Department Of General Hospital Research Articles

Prevalence of odontogenic cysts in oral and maxillofacial surgery department of hasan sadikin general hospital: 2 years retrospective study

Background: Odontogenic cysts are cysts arising from the odontogenic epithelium. According to the World Health Organization in 2017, classification of odontogenic cysts are classified into cysts originating from inflammatory and developmental processes. Most cystic lesions of the oral and maxillofacial cavity are of odontogenic origin and have higher incidence than other body parts. This study to explain about prevalence of odontogenic cyst in RSUP Hasan Sadikin in 2019-2020 .Method: This study was a retrospective study that included 30 patients diagnosed with odontogenic cysts during 2019-2020. The data taken in each patient were age, gender, location of predilection, investigations, diagnosis, management, and recurrence of cases of odontogenic cysts.Result: A total of 15 patients had developmental odontogenic cysts and 15 had inflammatory odontogenic cysts. Most developmental cysts were 12 patients with dentigerous cysts, Odontogenci Keratocyst in 2 patients, and calcifying odontogenic cyst in 1 case. Inflammatory cysts were dominated by 15 patients with radicular cysts.Conclusion: Prevalence of odontogenic cyst was found more in female, with radicular cyst and location in the maxilla

Evaluation of knowledge, attitude and practice towards drug-drug interactions among postgraduates in tertiary care hospital, Kurnool

Background: Drug-drug interactions (DDIs) are changes in a drug’s effects due to concurrent use of another drug. Clinically significant interactions lead to undesired adverse effects, therapeutic failure, toxicity or may even cause death of the patients. The Aim is to evaluate the Knowledge, Attitude and Practice of Postgraduates regarding DDIs and implementation of educational program may enhance patient’s safety.Methods: A cross-sectional study was conducted among postgraduates in all clinical departments of Government general hospital, Kurnool in the month of October 2021. Pre-validated questionnaire was used to assess the KAP. It contains demographic data, knowledge and practice questions related to DDIs and attitude towards the preferable sources of drug interaction information. Data analysis was done by using SPSS version 26.Results: Out of 220 questionnaires distributed, 126 postgraduates submitted with complete answers(n=126). Overall response rate is 57%. By using the Bloom’s cut-off points, most of the respondents (43.5%) had low level of knowledge towards DDIs. Even respondents with high knowledge level (19%) are not practicing the drug interaction screening during the admission of patients. Majority of PGs with low level knowledge agreed to ask doctors than pharmacist about DDIs and prefer to search for DDIs using reference book than online mode as the source of drug information.Conclusions: In my study, most of the respondents had insufficient knowledge to prevent life threatening DDI’s. So, there is a need to increase medical educational program regarding the importance of screening and assessing of DDI’s before prescribing medicines.

Do patients prefer face-to-face or telephone consultations in an outpatient cardiology department?

Abstract Introduction There has been a significant rise in the telephone clinic consultations in preference to face-to-face (FTF) clinics in the UK during the COVID 19 pandemic. The cardiology department in a district general hospital has also seen increased use of telephone clinics. We wanted a greater understanding of the impact of telephone consultations on patient satisfaction. Methods A patient satisfaction survey was designed based on the joint Royal College of Physicians training board (JRCPTB) patient satisfaction survey. The survey (Image 1) was sent via post to 300 patients reviewed by the cardiology outpatient department during November 2021. 150 who had telephone appointments and to 150 patients who had FTF appointments. Descriptive statistics and student T test were used to compare differences between the two groups with a p value of <0.05. Results There were 171 responses returned over a four-week period giving a 57% response rate. Of these, 75 respondents had a telephone appointment and 96 who had FTF appointments. 49% of the FTF patients were male compared to 55% of the telephone clinic respondents. The majority of patients were aged 70–89 in both groups and most patients were retired (79.2% for FTF and 65.3% on the telephone consultation group). More patients felt the doctor was polite and considerate in FTF clinics compared to telephone consultation (97% compared to 92% positive responses, p value – 0.02). There was no significant difference in patients feeling listened too, being allowed time to ask questions, understanding their condition and being involved in decision making between the two groups (Table 1). Of the FTF group, 81% preferred FTF clinics with only 3% preferring telephone clinics and 16% with no preference. Of the telephone group 53% stated a preference for FTF clinics, with 11% having a preference for phone clinics and 36% having no preference. Patients rated overall experience more positively with FTF appointments (95%) compared to telephone clinics (85%, p value 0.02). Conclusion Telephone consultations performed at a comparable level to FTF clinics although patients demonstrate an overall preference for FTF clinics. Funding Acknowledgement Type of funding sources: None.

