Sterilization Practices Research Articles

Infection in nicu setting pose serious health risks to neonates - A meta-analysis

Infections in Neonatal Intensive Care Units (NICUs) pose significant health risks to neonates, particularly due to their underdeveloped immune systems and the invasive procedures often necessary for treatment. These infections can lead to severe complications, prolonged hospital stays, and increased mortality rates. This meta-analysis aims to assess the prevalence, risk factors, outcomes, and preventive strategies associated with infections in NICU settings to better understand the scope of the problem and provide insights for improved healthcare practices. A systematic search was conducted across multiple databases, including PubMed, CINAHL, and Medline, for peer-reviewed studies published in the last two decades. Studies were selected based on criteria that included focus on NICU-acquired infections, study design, and outcomes reported on neonatal health. Data on infection prevalence, types, risk factors, treatment efficacy, and preventive interventions were extracted and analyzed using meta-analytic techniques to calculate pooled estimates and examine statistical associations. Findings indicate a high prevalence of infections in NICUs, with bloodstream infections, pneumonia, and urinary tract infections as the most common types. Risk factors such as prematurity, low birth weight, invasive procedures, and prolonged NICU stay significantly increase infection rates. Neonates with infections demonstrated higher morbidity, longer hospital stays, and a higher risk of long-term health complications. Preventive measures, particularly hand hygiene protocols, sterilization practices, and early identification strategies, were associated with reduced infection rates. Infections in NICUs remain a critical issue, impacting neonatal outcomes and healthcare costs. Strengthening preventive measures and developing standardized protocols for infection control are essential to reduce infection rates and improve neonatal health outcomes. Further research is needed to identify the most effective interventions and foster a culture of infection prevention within NICU settings.

Prevalence of surgical site infections in a tertiary care teaching hospital in Goa, India: a cross-sectional study

Background: Surgical site infections (SSIs) are a major category of healthcare-associated infections (HAIs), particularly in surgical settings. They lead to extended hospital stays, increased morbidity, and financial burden. The study was conducted in the surgical wards of Goa medical college, a tertiary care hospital, to assess the prevalence of SSIs and identify the key bacterial pathogens and associated risk factors. Methods: A cross-sectional, prospective study design was employed, involving 378 patients aged over 18 years admitted for surgical procedures. Data collection included daily follow-up for signs of infection, identification of bacterial pathogens, and analysis of potential risk factors such as age, type of surgery, duration of postoperative drain, length of hospital stays, and wound classification. Statistical analyses were conducted using SPSS software, with significance set at p<0.05. Results: The study identified an SSI prevalence of 12.69% among the participants, with Pseudomonas being the most common causative agent. Significant risk factors included extended postoperative drain duration, longer hospital stays, emergency surgical procedures, and surgeries involving contaminated or clean-contaminated wounds. Patients with prolonged postoperative drains had a markedly higher incidence of SSIs (63.63%). Conclusions: The findings reveal a considerable burden of SSIs in the studied setting, with high infection rates in patients undergoing prolonged drain usage, emergency surgeries, and surgeries on contaminated wounds. Strengthening infection prevention measures, particularly in high-risk cases, and enforcing strict adherence to hygiene and sterilization practices are critical. Enhanced infection surveillance programs and targeted interventions could help reduce SSI rates, improve patient outcomes, and minimize healthcare costs.

Switching to reusable operating theatre equipment: lessons learnt from sterile light handle projects in two Australian hospitals.

Replacing single-use operating theatre equipment with reusables might be one strategy for reducing the carbon footprint of operating theatres. However, in Australia, where the energy mix is predominantly fossil-fuel-based, the re-sterilization of reusables may increase the carbon footprint. We analyzed the financial and environmental impacts of introducing reusable operating theatre light handles in two NSW hospitals. The effects on cost, waste, and carbon footprint of replacing disposable light handle covers with reusable handles in each hospital were analyzed over 12 months using procurement, waste and sterilization data, and life cycle assessment. Energy requirement for sterilization of reusable handles, increasing alongside weight of the handle, resulted in higher carbon footprint than using disposable covers. At one hospital, using a heavy handle increased carbon emissions sixfold, while the cost of handle sterilization exceeded the cost of disposable covers, resulting in 11% higher cost per use. At the other hospital, using a lighter handle increased carbon emissions by 40% per use, while sterilization cost was less than the cost of disposable covers, resulting in 14.8% lower cost per use. Scenario modelling indicated that sterilizing handles as part of a hollowware set rather than as individual items would significantly reduce cost and carbon footprint. At both hospitals, associated clinical waste was essentially eliminated. Judicious replacement of disposable covers with lightweight yet durable reusable handles can reduce costs, but increases carbon footprint in the current Australian energy context. Adopting predominantly renewable energy and more efficient sterilization practice would mitigate this.

