Record Form Research Articles

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)

A Study to Assess the Burden of Hematological Malignancies at a Tertiary Care Center

Objectives Hematological malignancies place a significant financial and medical burden on the affected patients. Well-equipped oncology centers providing healthcare for these patients are also sparse. By studying the epidemiology of those diagnosed with hematological malignancies, it can be correlated with the outcomes and compared with global and national trends. This will allow healthcare decision-makers at all levels to make informed decisions, while allocating resources to combat hematological malignancies. This study is aimed at understanding the pattern of various hematological malignancies presenting at a tertiary care center including their clinical profile, risk factors, etiology and presentation. Material and Methods This was an observational prospective study conducted in King Edward Memorial Hospital, Mumbai, India. Patients aged 12 years and above suffering from hematological malignancies were recruited from the medical wards. The history and systemic examination findings were recorded from patients’ records. The patients were treated as per the discretion of the treating physician and all investigations advised by the treating physician were noted in the respective case record forms. Results The maximum cases were from the age group 36–50 years, i.e., 32 in number (40%), followed by the age group 51–65 years (25%). A greater number of male patients were encountered than female ones (67.5% vs 32.5%). Most of the patients were unskilled laborers followed by semi-skilled workers. Pesticide exposure was the commonest etiological factor reported in 16 (20%) patients, followed by exposure to silica that was reported in nine patients (11.25%). Conclusion The common age group to encounter hematological malignancies in patients is 36–50 years, being more prevalent among males. History of exposure to risk factors such as pesticides is commonly seen. Factors such as age and family history do not correlate with the outcome. Females tend to have a better outcome than males.

Prevalence and patterns of comorbidities in older people with type 2 diabetes in Australian primary care settings.

The aim of this study was to identify the prevalence and patterns of comorbidity in community-dwelling older people with type 2 diabetes mellitus (T2DM) attending general practice settings in Australia. This study involveda cross-sectional analysis using the Bettering the Evaluation and Care of Health (BEACH) sub-study data. In a series of sub-studies, a representative sample of general practitioners was asked to record all diagnosed chronic conditions for patients at 40 consecutive encounters using structured paper-based recording forms. The dataset was analysed with descriptive analyses, and exploratory factor analyses were applied to examine comorbidity patterns. Of the 14,042 patients aged 65 years or older, 2688 had a diagnosis of T2DM (19%). Of the 2688 patients with T2DM, hypertension was present in 67% (95% CI: 64.6-70.0), followed by arthritis 52% (95% CI: 48.8-54.8), hyperlipidaemia 45% (95% CI: 41.8-47.9), ischemic heart disease, 23% (95% CI: 20.7-24.9), depression 16% (95% CI: 48.8-54.8), atrial fibrillation 10% (95% CI: 8.9-11.6), congestive heart failure 7% (95% CI: 6.0-8.1), stroke/cerebrovascular accident 7% (95% CI: 5.4-8.2) and peripheral vascular disease 5% (95% CI: 4.4-6.2). We identified two comorbidity patterns among older people with T2DM. The first were psychological and musculoskeletal conditions and the second were cardiovascular conditions and chronic renal failure. The prevalence of cardiovascular and non-cardiovascular comorbidities in community-dwelling older people with T2DM was high. Adequate primary care strategies should be in place to support the long-term care for this population.

Analisis Kelengkapan Kuantitatif Berkas Resume Medis di Rumah Sakit Angkatan Laut Dr. Ramelan Surabaya

A complete medical record form is an indicator of good medical record management and directly affects service quality. Analysis of the completeness of medical record files at Dr. Ramelan Surabaya found that the completeness of the medical resume had not reached 100%, only 90% completeness. The purpose of this study was to analyze the completeness of medical resume files at Dr. Ramelan Surabaya with descriptive method. Data collection used the cross sectional method in September 2022 as many as 21 medical resume forms. The results showed that the identification review obtained 100% complete in filling out medical resumes. Completion of medical resumes on critical report reviews is at least 19% on treatment while being treated. Authentication review is only 76% for filling in the patient's full name. Review the documentation that is correct, the blank part is 19%. The conclusion of this study is the highest incompleteness in the treatment while being treated by 81% in the review of important reports, so filling out the medical record file at RSPAL Dr. Ramelan is said to be still incomplete.

