Tertiary Care Government Hospital Research Articles

Perceptions about hypertension in an urban population in Pakistan

Background: As the risk factors and prevalence of hypertension continue to increase in Pakistan, it is imperative to understand the perceptions of patients about its prevention, symptoms, diagnosis, treatment, and management to inform the design of programmes to improve management. Objective: To explore patients’ perceptions about the treatment, management and control of hypertension in an urban population in Pakistan. Methods: Using a semi-structured questionnaire, we conducted one-on-one interviews with 30 hypertensive patients at 2 urban government tertiary care hospitals in Lahore and Sargodha. The patients were aged 35–70 years, diagnosed with hypertension by a registered medical doctor, and being treated with anti-hypertensive medication. The interviews were recorded, transcribed and analysed using Quirkos. Results: Almost all the patients recognized the potential long-term consequences of hypertension. Most of them said regular use of prescribed medication was beneficial, including for blood pressure control and relief of symptoms. They understood the benefits of lifestyle modification, such as engaging in physical activity, for the management of blood pressure. They however had inadequate knowledge of their treatment regimens; some of them took their medications irregularly, while some took them only when they felt symptoms. Most patients relied solely on medical management. Conclusion: We identified major challenges with the management of hypertension among the study population. Patients and caregivers relied mostly on medical management, with insufficient follow-up after initiating treatment. There is a need to improve patient follow-up and provide better patient education on the benefits of adhering to treatment regimens and adopting lifestyle changes including dietary and exercise management.

Rotator Cuff Repair by All-Arthroscopic Versus Mini-Open Technique: A Comparison of Clinical and Functional Outcome.

Rotator cuff tears can lead to debilitating shoulder function and impairment. Rotator cuff repair aims to eliminate pain and improve function with increased shoulder strength and range of motion. This study evaluated the differences between all-arthroscopic (AA) and mini-open (MO) repair procedures for rotator cuff tendon tears regarding clinical and functional outcomes. This was a prospective study conducted at a tertiary care government Hospital in Kolkata, India, between March 2015 and September 2016 which evaluated 25 patients who had undergone all-arthroscopic surgery and 25 patients who underwent mini-open repair (total of 50 patients) for rotator cuff tear with a minimum one-year follow-up. The UCLA score was used to assess the functional outcome of these patients. The mean age of all patients included in this study was 45.32 years. 86% of patients were male. The two groups had similar demographic characteristics, pre-operative baseline parameters, and intra-op findings. The average UCLA score showed significant improvement from 13.92 pre-operatively to 29.76 at the final follow-up. The patients in the all-arthroscopic surgery group experienced a notable decrease in pain within the first three months compared to the mini-open group. However, at the time of the final follow-up, no significant difference was noted between both groups when comparing the University of California at Los Angeles (UCLA) score, Visual Analogue Scale (VAS) score for pain, and active or passive glenohumeral motion. The outcomes of all-arthroscopic and mini-open rotator cuff repair surgery are equivocal in terms of both clinical and functional results, with no significant difference in post-operative pain, shoulder joint strength range of motion, or patient satisfaction over the long term.

Enhancing infection control in dialysis at a resource limited public healthcare institute: A cross-sectional study on microbiological quality assessment of dialysis water and dialysate

PurposeTo evaluate the microbiological quality of dialysis water and dialysate samples from hemodialysis units at a tertiary care government hospital and to assess the use of culture, endotoxin and periodicity of testing these assays to guide the actions of monitoring the quality of hemodialysis fluids, implement preventive and corrective actions, and improve the safety and outcomes of the dialysis process. MethodsA cross-sectional study was conducted at a 250-bedded super-specialty government hospital with a 24/7 hemodialysis unit equipped with 40 dialysis machines. Dialysis water and dialysate samples were collected monthly and analysed for microbial contamination and endotoxin levels as per AAMI guidelines. Bacterial cultures were done using Reasoner's Agar plates, and endotoxin analysis was performed using gel clot assay. Interpretation of results was based on predefined thresholds. ResultsAmong the 740 samples processed for microbial culture 19.6 % and 80.4% were unacceptable and acceptable respectively.Among the acceptable samples 10.5 % were at action level. At the end of 2 days of incubation, 15.2%dialysis water samples and 5.1%dialysate samples had unacceptable levels of bacterial colonies and at 5days additional 10.6 % dialysis water samples and 7.7%dialysate samples were unacceptable. 21.5 % of the samples tested for endotoxin had unacceptable levels. ConclusionsRegular monitoring of water quality in government healthcare hemodialysis units is crucial for quality of care, timely preventive and corrective actions for mitigating adverse outcomes. Processing cultures for 5–7 days is essential for detecting all contaminated specimens. While there might be a link between endotoxin levels and bacterial contamination, both endotoxin testing and bacterial culture independently are vital for evaluating water quality in dialysis settings. A comprehensive approach integrating various testing methods is necessary to uphold patient safety and enable necessary improvements.