E-mental health implementation in inpatient care: Exploring its potential and future challenges.

There is a great evidence base today for the effectiveness of e-mental health, or the use of technology in mental healthcare. However, large-scale implementation in mental healthcare organisations is lacking, especially in inpatient specialized mental healthcare settings. The current study aimed to gain insights into the factors that promote or hinder the implementation of e-mental health applications on organisational, professional and patient levels in Belgium. Four Belgian psychiatric hospitals and psychiatric departments of general hospitals invited their professionals and patients to use Moodbuster, which is a modular web-based platform with a connected smartphone application for monitoring. The platform was used in addition to treatment as usual for three to four months. The professionals and patients completed pre- and post-implementation questionnaires on their reasons to participate or to decline participation and experiences with the Moodbuster platform. Main reasons for the organisations to participate in the implementation study were a general interest in e-mental health and seeing it is a helpful add-on to regular treatment. The actual use of Moodbuster by professionals and patients proved to be challenging with only 10 professionals and 24 patients participating. Implementation was hindered by technical difficulties and inpatient care specific factors such as lack of structural facilities to use e-mental health and patient-specific factors. Professionals saw value in using e-mental health applications for bridging the transition from inpatient to outpatient care. Twenty-two professionals and 31 patients completed the questionnaire on reasons not to participate. For the patients, lack of motivation because of too severe depressive symptoms was the most important reason not to participate. For professionals, it was lack of time and high workload. The current implementation study reveals several important barriers to overcome in order to successfully implement e-mental health in inpatient psychiatric care.

Tuberculosis screening in respiratory department inpatients in comprehensive medical institutions

Objective: To explore the effect of screening tuberculosis patients in the respiratory department of general hospitals, and to provide a basis for the development of patient screening strategy. Methods: Clinical information and sputum samples of inpatients in the respiratory department of a general hospital in Longhua District, Shenzhen from December 2018 to December 2020 were collected. Sputum samples were sent to the tuberculosis laboratory of the Shenzhen Longhua Center for Chronic Disease Control (designated tuberculosis diagnosis and treatment institution) for sputum smear, liquid culture and Gene-Xpert test. Results: A total of 407 sputum samples (23 cases of suspected tuberculosis by chest imaging and 384 by clinical manifestations) were collected from 3 724 hospitalized patients. A total of 88 patients with positive etiology were detected by the three methods, and the positive rate was 21.6% (88/407), among which 15 patients with suspected tuberculosis were detected by imaging reports, and the positive rate of etiology was 19.0% (73/384) in the reported patients without imaging reports. At least 1.96% (73/3 724) of the hospitalized patients were estimated to be tuberculosis positive during the study. Pneumonia (30.1%,22/73), cough (15.1%,11/73) and pulmonary infection (15.1%,11/73) were the main characteristics in the patients with positive pathogens. Conclusions: Screening for tuberculosis among inpatients in the respiratory department of general hospitals is an effective way to detect patients who were radiographically reported to have probable tuberculosis. It is of great significance to carry out active screening in key departments of general hospitals for tuberculosis detection and control.

