Tertiary Hospital Setting Research Articles

Incidence of Helminthic and Viral Coinfections in Malaria Patients in the Tertiary Care Hospital Setup.

This study determines the incidence of common viral and helminth coinfections with malaria in the tertiary care hospital set up in southern Khyber Pakhtunkhwa, Pakistan. The multidimensional research included malaria patients admitted to different hospitals of district Kohat during January and December 2021. Stool samples and blood were assembled from the patients. Giemsa-stained microscopy-positive samples were processed by the immunochromatography technique (ICT) to identify Plasmodium species. Common viral infections such as viral hepatitis (A, B, and C), HIV, and dengue (DENV) were analyzed by ICT kits while SARS-CoV-2 was confirmed through real-time PCR. Furthermore, the intestinal helminths were identified using the Kato-Katz thick smear method. Among 1278 patients, 548 were diagnosed with malaria, 412 (75.2%) were positive for P. vivax infection, 115 (21%) for P. falciparum, and 21 (3.8%) for mixed malaria infection (P. vivax/P. falciparum), with a higher incidence among males (65.2%) than females (34.8%). Coinfection with helminths was positive in 215 (39.3%) malaria patients. The most common infections were caused by the Ascaris lumbricoides species (42.6%) followed by Enterobius vermicularis (31.7%) and hookworm. A total of 24.6% of malaria-positive cases were also coinfected with different viruses with higher frequencies of confection for HAV (8.2%) and DENV (6.2%), respectively. The patients revealed higher incidence of coinfections with P. falciparum (57%) as compared with P. vivax (39.2%) and mixed infections (3.7%). This study demonstrated that the study population exhibited a significant incidence of coinfections with intestinal helminth and viral malaria.

Training healthcare professionals to discriminate between examples and non‐examples of racial microaggressions

AbstractPresident Bill Clinton's Race Advisory Board (1998) discussed racism as being nearly invisible to Americans, and White Americans are often unaware of their role in perpetuating racism today. Microaggressions are a common type of racism that take the form of denigrating comments toward those of racial minority groups (Sue et al., 2007). While often unintentional or unconsciously used, microaggressions adversely affect today's society. The purpose of the current study was to evaluate a differential reinforcement with feedback intervention to facilitate discrimination between examples and non‐examples of microaggressions among healthcare workers employed by a tertiary hospital setting. We recruited 26 healthcare workers to complete three surveys via a Qualtrics survey. Baseline data showed moderately high, but variable, accuracy in discriminating examples and non‐examples of microaggressions. Following the reinforcement plus feedback intervention, participants' accurate discrimination between (non‐) examples of microaggressions increased. We will discuss these results in terms of using behavior‐analytic procedures to effectively teach what constitutes microaggressive acts that negatively impact people of color.

Surgical and Fertility Outcomes of Reduced-Port Robotic Myomectomy: A Single-Center Experience of 401 Cases.

Background: Reduced-port robotic myomectomy (RPRM) using Da Vinci® Xi™ is a good fertility-saving surgical option, but the surgical and fertility outcomes are unknown. Methods: This was a retrospective cohort study evaluating the feasibility of RPRM in an academic tertiary hospital setting. A total of 401 patients who underwent RPRM by a single operator between October 2017 and October 2021 were included. For RPRM, three ports are required: a 1.5 cm umbilical incision and two 0.8 cm incisions 8 cm lateral to the umbilicus. A single-port system was applied through the umbilicus, which also functioned as a working port. Unlike conventional robotic surgery, only three robot arms were utilized for the entire surgical procedure. Results: Surgical and fertility outcomes were assessed through medical records review and follow-up telephone contact. The mean age of patients at the time of surgery was 39.7 ± 6.0 years. The most common indication for surgery was menorrhagia (n = 128, 31.9%). The average number of myomas removed was 4.7 ± 4.1 (1-22), and the size was 7.8 ± 2.5 cm (2.5-16.0). The mean operation time was 103.7 ± 45.6 min. Postoperative complications were found in 9.7% (n = 39) of patients; the most common complication was transfusion (7.7%, n = 31). After surgery, 70 patients tried to conceive, and 56 became pregnant naturally or by assisted reproduction (56/70, 80.0%). The mean interval time from operation to conception was 13.5 ± 10.1 months. Among 56 who conceived, 44 gave birth (62.9%), five were still ongoing (7.1%), and seven had miscarriages (10.0%). Cesarean section was performed for most cases (43/44, 97.7%). Eight patients had obstetric complications (16.3%), but no uterine rupture was reported. Conclusions: RPRM, which provides the benefits of conventional robotic surgery along with favorable obstetric and cosmetic results, is a feasible option for patients with symptomatic uterine myomas who wish to conceive in the future.