Test–retest Reliability of Perceived Wellness Survey among Community-dwelling Geriatric Population: An Observational Study

Abstract Introduction: The aging population faces unique challenges, so incorporating their perspective is necessary for providing patient-centered care and enhancing the quality of life for older adults. However, this self-assessed well-being of the elderly population is not extensively documented, despite being a key approach in the health and welfare domain. The Perceived Wellness Survey (PWS), designed to assess well-being across multiple dimensions, could be suitable for determining wellness among the elderly. Therefore, this study seeks to evaluate the test–retest reliability of the PWS among the geriatric population. Subjects and Methods: An observational study was conducted which included 100 subjects in the age group of 60–74 years, at a government tertiary care hospital, in Mumbai, after procuring approval from the departmental review board. The participants completed the questionnaire at two different time points, separated by 1 week. The test–retest reliability was assessed using the Pearson’s product-moment correlation coefficient test, and the internal consistency was tested by Cronbach’s alpha. Results: One hundred subjects were recruited, of which 45% were female and 55% were male, with a mean age of 66.38 ± 3.96 years. The Pearson coefficients for test–retest reliability among observations varied between 0.870 and 0.946, indicating good reliability. Internal consistency ranges between 0.930 and 0.970, suggesting excellent reliability. Conclusion: The PWS is a reliable and internally consistent tool for assessing wellness perception among the geriatric population.

Evaluation of Infection Preventionists' Competencies Using the Association for Professionals in Infection Control and Epidemiology Competency Model in Tertiary Care Government Hospitals, Bahrain.

Introduction Infection preventionists (IPs) are healthcare workers (HCWs) who received specialized training in infection prevention and control (IPC) to be able to deliver specific tasks to prevent and control infection transmission to patients, HCWs, and visitors in all healthcare settings. Most IPs started their professional life as nurses, physicians, microbiology, public health, or allied health specialties before moving to the IPC field, not necessarily with specialized training or diploma, which may need more focus on unified competency tool to evaluate their skills and strengths and improve IPC program outcome. Aim This study aimed to examine IPs' self-rated competency level using the Association for Professionals in Infection Control and Epidemiology(APIC) core competencies and to determine what factors influence the level of competency among IPs in Government Hospitals (GHs) in Manama, Bahrain. Subject and methods This cross-sectional study was conducted among non-certified IPs in Bahrain's GHs. A self-administered questionnaire was distributed among the targeted IPs using the Microsoft 365 form (Microsoft® Corp., Redmond, WA). The questionnaire includes socio-demographic characteristics (e.g., age, gender, years of experience, etc.), the APIC competency tool to assess IP competency, and the perceived effectiveness of the IPC program. Results Of the 17 IPs, 88.2% were females, and 47.1% were between 31 and 35 years old. Among the eight APIC core competencies, management and communication had the highest mean percentage score (84.2%), followed by preventing/controlling the transmission of infectious diseases (84.1%) and the identification of infectious disease processes (81.5%). The total mean competency score was 142.8 (SD: 20.3), with 70.6% classified as having a good level of competency. Increasing years of IP experience was the only factor associated with increased competency scores. Conclusion The level of IPC competency among "novice" or "becoming" proficient IPs was sufficient. Using the APIC competency tool, IPs showed competence in managing and communicating, preventing or controlling transmission of infectious agents, identifying infectious disease processes, and surveillance and epidemiologic investigations. Further research is needed to give more insights into the level of IPC competency of IPs in our region.