A Comparative Study of Fetal MRI and Antenatal Ultrasound in Prenatal Diagnosis with Histopathological Correlation

AbstractThe aim of this study was to assess the role of magnetic resonance imaging (MRI) in the diagnosis of fetal anomalies and its correlation with antenatal Ultrasound (US) and histopathology. The study was conducted in the Department of Radiodiagnosis, Basaveshwar Teaching and General Hospital attached to Mahadevappa Rampure Medical College, Kalaburagi. It was conducted over 6 months and included pregnant women with suspected fetal anomalies on US. MR images were read independently by two radiologists and findings were confirmed with histopathology and post natal follow up. 15 patients underwent MRI for different indications all of who were referred after US. In 8/15 cases (53.34%), the US findings and MRI findings were concordant. MRI imaging provided additional information in 7/15 cases (46.66%). With advances in MRI technology and cumulative experience, MRI can be used as a valuable complementary tool to ultrasound in detecting and better evaluating fetal anomalies. The major role of fetal MRI is confirmation of abnormal sonological findings, evaluation of sonological occult fetal CNS pathologies and reassurance in equivocal US findings.

Treatment Outcome and Associated Factors Among Patients Admitted with Hypertensive Crisis in Public Hospitals at Harar Town, Eastern Ethiopia: A Cross-Sectional Study.

Hypertensive crisis is a significant global health issue that raises the costs to healthcare systems and requires specific attention to improve clinical outcome. There is scarce information on hypertensive crisis cases treatment outcome in the study setting. This study aimed to assess treatment outcome and associated factors among patients admitted with hypertensive crisis at Public Hospitals in Harar Town, Eastern Ethiopia. A cross-sectional study was conducted among 369 hypertensive crisis patients who had been admitted to the emergency department of Hiwot Fana Comprehensive Specialized Hospital and Jugol General Hospital from May 1, 2017, to May 1, 2022. All hypertensive crisis patients who fulfilled the inclusion criteria were included. The data were extracted from medical records using a data abstraction format. The collected data were analyzed using Statistical Package for Social Sciences version 22. Binary logistics regression model using bivariate and multivariable analysis with 95% confidence intervals and P-values were used to determine the association between variables. The medical records of 369 patients in total were reviewed. Of these, the medical records of 363 patients contained all the necessary information and were used in the study. More than half of the patients (238; 65.6%) were males. Among 363 patients admitted with hypertensive crisis, 98 (27.0%, 95% Confidence Interval (CI):22.5%-31.9%) of them had poor treatment outcome of hypertensive crisis. Being female (Adjusted Odds Ratio (AOR)=3.4; 95% CI=1.7-7.9), residing in rural areas (AOR=2.4; 95% CI=2.7-5.1), taking captopril during admission (AOR=5.6; 95% CI=2.4-7.9), taking antihypertensive treatment before admission (AOR=0.5; 95% CI=0.2-0.9), and being non compliant to treatment (AOR=2.7; 95% CI=1.4-3.5) had statistically significant associations with poor treatment outcome of hypertensive crisis compared to their counterparts. The magnitude of poor treatment outcome of hypertensive crisis was high. Sex, residence, non-compliance, and type of emergency drug administered during admission were substantially related with poor treatment outcome of hypertensive crisis. Health professionals should put great emphasis on emergency drugs administered during admission to achieve the desired outcome.

Characteristics of Pediatric Patient Transfers From General Emergency Departments in California From 2005 to 2018.