Use of potentially inappropriate medication for elderly patients in tertiary care hospital of Riyadh, Saudi Arabia

Background and objectivesThe elderly population is affected by chronic diseases and lifelong medication. The American Geriatrics Society (AGS) Beers Criteria is a comprehensive approach to medication usage in the older population to reduce potentially inappropriate medication (PIM) use. The purpose of this study was to assess the usage of PIMs in elderly patients upon discharge from tertiary care hospital settings in Riyadh, Saudi Arabia, using the AGS Beers Criteria 2019. MethodsThe data was obtained from the medical records of 1237 patients (>65 years) who were discharged from medical or surgical wards at two hospitals affiliated with King Abdulaziz Medical City. The data was analyzed to determine the prevalence of PIM prescription, and the proportional odds of the independent factors influencing outcomes were estimated using ordinal regression analysis for criteria 1 and 2, while Binary regression analysis was conducted for criterion 3. ResultsThere were approximately equal numbers of male and female participants in our study (male: 50.8 % vs. female: 49.2 %). One-third of the patients were above the age of 80 years, with 41 % being between the ages of 70 and 80 years. Moreover, almost 70 % of the samples had chronic illnesses. The overall prevalence of PIMs was 29.2 %, with 11 % of PIMs to be avoided in elderly patients and 17 % to be used with caution in the elderly, while disease-specific PIMs were identified in 1.2 % of the patients. The most common PIM class was proton pump inhibitors (44.41 %), and patients discharged from the surgical unit were more likely to be prescribed PIMs. Proton pump inhibitors (44.41 %) were the most inappropriately prescribed drug class, and patients discharged from the surgical unit were more likely to be prescribed PIMs. ConclusionThe study noticed that male gender, the presence of multiple diseases, and obesity are associated with more than one PIM prescription. There is a need to streamline the surgical department’s prescription procedure to eliminate prescription disparities. Prescription monitoring is recommended to avoid medication errors, particularly in patients who are taking multiple medications.

HEMATOLOGICAL DYNAMICS IN HEMODIALYSIS: A COMPREHENSIVE EXAMINATION OF PATIENTS WITH CHRONIC RENAL FAILURE IN A TERTIARY CARE HOSPITAL

Background: Chronic kidney disease (CKD) is a significant health burden in developing countries like India, leading to high morbidity and mortality rates. The study aimed to determine the incidence of anemia among patients with CKD and examine its potential association with other predictive markers. Methods: A cross-sectional observational research was undertaken within a tertiary hospital setting to examine the incidence of hematological abnormalities and explore the association between anemia and its many manifestations in patients with stages 3-5 chronic kidney disease (CKD). The markers for anemia encompassed measurements of hemoglobin percentage (Hb%), mean corpuscular volume (MCV), and examination of peripheral smears. The investigation also examined the correlation between stages of chronic kidney disease (CKD) and red cell distribution width (RDW), thrombocytopenia, leucocyte count, and differential count. Result: The study found that 96.8% of participants displayed symptoms of anemia, characterized by normocytic and normochromic observations on peripheral measures. A significant number of patients (57.3% of them) had a higher total leucocyte count (TLC), but there was no statistically significant link between a higher TLC and the worsening stages of CKD. The mean corpuscular volume (MCV) and platelet levels exhibited a predominantly normal range, with relatively few observed fluctuations. However, there is a positive link between the advancement of CKD and an increase in red cell distribution width (RDW). Conclusion: The study highlights the changes in blood parameters observed in individuals with CKD, with particular attention given to the high occurrence of anemia. The findings underscore the importance of comprehensive iron investigations and the timely identification and intervention of anemia. Adopting a comprehensive strategy that includes regular monitoring of blood parameters, specifically focusing on anemia and iron levels, is crucial for effectively managing and enhancing the overall health of individuals with CKD KEY WORDS- Anemia in CKD, Chronic kidney disease, Iron deficiency anemia

Longitudinal evaluation of an electronic audit and feedback system for patient safety in a large tertiary hospital setting.

