Hospital Equipment Research Articles

The Utility Of Pre-Procedural COVID-PCR Testing For Dental Aerosol Generating Procedures Is Questionable.

To compare the number of aerosol-generating procedures performed and the number of coronavirus disease-2019-positive workers in dental practice. The audit study was conducted in May 2021 at the Aga Khan University Hospital, Karachi, and comprised data from April 1, 2020, to March 31, 2021, which was retrieved from dental clinics at the main hospital and its Clifton branch as well as in three secondary care hospitals in Garden, Kharadar, Karimabad areas of Karachi, and one in Hyderabad, Pakistan. Data of individuals who followed mandatory pre 20 procedural polymerase chain reaction testing in addition to using personal protective equipment in the main hospital and Clifton branch was placed in group A, and of those using personal protective equipment only at the 4 satellite clinics with no testing was placed in group B. Dental charts of patients who underwent dental aerosol-generating procedures were analysed. Number of dental clinics affected by coronavirus disease 25 2019 and number of dental patients who were reported positive on pre-procedural polymerase chain reaction testing were evaluated. Data was analysed using SPSS 23. Of the 63 dental healthcare workers, 44(69.8%) were in group A and 19(30.2%) were in group B. In group A, 19(43.2%) were affected by coronavirus disease-2019 compared to 2(11%) in group B (p=0.01). Among 782(67.8%) patients who underwent polymerase chain reaction testing, 26(3.3%) turned out positive for coronavirus disease-2019. Due to the mandatory testing imposed on patients, 371/1153(32.2%) refused to get the desired dental treatment. The benefit of pre-procedural testing in dentistry remained uncertain.

Corrosion of Household Utensils: Causes, Effects and Remedies

This article was motivated by the avalanche of finance spent annually on addressing the harm caused by corrosion on household wares and buildings, industrial machines and facilities, hospital equipment and many other establishment of man in the universe. Corrosion is a universal phenomenon referred to as the deterioration of metallic material. Metal alloys like stainless steel and aluminium are extensively used in household utensils for their durability, affordability and corrosion resistance. However, these materials can leach heavy metals such as chromium, nickel, iron, and aluminium into food, posing serious health challenges. Stainless steel, despite its corrosion resistance, releases harmful metals when exposed to acidic foods, while aluminium utensils corrode and release harmful elements under certain conditions too. Hence, this article was aimed at examining the historical background of corrosion, the causes of corrosion in household wares and utensils, its impact especially on human health and economy, and the potential remedies. The findings indicated that acidic foods and prolonged storage increase metal leaching. Health concerns included increased risks of anemia, dementia, and osteomalacia due to excessive metal accumulation in the body. Mitigation strategies included using anodized aluminium, minimizing storage time of acidic foods in metal containers, and increasing public awareness about the potential health risks. Proper maintenance and selection of utensils could significantly reduce the hazards associated with metal leaching.

Research and Development Trend of Medical Oxygen Production Equipment

Oxygen therapy is an effective clinical method for the treatment of respiratory disorders, oxygen concentrator as a necessary medical auxiliary equipment in hospitals, its research and development has been a hot spot. The study reviewed the development history of the ventilator, introduced the two preparation technique of the oxygen generator pressure swing absorption (PSA) and vacuum pressure swing adsorption (VPSA), and analyzed the core technology development of the oxygen generator. In addition, the study compared some major brands of oxygen concentrators on the market and prospected the development trend of oxygen concentrators.

