Specialist Hospital Research Articles

Adverse drug reactions and its associated factors among geriatric hospitalized patients at selected comprehensive specialized hospitals of the Amhara Region, Ethiopia: a multicenter prospective cohort study.

Adverse drug reactions are more prevalent in geriatric patients and are frequently associated with a range of polypharmacy-related issues as well as some physiological aging-related alterations. These affect the pharmacokinetic and pharmacodynamic properties of drugs. This study aimed to assess the magnitude of ADRs and their contributing factors among geriatric patients admitted at Comprehensive Specialized Hospitals of the Amhara Region. A multicenter prospective cohort study was carried out from May 2023 to August 2023 on geriatric patients admitted to four randomly selected comprehensive hospitals in the Amhara region. We used logistic regression to find the factors influencing the occurrence of ADRs. A P value of less than 0.05 was deemed statistically significant. During the study's follow-up period, 373 patients in total were included. An incidence rate of 31.10% (95% CI: 26.38-35.82) was obtained from the identification of 121 ADRs in total. The organ most frequently affected by ADRs was the gastrointestinal tract (28.92%), followed by the cardiovascular system (19.01%), and the drug class most often implicated in ADRs was antibiotics (21.49%), then anticoagulants (12.40%). ADRs were substantially linked to being overweight (P < 0.001), having been hospitalized in the previous six months (P = 0.000), and hyperpolypharmacy (p = 0.047). 93.39% of all ADRs received the interventions. 85.12% of the adverse drug reactions were successfully resolved. This study found that over one-third of older people and individuals admitted to the hospital experienced ADRs. Overweight, hyperpolypharmacy, and patients who had previously been admitted during the preceding six months were significantly linked with the occurrence of ADRs. Improving the drug safety of elderly patients, particularly those who are admitted, should be a greater priority for healthcare professionals.

The effectiveness of liver transplantation in reducing lipid levels in Saudi children with homozygous familial hypercholesterolemia

IntroductionThe lipid profiles of patients aged &amp;lt;15 years who have been diagnosed with homozygous familial hypercholesterolemia (HoFH) at King Faisal Specialist Hospital &amp;amp; Research Center (Riyadh) were examined.MethodsThe total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels of 17 patients were measured on initial presentation and compared with the levels measured after pharmacological treatment and then again after liver transplantation.ResultsAt the end of the pharmacological treatment, the total cholesterol levels decreased by an average of 3.79 mmol/L (reduced by 15.40%) (P &amp;lt; 0.001), and LDL-C levels decreased on average by 2.73 mmol/L (reduced by 13.46%) (P = 0.014). However, in two patients, LDL-C levels increased by 5.42% and 9.03% after pharmacological treatment. Conversely, the lipid values measured after liver transplantation decreased significantly nearly to within normal and borderline limits. The post-transplant total cholesterol and LDL-C levels declined by a mean of 19.96 mmol/L (reduced by 81.04%) and 17.47 mmol/L (reduced by 84.27%), respectively (P &amp;lt; 0.001 for both).DiscussionThese findings suggest that liver transplantation provides a more effective means to reduce elevated total cholesterol and LDL-C levels in patients with HoFH. Although liver transplantation is considered a better treatment for FHoH, risks, complications, and donor organ shortage may present problems.

Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx

Background: Infective endocarditis is a life-threatening disease with diverse clinical presentations, making diagnosis challenging and requiring a range of complementary tests. The level of suspicion, based on clinical judgment, guides decisions regarding the initiation of empirical treatment and the selection of appropriate diagnostic tools. This study aimed to develop and validate the EndoPredict-Dx score for early prediction of infective endocarditis diagnosis. Methods: Patients admitted to a specialized cardiovascular hospital emergency department with suspected infective endocarditis between January 2011 and January 2020 were included. The primary outcome was left-sided infective endocarditis according to the Duke criteria. Logistic regression was used to derive the scoring system, with internal validation performed through bootstrapping. Candidate variables were obtained from the admission medical history, physical examination, and laboratory parameters. Results: Of the 805 individuals with suspected infective endocarditis (median age 56 years (40–73); 58.6% men), 530 confirmed the diagnosis based on the Duke criteria. The EndoPredict-Dx assigned points for male sex, previous endocarditis, petechiae, heart murmur, suspected embolism, symptoms lasting 14 or more days at the time of admission, hemoglobin level ≤ 12 g/dL, leukocyte level ≥ 10 × 109/L, C-reactive protein level ≥ 20 mg/L, and urine red blood cells ≥ 20,000 cells/mL. Patients were divided into three risk groups. The AUROC was 0.78 (95% CI 0.75–0.81) for the derivation cohort and 0.77 for the internal validation. Conclusions: The EndoPredict-Dx score accurately predicted the likelihood of infective endocarditis using clinical and laboratory data collected at admission.