Objective: This study sought to assess the impact of a novel electronic audit and feedback (e-A&F) system on patient outcomes. Methods: The e-A&F intervention was implemented in a tertiary hospital and involved near real-time feedback via web-based dashboards. We used a segmented regression analysis of interrupted time series. We modelled the pre-post change in outcomes for the (1) announcement of this priority list, and (2) implementation of the e-A&F intervention to have affected patient outcomes. Results: Across the study period there were 222,792 episodes of inpatient care, of which 13,904 episodes were found to contain one or more HACs, a risk of 6.24%. From the point of the first intervention until the end of the study the overall risk of a HAC reduced from 8.57% to 4.12% - a 51.93% reduction. Of this reduction the proportion attributed to each of these interventions was found to be 29.99% for the announcement of the priority list and 21.93% for the implementation of the e-A&F intervention. Discussion: Our findings lend evidence to a mechanism that the announcement of a measurement framework, at a national level, can lead to local strategies, such as e-A&F, that lead to significant continued improvements over time.

Assessing the Impact of Antimicrobial Stewardship on Antibiotic Rationality in a Tertiary Hospital Setting

Introduction: Irrational use of antibiotics can lead to antibiotics resistance, necessitating efforts for prevention. The implementation of an Antimicrobial Stewardship Program aims to mitigate inapproriate antimicrobial prescribing. This study aims to compare antibiotic rationality based on quantity, quality, and total cost of antimicrobial utilization following the Antimicrobial Stewardship Program in a tertiary hospital setting.Methods: This was a cross-sectional study. Data were obtained from the medical record of 120 patients hospitalized in the pediatrics ward and classified into two groups: post-program and control. The quantity of antibiotic utilization was measured using Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD). Antibiotic rationality was assessed using Gyssens modified category. Normality was evaluated using the Kolmogorov-Smirnov test and analyzed with an independent t-test.Results: There was 10% increase of prudent antibiotic use and a 30.61% reduction in total cost in the post-program study group. However, there was no significant difference in the quantity of antimicrobial utilization in both groups (p=0.06).Conclusion: The program improves the rationality of prudent antibiotic prescription and reduces the total cost of antimicrobial utilization.

Perinatal Outcome and Preventable Causes of Morbidity and Mortality in Eclampsia: A Cross-Sectional Observational Study in a Tertiary Hospital in Bangladesh

Background: Eclampsia poses a substantial threat to perinatal health in developing countries, with Bangladesh experiencing a notable impact on infant well-being. This cross-sectional observational study, conducted at Enam Medical College Hospital, Savar, Dhaka, aimed to investigate perinatal outcomes in eclampsia patients and identify preventable causes of perinatal mortality and morbidity associated with this condition. The study period spanned from June 2015 to July 2017, with a focus on understanding the specific factors contributing to adverse perinatal events in this population. Methods: A total of 155 eclampsia patients were enrolled in the study, resulting in the delivery of 161 babies, including six sets of twins. The study employed a comprehensive observational approach, assessing maternal and fetal conditions to analyze their correlation with perinatal outcomes. Data collection and analysis were conducted in the Department of Obstetrics and Gynaecology at the tertiary hospital, employing standard protocols and statistical methods to derive meaningful insights. Results: The study revealed a perinatal death rate of 27.32%, with stillbirth accounting for 15.52% and early neonatal death for 11.80%. In contrast, 84.47% of babies were born healthy. Among live-born neonates, 27.94% experienced jaundice, while 30.88% had no complications. Prematurity emerged as a significant contributor to perinatal loss in eclampsia cases. The findings underscore the critical role of early referral of eclampsia patients, the implementation of timely resuscitative measures, and improved neonatal care as potential avenues to enhance perinatal outcomes. Conclusion: In conclusion, this study highlights the importance of addressing stillbirth as a predominant component of perinatal death in eclampsia cases. Prematurity was identified as a key factor contributing to adverse perinatal outcomes. Early referral of eclampsia patients and the implementation of resuscitative measures, coupled with enhanced neonatal care, are crucial interventions that can potentially mitigate perinatal morbidity and mortality associated with eclampsia in the context of a tertiary hospital setting in Bangladesh. These findings provide valuable insights for healthcare practitioners and policymakers to guide strategies aimed at improving perinatal outcomes in similar healthcare settings.