Each year, approximately 300,000 pediatric patients are transferred out of emergency departments (EDs). Emergency department transfers may not only provide a higher level of care but also incur increased resource use and cost. Our objective was to identify hospital characteristics and patient demographics and conditions associated with ED transfer as well as the trend of transfers over time. This was a retrospective cohort study of pediatric visits to EDs in California using the California Office of Statewide Health Planning and Development ED data set (2005-2018). Hospitals were categorized based on inpatient pediatric capabilities. Patients were characterized by demographics and Clinical Classifications Software diagnostic categories. Regression models were created to analyze likelihood of outcome of transfer compared with admission. Over the 14-year period, there were 38,117,422 pediatric visits to 364 EDs in California with a transfer rate of 1% to 2%. During this time, the overall proportion of pediatric transfers increased, whereas pediatric admissions decreased for all hospital types. Transfers were more likely in general hospitals without licensed pediatric beds (odds ratio [OR], 16.26; 95% confidence interval [CI], 15.87-16.67) and in general hospitals with licensed pediatric beds (OR, 3.54; 95% CI, 3.46-3.62) than in general hospitals with pediatric intensive care unit beds. Mental illness (OR, 61.00; 95% CI, 57.90-63.20), poisoning (OR, 11.78; 95% CI, 11.30-12.30), diseases of the circulatory system (OR, 6.13; 95% CI, 5.84-6.43), diseases of the nervous system (OR, 4.61; 95% CI, 4.46-4.76), and diseases of the blood and blood-forming organs (OR, 3.21; 95% CI, 3.62; 95% CI, 3.45-3.79) had increased odds of transfer. Emergency departments in general hospitals without pediatric intensive care units and patients' Clinical Classifications Software category were associated with increased likelihood of transfer. A higher proportion of patients with complex conditions are transferred than those with common conditions. General EDs may benefit from developing transfer processes and protocols for patients with complex medical conditions.

Lessons From a Near-Peer Junior Doctor Teaching Program in Trauma and Orthopedics.

A junior doctor teaching program delivered by near-peers can foster collaboration in a less-pressured and conducive learning environment. The aim of this study was to provide an analysis of an orthopedic teaching program in a high-resource environment utilizing readily available tools and resources that are potentially available in most hospitals globally. Methods:This study involved the utilization of an outcome-based learning approach with regular formal feedback. An anonymized Google Forms survey using a 10-point Likert scale was conducted after a 30-week period. The survey tool was sent out to 28 doctors and two senior nurse practitioners who participated in the program either as tutors, learners, or both. A total of 19 out of 30 respondentscompleted the survey giving a 63% survey completion rate. The setting for this study was the trauma and orthopedics department in a United Kingdom district general hospital. Learners' confidence in their orthopedic knowledge and skills pre-program had a median response of eight with a mode of seven whereas confidence following engagement on the program improved with a median response of nine and a mode of 10. At an alpha level of 0.05, this observed improvement was statistically significant using the Mann-Whitney U test (p=0.466). Tutors' perception of the usefulness of the teaching feedback had a median response of nine with a mode of 10. Relevance of the selected topics had a median response of nine and a mode of 10. Inclusion in the teaching program to cater to learner diversity had a median response of nine and a mode of 10. The effectiveness of a blended approach for learning had a median response of nine and a mode of 10. Conclusion:This study has provided evidence of the benefits ofa near-peer teaching program. This is especially important in the post-coronavirus disease (COVID) pandemic recovery period where easily accessible and well-grounded educational programs will be useful to complement the deanery teachings for trainees. This is important as this may be the main source of formal teaching for non-trainee junior doctors in many hospital settings.Additional research will be needed to further explore the pros and cons of such programs within a surgical specialty like orthopedics with an emphasis on the various pedagogical approaches to teaching and learning for junior doctors working in a busy clinical setting.

A Novel Index in the Prediction of Pneumonia Following Acute Ischemic Stroke.

The aim of our study was to search for predictive factors and to develop a model (index) for the risk of pneumonia following acute ischemic stroke. This study is an analysis of prospectively collected data from the neurology department of a district general hospital in Poland, comprising 1001 patients suffering from an acute ischemic stroke. Based on the medical data, the formula for the prediction of pneumonia was calculated. Multivariate assessment for pneumonia occurrence was performed using the new PNEUMOINDEX. The study showed a significant increase in pneumonia risk with an increasing PNEUMOINDEX (OR non-adjusted = 2.738, p < 0.001). After accounting for age and comorbidities as confounders, the effect of the Index on pneumonia changed marginally (OR = 2.636, p < 0.001). This study presents factors that show a significant association with the occurrence of pneumonia in patients with acute ischemic stroke. The calculated PNEUMOINDEX consists of data obtained at admission, namely NYHA III and IV heart failure, COPD, generalized atherosclerosis, NIHHS score on admission, and CRP/Hgb ratio, and shows high prediction accuracy in predicting hospital-acquired pneumonia in ischemic stroke patients.

