Physicians Research Articles

Expert consensus on diagnosis and treatment of spontaneous intracranial hypotension(2024)

Spontaneous intracranial hypotension is a disease characterized by orthostatic headache caused by spinal cerebrospinal fluid leakage. Patients have to remain bedridden, which significantly affects their quality of life. In severe cases, complications such as subdural hematomas may occur. Clinical practice reveals a high rate of misdiagnosis and insufficient implementation of diagnostic and treatment measures. To improve clinical physicians' understanding of spontaneous intracranial hypotension and to standardize the diagnosis and treatment, the Neurologist Branch of the Chinese Medical Doctor Association and the Headache and Sensory Disorders Committee of the Chinese Research Hospital Association organized experts to develop a total of 30 recommendations on the clinical identification, examination processes, diagnostic criteria, treatment, and follow-up of spontaneous intracranial hypotension based on domestic and international clinical practices and recent literature evidence after extensive discussions.

Integrating Islamic Values and Modern Medical Practices to Enhance Public Health in Muslim Communities

This study aims to explore the integration of Islamic spiritual values with modern medical practices as a holistic approach to improving public health, particularly in Muslim-majority regions. The approach seeks to bridge the gap between physical and spiritual health through a framework that accommodates religious, cultural, and socio-economic aspects. The method employed is qualitative literature review, utilizing content analysis and interpretative analysis of relevant scholarly sources. The main findings reveal that Islamic values can play a strategic role in creating more inclusive and effective healthcare services, through community-based policies and synergy between traditional and modern medicine. The study also identifies barriers such as inadequate regulations, limited access, and misconceptions about traditional and modern medicine, which can be addressed through stricter regulations and public education. This research contributes to developing a new paradigm in health policy by integrating religion and science, offering a multidisciplinary and contextual perspective. It highlights the importance of collaboration among governments, medical practitioners, and local communities in creating a holistic healthcare system. In conclusion, the integration of Islamic spiritual values with modern medical practices holds significant potential for enhancing public health outcomes while fostering harmonious dialogue between religion and science for the future.

Group medical visits in cancer survivorship care: a scoping review

Abstract Background More than 60% of cancer survivors report unmet physical, psychosocial, and informational needs. The care of cancer survivors includes surveillance, health maintenance monitoring, referral for long-term adverse effects of cancer treatment, and coordination of care. Group medical visits (GMV) include medical care, education, and peer support and can be used to facilitate the delivery of multidisciplinary survivorship care. We aimed to characterize the current state of related research describing the role of GMV in cancer survivorship care. Methods For this scoping review, we searched for published literature using PubMed, Embase, and other resources. We included intervention studies of multidisciplinary care involving GMVs of adult patients with a history of cancer requiring the presence of medical personnel, physicians, advanced practitioners, or oncology nurses. We included studies that focused on broad cancer survivorship care, rather than those using specific modalities, such as yoga, or limited to specific aspects of cancer survivorship care, such as weight loss. We characterized the studies by cancer type, structure of GMVs, and reported outcomes. Results We identified 2311 studies (2122 from PubMed and 189 from Embase). We excluded 1524 duplicates and screened 787 studies for title and abstract review. Finally, 63 studies were retrieved for full-text review, and six were included in this scoping review. Of the included studies, four were non-randomized, and two were randomized. Breast cancer was the most common site (4); other studies included breast and other cancers (1) and hematopoietic transplant cancer survivors (1). There was heterogeneity in the structure and frequency of sessions and the survivorship domains addressed. The outcomes studied included quality of life, healthcare utilization, and costs. Conclusions Limited high-quality research exists on the role of GMV in cancer survivorship. Though shown to be effective in chronic disease, the evidence for the effectiveness of this important and widely used approach in multidisciplinary survivorship care remains inconsistent and preliminary; the literature to date provides a starting point for larger-scale studies of GMV in cancer survivorship care. Implications for Cancer Survivors While Group medical visits are a promising intervention to provide multidisciplinary care, larger studies are needed to support their benefit in the care of cancer survivors.