Detection and molecular characterization of carbapenem-resistant gram-negative bacterial isolates.

Antimicrobial-resistant bacteria (ARB) are responsible for increased mortality and morbidity. Therefore, this study focuses on evaluating traditional and molecular diagnostic tools of carbapenem-resistant gram-negative bacteria (CRGNB). In order to achieve this, 94 samples, from different patients' specimens, and surrounding environment, were collected from intensive care units (ICUs) at Ain Shams University Specialized Hospital and the National Cancer Institute, Cairo, Egypt. The swabs were cultured on appropriate media, including Chromogenic medium (HiCrome KPC Agar Base "HIMEDI AM1831"), and MacConkey-10µg imipenem disc resulting in 136 isolates with different culture characteristics. Next, the selected isolates were subjected to VITEK 2 machine and 16SrRNA (16S ribosomal RNA) sequencing. The sensitivity of HiCROME KPC agar for CRGNB detection was 99.3% and 94.7%, in reference to the MacConkey-disc and VITEK-2 methods, respectively. The HiCrome KPC agar assumptions for bacterial identification were not as consistent as those of VITEK 2 (with only 47.4% agreement) and 16SrRNA gene sequencing analysis. The approaches discussed in this study facilitate providing rapid diagnosis and treatment of CRGNB, which helps increase survival rates. HiCrome KPC agar is considered a relatively accurate and easy method that can be used in any laboratory. In addition, the selected strains were deposited in the gene bank with the accession numbers OR553657, OR553658, and OR553659. It is noteworthy that Genus Acinetobacter is the major CRGNB isolated from the patients and environmental surfaces in the hospitals. This highlights the importance of proper environmental and terminal cleaning procedures in healthcare facilities and applying control measures to ensure infection prevention.

Testicular enlargement, abdominal pain and vomiting in 3‐month‐old, male, entire Airedale terrier

AbstractNon‐neoplastic scrotal testicular torsions in juvenile dogs have been rarely reported. This case report describes a scenario in which a patient presented with abdominal pain, vomiting and unilateral testicular enlargement. The primary veterinarian performed abdominal radiographs that were suspicious for a hernia. The patient was referred to a specialty hospital for further diagnostics and treatment. Upon referral, an abdominal ultrasound revealed a suspected non‐neoplastic scrotal testicular torsion. The patient underwent hemicastration to remove the affected testis and recovered uneventfully.

Patient awareness, knowledge, and acceptability of antenatal perineal massage: A single-center cross-sectional study from Saudi Arabia.

This study assessed the knowledge, awareness, and acceptability of antenatal perineal massage (APM) among pregnant women in Saudi Arabia. This cross-sectional study included 240 pregnant women who met the predefined inclusion criteria and attended the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia, from 1 October to 31 December 2023. Participants answered seven knowledge questions, classified as having good knowledge if they answered ≥4 correctly and poor knowledge if <4 were correct. Most women (46.25%) reported it was their first encounter with APM. Common sources of information included the internet (39.58%), physicians/midwives (7.92%), and friends/family (3.75%). Nearly half (47.5%) had heard of APM, but only 8.75% had practiced it, and 3.75% attended related classes. Only 17.5% knew that APM could be performed by the woman or her partner, while 25.83% knew it should start at 34 weeks, and 17.92% recognized the recommended duration of 5 to 10 minutes daily. Additionally, 22.5%, 15.83%, and 35.42% acknowledged APM's benefits for labor duration, anal sphincter dysfunction, and perineal injuries, respectively. The average knowledge score was 1.39±1.84, with 84.17% classified as having poor knowledge. No significant differences were found between knowledge levels (p>0.05). Low acceptability was noted, with only 58% of patients and 37% of their partners willing to engage in APM. No significant differences in acceptability were found between poor and good knowledge groups (p>0.05). The study revealed low awareness, poor knowledge, and weak acceptability of APM among pregnant patients. Targeted education for patients and healthcare providers could enhance knowledge and improve maternal-fetal health outcomes.

