Hospital In Trinidad Research Articles

Prevalence of risk factors in cardiovascular patients in a Caribbean country: Age and sex differences

Background/objectivesCardiovascular disease (CVD) is the leading cause of death worldwide, however little is known about the prevalence of risk factors in the Caribbean country of Trinidad and Tobago. This study investigates the prevalence of major cardiovascular risk factors in patients with CVD in Trinidad and Tobago between two age groups – <60 years and ≥60 years – and determines if the prevalence differed with sex. MethodsMedical records of 151 patients with CVD admitted to a private hospital in Trinidad and Tobago between January 2015 and March 2021 were analyzed. Patients were divided by sex, and into two age groups: <60 years (young) and ≥60 years (elderly). Chi-squared and Mann-Whitney U tests were used to analyze five major cardiovascular risk factors: hypertension, diabetes, smoking, hypercholesterolaemia, and family history of coronary heart disease (CHD). ResultsIt was found that the prevalence of hypertension was higher in the elderly group, while smoking, hypercholesterolaemia and family history of CHD were more common in males than in females. The prevalence of different risk factors varied with sex in the age groups: diabetes and family history of CHD in the <60 age group, and smoking and hypercholesterolaemia in the ≥60 age group. These risk factors were more prevalent in males than in females within the age groups. Additionally, the mean age of females in the ≥60 age group was found to be greater than that of males in the same age group. ConclusionsAge and sex differences were observed in the prevalence of major CVD risk factors, which may influence the management of CVD in Trinidad and Tobago. Intervention strategies, such as health education and counselling programmes that are age- and sex-specific, are recommended.

A profile of facial bone fractures in an Oral and Maxillofacial Unit in Trinidad and Tobago

Objective: Investigate the patterns of facial fractures presenting to an oral and maxillofacial service at a teaching hospital in Trinidad. Methods: A retrospective study was conducted to obtain information on traumatic maxillofacial and mandibular fractures from the Oral and Maxillofacial unit at the Eric Williams Medical Complex, Trinidad. Data was collected from February 2019 to February 2020 from 174 patients. For each patient the month of presenting injury, age, sex, ethnicity, mechanism of injury and fracture type was recorded. Results: In the (174) patients that reported fractures, 72% were male and 28% were female patients with a mean age of 34.9 years and mainly from the ethnicity of Afro-Caribbean (63.2%) followed by East Indian (30.5%). Two hundred and thirty-one (231) fractures were reported in this study with the highest number of fractures occurring in the 20-29 years age group (22%) and the most common fracture type was orbital floor fractures (31.6%). The predominant cause of traumatic fracture was physical assault (37.9%) followed by accidental injury (25.9%). Conclusion: The main cause of traumatic maxillofacial injury was physical assault and generally in young adult males. Orbital floor fractures comprised the most common fracture type in this study.

THE CHALLENGE ASSOCIATED WITH THE INTRODUCTION OF NEW SURGICAL SERVICES IN A RURAL HOSPITAL IN TRINIDAD &amp; TOBAGO

The introduction of new services at any institution requires significant input from a myriad of departments and specialties. This paper will explore the various challenges that arose with the implementation of an orthopaedic surgical service at the Point Fortin Hospital in Trinidad and Tobago. It identifies the obstacles faced in terms of resource allocation, infrastructure development, staffing, and collaboration. Additionally, it proposes effective strategies and solutions to overcome these challenges, thus ensuring the successful establishment of a sustainable orthopaedic surgical service at Point Fortin Hospital.