Review of doxycycline for prophylaxis of sexually transmitted infections

AbstractThe surging rates of STIs necessitate medical practitioners in the appropriate specialties to focus on rapid recognition, treatment and prevention of these conditions. Through both pre‐ and post‐exposure prophylaxis with doxycycline, dermatologists can provide up‐to‐date treatment in the field of venereology. Herein, we review the results of clinical trials in the available literature that investigate doxycycline prophylaxis in the prevention of bacterial STIs. A search was performed using the PubMED and Scopus databases which yielded six clinical trials for our review. Based on the results of these clinical trials, doxycycline prophylaxis offers significant reductions in bacterial STIs, specifically in men who have sex with men (MSM). Additional research is needed in other high‐risk groups, including females. Moreover, additional research is needed to determine the effects of doxycycline prophylaxis on tetracycline resistance in STI‐causing bacteria. As the utilization of doxycycline prophylaxis for STIs becomes more common, it is important that dermatologists become familiar with the data surrounding this prevention regimen and patient populations who may seek to know more about it. More research is needed to determine benefits in other subpopulations, antimicrobial resistance and cost effectiveness.

NSW cannabis medicines advisory service retrospective enquiry analysis to inform clinical guidance resource development

AbstractBackgroundAn innovative New South Wales government funded statewide Cannabis Medicines Advisory Service (CMAS) operated between January 2018 and June 2022. The service provided comprehensive patient‐specific and evidence‐based information to support health professionals in prescribing and patient care decisions. This study aimed to describe real‐world data collected by CMAS.MethodsA sub‐set of de‐identified, patient‐specific enquiries collected between January 2021 and June 2022 (n = 123/567; 21.7%) were analyzed using R version 4.2.1. Diagnosis, indication, and comorbidities were coded using Medical Dictionary for Regulatory Activities (MedDRA) terminology.ResultsMost patient‐specific enquiries from medical practitioners were from general practitioners (n = 103/123; 83.7%). Female (n = 53/123; 43.1%) and male (n = 59/123; 48.0%) patients were similarly represented. Sex was not specified for 8.9% (n = 11/123) of patients. The mean age of patients was 52.1 years (range <10–90). The most common three diagnoses were osteoarthritis, anxiety, and chronic pain. Indications that were most frequently reported included chronic pain, anxiety, back pain, non‐neuropathic pain, and insomnia. Comedications were most commonly non‐opioid and opioid analgesics and antidepressants. Most practitioners were considering prescribing a cannabidiol (CBD) product for their patient. Cannabinoid composition selection guidance provided by CMAS was predominantly (delta‐9‐tetrahydrocannabinol) THC:CBD ~1:1, followed by CBD‐only products. CMAS was contacted by health professionals regarding the management of potential adverse events for five patients.ConclusionThe findings of this study shed light on the information medical practitioners were seeking to inform their clinical decision‐making about medical cannabis and can inform the development of clinical guidance resources.

Communication skills influence horse owners' trust in their equine veterinarians.

Trust is an essential component of the relationship between veterinarians and horse owners. To what extent do horse owners consider their vets to be trustworthy, what aspects are important to horse owners when evaluating their vet's trustworthiness and how can equine vets become more trusted? Using an anonymous online survey, we asked horse owners whether they consider their veterinarians to be credible, reliable, empathetic and self-orientated, and therefore trustworthy compared with other professionals. Which of their equine vet's characteristics and behaviours influence how credible, reliable, empathetic and self-orientated, and therefore trustworthy, they appear? Credibility, reliability, empathy and self-orientation scores for equine veterinarians, human medical general practitioners (GPs), hairdressers/barbers and dentists were compared using a Kruskal‒Wallis H-test and post hoc Dunn's test and then combined to create a trustworthiness rating. The importance of various characteristics and behaviours displayed by equine vets when horse owners assess how credible, reliable, empathetic and self-orientated they appear was investigated using quantitative scoring and thematic analysis. A total of 415 horse owners completed the survey. Overall, respondents considered equine veterinarians to be significantly more credible, reliable and empathetic than GPs, hairdressers/barbers and dentists. Using the trust equation, equine veterinarians had the highest trustworthiness rating(8.33), followed by hairdressers/barbers and dentists (5.5) and then GPs (4.75). Only the views of a small subset of horse owners are represented. As such, the findings may not be representative of horse owners more generally. Veterinarians' communication skills influence clients' perceptions of their credibility, reliability, empathy and self-orientation. Additionally, equine veterinarians should develop their clinical skills and knowledge to increase credibility. Meanwhile, perceptions of reliability, empathy and self-orientation can be improved by continuity of care, demonstrating a clear interest in the patient and avoiding rushed consultations, respectively.

