Department Wards Research Articles

Comparison of post-operative pain in stapled haemorrhoidectomy v/s open haemorrhoidectomy.

Objective: To compare mean post-operative pain in stapled haemorrhoidectomy versus open haemorrhoidectomy. Study Design: Randomized Control Trial. Setting: Department of Surgery, Allied Hospital Faisalabad. Period: 18-04-2021 to 17-10-2021. Methods: There are 94 patients that fill the concert form that agree in this study. The presenting complaints that included such as bleeding per anus ,prolapsed of the mucosal membrane, hardening of stool and itching of rectum that were noted. Complete history was taken and physical examination was done as per rule. There are two groups arranged where patients are divided in this group with a well-mannered numerical method. Patients having the group that labeled as Group A underwent open haemorrhoidectomy that compare with the patients that labelled with as Group B with stapled heamorrhoidectomy. All operations were done by same surgical team .All patients were retained in surgical ward in surgical department of Allied hospital Faisalabad .there are several post-operative therapies were taken for reducing the pain and recommend the analgesic NASIDS in the form of Intravenous rout. In the first post-operative day of treatment I/v Paracetamol were administered for 08 hours. NSAIDS and other pain killers were administered in the form of Diclofenac 50mg for the next five post-operative days. However, these medications were administered in both groups that labeled as Group a and Group B of the patients. Results: Comparison of post-operative pain in both groups shows 2.28+0.45 pain in Group-A and 1.26+0.49 in Group-B, p value is 0.0001. Conclusion: The conclusion that showed post-operative pain is significantly lower in stapled haemorrhoidectomy when compared with open haemorrhoidectomy in 3rd and 4th degree of haemorrhoids.

Survey analysis of workplace violence among public healthcare workers in Yogyakarta, Indonesia

BackgroundWorkplace violence in the healthcare sector has become a global issue that poses a threat to the safety and well-being of healthcare staff. This study aims to understand and analyze workplace violence experienced by public healthcare workers in Yogyakarta, Indonesia.ResultsThis is an observational analytical descriptive study using a cross-sectional design across 482 healthcare workers from 7 general public hospitals taken through stratified random sampling with a standardized questionnaire. The surveys found that 65 from 482 healthcare workers (13.6%) admitted to experiencing physical violence, verbal abuse, bullying, and/or sexual harassment. It is most prevalent among nurses, with the majority occurring in the emergency department ward. Verbal abuse is the most common type, mainly perpetrated by patients’ relatives. Most workers who experience violence take no action. In the bivariate analysis, there was a significant relationship between professions (p = 0.045) and their workplace (p < 0.001) with workers experiencing violence. No significant relationships were found regarding age, gender, marital status, duration of work, and years of service.ConclusionsA low prevalence of workplace violence was noted in public hospitals in Yogyakarta, suggesting that underreporting might be a major concern. Nurses and the emergency department are the most vulnerable and thus need more urgent interventions. Further research should focus on private hospitals and more effective preventive and responsive measures.

A Cross-Sectional Study of Acute Poisoning Cases Admitted in a Tertiary Care Hospital in Mangaluru, Karnataka, India

Abstract Introduction: A poison is a substance that causes serious illness and endangers the life of a person when ingested in a relatively small quantity. Poisoning is one of the most common problems encountered in day-to-day clinical practice. Poisoning causes morbidity and mortality which can be prevented and managed if clinicians are sensitized with adequate knowledge of common poisons. Therefore, this study was conducted to know the profile of acute poisoning cases admitted in a tertiary care hospital in Mangaluru. Materials and Methods: 100 patients admitted in the intensive care units and wards of the General Medicine department, Kasturba Medical College, Mangaluru, and Government Wenlock District Hospital, Mangaluru with various poisoning were evaluated for various factors like the distribution of poisoning cases according to age, gender, intention of poisoning, nature of poisons consumed and the nature of treatment received at another hospital before getting admitted. Results: Most of the cases of poisoning occurred in the age group between 21-30 years of age (38%). The majority of the patients in the study were males (60%) and females formed 40% of the study population. The majority of patients in this study (99%) consumed poison with suicidal intention. 77% of patients received first-aid treatment in a peripheral hospital before getting admitted to our hospital. Conclusion: This study shows that the peak incidence of acute poisoning cases was seen in the age group of 21 to 30 years with male predominance. The pattern of poisoning was suicidal in the majority of the patients.