Characteristics and outcomes of surgical clipping of ruptured intracranial aneurysms at a tertiary care institution in Trinidad &amp; Tobago – a descriptive report

ABSTRACT Objectives Reports on the management and outcomes of intracranial aneurysms are sparse from the English-Speaking Caribbean. This study aimed to determine the characteristics and outcomes of surgically clipped ruptured intracranial aneurysms undertaken by a single neurosurgeon, under the unique challenges faced in a low-resources setting. Methods The neurosurgical operative logbook from the period July 1st 2018 - July 31st 2021 was examined to identify all patients who had surgically clipped cerebral aneurysms at a tertiary care teaching hospital in Trinidad and Tobago. Patients’ charts were reviewed to assess risk factors such as hypertension, smoking, positive family history, aneurysm grades and types, including presenting Hunt and Hess (HH) Grade, modified Fisher CT Grade, time to definitive surgery and Glasgow Outcome Scale - extended (GOSE). Results Twenty-six patients underwent open surgical aneurysmal clipping, between the ages of 20 – 73 years. Posterior communicating artery aneurysms (35%) and anterior communicating artery aneurysms (38%) were the most commonly encountered types of aneurysms. One half of patients were HH Grade 1, and 58% were Fisher Grade 4. Time to clipping ranged from 3 – 62 days, with a mean of 12 days. About 42% of aneurysms were clipped prior to the peak vasospasm period, while 61% were clipped within 14 days. Following the procedure, 62% of patients had GOSE score of 8 (maximum function). Conclusion Surgical clipping of ruptured intracranial aneurysms may yield good patient outcomes even in a low-resource setting, despite challenges faced due to limited resources and operating time. Clipping during peak vasospasm period did not result in worse outcomes. The establishment of a neurovascular service may be beneficial even in low-resource settings. Keywords Intracranial aneurysm; clipping; endovascular; Trinidad and Tobago; Caribbean

The Correlation of Papanicolaou Smears and Clinical Features to Identify the Common Risk Factors for Cervical Cancer: A Retrospective and Descriptive Study from a Tertiary Care Hospital in Trinidad.

Background: Cervical cancer, the fourth most frequent cancer in women, is associated with the human papillomavirus (HPV). This study identifies risk factors and clinical findings for abnormal cervical cytology and histopathology in the Trinidad and Tobago populations. Some risk factors include early age of first coitus, a high number of sexual partners, high parity, smoking, and using certain medications, such as oral contraception. This study aims to identify the significance of Papanicolaou (pap) smears and the common risk factors that contribute to the development of premalignant and malignant cervical lesions. Method: A three-year retrospective, descriptive study of cervical cancer was conducted at the Eric Williams Medical Sciences Complex. The subject population included 215 female patients aged 18 years and older with the following documented abnormal cervical cytology: (ASCUS), ASC-H, LSIL, HSIL, Atypical Glandular cells, HPV, Adenocarcinoma, and Invasive Squamous Cell Carcinoma. Histopathology records were analysed for thirty-three of these patients. Patients' information was recorded on data collection sheets adapted from the North Central Regional Health Authority's cytology laboratory standardised reporting format request form. Results and Findings: The data were analysed via Statistical Package for Social Sciences (SPSS) software edition 23 using frequency tables and descriptive analysis. The mean sample age of the population was 36.7 years, the first age of coitus was 18.1 years, the number of sexual partners was 3.8, and the number of live births was 2. LSIL was the most popular abnormal finding, 32.6%, followed by HSIL, 28.8%, and ASCUS, 27.4%. Most histopathological reports resulted in CIN I and II. Conclusions: The significant risk factors observed for cytology abnormalities and premalignant lesions were early age of coitus, a high number of sexual partners, and no use of contraception. Patients mostly presented as asymptomatic despite obtaining abnormal cytology results. Hence, regular pap smear screening should continue to be highly encouraged.

Laparoscopic Common Bile Duct Exploration for Stones at a Resource Poor Hospital in Trinidad &amp; Tobago: A Retrospective Study