Demographic Profile and Outcome of Covid- 19 Obstetric Patients Undergoing Caesarean Section in a Tertiary Care Government Hospital in Dhaka, Bangladesh

Background: Pregnancy itself is a hypercoagulable state. COVID-19 infection makes it more deleterious. As a consequence of exaggerated inflammatory response in COVID 19 infected mothers, there is alterations of coagulation system occurs, causing thrombi (micro and macro) in various organs reducing blood flow in capillaries , followed by emboli formation mainly in lung, heart, brain and kidney, resulting in multiple organ failure even death. The present study aims to observe retrospectively the clinical outcome of parturients with COVID-19 infection undergoing caesarean sections. Methods: This observational study was done in the COVID dedicated operation theatre of Department of Anaesthesia, Pain, Palliative and Intensive Care, Dhaka Medical College Hospital, Bangladesh, between May 2020 and December 2021. A total 640 obstetric patients undergoing caesarean section (both COVID positive and suspected) were observed. The demographic and outcome data of mothers ( transferred from post-operative ward to parent ward/ICU) were collected. Informations of ultimate fate (alive/death) of operated mothers were also noted. Demographic (sex) data and outcome data of newborn baby (alive/dead) were also included. The statistical analysis was carried out by using the Statistical Package for Social Sciences version 22.0 for Windows. Results: In this study, the age of the most (n=532, 83.13%) of the pregnant mothers belongs to 18-30 years of age group, remaining 16.86% patients are within the age group of 31-45 years (n=108). Although 18.75% study subjects were illiterate below class VIII(31.25), SSC(17.97%), HSC(16.40%), Graduate(12.5%), masters(3.13%)], miscellaneous type of occupational status [home-maker(70%), service holder(19.85%), entrepreneurship(1.56%) & others(8.59%. and came from different category of social class[ most of the patients belong to lower(54.68%) and lower middle class (27.81%) socioeconomic status]. Among total study sample (n=640), 55.63% (n=356) patients were infected with COVID 19 virus confirmed by RT-PCR and 44.38% (n-284) mothers were clinically COVID infected or suspected cases. The majority of the pregnant mothers (n=565. 88.28%) experienced sub-arachnoid block or spinal anaesthesia whereas only 6.09% (n=39) patients got experience of general anaesthesia. Apparently, 93.44% (n=598) of mothers come back to the parent ward after observing in post-operative ward. Of them, (n=640), 2.19% of mothers were not survived in operation theatre or post-operative ward and 4.34% (n=21)of patients had to go to Covid dedicated Intensive Care Unit. Survivors mothers (n=619, 96.72%) were greater than that of non-survivors (n=21, 3.28%). Among the delivered new born babies, the number of female babies (n=330, 51.56%) were slightly higher than that of male (n=310, 48.44%). In a total 640 babies, 560 babies (87.50%) were survived but 12.50% (n-=80 ) of babies were not survived. Conclusions: This observational study represents that among 640 number of COVID positive or suspected pregnant mothers who were undergoing caesarean section , 93.44% of mothers come back to the parent ward, 2.19% of mothers were expired in operation theatre or post operative ward because of complications. Unfortunanely, 4.34% of mothers had experience to go to Intensive Care Unit. Survivors mothers were greater than that of non-survivors. New born babies of confirmed and suspected COVID mothers were slightly female predominant. Total of them, 87.50% of babies were survived. J Dhaka Med Coll. 2022; 31(2) : 187-193

Prevalence and Association of Risk Factors for Plantar Fasciitis Among Nurses in Government Tertiary Care Hospitals of Peshawar