In this June issue

In line with several other journals we co-publish the Australian Commission on Safety and Quality in Health Care Low Back Pain Clinical Care Standard. It describes the early clinical management of people who present with a new acute episode of low back pain. The background to how the standard was developed and finalised are described in an introductory editorial. Coronial findings and royal commissions have repeatedly identified deficiencies in the emergency health care provided to prisoners in Australia. These deficiencies are operational, clinical and stigmatic and not limited to a single prison or jurisdiction. Applying a health quality of care framework focused on prevention and chronic health management appropriate assessment and escalation when urgent medical assistance is requested, and a structured audit framework could avoid future preventable deaths in prisons. We publish an editorial on this topic to accompany the paper written by a team from Victoria and Queensland. A group from the neurosurgery department of the Royal Brisbane and Women's Hospital report that the availability of cranial access equipment outside Queensland tertiary centres is limited. Inter-hospital transfers are likely to persist in Queensland and so improving access to cranial access equipment in hospitals where it is currently lacking is highly warranted. They surveyed senior theatre nurse or surgical service directors from rural and regional Queensland hospitals located outside the local catchment of a tertiary centre and had a CT scanner. Questions regarded availability, location and storage conditions of mechanical cranial access kits, as well as last usage, and associated patient outcomes. Life-threatening thoracic trauma requires emergency pleural decompression, and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe site for pleural decompression in children is challenging, even for experienced clinicians. A team from Melbourne report that the Mid-Arm-Point (MAP) technique, a procedural aid for use with injured adults, is also a safe site for pleural decompression in children <4 years and with a very minor modification is safe in children ≥4 years. An excellent study from Queensland describes the demographics, presentation characteristics, clinical features and cardiac outcomes for Aboriginal and Torres Strait Islander patients who present to a regional cardiac referral centre ED with suspected acute coronary syndrome (ACS). The authors conclude this cohort with suspected ACS have a high burden of traditional cardiac risk factors, regardless of whether they are eventually diagnosed with ACS. These patients may benefit from assessment for coronary artery disease regardless of age at presentation. In a nice paper, James Mallows explores the concept of collegiality, something considered to be any extra-role behaviour that is discretionary, not recognised by a formal reward system and that promotes the effective functioning of the organisation. There are few studies examining collegiality in the medical profession and none looking at collegiality among emergency physicians (EPs). He explores the perceptions of different ED health care professionals on the meaning of collegiality among EPs, the benefits of collegiality and behaviours they identify as indicative of collegiality. He identifies distinct themes and behaviours indicative of collegiality among EPs. Promoting these behaviours could improve staff well-being, ED efficiency, patient safety and productivity. Continuing with the previous theme, team culture underpins team performance. Psychological safety is a critical component of team culture for high performing teams. A group from the Gold Coast Hospital decided to explore this further. They conclude that familiarity of team members and leaders is critical to the development of psychological safety within the ED. Fostering familiarity should be a focus for frontline leadership each shift and a priority in broader departmental decisions for those seeking to enhance the psychological safety of their teams. The focus in this issue is on the anaesthetic component of the Fellowship training programme.

Letter: Evaluating Brain Tumor Surgical Management Capacity in Sub-Saharan Africa.

Letter: Evaluating Brain Tumor Surgical Management Capacity in Sub-Saharan Africa.

Redefine the Value of High-End Medical Equipment in the Construction of High-Level Hospitals

<i>Background:</i> Guangdong Province of China has started the construction of high-level hospitals, and Guangdong Province has started to build the Nogan as a national medical center and a national regional medical center, with the implementation of high-level hospital construction as the traction, to enhance the overall strength of medical and health services in Guangdong Province, and to provide higher quality medical and health services for the people. <i>Objective: </i>The introduction of high-end medical equipment in high-level hospitals is one of the important inputs. The high-level development of hospitals in the new form is inseparable from the configuration of high-end medical equipment. This paper takes the construction of high-level hospitals in Guangdong Province as an example, combined with the significance of the development of high-level hospitals, and repositions the value evaluation of high-end medical equipment. <i>Methods:</i> This study shows the importance of DRG index of high-end medical equipment. Focus on scientific evaluation of the social value of high-end medical equipment, high-end medical equipment continues to play a positive role, especially in promoting hospital teaching, medical treatment and scientific research work, has an irreplaceable role, and it is of great strategic significance to improve the core competitiveness of hospitals. <i>Conclusion: </i>In the construction of high-level hospitals, the social benefits of introducing high-end medical equipment are greater than the economic benefits.