exploration at the time of cholecystectomy because exploration is perceived to have low clearance rates. We routinely perform laparoscopic explorations for CBD stones at the Port of Spain General Hospital in Trinidad &amp; Tobago. This retrospective study sought to document outcomes after laparoscopic CBD exploration. Methods: We identified all patients who underwent laparoscopic CBD exploration for stone extraction at the General Hospital in Port of Spain over a ten-year period from January 1, 2013 to January 30, 2023. The following data were extracted: demographic details, operating time, stone clearance rates, retained stone rates, conversions, complications. All data were entered into an excel database and the data were analyzed with SPSS version 20. Results: Intra-operative cholangiograms were performed in 49 patients, and CBD stones identified in 12 (25%) patients at a mean age of 48.7+/- 8.63 years. These patients underwent laparoscopic CBD exploration without prior endoscopic retrograde cholangio-pancreatography. The mean stone burden was 4.7+/-2.54 stones. Four (33%) patients had attempts at trans-cystic exploration, and they all required choledochotomies to complete CBD exploration. Eight patients had initial attempts at choledochotomy for stone extraction. The mean operating time for laparoscopic cholecystectomy, operative cholangiography and CBD exploration with duct clearance was 169.6+/-35.1 minutes. There were 2 (17%) conversions, 1 (8.3%) complication (bile leak) and no mortality. Stone clearance rate was 91.7% (11). The mean duration of hospitalization was 0.6 days. There were no instances of retained or recurrent CBD stones in this series. Conclusions: While laparoscopic CBD exploration does demand increased skill sets, such as laparoscopic suturing, mastering duct exploration techniques, interpreting biliary anatomy and operative cholangiography, we have shown that it is feasible in the resource poor Caribbean setting. Surgeons planning to perform laparoscopic CBD exploration should have a working knowledge of biliary anatomy and variations and the ability to suture laparoscopically.

Assessment of Risk Factors, Prehospital Measures and Clinical Needs of Patients Admitted With Snake Envenomation at a Rural Hospital in Trinidad and Tobago.

This study assessed the risk factors for sustaining a snake bite, the prehospital measures employed, and the clinical needs of patients admitted with confirmed envenomation. Data was collected at a single center, a rural secondary care hospital in Trinidad and Tobago. A cross-sectional method was used that enrolled all consenting patients requiring admission following clinical confirmation of snake envenomation during the period 2017-2019.Data collection involved a review of the patient record from the emergency room and hospital admission to establish the clinical need during the time of admission which was defined as the administration of medication, need for surgery, and critical care intervention. Data collection also involved a patient interview to establish demographics, prehospital measures employed, and assessment of the risk factors associated with sustaining the snake bite. 29 patients were admitted for snakebite envenomation during 2017-2019 and all patients consented to enrolment. Of these patients, 22 were male and most commonly were within the age range of 18-40 years old. 34.5% of patients were farmers and 68.9% of patients identified being bitten by the Mapepire Balsain snake. 65.5% of patients reported being unaware of the risk of snake bites and 82.8% were not wearing boots, with the lower limb being the most common bite site among 55.2%. 41.4% of bites were sustained during work-related activity while 34.5% of bites were sustained during recreational activity. Prehospital measures were employed by 18 of the 29 patients with the most common types beingirrigation (10.3%), cutting (6.9%), tourniquets (44.8%), pressure immobilization (6.9%), topical applications (3.4%), and ingestion of a substance (6.9%). 34.5% received hospital care within 1 hour of the bite while 55.2% arrived at the hospital between 1 and 4 hours of being bitten. The clinical challenges of these patients included local reactions (82.8%), coagulopathy (72.4%), compartment syndrome (17.2%), cellulitis (3.4%), and dislocated shoulder (3.4%). The clinical needs of these patients included vitamin K (13.8%), antibiotics (93.1%), tetanus shots (17.2%), analgesia (6.8%), and anti-venom (82.7%). 10.3% of patients required debridement and 3.4% required a fasciotomy. The average stay in the hospital was 3.8 days. There were no documents of deaths or need for critical care. Persons are most likely to be envenomated by the M. Balsain in Trinidad. These patients are commonly males ranging anywhere from 18 to 40 years presenting local reactions and coagulopathy needing admittance to the hospital. While the majority of patients requiring admission performed some type of prehospital measure, very few did so with pressure immobilization. Furthermore, the majority of patients had a prolonged time before presenting to the hospital; this is a potential area for improvement in the health system through education and sensitization. There was a significant utilization of resources on these patients when taking into consideration their clinical needs, medication, and hospital stay; primary prevention should be a focus through the education of groups who are at higher risk for a venomous snake encounter.