Background: Plantar fasciitis is a common cause of heel discomfort and pain, resulting from inflammation of the plantar fascia, a thickened fibrous aponeurosis extending from the medial calcaneal tuberosity to the metatarsal heads. It affects more than 1 million people worldwide annually, with a lifetime prevalence that may reach 10% of the general population. Despite its widespread impact, the exact incidence remains unknown. Objective: This study aimed to determine the prevalence and associated risk factors of plantar fasciitis among nurses working in government tertiary care hospitals in Peshawar. Methods: A cross-sectional survey was conducted over six months, utilizing a convenient sampling technique. A total of 332 female nurses aged 25 to 50 years with clinical duties exceeding five hours per day participated in the study. Data were collected using the Plantar Fasciitis Pain and Disability Scale and the Visual Analogue Scale (VAS) for pain intensity. Face-to-face interviews and physical assessments were conducted by trained healthcare professionals. Statistical analysis was performed using SPSS version 25.0, with descriptive statistics calculated for quantitative variables and Chi-Square tests used to examine associations between variables. Ethical approval was obtained from the Institutional Review Board, and informed consent was secured from all participants. Results: The mean age of participants was 29.8042 ± 3.67743 years. The mean total score for plantar fasciitis was 31.4096, and the mean VAS score was 1.9458. Pain occurrence per week was reported as 1-2 days by 44.0% of participants, 3-4 days by 46.7%, and 5-7 days by 9.3%. Pain was most commonly worse in the afternoon (35.8%) and interfered with walking occasionally (52.7%). High heel standing was uncomfortable for 54.5% of participants. A significant relationship was found between age and VAS scores (p=0.001), as well as between high heel usage and increased pain levels (p=0.000). Conclusion: The mean score of plantar fasciitis among the nurses was below the threshold indicating significant prevalence. However, a significant association was found between high heel usage and plantar fasciitis, suggesting that footwear choices play a critical role in the development of this condition. Ergonomic interventions promoting supportive footwear and regular breaks are recommended to mitigate the risk of plantar fasciitis among nurses.

Burnout among Nurses and Doctors Working at a Tertiary Care Government Hospital: A Descriptive Cross-sectional Study.

Work environment related feelings of dissatisfaction, exhaustion, decreased interest and isolation is common. Burnout among health professionals has been on rise at every stage of professional growth affecting wellness of service providers, patient care and health care organizational efficiency. Assessment of burnout among health care workers from government setup in the current context in this post COVID era in our socio-geographical context has become essential. The aim of this study was to find the prevalence of burnout among nurses and doctors working at a tertiary care government hospital in Nepal. This descriptive cross sectional study was conducted among nurses and doctors working at a tertiary level government hospital from 10th May 2022 to 9th Nov 2022 after approval from Institutional Review Committee of the same institute. Nurses and doctors available on duty, from all ages were included. Trainees and students, those unable to participate due to their illness, on leave, known cases of mental illness were excluded. The point estimate was calculated at 95% Confidence. Among 180 participants, the prevalence of moderate burnout was 94 (52.22%) (44.92-59.51, 95% Confidence Interval). Among nurses 72 (50%), while in doctors 22 (61.11%) had moderate burnout. Out of those with moderate levels of burnout, the majority of 66 (52.80%) were in the age group 26-50 years. The prevalence of burnout among nurses and doctors is high, similar to other studies done in similar settings.

Burnout among Nurses and Doctors Working at a Tertiary Care Government Hospital: A Descriptive Cross-sectional Study.

Work environment related feelings of dissatisfaction, exhaustion, decreased interest and isolation is common. Burnout among health professionals has been on rise at every stage of professional growth affecting wellness of service providers, patient care and health care organizational efficiency. Assessment of burnout among health care workers from government setup in the current context in this post COVID era in our socio-geographical context has become essential. The aim of this study was to find the prevalence of burnout among nurses and doctors working at a tertiary care government hospital in Nepal. This descriptive cross sectional study was conducted among nurses and doctors working at a tertiary level government hospital from May 2022 to Nov 2022 after approval from Institutional Review Committee of the same institute. Nurses and doctors available on duty, from all ages were included. Trainees and students, those unable to participate due to their illness, on leave, known cases of mental illness were excluded. The point estimate was calculated at 95% Confidence Interval. Among 180 participants, the prevalence of moderate burnout was 94 (52.22%) (44.92-59.51, 95% Confidence Interval). Among nurses 72 (50%), while in doctors 22 (61.11%) had moderate burnout. Out of those with moderate levels of burnout, the majority of 66 (52.80%) were in the age group 26-50 years. The prevalence of burnout among nurses and doctors is high, similar to other studies done in similar settings.

