Disposable Instruments Research Articles

In Situ Processing and Efficient Environmental Detection (iSPEED) of tree pests and pathogens using point-of-use real-time PCR.

Global trade and climate change are responsible for a surge in foreign invasive species and emerging pests and pathogens across the world. Early detection and surveillance activities are essential to monitor the environment and prevent or mitigate future ecosystem impacts. Molecular diagnostics by DNA testing has become an integral part of this process. However, for environmental applications, there is a need for cost-effective and efficient point-of-use DNA testing to obtain accurate results from remote sites in real-time. This requires the development of simple and fast sample processing and DNA extraction, room-temperature stable reagents and a portable instrument. We developed a point-of-use real-time Polymerase Chain Reaction system using a crude buffer-based DNA extraction protocol and lyophilized, pre-made, reactions for on-site applications. We demonstrate the use of this approach with pathogens and pests covering a broad spectrum of known undesirable forest enemies: the fungi Sphaerulina musiva, Cronartium ribicola and Cronartium comandrae, the oomycete Phytophthora ramorum and the insect Lymantria dispar. We obtained positive DNA identification from a variety of different tissues, including infected leaves, pathogen spores, or insect legs and antenna. The assays were accurate and yielded no false positive nor negative. The shelf-life of the lyophilized reactions was confirmed after one year at room temperature. Finally, successful tests conducted with portable thermocyclers and disposable instruments demonstrate the suitability of the method, named in Situ Processing and Efficient Environmental Detection (iSPEED), for field testing. This kit fits in a backpack and can be carried to remote locations for accurate and rapid detection of pests and pathogens.

PD01-10 SURGICAL SITE INFLUENCES COST EFFECTIVENESS OF URETEROSCOPY IN A LARGE HEALTHCARE SYSTEM

You have accessJournal of UrologyStone Disease: Surgical Therapy I (PD01)1 Apr 2020PD01-10 SURGICAL SITE INFLUENCES COST EFFECTIVENESS OF URETEROSCOPY IN A LARGE HEALTHCARE SYSTEM Sari Khaleel*, Andrew Portis, James Anderson, and Michael Borofsky Sari Khaleel*Sari Khaleel* More articles by this author , Andrew PortisAndrew Portis More articles by this author , James AndersonJames Anderson More articles by this author , and Michael BorofskyMichael Borofsky More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000821.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopy(URS) has become the most common surgical management for urolithiasis. Disposable instruments (DI’s) used during URS may vary, which in turn affects overall procedure cost. To date, the influence of surgeon and hospital site on the total DI cost (DIC) of URS has not been formally studied. We sought to assess whether surgeon and site were independently associated with DIC in a large multi-hospital system. METHODS: Our institutional electronic medical record (Epic Systems, Madison, WI) was retrospectively searched for procedures billed for CPT codes 52356/52353 (URS with/without stent placement), performed from 8/2018 – 08/2019. We developed a computer program in Perl programming language to analyze raw EMR data. Our outcomes of interest were mean case length, number of DI’s, and hospital-incurred total DIC. DI’s were classified as laser fiber, wires, ureteral stent, stone basket, ureteral access sheath, ureteral dilator, dual lumen catheter, or other “miscellaneous” items with DIC ≥$50. We selected for surgeons who performed at least 20 procedures at more than one site. Sites were deemed high- or low-volume (HV, LV) sites if their annual volume was above or below median site volume in the system.Multivariate regression was used identify predictive factors, and analysis of variance (ANOVA) was used to assess variation across different sites and surgeons. RESULTS: We identified 368 cases performed by 8 surgeons across 6 sites (3 HV sites, 3 LV sites). Median site volume was 100 cases. Most cases (304, 75.2%) were performed at HV sites. Mean case DIC, case length, and number DI’s used varied significantly across sites (ANOVA p = 0.000 for all three variables). Overall mean DIC was $975 ($388.8 – $1863), mean number of DI’s used was 5.48 (3-9), and mean total case length was 78.7 minutes (28 – 187.8). On multivariate regression, only surgical site was a significant predictor of DIC (p = 0.000), when adjusting for surgeon and high/low volume status (Figure 1). Site and surgeon were both significant predictors of number of DI’s used (p=0.000), and case length (p = <0.01). CONCLUSIONS: Procedural costs related to URS may vary between hospitals even when performed by the same surgeon. Further investigation into hospital practices with low DIC’s is warranted in an effort to potentially identify opportunities for cost savings. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e63-e64 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sari Khaleel* More articles by this author Andrew Portis More articles by this author James Anderson More articles by this author Michael Borofsky More articles by this author Expand All Advertisement PDF downloadLoading ...