American Society for Microbiology evidence-based laboratory medicine practice guidelines to reduce blood culture contamination rates: a systematic review and meta-analysis.

SUMMARYBlood cultures (BCs) are one of the critical tests used to detect bloodstream infections. BC results are not 100% specific. Interpretation of BC results is often complicated by detecting microbial contamination rather than true infection. False positives due to blood culture contamination (BCC) vary from 1% to as high as >10% of all BC results. False-positive BC results may result in patients undergoing unnecessary antimicrobial treatments, increased healthcare costs, and delay in detecting the true cause of infection or other non-infectious illness. Previous guidelines from the Clinical and Laboratory Standards Institute, College of American Pathologists, and others, based on expert opinion and surveys, promoted a limit of ≤3% as acceptable for BCC rates. However, the data supporting such recommendations are controversial. A previous systematic review of BCC examined three practices for reducing BCC rates (venipuncture, phlebotomy teams, and pre-packaged kits). Subsequently, numerous studies on different practices including using diversion devices, disinfectants, and education/training to lower BCC have been published. The goal of the current guideline is to identify beneficial intervention strategies to reduce BCC rates, including devices, practices, and education/training by providers in collaboration with the laboratory. We performed a systematic review of the literature between 2017 and 2022 using numerous databases. Of the 11,319 unique records identified, 311 articles were sought for full-text review, of which 177 were reviewed; 126 of the full-text articles were excluded based on pre-defined inclusion and exclusion criteria. Data were extracted from a total of 49 articles included in the final analysis. An evidenced-based committee's expert panel reviewed all the references as mentioned in Data Collection and determined if the articles met the inclusion criteria. Data from extractions were captured within an extraction template in the US Agency for Healthcare Research and Quality's Systematic Review Data Repository (https://srdr.ahrq.gov/). BCC rates were captured as the number of events (contaminated samples) per arm (standard practice versus improvement practice). Modified versions of the National Heart, Lung, and Blood Institute Study Quality Assessment Tools were used for risk of bias assessment (https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools). We used Grading of Recommendations, Assessment, Development and Evaluations to assess strength of evidence. There are several interventions that resulted in significant reduction in BCC rates: chlorhexidine as a disinfectant for skin preparation, using a diversion device prior to drawing BCs, using sterile technique practices, using a phlebotomy team to obtain BCs, and education/training programs. While there were no substantial differences between methods of decreasing BCC, our results indicate that the method of implementation can determine the success or failure of the intervention. Our evidence-based systematic review and meta-analysis support several interventions to effectively reduce BCC by approximately 40%-60%. However, devices alone without an education/training component and buy-in from key stakeholders to implement various interventions would not be as effective in reducing BCC rates.

Practice of Sterilization and Disinfection during Hysterosalpingography in some Hospitals of the Northwest, Southwest and Littoral Regions of Cameroon

Hysterosalpingography (HSG) is a diagnostic imaging procedure used to study the female reproductive system using contrast medium which is injected into the uterus and x-ray images are taken as the dye fills the uterus and fallopian tubes. Proper sterilization and disinfection protocols are essential to minimize the risk of introducing pathogens into the reproductive tract during the procedure. The purpose of this study was to investigate disinfection and sterilization practices of HSG equipment before HSG procedure in some hospitals in Cameroon. At the end of the study, collected data was compiled and analysed, the results showed 0% of proper sterilization was done for the equipment used, all the equipment were poorly disinfected with poorly made chemicals (sodium hypochlorite) solution (100%). Most of the equipment used were either about 80% stained or rusted. Based on the finding of this study, it was concluded that the practice of sterilization and disinfection of HSG equipment in Cameroon is poor, and there is need for improvements of the practice.