Organ donation in a developing Caribbean country: a single centre experience in Trinidad and Tobago

ABSTRACT Objectives The National Organ Transplant Unit was established in 2006 with the aim of providing renal and corneal transplants services. This study assessed the current state of the National Organ Transplant Unit and the organ donation experience at a single centre intensive care unit in Trinidad. Methods A review of legal, human and material resources and a retrospective chart review of the current status of organ donation and transplantation in Trinidad and Tobago was conducted. Data were collected from medical records of deceased donors for the period January 2006 to December 2020. The organ donor experience in the Adult Intensive Care Unit at a tertiary care hospital in Trinidad was also evaluated. Data were collected from medical records of all patients in the adult intensive care unit for the period October 2016 to December 2016. Results Trinidad and Tobago has four donor hospitals, one transplant centre, and one surgical team consisting of three surgeons, approximately 100 trained Transplant Procurement Managers and one trained laboratory technician. The deceased donation rate was 0.77 donor per million population in 2006, peaked in 2014 at 3.85 and then remained at 0.77. Donor potentiality for the adult intensive care unit was 66.7% with a donation rate of 5.3%. Conclusions Organ donation in Trinidad and Tobago mostly relies on living donors. Despite increases in organ donation and conversion rates, the country has not yet achieved self-sufficiency. The implementation of a taskforce dedicated to developing action plans to improve organ donation services may assist the country in achieving self-sufficiency.

Epidemiological evaluation of risk factors associated with vaginal candidiasis in a cross section of pregnant women in Trinidad and Tobago.

Vaginal Candidiasis and associated epidemiological risk factors prevalent among a cross section of pregnant women attending tertiary hospital in Trinidad and Tobago was evaluated. Standardized questionnaire was used to survey 492 pregnant women over a period of 10 months in 2019. Vaginal swab was collected and processed using standard microbiological laboratory methods for phenotypic identification. Data were analyzed using SPSS to identify potential risk factors. Chi-squared (ꭓ2) test and logistic regression tests examined associations and odds ratios with corresponding 95% confidence intervals. Prevalence of vulvovaginal candidiasis was 44.9% with Candida albicans as predominant species identified (62%, N=492). Vaginal candidiasis was statistically significant for several risk factors, including second trimester (p = 0.03), age group 26 - 34 years (p=003), history of masturbation especially during the last 48hours prior to the swabbing (p=0.05), and wearing of pants as opposed to skirt clothes (p=0.04). In conclusion, several epidemiological risk factors are associated vaginal candidiasis among cross section of pregnant women in the country. Patient education, microbiological investigations and appropriate treatment will improve antenatal healthcare delivery in the country.

A Survey of Surgical Trainees in Trinidad &amp; Tobago Using a Robotic Laparoscopic Camera Holder

Background: In the year 2021, the FreeHand robotic camera holder was introduced to a hospital in Trinidad &amp; Tobago, amid strong opposition from postgraduate trainees who were concerned about diluted training opportunities. The aim of this study was to document trainees’ opinions on this surgical tool before and after its use. Methods: A self-administered questionnaire was completed by surgical trainees who had the opportunity to use the surgical robot in laparoscopic operations. The questionnaire sought data on three specific aspects: impact on training, technical aspects and perceived value for training. Results: Six trainees answered the questionnaire after using the robot. The number of trainees who believed the robot negatively impacted training reduced from 100% to 33%. All responders reported that head movements to control the robot were uncomplicated and the docked robot was not intrusive toward instrument movement. All were willing to support the use of the robot after having used the robot. Conclusions: This survey has revealed that surgical residents’ opinions of the Freehand® robot dramatically changed after becoming familiar with its use. There is no valid reason that surgical trainees would be denied the opportunity to participate in an operation, once they have become facile with the robot.

A Preliminary Study of the Treatment Outcomes of Paediatric Dental Patients Referred for General Anaesthesia or Sedation at a Regional Hospital in Trinidad.