Bolstering Advance Care Planning Measurement Using Natural Language Processing.

Despite its growth as a clinical activity and research topic, the complex dynamic nature of advance care planning (ACP) has posed serious challenges for researchers hoping to quantitatively measure it. Methods for measurement have traditionally depended on lengthy manual chart abstractions or static documents (e.g., advance directive forms) even though completion of such documents is only one aspect of ACP. Natural language processing (NLP), in the form of an assisted electronic health record (EHR) review, is a technological advancement that may help researchers better measure ACP activity. In this article, we aim to show how NLP-assisted EHR review supports more accurate and robust measurement of ACP. We do so by presenting three example applications that illustrate how using NLP for this purpose supports (1) measurement in research, (2) detailed insights into ACP in quality improvement, and (3) identification of current limitations of ACP in clinical settings.

Blasfemi's Speech in Speech Made Darmawati's Religious Lecture on Youtube Media: Forensic Linguistic Study

This Forensic Linguistic Study aims to describe the elements of insults against Hinduism committed by Desak Made Darmawati and whether these speeches violate Article 156a of the Criminal Code, Law on Blasphemy by applying speech act theory. The data in this research is in the form of video recordings which are transcribed into text. The method used is descriptive qualitative with a forensic linguistic approach. The results of data analysis show that there are elements of religious blasphemy spoken by Desak Made Darmawati in his video. He talked a lot about his experiences when he was still a Hindu, which he then compared with the religion he currently adheres to, namely Islam. The elements of blasphemy committed relate to Hindu religious ceremonies, the form of God in Hinduism, prayer in Hinduism, fasting in Hinduism and also Ngaben in Hinduism. Based on the results of the analysis, it was found that the blasphemous speech committed by Desak Made Darmawati contained elements of a violation of Article 156a of the Criminal Code concerning Religious Blasphemy and also the ITE Law with various types of blasphemy, namely blasphemy against the concept of divinity, cremation procession, and fasting procession in Hindu religious teachings. . This type of blasphemy is expressed in Directive Illocutionary speech acts which aim to insult or insult. From a linguistic aspect, it was found that the utterances in the video were sufficient to fulfill the requirements to become a suspect as stated in Article 156a of the Criminal Code, namely [1] the perpetrator intentionally expressed feelings or committed acts which were essentially hostile, abusive or desecrating the religion he adhered to. in Indonesia, [2] acts are committed in public or through written or electronic media.

Ideology on Children Formula Milk Television Commercials

Television advertising for children's formula milk is also a text produced from a certain ideological point of view, in the sense that advertising not only functions as a marketing medium for dairy products but also conveys ideology that can influence the mindset and decisions of the audience. This study focuses on analyzing the ideology behind television commercials for children's formula milk. The research aims to find out and provide an explanation of ideology in television commercials for children's formula milk. The method in this research is qualitative, with a textual analysis approach. The primary data is in the form of recordings of ten advertisements for formula milk products aired by several Indonesian national television stations. Secondary data was obtained through observation, literature study, online data searches, and questionnaires on the public as television viewers/consumers/parents. The results of the study show that the ideology behind the ten television advertisements for children's formula milk includes the ideology of idealism and consumerism.