Effects of antenatal corticosteroids on neonatal blood glucose fluctuation in late-preterm infants.

To evaluate the effects of antenatal corticosteroids (ACS) on blood glucose fluctuations in late-preterm neonates. A retrospective study was performed on 236 neonates with gestational age of 34+0 to 36+6 weeks who were admitted to the neonatology department of a tertiary general hospital in China's Zhejiang Province between April 2020 and February 2022. The neonates were divided into three groups: complete course, partial course, and control. Primary outcome was the neonatal blood glucose levels within the first 48 h of life. 134 (56.8%) newborns were exposed to a complete course of ACS, 56 (23.7%) had a to a partial course of ACS, and 46 (19.5%) had no exposure to ACS. The patients in the complete course group had the highest proportion of neonatal hypoglycemia (16.4% vs. 3.6% and 6.5%).The patients exposed to a complete course of dexamethasone had significantly lower blood glucose levels within 12 h of birth than the control group, although no significant differences were observed after 24 h. Differences in blood glucose levels were more significant among male infants, although blood glucose curves of the male and female infants remained close to the overall trend. Blood glucose levels in late-preterm neonates may decrease after ACS administration, especially after exposure to a complete course. The effects are more pronounced in the first 12 h of life, with males being more severely affected; however, the effects on blood glucose levels were not significant 24 h after birth. This can provide a reference for future clinical studies.

Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro

To identify factors associated with adverse maternal outcomes during the coronavirus disease 2019 (COVID-19) pandemic. This was a single-centre prospective cohort study at a maternity department in a public general hospital in Rio de Janeiro. All pregnant women evaluated for emergency care, labour and delivery, respiratory symptoms, obstetric reasons or medical reasons between May 2020 and March 2022 at the study institution were invited to enrol in this study. The endpoint was maternal mortality or intensive care unit (ICU) admission. In total, 1609 pregnant women were enrolled in this study. Of these, 25.5% (n=410) were infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) based on reverse transcription polymerase chain reaction or an antigen test. There were 21 deaths and 67 ICU admissions in 4% of the cohort. The incidence of severe maternal morbidity and mortality was higher during the Gamma wave than during the Delta wave (P=0.003). Vaccination conferred protection against the endpoint [relative risk (RR) 0.4, 95% confidence interval (CI) 0.1-0.9; P=0.0169]. Factors associated with severe morbidity and mortality included caesarean section (RR 3.7, 95% CI 1.7-7.9; P=0.0008), SARS-CoV-2 infection in the third trimester (RR 2.4, 95% CI 1.1-5.6; P=0.0006) and comorbidities (RR 3, 95% CI 1.8-5.2; P<0.0001). COVID-19 was significantly associated with the risk of severe maternal morbidity and mortality. Immunization of pregnant women against COVID-19 was highly protective against adverse outcomes, and should be encouraged during pregnancy.

Ultrasound Assessment of Cesarean Section Scar and its Correlation to Intraoperative Scar Status

Background and Aim: In the past decades the rate of cesarean sections has increased enormously, there are many indications for cesarean section like placenta previa, labor dystocia, presumed fetal distress, fetal malpresentation, multiple gestation, and suspected fetal macrosomia, but the commonest reason for performing a cesarean is a previous cesarean birth .The present study aimed to compare the sonographically measured lower uterine scar with actual status of scar at the time of operation. Methodology: The descriptive cross-sectional study was conducted on 150 female patients who presented to Obstetrics department of Creek general hospital, affiliated with UMDC from August 2021 to January 2022. The Inclusion Criteria was: females with singleton pregnancy with history of previous single caesarian section, vertex presentation and gestational age 36-40 weeks. While women with multiple gestations, placenta previa, polyhydramnios or any uterine abnormality were excluded. Results: The overall mean of age, gestational age, parity and fetal weight were 28.22±4.59 years, 37.60±0.78 weeks, 1.73±0.94 and 2.75± 0.47 kg respectively. Significant association was observed between lower uterine segment measurements by Sonographic scar thickness during pregnancy and intra-operative scar findings at the time of delivery (p-value&lt; 0.05). Conclusion: The present study found that sonographically measured lower uterine scar thickness is a solid predictor for scar defect in women with previous cesarean section. As a result, we can conclude that sonographic measurement of lower uterine segment thickness is a reliable tool for assessing scar status and deciding which women should be given a vaginal delivery trial. Keywords: Previous Caesarean Section, Lower uterine scar, Sonography