Assessing the effect of implementing a central line care bundle on central line-associated bloodstream infections in a tertiary hospital in Saudi Arabia

Central line-associated bloodstream infections (CLABSIs) are severe bloodstream infections caused by catheter use and are often associated with a longer hospital stay, increased healthcare costs, and a higher mortality rate. However, catheter-related bloodstream infections can be successfully treated. It is essential that healthcare workers are aware of central line (CL) insertion and maintenance bundles to reduce and prevent the incidence of CLABSI. The objective of this study was to assess the impact of implementing CL care bundles on hospital-wide CLABSI incidence rates. This is a prospective study conducted at the King Faisal Specialist Hospital and Research Center in Saudi Arabia from January 2017 to December 2021. The research period was divided into two phases: the pre-intervention phase (January 1, 2017 to December 31, 2018) and the post-intervention phase (January, 2019 to December 31, 2020). During both phases, outcome variables, including CLABSI rate, were assessed. In the present study, the total number of CLABSIs is 439, of which 266 were in the pre-intervention phase and 173 were in the post-intervention phase. The overall CLABSI rate significantly decreased from 1.6±0.05 in the pre-intervention phase to 0.9±0.05 in the post-intervention phase. This decline in CLABSI was significant (p&lt;0.0001) across all hospital settings, including critical care and non-critical care units. The implementation of care bundles is essential and has been shown to significantly reduce CLABSI rates in nearly all participating units.

Hematological changes in women with cervical cancer before and after cancer treatment: retrospective cohort study.

Hematological changes is one of the most common complications occurred in cancer patients. Therefore, the current study aimed to assess the hematological toxicity of cervical cancer patients before and after the initiation of treatment. The retrospective cohort study was conducted from 2015 to 2022 at the University of Gondar Comprehensive Specialized Hospital. The hematological profile and sociodemographic and clinical data of the cervical cancer patients were collected using data extraction sheets. The Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. Descriptive statistics were employed to summarize the data. To compare the median differences in hematological parameters before and after treatment, the Wilcoxon rank test was used. In addition, to assess the presence of an independent association between hematological abnormalities and the independent variables, logistic regression models were used. A p value less than 0.05 was considered to indicate statistical significance for all tests. In current study, the median (Interquartile range) of hemoglobin levels, white blood cell counts, and platelet counts, before treatment were 13.2 (12.1, 15) g/dl, 7.5 (5.8, 11.8) *109/L, and 330 (252, 383) *109/L, respectively. However, after treatment the median (Interquartile range) value of hemoglobin levels, white blood cell counts, and platelet counts were significantly lowered. On the other hand, red cell distribution width was significantly greater after treatment. At baseline, the magnitude of leucocytosis, anemia, and thrombocytosis were 27.9%, 24.6%, and 18.7%, respectively. After the treatment, anemia increased to 44.3%, but leucocytosis and thrombocytosis were replaced by leucopenia 18.3% and thrombocytopenia 17.8%, respectively. Hematological abnormalities such as anemia, leucopenia and thrombocytopenia were high after chemo-radiotherapy, and surgery. As the stage of cancer advances, the risk of developing anemia, leucocytosis, and thrombocytosis increased in 7.6, 6.9 and 9 times, respectively. Furthermore, being HIV patients and rural resident increased the risk of developing anemia about twofold. In conclusion hematological abnormalities were observed before and after cervical cancer treatment, with significance increment after chemo-radiotherapy and surgery. As the stage of cancer advances, the risk of developing hematological abnormalities increases. Therefore, routine monitoring of hematological changes before and after treatment and screening for major risk factors are important for improved patients' management.

The effect of comorbidity on 28-day perioperative mortality rate among non-cardiac surgical patients in Northwest Ethiopia: a prospective cohort study using propensity score matching.