Literatur Review : Pengelolaan Assembling Rekam Medis Rawat Inap di Rumah Sakit

Assembling is an important part of medical records to examine the correctness of recording, control the use of medical record numbers and control the use of medical record forms. In order for assembling to be carried out well, the medical records unit creates Standard Operating Procedures (SOP) for the assembling section and medical records officers managing assembling must follow the SOP. The aim of the research is to find out the management of assembling inpatient medical records in hospitals using the Literature Review method or also called Narrative Review by collecting several journals using the Bolean System from the Google Scholar Database, to identify and conclude the analysis of the management of assembling inpatient medical records in hospitals From these journals, researchers obtained a sample of 16 journals. The results of the research showed that there were several factors in managing assembly in hospitals, namely: 40% of hospitals did not use medical record SOPs according to established regulations, 73% of medical record files were still incomplete in hospitals, 73% of medical record files were returned to the medical records room. in hospitals it is still not on time 100%, and the factor that causes Assembling not to be in accordance with SOPs using Fishbone theory which has the most influence is the Man factor which is related to the lack of discipline of Medical Records officers in hospitals as much as 100%.

National Identity and Foreign Borrowing in the Legal Forms of Personnel Management: History and Modernity

Relevance. The introduction of special rules for the use of foreign vocabulary in the texts of public acts, improving the form of a business letter, modifying the structure of documents in accordance with the powers of public authorities are trends in the current and past Russian administration experience. Both in the modern and historical and legal context of scientific research, it is relevant to consider state approaches in the field of regulating official paperwork, which are aimed at forming a stable management model in accordance with domestic national interests and values. The purpose of the study is to establish the relationship between elements of national identity and foreign models in the state personnel practice of document flow in Russia in the 18th century, which is useful for taking into account this experience in modern transformations of the foundations of legal and business writing.Objective: are to consider legislative innovations in terms of regulating the field of record keeping and personnel management; to identify forms of record keeping in the XVIII century and socio-political factors influencing their application; a retrospective assessment of the methodology for drafting texts of government acts.Methodology. The methodology is based on comparative legal, comparative historical, historical legal and systemic research methods.The results of the study indicate the improvement of grammatical, stylistic, translation and other business skills and competencies of personnel of public authorities. A historical and legal analysis of the directions of development of personnel management revealed an active borrowing of foreign vocabulary in the execution of administrative acts. The clerical mechanism of interdepartmental communication gradually became more complicated, and the procedure for receiving and responding to petitions from private individuals was regulated. Conclusion. The experience of forming the Russian management and personnel practice of paperwork, developing in conditions of value crises and political contradictions, is important for taking into account the political and legal measures carried out in the modern state.

Social Media Platform Slang Language: Learning Indonesian as a Language of Communication in Daily Conversation

This research aims to identify and interpret slang messages used in daily conversations, especially those used among young people, and create material content on the social media platform 'Bahasa Gaul-Bahasa Indonesia.' Instagram is the social media platform used to include the material content of the slang findings from this research. So, the results of the research can be used as a medium for speakers to learn Indonesian, especially the language of daily communication, with the selection of appropriate diction so that communication becomes more efficient and effective. The method used in this research is a qualitative method with a case study approach. The data collection technique used was the document technique. The data is in the form of recordings of the slang vocabulary used by Palembang speakers. The observed utterances were taken randomly for 30 minutes, either in situations in the canteen, in class, with relatives, or in the researcher's neighborhood. The number of utterances obtained was 107 utterances, with 40 speakers. The data analysis technique uses semiotic techniques with a pragmatic approach. The findings in this study are 100 slang words used in Palembang Sari-Sari conversations by Palembang speakers who are the subjects of this study. Then, the results of the findings and analysis are used as content on the Instagram platform of Bahasa Gaul-Bahasa Palembang-Bahasa Indonesia (BBG-Belajar Bahasa Gaul), with the Instagram name @belajar_bahasa_gaul.

Real-world clinical profile, RET mutation testing, treatments, and PROs for MTC in Europe.

