficiency and dry eye disease searching for finding a correlation between dry eye parameters with vitamin D deficiency. Patients and Methods Cross sectional study. A total 50 patients attending the ophthalmology outpatient clinic of General Ain Shams Hospital, from February 2019 to October 2019 were enrolled in the study after the approval of the research ethical committee in the Faculty of Medicine, Ain Shams University. They were divided randomly into 2 groups. Group 1: consisted of 35 patients who were vitamin D deficient. Group 2: consisted of 15 patients who had normal vitamin D levels (control group). Results The study showed that there was statistically significant increase in symptoms of dry eye in female patients than male patients and there was statistically significant decrease in the level of tear film break up time, Shirmer test and serum 25 (OH) vitamin D in cases with dry eye than those without. It was found that there was statistically significant decrease in vitamin D level in female cases than male cases. Also, there was statistically significant decrease in vitamin D level in cases with symptoms of dry eye and conjunctival hyperemia than cases without. There was also statistically significant positive correlation between serum 25 (OH) vitamin D and tear film break up time and Shirmer test. Conclusion The present study suggests that patients with vitamin D deficiency may suffer from dry eye. Investigations to confirm and quantify a clinical diagnosis of dry eye should include serum 25 (OH) vitamin D when suspecting vitamin D deficiency especially in patients prone to this type of vitamin deficiency.

FTP6.2 Utility of Ultrasound Imaging in a Successful Ambulatory Emergency Surgical Unit

Abstract Aim Drives towards ambulatory management in emergency surgery have been supported by same day imaging to expedite decision making. We aimed to assess the frequency of surgical pathology identified by ultrasound, and subsequent requirement for operation. Methods All acute general surgery referrals to the ambulatory clinic of a large District General Hospital between 01/01/2021 and 22/07/2022 were included. Information regarding presentation, imaging, and diagnosis were collected in prospectively maintained databases, and subsequently analysed. Results Over an 18-month period, 3154 patients were seen, with a 91.7% successful ambulation rate (n=2938). 1099 patients (34.8%) underwent ultrasound, the majority were upper abdominal (63.7%, n=698); a further 33.1% (n=364) were pelvic. Ultrasound diagnosis was suggested in 52.7% of scans (n=588); upper abdominal ultrasound provided a diagnosis in 54.9% (383/698), compared to 28.8% (105/364) of pelvic ultrasounds (p&amp;lt;0.001). 61 patients (5.6%) were admitted following ultrasound, of whom 36% (n=22) had no ultrasound diagnosis. Admission rate for diagnostic ultrasound was 6.9% (39/567). Some 204 (18.6%) patients proceeded to operation; 25 (2.3%) underwent an emergency operation, 88 (8%) were operated on ambulatory lists, and 91 (8.3%) were listed electively. Conclusions Ultrasound is a commonly used adjunct in the ambulatory setting, particularly for assessment of biliary pathology. It has an acceptably high pathology pick up rate, and significant proportions go on to require surgical intervention, which can be ambulatory for the majority.

Awareness of Hepatitis B Virus Infection and Vaccination Rate Among Adults Attending the Out-Patient Clinic of General Hospital, Ilorin, Nigeria

Background: Hepatitis B virus (HBV) is a potentially life-threatening infection affecting the liver from acute disease to chronic infection state and sometimes even leading to death. This study was done to determine the level of awareness of the hepatitis B virus as a disease, the availability of its vaccine, as well as the vaccination rate among the study population. Methods: This study was a descriptive cross-sectional study, and it was done at the General Hospi-tal Ilorin, Kwara State, Nigeria. The study population was adults aged 18 years and above attend-ing outpatient clinics. The sample size for this study was 377, with a male to female ratio of 128:249. The study instrument was a structured and semi-structured interviewer-administered questionnaire. The data was analyzed using Statistical Packages for Social Sciences IBM (SPSS) 21. Results: The overall level of awareness of HBV infection was very low (19.4%), only 38% of the participants knew HBV infection as a disease, while very few of them knew the causative agent (4.9%), and only 15.4% of the participants knew the transmission routes of the HBV. However, about half of the participants were aware of the existence of the HBV vaccine (50.8%). Only very few participants had ever received the vaccine as an adult, with a vaccination rate of 4.6%. There were statistically significant associations between HBV vaccination status, knowledge of the dis-ease, knowledge of HBV causative agent (P &lt;0.001), and knowledge of HBV transmission routes (P &lt;0.001). These factors positively impact vaccination uptake in this study. It was also observed that more young people were more likely to have received the HBV vaccine when compared to the elderly ones (P &lt;0.001). Similarly, secondary education students were more likely to receive the HBV vaccine (P = 0.039). Conclusion: The awareness of HBV infection and the knowledge of the disease were very low, same with vaccination uptake. Young people and those with formal education would likely obtain the HBV vaccination.