Live Streaming of the Professor's Ward Rounds in Undergraduate Neurology Education: Usability Study.

Although neurology department ward rounds are among the most important medical education exercises in Japan, they have several issues. Patients may find it unpleasant to undergo repeated neurological tests, especially when in the presence of several students. Only the front row of students can closely observe the examination findings; moreover, students were prohibited from contacting patients altogether during the COVID-19 pandemic. One possible solution is to use commercial videoconferencing systems. However, Japanese patients are reluctant to have their medical information or video footage of them sent outside of the hospital via the internet. The study aimed to confirm the feasibility of conducting remote teaching rounds using an in-house web conferencing system in which the patients' personal data are securely protected. This study also explored whether using remote rounds alongside face-to-face participation would enhance learning. We created an on-premises videoconferencing system using an open-source app. To perform video ward rounds, the professor wore a wireless microphone while leading routine in-person rounds and the attending physician carried a tablet device linked to a web conference, allowing students in another room to watch the rounds on a live stream. In total, 112 of 5th-year students who entered their 1-week neurology rotation between 2021 and 2022 were instructed to participate in 1-hour in-person and remote rounds. Students were given questionnaires to evaluate their satisfaction and the educational effects of the remote rounds. The remote ward rounds were conducted easily with no interference with the in-person rounds, nor any complaints from the patients. Each examination technique was explained by another teacher to the students who participated in remote rounds in the conference room. Characteristic neurological findings, such as plantar reflexes (Babinski sign), which are usually seen only by close observers during in-person rounds, could be visualized under magnification by all students. The postexperience survey (82/112, 73% response rate) showed that the mean score of participants' satisfaction was 3.94 (SD 0.83; excellent 5 and poor 1). No participant scoring 1 was noted. The proportion of students who observed 6 representative abnormal neurological findings (Babinski sign, hyperreflexia, cerebellar ataxia, involuntary movement, muscular weakness, and abnormality in sensory examination) increased by 22% (18/82, range 13-24) compared to in-person rounds alone. When self-rating the learning value, 43% (35/82) of the students answered that remote rounds are equally as valuable as in-person rounds, while 32% (26/82) preferred remote rounds. Live-streaming of neurology ward rounds using a secure in-house web conferencing system provides additional learning experience without concerns regarding leakage of patient information. This initiative could enhance neurology learning before entering a clinical clerkship.

Departmental Workload and Job Satisfaction of Indonesian Nurses in Saudi Arabia: A Cross Sectional Study

Indonesian foreign nurses working in Saudi Arabia have not been surveyed regarding workload and job satisfaction in the healthcare setting. Understanding the workload at hospital that influences job satisfaction provides an overview of the nurse’s existence at work. This study aimed to determine the prevalence of workload, and job satisfaction of Indonesian nurses in Saudi Arabia. A cross sectional study using self- administered questionnaire by Nasa Task Load Index (NASA-TLX) was used to analyze the workload, and the Minnesota Satisfaction Questionnaire (MSQ) for the satisfaction. Data were analyzed using descriptive methods and univariate statistics by SPSS version 26. A total of 132 nurses participated in this research. Five departments, including intensive care unit (ICU), emergency department (ER), operating room (OR), hemodialysis (HD), and ward department (WD) reported high workload levels (61-80 points). Job satisfaction in five departments was neutral category, while the ward department showed dissatisfied category. The analysis of nurses' characteristics revealed that the majority were aged 31-40 years old (46.2%), length of work was 1-5 years (54.5%), and worked in the outpatient department (42.4%). The study suggests that healthcare management and policymakers should implement programs to improve job satisfaction and reduce workload, especially for foreign nurses working in critical areas, including the five departments mentioned.

BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF SURGICAL SITE INFECTIONS IN A TEACHING HOSPITAL

Objective: Surgical site infections (SSI) are defined as infections occurring within 30 or 90 d after surgical operation or within 1 y, if an implant is left in place after procedure and affecting either incision or deep tissues at the operation site. SSI is one of the quality indicators of the healthcare system. Due to advent of newer antibiotics and emergence of multidrug-resistant bacteria, SSI requires reappraisal of the microbiological flora and in vitro antibiotic sensitivity pattern. The aim of the present study is to determine the incidence etiology of SSI, and determine their Antibiogram. Methods: Cross-sectional study conducted for a period of three months from January 2024 to March 2024. A total of fifty swabs/pus specimens from various types of surgical sites suspected to be infected on clinical grounds were collected from the post-operative wards of surgical departments and processed in Microbiology laboratory. Isolation and identification of bacterial agents were done as per standard protocols. Antimicrobial susceptibility testing was performed by Kirby-Bauer’s disc diffusion method. Results: Out of 50 samples, 32 were culture-positive. 87.50% showed monomicrobial growth and 12.50% showed polymicrobial growth. Analysis of bacterial profile shows Staphylococcus aureus (27.77%) was the predominant isolate, followed by Pseudomonas aeruginosa (19.44%) and Escherichia coli (19.44%). Antibiogram of gram-positive isolates showed sensitivity to Teicoplanin, Vancomycin, and linezolid, whereas gram-negative isolates were sensitive to Meropenem, Piperacillin-tazobactam and levofloxacin. Conclusion: Status of SSI is the main quality indicators of hospital infection control and prevention measures. Continuous surveillance on etiology and antibiogram of SSI is necessary to monitor antimicrobial resistance and guide in empirical treatment.

Serum Glial Fibrillary Acidic Protein as a Blood Biomarker in Relapsing Remitting Multiple Sclerosis Egyptian Patients

Abstract Background Multiple sclerosis (MS) is a neurodegenerative disease with various clinical subtypes. Glial fibrillary acidic protein (GFAP) is significantly elevated in the cerebrospinal fluid (CSF) of MS patients compared with that of healthy controls and serum concentrations have been shown to reflect CSF levels. Objectives The aim of this study was to evaluate serum levels of GFAP in relation to disease activity in relapsing-remitting MS patients and to compare them with those of healthy controls. Subjects and Methods This case-control study involved 45 RRMS patients; 21 in relapse and 24 in remission, and 45 healthy individuals as age- and sex-matched controls. Blood samples were taken from the patients at inpatient ward and outpatient clinic of Neurology Department of Ain Shams University hospitals and the serum levels of GFAP were determined using the enzyme-linked immunosorbent assay (ELISA) technique. Results Patients in relapse showed higher serum concentration of GFAP than that of patients in remission and this result was highly significantly different (p = 0.000). ROC curve of serum GFAP demonstrated at cut off point &amp;gt;200 pg/ml, it yielded a sensitivity of 76% being in relapse and specificity of 82%. Conclusion GFAP biomarker is an indicator of disease activity in RRMS patients and its serum level may correlate with the state of disease activity.