This study aimed to describe real-world patient and physician characteristics, rearranged during transfection (RET) mutation testing and results, treatment patterns, and patient-reported outcomes (PROs) in advanced or metastatic medullary thyroid cancer (aMTC) across five populous European countries. Cross-sectional physician and patient surveys were used to collect quantitative and qualitative data in France, Germany, Italy, Spain, and the UK from July to December 2020, prior to the introduction of selective RET inhibitors in Europe. Physicians completed patient record forms and a survey about their specialty and practice site. Patients were asked to provide PRO data using four validated instruments, including the EuroQol 5 Dimension (EQ-5D) questionnaire. The physician-reported sample included 275 patients with aMTC, including 79 patients with RET mutation-positive disease; median age was 60 and 56 years, respectively. Overall, 75% were tested for RET mutation (35% germline only, 21% somatic only, 44% both). Common physician-cited barriers to RET mutation testing included high cost, difficulty accessing latest tests, and time delay for results. First-line systemic therapy (most commonly vandetanib or cabozantinib) was prescribed for 69% of patients overall and 82% of the RET mutation-positive subgroup. Second-line therapy was prescribed for 12% of patients who received first-line therapy; most patients remained on first-line therapy at data capture. PROs revealed substantial disease/treatment burden. Patients with aMTC report substantial disease/treatment burden. Outcomes could be improved by identifying patients eligible for treatment with selective RET inhibitors through more optimal RET mutation testing.

Media Pembelajaran Untuk ABK Dengan Model Adaptasi Kurikulum Merdeka Pada Mata Pelajaran Bahasa Indonesia

The aim of this research is to provide innovation related to learning media for crew members with an independent curriculum adaptation model for Indonesian language subjects, especially learning media for children with visual impairments or who are blind. The method used in this research is a literature review study or literature review. Literature study is a research design used to collect data sources related to a topic found in the field. Data collection for literature studies was carried out using the Google Scholar search tool. The screening results that were appropriate and needed were 3 National Journal articles based on the articles found and analyzed. The results of this research were that a suitable learning media for improving the reading skills of blind students was found to be using audio media in the form of voice recordings.

Association of Left Atrial Volume Index with Adverse In-Hospital Outcome in Patients with St-Elevated Acute Myocardial Infarction

Background: Coronary heart disease is the leading cause of death worldwide, with acute STEMI being the most severe manifestation. Left atrium (LA) plays a major role in left ventricular performance. LA function is a surrogate marker of LV diastolic dysfunction. In recent past, several studies conducted in different parts in the world have focused on the effect of ASTEMI on the volume and function of left atrium. So, assessment of left atrial volume index (LAVI) by 2D echocardiography in patients who have suffered an acute STEMI helps to predict the adverse cardiovascular outcome. Objective: The aim of the study is to assess the LAVI for prediction of adverse in-hospital outcomes following acute STEMI patients admitted in a tertiary care hospital. Methods: This Hospital based prospective observational study was conducted in the department of cardiology in DMCH over 1-year period. Patients with acute STEMI admitted in the CCU of DMCH were approached for inclusion in the study. Clinical and echocardiographic parameters were collected within 48 hours of admission. LA volume is measured and then indexed to body surface area called LA volume index (LAVI) and the population was divided according to LAVI. The study comprised of 150 acute STE-MI patients and were divided into two groups, including 75 patients in each group. Patients with LAVI>34 ml/m2and LAVI≤34 ml/m2 were assigned as Group I and Group II respectively & followed up for adverse in-hospital outcome. All necessary information were recorded in a pretested case record form. Statistical analyses were done by SPSS 17.0. Result: The mean age was 57.7 ± 7.0 years ranging from 39 to 80 years. Most of the patients were male 109 (72.7%). Majority of the patients had anterior wall ( anterior, antero-septal & extensive anterior) myocardial infarction (85%).It was observed that patients with LAVI>34 ml/m2(Group I) had more adverse in-hospital outcomes than patients with LAVI≤34 ml/m2( Group II) (46.7% vs 14.7 % ;p< 0.001 ).By multivariate logistic regression analysis, LAVI>34 ml/m2 emerged as an independent significant predictor of adverse in-hospital outcome(Odds Ratio 6.55,95% confidence interval: 2.069 – 20.735, p = 0.001 ) Conclusion: In patients with acute STEMI, with LAVI>34 ml/m2 had more adverse in-hospital outcomes than patients with LAVI≤34 ml/m2. So early assessment of LAVI by echocardiography is useful to predict adverse in-hospital outcome. Bangladesh Heart Journal 2024; 39(1): 10-16