Non-communicable diseases account for nearly three-fourths of global deaths impacting public health and development. Coexisting diseases can complicate the management of surgical diseases, increasing the risk of perioperative mortality. Despite this, few studies have examined the burden of comorbidities among surgical patients and their effect on perioperative outcomes in low-income countries. In this study, we assessed the impact of comorbidity burden on 28-day perioperative mortality using a prospective data set. This was a facility-based prospective cohort study. Adult patients aged ≥ 18 who underwent non-cardiac surgery were included. Patients were followed for 28 days following surgery. Perioperative data were collected using an electronic data collection system from June 01, 2019, to June 30, 2021, at Tibebe Ghion Specialized Hospital, Northwest, Ethiopia. A propensity score-matched analysis was employed to assess the effect of comorbidity on the 28-day perioperative mortality rate. Of the 3030 patients included in this study, 715 (23.59%) had at least one comorbidity. Based on the prevalence rate, the top four comorbid conditions observed were hypertension (0.050), cancer (0.036), diabetes mellitus (0.021), and human immunodeficiency virus (0.021). The 28-day perioperative mortality rate was shown to be significantly higher among patients with comorbidity, where 45 (6.29%) of the 715 patients with comorbidity died compared to 49 (2.12%) of the 2315 patients with no comorbidity (p-value < 0.0001). After propensity score matching potential confounders, patients who have comorbidity had a 2.52% (average treatment effect on treated (ATT) = 0.0252) higher risk of perioperative death at 28 days after surgery compared with patients who did not have comorbidity. This study found a moderate prevalence of comorbid illnesses among non-cardiac surgical patients, with comorbidity increasing the risk of 28-day perioperative mortality. Preoperative screening and optimization are highly recommended for patients with comorbid illness to decrease perioperative mortality rate.

Evaluation of routine health monitoring for metabolic disorders in patients with serious mental illness on psychotropic medications: a study from Ethiopia.

Compared to the overall population, patients with mental health problems are more likely to experience concurrent physical illnesses, poorer health outcomes, and mortality. Psychotropic medications, which are the pillars in the management of mental health conditions, are associated with adverse effects such as weight gain, an increased level of glucose, and elevated circulating lipid levels, all of which contribute to metabolic disorders. Inadequate health monitoring may led to suboptimal interventions and worsening of these conditions. However, there is a lack of studies assessing routine health monitoring practices for metabolic disorders and their determinants among patients with serious mental illnesses taking psychotropic medications in Ethiopia. This study aimed to evaluate routine health monitoring for metabolic disorders and its determinants in patients with serious mental illnesses on psychotropic medications in Ethiopia. A hospital based prospective follow-up study was conducted among patients with serious mental illness taking psychotropic medications who attended the outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Eligible participants were selected using a simple random sampling technique. Routine health monitoring was evaluated using guidelines and previous literature. Binary logistic regression was employed to identify the determinants of routine health monitoring, with statistical significance determined by a p-value of less than 0.05 and a 95% confidence interval (CI). The overall routine health monitoring practice for metabolic disorders was found to be sub-optimal. Vital signs were the most commonly assessed parameters. Key determinants of routine health monitoring included participants aged 45 and above (AOR (95% CI): 2.82 (1.34-5.92), having social insurance (AOR (95% CI): 2.94 (1.86-4.64), availability of laboratory tests at the hospital (AOR (95% CI): 3.46 (2.16-5.55), and reporting of medication-related side effects (AOR (95% CI): 1.96 (1.21-3.17)). Routine health monitoring for metabolic disorders in patients with serious mental illnesses attending the outpatient psychiatry department was inadequate. Health care providers should give more attention to younger patients, those without health insurance, and who are not reported side effects. These findings provide crucial insights for improving routine health monitoring and promoting better health outcomes.

Incidence of acute kidney injury and its predictors among neonates admitted at neonatal intensive care unit of, Northwest Ethiopia comprehensive specialized hospitals, 2023.