15 Years Survival of Budd-Chiari Patients in a Single Center Study

Abstract Background Budd–Chiari syndrome (BCS) is a heterogeneous group of clinical conditions ranging from acute liver failure to completely asymptomatic patient. It is caused by hepatic venous outflow obstruction at any level from the small hepatic veins (HVs) to the junction of inferior vena cava (IVC) with the right atrium. Aim of the Work: The idea of this work was to report the result so favast clinical experience over 15 years presented by Tropical medicine department Ain Shams University through analysing the patient and disease characteristics, outcome, complications and innovations in therapeutic intervention. Ultimately this should throw lights on the understanding of the pathophysiology causes and clinical consequences of BCS among Egyptian patients. Patients and Methods 199 Egyptian patients with confirmed diagnoses of primary BCS were evaluated regarding their socio-demographic features, etiology, risk factors for BCS, clinical manifestations, management modalities and outcomes. The studied patients were enrolled from patients presented to Budd chiari study group clinic, Tropical Medicine Department ward, Ain Shams University hospitals, from January 2006 till December 2021. Results The commonest complaints in Budd Chiari patients were abdominal enlargement in 79.9% (159 patients) and abdominal pain in 77.9% (155 patients), Ascites was present in 75.4% (150), Hepatomegaly in 75.4% (150), Splenomegaly 61.8% (123). More than Seventy Seven percent (77.9%) of the enrolled patients were Chronic BCS patients, 12.6% were subacute BCS and 9.5% were acute BCS. In this study the leading cause of Budd-Chiari was FVLM 76 patients (38.2%). Several papers concluded that FVLM is the main or leading etiology to BCS but regarding the other papers that showed different results, these differences might possibly be due to the difference in sample size. In the current study the outcomes varied from one etiological factor to the other as in FVLM 78.7% of the BCS FVLM patients were compensated, 14.7% were decompensated and 6.7% died and these results were highly significant. Conclusion It seems that TIPS creation is an effective treatment for eligible BCS patients and has long-term survival benefit with satisfactory shunt patency and patient survival. The outcome of TIPS has improved over the years due to the increase in the operator experience and the availability of PTFE-covered stents.

One-day surgery: treatment of grade 3–4 hemorrhoids in a day patient department

Introduction. “One-day surgery” expands the possibilities of providing surgical care in a polyclinic with hospitalization for just one day. This area of medicine allows you to use the most effective method of treating hemorrhoids in a polyclinic – the operation hemorrhoidectomy.Aim. To substantiate the effectiveness of performing hemorrhoidectomy surgery in patients with stage 3–4 hemorrhoids in a day hospital of a polyclinic under the program “One-day surgery” with accelerated recovery of patients.Materials and methods. The main principle for performing hemorrhoidectomy surgery in a day hospital is a careful selection of patients. Closed hemorrhoidectomy with restoration of the anal canal mucosa (by Parks – Milligan – Morgan’s in the second modification of the State Research Center of Coloproctology) under spinal or general anesthesia is the surgery of choice for hemorrhoids treatment in the day patient department of a clinic. 138 surgeries were performed in the day patient department during 2 years and 10 months. After surgery, patients were placed in the surgical day-patient department wards for 3–5 hours until full activation. Then they were allowed to go home without being accompanied by a medical worker. The satisfaction of patients with the program was analyzed by a survey with a 5-point scale.Results. The timing of scheduled operations for patients has been shortened. The number of complications after hemorrhoidectomy in the early postoperative period was decreased, without long-term postoperative complications. The treatment of such patients in the surgical day-patient department demonstrated a good economic effect. The overall satisfaction with the one-day surgery program was very high (4.82). The results confirmed the effectiveness of this area of medicine.Discussion. Our experience of performing hemorrhoidectomy operations in a day surgical hospital for 3 years confirms the existence of a number of advantages over treating patients in a 24-hour hospital.Conclusions. The “One-day Surgery” and accelerated patient recovery programs expand the possibilities for treating patients with stage 4 hemorrhoids directly in the polyclinic, and thus reduce the burden on the surgical hospital.