Prevalence and determinants of depression after acute stroke at tertiary care rural hospital in India: A cross-sectional study

Background: Depression is commonly unrecognized, undertreated, and associated with poor functional outcomes in stroke patients. There is a paucity of data available on post-stroke depression in India, especially in rural areas. The study aimed to bridge the existing knowledge gap by estimating the prevalence and identifying determinants of depression in post-acute stroke patients within rural settings by using standardized tools. Materials and methods: A cross-sectional study was conducted in a tertiary rural hospital setting. Participants included post-acute stroke patients aged 18 years and above of either sex, admitted to the hospital between October 2020 and September 2022. Depression was assessed using standardized tools, and DSMV Criteria, and severity was assessed using Hamilton Rating Score. Results: Out of 80 stroke patients, the majority 62.5% of patients were male, and 68.8% of patients were older than 60 years of age. 37.5% of patients had co-morbidities, the most common co-morbidity was hypertension, followed by diabetes. 28.7% of patients had an addiction history, majority were tobacco chewers. The prevalence of depression in post-acute stroke patients in this study was 58.7%. Depression was common in male patients older than 60 years of age (57%) and patients with right hemisphere infarcts (58.3%). Depression has an inverse relation with co-morbidities and addiction. Conclusion: This study revealed a high prevalence of depression and helped to understand demographic and clinical determinants among post-acute stroke patients in a rural setting, which provides insight for healthcare personnel to routinely assess the mental health of post-stroke patients.

Clinical characteristics and long-term prognosis of female patients with acute coronary syndrome.

Cardiovascular disease has traditionally been studied predominantly in men, but understanding its manifestations in women is crucial for effective management. This study aims to evaluate the long-term prognosis of female patients with acute coronary syndrome (ACS) within a tertiary hospital setting in Spain. Retrospective observational study based on a cohort of consecutive hospitalized patients with ACS from January 2009 to December 2014. Data on demographics, risk factors, treatment, and outcomes were collected, with a median follow-up of 9.2 years. Women with ACS, constituting 27.3% of 2,330 patients, were older and had a higher prevalence of cardiovascular risk factors such as obesity, hypertension, and diabetes mellitus compared to men. They presented with more non-ST-segment elevation myocardial infarction and underwent less coronary angiography. Female patients were also less likely to be treated with acetylsalicylic acid, a second antiplatelet drug, or statins. Despite initial higher mortality rates [hazard ratio (HR) 1.30; 95% confidence interval (CI) 1.13-1.49; p < 0.001], female patients exhibited a more favorable long-term prognosis after adjustments (adjusted HR 0.82; 95% CI 0.71-0.96; p = 0.014), even in the subgroup analysis excluding patients with unstable angina. Women with ACS are more comorbid, but after adjustments, female sex appears to be a protective factor that confers a better long-term prognosis.