A Comprehensive Survey on Requirements and Design of AI-Powered Clinical Intelligence Systems in Healthcare

With the increasing complexity of healthcare services, artificial intelligence (AI) is emerging as a vital tool to support medical practitioners by providing real-time clinical insights, automating routine documentation, and enhancing patient engagement. This survey investigates the design requirements, technical challenges, and ethical considerations for AI-powered clinical intelligence systems intended for healthcare environments. Our study is based on a survey conducted with healthcare professionals, patients, and AI researchers, capturing diverse perspectives on functionality, usability, data privacy, and ethical concerns. This paper synthesizes these insights into a detailed requirement analysis that can guide the development of clinically effective, ethically sound, and user-centric AI systems. Through this analysis, we aim to lay the groundwork for creating AIdriven tools that improve clinical workflows, foster better patient outcomes, and support healthcare professionals in delivering quality care.

Medical Doctors in Health Reforms: A Comparative Study of England and Canada

Medical Doctors in Health Reforms: A Comparative Study of England and Canada

YouTube as a source of education on tunneled catheter insertion: content and quality analysis.

Tunneled catheters can be inserted for many reasons, and in most centers, and in most centers it is not clear who should insert these catheters. Some anesthesiologists may not have seen first-hand the insertion of a tunneled catheter during their residency, depending on the policies of the institution. YouTube is one of the most commonly used online platforms for accessing medical information. The aim of this study was to investigate the reliability of YouTube videos, for tunneled central venous catheter (Hickman and tunneled hemodialysis catheters) insertion for education. The keywords "Tunneled catheter insertion" and "Tunneled central venous catheter insertion" were searched for on YouTube. The first 100 videos ranked by the YouTube algorithm were analysed. Animation and theoretical content videos, as well as videos that included only a part of the catheter insertion, were excluded. The sources of the videos were categorized as medical doctors or professional organizations. medical device advertisement and hospital. Two authors evaluated all videos via the Journal of the American Medical Association (JAMA) benchmark criteria, modified DISCERN scores and the Global Quality Scale (GQS). Twenty-three videos were analysed in the study. The video quality scores were similar across the video sources. The number of views and the number of likes were significantly positively correlated. Furthermore, a significant correlation was found between the JAMA, Modified DISCERN, and GQS scores. Notably, none of the analysed videos achieved full points in all three scoring systems. Relying on a single criterion, such as the video source or number of likes, is not sufficient to determine a video's quality. Therefore, what is learned from videos needs to be double-checked. These platforms should be used as an additional tool, not as the primary source of education.

Practice and outcomes of endotracheal intubation in the emergency department: a retrospective observational study at a single institution in Bhutan

Abstract Background Airway management is a critical skill required in the Emergency Department (ED). We conducted an observational airway registry-based study to report the practice and outcome of endotracheal intubations in the ED at the national referral hospital in Thimphu. Methods All patients who were intubated in the ED and recorded on the registry data form between May 2020 to November 2022 were studied. Variables such as indications, type of physician performing intubations, success rate, complications, medications, and disposition were captured. Descriptive analysis was presented in frequency and proportions. Results There were a total of 336 intubations during the study period. First pass success rate was 87.80% and complication rate was 19.64%. 40 patients (11.90%) needed a second attempt and only 1 patient required a third attempt. Most intubations were performed by emergency medicine (EM) residents (54.17%), followed by medical officers (37.8%). Emergency Physician (EP) performed the least number of intubations, 27 (8.04%). During preoxygenation, 64.5% (n = 217) patients received positive pressure ventilations and 119 (35.42%) did not. Conclusion Physicians working in the ED are the primary airway provider. First pass success rate was 87.80%. 40 patients (11.90%) needed a second attempt and only 1 patient required a third attempt.

