Government Teaching Hospital Research Articles

Our experience of laproscopic cholecystectomy with associated complications and their treatment: a study of 200 cases

Background: The aim of this study was to evaluate the intraoperative and postoperative complications of laparoscopic cholecystectomy along with their treatment. Methods: The study was conducted in a tertiary care government teaching hospital in central Gujarat, India. And conventional laparoscopic cholecystectomy was performed after all relevant investigations. Results: In our analysis of 200 cases of planned laparoscopic cholecystectomy, we have found that the median age of patients undergoing operation was 47 years. In our study, 140 (67%) of the patients were female and 60(33%) male cases. It is noted that there were more complications in male patients (OR=2.95, CI 95%, 1.42-4.23, p<0.001). The total number of complications were 60 (30%) out of which 45 (22%) were found to be intraoperative complications and rest were post operative complications. In our study, most common complication encountered was iatrogenic perforation which caused spillage of stones or bile 35 (17.5%) followed by bleeding from gallbladder fossa 12 (6%). CBD injury which is one of the most dreaded complications of laparoscopic cholecystectomy occurred in only 1 patient (0.5%). Among the post operative complications bleeding from abdominal cavity 12 (6%), bilioma 7 (3.5%) and infection of surgical wounds 4 (1.5%) were common. There was a total rate of 5% conversions to open surgery. Conclusions: Adopting laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of the hospital stay. It is important recognizing IOC complications during the surgery so they are taken care of in a timely manner during the surgical intervention.

KNOWLEDGE & ATTITUDE OF GENERAL DENTIST, REGARDING PERIODONTAL DISEASE DIAGNOSIS, TREATMENT PROTOCOL AND PERIODONTAL SPECIALIST REFERRAL

Objectives: To assess the knowledge, attitudes, and practices of general dentists regarding periodontal disease diagnosis, treatment strategies, and referrals to specialists.Materials and Methods: A cross-sectional survey was conducted among 185 dentists in Peshawar, utilizing a pre-customized, closed-ended questionnaire through convenience sampling technique. The survey included practitioners from dental government and private teaching hospitals as well as independent clinics, encompassing both genders and any age. Informed consent was incorporated into the questionnaire. Exclusion criteria were undergraduate students, house surgeons, and periodontists. Data were collected using the questionnaire based on participants' understanding of periodontal diseases, diagnostic frequency, referral practices, and treatment approaches.Results: Most dentists favored scaling as the primary treatment for bleeding on probing (n=149, 80.54%) and identifi ed loss of attachment as the cause of tooth mobility (n=158, 85.41%). The study revealed a significant association between years of experience and various aspects of periodontal care, including referral practices (p=0.047), diagnostic accuracy (p=0.018), and treatment strategies (p=0.05). Despite a recognized link between poor oral hygiene and periodontal diseases, the referral rate to periodontists was notably low (10.27%). Conclusion: General dentists exhibit defi ciencies in knowledge concerning the causes, referral processes, and the importance of specialized care in periodontology.

ILLNESS PERCEPTION AND TREATMENT EXPECTATION IN PATIENTS WITH FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER AT LAHORE, PAKISTAN

OBJECTIVE To explore the perceived illness and treatment expectations of patients with Functional Neurological Symptom Disorder. DESIGN OF STUDY It is a Descriptive Research Design PLACE AND DURATION The study was executed at Department of Psychiatry of government and private teaching hospitals of Lahore, Pakistan over a period of 12 months, from Jan 2023 to Dec 2023. METHOD A total of 100 adult participants were recruited as per criteria. Demographic Information Questionnaire and Short Explanatory Model Interview (SEMI) were employed and the qualitative data generated from SEMI was converted to numerical codes and discrete categories by the method of stepwise reduction. The descriptive frequencies were then presented in the tabular format. RESULTS Majority of the participants were female, educated, students and housewives, with 1 – 6 months duration of the illness, mixed symptoms presentation, pseudo seizures and motor symptoms. The main reasons of onset of illness was mentioned as marriage related factors and familial and social factors and majority participants believe that magic can affect others. The intensity of the symptoms were perceived as ‘extreme intense’ associated with the fear about the worsening of symptoms and serious discomfort. The main difficulties due to illness was reported to be lack of interest in daily activities, and increase in problem in relationships. The patients expect proper treatment and prescription of medicines which was followed by responses that they will learn the diagnosis and will receive advice from doctors regarding their illness. CONCLUSION The patient’s perception towards their illness was serious and concerned and their expectations was receiving proper treatment, medications and learning the disorder and doctor’s advice.