Acute kidney injury is an acute and reversible increment in serum creatinine (SCr) levels with a reduction in urine output oliguria, or anuria. Acute kidney injury is a major cause of neonatal morbidity and mortality worldwide; it is a serious problem in low and middle-income countries, particularly in sub-Saharan Africa such as Ethiopia. Moreover, there are few studies in developing countries. This study aimed to investigate the incidence and predictors of acute kidney injury in neonates admitted to the neonatal intensive care unit of some specialized hospitals in the Amhara region of northwestern Ethiopia. A facility-based retrospective follow-up study was conducted in the Northwest Amhara Region's comprehensive specialized hospitals with 634 neonates from January 2020 to December 2022. Data were collected by reviewing patient charts using simple random sampling with a pretested checklist, entered using Epi-data 4.6, and analyzed using STATA 14. Median survival time, Kaplan-Meier survival curve, and log-rank test were calculated. Bivariable and multivariable Cox hazard models were used to determine the determinants of acute kidney injury. A hazard ratio with a 95% confidence interval was calculated. Variables with p-values less than 0.05 were considered statistically significant. The incidence of Acute Kidney Injury among Neonates admitted to Neonatal IntensiveCare Unit was 14.9 per 1000 (95% CI: 12.5-17.7) with the proportion of acute kidney injury (20.19%) (95% CI: 17.23-23.50) neonates with sepsis (AHR: 2.59; 95%CI: 1.21-5.56), neonates with perinatal asphyxia [(AHR: 2.70; 95%CI: 1.29-5.65) were taking gentamicin drugs [(AHR = 1.74; 95%CI: 1.03-2.94], neonates were preterm [(AHR; 1.77: 95%CI: 1.05 -2.98], and neonatal-hyponatremia [(AHR: 2.14; 95%CI: (1.00 -4.9)] and hyperkalemia [(AHR: 2.64; 95 CI: (1.11- 6.2)] were statistically found to be significant predictors of acute kidney injury. The incidence of acute kidney injury in neonates was high. Premature infants, neonates with sepsis, who suffered perinatal asphyxia, who received gentamicin drugs, whose sodium levels decreased and potassium levels increased were at higher risk of developing acute kidney injury. All concerned agencies should work to prevent acute kidney injury and pay special attention to multifactorial causes. Therefore, strategies need to be developed and/or strengthened to prevent the occurrence of acute kidney injury in infants with sepsis, neonates who suffered perinatal asphyxia, and preterm infants whose sodium levels decreased and potassium levels increased.

A Case Study on Insomnia Disease Treatment in Acupuncture at Suo-Xi Specialized Hospital in Bangladesh

A Case Study on Insomnia Disease Treatment in Acupuncture at Suo-Xi Specialized Hospital in Bangladesh

Bacterial profile and antimicrobial susceptibility patterns of isolates from inanimate objects used by healthcare professionals at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

Healthcare-associated infections occur in patients under medical care, which is a major public health issue in hospitals worldwide. The prevalence is two to three folds higher in developing countries compared to developed countries. Inanimate objects used by healthcare professionals such as gowns, mobile phones, and stethoscopes are highly prone to bacterial contamination from the healthcare setting. In Ethiopia, there is a paucity of published data on the bacterial profile and susceptibility patterns of an isolates. To determine the bacterial profile and antimicrobial susceptibility patterns from inanimate objects used by healthcare professionals and associated factors at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. A cross-sectional study was conducted at Debre Markos Comprehensive Specialized Hospital from inanimate objects from April 10, 2023 to June 30, 2023 using simple random sampling technique with lottery method. Socio-demographic data was collected using a structured questionnaire. A swab sample from healthcare professionals' gowns, mobile phones, and stethoscopes were collected and inoculated onto blood agar, chocolate and MacConkey agar. Isolates were identified and characterized by colony morphology, Gram staining and biochemical tests. Antimicrobial susceptibility testing was performed in all isolates by the disk diffusion technique on Muller Hinton agar according to CLSI, 2022 guidelines. Data was entered into EPI-Data and analyzed using SPSS version 25. Logistic regression model was used. Variables with p-value ≤ 0.25 in bivariable logistic regression was fitted to multivariate logistic regression analysis. A p-value of ≤ 0.05 with 95%CI was considered statistically significant. A total of 376 healthcare professionals' inanimate objects were included from 191 study participants. Overall, 60.1% (226/376) (95%CI: 55.1-65) inanimate objects were contaminated. The proportion of bacterial contamination was (65.1%; 82/126), (60.3%; 76/126) and (54.8%; 68/124) for mobile phones, gowns and stethoscopes, respectively. Staphylococcus aureus was the most frequent isolate accounting (22.1%; 83/376) followed by Staphylococcus epidermidis (17.0%; 64/376), Escherichia coli (8.8%; 33/376) and Pseudomonas aeruginosa (4.9%; 18/376). Working in gynecology/ obstetrics wards (AOR: 8.69; 95%CI: 1.09-69.41, P = 0.041), did not disinfect mobile phones (AOR: 2.69; 95%CI: 1.15-6.25; P = 0.021) and stethoscopes regularly (AOR: 3.06, 95%CI: 1.23-7.59; P = 0.016), carry mobile phones with patient care materials (AOR: 2.72; 95%CI: 1.18-6.29, P = 0.019) and not taken infection prevention training (AOR:3.91; 95%CI:1.71-8.93; P = 0.001) were significantly associated with bacterial contamination.Most Gram-negative bacteria were resistant to ampicillin, trimethoprim-sulfamethoxazole and amoxacilline-clavunic acid, while Gram-positive isolates showed high level of resistant to penicillin. On the other hand, meropenem, for Gram-negative and clindamycin for Gram-positive bacteria showed lower level of resistance. Multidrug resistance among Gram-positive and Gram-negative bacteria were (62.6%; 92/147) and (75.3%; 64/85), respectively with over all MDR (67.2%, 156/232). Inanimate objects commonly used by healthcare professionals are important sources of bacterial contamination. S. aureus, S. epidermidis and E. coli were the predominant isolates. Most Gram-negative bacteria were resistant to ampicillin while Gram-positive isolates showed high level of resistant to penicillin. All healthcare professionals should regularly disinfect their inanimate objects to prevent bacterial colonization and potential spread of infection.