Non-Invasive Ventilation via Tracheostomy in COVID-19 Patients Requiring Respiratory Support: Case Report

Since the first wave of COVID-19, different methods for management of COVID-19 ARDS were proposed. Early intubation and mechanical ventilation was performing more than other methods. after several mounths, limitation of equipment in hospitals, made the specialists think of less aggresive methods. NIV was one of suggestion performed before intubation which improve oxygenation of patients. They don't get any sedation and have regular diet. As a result, the need for ICU and ventilator for respiratory support decreases. In this case study, we report a patient that had permanent tracheostomy and hospitalised for COVID-19 ARDS. At first we connected the tracheostomy to a CPAP devise.

Impact of Sars-Cov-2 on access to healthcare by person with disabilities.

The Sars-Cov-2 pandemic has ravaged societies at their very core and deepened pre-existing inequalities. Meanwhile, persons with disabilities (PwDs), the most oppressed group in Ghana that live in poor and deplorable conditions are most like to be negatively impacted by the Sars-Cov-2 crisis. Therefore, the aim of this study is to explore how the Sars-Cov-2 pandemic is influencing access to healthcare by PwDs in the Sekondi-Takoradi Metropolis (STM). We collected data from 17 participants, nine from the Ghana Blind Union (GBU), five from Ghana Society for the Physically Challenged (GSPC), and three from the Ghana National Association of the Deaf (GNAD). An interview guide containing 25 items was used to gather data from the participants and we employed Phenomenological Analysis (PA) approach in making sense of the data. PWDs encounter many different barriers like; i) stigma and discrimination, ii) cost and availability of transport, iii) poor attitude of healthcare staff, iv) poor communication, v) hospital environment and equipment, vi) handwashing and sanitizing facilities, vii) unsuitable washrooms, viii) cost of healthcare, ix) registration and renewal of NHIS cards, and x) loss of income as they attempt to seek healthcare during this Covid-19 era in the STM. Covid-19 pandemic has widened the disproportionate and inequality gaps against PWDs in the STM when they attempt to seek healthcare. in the face of this, STM may lead Ghana to lag in achieving the Sustainable Development Goal (SDG) 3.8, which entreats nations to provide quality healthcare for all persons including PWDs. PWDs need education and empowerment to enable them demand for their rights when accessing healthcare. The findings highlight existing gaps in the implementation of the disability law by healthcare facilities in STM and, re-focus the attention of hospital managers in STM to the healthcare needs of PWDs in STM.

History of Diagnostic Radiology in Ghana

The history of Radiology in Ghana which began in 1951 has not been fully documented. The establishment of the Ghana College of Physicians and Surgeons, of which the Faculty of Radiology is a part, the West African College of Surgeons, as well as other institutions for radiography training, have played a major role in improving the Radiologist/Population-, Radiologist/Radiographer- and Radiographer/Population ratios in the country. Credence has also been given to a number of aims and objectives of the Faculty of Radiology of the Ghana College of Physicians and Surgeons such as a) The turning out of Radiologists for 9 out of the 16 regions of the country. b) A vast improvement in the quality and quantity of radiological services to the citizenry by the provision of modern radiological equipment, as well as increased manpower for the various diagnostic procedures. c) The establishment of subspecialties such as Interventional radiology, Neuroradiology and Paediatric radiology. The article seeks to highlight some of the major achievements and challenges in the delivery of radiological services to the citizenry of Ghana. Some of the challenges facing the specialty such as inadequate equipment in some public hospitals and the lack of maintenance of same are discussed. There is also inequitable distribution of radiologists across the country. Recommendations in the area of increased number of resident’s slots for postgraduate training by the Ministry of Health, as well as the reestablishment of external exposure for trainers to deepen their knowledge for the training of residents have been mentioned.

PVC containing silver nanoparticles with antimicrobial properties effective against SARS-CoV-2.