Factors leading to surgical site infection (SSI); a 6 years analysis of general surgical cases in a newly developed teaching hospital.

Objective: To determine the major factors leading to surgical site infection in elective surgeries. Study Design: Retrospective Cross Sectional study. Setting: Department of Surgery, Government Teaching Hospital Shahdara, Lahore. Period: January 2016 to December 2021. Methods: The cases of surgical site infections were collected from well-organized data according to health care commission’s format of recording data in surgical site infection Register. Emergency patients were excluded. Each infected case was thoroughly investigated according to Performa and presented in meeting of infection control committee. Demographics were recorded and the factors were determined in individual case. Frequency and percentages of infected cases and main factors in all cases were analyzed by SPSS version 24. Results: We had 61 cases of SSI out of 2962 cases operated during the study period with calculated rate of 2.06%. Seventy two percent cases had age more than 40 years. 39(63.93%) were female and 22(36/07) were male. Mean age was 43.02 years with standard deviation of ± 8.98. 72% of infected cases. BMI in infected cases was 29.56 mean and Standard deviation ± 2.74 and 27.29 in non-infected cases (significant). Diabetes and Rank of surgeon had significant difference with increased infection in resident level. Smoking and gender of patients had no statistically significant impact. Conclusion: High Body mass index, diabetes, longer duration of procedure, rank of surgeon and use of mesh are the leading factors causing surgical site infection. Smoking, age and gender had no significant effect on SSI.

Cytological and Histopathological Correlation of Patterns of Breast Lesions in Women above 18 Years at a Tertiary Care Government Teaching Hospital in Jaipur

Cytological and Histopathological Correlation of Patterns of Breast Lesions in Women above 18 Years at a Tertiary Care Government Teaching Hospital in Jaipur

Analysis of Prescription Pattern, Treatment, and Clinical Outcome in Chronic Obstructive Pulmonary Disease Patients at Tertiary Care Teaching Hospital

Background and Aims: A major economic and social burden is associated with chronic obstructive pulmonary disease (COPD), an incurable lung illness that affects people all over the world. With a rising incidence rate, COPD is predicted to overtake all other causes of mortality by 2030. This study employs the BMI, Obstruction, Dyspnea scale, exercise tolerance (BODE) index as a multidimensional staging approach to evaluate the prescription pattern, safety, and efficacy of therapy in patients with COPD. The body mass index (BMI), forced expiratory volume in one second (FEV1), modified british medical research council questionnaire (MMRC) Dyspnoea scale, and the 6-minute walk test are among the factors that the BODE index uses to classify the severity of an illness. Methods: An observational and prospective study was conducted at a government teaching hospital’s outpatient department for one and a half years. Demographic, clinical, and treatment data were collected from patients with COPD, and severity was assessed using the BODE index. The study aimed to evaluate prescription trends, treatment effectiveness, and safety, with primary and secondary objectives. Results: Out of 100 enrolled participants, 79 completed follow-ups. Sociodemographic analysis revealed a male predominance (83.54%), with the highest prevalence in the 51–70 age group. Most patients exhibited moderate COPD severity (51.9%), based on the BODE index. Prescriptions included inhalation therapy (94.94%), predominantly combining corticosteroids and bronchodilators. Assessing treatment effectiveness, the BODE index significantly improved over 6 months ( P = 0.0002), demonstrating reduced disease severity. Adverse drug reactions occurred in 13.92% of participants, primarily mild in nature. Conclusion: The study highlights prevalent prescription patterns, emphasising inhalation therapy, and demonstrates the effectiveness and safety of the selected treatments using the BODE index. The findings underscore the importance of tailored therapeutic approaches in COPD management.