Poor sleep hygiene practice and associated factors among adults with epilepsy attending follow up care at Mettu Karl comprehensive specialized hospitals in Illu Ababora Zone and general hospital in Buno Bedele zone, Southwest Ethiopia’

BackgroundGlobally, sleep disorders are an important global public health problem. Poor sleep hygiene is at the core of chronic insomnia and other sleep disorders. Sleep hygiene practices are effective, practical, and affordable, and have no side effects other than other therapies benefiting patients with epilepsy. However, there is no research regarding sleep hygiene practice and its awareness among people with epilepsy in Ethiopia. This study aimed to assess sleep hygiene practice and its factors in patients with epilepsy.MethodsAn institutional-based cross-sectional study was conducted. The study included 424 participants selected through systematic random sampling. An interviewer-administered Sleep Hygiene Index (SHI) questionnaire was used to collect data.The collected data was analyzed using SPSS Version 25.0. Bi-variable and multi-variable analyses were conducted to identify factors related to poor sleep hygiene.ResultsThe frequency of poor sleep hygiene practice among people with epilepsy was 59.5%. Non-adherence to AED (AOR = 1.86, 95% CI: 1.13, 3.23), depression (AOR = 2.10, 95% CI: 1.42, 4.21), poor sleep quality (AOR = 5.7, 95% CI: 3.12, 10.01), anxiety (AOR = 2.71, 95% CI: 1.67, 4.82), and current alcohol drinkers (AOR = 1.74, 95% CI: 1.27, 3.13) were associated with poor sleep hygiene practice.Conclusion and recommendationThe perception of sleep hygiene practice among patients with epilepsy was poor. Non-adherence to AED, depression, poor sleep quality, anxiety, and current use of alcohol were associated with poor sleep hygiene practices. Therefore, regular screening, sleep issue management, and expanded mental health support are crucial. Training programs and awareness strategies to improve sleep hygiene are highly recommended. Professionals should incorporate sleep hygiene in epilepsy care.

Characteristics of adverse events recorded in various hospital wards: a case study of a level II referral specialist hospital

Abstract Aim. The aim of the study was to assess the incidence of selected adverse events and their characteristics in hospital wards with varying specialties at a Level II referral hospital in Kraków. Material and methods. The research was conducted at the Józef Dietl Specialist Hospital in Kraków on a group of 1272 patients who experienced an adverse event between 2013 and 2020. In order to answer the research questions, a retrospective analysis of the available medical records was performed in 2022 and statistical analyses were performed using the IBM SPSS Statistics package version 29. Results. The most frequent adverse events included falls, pressure sores and patient absconding. There were no statistically signifi cant diff erences in the age of patients experiencing adverse events. Women were more likely to experience falls without injury and the formation of pressure sores, while men were more likely to abscond from hospital. Higher BMI was observed in patients experiencing falls without injury. Conclusions. The risk of falls, both with and without injury, is a serious problem in hospitals. Although less common than falls, pressure sores are associated with longer hospitalisation and more frequently affect women. Seasonality and time of the day affect the type and frequency of adverse events. Differences between wards may indicate specific challenges related to the nature of patients.