Poly (vinyl chloride) (PVC) is commonly used to manufacture biomedical devices and hospital components, but it does not present antimicrobial activity enough to prevent biofouling. With the emergence of new microorganisms and viruses, such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that was responsible for the global pandemic caused by Coronavirus Disease 2019 (COVID-19), it is evident the importance of the development of self-disinfectant PVC for hospital environments and medical clinics where infected people remain for a long time. In this contribution, PVC nanocomposites with silver nanoparticles (AgNPs) were prepared in the molten state. AgNPs are well-known as antimicrobial agents suitable for designing antimicrobial polymer nanocomposites. Adding 0.1 to 0.5wt% AgNPs significantly reduced Young's modulus and ultimate tensile strength of PVC due to the emergence of microstructural defects in the PVC/AgNP nanocomposites, but the impact strength did not change significantly. Furthermore, nanocomposites have a higher yellowness index (YI) and lower optical bandgap values than PVC. The PVC/AgNP nanocomposites present virucidal activity against SARS-CoV-2 (B.1.1.28 strain) within 48h when the AgNP content is at least 0.3wt%, suitable for manufacturing furniture and hospital equipment with self-disinfectant capacity to avoid secondary routes of COVID-19 contagion.

Engaging physicians and nurses in balanced scorecard evaluation-An implication at Palestinian hospitals and recommendations for policy makers.

Healthcare workers (HCWs) are seldom involved in balanced scorecard (BSC) deployments. This study aims to incorporate Palestinian HCWs in the BSC to create health policy recommendations and action plans using BSC-HCW1, a survey designed and validated based on BSC dimensions. In this cross-sectional study, the BSC-HCW1 survey was delivered to HCWs in 14 hospitals from January to October 2021 to get them involved in PE. The differences between physicians' and nurses' evaluations were assessed by the Mann-Whitney U-test. The causal relationships between factors were analyzed using multiple linear regression. The multicollinearity of the model was checked. Path analysis was performed to understand the BSC strategic maps based on the Palestinian HCWs' evaluations. Out of 800 surveys, 454 (57%) were retrieved. No evaluation differences between physicians and nurses were found. The BSC-HCW1 model explains 22-35% of HCW loyalty attitudes, managerial trust, and perceived patient trust and respect. HCWs' workload time-life balance, quality and development initiatives, and managerial performance evaluation have a direct effect on improving HCWs' loyalty attitudes (β = 0.272, P < 0.001; β = 0.231, P < 0.001; β = 0.199, P < 0.001, respectively). HCWs' engagement, managerial performance evaluation, and loyalty attitudes have a direct effect on enhancing HCWs' respect toward managers (β = 0.260, P < 0.001; β = 0.191, P = 0.001; β = 0.135, P = 0.010, respectively). Quality and development initiatives, HCWs' loyalty attitudes, and workload time-life balance had a direct effect on improving perceived patient respect toward HCWs (β = 254, P < 0.001; β = 0.137, P = 0.006, β = 0.137, P = 0.006, respectively). This research shows that it is important to improve low-performing indicators, such as the duration of time HCWs spend with patients, their knowledge of medications and diseases, the quality of hospital equipment and maintenance, and the inclusion of strengths and weaknesses in HCWs' evaluations, so that HCWs are more loyal and less likely to want to leave. For Palestinian hospital managers to be respected more, they must include HCWs in their action plans and explain their evaluation criteria. Patients will respect Palestinian HCWs more if they prioritize their education and work quality, spend more time with patients, and reflect more loyalty. The results can be generalized since it encompassed 30% of Palestinian hospitals from all categories.

Hypervirulent R20291 Clostridioides difficile spores show disinfection resilience to sodium hypochlorite despite structural changes