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Minimally invasive, sutureless, adolescent male circumcision with topical anesthetic: a field trial of Unicirc, a single-use surgical instrument.

BackgroundCircumcision has been shown to reduce the rate of HIV transmission in Africa. It is most cost effective if performed in younger men. Surgical assist devices can increase the efficiency and potentially reduce the cost of performing circumcisions.MethodsWe used the Unicirc disposable instrument to perform circumcisions in an outpatient primary care clinic. The trial was non-blinded. Circumcisions were performed under topical anaesthetic and the wound was sealed with cyanoacrylate tissue adhesive. The primary outcome was intraoperative duration; secondary outcomes were intraoperative and postoperative pain; adverse events (AEs); time to healing and patient satisfaction; and, cosmetic result.ResultsA total of 82 adolescent boys (aged 10–15 years) were circumcised. The median intraoperative time was 10 minutes and the median blood loss was 1 mL. All wounds were healed by 4 weeks and cosmetic results were excellent. There were no AEs.ConclusionsAdolescent circumcision with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is safe, rapid, and heals by primary intention with excellent cosmetic results. It is cost effective and can be used for large scale programs.

X-ray endovascular treatment management in the hospital

Demand for X-ray endovascular treatment continues to grow in the medical services market. The use of X-ray endovascular technology for the treatment of acute and chronic cardiovascular diseases, which are a significant medical, social and economic problem on a global scale, is scientifically justified. Opening of the interventional radiology department in a healthcare organization provides level 3 of health care, increases frequency of hospitalization of patients with cardiovascular diseases and, as practice shows, changes the economic balance of the organization in a positive direction. In the Russian Federation X-ray endovascular treatment for patients is provided mainly in the interventional radiology departments by interventional radiologists, who are not attending physicians of these patients. Separation of duties and legal responsibilities, a conflict of interest between specialists can contribute to reducing the quality of health care. Performing X-ray endovascular surgeries with expensive disposable instruments and their non-rational use can reduce the cost-effectiveness of treatment and lead to unfavourable economic balance of the healthcare organization and receivables. The article presents basics of X-ray endovascular care system management at the local level, based on the analysis of results of its organization in the Moscow Oblast, in order to increase the clinical and economic efficiency of treating patients with cardiovascular diseases and improve public health. The obtained results show that the head of a healthcare organization must possess not only the knowledge and experience in organization of health care, but also be a crisis manager for managing regional vascular center in the structure of the healthcare institution in order to increase the clinical and economic effectiveness of X-ray endovascular treatment.

A comparative carbon footprint analysis of disposable and reusable vaginal specula