A Relationship between Physical Infrastructure and Patient Satisfaction: A Case Study of Kantipur Dental Hospital

This study investigates the impact of physical infrastructure on patient satisfaction at Kantipur Dental Hospital, a prominent dental care facility in Nepal. With the increasing demand for high-quality healthcare services, understanding the factors influencing patient satisfaction is crucial for healthcare providers. The research aims to explore how various aspects of the hospital’s infrastructure—specifically, the use of state-of-the-art equipment, cleanliness and hygiene, sterilization practices, and convenient location—affect patients' perceptions of care quality. A quantitative research design was employed, utilizing a structured questionnaire distributed to 117 patients who had received treatment at Kantipur Dental Hospital within the last six months. The questionnaire measured patients' perceptions of the clinic's infrastructure and their overall satisfaction, with a focus on two key dimensions: confidence after treatment and the acceptability of service fees. Data analysis was conducted using Spearman’s rho correlation to assess the relationships between the perceived infrastructure variables and patient satisfaction outcomes. The findings reveal significant positive correlations between perceptions of the hospital's physical infrastructure and patient satisfaction. Specifically, the use of modern equipment and a clean, hygienic environment were strongly associated with increased patient confidence post-treatment. Furthermore, the accessibility of the hospital location was also found to influence perceptions of service fee acceptability. Notably, while sterilization practices contributed positively to patient confidence, they did not significantly impact fee perceptions, suggesting that patients prioritize cleanliness and modernity in their overall evaluation of care. These results underscore the critical role of physical infrastructure in enhancing patient satisfaction at Kantipur Dental Hospital. The study recommends that healthcare facilities continue to invest in modern technology and maintain high standards of cleanliness to foster patient confidence and satisfaction. This research provides valuable insights for clinic management and policy-makers, emphasizing that improving physical infrastructure is essential for delivering quality healthcare services and ensuring positive patient experiences.

Development of an Effective Sterilization Protocol for Plant Tissue Culture Studies in Superfruit Aronia [Aronia melanocarpa (Michaux) Elliot

Effective sterilization protocols are crucial for a successful tissue culture study in Aronia. These protocols directly influence contamination rates, shoot health, and root development. In this context, the aim of the study is to develop an effective sterilization protocol for plant tissue culture studies in Aronia [Aronia melanocarpa (Michaux) Elliot], commonly known as the "superfruit." In study, shoot tips of the Nero Aronia variety were used as material. The sterilized shoot tips were transferred to the respective plant tissue culture media in a randomized parcels trial pattern with three replicates, each containing three explants per replicate. Various concentrations and combinations of sterilizing agents, such as sodium hypochlorite (NaOCl), hydrogen peroxide (H2O2), mercuric chloride (HgCl2), and ethanol (C2H5OH), were evaluated to determine their effectiveness in maintaining tissue health and reducing contamination. A total of twelve protocols were developed, incorporating different concentrations of these chemicals. The results showed that the combination of 5% NaOCl and 3% H2O2 provided the lowest average contamination rate (5%) and the highest average number of healthy (uncontaminated) explants (9.00 piece), demonstrating the sterilization efficiency of this combination. On the other hand, protocols containing HgCl2, especially at higher concentrations, resulted in impaired root development. High ethanol concentrations also contributed to effective sterilization, with the combination of 7% NaOCl and 80% ethanol yielding a low contamination rate (8%) and preserving tissue health. This study emphasizes the need to balance sterilization protocols between effective contamination control and tissue viability. The findings are expected to benefit the improvement and development of tissue culture techniques for Aronia and similar species, providing a basis for further research on effective sterilization practices, which are currently limited in Aronia tissue culture.