Dengue Hemorrhagic Fever Presenting with Acute Abdomen in a Non- Government Tertiary Care Hospital in Bangladesh

A 60-year-old diabetic and hypertensive post-menopausal lady, presented at a tertiary care Hospital in Dhaka, Bangladesh with severe abdominal pain in the right middle and lower abdomen, associated with oliguria for 1 day. She also gave history of having high grade fever and headache for 3 days, which subsided 2 days ago. On examination, she was afebrile, mildly dehydrated, tachycardic (PR- 110/min), hypotensive (BP- 90/60 mm Hg), Tourniquet Test was positive. Her abdomen was tense and diffusely tender, especially in the right middle and lower parts, bowel sound was present, no organomegaly or lump was found. S. Lipase was normal, Anti-dengue Antibody IgM and IgG were positive, CBC revealed Hemoglobin – 8.6 gm/dL, Hematocrit was raised- 52%, Platelet count was 16000/ microliter, Stool for OBT was negative, RBS- 16 mmol/L and Urine RME and ketone bodies was negative. A provisional diagnosis of Dengue Hemorrhagic fever with suspected intra- abdominal bleeding was made and she was shifted to ICU.

IJCM_240A: A cross sectional study to assess the health literacy among adults attending outpatient clinics at a government tertiary care hospital in urban Bangalore.

Background: WHO defines health literacy as cognitive and social skills that determine the motivation and ability of people to understand, gain access and use the information to obtain good health. Inadequate health literacy has been linked to increased hospital admissions, poorer physical and mental health, lower use of preventive health services like vaccinations and screening tests. These ultimately lead to higher healthcare costs. This study was conducted to assess health literacy among adults attending outpatient clinics at a government tertiary care hospital in urban Bangalore. Objectives: To estimate proportion of inadequate health literacy and its associated factors among adults attending outpatient clinics at a government tertiary care hospital in urban Bangalore. Methodology: A cross-sectional study was conducted among adult attendees (i.e., patients and companions) of outpatient clinics of a government tertiary care hospital in urban Bangalore. Based on a study done by Almaleh. R et al. (P = 34.3%) with 7% absolute precision, the sample size was calculated as 200. A total of 200 adults attending outpatient clinics at the government tertiary care hospital were selected using simple random sampling. Data was collected using a pre-tested, semi-structured questionnaire for sociodemographic factors and HLS-EU-Q16 (European Health Literacy Survey Questionnaire short version) for assessing health literacy. The data collected was entered in MS Excel and analysed using SPSS 21.0. Results: The proportion of inadequate health literacy among study participants was observed to be 38%. Factors like educational status, age, and gender were found to have an association with it. Health literacy was found to be least in lower-educated individuals. Conclusion: From the present study, it was found that a large part of adult population had limited health literacy. It should be addressed through proper interventions, like ensuring basic education and health awareness programmes.

IJCM_76A: Assessment of quality of life after normal vaginal delivery and caesarean section among mothers at a government tertiary care hospital, Bengaluru - A cross sectional study.

Background: Quality of life comprises multifaceted dimensions encompassing physical, emotional, social, and psychological aspects. Assessing quality of life is essential not only for mothers but also for their children, family members, and the community. Understanding the impact of different modes of delivery on women’s well-being is crucial for healthcare providers to offer appropriate support and interventions. Objective: To assess and compare the quality of life after normal vaginal delivery and caesarean section among mothers at a government tertiary care hospital, Bengaluru. Methodology: A cross-sectional study was conducted among mothers at a tertiary care hospital in Bengaluru. A pilot study was conducted and sample size was calculated as 200, with 100 participants in each group. Samples were selected using a simple random sampling method, and data were collected using a pre-tested, semi-structured questionnaire. The Short Form Health Survey (SF-36) was used to assess the quality of life. The collected data was entered into MS Excel and analyzed using SPSS 21.0 Results: Out of 200 participants, the mean age of the study population was 24.32 ± 5.58 years. Comparison between the vaginal and cesarean groups revealed that the vaginal birth group had higher mean scores in the physical health domain. Factors such as physical functioning, emotional well-being, socioeconomic status, and comorbidities were found to be significantly associated with modes of delivery. Conclusion: Different modes of delivery have their own unique challenges and benefits, this study illuminated distinct differences in quality of life. Normal vaginal delivery was associated with a quicker physical recuperation compared to caesarean section, while caesarean sections demanded a longer recovery period and potential physical limitations.