Retrospective observational study of clinical profile of hydrocephalus presenting to tertiary care teaching government hospital in Maharashtra.

Retrospective observational study of clinical profile of hydrocephalus presenting to tertiary care teaching government hospital in Maharashtra.

Comparison of intraperitoneal instillation of Bupivacaine vs Normal Saline for postoperative pain relief after laparoscopic cholecystectomy.

Objective: To evaluate whether local irrigation of Bupivacaine reduces post-operative pain after cholecystectomy. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Surgery, Government Teaching Hospital, Shahdara Lahore. Period: June 2020 to December 2022. Methods: For this study, 86 participants were divided into two groups, each containing 43 participants (Bupivacaine vs. no Bupivacaine). The control group (Group A) received an infiltration of 15 ml of 0.5% bupivacaine in the sub-diaphragmatic region on the right side and at port sites, while normal saline was administered to Group B. The Visual Analogue Pain Score Scale was employed to assess pain levels at 0-3, 3-5, 5-7, and above 7-10 hours post-surgery (VAS). Results: In this study, the total number of included individuals was 86. Moreover, the overall mean and median ages in months for both groups were 47.7 ± 8.97 and 47 (18-60) respectively, with the majority of patients being male (59 individuals, 68.6%). Furthermore, there was a statistically significant mean difference in pain scores on the visual analogue scale at 0–3 hours, 3–5 hours, 5–7 hours, and 7–10 hours (p-value < 0.05). Similarly, there was a statistically significant mean difference in pain scores on the visual analogue scale after more than three to five hours, more than seven hours, and more than ten hours (p-value < 0.05). Conclusion: Consequently, we inferred that intraperitoneal and local infiltration of Bupivacaine following laparoscopic cholecystectomy significantly reduced the level of postoperative discomfort and the requirement for analgesics.

The influence of infant characteristics on postpartum depression among mothers with hospitalized infant in NICU.

The purpose of the study to determine the prevalence of mother postpartum depression and to examine the association between infant characteristics and postpartum depression in the neonatal intensive care unit. A quantitative cross-sectional survey design was conducted in three government teaching hospitals in Jordan. A convenience sample of 188 mothers with hospitalized 188 infants in NICU was recruited. Questionnaires were used to collect the quantitative data, which include Infant Demographic Data Questionnaire, Mother Demographic Data Questionnaire and Edinburgh Postnatal Depression Scale (EPDS). The study revealed that infant characteristics such as gestational age, medical condition classification, and birth weight are found to be significant factors that influence depression among mothers. The results showed that mothers with infants admitted to NICU experience postpartum depression with a mean of 3.82 and median of 4.04. There were significant differences based on gestational age, birth weight, and classification of medical condition and mothers' postpartum depression. Knowing the relationship of certain infant's characteristics and postpartum depression can help to focus on relevant infant characteristics so that timely interventions to improve mothers' well-being can be developed.

Prescribing Change: Unpacking Privatization's Impact on Government Teaching Hospitals in Punjab, Pakistan

Lack of financial support is one of the main causes of low-quality services in Government teaching hospitals of developing countries. Recent recommendations for privatization of government teaching hospitals were aimed at improving the services to that of private teaching hospitals. The strategy is expected to increase the efficiency & performance of government teaching hospitals and generate revenues for their continued improvements. The measuring dimensions of hospital performance not only predict the financial performance of a hospital, but also provide assessment on steps required for betterment of the Government teaching hospital. The non-financial performance of a hospital setting is based on non-financial variables such as Reliability, waiting time, sanitary facility, hygiene and information unique to particular treatment. Good human resource practices are one of the key components that may predict the monetary & non-monetary performances of a hospital. This study demonstrated these variables along with their dimensions across the whole public teaching hospitals settings in Lahore Punjab with a sample size of 300 respondents. Respondents were highly qualified Doctors, Nurses and administration staff of public teaching hospitals Lahore, Punjab. Smart PLS-4 was used as a statistical tool and ran reliability, mediation analysis and linear correlation for research findings. The results have been found significant that hospital performance can be increased through privatization. Although there are some limitations such as it was limited to public teaching hospitals only. Public DHQs (District Head-quarters), THQs (Tehsil Head-quarters) & RHC (Rural Health Centers) were not part of study. The opted variables to assess the hospital performance were not total markers, so for future research there is a path for researchers to opt the rest variables to explore the further significance.