General anaesthesia and sedation are known to be useful adjuncts in the care of paediatric dental patients. There are several challenges that prevent patients from receiving care. Aim: To assess the treatment outcomes of paediatric dental patients seen at an emergency facility who were referred for treatment under sedation or general anaesthesia at a regional hospital in Trinidad. Methods: Records of patients seen at the Child Dental Health Unit Emergency clinic at the University of The West Indies Dental School from 2012 to 2017 were assessed. The parents of children referred for general anaesthesia or sedation at the regional hospital were then interviewed via telephone. Results: Most children (53.4%) were younger than 6 years old and the most common reasons for referral were the treatment of multiple carious teeth and behaviour management. Furthermore, 66.1% of cases did not receive treatment and had a mean waiting time of 4.7 years, and 61.7% of referred cases needed emergency care while awaiting general anaesthesia or sedation. Limited access to these services and the high cost of treatment were the main reasons for non-treatment. Conclusion: There is significant need for the timely treatment of paediatric dental patients referred for general anaesthesia or sedation. Improved availability and accessibility of these services could improve patients’ quality of life.

Awake craniotomy for a low-grade glioma - a pilot procedure at a public hospital in Trinidad and Tobago

Awake craniotomies (AC) are proven to reduce the neurological deficit associated with tumour resection in areas of eloquent cortex. Successful performance requires not only technical skill, but the availability of neuronavigation, cortical mapping, intra-operative frozen section and the appropriate anaesthetic support. This case report describes the first fully awake craniotomy done in Trinidad, at a public hospital, for a patient with seizures secondary to a low-grade glioma. It resulted in an excellent patient outcome, with full cessation of seizures and no postoperative deficits.

Flap Tubing And Waltzing For Complex Facial Reconstruction In The West Indies

Ballistic facial wounds present daunting reconstructive challenges to the most experienced of surgeons. The early Waltzing method of tissue transfer, perfected by Sir Gillies, was superseded by free flaps and facial transplantation as methods for facial reconstruction. In the low resource setting, however, the Waltz may be the only suitable option. This case study describes the use of the Waltz for facial reconstruction at the Port of Spain General Hospital in Trinidad. The subject sustained a gunshot wound to the face resulting in complex midface and mandibular defects. Here, bilateral deltopectoral flaps were used to replace destroyed soft tissue.

The Perceived Oral Health Status, Practices, Knowledge and Periodontal Status of Pregnant Women in a Maternity Hospital in Trinidad

The Perceived Oral Health Status, Practices, Knowledge and Periodontal Status of Pregnant Women in a Maternity Hospital in Trinidad

Factors contributing to needle stick injuries among new registered nurses at a hospital in Trinidad.

Newly educated RNs are vulnerable to needle stick injuries (NSIs). Most needle stick injuries occur during practice and associated with nurses' practice and available resources. This was a quantitative, descriptive study. Registered nurses (N = 120) with less than three years' experience. Data collected using a 26-item questionnaire among newly registered nurses. Data were analyzed descriptively and inferentially using (SPSS) version 20. Most of the nurses between the ages 20-30 years (49.7%), were female (73.4%), had 2 to <3 years' experience (44.2%) and experienced a needle stick injury (43.3%). Respondents knew about the policies on standard precautions but their practice was not compliant with safe practices. Adherence was associated with knowledge of policies on standard precautions (r. = 534, p < .01), having updated policies (r = .404, p < .01) and the appropriate use of resources (r. = 805, p < .01). There are a number of factors that contribute to NSIs among newly registered nurses which are personal as well as structural. Avoidable practices such as non-adherence to standard precautions while using hypodermic needles contributed to NSIs. Mandatory training and evaluation of nurses' knowledge and attitude regarding safety practices should be examined.

Establishing a pediatric occupational therapy clinic in the public-sector in Trinidad: The quest for clinical and professional expansion.