Comparison of Shearwave Elastography and Apri Score for Liver Fibrosis in Patients of Chronic Liver Disease

Chronic liver disease of various etiologies is the major causes of mortality and morbidity globally. Liver biopsy is the most accurate and oldest method to determine the chronic liver disease progression and for liver histology. Shear wave elastography (SWE) is a new non-invasive technique that applies localized mechanical compression to the soft tissue with focused ultrasonography and obtains tension images showing the tissue response. Aspartate aminotransferase to platelets ratio (APRI) on the other hand is relatively less expensive test and can be done on outpatient basis. Objective: To find the relation between APRI aspartate and SWE for detection of liver fibrosis in patients with chronic liver disease. Study Design: A Cross Sectional study Setting: Medical Unit-1 Lahore General Hospital Lahore and Department of Gastroenterology &amp; Hepatology, Doctors Hospital and Medical Centre, Lahore. Study Duration: From July 2019 to December 2021. Methods: 180 patients met the criteria of inclusion were included, the blood samples were obtained and sent to the hospital laboratory for valuation of AST and Platelets. Reports were evaluated, APRI was calculated and patients were labeled as negative or positive. Then all patients underwent SWE by a senior radiologist for assessment of liver fibrosis. Patients were labeled as negative or positive. Agreement was noted, all data was entered on a specifically designed proforma, and data were analyzed and entered in SPSS version 20 statistical method. Agreement was calculated by generating 2x2 tables between APRI and SWE findings. Kappa statistics was calculated to measure the strength and significance of agreement. P-value ≤0.05 was taken as significant. Results: In this study, the patients mean age was 46.39 ± 16.02years. There were 119 (66.11%) males and 61 (33.89%) females. The mean BMI of patients was 24.70 ± 5.23kg/m2. The mean duration of CLD was 5.50 ± 2.672 years. The mean AST of patients was 73.98 ± 60.23IU/L while mean platelet count was 200.65 ± 92.47/cm3. The mean APRI was 1.41 ± 1.20. The mean SWE was 18.32 ± 23.85kPa. The APRI and SWE agreed on 73 (54.9%) cases and showed 66.7% agreement between them for diagnosis of liver fibrosis (p&lt;0.05). Conclusion: Thus, APRI and SWE showed strong agreement but further trials are required to confirm the evidence. Keywords: Agreement, APRI, Aspartate aminotransferase to platelets ratio, SWE, Shear-wave elastography, Chronic liver disease and Liver fibrosis.

Demographic and Occupational Factors Affecting Fatigue and Social Support among Nurses in the Emergency Department: A Cross-Sectional Study

The aim of the present study is the investigation of the levels of fatigue and social support in nursing staff working in the Emergency Department of General Hospitals in the broader area of Athens. Moreover, the impact of demographic and occupational factors on fatigue and social support was examined. This is a quantitative cross-sectional study including 62 nurses who completed the Fatigue Assessment Scale (FAS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Based on the results, males presented higher score of mental fatigue compared to females (p=0,015) while nurses with master or PhD degree appeared to have more support from their family in comparison to those with lower educational level (p=0,040). Further, the results demonstrated a statistically significant and negative correlation between working hours per week and the perceived social support from friends (r= -0,302, p=0,021) as well as the total social support (r= -0,296, p=0,024). The findings show that there is a strong effect of demographic and occupational factors on fatigue and social support among nurses.