Impact of storage on sterility of surgical instruments in autoclave bags

Background: There is no published veterinary research to support an optimal storage duration and method of sterile surgical instrumentation (SI) when using self-seal autoclave bags (SSABs), although aspects of research from human healthcare are transferable. Multiple pieces of research in human healthcare have demonstrated the ability of sterilisation packaging materials to maintain barrier integrity and sterility for several months poststerilisation. Research on an optimal storage method is inconclusive. Aims: To determine an ideal storage duration and method of single SI, packaged in SSABs and sterilised via an autoclave. To determine the current practice of sterilisation, storage methods and durations using SSABs in small animal practice. Methods: This mixed methods study consisted of an online questionnaire to investigate the current procedures for autoclave sterilisation in veterinary practice. Alongside this, a non-randomised control study was conducted to assess the sterility of single SI, packaged in SSABs and sterilised via autoclave, to determine an ideal storage duration and method. SI was sterilised and stored for one, three and six months, in open (on a shelf) and closed (in a box) environments. Results: The questionnaire indicated veterinary professionals are adopting a cautious approach to storage durations with 75.5% (n=40) storing sterile single SI for between one and three months, prior to reprocessing. The experimental study did not identify an optimal storage method and either open or closed could be used for effective storage in undisturbed conditions. It is highly probable that most SI were sterile at the end of the storage durations and for up to 6 months. Conclusions: Laboratory findings are mostly consistent with those in existing literature. Results suggest the storage of sterile SI, in either open or closed environments for up to 6 months was not detrimental to the sterility of the instruments. To encourage good sustainability performance, practices could extend the storage times of sterilised SI prior to reprocessing.

A Prospective Clinical Audit of Sterile Surgical Glove-Donning Practices Among Young Surgeons at a Tertiary Care Hospital in Sudan.

Background Adherence to aseptic protocols and proper sterilization is critical for optimal patient recovery post-surgery. The standard procedure for donning sterile surgical gloves helps manage infection risk and maintain surgical site cleanliness by following aseptic principles. This study evaluates adherence to these protocols among young surgeons at a tertiary care hospital in Sudan. Methods This prospective audit included 42 young residents and house officers at a tertiary care hospital in Sudan, following ethical clearance. Compliance with sterile surgical glove-donning practices was assessed using the World Health Organization (WHO) pre- and post-intervention criteria. Participants were observed in the operating room without prior notice. The intervention comprised a video presentation and a live demonstration. Results Pre-intervention adherence to standard criteria for donning sterile surgical gloves was 73.4% (n= 31). This rate increased significantly to 91.4% (n= 38) following the intervention and showed marked improvement. Conclusion The audit demonstrated a significant improvement in adherence to donning sterile surgical gloves practices after the intervention. Implementing WHO guidelines effectively enhances compliance, reduces infection risks, and increases awareness of aseptic practices.

Knowledge, Attitude and Practices (KAP) of Sterilization and Disinfection of Health Care Professionals in Bangladesh

<i>Background:</i> Healthcare professionals face a constant risk of acquiring infections from patients. Exposure to blood, saliva, and sharp instruments increases their susceptibility to various infectious diseases. Proper sterilization and disinfection procedures are crucial for protecting both healthcare workers and patients. <i>Objective:</i> This study aimed to assess the knowledge, attitude, and practices regarding sterilization and disinfection among healthcare professionals in Bangladesh.<i> Methods</i>: A cross-sectional study was conducted at the National Institute of Cardiovascular Diseases & Hospital in Dhaka, Bangladesh, from January to June 2023. A total of 81 healthcare professionals were randomly selected and participated in the study after providing verbal consent. Data collection involved a pre-structured questionnaire focusing on knowledge, attitude, and practices related to sterilization and disinfection. Statistical analysis was performed using SPSS software, and results were presented as frequencies and percentages. Ethical clearance was obtained before the study commenced. <i>Results: </i>The study included healthcare professionals from various backgrounds, with the majority being young adults (21-25 years old). Knowledge assessment revealed a good understanding of sterilization methods, disinfection procedures, post-sterilization instrument management, and waste disposal practices. Additionally, most participants were aware of the hospital's sterilization protocols and infection prevention policies. Regarding attitudes, a positive response was observed towards regular training for staff, proper use of personal protective equipment (PPE), and adherence to sterilization and disinfection guidelines. However, a minority expressed concerns about reusing disposable items. Practices reflected the positive knowledge and attitudes, with a high percentage of participants following hand hygiene protocols, using PPE, and opting for disposable equipment. However, a small number reported experiencing needle-stick injuries, highlighting a potential gap between knowledge and practice. <i>Conclusions:</i> the study found that a majority of healthcare professionals in this setting demonstrated good knowledge, positive attitudes, and appropriate practices regarding sterilization and disinfection. However, a small knowledge, attitude, and practice gap was identified, particularly concerning needle-stick injuries. These findings suggest a need for ongoing education and reinforcement of safe practices to ensure optimal infection prevention and control in healthcare facilities.

Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review.

Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.

Assessment of dental bur sterilization awareness among general dentists in Uttarakhand

This study assesses general dentists' knowledge and adherence to dental bur sterilization practices in Uttarakhand, aiming to enhance patient safety and clinical precision by identifying implementation gaps. Evaluate practitioners' understanding of optimal sterilization protocols for burs, pinpoint areas for improvement, and establish a baseline of current practices in general dentistry. A state-wide distribution of a structured questionnaire gathered responses from 237 general dentists. The survey focused on sterilization equipment usage, frequency, and compliance with industry guidelines. Quantitative data were analyzed for insights into current practices. Preliminary findings show varying awareness and adherence levels among practitioners. While a significant proportion demonstrated commendable knowledge, specific gaps and deviations were identified, suggesting areas for improvement. Continuous education and reinforcement of best practices in bur sterilization are crucial within the general dentistry community. Addressing identified gaps can elevate the standard of care, ensuring patient safety and precision in dental procedures. Ongoing education and awareness campaigns are vital for sustained improvement in bur sterilization practices.

Novel spore-forming species exhibiting intrinsic resistance to third- and fourth-generation cephalosporins and description of Tigheibacillus jepli gen. nov., sp. nov.

The significance of this research extends to understanding microbial survival and adaptation in oligotrophic environments, such as those found in SAF. Whole-genome sequencing of several strains isolated from Mars 2020 mission assembly cleanroom facilities, including the discovery of the novel species Tigheibacillus jepli, highlights the resilience and antimicrobial resistance (AMR) in clinically relevant antibiotic classes of microbes in nutrient-scarce settings. The study also redefines the taxonomic classifications within the Amphibacillaceae family, aligning genetic identities with phylogenetic data. Investigating ARG and virulence factors (VF) across these strains illuminates the microbial capability for resistance under resource-limited conditions while emphasizing the role of human-associated VF in microbial survival, informing sterilization practices and microbial management in similar oligotrophic settings beyond spacecraft assembly cleanrooms such as pharmaceutical and medical industry cleanrooms.

Evaluating the Impact of Seed‐Borne Mycoflora on Seed Quality and Health of Various Oryza sativa Varieties

Seed mycoflora poses significant challenges to rice production, leading to substantial economic losses. Fourteen samples of stored and freshly harvested seeds of five rice varieties were collected from the Agricultural farm of Orissa University of Agriculture and Technology, Bhubaneswar, Odisha, to study the morphology of the mycoflora associated with rice seeds and their impact on seed health and quality. Eight fungal species, including Fusarium pallidoroseum, Fusarium fujikuroi, Curvularia lunata, Helminthosporium oryzae, Trichoconis padwickii, Aspergillus flavus, Rhizopus sp., and Penicillium sp., were isolated, identified, and morphologically characterized based on colony growth, mycelial features, conidial structures, and spore measurements. The rice varieties, viz., Hema, Jyotirmayee, Swarna, Lalat, and Annapurna, were artificially inoculated with F. pallidoroseum, F. fujikuroi, T. padwickii, C. lunata, and H. oryzae. Seeds showed that the fungi had a variable effect on seed quality parameters like germination, seedling vigor index I and seedling vigor index II, speed of germination, and seed health. A maximum of 16.33% reduction of germination was observed by T. padwickii, followed by F. fujikuroi (14.80% in Hema). Seedling vigor (1754.81) incited by T. padwickii inoculation was recorded to be the lowest. Seed rot up to 15.8% was observed in the case of F. fujikuroi. The percentage of root discoloration reached 40.0% by F. pallidoroseum and T. padwickii. In Jyotirmayee, C. lunata caused an 18.88% germination reduction and the lowest seedling vigor (1866.03) by T. padwickii. T padwickii also caused the highest reduction of seedling dry weight (36.12%) in this variety. The result reveals the diversity and prevalence of fungal pathogens in rice seeds. Hence, this study underscores the importance of seed sterilization practices in reducing fungal contamination and the requirement of thorough seed examination to reduce the effects of seed mycoflora associated with rice seeds, which could affect rice production.