AUDIT OF COVID-19 WARD PERFORMANCE AND PRACTICE IN THE COVID-19 PANDEMIC: FUTURE DIRECTIONS FOR UNDERSTANDING: A RETROSPECTIVE STUDY

A retrospective study was conducted to assess the trend of the COVID-19 pandemic in the COVID Ward emergency and COVID Ward treatment departments of the Department of COVID Ward at POF Hospital Wah Cantt from January 2021 to January 2022. Data on every patient admitted to the COVID Ward department over a year was gathered retroactively. The following demographic factors were recorded: diagnosis, COVID-19 work-up, admission specialization, and COVID-19 ward vs. conservative therapy. In total, there were 156 patients, with 108 being primarily men (70.4%). Of these patients, 90 (72%) were admitted via the clinic, and 124 (46%) were admitted in May. One hundred five patients (62.8%) had a COVID-19 PCR, 135 had a chest x-ray (90.2%), and 56 patients (31.4%) had a chest HRCT. The orthopedic COVID Ward was the most common department for operational interventions, with 88.4% of patients undergoing operative care, despite the general COVID Ward being the busiest service line with 89 total patient admissions (43.1%). The study found that the existing local protocols for patient flow and COVID-19 crisis management are effective and practical. Hospitals should be prepared to redirect their resources to high-volume specialties like orthopaedics and general COVID Wards after the later COVID-19 waves. Arteriovenous fistula formation is a simple yet crucial technique that should only be discontinued in the event of a labor shortage.

Dehumanization in intensive care units and standard wards: A survey for a comparative cross-sectional study

ObjectivesDehumanization refers to the practice of treating patients as objects rather than individuals with dignity and respect. MethodsThis study explores dehumanization in healthcare, specifically mechanistic dehumanization and self-dehumanization, which can result in poor care and negative outcomes. A cross-sectional observational study was conducted using a dehumanization questionnaire given to 324 nurses in various departments. The study took place at ANONYMIZED, from September to November 2022. The questionnaire analyzed emotions like anger, impatience, and apathy, identified as key dehumanizing factors. ResultsResults indicated that these emotions were prevalent in nurses' perceptions of patients. Interestingly, while Intensive Care nurses often involved families in patient care, leading to higher satisfaction, ward department nurses sometimes viewed patient or family relationships as obstacles. Despite this, 66 % of nurses reported satisfaction with the care provided, while 12 % were indifferent. ConclusionsThe study concludes that the root of dehumanization lies in nurses' inability to feel emotions, the impersonality of care, and the sterility of assistance, leading to self-dehumanization. To combat this, the study suggests strengthening nursing autonomy and education and fostering a positive work environment. The way nurses perceive themselves directly impacts their treatment of patients.

Factors Affecting the Qualification Rate of Hand Disinfection Among Physicians: A Cross-Sectional Survey.

The objective of this study is to examine the qualification rate of hand disinfection in the surgical department wards and analyze the influencing factors. A surprise assessment was carried out to evaluate the daily adherence to hand hygiene protocols in the surgical department wards. We aimed to investigate the factors that impact the qualification rate of hand disinfection. In this study, the qualification rate of hand disinfection was determined to be 64.38%. Notably, this rate exhibited significant variations based on gender, age, surgical site, and department category. Specifically, the qualification rate of hand disinfection among female participants stood at 82.35%, surpassing the qualification rate observed among male counterparts of 52.83%. Furthermore, doctors in the age group of 41-50 years demonstrated the highest qualification rate, and the abdominal surgical site exhibited the most noteworthy qualification rate, reaching 79.49%. The outcomes of the multiple logistic regression analysis highlighted the significance of age and gender as influential factors impacting the qualification rate. Specifically, doctors aged 51 years or older exhibited the lowest hand hygiene compliance, whereas female doctors demonstrated a notably higher qualification rate compared to their male counterparts. The disheartening qualification rate of hand disinfection highlights a concerning lack of awareness regarding hand hygiene among surgeons in their professional duties. Consequently, targeted interventions are imperative, focusing on intensified training, educational initiatives, enhanced supervision, and internal performance evaluations for key groups. The findings not only serve as a valuable database but also offer a viable roadmap for similar hospitals to reinforce the management of nosocomial infections.