Microbial Pattern and their Sensitivity of Ventilator Associated Pneumonia in an Intensive Care Unit of a Ter-tiary Care Hospital in Dhaka

Background: ICU admission imposes great risk of nosocomial infections on the patients due to various invasive interventions. Patients treated in these units receive invasive procedures such as endotracheal intubation and mechanical ventilation which predispose to a nosocomial pneumonia of a special entity named as ‘Ventilator Associated Pneumonia’. Almost half of all the cases of hospital acquired pneumonia are due to VAP and about half of all antibiotics administration in ICU are for treatment of Ventilator Associated Pneumonia. Objectives: objective of the current study was to study the local microbiological profile of ventilator associated pneumonia and their sensitivity pattern in the Critical Care department of BIRDEM general hospital. Design: Cross-sectional study. Setting: ICU of an academic tertiary care hospital in the period of July 2017 to June 2018. Methods: All consecutive patients who were intubated and mechanically ventilated for a period of at least 48 hours within the study period were evaluated for the selection criteria of the study. The included study participants were followed up daily for signs of development of VAP. Once VAP was suspected pertinent investigations were sent to confirm the diagnosis. Tracheal aspirate was collected using conventional specimen trap and aseptic endotracheal suctioning technique and sent for Gram staining and culture and sensitivity testing. Results: In this study total 92 patients out of 625 intubated patients during the study period after fulfilling the inclusion criteria were selected as study participants. 35 participants out of 92developed VAP. Only 1 (2.9 %) patient did not yield any microbial growth in the tracheal aspirate sample and 34 (97.2 %) participants had growth of organisms in their tracheal aspirate samples. Total growths of 45 organisms were found in respiratory secretions of 34 VAP patients. The commonest organism was Acinetobacter which was grown in 21 (46.7%) samples followed by Pseudomonas in 10 (22.2%) samples; Klebsiella in 8 (17.8%) samples; Staphylococcus aureus in 3 (6.7%) samples; Candida in 2 (4.4%) and Enterococcus in 1 sample (2.2%). Most of the bacteria grown in the tracheal aspirates of VAP positive participants were sensitive to less than three antibiotic classes. Conclusion: Multidrug resistant organisms are mostly responsible for both early and late onset VAP in ICU. Bangladesh Crit Care J September 2022; 10(2): 122-126

Factors Affecting In Quality Of Healthcare Services In Critical Care Departments Of General Hospitals

Background: Healthcare organizations strive for quality in their service delivery as a way of keeping up with the competing trends in clients’ attraction. In the process, they have become cognizant of the key performance indicators to help track progress and performance. Despite the growing interests in healthcare KPIs, little has been done in terms of KPIs in the general hospitals, especially in the critical care units. Therefore, this study was designed to assess the implications of KPIs on the quality of healthcare service delivery in the critical care department in a general hospital in the Kingdom of Saudi Arabia.&#x0D; Methods: Quantitative descriptive quantitative research was conducted a among 300 healthcare workers in the critical care unit of a general hospital in Saudi Arabia. Data was collected after receiving ethical approval and participants’ consent. Accordingly, the researcher administered the questionnaires to the selected participants using a pre-made research questionnaire using the 5-point Likert scale. The collected data was analyzed using linear regression and the descriptive statistical tests of SPSS, version 26.&#x0D; Results: From the descriptive statistical analysis, two key performance indictors outstood in the critical care department of general hospitals. These include experiences with hospital staff (mean=3.143; SD =2.00) and Patient Readmission Rate (mean=3.106; SD=1.419). A statistically significant relationship was also noted between patient readmission rate (p=.030), experiences with hospital staff (p=.070) and staff's commitment to patients (p=.016) and the quality of critical care care services.&#x0D; Conclusion: Key performance indicators are crucial in tracking the milestones made in healthcare organizations towards meeting patients’ needs. Healthcare system management need to develop a means of tracking their key performance indicators for informed improvements in quality of their services.