Hepatic Decompensation in Patients with Chronic Liver Disease: Exploring the Role of Vitamin D Deficiency as a Prognostic Marker.

Although the function of vitamin D as a regulator of calcium and bone metabolism is well recognized, its role as an immunomodulator, regulator of cellular differentiation, and anti-inflammatory and antifibrotic actions is being increasingly noted. It is estimated that one-third of liver cirrhosis patients are vitamin D deficient. It has been reported that as liver disease progresses, the incidence of vitamin D deficiency rises. Several clinical implications of vitamin D levels have been proposed, including as a prognostic marker for the assessment of mortality in liver cirrhosis. To analyze the link between levels of vitamin D and decompensation of liver cirrhosis. This observational, cross-sectional study was conducted on 100 patients with liver cirrhosis admitted at Goa Medical College, a tertiary care government hospital in Goa, from March 2020 to February 2022. Demographic profile, history, and examination findings were recorded, and biochemical analysis included vitamin D levels. Child-Pugh (CP) and Model for End-Stage Liver Disease (MELD) scores were calculated, and based on these, patients were grouped into classes of disease severity. Data was interpreted using Statistical Package for the Social Sciences (SPSS) version 22. Mean age of the study population was 50 ± 9 years, with a 96% male predominance. Mean levels of vitamin D were 12.13, with a standard deviation (SD) of 7.38. Significant differences were noted between different classes of CP score (CPS). A vitamin D deficient state was noted in 93.3% CP class C group and 0% of class A group. A statistically significant association was demonstrated between low levels of vitamin D and CP class severity of liver dysfunction as well as MELD scores. This study confirms a high prevalence of vitamin D deficiency among patients with liver cirrhosis concurrent with the results of similar studies done earlier. More importantly, with increasing severity of hepatic decompensation as measured by CPS and MELD, vitamin D concentrations reduce.

Emergent Endoscopic Services for Acute Upper Gastrointestinal Bleeds: A Critical Need in Government Tertiary Care Hospitals.

Upper gastrointestinal bleeding (UGIB), defined as blood loss originating from above the ligament of Treitz in the gastrointestinal tract, is the most common gastroenterological emergency.1 Acute forms of UGIB have an approximate in-patient mortality rate of 2-10 percent, despite advances in management options over the last three decades. Urgent endoscopy within 12 hours is the standard management for all patients presenting with UGIB, both as a diagnostic and therapeutic tool.1 Worldwide, most cases of UGIB are due to peptic ulcers, however, this trend differs in Pakistan, where variceal haemorrhage is the predominant cause most likely due to the high disease burden of hepatitis C in the country2. According to the national health survey conducted in 2009, there is limited data on the exact prevalence and incidence, but trends have shown a frequency of 4.7% (CI 4.6-4.8), and around 8 million affected people.3 The major viral epidemic continues to impact the country’s healthcare system, primarily due to resource constraints, overburdened government setups, and lack of public awareness.2 As such, there is an urgent need to cater to this healthcare detriment, especially the decompensated forms of the disease which contribute to most mortalities.4 Like other low-income countries, Pakistan does not have the luxury of emergent endoscopic services and facilities in the well-developed world as a primary care modality. No national data on mortality from UGIB in Pakistan, or numbers on acute cases managed without emergent endoscopy exist. A study by Rajan et al 5 demonstrates that a lack of emergent endoscopy is an independent predictor of mortality among patients with UGIB in similar low-income setups, with numbers rising up to 30%. Such trends indicate a significant gap in our literature that needs to be addressed, with more studies oriented around this health concern. We also require a higher number of emergent endoscopic services to be made readily available, especially at large government tertiary care centers which cater to most of these patients, especially given the epidemic of Hepatitis C.