Small Animal Ovariohysterectomy and Avoidance of Associated Complications in Pet Practices Across Pakistan: A Current Perspective

Ovariohysterectomy (OVH) is a routine surgical procedure in small animal practices for sterilization and management of several uterine diseases, namely pyometra, cystic endometrial hyperplasia, uterine tumors, rupture, and torsion. Ovariohysterectomy (OVH) offers numerous clinical advantages, but post-operative complications could pose financial challenges for veterinarians due to the inherent risk of malpractice suits and clients owing to the extended recovery period for their pets. The authors reviewed about two dozen peer-reviewed English language articles from PubMed, Scopus, Web of Science, and Google Scholar databases to identify risks and avoidance strategies following OVH. These may include the ones arising from celiotomy (infection, incisional hernias, wound dehiscence, inadvertent injury to organs and adhesions) or affections, such as intraoperative hemorrhage, stump pyometra, ovarian remnant syndrome, ureteral ligation, urinary incontinence, granulomas, fistulous tracts, post-surgery weight gain, and eunuchoid syndrome. This review emphasizes prevention and management methods for each of these complications. Effective surgical techniques play a vital role in preventing hemorrhage, while meticulous resection, ligation, and omentalization of uterine stump reduce the risk of stump pyometra. Complete removal of ovarian tissue and systematic exploration prevent ovarian remnant syndrome. The use of advanced imaging methods, such as ultrasound, fluoroscopy, or CT scans, can greatly aid in identifying and preserving ureters during surgical procedures, thus minimizing the risk of ureteral complications. Strategies to address urinary incontinence, granulomas, and post-surgery weight gain might encompass the use of hormonal therapy involving estradiol analogs or the application of precise surgical techniques involving ureteral reimplantation. Innovative strategies such as auto-transplantation of ovaries are suggested for managing eunuchoid syndrome, while inadvertent prostatectomy and bowel obstruction may simply be avoided by better tissue handling and dissection. In summary, optimizing surgical protocols, incorporating CT scans, using appropriate drug therapies, and continuous education within the veterinary community are crucial for reducing complications associated with OVH.

Optimizing HCV Disease Prediction in Egypt: The hyOPTGB Framework.

The paper focuses on the hepatitis C virus (HCV) infection in Egypt, which has one of the highest rates of HCV in the world. The high prevalence is linked to several factors, including the use of injection drugs, poor sterilization practices in medical facilities, and low public awareness. This paper introduces a hyOPTGB model, which employs an optimized gradient boosting (GB) classifier to predict HCV disease in Egypt. The model's accuracy is enhanced by optimizing hyperparameters with the OPTUNA framework. Min-Max normalization is used as a preprocessing step for scaling the dataset values and using the forward selection (FS) wrapped method to identify essential features. The dataset used in the study contains 1385 instances and 29 features and is available at the UCI machine learning repository. The authors compare the performance of five machine learning models, including decision tree (DT), support vector machine (SVM), dummy classifier (DC), ridge classifier (RC), and bagging classifier (BC), with the hyOPTGB model. The system's efficacy is assessed using various metrics, including accuracy, recall, precision, and F1-score. The hyOPTGB model outperformed the other machine learning models, achieving a 95.3% accuracy rate. The authors also compared the hyOPTGB model against other models proposed by authors who used the same dataset.

EEVALUATION AND QUANTITATIVE ANALYSIS OF OPERATING ROOM PERSONAL KNOWLEDGE, ATTITUDE, AND PRACTICE OF STERILE TECHNIQUES IN KHYBER TEACHING HOSPITAL PESHAWAR

The pivotal aspect of patient care within the operating room is the operating room personnel. Therefore, assessing their knowledge, attitudes, and practices concerning sterile techniques in the operating theatre is crucial, as infections pose a significant risk to post-operative patient morbidity and mortality. Wound infections are the second most prevalent type of hospital-acquired nosocomial infection in the United States. Recognizing that inadequate infection control and sterile technique practices in the operating room can contribute to wound infections, it is imperative to establish infection control principles and adhere to sterile technique standards. The primary aim of this study was to evaluate the knowledge, attitudes, and practices of operating room personnel with respect to sterile techniques at Khyber Teaching Hospital (KTH) in Peshawar. A cross-sectional descriptive study approach was employed to assess the knowledge, attitudes, and practices of operating room personnel in the operating theaters of KTH. One hundred and eighty operating room personnel from the selected hospitals were chosen from the population using a non-probability convenient sampling method. The self-administered questionnaires were used to gauge their understanding of, attitude toward, and adherence to sterile techniques. The study's findings revealed that most respondents (74%) were male, 44.2% fell within the age range of 25-30 years, and most (74.6%) had less than 10 years of experience. Many respondents exhibited good knowledge, a positive attitude, and solid practices regarding sterile techniques. In conclusion, the study found that operating room personnel displayed good knowledge, a positive attitude, and sound practices about sterile techniques. Furthermore, the study established a direct relationship between knowledge, attitude, and practice. As a result, it is recommended that operating room personnel should participate in additional workshops or seminars on sterile techniques to stay updated on new developments in this field.