Caring burden and coping with haemodialysis: a qualitative study with family caregivers in Sri Lanka

ObjectiveThe number of patients with end-stage kidney disease (ESKD) requiring renal replacement therapy in Sri Lanka is significantly rising. Most of these patients depend on haemodialysis, carrying a significant burden...

Nursing care for respiratory failure in a patient with pulmonary edema and acidosis metabolic

ABSTRACT Impaired performance of the respiratory muscle pump or lung dysfunction can lead to a severe condition of respiratory failure. Therefore, mechanical ventilation is used to sustain the life of individuals with this syndrome. Furthermore, this condition is harmful to the body and can cause complications. This study aimed to describe nursing care provided to patients with respiratory failure. The design was a case study with narrative analysis. The data were collected in October 2022 at a Government Teaching Hospital in Bandung. The nursing assessment shows that the patient (Mr. S) was unconscious and unresponsive to pain stimuli under sedation. The patient was in moderate acute respiratory distress syndrome, receiving mechanical ventilation with synchronized intermitten mandatory ventilation pressure control and pressure support (SIMV PCPS) mode, and was breathing spontaneously. Furthermore, there were rhonchi breath sounds, temporary gurgling sounds, pitting edema in the upper and lower extremities, and anuria. Impaired spontaneous breathing is the key nursing concern for this patient, along with poor airway clearance as well as fluid and electrolyte imbalance. In conclusion, ventilation is the primary management of the patient with respiratory failure. This intervention should be given appropriately to reduce the disease’s symptoms and the risk of complications. Therefore, maintaining a low tidal volume, prone position, continuous respiratory assessment, minimizing sedation, suctioning, and chest physiotherapy are essential to achieve a good outcome.

A population proportion to each stratum study on knowledge, attitude and practices on vaccine preventable hospital acquired infections

Abstract Background and Objective: Health-care workers (HCWs) need to be immunized against vaccine-preventable diseases such as hepatitis B virus and tetanus. The study was conducted to assess knowledge, attitude, and practices on immunization against vaccine-preventable hospital-acquired infection (HAI). Materials and Methods: It was a cross-sectional descriptive study conducted in the clinical care areas of a tertiary care government teaching hospital. The study was conducted from June 2019 to June 2020. Institutional Ethics Committee approval was attained before taking up the study. A study sample of 407 was calculated by applying the population proportion to size formula to each stratum and was drawn among the resident (academic) doctors, staff nurses, and paramedical and housekeeping staff of the institute. The results were analyzed statistically. Results: Out of 407 study participants, 91 (22.4%) were resident (academic) doctors, 122 (30%) were staff nurses, 23 (5.7%) were paramedical staff, and 171 (42%) were housekeeping staff, respectively. The overall mean score for all the study participants’ knowledge, attitude, and practice for immunization against vaccine-preventable HAIs and health checkup among HCWs was 1.71 out of 2, 0.96 out of 1, and 1.18 out of 2, respectively. Conclusion: The knowledge with respect to immunization against vaccine-preventable HAIs and health checkup for HCWs was good for resident (academic) doctors. However, with respect to attitude and practice, it was found that the housekeeping staff and the staff nurses had better scores than the resident (academic) doctors. The author has suggested a few administrative measures in the article.