Determinants of Early Initiation of Breastfeeding after Cesarean Section in aTertiary Care Hospital

Objectives: To assessthe determinants of early initiation of breastfeeding (EIBF≤1 hr.) after cesarean section in a tertiary care hospital and to determine the perception of WHO breastfeeding recommendations among mothers. Material and Methods: An analytical cross-sectional study was conducted in Post-operative ward of obstetrics department of Services Hospital Lahore. Duration of Study was (9 October 2022 to 9 January, 2023). Sample size of 246 was calculated. Sampling technique was used purposive sampling. All mothers who had cesarean section deliveries were included except terminally ill. Data was analyzed by SPSS 26 using Binary logistic Regression . Results: Only 13.4% of mothers started breastfeeding within 1 hour after caesarean section. Adverse effects of analgesics (opioids) on milk production and delayed skin-to-skin contact immediately after delivery contributed for delay in EIBF. Conclusion: Delay in EIBF is attributed to decreased production of milk due to analgesics(opioids used for labour pain ) and non-practicing of immediate skin-to-skin contact. Perception regarding breastfeeding among mothers was good.

PREVALANCE OF JAPANESE ENCEPHALITIS IN PATIENTS PRESENTING WITH ACUTE ENCEPHALITIS SYNDROME IN A TERITARY CARE HOSPITAL OF NORTH EASTERN STATE - TRIPURA

Introduction: Japanese encephalitis virus (JEV) is an arthropod-borne flavivirus, which has a wide distribution in many countries of Asia, Western Pacific and in northern Australia. Twenty-four countries from South-East Asia, Western Pacific regions are endemic for this disease and more than three billion people are at risks of infection. This study is conducted to observe the clinicodemographic profile and prevalence of Japanese Encephalitis in patients presenting with Acute Encephalitis Syndrome Methods: An observational longitudinal study was carried over a period of 8 months from January 2023 to august 2023 among 80 indoor patients admitted in department of medicine of a tertiary care hospital in North-Eastern state in Tripura. Results: Total of 80 patients were admitted in male and female wards of Department of Medicine who were diagnosed to have Acute Encephalitis Syndrome. Among 80 patients 58(72.5%) were male and 22(27.5%) were female. Out of 80 patients 60(75%) serum samples were taken and 20(25%) CSF samples were taken of which 9(11.25%) patients were tested positive for serum and 5(6.25%) tested for CSF respectively. Mean age group of patients with positive results was 50.80±10.35. Most common presentation was fever(100%) followed by focal neurological deficit(57%), headache and vomitings (30%), coma(8%), convulsions(15%) and meningeal signs(30%). Out of 14 patients who were positive for JE 12(86%) patients were from rural areas and 2(14%) people were from urban areas. Out of 14 patients 10(71%) were male and 4 patients(29%) were female respectively. Conclusion: In this study we found that a considerable number of patients are suffering from Japanese Encephalitis which enhances and enlightens our knowledge to think about the disease and its complications to prevent the increasing mortality rates among the patients and create awareness among them as most of them are from rural areas.

Characteristics of cancer-related fatigue and its correlation with anxiety, depression, and stress-related hormones among Chinese cancer survivors: a cross-sectional study.