Patient’s satisfaction and service quality of clinical laboratory: A questionnaire based analysis in accredited tertiary care government hospital

The Phlebotomy is the first phase of interaction of the patient to the laboratory. It is therefore considered as an important step of good clinical laboratory practice and is referred to as "pre-analytic phase”. Patient’s satisfaction is one of the key quality indicators in the laboratory. : To assess the patient's satisfaction , to investigate, monitor, and analyse the non-conformities in order to remove the root cause by performing corrective and preventive action in order to improve the quality of laboratory services.: A cross-sectional study conducted in a NABH/NABL accredited government super-speciality hospital on 1500 patients over a period of three months. Data were collected in a self administered predesigned, pretested, structured questionaired feedback form in both Hindi and English, further reviewed by Senior Pathologist in a quality assurance meet and CAPA.A statistical analysis performed by using SPSS version 16.0 software and Likert Scale.Overall patient satisfaction with phlebotomy services found to be high, i.e 88%. Highest mean rating of satisfaction was 99.2% for parameter -Whether the seats during phlebotomy was comfortable. The parameter for washroom facility accounted for 75 % dissatisfaction followed by 63.4% overall dissatisfaction noted for ambulatory services. Phlebotomy services needs improvements: 12%.The study enlighten to understand patient preferences through a patient satisfaction questionnaire known as a "feedback form." Knowing how our patients feel about our laboratory services is vital and to identify all problems (non-conformities) found in the analysis and take appropriate CAPA.

Mobility as an Effective Non-pharmacological Method for Parturition: A Pilot Study

Background Childbirth is a transformative process. Modern healthcare offers pharmacological and non-pharmacological interventions for safe and improved childbirth experience. Studies have found that maternal mobility during the first stage of labour has a significant effect on maternal and child outcomes. A pilot study was done to find the effect of mobility during the first stage of labour on maternal satisfaction and foetal outcome. Method An experimental study was done with 60 primigravida women with uncomplicated antenatal history reporting to the labour room of a tertiary care government hospital in Delhi chosen as study participants. Validated and reliable tools were used to measure labour, maternal and neonatal outcomes within 24 h post-delivery. Results The results showed that there was an impact on mobility intervention during the first stage of labour on parturition ( p = .03) and significant maternal satisfaction ( p = .001). However, the neonatal outcome of both groups was not significant. Conclusion Mobility was an effective non-pharmacological intervention for enhancing parturition and maternal satisfaction. Mobility during the first stage of labour can be recommended for practice guidelines for all midwives in the labour room as a protocol.

Seroprevalence of COVID antibodies in health-care population of tertiary care government hospital in South India

Background: The pandemic coronavirus disease 2019 (COVID-19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a worldwide abrupt and significant rise in admissions for pneumonia with multiorgan diseases. Aims and Objective: To determine the positive prevalence of SARS-CoV-2 antibodies in health-care professionals over 6 months. In addition, to make a subgroup analysis and estimate the age, gender, and workforce-based prevalence of SARS-CoV-2. Materials and Methods: An observational cross-sectional study was conducted on 200 healthcare professionals during 6 months. After taking proper informed consent, the study was started. We included subjects aged ≥18 years in this study. Not receiving any other vaccine during the study, suspected or confirmed immunosuppressive condition, imaging confirmed COVID-19 or recent blood transfusions were excluded from the study. Results: Most patients were 26–30 years old. Out of 200 patients, 116 (58%) were males, and 84 (42%) were females. The total positivity of the titers amounts was 57%. In addition, the males had higher mean titers than the females, with 24.186 versus 13.304. Of the 116 males, 68 were positive (58.6%), and of the 84 females, 46 were positive (54.7%). The age-wise positivity of the titers was high among the 26–30 years of age group, of which, in the 53 people, 33 were seropositive, which is 62.2% of this age group and lowest in the 51–55 years age group, of which in the 23 participants 9 were positive (39.31%), and 14 were negative (60.85%). Conclusion: We concluded that male doctors and adults had a greater seroprevalence of SARS-CoV-2 infection, suggesting that they are more susceptible to contracting COVID-19 through patient contact or surgical procedures.

Vaccination status, awareness, and its correlates among healthcare workers in the Delhi-National Capital Region (NCR): a mixed-method study.