To assess the knowledge, attitude, and practice about prescribing fixed-dose combinations among medical doctors in a tertiary care hospital in Karnataka: A cross-sectional study

Background: Fixed-dose combinations (FDCs) constitute a substantial portion of prescribed medications worldwide and offer benefits such as enhanced efficacy, reduced pill burden, and improved patient compliance. However, their improper utilization can lead to inefficacies, increased costs, and adverse health outcomes. The assessment of clinicians’ understanding, attitudes, and practices regarding FDC prescription at a tertiary care teaching hospital in South India serves as a crucial step toward ensuring informed and rational medication practices. Aims and Objectives: The aim and objectives of the study are to evaluate the knowledge, attitude, and practice of prescribing FDCs among medical doctors. Materials and Methods: Following approval from the Ethics Committee at Mysore Medical College and Research Institute, as well as obtaining written informed consent from medical doctors working in the institute, a selfadministered, structured, and pre-tested questionnaire was utilized. This questionnaire had been adapted from prior studies with similarities and was adjusted to align with the specific context of the present study. Results: The study of 72 doctors highlighted high FDC awareness (91.7%). The generic name of FDC was employed by 69.4% of the participants in the study. Most advocated proper prescriptions (84.8%). 57% of them identified FDC rationality. 22.2% relied on drug indexes, among other varied sources, for FDC information. Conclusion: It is essential to emphasize gaps in knowledge, attitude, and practice as it increases the risk of irrational prescriptions. Measures aiming to educate and rectify this issue, particularly in a tertiary hospital setting, help in mitigating the irrational use of drugs and optimizing patient care.

Enablers and Barriers of Research Engagement Among Clinician Researchers: Nursing, Allied Health and Medical Professionals.

In response to the increasing involvement of nursing, allied health and medical professionals in research within clinical service roles, understanding the varying research capacities across public health institutions and professions is crucial. This study aims to explore the lived experiences of conducting research among nursing, allied health and medical health professionals within a tertiary public hospital setting in New South Wales (NSW). The focus is on identifying barriers and enablers to research engagement. Research active health professionals across nursing, allied health and medical professions were invited to participate in a semi-structured interview to discuss enablers and barriers experienced whilst conducting research. All interviews were transcribed verbatim, conceptual and thematic analysis of the interviews was conducted. Nine allied health professionals, eight nurses/midwives and thirteen medical officers were interviewed. Key themes were categorised as barriers or enablers. The ethics regulatory process was identified as a strong barrier in all professions, other commonly identified barriers were lack of time to conduct research and lack of funding. Researchers reported difficulties knowing where to obtain assistance and support when required. Mentorship was the most common enabler identified by all three professions. In addition, a positive research culture and organisational support and assistance within the organisation were seen as strong enablers. This research provides insight into the barriers and enablers for active clinician researchers across three professional groups. We have identified priority areas to increase research capacity within our health care organisation and will focus on training in the ethics regulatory process and mentorship along with infrastructure support to strengthen the positive research culture across all professions.

Catheter-associated urinary tract infections in critical care: Understanding incidence, risk factors, and pathogenic causes in Palestine.

Catheter-associated urinary tract infections (CAUTI) are the most common secondary cause of bloodstream infection. CAUTI is particularly prevalent in critical care departments and developing countries, where the duration of catheterization remains the most significant risk factor. This study focused on the characteristics, risk factors, and outcomes of CAUTI patients in a tertiary care hospital setting. It also provides the incidence rate of CAUTI in an ICU setting in Palestine. The study adopted a retrospective observational design at a tertiary care hospital in Palestine. The data were collected from patient records as well as from nursing flow charts. Variables are reported as frequencies, percentages and means + standard deviations. Independent t-tests was used for numerical variables, while Pearson's chi-square or Fisher's exact test were used for categorical variables. Multivariate analysis was performed to adjust for confounders using binary logistic regression. Mortality risk factors were assessed using the proportional Cox regression model. Of the 377 patients included in the study, 33 (9%) developed CAUTI. Among CAUTI patients, 75% had Candida species isolated, with non-albicans Candida predominating (72%) fungal isolates. On the other hand, 25% of the patients had bacterial isolates in their urine, with a predominance of Escherichia coli growing in 36% of bacterial cultures. Multivariate regression analysis revealed that female gender, longer catheterization days, and corticosteroid use were associated with an increased risk of CAUTI. On the other hand, developing CAUTI, having a malignant disease, developing kidney injury, and developing shock were associated with increased mortality. This study highlighted the emerging presence of fungal and resistant bacterial CAUTI. It also emphasized that the risk of CAUTI was associated with a longer duration of urinary catheterization. The findings of this study may help formulate antimicrobial management and stewardship plans as well as emphasize the risk of urinary catheterizations.