Fatigue is a common source of distress for cancer survivors. The severity of cancer-related fatigue varies significantly, which may be due to individual differences in host factors. This cross-sectional study aims to explore how demographic, oncological, sociological, psychological, and stress-related hormones levels interact to influence the distinct experiences of fatigue (Cancer-related fatigue [CRF] occurrence and fatigue degree). A cross-sectional study carried out at the oncology outpatient and ward department of Xiyuan Hospital of China Academy of Chinese Medical Sciences recruited 306 cancer patients between January 2021 to December 2021. General information, fatigue, psychological factors was evaluated by general information questionnaire, the Revised Piper's Fatigue Scale-Chinese Version (RPFS-CV), and the self-report Hospital Anxiety and Depression Scale (HADS). Stress-related hormones were measured with chemiluminescent enzyme immunoassay (Zhengzhou Antobio). 306 patients were included, 229 (74.8%) were diagnosed with CRF, including 94 (41.0%) with mild fatigue, 121 (52.8%) with moderate fatigue, and 14 (6.1%) with severe fatigue. Multivariate regression analysis showed that higher depression scores, aldosterone levels may increase the risk of CRF. Patients who are obese (Body mass index ≥ 28 kg/m2) may help to reduce the risk of CRF. Other contributing factors for increased levels of fatigue (p< 0.05) include being female, having anxiety, depression and high aldosterone levels. The research suggested that CRF was a common symptom in cancer survivors and pay attention to these influencing factors may help to better identify patients susceptible to fatigue and provide long-term, targeted interventions.

Estimation of Foetal Weight by Ultrasonography and Neonate at Birth

Background: Ultrasonography intervention in delivery is highly sensitive and primary important for further tests of foetal well-being. Objective: The purpose of the present study was to observe the correlation of estimated foetal weight with neonatal birth weight. Methodology: This was a cross-sectional study on patients at the Labour Ward of Department of Obstetrics and Gynaecology at Sir Salimullah Medical College and Mitford Hospiptal, Dhaka, Bangladesh for six months. The women were selected who had normal pregnancy with early ultrasounographic examination for confirmation of gestational age, singleton live foetus, ultrasound examination for pregnancy profile done within 3 days before delivery. A sonographic foetal weight was estimated by using measurements of foetal body parts-biparietal diameter, abdominal circumference and femoral length. To measure the femur length, first a projection was made that shows a transverse section of one of the long bones, then scan at 900 to this to obtain a longitudinal section. Results: A total number of 100 patients were recruited for this study. The mean (±SD) sonographically estimated foetal weight was 3074±534gm with ranged from 2100 to 4100 gm. The mean (±SD) neonatal birth weight was 2978±466 gm with ranged from 2500 to 3800 gm (p&lt;0.05). Sonographically estimated foetal weight less than 3000 g were correlated with neonatal birth weight. Out of the 100 cases 57(57.0%) cases had less than 3000 g estimated foetal weight and 43(43.0%) cases had 3000 g or more than 3000gm estimated foetal weight Sonographically. Among the 57 cases, which were less than 3000 g by Sonographically, 41 cases were less than 3000 g and 16 cases were found 3000 g or more than 3000 g in neonatal birth weight. Conclusion: Ultrasonography has definite value in the diagnosis of estimated foetal weight and can be regarded as a sensitive and specific imaging modality for pre-operative discrimination of the pregnant women. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):42-47

A Study Comparing Various Phenotypic Techniques for Finding Enterobacteriaceae with Extended-Spectrum Beta-lactamases in Urinary Tract Infections of a Tertiary Care Facility

Background: Enterobacteriaceae is a group of facultative and nonsporing gram-negative anaerobes. These are the significant contributors to community-acquired and nosocomial illnesses. They have the potential to infect the urine, respiratory, bloodstream, and skin. Antibiotic resistance is on the rise and has been a worldwide problem, where the gram-negative Enterobacteriaceae group of bacteria is the main culprits. Materials and Methods: The current study was conducted in a tertiary care institution of Tamil Nadu between June 2019 and March 2020 after getting ethical committee clearance from the institution review board. Patients attending outpatient departments and inpatient wards of various departments, with increased frequency or urgency of urination, fever, lower abdominal or flank pain, dysuria, and suprapubic tenderness which are suggestive of upper and lower urinary tract infections (UTIs) were considered into the study through a purposive sampling method. Results: A sum of 400 urine samples was collected from individuals with UTI-like symptoms who were inpatients and outpatients and ranged in age from 0 to 80 years. Of the 400 cases, 24.5% were children under the age of 12 years. 34% of people in the population were below the age of 13 years, 16.5% were between 25 and 44 years, and 26% were over 60 years. One hundred and fifty-four out of the 400 specimens that were collected showed a significant increase, and the prevalence of UTI was 38.50%. Conclusion: A health-care facility’s institutional antibiotic strategy can be modified based on the prevalent rate of extended-spectrum beta-lactamases generation to improve treatment outcomes and lower health-care expenses.