Healthcare workers (HCWs) are on the frontline of infections. To safeguard HCWs from occupational exposure to infections and to curb nosocomial infection a set of vaccines has been recommended for them by the WHO. Hence, we aimed to assess the vaccination status, awareness, and its correlates amongst HCWs in the Delhi-NCR. The study used a cross-sectional mixed-method approach from January to April 2023. For the quantitative arm, a structured questionnaire was circulated to the participants in conveniently-selected private and government tertiary care hospitals of the Delhi-NCR, both through e-survey using Google form, and in person, data were collected on socio-demographics, vaccination status, and awareness. SPSS version 25 was used for the analysis. For the qualitative arm, in-depth interviews were conducted and data were analyzed manually. Out of 387 participants (62.8% males, 37.2% females), the awareness about the vaccines recommended for HCWs was 64.1%. However, only 15.3% of HCWs were completely aware of all the recommended vaccines. SARS CoV-2, Polio, Hepatitis B, and BCG had the highest vaccination coverage, 97.4%, 87.9%, 83.7%, and 50.9%, respectively. It was found that gender, education, type (private or governmental) of tertiary care hospital, and profession had a significance (p<0.05) on the vaccination status score and awareness of all WHO-recommended vaccines (AOR=7.6, 95% CI, 3.24-18.0). The qualitative arm further augmented the findings. The study reveals insufficient awareness and vaccination status regarding recommended vaccines. Prioritizing the preparation of unified standard guidelines for Indian HCWs and involving concerned stakeholders is crucial.

Drug susceptibility, Prevalence and effect of Pseudomonas aeruginosa on wound healing of burn patients.

To determine the prevalence, antibiotic susceptibility and effect of Pseudomonas aeruginosa in relation to burn patients. The cross-sectional study was conducted at the Centre for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan, from March 2018 to May 2021, and comprised pus swab cultures were isolated from inpatients with 2nd and 3rd degree burns aged up to 60 years at Bolan Medical Complex Hospital and Sandeman Provinical Hospital, the two main government tertiary care hospitals in Quetta. The samples were immediately cultured, and evaluated using biochemical tests, antibiotic susceptibility and molecular identification using polymerase chain reaction. Data was analysed using SPSS 20. Of the 720 burn wound samples, 424(58.9%) were positive for Pseudomonas aeruginosa; 304(42%) males and 120(16%) females (p<0.02). The overall mean age of the patients was 27.7±6.2 years (range: 1-60 years). The mean total burn surface area was not significantly different in positive 29.6±6.2% and negative 30.3±6.2% cases (p>0.05). The time leading to skin grafts in positive patients was 29.5±6.5 days compared to 22.3±6.3 days for negative patients (p< 0.007), and the time required for wound healing was 25.0±4.7 days and 16.7±5.2 days, respectively (p<0.001). Length of hospital stay of Pseudomonas aeruginosa positive patients was 38.0±7.8 days compared to 32.1±6.8 days for negative patients (p<0.001). Nosocomial infections and multidrug resistance species were observed frequently at the burn wound site. P. aeruginosa.

Prevalence of co-morbidities and referral patterns in routine preoperative evaluation: A retrospective observational analysis in a tertiary care government hospital

The initial interaction between patients and anaesthesiologists during pre-anaesthesia check-ups (PAC) is a crucial opportunity to diagnose and pre-optimize co-morbidities that might go unnoticed. This proactive approach contributes to safe anaesthesia administration, uneventful intra-operative experiences, and smooth post-operative recovery. Our study assesses the prevalence of diverse co-morbidities within a tertiary care centre's PAC. After analysing data from 3 months involving 905 patients, 624 individuals exhibited co-morbidities, with 217 cases being newly identified within the PAC clinic. Among female patients, anaemia emerged as the most prevalent anomaly (219 cases), while hypertension dominated among male patients (171 cases). Overall, anaemia constituted the most common co-morbidity (362 cases). A comprehensive clinical assessment during the Pre-Anaesthetic Clinic empowers formulation strategies for pre-optimization and treatment of co-morbidities. Timely intervention is pivotal, not only to prevent surgery delays but also to avert potentially catastrophic outcomes arising from untreated conditions. This approach translates into expedited patient recovery, minimizing anaesthesia-related complications. The Pre-Anaesthetic Clinic plays a pivotal role in diagnosing and intervening in patient co-morbidities. Beyond diagnosis, it is a crucial early intervention and treatment platform, significantly enhancing the overall surgical recovery process.