BackgroundClostridioides difficile is a spore forming bacterial species and the major causative agent of nosocomial gastrointestinal infections. C. difficile spores are highly resilient to disinfection methods and to prevent infection, common cleaning protocols use sodium hypochlorite solutions to decontaminate hospital surfaces and equipment. However, there is a balance between minimising the use of harmful chemicals to the environment and patients as well as the need to eliminate spores, which can have varying resistance properties between strains. In this work, we employ TEM imaging and Raman spectroscopy to analyse changes in spore physiology in response to sodium hypochlorite. We characterize different C. difficile clinical isolates and assess the chemical’s impact on spores’ biochemical composition. Changes in the biochemical composition can, in turn, change spores’ vibrational spectroscopic fingerprints, which can impact the possibility of detecting spores in a hospital using Raman based methods.ResultsWe found that the isolates show significantly different susceptibility to hypochlorite, with the R20291 strain, in particular, showing less than 1 log reduction in viability for a 0.5% hypochlorite treatment, far below typically reported values for C. difficile. While TEM and Raman spectra analysis of hypochlorite-treated spores revealed that some hypochlorite-exposed spores remained intact and not distinguishable from controls, most spores showed structural changes. These changes were prominent in B. thuringiensis spores than C. difficile spores.ConclusionThis study highlights the ability of certain C. difficile spores to survive practical disinfection exposure and the related changes in spore Raman spectra that can be seen after exposure. These findings are important to consider when designing practical disinfection protocols and vibrational-based detection methods to avoid a false-positive response when screening decontaminated areas.Graphical

Medical Equipment Management in General Hospitals: Experience of Tulu Bolo General Hospital, South West Shoa Zone, Central Ethiopia.

Medical equipment are vital items to deliver quality services in health facilities and the role of medical equipment is a well-founded reality. It is mainly used in many diverse settings in hospitals to diagnose, treat illnesses; support disabled and intervened acute and chronic cases. Effective maintenance and proper management are major utilization issues to provide quality services while saving scarce resources. However, managing medical equipment, especially, the utilization phase of medical equipment, was not well studied in this general hospital. This study aims to assess the utilization of medical devices in Tulu Bolo General Hospital. The study was conducted from December 25, 2021 to February 9, 2022. Data sources included health professionals and document archives in the hospital. Data collection method includes questionnaires and observations checklists. A census of 165 health workers was conducted, with a response rate 94.5%. Data was entered into epi-data; version 3.1, then analyzed by SPSS version 23 and presented using descriptive statistics. Procurement, storage, and utilization were found to be 53.47%, 56.57%, and 45.88%, respectively. Only 114 (57.3%) of the 199 pieces of medical equipment discovered were functional. Pearson correlation indicated that procurement and utilization of medical equipment are related to a higher proportion of non-functional devices (P = 0.000, B1 = 1.47, OR = 4.349, and CI 95% = 2.047-9.241) and nonfunctional medical equipment (B2 = 0.790, OR = 2.203, and CI 95% = 1.065-4.556) for procurement and utilization, respectively. Procurement, storage, and utilization of available medical equipment in Tulu Bolo Hospital were low. While health sectors operating in a resource-limited were assumed to have a big shortage of medical technologies, procurement, storage, and utilization of the limited available medical equipment need the attention of health program managers.

ENT health services burdens during COVID-19 pandemic and current critical situations in Sudan

Background: Sudan, a Low and Middle-Income Country, has suffered from human resource shortages and severe medical supply following economic troubles in the last few years. The current pandemic coronavirus (COVID-19) has worsened the already existing burdens. The COVID-19 pandemic has hurt the provision of healthcare services and constitutes a tremendous burden in all branches of medicine globally. Ear, nose, and throat (ENT) surgery was not exempted. This article is designed to explore the perception of Sudanese Otolaryngologists in different burdens impacting the delivery, approach, and practice of Ear, Nose, and Throat (ENT) healthcare services and to explore the situations during the COVID-19 pandemic in Sudan. Methods: A cross-sectional online survey was conducted through Google Forms; participants were asked to fill up a multiple-choice questionnaire. Responses collected were analyzed and interpretations were made on basis of the most favored options. Results: Most of the otolaryngologists were working in the governmental urban area and agreed with the shortage and maldistribution of Otolaryngologists in Sudan, besides agreeing with the rarity of training opportunities and migration of qualified Otolaryngologists out of Sudan. During the COVID-19 pandemic, most Otolaryngologists observed the lack of Personal-protection equipment (PPE), training, academic activities, and clinical meeting, besides the lack of a triage system and guidelines to covid 19 infection. Almost all the otolaryngologists observed a shortage of ENT materials and quarantines and agreed with the economic instabilities as burdens impede the provision of ENT health services. Conclusion: There were absolute deficiencies in infrastructure, human resources, and equipment in ENT hospitals in Sudan.