Healthcare systems in the United States have increasingly turned toward the use of disposable medical equipment in an attempt to save time, lower costs, and reduce the transmission of infections. However, the use of disposable instruments is associated with increased solid waste production and may have negative impacts on the environment, such as increased greenhouse gas emissions. The purpose of this study was to inform this discussion; we applied life cycle assessment methods to evaluate the carbon footprints of 3 vaginal specula: a single-use acrylic model and 2 reusable stainless steel models. The functional unit of the study was defined as the completion of 20 gynecologic examinations by either type of speculum. The greenhouse gas emissions (eg, carbon dioxide, methane, nitrous oxide) across all life cycle stages, which includes material production and manufacturing, transportation, use and reprocessing, and end-of-life, were analyzed with the use of SimaPro life cycle assessment software and converted into carbon dioxide equivalents. The reusable stainless steel grade 304 speculum was found to have a lesser carbon footprint over multiple model scenarios (different reprocessing techniques, autoclave loading/efficiency, and number of uses) than either the reusable stainless steel grade 316 or the disposable acrylic specula. The material production and manufacturing phase contributed most heavily to the total life cycle carbon footprint of the acrylic speculum, whereas the use and reprocessing phase contributed most to the carbon footprints of both stainless steel specula. The use of disposable vaginal specula is associated with increased greenhouse gas equivalents compared with reusable alternatives with no significant difference in clinical utility. These findings can be used to inform decision-making by healthcare systems, because they weigh a wide range of considerations in making final purchase decisions; similar analytic methods can and should be applied to other components of health systems' waste streams.

Life cycle assessment of a disposable and a reusable surgery instrument set for spinal fusion surgeries

The worldwide increasing wealth and increased life expectancy of humans has led to an increase in the number of medical procedures and surgeries. Surgeries are complex medical procedures which contribute to a significant share of the total environmental impact of the healthcare system. Among other important sources of environmental impacts from surgeries, material consumption due to required instrumentation accounts for up to 65 % of greenhouse gas emissions from surgeries. This study investigates how a disposable and a reusable surgery instrument sets for lumbar fusion surgeries contribute to the environmental impact and which system is more advantageous for the environment. For lumbar fusion surgeries, reusable and disposable instrumentation and implant sets are commercially available. Both sets are capable to support a one level lumbar fusion surgery. The reusable set is comprehensive and fully opened before the surgery, while the disposable system comes in a modular box system, and the boxes are opened on demand during the surgery. To compare the environmental impact of these different configurations, a comparative Life Cycle Assessment (LCA) was performed to assess the overall environmental impacts of both alternatives. One of the key findings is that the selected cleaning and sterilization process for reusable instruments is responsible for up to 90 % of the greenhouse gas emissions and decides which system is advantageous from an environmental perspective. Reducing the number of instruments to be cleaned and sterilized for a surgery should be the focus for future surgery instruments development from an environmental perspective.

Dermatosurgery Practice and Implications of COVID-19 Pandemic: Recommendations by IADVL SIG Dermatosurgery (IADVL Academy).

Dermatosurgery Practice and Implications of COVID-19 Pandemic: Recommendations by IADVL SIG Dermatosurgery (IADVL Academy).

Can a simple ‘cost-awareness’ campaign for laparoscopic hysterectomy change the use and costs of disposable surgical supplies? Pre–post non-controlled study

ObjectivesDoes a cost-awareness campaign for gynaecologists lead to a change in use and costs of disposable surgical supplies for laparoscopic hysterectomy (LH) without increasing hospital utilisation measures (operating room (OR)...

Letting the Numbers Speak for Themselves: A Simple Approach to Cost Reduction for Laparoscopic Appendectomy

Instrument choices are influenced primarily by a surgeon's training and individual preference. Cost is often of secondary interest, particularly in the absence of any contracted fiscal obligation to the hospital. The purpose of this study was to evaluate how a simple intervention involving dissemination of cost data among a surgeon peer group influenced behavior with respect to surgical instrument choice. Cost data for laparoscopic appendectomies between July-December 2016 were disseminated to surgeons belonging to the same department of a teaching hospital. Each surgeon was provided his or her own cost data along with blinded data for his or her peers for comparison. Cost for each disposable instrument used among the group was provided for reference. Costs of laparoscopic appendectomy performed after the intervention (June-December 2017) were compared with costs before the intervention, for both individual surgeons and the group as a whole. A random effects linear regression model clustered on surgeon was then used to assess the average cost saving of the intervention while accounting for the intracorrelation of surgeon costs. One outlier was removed from the analysis, resulting in a cohort of 89 cases before the intervention and 74 postintervention. After outlier removal, data were normally distributed. The mean cost per case decreased for 10 of the 11 surgeons analyzed (minimum decrease of $7 to maximum decrease of $725). The remaining surgeon increased from an average of $985 ± 235 pre-intervention to $1003 ± 227 postintervention. The average cost saving for the group was $238 ± 226 and was associated with an average reduction in cost of 21 per cent. A linear regression analysis clustered on surgeon suggested the intervention was associated with an average saving of $260 (β = -260, SE = 39, P < 0.001). After dissemination of cost data among surgeon peers, a reduction in costs was observed. Most notably, significant savings occurred in the absence of any mandate or incentive to reduce costs. Providing cost data to surgeons to facilitate natural competition among peers is a simple and effective tool for reducing operating room costs.