Nurse-Led Educational Program on Practice of Asthma Management Using Global Initiative for Asthma Guideline

The pivotal and nodal role of nurses in the healthcare industry is very vital for the proper management of asthma. To effectively intervene, nurses must be skillful in techniques used in asthma management which must be evidenced-based. The study objective is to use educational program to enhance nurses’ asthma management practice. This study adopted Quasi-experimental one group pre-post research design. Two government teaching hospitals in Rivers State were used in this study. A total number of 52 nurses were purposively selected in collaboration with nurse-leaders in each study setting. Checklist developed by the researcher and experts in the field of medical surgical nursing using modified Delphi method was used to collect data based on GINA guidelines pre- and post-educational program. Reliability test for the checklist using Cronbach’s alpha co-efficient yielded .89. Educational program was administered for six days respectively at the two study settings. Data collected were analysed using descriptive and inferential statistics (paired t-test) at level of 0.05 level of significance. Participants with good asthma management practice at pre-educational program were 36.5% while at post-educational was 80.8%. Paired-simple t-test analysis on the difference in asthma management practice before and after nurse led educational program using GINA guideline indicates that tcal = 51.23, df = 51, and ttab = 1.96 Since tcal>ttab at P<0.05, Hence, the null hypotheses was rejected. The study concluded that nurse-led educational program using adopted GINA guidelines enhanced practice of asthma management among nurses.

Pattern of Violence Among Healthcare Workers in a Tertiary Care Government Hospital and a Multi-Specialty Private Hospital in Sagar, India: A Cross-Sectional Study.

Background Workplace violence in hospitals is an occupational hazard that affects healthcare workers (HCWs) negatively in many aspects and causes deterioration of the doctor-patient relationship, resulting in providence of substandard healthcare. This study was conducted to compare the pattern of violence in a tertiary care government teaching hospital and a multi-specialty private trust hospital in Sagar district, Madhya Pradesh, India. Methodology After ethical clearance of this cross-sectional, observational study, participants (frontline healthcare workers, including doctors and nurses) were asked about the type, frequency, department, and place of violence, etc., along with its perceived causes, solutions, and arrangements made by hospitals for dealing with it using a pretested, semi-structured questionnaire. Data analysis was performed using IBM SPSS Version 26.0 (IBM Corp., Armonk, NY). Categorical variables were described using frequency and percentages, and inferential analysis was conducted using the chi-square/Fisher's exact test. A P-value of <0.05 was considered statistically significant. Results Among the 113 participants, 67 (59.3%) were female, 53 (46.9%) were doctors, and 60 (53.1%) were nurses. The mean age of participants was 30.9±7.3 years. Predominantly verbal, emotional, and physical violence were present in 96.5%, 43.4%, and 6.2% of participants, respectively. Violent incidents against healthcare workers were more frequent in government hospitals as compared to private hospitals. Most healthcare workers (87.6%) tried to resolve violent incidents peacefully, and 1.8% tried to fight back. The most perceived cause of violence in both setups was a lack of morality and literacy among patients and their relatives (i.e., 83.2%), followed by a lack of proper facilities and a lack of trust in healthcare workers. Conclusion Both setups faced a substantial amount of violence. The loopholes in both setups, considering resources, security, and other facilities, are clearly visible, and specific steps must be adopted to protect both systems from violence.

Drug resistant typhoid fever; its clinical spectrum and management in different age groups.