Exploring the attitudes and experiences of Hungarian primary care physicians on the utilisation of digital health solutions.

During the COVID-19 pandemic, digital health solutions ensured the continuity of care especially in primary healthcare practices. COVID-19 accelerated the adoption of digital health solutions. The aim of this study is to describe the digital health-related attitudes and experiences of Hungarian Primary Care Physicians (PCPs) and also analyse the socio-demographic effects on digital health attitudes among PCPs. This study used a quantitative and qualitative mixed methodological approach to examine the digital health-related attitudes and experience of Hungarian PCPs. As part of the "E-physicians and E-patients in Hungary" survey, we conducted an online survey among medical doctors working in Hungary between July 2021 to May 2022. A total of 1,774 questionnaires were received, consisting of 1,576 medical doctors and 198 dentists. Among the medical doctors there were 415 primary care physicians (PCPs). In addition to the online questionnaire survey, qualitative research in the form of semi-structured interviews with doctors was also conducted. These interviews took place between October 2021 and June 2022. A total of 62 interviews were conducted,19 with PCPs. Primary care physicians are more open to technologies that facilitate communication and collaboration with patients, while showing less interest in technologies that support clinical work. Of the demographic variables (age, gender, type of settlement), age was found to have the most significant effect on digital health knowledge, use and intended use. Both the interviews and the multivariate analysis indicate that individuals with greater knowledge, expertise, and experience are more likely to perceive the advantages of digital solutions. This highlights the importance of training, especially given the significant aging population among Hungarian primary care physicians, who may not be accustomed to using these tools naturally. The way PCPs perceive patient expectations regarding the use of digital health tools has a significant impact on the PCPs' use and intended use of digital tools. When looking at perceived patient needs among PCPs the effect of age and municipality type of PCPs is significant. As age increases, the perception of patient needs decreases (from 5.02 to 4.47), and by municipality type, the average number of perceived needs decreases as one moves from larger cities to smaller municipalities (from 4.85 to 4.14). Digital health solutions have the potential to enhance the work of PCPs, but successful implementation requires addressing specific needs, demographic differences, and challenges faced by PCPs. Development of infrastructure, education, and institutional support is necessary to ensure more efficient and higher-quality healthcare delivery through the use of digital technologies.

Analysis of the Completeness of Medical Records in RSJ. Prof. Dr. Saanin Padang

Complete medical records are very useful for knowing in detail the patient's history, examinations that have been carried out, and planning further actions. To achieve this, the medical records department is obliged to carry out quality monitoring by carrying out quantitative, qualitative, and statistical analysis. To know whether a medical record file is complete or incomplete, it is necessary to carry out a quantitative analysis, namely four reviews consisting of an identity review, recording review, reporting review, and authentication review. Based on the results of a preliminary study with existing medical record officers, it was stated that every patient's medical record file received from inpatient care was always assessed for completeness but was still not optimal, and incomplete values ​​were always obtained. One of the problems, among others, is in terms of input, namely the high workload of medical record officers, facilities, and infrastructure, especially storage space and technology, which are not yet optimal. It is important to discuss this problem so that researchers research to find out the completeness of medical record files in RSJ. Prof. HB. Saanin Padang City. This research was carried out in March 2024 at RSJ. Prof. HB. Sa'anin Padang. From the study, it was found that the highest percentage of completeness in filling out identification components was the name item at 97.98%, the highest percentage of completeness in important report components was found in the discharge summary form, CPPT and General consent each at 100%, the percentage of completeness in the recording method component was highest in You can use item type x at 100%. In the medical record file, no type-x was used. There is a need for policies regarding filling rules and periodic audits regarding the completeness of medical record files. Keywords: Completeness, Medical record, files, hospital, analysis.

From Silos to Synergy: A Scoping Review of Team Approaches to Outpatient Eating Disorder Treatment.