Pediatric occupational therapy (OT) in Trinidad is limited to costly private sector provision, which restricts access to only those families that can afford it. Public-sector healthcare, however, is offered free of charge to citizens. Establishing public-sector OT can increase the well-being and quality of life of children with disabilities and their families, as well as broaden the professional paths available to occupational therapists. In the absence of local studies, primary research was undertaken to demonstrate the demand for services. The results of this study will be presented to government officials to argue for the inclusion of pediatric OT into one public-sector hospital in Trinidad. Eighty-eight parents/caregivers of a child with special needs were surveyed at one public sector-waiting room or two private-sector therapy clinics. Surveys questioned parents' desire for occupational therapy services for their child, their willingness to use public-sector-provided therapy and their belief that such therapy would benefit families in Trinidad, among other items. Of the 88 participants surveyed, 98.8% believed that occupational therapy offered at one public-sector clinic in Trinidad would benefit families. The main deterrents to accessing the proposed public-sector therapy included satisfaction with the current therapist (40%) and concerns with convenience (33%) and efficiency (27%). Parents whose children were not currently receiving therapy cited cost (67%) and location (38%) as the main barriers. Primary research findings demonstrate that the vast majority of parents/caregivers believe that public-sector pediatric occupational therapy would benefit families. Service free of charge will increase access for many families who cannot currently afford treatment. Implications of a pediatric public-sector clinic also include the expansion of occupational therapy as a profession in Trinidad.

An assessment of postoperative cognitive impairment in the elderly patients at the Port of Spain General Hospital

Objectives: Post-operative delirium (POD) is a relatively common occurrence particularly in the elderly, especially after prolonged surgery. This study aimed to determine the incidence of post-operative delirium at the Port of Spain General Hospital, Trinidad, West Indies. Methods: After obtaining consent, elderly patients (≥ 65 years of age) were prospectively screened using the 4AT questionnaire pre and post-operatively. Post-operative assessment was done on day 0, 1 and 2 between the hours of 18:00 and 22:00. Demographic and clinical data were recorded. Results: Sixty-one (61) patients were recruited. After exclusion, a total of 42 were included for the study. The incidence of POD in elderly patients at the Port-of-Spain General Hospital in Trinidad was 21.4%. Overall, eighteen (43%) patients displayed cognitive impairment post-operatively. The factors associated with development of POD were duration of anaesthesia, with surgery lasting &gt;120 min having a 17% incidence. Delirium occurred more frequently after general anaesthesia (27%) compared to regional anaesthesia (8%). Vasopressor use and malignancy was also associated with a higher incidence of POD (33%). Conclusion: Elderly patients had a higher risk of developing postoperative delirium following general anaesthesia compared to regional anaesthesia, and where the surgical duration exceeded 2 hours. Other factors included hypotension requiring vasopressor use and gynaecological malignancy. The 4AT is a useful tool in detecting postoperative delirium in our setting.

Factors affecting mortality in major trauma patients in Trinidad and Tobago – A view from the developing world

IntroductionThere are few data on major trauma in the developing world. This study investigated the characteristics and outcomes of seriously injured patients in Trinidad and Tobago, using Trauma and Injury Severity Score (TRISS) methodology. We also aimed to assess the predictive accuracy of the TRISS model in patients in Trinidad and Tobago.MethodsRetrospective data from major trauma patients attending the Emergency Department of a tertiary hospital in Trinidad between 2010 and 2014 were analysed. Patients ≥18 years having an Injury Severity Score &gt;15 were included. The impact of age, gender, comorbidities, mechanisms and patterns of injury on mortality was investigated. Using TRISS methodology, predicted mortality was calculated and compared to actual mortality.ResultsOf 323 patients analysed, 284 were male and 24 were aged ≥65 years. The commonest injury mechanisms in younger people were motor vehicle accidents (34.1%) and stabbings (30.8%) compared to falls (66.7%) and motor vehicle accidents (20.8%) in people aged ≥65 years. The commonest areas injured were the chest in younger patients (81.9%) and the head and neck in patients aged ≥65 years (58.3%). Women’s mortality rates were similar to men (RR 1.8; 95% CI 0.7–4.9). Mortality was higher with age ≥65 years (RR 7.0; 95% CI 3.1–15.9), blunt trauma (RR 7.6; 95% CI 1.8–32.4) and Charlson Comorbidity Index of 1 or more (RR 3.2; 95% CI 1.3–8.0). The TRISS model performed well at lower ISS scores and was excellent at predicting survival (discrimination statistic 0.94).ConclusionMultiple factors influence mortality in major trauma patients in Trinidad and Tobago, including age, co-morbidities and injury mechanism. TRISS methodology accurately predicted survival in this population but was better at predicting mortality in patients with lower Injury Severity Score.