P44 Can dermatologists help save the planet?

Abstract The National Health Service (NHS) is England’s largest contributor to public greenhouse gas emissions, accounting for 6.3% of the country’s carbon footprint (Tennison I, Roschnik S, Ashby B et al. Health care’s response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health 2021; 5:e84–92). Promoting sustainable practices within dermatology is often overlooked and remains an understudied area of research. Dermatologists should consider environmental sustainability when choosing their day-to-day personal protective equipment (PPE). An over-reliance on sterile PPE for minor surgical practices costs millions of pounds annually, ultimately occupying landfills and causing detrimental effects to our ecosystem. Are these sterile practices really improving clinical outcomes and reducing the prevalence of surgical site infections (SSIs)? Over the last decade, there has been an emphasis on comparing the use of sterile vs. nonsterile gloves and associated SSI rates in dermatology and Mohs micrographic surgery (MMS). MMS is often conducted with two sterile gloves and two surgical gowns. According to the sustainability guidance published by the British Society for Dermatological Surgery, surgical aprons and nonsterile gloves are preferred to surgical gowns and sterile gloves in procedures such as diagnostic biopsies, simple excision, tumour extirpation stages in MMS and outpatient reconstructive surgeries (https://bsds.org.uk/wp-content/uploads/2022/09/2022-BSDS_Sustainability_Guidance.pdf). Based on this guidance and to reduce our carbon footprint, we decided to use two plastic aprons, one pair of nonsterile and one pair of sterile gloves from August 2020 to September 2022. Of 410 MMS procedures conducted, only 1.7% resulted in a minor postoperative complication related to infection. Our data suggest no significant difference in postoperative wound infections with the use of nonsterile PPE vs. sterile PPE. Moreover, the use of nonsterile PPE has saved our department £1471.90, allowing funding to be distributed to other areas. In line with the NHS multiyear plan to become the world’s first carbon net zero national health system by 2040, we should invest in processes that facilitate sustainable alternatives to construct a fully operational eco-friendly healthcare system. By using less PPE in reconstructive surgeries, we reduce plastic waste. Despite not being able to remove PPE completely, we can make dermatology more sustainable, to help save the planet we live on.

Common infections acquired in intensive care: Microbiological aspects and risk factors

Nosocomial infections are a serious health problem resulting in an enormous burden of morbidity and mortality rates, and high health care costs. The various microorganisms implicated in nosocomial infections were not known for causing recalcitrant nosocomial infections, they are opportunistic pathogens and hence pose a challenge to patients especially those with immunocompromised conditions. Patients at the intensive care unit are the most at risk of these hospital-acquired infections The infections usually encountered in intensive care unit (ICU) include urinary tract infection, pneumonia, tuberculosis, gastroenteritis. The main risk factors for these infections can be divided into three key groups: those related to patient characteristics and underlying diseases, those related to the acute disease process, and those related to the use of invasive diagnostic or therapeutic procedures. Incidence of ICU-acquired infections vary between hospitals and according to the type of population studied, being highest in burn units and surgical and trauma ICUs and lowest in coronary care units.The major preventive effort to reducing the risk of nosocomial infections should be focused on hospitals and other health care facilities. The responsible health authority should develop a national (or regional) programme to support hospitals. Such programmes must assess and promote good health care, appropriate isolation, sterilization, and other practices, staff training, and epidemiological surveillance should be developed.

Family planning policy, sterilisation practices and social hierarchy in Iran

Family planning policy, sterilisation practices and social hierarchy in Iran