This scoping review synthesizes the available evidence on team outpatient eating disorder treatment, focusing on team composition, reported health and service outcomes, and reported principles of Interprofessional Collaborative Practice (IPCP), a synergistic healthcare approach characterized by shared values and ethics, clear roles, communication, and teamwork. A comprehensive search was conducted across five databases, targeting studies published between January 2004 and August 2024 that discussed team-based outpatient eating disorder treatment. Peer-reviewed and gray literature were included if they detailed team composition, characteristics, dynamics, experiences, processes, or outcomes. Forty-five studies met the inclusion criteria; nearly half were case reports or lacked primary data. Treatment teams commonly comprised mental health professionals, dietitians, and medical practitioners. Clinical outcomes, such as body mass index and psychopathology, were the most frequently reported, while satisfaction and organizational outcomes were underrepresented. IPCP principles were inconsistently reported, with "Roles/Responsibilities" and "Communication" most frequently mentioned but often superficially addressed. The evidence base for team outpatient eating disorder treatment lacks rigor and depth. Future research should focus on refining the integration of roles across disciplines, developing comprehensive outcome measures for benchmarking, and applying IPCP principles more systematically.

Race, Gender, and Faculty Retention in Academic Medicine.

Poor retention may be associated with lack of faculty diversity in academic medicine. To examine differences in faculty retention by gender, degree type, and race and ethnicity using data from US medical schools. This cohort study analyzed data from 155 medical schools for 1978 to 2021, which were obtained from the Association of American Medical Colleges. Retention rates were calculated by gender, race and ethnicity, and degree type. Time to attrition was estimated using Kaplan-Meier curves and adjusted Cox proportional hazards models were used to examine the differences in retention by gender and race. Data were analyzed from March 2021 to November 2022. The duration of continuous employment in academic medicine and variations in retention based on gender, race, ethnicity, and terminal degree. Among 390 766 faculty members (232 829 [59.6%] men; 1190 American Indian, Alaska Native, Native Hawaiian, or Pacific Islander [0.3%]; 72 490 Asian [18.6%]; 14 920 Black [3.8%]; 20 345 Hispanic, Latino, of Spanish origin, or multirace Hispanic [5.2%]; 251 670 non-Hispanic White [64.4%] participants; and 30 151 [7.7%] other race), 259 628 (66.4%) had MD or MD-equivalent terminal degrees. Women left academic medicine a median of 1 year earlier (median retention, 8.33 years; 95% CI, 8.18-8.41 years) than men (median retention, 9.35 years; 95% CI, 9.25-9.42 years). Compared with White faculty (median retention, 9.91 years; 95% CI, 9.83-9.92 years), multiracial and faculty of other races had the lowest retention (median retention, 5.42 years; 95% CI, 5.33-5.55 years), followed by Alaska Native, American Indian, Native Hawaiian, and Pacific Islander (median retention, 6.00 years; 95% CI, 5.62-6.62 years), Black (median retention, 7.78 years; 95% CI, 7.50-8.00 years), Asian (median retention, 8.00 years; 95% CI, 8.00-8.11 years) and Hispanic faculty (median retention, 9.00 years; 95% CI, 8.75-9.16 years). Women faculty in the 1970s were 20% more likely than men to leave academia, whereas women in the 2010s had no greater risk of leaving, mainly due to a decline in retention of men. Gender differences in faculty retention have decreased in the most recent decade; however, men had lower retention compared with earlier cohorts. In this study, faculty who were underrepresented in medicine left academic medicine a median of 1 to 4 years earlier than White faculty. Greater attrition among men and women for recent cohorts suggests that enhanced retention efforts are imperative to maintain an experienced and diverse faculty.

Navigating brain drain: understanding public discourse on legislation to retain medical professionals in Nigeria.