Ex vivo Comparison of 2 Disposable versus a State-of-the-Art Reusable Ureterorenoscope

Introduction: The success of upper urinary tract endoscopy on one hand and the high cost of purchase and maintenance of the scopes on the other hand have driven the development of disposable digital flexible ureterorenoscopy (fURS). Materials and Methods: We performed an ex vivo comparison of 2 disposable digital fURS from different companies with a state-of-the-art reusable endoscope from another well-established scope manufacturer. The scopes were tested comparing parameters such as instrument handling, irrigation flow, image quality, and deflection. For the disposable scopes, the latter 2 were evaluated both, before and after vigorous stress testing. Results: Expectedly, the most consistent finding among the 3 instruments was the marked decrease on irrigation flow following insertion of a working element, most notably a guidewire. Depth perception and ergonomic handling were comparable in all 3 instruments. Poststress testing revealed a significant loss of upward deflection in both disposable instruments, more so when an auxiliary instrument is inserted into the working channel. However, this did not appear to be the case in downward deflection. Conclusions: To our knowledge, this is the first study that used a vigorous stress testing protocol comparing disposable and reusable fURS. The newer generation disposable scope fared better than the older one. Results are encouraging and indicate that improvements are ongoing and progressing, bringing the quality of disposable scopes to the level that we are used to from our reusable high performance scopes while at the same time avoiding costly damage repairs. Continuous research and evidence-based interpretation of results in the absence of commercial bias are paramount to ensure this ongoing development.

THE PREVALENCE RATE OF HEPATITIS C VIRUS IN BASRAH CITY AND THE COMMON CAUSATIVE RISK FACTORS

Background: This prospective descriptive study was carried out in the Basra Public Health Department fromAugust 2017 to August 2018 on all patients registered at the Communicable Disease Control unit. Aim of the study. is to detect the prevalence rate of hepatitis c virus among risky group and to determined the most common risk factors. Patients and method.A total of 162137 (97283 male and 64854 female) people were screened and 355 (205 male and 150 female) people were found to be infected. The laboratory investigation included a blood sample to detect anti-hepatitis C virus antibodies by using an enzyme-linked immunosorbent assay test, which is a confirmatory test for those with positive results found using the HCV RNA genotype. Result. In this study, we found that the prevalence rate of the hepatitis C virus in Basra city among the screening group was 2% in comparison with the global population affected by this diseasebeing a little more than 3%. The most common risk factor for infection with the hepatitis C virus is dentinal interference (83 patients) with 23% affected cases, while the lowest risk factor is in prisoners. Among patients with cancer, the most common age group at the risk of infection with hepatitis C is 15 to less than 45 years and 0.5%. The number of infected people in rural areas is greater than in the center with a prevalence rate of 0.22% in Al-Qurna. The most common risky group exposed to infection are hemodialysis patient( prevalence rate 84.5%). Conclusion. It’s important to apply a screening program of hepatitis C to all population to have a more quorate prevalence rate; population health education about the risk factor of infection with hepatitis C and how to prevent it; a strict follow-up of all dentinal clinics by the health directorate and insure the use of sterilized instrument for every patient; use of disposable instrument in dentinal clinic if possible; early screening for renal disease is necessary to prevent the development of renal failure and its complication. Keywords. HBV, HCV, prevalence of hepatitis virus