Oral health among children attending an oncology clinic in Trinidad.

ObjectivesLittle is known about the oral health of paediatric oncology patients in the Caribbean. Poor oral health can complicate oncology treatment, negatively affecting a child's health. In children undergoing chemotherapy or bone marrow transplant, odontogenic infections can progress to life‐threatening sepsis. The aim of this study is to investigate the oral health among children attending an oncology clinic in Trinidad.Material and MethodsSample population included paediatric oncology patients attending a children's hospital in Trinidad. Subsequent to obtaining informed consent, a 14‐item questionnaire was administered to parents/caregivers. An intra‐oral examination was undertaken by two dentists to assess soft tissues, gingival health, and dentition status, using visual examination only.ResultsSeventy‐one children and their caregivers participated in the study. The children consisted of both patients warded or attending as outpatients; 53.5% of patients were male and the mean age 6.64 (SD 3.33) years with a range of 1 to 15 years. Gingivitis and mucositis were present among 41.3% and 3% of patients, respectively. The prevalence of visible dental caries was 54.3%. Caries experience (dmft) was 2.28 (SD 3.63), and for those children with some caries experience (dmft > 0), this was 5.59 (SD 3.72). The majority (62.5%) had never visited a dentist. The most common dental treatment needs were dental prophylaxis (98.4%) and restorative treatment (50.8%). Acute lymphocytic leukaemia (39.1%) was the most common malignancy among this sample, and patients were at varying stages of cancer treatment.ConclusionsOral health among this sample of paediatric oncology patients was generally poor, with untreated caries being common, and the majority of children not having had any previous dental care. Preventive dental care for these patients should include oral hygiene instruction, dietary advice, topical fluoride application along with management of carious lesions, and odontogenic infections. This preliminary study highlights the need for closer collaboration between general dental practitioners, paediatric dentists, and paediatric oncology physicians, in caring for these patients.

Patient satisfaction with inpatient services in a public tertiary hospital in Trinidad and Tobago: associated factors and predictors

Background: Patient experience is an important factor in assessing the quality of healthcare. Numerous reports highlight the continued inconsistencies in healthcare and poor patient satisfaction affecting outcomes. This study aimed to assess patient satisfaction in a teaching hospital in Trinidad and Tobago.Methods: A cohort study was conducted among recently discharged patients from the largest teaching hospital in Trinidad and Tobago. The survey instrument was an adaptation of the Picker Patient Experience Questionnaire. Data were collected from January 1, 2017 to March 2017, using face-to-face interviews. SPSS version 21 was used for descriptive and inferential analysis of data.Results: The majority of the 300 participants was female (n=157; 53.3%), aged over 35 years (n=202; 67.3%) with secondary school education (n=137; 45.7%). Satisfaction levels ranged from 50% and 70% for management issues, treatment-related communication issues, environmental issues, and deportment of medical staff. Patient satisfaction with treatment-related support and hotel services was less than 50%. All satisfaction domains were inter-dependent with the highest correlation between treatment-related communication and management issues (r=0.691; p≤0.001) and the lowest between support services and hotel services (r=0.311; p≤0.001). Education was the only factor that was both associated with, and a predictor of, patient satisfaction. Satisfaction level decreased with increased education level.Conclusions: Low satisfaction was found with treatment-related support and hotel services with education level as the only predictor. Steps are needed to ensure periodical satisfaction monitoring and continuous improvement of services such as support and hotel services.