PERKEMBANGAN SOSIO-EMOSI KANAK-KANAK MELALUI PEDAGOGI PERMAINAN DRAMA KREATIF [DEVELOPMENT OF SOCIO-EMOTIONAL ASPECTS IN CHILDREN THROUGH CREATIVE DRAMA PEDAGOGY

This study was conducted to investigate the effectiveness of drama games on the socio-emotional development of empathy, self-confidence, and friendship among six-year-old children. The study has two objectives, which is to identify Drama Games that are attractive, unique, and suitable for the socio-emotional development of six-year-old children and to analyze the effectiveness of the selected Drama Games in addressing negative traits that contradict the socio-emotional aspects of children. This study involves six sample kanak-kanak among six-year-old children divided into two groups, three childrens from experimental group kanak-kanakts (EG) and three childrens from control group kanak-kanakts (CG). The study was conducted at two Kemas Kindergartens located in Penang. The research instrument employed is a qualitative method through observations in the form of video recordings, pictures, and field notes. Data obtained from video recordings were used to observe the level of socio-emotional development, which was then recorded in the form of checklists, anecdotal records, and subsequently interpreted in a scale rate. The study findings have shown that the medium of Drama Games can stimulate the socio-emotional development of preschool children in terms of empathy, self-confidence, and friendship.

The frequency and factors associated with psychotropic polypharmacy among patients with psychiatric illness

Background: Psychotropic polypharmacy involves the concurrent prescription of two or more psychotropic medications to a patient. The prevalence varies from 13% to 90%. Polypharmacy may increase the effectiveness of treatment but can increase the chances of adverse effects, drug interactions, cost, and lower adherence. Aim and Objective: The aim and objective of the study are to assess the frequency and the factors associated with psychotropic polypharmacy. Materials and Methods: A cross-sectional study was conducted among adult patients attending a psychiatry clinic in a tertiary care center. The study was initiated after obtaining clearance from the institutional ethics committee and informed consent from the patients. Detailed demographic, disease, and drug data were collected through interviewing and reviewing the case record forms of patients. The Chi-square test and binary logistic regression were used to determine the factors associated with polypharmacy. Results: Of the 125 study participants, 87.2% were aged between 20 and 60 years. The overall frequency of polypharmacy was 68.8%. The frequency of polypharmacy was 100% in bipolar disorder (BPD), 85.2% in psychosis, 81.3% in anxiety, 64.7% in depression, and 52.4% in alcohol dependence syndrome. 70% of BPD and 37% of psychosis patients had antipsychotic polypharmacy and 19% of anxiety patients had selective serotonin reuptake inhibitor polypharmacy. 11% of psychosis patients had polypharmacy of sedatives. On regression analysis, the factors significantly associated with psychotropic polypharmacy were the primary diagnoses of the patient, i.e., psychosis and anxiety. Conclusion: More than half of the patients were noted to have psychotropic polypharmacy. The frequency was higher in BPD and psychosis.

A Cross-sectional Study to Estimate the Proportion and Ascertain Risk Factors for Osteoarthritis Knee among Women above 45 Years of Age Attending a Tertiary Care Hospital.

With aging, women face various health issues, the most common of which are musculoskeletal disorders. Osteoarthritis accounts for 15% of all musculoskeletal disorders in patients above the age of 45 years but receives little attention. This study aims to estimate the proportion of women above 45 years suffering from Osteoarthritis (OA) knee and to ascertain its risk determinants. A cross-sectional study was conducted among 380 women above 45 years of age attending the Orthopedic outpatient department of a tertiary care hospital over a period of 18 months. American College of Rheumatology clinicoradiological criteria were used for the diagnosis of OA knee. A predesigned case record form was used to collect information on sociodemographic profile and other risk factors. Data were analyzed using SPSS version 16.0. Our study found the overall proportion of OA knee to be 69.2%. The Chi-square test was used to find the association of various factors with OA knee. On logistic regression, diabetes mellitus, hypertension, menopause, and increased body mass index were found to be significant for OA Knee. The study concludes the possibility of prevention of disabilities by early screening for OA Knee in those with risk factors as a part of wellness clinics.