Modern evaluation of abnormal uterine bleeding

Abnormal uterine bleeding in women older than age 40 years, and certainly in menopausal patients, mandates evaluation, mainly to exclude cancer and hyperplasia, but also to better diagnose the source of the bleeding to appropriately manage the patient. In the past, dilation and curettage was the mainstay of diagnosis. This gave way to in-office suction pump-generated biopsies. Most recently, disposable biopsy instruments with their own internal piston to generate suction have become the standard of care. Rarely has such a technique received such widespread acceptance with such limited validation. Transvaginal ultrasonography, when technically feasible, is a noninvasive way to image the endometrial cavity. Saline-infusion sonohysterography is a subset of transvaginal ultrasonography reserved for patients in whom an adequate endometrial echo is not seen or when an endometrial echo is seen but not sufficiently thin. Appropriate understanding and use of transvaginal ultrasonography and addition of sonohysterography when necessary can allow a clinical algorithm that can triage patients with abnormal uterine bleeding to (1) no anatomic pathology best treated expectantly; (2) a global endometrial process, in which case random blind endometrial sampling is appropriate; or (3) a focal endometrial abnormality in which case endometrial sampling should be done with the visualization offered by hysteroscopy. Newer disposable office hysteroscopes finally allow office hysteroscopy to be done as a truly “point-of-care option.” Finally, the incidence of thick endometrial echo found incidentally in postmenopausal women with no bleeding is extremely high (10–17%) and should not trigger automatic invasive endometrial evaluation.

Does Cost Influence the Choice of Disposable Versus Reusable Instruments? Mailed Survey of Obstetrician/Gynaecologists.

A "cost-awareness" campaign was undertaken at a tertiary hospital from 2015 to 2016 to raise awareness about costs of disposable versus reusable instruments in laparoscopic procedures. We undertook a before and after survey of obstetrician/gynecologists (Ob/Gyns) to find out if the campaign had affected their attitudes about choosing disposable versus less expensive reusable instruments. In 2015 (before the cost-awareness campaign) and 2017 (after the cost-awareness campaign), all full-time university-associated Ob/Gyns were mailed a cover letter, questionnaire, and coffee card ($5) with a postage-paid return envelope. Responses (with unique identification) from Ob/Gyns who perform laparoscopic procedures were entered into a password-protected REDCap database on a secure server. All statistical analyses were performed using SAS software version 9.4 (SAS Institute Inc, Cary, NC) (Canadian Task Force Classification II-3). A total of 35 of 42 eligible Ob/Gyns (85%) with a median 10 years in practice completed questionnaires before and after the intervention. The majority had undertaken minimally invasive surgery training, mainly during residency (80%) and conferences (71%). Before the intervention, the three most important qualities influencing their decision to use a particular instrument were safety (66%), effectiveness (57%), and personal experience (49%). After the intervention, the three most important qualities were effectiveness (57%), safety (57%), and ease of use (46%). Device cost was ranked sixth (26%) before and seventh (17%) after the intervention. The majority (57%) of participants did not change their choice of disposable or reusable instruments, or they would make the choice according to the specific procedure. Given the current economy, operative costs are constantly under review. Knowledge about Ob/Gyns' attitudes provides information to design more effective awareness campaigns to encourage use of less costly instruments. To change practice, a campaign increasing Ob/Gyns' exposure to less expensive but safe and effective instruments may help to increase uptake and potentially lead to cost reduction. Cost awareness alone is unlikely to change practice.

Surgical Management of Intraocular Silicone Oil Microdroplet.