A questionnaire-based study to assess the knowledge, attitude, and practice of Materiovigilance among health-care professionals of a tertiary care teaching hospital in Gujarat

Background: Medical devices are now an essential component of modern healthcare, providing better illness screening, diagnosis, and treatment. Every medical equipment has some level of health risk. Health-care professionals such as resident doctors, intern doctors, and nursing staff play an important role in identifying and reporting adverse events caused by medical devices. Aim and Objective: The study aimed to evaluate doctors’ awareness and attitudes concerning Materiovigilance within a tertiary care hospital setting. Materials and Methods: This was a cross-sectional questionnaire-based study done among resident doctors, intern doctors, and nursing staff of a Tertiary Care Teaching Hospital. To collect the relevant data of the study variable, a self-administered Google Forms-based questionnaire was created. It consists of a total of 18 questions related to KAP aspects of the Materiovigilance. The study participants were given access to the questionnaire via a digital web link using several social media platforms, and their responses were collected. Results: A total of 147 participants responded, of which 40.1% were resident doctors, 29.9% were intern doctors, and 29.9% were nursing staff. After analysis of responded data, 50% had proper Knowledge, 77.5% had proper Attitude, and 37.4% had a proper practice of materiovigilance. Conclusion: It was discovered that the participants in our study lacked adequate Materiovigilance knowledge and practice, but had better attitudes toward Materiovigilance. For the purpose of raising awareness and encouraging the reporting of adverse events caused by medical devices, more workshops and training programs must be held.

Appropriateness of gentamicin therapeutic drug monitoring at a Middle Eastern tertiary hospital setting: a retrospective evaluation and quality audit.

The use of gentamicin in the treatment of infectious diseases requires frequent monitoring to attain the best treatment outcomes. This study aimed to evaluate the appropriateness of gentamicin therapeutic drug monitoring (TDM) at a tertiary care hospital in Qatar. A one-year quantitative retrospective chart review of all gentamicin TDM records was conducted. Evidence-based criteria were applied to evaluate the appropriateness of gentamicin TDM in terms of indication, sampling times, and post-analytical actions. Out of 59 captured gentamicin TDM records, 58 gentamicin samples were eligible for evaluation. Overall, gentamicin TDM appropriateness was achieved in 50% (n = 29) of the evaluated records. However, 12% (n = 7) of gentamicin drug concentrations were below the assay quantification limits or were not sampled appropriately. Inappropriate post-analytical actions (22.4%, n = 13) and inappropriate sampling times (44.8%, n = 26) were recorded. Most of the gentamicin blood samples (n = 43; 74.2%) were taken appropriately at steady-state. Inappropriate sampling time relative to the last dose was captured in 31% (n = 18) of the cases. Although 27.6% (n = 16) of gentamicin concentrations were non-therapeutic, continuing gentamicin dosing without adjustment was the most frequent post-analytical action (69.8%, n = 37). Gentamicin dose regimen continuations, dose regimen decreases and dose regimen discontinuations were inappropriately applied in 27% (n = 10), 25% (n = 2) and 14% (n = 1) of the times, respectively. Suboptimal gentamicin TDM practices exist in relation to sampling time and post-analytical actions. Studies exploring setting-specific reasons behind inappropriate TDM practices and methods of its optimisation are needed.