Doffing Corridor: Establishing Expedited High-Volume Doffing With Exposure Reduction to Contaminated Personal Protective Equipment (PPE) in a COVID-19 Hospital in India.

Background Considering the virulent nature of the COVID-19, the safety of healthcare workers (HCW)became a challenge for hospital administrators. Wearing a personal protective equipment (PPE) kit, called donning, which can be easily done by the help of another staff.But correctly removing the infectious PPE kit (doffing) was a challenge. The increased number of HCWs for COVID-19 patient care raised the opportunity to develop an innovative method for the smooth doffing of PPEs. Objective We aimed to design and establish an innovative PPE doffing corridor in a tertiary care COVID-19 hospital during the pandemic in India with a heavy doffing rate and minimize the COVID-19 virus spread among healthcare workers. Methodology A prospective, observational cohort study at the COVID-19 hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, was conducted from July 19, 2020, to March 30, 2021. The time taken for PPE doffing process of HCWs was observed and compared between the doffing room and doffing corridor. The data was collected by a public health nursing officer using Epicollect5 mobile software and Google forms. The following parameters, like grade of satisfaction, time and volume of doffing, the errors in the steps of doffing, rate of infection, were compared between the doffing corridor and the doffing room. The statistical analysis was done by the use of SPSS software. Result 'Doffing corridor' decreased the overall doffing time by 50% compared to the initial doffing room. The doffing corridor solved the purpose of accommodating more HCWs for PPE doffing and an overall saving of 50% time. Fifty-one percent of HCWs rated the satisfaction rate as Good in the grading scale. The errors in the steps of doffingthat occurred in the doffing process were comparatively lesser in the doffing corridor. The HCWs who doffed in the doffing corridor were three times less likely to get self-infection than the conventional doffing room. Conclusion Since COVID-19 was a new pandemic, the healthcare organizationsfocused on innovations to combat the spread of virus. One of these was an innovative doffing corridor to expedite the doffing process and decrease the exposure time to the contaminated items. The doffing corridor process can be considered at a high-interest rate to any hospital dealing with infectious disease, with high working satisfaction, less exposure to the contagion, and less risk of infection.

An IoT-Based GeoData Production System Deployed in a Hospital.

Navigation in large hospitals remains a challenge, especially for patients, visitors and, in some cases, for staff, but in particular it is notable in the case of tracking ambulatory equipment. Current techniques generally seek to reproduce what outdoor navigation systems provide, i.e., "good" accuracy. In many cases, especially in hospitals, reliability is much more important than accuracy. We show that it is possible to realize a simple, reliable system with a low accuracy, but which perfectly fulfills the task assigned in the particular case of tracking stretchers. Optimizing the use of hospital equipment requires the knowledge of its movement. The possibility to access equipment location in real time as well as on the knowledge of the time necessary to move it between two locations allows to predict or to estimate the load and possibly to scale the necessary number of stretchers, and thus the availability of the stretcher bearers. In this paper, an approach of the real-time location of these devices is proposed, and it is called "symbolic". The principle is described, as well as the practical implementation and the data that can be retrieved. In the second part, an analysis of the results obtained is provided in two directions: the location of stretchers and the determination of travel times. The methodology followed is described, and it is shown that a correct positioning rate of 90% is reached, which is slightly lower than expected, explained by the chosen practical implementation. Moreover, the average error on the determination of travel times is approximately ten seconds on 2 to 7 min trips. The "reliability" (the terminology of which is discussed at the end of the paper) of the results is related to the simplicity of the approach.