Airway Management in COVID-19: The University of the Philippines – Philippine General Hospital Experience

As a designated COVID-19 referral center, managing COVID-19 patients who will require respiratory support wasexpected. This paper describes how the University of the Philippines - Philippine General Hospital Department ofAnesthesiology created and continuously revised airway management guidelines for these patients in light of theconstantly evolving COVID-19 pandemic.

Intestinal infectious diseases increase the risk of psychiatric disorders: A nationwide population-based cohort study.

Intestinal infectious diseases (IIDs) are among the most common diseases and are prevalent worldwide. IIDs are also one of the major disease groups with the highest incidence worldwide, especially among children and older adults. We observed a higher probability of IIDs in patients from the psychiatric department of Tri-Service General Hospital. Therefore, our objective was to investigate if there is an association between IIDs and the risk of developing psychiatric disorders. This nationwide population-based study used the database of the National Health Insurance (NHI) program in Taiwan. The study included 150,995 patients from 2000 to 2015, comprising 30,199 patients with IIDs as the study group and 120,796 patients without IIDs as the control group. Cox proportional hazards regression analysis was performed to calculate the hazard ratio of psychiatric disorders during the 16-year follow-up. Of the patients with IIDs, 4022 (13.32%) developed psychiatric disorders compared to 8119 (6.72%) who did not (P < .001). The adjusted hazard ratio (aHR) for overall psychiatric disorders in the study group was 2.724 (95% confidence interval [CI]: 2.482–2.976; P < .001). More specifically, the study group had a higher risk of developing a psychiatric disorder, including sleep disorders, depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD)/acute stress disorder (ASD), schizophrenia, mental retardation (MR), substance abuse, and other psychiatric disorders. Furthermore, refractory IIDs (seeking medical attention for IIDs 3 or more times) increased the risk (aHR: 3.918; 95% CI: 3.569–4.280; P < .001) of developing psychiatric disorders. There was an association between IIDs and the increased risk of developing psychiatric disorders. The novel role of etiological factors in the development of psychiatric disorders deserves more attention, and the control of pathogens that cause IIDs is of urgent public health importance.

Do patients prefer face-to-face or telephone consultations in an outpatient cardiology department?

Abstract Introduction There has been a significant rise in the telephone clinic consultations in preference to face-to-face (FTF) clinics in the UK during the COVID 19 pandemic. The cardiology department in a district general hospital has also seen increased use of telephone clinics. We wanted a greater understanding of the impact of telephone consultations on patient satisfaction. Methods A patient satisfaction survey was designed based on the joint Royal College of Physicians training board (JRCPTB) patient satisfaction survey. The survey (Image 1) was sent via post to 300 patients reviewed by the cardiology outpatient department during November 2021. 150 who had telephone appointments and to 150 patients who had FTF appointments. Descriptive statistics and student T test were used to compare differences between the two groups with a p value of &amp;lt;0.05. Results There were 171 responses returned over a four-week period giving a 57% response rate. Of these, 75 respondents had a telephone appointment and 96 who had FTF appointments. 49% of the FTF patients were male compared to 55% of the telephone clinic respondents. The majority of patients were aged 70–89 in both groups and most patients were retired (79.2% for FTF and 65.3% on the telephone consultation group). More patients felt the doctor was polite and considerate in FTF clinics compared to telephone consultation (97% compared to 92% positive responses, p value – 0.02). There was no significant difference in patients feeling listened too, being allowed time to ask questions, understanding their condition and being involved in decision making between the two groups (Table 1). Of the FTF group, 81% preferred FTF clinics with only 3% preferring telephone clinics and 16% with no preference. Of the telephone group 53% stated a preference for FTF clinics, with 11% having a preference for phone clinics and 36% having no preference. Patients rated overall experience more positively with FTF appointments (95%) compared to telephone clinics (85%, p value 0.02). Conclusion Telephone consultations performed at a comparable level to FTF clinics although patients demonstrate an overall preference for FTF clinics. Funding Acknowledgement Type of funding sources: None.