Objective: To describe the clinical spectrum of MDR and XDR typhoid fever in different age groups of pediatric population as the disease is generally more common in children with higher rates of complications and mortality. Study Design: Prospective Cross-sectional study. Setting: Department of Pediatric, Government Teaching Hospital Shahdara, Lahore. Period: July 2020 to July 2021. Material &amp; Methods: 211 patients with suspected/confirmed enteric fever between 6 months to 5 years were initially enrolled. Blood culture was performed in all cases. Only culture confirmed cases (143/211) were included. Data was entered and analyzed using SPSS version 23. Quantitative variables like age group, fever defervescence time and duration of hospital stay were calculated as mean and standard deviations while qualitative variables like gender, clinical symptoms and signs, types of typhoid and response to antibiotics were calculated as percentages. Chi-square test was used taking P value &lt;0.05 as statistically significant. Results: Mean age of study population was 6.8 ± 3.1 years. Majority (44.1%) of patients belonged to age group &gt;5-10 years and were males (54.5%). Anorexia, coated tongue and hepatomegaly was prevalent among all age groups. High grade fever, loose motions and splenomegaly were common in children &lt;5 years as were anemia, leukocytosis and enteric hepatitis. Children &gt;5-10 years of age had more frequency of abdominal pain (P value &lt;0.03), toxic look (P value &lt;0.04) and leucopenia. While vomiting and thrombocytopenia were common in children &gt;10-15 years of age. MDR typhoid was common in young children (&lt;5 years) while XDR typhoid was common in children of &gt;5-15 years. All MDR patients responded to ceftriaxone while XDR patients responded to either monotherapy or a combination of drugs. Age and gender did not affect antibiotic resistance in both MDR and XDR typhoid (P value &gt;0.05). Fever defervescence time (FDT) was 3-5 days in both MDR and XDR typhoid and it was not significantly different with either monotherapy or a combination of drugs (P value 0.40). Conclusion: There are age related differences in clinical spectrum and lab parameters of drug resistant typhoid fever (MDR &amp; XDR). Resistance to antibiotics in both MDR and XDR typhoid was not significantly affected by age and gender.

COVID-19 pandemic impact on antibiotics sensitivity of E. coli and K. pneumoniae from urine specimens: a retrospective study.

Escherichia coli and Klebsiella pneumoniae are common organisms associated with urinary tract infections. The COVID-19 pandemic has had a negative impact on antibiotics misuse globally. This study analyzed the antibiotic susceptibility for these two pathogens isolated from urine samples during the period of 18 months before and after the COVID-19 pandemic. This retrospective study was conducted in Al-Karak government referral and teaching hospital in Jordan. The study included two groups; group A included urine samples from September 2018 to March 11, 2020, while group B from March 12, 2020 to August 2021. Samples were analyzed using the automated VITEK 2 system and the analysis of results was done using the WHONET version 5.6. A total of 642 E. coli and 113 K. pneumoniae were isolated and analyzed. The antibiogram showed a significant overall increase in antibiotic susceptibility of both bacteria during the pandemic period (group B). The sensitivity has significantly increased by 75% (15/20) and 50% (10/20) for all antibiotics used for E. coli and K. pneumoniae respectively. On the other hand, E. coli showed a significant increase in resistance to ceftriaxone (13.4%) and gentamicin (6.4%). A similar trend of an increase in resistance to gentamicin (17.4%) was also noticed among K. pneumoniae isolates. The antimicrobial susceptibility pattern for urine isolates showed an increased overall sensitivity and an increased resistance to ceftriaxone and gentamicin during the pandemic period. Our results highlight the need for revising and updating the antimicrobial stewardship programs post-COVID pandemic utilizing local data.

EFFECT OF PSYCHOLOGICAL FIRST AID ON MENTAL HEALTH IN HOSPITALIZED STABLE COVID-19 PATIENTS: A PRE-POST RESEARCH DESIGN.

The COVID-19 pandemic is known to affect mental health of sufferers. Psychological First Aid (PFA) is a mental health service for individuals in crisis, which can be provided to anyone regardless of age and it does not require mental health expertise. Its effect on mental health issues of COVID-19 patients has not been studied effectively. The present study aimed to assess the psychological impact and effect of PFA on mental health in stable COVID-19 hospitalized patients. This was an interventional study with a pre-post research design in a tertiary government teaching hospital in eastern India. 93 stable patients who were admitted in a period of a month with COVID-19 were included in the study after obtaining appropriate consent. They were provided PFA (both structured individual and group sessions) by trained nurses. The Depression, Anxiety, and Stress scale (DASS-21) was used to assess depression, anxiety, and stress in the patients before and after intervention. The mean age of study population which comprised of 68.8% males was 56.2 ± 13.7 years. Median scores for depression, anxiety and stress were 4, 6 and 6 on admission and 0, 2 and 2 respectively before discharge after intervention (P<0.001). 13%, 25.9% and 8.6% were the combined percentages scores of patients with varying levels of depression, anxiety and stress at the time of admission which were reduced to 4.3% (P=0.046), 5.4% (P=0.001), 2.2% (P=0.03) respectively before discharge after intervention within one week. PFA may be a cost-effective intervention in stable COVID-19 admitted patients who had depression, anxiety, and stress.