Design and Application of Medical Equipment Management System Based on B/S Architecture and WeChat Official Accounts

In order to solve the problems of equipment comprehensive management in grade A hospitals, such as complicated work, low maintenance efficiency, error-prone, non-standard management process, et al. A set of efficient information-based medical management equipment platform was designed to serve the concept of medical departments. B/S (browser and server) architecture and WeChat official accounts technology were adopted to construct the application end and WeChat official accounts client developed by Web technology, and MySQL server was selected as the system database technology. Asset management, equipment maintenance, quality control management, equipment leasing, data statistical analysis and other modules were integrated into the system, which optimized and standardized the medical equipment management process, improved the work efficiency of equipment management personnel, and improved the opening rate of medical equipment. Intelligent management by means of computer technology can effectively improve the utilization rate of hospital equipment, improve the level of hospital informatization and fine management, and contribute to the informatization development of medical engineering department.

Identification of Clinical Isolates of the Bacillus cereus Group and Their Characterization by Mass Spectrometry and Electron Microscopy

Bacillus cereus is a spore-forming bacterium found in the environment mainly in soil. Bacillus spores are known to be extremely resistant not only to environmental factors, but also to various sanitation regimes. This leads to spore contamination of toxin-producing strains in hospital and food equipment and, therefore, poses a great threat to human health. Two clinical isolates identified as B. cereus and B. cytotoxicus were used in the present work. It was shown that their calcium ion content was significantly lower than that of the reference strains. According to electron microscopy, one of the SRCC 19/16 isolates has an enlarged exosporium, and the SRCC 1208 isolate has large electron-dense inclusions of an unclear nature during sporulation. We can assume that these contain a biologically active component with a cytotoxic effect and possibly play a role in pathogenesis. Comparative chemical, biochemical, physiological, and ultrastructural analysis of spores of clinical isolates and reference strains of B. cereus was performed. The results we obtained deepen our understanding of the properties of spores that contribute to the increased pathogenicity of B. cereus group species.

Hospital Equipment Maintenance Management for Reliable and Effective Health Care Services in Nepal

The management of biomedical engineering instruments accuracy in Nepali hospitals has been a pressing issue, largely attributed to the lack of qualified biomedical engineering operations management teams. This challenge becomes even more complex due to the vast array of biomedical equipment imported from abroad, many of which are not only diverse but also relatively expensive. The primary concern in Nepal is to establish an efficient and competent biomedical equipment accuracy management system that can optimize the precision, longevity, and reliability of these crucial medical devices. The absence of well-organized biomedical engineering operations management teams has far-reaching consequences, as it hinders the healthcare sector's ability to deliver superior and consistent services to patients, ultimately affecting diagnostic accuracy. To overcome this challenge, it is imperative to develop a well-managed and qualified biomedical engineering operations management workforce in hospitals and healthcare centers. This entails the acquisition of modern skills to effectively oversee, test, calibrate, and validate medical devices, thereby extending the lifespan of these instruments and ensuring consistent and accurate diagnostics for reliable healthcare services. The integration of such skills is essential for elevating the standards of healthcare in Nepal and enhancing the well-being of its population.

Risk factors associated with prolonged intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease.

Prolonged intensive care unit stay not only increases hospital cost but it also prevents hospital equipment to be used by other patients who need them. The aim of this study was to identify factors that affect the duration of intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease. This is a single centered observational prospective study done on 191 post coronary artery bypass grafting patients from June 2018 to April 2019 at Cardiac Surgery Unit of Doctor's hospital and medical center, Lahore, Pakistan. Patients above 18 years with and without chronic kidney disease were included. Mean age of the patients was 57.83 years (± 9.862 SD. Logistic regression analysis shows that patients with post op arrhythmias had the strongest positive association with prolonged intensive care unit stay (OR:11; p value :<0.01), followed by recent myocardial infarction less than 90 days pre coronary artery bypass grafting (OR:5.93; p value:<0.01), shock (OR:3.93;p value:0.04) and acute kidney injury (OR :2.08;p value:0.04). 37.5% chronic kidney disease patients with recent myocardial infarction less than 90 days pre coronary artery bypass grafting and 51.4% patients of chronic kidney disease found with acute kidney injury, showed significant association with p values less than 0.05. Post op arrhythmias, recent myocardial infarction, shock and acute kidney injury are independent risk factors causing prolonged intensive care unit stay in post coronary artery bypass grafting patients.