Prevalence, antimicrobial susceptibility, and phenotypic identification of ESBL and carbapenemase-producing Escherichia coli from isolates of patients attending Edo Specialist Hospital, Nigeria

Prevalence, antimicrobial susceptibility, and phenotypic identification of ESBL and carbapenemase-producing Escherichia coli from isolates of patients attending Edo Specialist Hospital, Nigeria

Continuing medical education program completion and influencing factors: a cross-sectional study in Sichuan Province, China

ObjectivesThis cross-sectional study was designed to explore the completion of continuing medical education (CME) programs and identify the factors influencing their completion.MethodsThe data for this study were generated from the National CME Program Application and Information Feedback Online System and the Sichuan CME Administrative Platform. The data were processed using descriptive analysis, Chi-square test, and binary logistic regression methods. The completion of each CME program was determined by the research team members according to the criteria created by the Office of the Sichuan CME Commission.ResultsA total of 180 hospitals and 3,622 CME programs were included. Among the 3,622 CME programs, 2,936 (81.1%) were determined to be completed. Comparative analysis showed that in terms of hospital characteristics, specialist hospitals, county hospitals, hospitals with 500–1,000 beds, and hospitals in the regions with government medical expenditure input equal to or more than 3,000 million RMB displayed the highest completion rates. For program attributes, national programs, programs in the field of pharmacy, and programs with 1–3 duration days demonstrated the highest completion rates. The binary logistic regression analysis showed that hospital region with different government medical expenditure input had the strongest positive association with the completion of CME programs [OR = 2.922, 95%CI (1.642–5.198)], while the duration time showed the strongest negative association [OR = 0.235, 95%CI (0.141–0.393)].ConclusionThis is the first study in China to analyze the completion of CME programs and identify its influencing factors at the provincial level. It is recommended that the government in the region should pay great attention to the construction of measures regarding the factors affecting the completion of CME programs. This includes providing more financial support to CME providers to ensure the formal operation of their CME activities, formulating guidelines on the application of CME programs to reasonably allocate and control the distribution of accredited CME programs across different hospital scales and disciplines, especially offering more training support to county hospitals, promulgating administrative documents to raise attention to the completion of CME programs, and special scrutiny on CME programs with longer durations to provide and protect training opportunities for those in need.

The Influence of Emotional Intelligence on Psychiatric Nurses' Care Behavior, and the Chain Mediating Role of Compassion Fatigue and Perception of Management.

To investigate psychiatric nurses' emotional intelligence and its effect on care behavior, while also examining the mediating effect of compassion fatigue and perception of management. This cross-sectional study was conducted in several specialized psychiatric hospitals with 360 psychiatric nurses. Self-report surveys were administered, which included the Caring Factor Survey-Caring of Manager, Caring Behaviors Inventory, Compassion Fatigue Short Scale, and Wong Law Emotional Intelligence Scale. Data were analyzed using descriptive, correlation, and path analyses. Mean score for care behavior was 4.78 (SD = 0.83), which was at a moderate level. Compassion fatigue exhibited negative correlations with other variables. Results of mediation effect analysis showed that emotional intelligence directly predicted care behavior (p < 0.001). Emotional intelligence also indirectly affected care behavior through the mediating roles of perception of management and compassion fatigue, and affected care behavior through the chain mediation effect of perception of management and compassion fatigue. Nurse managers should pay attention to the influence of emotional intelligence on care behavior and improve care behavior by strengthening leadership and alleviating compassion fatigue. [Journal of Psychiatric Nursing and Mental Health Services, xx(xx), xx-xx.].

Timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, South Gondar Zone, North West, Ethiopia

BackgroundInitiation of breast feeding within one hour of birth is the easiest and most cost-effective intervention to reduce the risk of neonatal morbidity and mortality. Conducting studies immediately after an hour of birth for the timely initiation of breastfeeding has the significance of initiating breastfeeding and acting immediately. However, there was a paucity of information in the region as well as in the country at large. Therefore, the aim of this study was to assess the magnitude of timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, northwest Ethiopia, in 2024.MethodAn institutional-based cross-sectional study was conducted from October 25, 2023, to January 25, 2024, at Debre Tabor Comprehensive Specialized Hospital. A total of 478 immediate postpartum mothers were selected at birth using systematic random sampling techniques. Data were collected using chart reviews, interviewer-administered questionnaires, and through observation. Data entry and analysis was performed by Epi-Data version 4.6.02 and Statistical Package for Social Sciences version 25(SPSS) soft war respectively. Descriptive statistics were computed to determine the frequency of variables. After doing a binary logistic regression analysis, a p-value less than 0.25 indicated a potential candidate for multivariable analysis aimed at identifying statistically relevant factors. Both crude and adjusted odds ratios (AOR) were computed, and the levels of significance were declared based on the AOR with a 95% confidence interval (CI) at a p-value < 0.05.ResultsIn this study, the prevalence of timely initiation of breastfeeding was 73.7% with a 95% CI (69.65%, 77.67%). Being multiparous (AOR: 2.25, 95% CI: 1.32, 3.84), receiving counseling immediately after delivery (AOR: 4.19, 95% CI: 2.20, 7.98), receiving support and guidance from health care providers (AOR: 1.95, 95% CI: 1.01, 3.77), having no obstetric complications during and immediately after delivery (AOR: 4.44, 95% CI: 2.34, 8.42), and practicing rooming-in (AOR: 3.65, 95% CI: 2.05, 6.51) were significantly associated variables with timely initiation of breast feeding.ConclusionThe overall timely initiation of breastfeeding in this study was lower than the World Health Organization’s recommendations. Therefore, interventions need to focus on mothers who developed obstetric complications, primiparous mothers, improper rooming-in, a lack of advice immediately after delivery, and the support and guidance of mothers on the timely initiation of breastfeeding to improve the timely initiation of breastfeeding practice.

Post stroke aspiration pneumonia, associated factors, and treatment outcome among stroke patients admitted to Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia

BackgroundPost-stroke aspiration pneumonia is a serious lung infection that occurs when stroke patients inhale food, saliva, liquid, vomit, or foreign objects. It is the leading cause of death for stroke patients worldwide, which accounts for 60% of stroke-associated deaths. Little is known about its prevalence, adverse outcomes, and determinants in Ethiopia. Therefore, this study aims to evaluate the prevalence of post-stroke aspiration pneumonia and associated factors in stroke patients admitted to the Tibebe Ghion Specialized Hospital.Methods and materialsA retrospective cross-sectional study was conducted on 242 stroke patients admitted to the neurology unit of a medical ward from January 1, 2019, to December 30, 2020. Data were collected from the patients' cards using a pre-developed data collection tool. The collected data was coded, cleaned, and entered into Epi-Info version 7.25, and then exported to SPSS 26 for further analysis. Logistic regression analyses were performed to identify factors associated with aspiration pneumonia. The adjusted odds ratio with the corresponding 95% confidence interval and a p &amp;lt; 0.05 were noted to declare variables had a significant association.ResultsThe mean age of the patient was 61.15 ± 13.959 years with a minimum age of 21 and maximum age of 102 years. Males account for 55.8% and females for 44.2%. Out of 242 patients post-stroke aspiration pneumonia was identified in 23.1% of patients, and 55.4% of stroke patients improved, while 23.2% died from post-stroke aspiration pneumonia. The study found that having dysphagia (AOR = 3.05; 95% CI: 1.13, 8.21), feeding through a Nasogastric tube (AOR = 10.58; 95% CI: 4.58, 24.42), and a GCS level of 8–12 (AOR = 2.58; 95% CI: 1.04, 6.42) were independent predictors of post-stroke aspiration pneumonia.ConclusionThis study found a high prevalence of post-stroke aspiration pneumonia and its associated mortality. Stroke patients with dysphagia, low levels of consciousness, and those who are fed through a tube are at a higher risk of developing this condition. Therefore, it is crucial to provide special care to stroke patients with these conditions. The study also highlights the importance of assessing the practice of preventative measures for PSAP among stroke patients in this study setting.