Assessing Knowledge, Attitudes and Practices of Health Professionals Regarding use of Telemedicine in Jhansi District, Uttar Pradesh, India

INTRODUCTION: Telemedicine, the delivery of healthcare services remotely using communication technologies, has rapidly emerged as a transformative solution in the healthcare industry. The successful implementation of any new technology is influenced by several factors, including the knowledge and comprehension of the concept, acquired skills, attitudes towards technology, and the working environment of the professionals involved. AIM: The main objective of this study was to assess the awareness, knowledge, attitude and skills of telemedicine among the health professionals working in various private and government teaching hospitals in Jhansi district of Uttar Pradesh, India. MATERIALS AND METHOD: A cross-sectional survey was conducted among 110 healthcare professionals, including teaching faculties and practitioners from preclinical, para-clinical, and clinical departments in Jhansi district of Uttar Pradesh, India. A pre-validated self-administered questionnaire was used to assess the awareness, knowledge, attitude, and practice of telemedicine. Quantitative data was analyzed using descriptive statistics and the application of the t-test. The study provides valuable insights into the current state of telemedicine among healthcare professionals in the region. RESULTS: The study found that among the respondents, 41% demonstrated good knowledge of telemedicine, while 35% had fair knowledge, and 24% lacked adequate knowledge. Regarding attitude, 39% exhibited a high attitude towards telemedicine, 31% had a moderate attitude, and 30% had a low attitude. In terms of practice, only 9% were skilfully practicing telemedicine on a regular basis, 35% were in learners or beginners stage of practice and 56% were unskilled and incapable of practicing telemedicine and handling related equipments. CONCLUSION: The study findings indicate that while the respondents have limited experience and knowledge in telemedicine technology, a significant proportion of them exhibit a positive attitude towards telemedicine. It is imperative to prioritize the education and training of teaching faculty, practicing physicians, residents, medical students, and other healthcare professionals regarding telemedicine and its associated considerations.

Study on needle stick injury in a tertiary-level government teaching hospital

Background and Objective: A safe injection does not harm the recipient, nor does it expose the provider of injection at risk and, does not result in the generation of hazardous waste. The study was performed with the aim to assess the knowledge, attitude and practice (KAP) about needle stick injury (NSI) with respect to biomedical waste management rules 2016 among staff of a government tertiary care teaching hospital. Methodology: It was a cross-sectional descriptive study conducted in the clinical care areas of a tertiary care government teaching hospital. The study was conducted from June 2019 to June 2020. Institutional ethics committee approval was attained before taking up the study. A study sample of 407 was calculated by applying the population proportion to size formula to each stratum and was drawn among the resident (academic) doctor, staff nurse, paramedical staff and housekeeping staff of the institute. The results were analysed statistically. Results: Out of 407 study participants, 91 (22.4%) were resident (academic) doctors, 122 (30%) were staff nurses, 23 (5.7%) were paramedical staff and 171 (42%) were housekeeping staff, respectively. Regarding the knowledge aspect, most of the study participants were unaware of the safe injection practices such as not to recap the needle and to use a needle cutter to discard the used needle immediately and NSI. The overall KAP mean score of the study participants was 0.43 out of 1, 2.7 out of 3 and 0.73 out of 1, respectively. Conclusion: The attitude and practice aspect concerning the approach to NSI was found to be better for the housekeeping staff and nursing officers when compared with the resident doctors.