Comparing the Efficacy of Local Intraligamentary Injection of Dexamethasone and Piroxicam on Postoperative Pain in Mandibular Molars with Symptomatic Irreversible Pulpitis

Abstract Background: Endodontic therapy may cause the expulsion of inflammatory agents into the nearby periapical tissues, directly stimulating or sensitizing pain fibers. With the help of glucocorticoids pharmacotherapeutic agents and nonsteroidal anti-inflammatory drugs, the majority of pain following an endodontic therapy is typically successfully controlled. The intraligamentary shot is thought to make it possible to apply localized anti-inflammatory medications precisely to the periapical area. Hence, the aim of the study was to evaluate the impact of piroxicam intraligamentary injection, dexamethasone intraligamentary injection, and local anesthetic agent intraligamentary injection on pain following endodontic therapy in teeth having symptomatic irrevocable pulpitis. Materials and Methods: To create the random order, 84 patients were separated into three comparable categories of 28 patients. Dexamethasone, piroxicam, and mepivacaine were the three interventions that received letters A, B, and C, respectively. On the Numeric Pain Rating Scale pain record form, patients who participated were requested to indicate their degree of preoperative pain. For the typical mandibular inferior alveolar nerve block injections, every individual got 1.8 mL of 2% mepivacaine plus 1:20,000 levonordefrin. When the procedure began, the operator blinding was being performed, the support worker loaded a vacant cartridge with 0.4 mL of either dexamethasone pharmaceutical agent (8 mg/2 mL) or 0.4 mL of piroxicam pharmaceutical agent (20 mg/mL) from the drug vial to the cartridges utilizing an insulin syringe. The study’s main finding was the degree of pain following a root canal therapy, which was assessed employing an eleven-point Numeric Rating Score (NRS) with the limits of no pain and severe pain as endpoints. Results: The postoperative pain was maximum in the mepivacaine category, while it was minimum in the piroxicam category at 4 and 12 h follow-up. Similar trends were observed when there was analysis at 24 h follow-up and 48 h follow up where the postoperative pain was maximum in the mepivacaine category while it was minimum in the piroxicam category. Mann–Whitney pairwise comparison at all postoperatively follow-up time intervals revealed no statistically significant variance in pain decrease after the therapy between the dexamethasone category and piroxicam category (P > 0.05). At every postoperative follow-up, the decrease in pain was demonstrated to be statistically vital among the piroxicam subcategory and the mepivacaine category (P < 0.05). Conclusion: Within the constraints of the present investigation, it could be determined that preventative intraligamentary injections of dexamethasone and piroxicam were significantly more effective than mepivacaine at decreasing postendodontic pain, however, there wasn’t statistical variance between the use of either drug.

Prescribing patterns of antidiabetic drugs in elderly patients attending a tertiary care hospital

Background: Type 2 diabetes mellitus is one of the most known chronic diseases in almost all countries and continues to rise in numbers and significance. Prescription pattern studies are drug utilization studies with the main focus on prescribing, dispensing, and administration of drugs and are mainly undertaken to promote rational use of medicines. Aims and Objectives: To study the prescribing patterns of antidiabetic drugs in elderly patients attending tertiary care hospitals. Materials and Methods: It was a cross-sectional study. After obtaining Institutional Ethics Committee clearance, written informed consent was obtained from all patients in the study. After consultation, prescriptions issued to the patients were copied into pro forma and case record forms. All participants with a disease duration >1 year and an age above 65 years were included in the study. Details like the number of drugs, dosage forms, frequencies, and number of comorbidities were entered into the pro forma. Results: The total number of drugs prescribed was 654. The average number of drugs per prescription was 2.18. The most commonly prescribed class of drugs were biguanides (93.4%), followed by sulfonylureas (81%), and alpha-glucosidase inhibitors (42.3%). Generic drugs were seen in 97.4% of prescriptions, and insulins were seen in 22% of prescriptions. The percentage of prescriptions with drugs from the Essential Drug List (EDL) was 98%. Conclusion: Prescription pattern monitoring studies would thus help in the understanding of the extent of quality prescribing and rationality. In this study, the prescribing of injections, generic prescribing, and prescribing from EDL were adequate.