Intraocular silicone oil microdroplets have been described after intravitreal injection of anti-VEGF agents packaged at a compound pharmacy. We present a case with the presence of an intraocular silicone oil microdroplet after a vitreoretinal operation using disposable instruments, and the surgical technique for its removal. A 59-year-old patient who had been operated on for vitreous opacities using a disposable 27-g vitrectomy kit complained of a small round structure floating in the eye. It appeared a few days after surgery. The bubble was not present at all times and it disappeared for days on end. Clinical examination of the vitreous and retina during these uneventful periods was normal. The bubble reappeared intermittently without a link to any specific movement for some time but was again absent once the patient was examined. The physical properties of the mobile round lesion could be identified as lighter than aqueous humor, as it was described as being in the center of the visual field if the head was tilted forward. As the patient was very bothered by this bubble, a 23-g vitrectomy was performed. During deep indentation of the pars plana over 360 degrees, a tiny bubble of silicone oil could be found buried in the peripheral vitreous base, and controlled aspiration under deep indentation was performed. The patient has been without symptoms since the removal of the droplet and made an uneventful clinical recovery. Microdroplets of silicone oil may be present in disposable vitreoretinal instruments and stay in the eye after surgery, causing a visual disturbance. The origin of these droplets may be linked to the plastic tubing of the instruments.

Development of a Unique Retractor for Performing Endoscopic Pituitary Surgery-EASYTRAC.

A unique self-expanding retractor (EASYTRAC®) is described, which provides several advantages for endoscopic pituitary surgery-enhanced visualization, creating more space, reducing the mucosal damage, and enhancing the nasal quality of life (QoF). Presented here is the proof of concept. EASYTRAC® is made of an aircraft-grade, SS-titanium alloy to provide optimal opening strength with a low profile (0.5 mm thick). It has a nonreflective, smooth surface finish. Patented design and wire pulling method of the EASYTRAC® makes it easy to insert and deploy. EASYTRAC® is inserted through the submucosal tunnel using a small, unilateral mucocutaneous incision. Following this, the ring attached to the wire is pulled out to deploy the retractor. This provides expansion of the retractor leading to fracture of the septum to one side at the keel of the vomer. The rest of the surgery is performed in the standard manner using an endoscope. The retractor is a single-use, disposable instrument and available in three different sizes. Five endoscopic endonasal surgeries have been performed using the EASYTRAC®(four pituitary adenomas, one craniopharyngioma). Deviated nasal septum (DNS) was present in two of the surgeries. All surgeries were approached through the right mucoseptal corridor, and presence of DNS did not reduce exposure (<10 minutes for exposure). No hardware problem was observed in any of the cases. Intraoperative cerebrospinal fluid (CSF) leak (n = 1) was managed with intraoperative, standard, triple-layer closure with glue and lumbar drain. Retractor seems to be safe, easy to use, and effective. The surgeon's capabilities are enhanced by the retractor's dynamicity, minimal fogging of scope, minimal trauma to the mucosa, and adequate space to allow the introduction of three instruments through a single nostril.

Does Cost Influence the Choice of Disposable vs Reusable Instruments? Survey of Obstetrician/Gynecologists.

Does Cost Influence the Choice of Disposable vs Reusable Instruments? Survey of Obstetrician/Gynecologists.

Does Cost Influence the Choice of Disposable vs Reusable Instruments? Survey of Obstetrician/Gynecologists [24Q

INTRODUCTION: A “cost awareness” campaign was undertaken at the Lois Hole Hospital for Women from 2015 to 2016 to raise awareness about costs of disposable versus reusable instruments for laparoscopic procedures. We undertook a survey of obstetrician/gynecologists (Ob/Gyns) to find out if the campaign had affected their attitudes about choosing disposable versus cheaper reusable instruments. METHODS: In 2015 and 2017, all full-time university-associated Ob/Gyns were mailed a cover letter, questionnaire and coffee card ($5) with postage-paid return envelope. Responses (with unique ID) from Ob/Gyns who perform laparoscopic procedures were entered into a password-protected REDCap database on a secure server. Data analysis used REDCap summary descriptive statistics. RESULTS: 34/47 eligible Ob/Gyns (72%) completed questionnaires before and after the intervention, with median 11.5 years in practice. The majority had undertaken MIS training, mainly during residency (78.4%) and conferences (73.0%). Before the intervention, the three most important qualities influencing their decision to use a particular instrument were safety (64.9%), effectiveness (54.1%) and personal experience (48.6%), and after the intervention were effectiveness (63.0%), safety (47.8%) and ease of use (47.8%). Device cost was ranked sixth (29.7%) before and fourth after (26.1%). CONCLUSION: Given the current economy, operative costs are constantly under review. Knowledge about Ob/Gyns’ attitudes provides information to design more effective awareness campaigns to encourage use of less costly instruments. To change practice, a campaign increasing Ob/Gyns’ exposure to cheaper but safe and effective instruments may help to increase uptake and potentially lead to cost reduction. Cost awareness alone is unlikely to change practice.