An audit of the establishment of a cardiac magnetic resonance imaging service in a public tertiary hospital setting in the Western Cape Province of South Africa

An audit of the establishment of a cardiac magnetic resonance imaging service in a public tertiary hospital setting in the Western Cape Province of South Africa

Assessing the Relationship between Fingerprints and Lip Prints Patterns with Gender and Blood Group at a Tertiary Care Hospital

Background: Fingerprints and lip prints are unique biometric markers extensively studied in forensic science for individual identification. Objective: This study investigates the relationship between fingerprints and lip print patterns concerning gender and blood group characteristics within a tertiary care hospital setting. Study Design: Cross-sectional study. Settings: Department of Forensic Medicine Loralai Medical College, Loralai Pakistan. Duration: From August 2022 to January 2023. Methods: Total 150 patients involving the collection of fingerprints and lip prints from participants were enrolled. Gender and blood group information were also recorded. Statistical analysis, including correlation tests and chi-square analysis, was employed to examine associations between biometric patterns and demographic variables. Results: The mean age of the sample population was 37.53 years, with a standard deviation of 3.2 years. Approximately 53.33% of the participants were male, while 46.67% were female. Groups A and O each comprised 26.67% of the sample, while group AB accounted for 16.67%. Type II and Type III patterns followed, accounting for 23.33% and 20.00%, respectively, while Type I patterns were least common at 16.67%. In terms of fingerprint types, loops were the most prevalent at 46.67%, followed by whorls at 30.00% and arches at 23.33%. The correlation indicates significant associations between lip prints and fingerprints with gender (χ² = 7.128, df = 3, p &lt; 0.001*) and between lip prints and fingerprints with blood group (χ² = 5.454, df = 3, p = 0.001*). These findings suggest that gender and blood group may influence the distribution of lip prints and fingerprints. Conclusion: This study demonstrates significant associations between fingerprints, lip prints, gender, and blood group characteristics among individuals at a tertiary care hospital. These findings underscore the potential utility of integrating biometric parameters for enhanced forensic identification and medical diagnostics.

Observation of Clinical Profile of Different Types of Meningitis in a Tertiary Care Hospital

Background: Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, presents significant diagnostic challenges due to its varied etiologies and overlapping clinical symptoms. This study aims to observe and document the clinical and laboratory characteristics of viral, bacterial, and tubercular meningitis in a tertiary care hospital setting. Methods: This descriptive observational study was conducted at the Department of Neuromedicine, Cumilla Medical College Hospital, Bangladesh, from January 2020 to December 2020. We enrolled 159 patients diagnosed with meningitis based on clinical, biochemical, and investigative criteria. Detailed demographic data, clinical examination findings, and relevant investigations, including cerebrospinal fluid (CSF) studies, were recorded. Data analysis was performed using SPSS software version 20 and MS-Excel 2016. Results: Among the 159 participants, 36.7% were diagnosed with bacterial meningitis, 32.5% with viral meningitis, and 24.9% with tubercular meningitis. Fever was a universal symptom, while headache was reported by 87.3% of viral, 87.1% of bacterial, and 95.2% of tubercular meningitis patients. Vomiting was more prevalent in tubercular (57.1%) and bacterial (50%) meningitis. Laboratory findings showed the highest mean white blood cell count in bacterial meningitis (11803.18±2905.55 cells/cmm). C-reactive protein levels were also highest in bacterial meningitis (21.23±16.20 mg/dl). Elevated adenosine deaminase levels were a distinguishing feature of tubercular meningitis (14.18±10.60 Unit/L). Conclusion: This study highlights the distinct clinical and laboratory profiles associated with different types of meningitis. The findings emphasize the importance of comprehensive evaluations for accurate diagnosis and effective management of meningitis. Further research should aim to refine diagnostic criteria and explore advanced diagnostic tools to improve patient outcomes. , , , , , ,

Healing rate of hospital-acquired skin tears using adhesive silicone foam versus meshed silicone interface dressings: A prospective, randomized, non-inferiority pilot study.

A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital-acquired skin tear. An intention-to-treat pilot study was designed using a randomized, non-inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3-week follow-up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention-to-treat sample, healing was 69% and 42%, respectively. Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow-up, a sample of at least 103 participants per arm would be required to power a definitive study.

RWD7 Graphical Representation of Real-World Data for Analysing Infection Outbreaks Within a Tertiary Hospital Setting: A Data-Driven Approach

RWD7 Graphical Representation of Real-World Data for Analysing Infection Outbreaks Within a Tertiary Hospital Setting: A Data-Driven Approach