Nigeria is witnessing a mass emigration of its active labor force to more advanced economies, just like other developing countries. Approximately half of licensed medical doctors in Nigeria have emigrated, contributing to a widening doctors-to-patients ratio. In response to this concerning trend, in 2023, a legislator introduced a bill to restrain doctors from leaving Nigeria upon completing their studies by withholding their full license for five years. The public, including health professionals, criticized the bill. This study investigates the public discourse on the bill by extracting and analyzing responses published in newspaper articles, blogs, tweets, and LinkedIn posts. The analysis revealed that, while a few politicians supported the bill, the general populace opposed it due to perceived inconsistencies, a lack of focus on the core causes of migration, allegations of political elite's hypocrisy, concerns about human rights violations and unemployment. By conducting this research, this article sheds light on the complexities of public opinion surrounding the proposed legislation, providing valuable insights into the multifaceted challenges associated with addressing the medical brain drain in Nigeria. The article contributes to the ongoing debate on the migratory trends of highly skilled workers from developing countries to advanced economies.

Leveraging large language models to construct feedback from medical multiple-choice Questions.

Exams like the formative Progress Test Medizin can enhance their effectiveness by offering feedback beyond numerical scores. Content-based feedback, which encompasses relevant information from exam questions, can be valuable for students by offering them insight into their performance on the current exam, as well as serving as study aids and tools for revision. Our goal was to utilize Large Language Models (LLMs) in preparing content-based feedback for the Progress Test Medizin and evaluate their effectiveness in this task. We utilize two popular LLMs and conduct a comparative assessment by performing textual similarity on the generated outputs. Furthermore, we study via a survey how medical practitioners and medical educators assess the capabilities of LLMs and perceive the usage of LLMs for the task of generating content-based feedback for PTM exams. Our findings show that both examined LLMs performed similarly. Both have their own advantages and disadvantages. Our survey results indicate that one LLM produces slightly better outputs; however, this comes at a cost since it is a paid service, while the other is free to use. Overall, medical practitioners and educators who participated in the survey find the generated feedback relevant and useful, and they are open to using LLMs for such tasks in the future. We conclude that while the content-based feedback generated by the LLM may not be perfect, it nevertheless can be considered a valuable addition to the numerical feedback currently provided.

Development and validation of situational judgement test for assessment of behavioural competencies required for effective medical practice in Nigeria.

The personal qualities of health workers determine the way health services are provided to clients. Some key personal qualities (also called behavioural competencies) of physicians that contribute to quality healthcare delivery include ethical responsibility, empathy, patient-centeredness, diligence, good judgment, respectful, teamwork, team leadership/conflict management, ability to take correction and tolerance. In this study, we developed and validated clinical scenarios (dilemmas) for assessing priority behavioural competencies for medical practice in Nigeria. Drawing on prioritized competencies generated via a scoping review and nominal group technique (NGT) exercises in a previous study in the study series, Faculty members from the University of Nigeria Teaching Hospital were consulted to develop or adapt clinical scenarios that could be used to assess these competencies in a physician. The clinical scenarios and options were framed as situational judgement tests (SJTs) and these tests were administered to a random sample of 192 undergraduate and 111 postgraduate medical doctors in a tertiary hospital in Enugu State. Using Kane's validity argument framework, we assessed scoring and generalization inferences of situational judgment tests (SJT) based on the developed scenarios. Scoring inference - difficulty and discrimination index - shows that most of the SJT items are good test items and can differentiate between high and low performers. The corrected point biserial correlations show positive correlation for most of the items. Generalization inference shows the items represent the domains of interest and are internally consistent. However, few items that show poor difficulty and discrimination index were subjected to re-evaluation and possible elimination. This study has produced a set of valid clinical scenarios that can be used to evaluate specific behavioural competencies among trainee medical doctors. It demonstrates that SJTs can be used to assess behavioural competencies for medical practice. However, further research is needed to establish the applicability of SJT beyond the immediate context, such as the medical school, in which it is developed.