Assessment of the use of antibiotics based on the WHO access, watch, and reserve index in a multidisciplinary intensive care unit of a medical college in Eastern India

Background: Antibiotics are frequently prescribed to critically ill patients admitted to intensive care units (ICUs). About 30–60% of antibiotics prescribed in ICUs are unnecessary, inappropriate, or suboptimal and contribute substantially to the development of antimicrobial resistance. Aims and Objectives: The present study was undertaken to assess the use of antibiotics based on the World Health Organization (WHO) access, watch, and reserve (AWaRe) index in a multidisciplinary ICU of a medical college and hospital in Eastern India. Materials and Methods: The descriptive past record-based study was carried out among patients admitted in the multidisciplinary ICU of a medical college and hospital over 6 months. Information from the ICU bed head tickets (BHTs) was captured in a data record form and analyzed. Results: A total of 97 BHTs were reviewed, and 257 antibiotics were prescribed to 90 patients. The prevalence of antibiotic use was 92.78%. Average number of antibiotics per patient was 2.85. In most instances (88.89%, 80), either two (28.88%), three (27.77%), or even four (20%) antibiotics were used. Frequency of use of AWaRe antibiotics was 21.43% (51/238), 67.23% (160/238), and 11.34% (27/238), respectively. Meropenem (15.12%, 36), piperacillin-tazobactam (36, 15.12%), and ceftriaxone (35, 14.70%) were the three most frequently prescribed watch group antibiotics. Most antibiotics were used empirically (60%), and 40% (36/90) use was targeted. Conclusion: Empirical treatment with antibiotics is common in ICUs. The WHO AWaRe tool may check the injudicious and unnecessary use of antibiotics and thus promotes the rational use of antibiotics and prevent the development of antibiotic resistance in ICUs.

The diagnostic journey of pulmonary arterial hypertension patients: results from a multinational real-world survey.

Pulmonary arterial hypertension (PAH) is a life-threatening, progressive disease often diagnosed late in its course. To present patient-reported data that were captured within a large, multinational, point-in-time survey of PAH-treating physicians and their patients to better understand the diagnostic journey. Cross-sectional survey conducted in five European countries (EU5), Japan and the USA. PAH-treating pulmonologists, cardiologists, rheumatologists or internists (USA only) completed a patient record form (PRF) for the next four consecutive adult PAH patients they saw; these patients filled in a patient self-completion (PSC) form on an anonymous, voluntary basis. Our report focuses on patient data; data are from PSC forms unless stated otherwise. Physician-reported PRFs and self-completed PSC forms were obtained for 1152 and 572 patients, respectively. Patients' mean (SD) age was 59.1 (14.0) years, 55.6% were female, and 57.3% had idiopathic PAH. Patient-reported data showed an average delay of 17.0 months between symptom onset and PAH diagnosis. This is longer than physicians estimated (13.8 months): this disparity may be partly due to the time taken by patients to consult a physician about their symptoms [9.6 months overall, longest in the USA (15.3 months)]. Most patients (71.6%) initially consulted primary care physicians about their symptoms and 76.4% of patients were referred to a specialist. Misdiagnoses occurred in 40.9% of patients [most frequent in the USA (51.3%), least common in Japan (27.6%)] and they saw an average of 2.9 physicians overall (3.5 in EU5 versus 2.0 in Japan/USA) before being diagnosed. Diagnosis was most often made by cardiologists (50.4%) or pulmonologists (49.3%). Our data suggest that diagnostic delay in PAH results from patient- and physician-related factors, which differ across regions and include lack of awareness of PAH on both sides. Development of better screening strategies may help address this barrier to timely PAH diagnosis.