STERILIZATION &amp; CROSS INFECTION IN DENTISTRY

Objectives: This study aims to assess the knowledge, perception and attitudeof patients towards sterilization and cross Infection and to assess the effects of education onperception and behavior towards sterilization and cross infection. Cross infection control ismost important in dentistry as it is considered one of the main reasons of rapid spread ofinfectious diseases now a days. Setting: Major public sector hospital of Punjab Pakistan, PunjabDental Hospital Lahore. Material &amp; Method: We surveyed patients in OPDs of Punjab DentalHospital Lahore. Survey questions covered demographics as well as 15 questions related tosterilization and cross infection in dentistry. Questionnaires were given to educated peopleand interviews were taken from uneducated or less educated people. Data was collected andanalyzed. Results: patients have some knowledge about sterilization and cross infection buttheir concepts need a lot of improvement. Patients know that microbial contamination occursbut they are unaware of the diseases that are transmitted. Similarly on other perspective thereis discrepancy in knowledge and practice, as they do not take it seriously or they are unawareof the consequences of cross infection or long term effects of HIV, Hepatitis B &amp; C. Disposableinstruments are very important for controlling cross infection. Only 60% people said they wouldprefer disposable instruments over reusable instruments when option is given to them. Mostpeople are reluctant to be treated with disposable instruments due to extra cost on treatment.92% were well aware of significance of hand washing of dentist before and after dental checkup,but when they go through dental examination they are either careless or hesitant to ask dentistto wash hands. Conclusion: Besides the knowledge there are other factors like patientsattitude and concerns also play vital role in preventing infection transmission in them. We haveto educate them about infectious diseases and their root of transmission and their long termeffects on health.

PATIENTS PERCEPTION

Objectives: This study aims to assess the knowledge, perception and attitudeof patients towards sterilization and cross Infection and to assess the effects of education onperception and behavior towards sterilization and cross infection. Cross infection control ismost important in dentistry as it is considered one of the main reasons of rapid spread ofinfectious diseases now a days. Setting: Major public sector hospital of Punjab Pakistan, PunjabDental Hospital Lahore. Material &amp; Method: We surveyed patients in OPDs of Punjab DentalHospital Lahore. Survey questions covered demographics as well as 15 questions related tosterilization and cross infection in dentistry. Questionnaires were given to educated peopleand interviews were taken from uneducated or less educated people. Data was collected andanalyzed. Results: patients have some knowledge about sterilization and cross infection buttheir concepts need a lot of improvement. Patients know that microbial contamination occursbut they are unaware of the diseases that are transmitted. Similarly on other perspective thereis discrepancy in knowledge and practice, as they do not take it seriously or they are unawareof the consequences of cross infection or long term effects of HIV, Hepatitis B &amp; C. Disposableinstruments are very important for controlling cross infection. Only 60% people said they wouldprefer disposable instruments over reusable instruments when option is given to them. Mostpeople are reluctant to be treated with disposable instruments due to extra cost on treatment.92% were well aware of significance of hand washing of dentist before and after dental checkup,but when they go through dental examination they are either careless or hesitant to ask dentistto wash hands. Conclusion: Besides the knowledge there are other factors like patientsattitude and concerns also play vital role in preventing infection transmission in them. We haveto educate them about infectious diseases and their root of transmission and their long termeffects on health.