Cardio Vascular Disease Risk Assessment by Medical Officers According to the Guidelines at Healthy Lifestyle Centers in Western and North Western Provinces and the Factors Affecting Implementation of Guidelines

Introduction: Healthy Lifestyle Centers (HLC) were established in 2011 to carry out Cardiovascular Disease (CVD) Risk Assessments and follow up with patients. The capacity of primary care institutions (PCI) for CVD risk assessment has not been studied in the recent past.Objective: To evaluate the existing CVD risk assessment guideline and assess its application process by Medical Officers (MOs) and facilities available at HLCs for CVD risk assessment.Methodology: A descriptive study with three components was carried out. Component one – CVD risk assessment Guideline evaluated through Key informant interviews (KII); component two- assessment of the Knowledge and practices on CVD risk assessment of all MOs working in HLCs using a self-administered questionnaire and an observational checklist; component three- assessment of available facilities and resources to carry out CVD risk assessment using a checklist.Results and Discussion: The study was conducted in 141 HLCs accessible during the Covid period. Assessment of CVD risk assessment guidelines showed Problems in methodological standards and in the identification and summary of evidence. MOs need to gain Knowledge in screening those under 35 years, in reading the WHO/ISH Risk Prediction Chart and in advising on further management and follow-up. All HLCs have at least one medical officer, but there is a lack of nursing officers and health care assistants.Conclusions and recommendations: There was a gap in Knowledge in screening criteria and management of those under 35 years of age. It is recommended to carry out training at national level every six months so all staff newly appointed to primary care could be trained. It is also recommended to appoint at least one nursing officer or a Public Health Nursing Officer (PHNO) to an HLC.

Effectiveness of an intervention to improve pharmacovigilance among selected government hospitals in a district of Sri Lanka

Introduction: Issues related to doctors' pharmacovigilance exist due to their lack of knowledge and the challenges of a rapidly changing society. In addition, issues exist with the subject's existing systems. Proper intervention with a comprehensive system of pharmacovigilance can resolve these problems.Objective: This research is intended to assess the knowledge, perception, and practices of pharmacovigilance among medical officers in a district of Sri Lanka with surveillance systems through interventions.Methodology: A pre-and post-intervention design research study was conducted among 237 doctors in the curative sector in the Hambanthota district. All the doctors in these hospitals were considered the study population, and no sampling method was employed. A self-administered questionnaire was used to collect the data using active and passive surveillance data systems and workshops.Results: The results indicated that most of the doctors were from the 31-40 age category (55.3%), females (53.59%), preliminary and grade 2 medical officers (67.1%, 37.6%) who are working in the base hospitals (64.1%) of the area with a basic medical degree (90.8%). A large proportion of them (67.5%) had training in this area as undergraduates (25%). The overall knowledge of pharmacovigilance was poor (69.7%). The overall perception was positive (53.2%). Overall, practices were poor. Knowledge and perception have improved with the intervention.Conclusion and recommendations: This research revealed poor general knowledge, practices, and a positive perception regarding pharmacovigilance, which improved through an intervention. Substantial consideration should be paid to including those topics in undergraduate and postgraduate curricula. Continuous professional development and in-service training programmes should be arranged for doctors with a comprehensive system of surveillance.

A Scientific Approach for Optimizing Patient Bed Occupancy in an Overcrowded Teaching Hospital in Sri Lanka

Background: In Sri Lanka, the healthcare system predominantly relies on the public sector, which delivers nearly 95% of inpatient care and approximately 50% of outpatient care. Effective monitoring of bed occupancy rates is crucial for optimizing resource allocation amidst limited hospital resources and fluctuating patient demands.Objectives: This study aims to develop a scientific approach to enhance patient bed utilization at Colombo South Teaching Hospital (CSTH) in Sri Lanka.Methodology: A mixed-method approach was employed, integrating quantitative analysis of historical patient data from CSTH's medical record room with qualitative insights from key stakeholders, including hospital administrators, consultants, medical officers, and nursing staff.Results and Discussion: In 2023, CSTH reported an overall bed occupancy rate of 80%, surpassing both national and global averages, indicating strain on healthcare delivery. The study identifies disparities in occupancy rates across different wards, highlighting overcrowding in medical and surgical units alongside underutilization in other specialities.Recommendations and Conclusions: Revising the consultant-based ward allocation system, implementing patient-centric ward clustering based on occupancy rates, appointing bed managers, and expanding facilities in high-demand units like Medical, Accident Service Unit, Emergency Treatment Unit, and Nephrology. Implementing these strategies could mitigate overcrowding, improve bed availability, and enhance the quality and safety of patient care services at CSTH.