A Syudy on Comparative Evaluation of Four Different Methods to Quantify Proteinuria in Pre-Eclampsia in a Tertiary Care Hospital

Background: Preeclampsia is a progressive, multisystem disorder due to spasm of small blood vessels of all organ systems characterized by new-onset hypertension and end- organ dysfunction in the last half of pregnancy. Objectives: Estimation of proteinuria by sulphosalicylic acid test in women with preeclampsia. Material &amp; Methods: Prospective hospital based clinical study. Study conducted in the Department of Obstetrics and Gynaecology, Murshidabad Medical college, Berhampore, Murshidabad, West Bengal. Sep. 2021 - Aug. 2022. Pregnant women after 20weeks of gestation diagnosed as preeclampsia and admitted in antenatal ward in obstetrics and gynaecology department, Murshidabad Medical college, Berhampore, Murshidabad, West Bengal. Study consisted a total of 100 subjects. Simple Random sampling method. The pregnant women diagnosed as preeclampsia meeting the inclusion and exclusion criteria included in the study. The study comprised of pregnant women who are more than 20 weeks of gestation diagnosed as preeclampsia fulfilling the inclusion and exclusion criteria. Written and informed consent was taken from all pregnant women participating in the study. The pregnant women in the study were subjected to a detailed history and general abdominal and pelvic examination. A first voided morning urine sample was obtained for sulphosalicylic acid test, dipstick test, spot urine PCR. Subsequent urine samples were collected for 24 h, including a next-day first-morning voided sample for the 24-h urine protein estimation. Results: On assessment of the ROC curve to assess the predictability of three methods for spot urine compared against the 24hr urine protein estimation, the AUC for the Sulphosalicylic acid was found to be significantly better (AUC=0.970, p&lt;0.05) compared to the urinary PCR (AUC=0.964, p&lt;0.05) and for urinary dipstick it was AUC=0.784, p&lt;0.05. Conclusion: This study concluded that spot urine sulphosalicylic acid and urine protein creatinine ratio are reliable investigations compared to the dipstick method to assess the proteinuria in hypertensive pregnant women or for diagnosis of pre-eclampsia. So, spot urine Sulphosalicylic acid and urine protein-creatinine ratio can be used for detection of proteinuria in pregnant women with suspected pre-eclampsia with high accuracy, which is more rapid than time consuming 24-hour urine protein estimation

A 5-Year Retrospective Analysis of Antibiotic Utilisation Pattern by AWaRe Classification in Qatar

Background: To analyse the trend and pattern of antibiotic consumption rates over a period of five years in a secondary care hospital in Qatar. Consumption of antibiotics is a crucial factor in the evaluation of antibiotic usage.&#x0D; Methods: To measure and compare a five-year antibiotic consumption trend in inpatient department wards using Defined Daily Dose (DDD) per 100 bed days (DDD/100-BD). Antibiotics dispensed between January 2018 and December 2022 were evaluated. Data collection was done using Microsoft Excel. The analysis was done using the World Health Organization (WHO) AWaRe classification of antibiotics.&#x0D; Results: The analysis showed that antibiotic consumption significantly increased from 2018 (4.11 DBD) to 2020 (15.55 DBD) and then sustained thereafter. Widely used antibiotic belongs to the third generation cephalosporins which is under Watch class of antibiotics. Ceftriaxone, cefuroxime, and amoxicillin clavulanate were the most consumed antibiotics in the hospital throughout the study period at 53.92 DBD, 32.22 DBD and 21.65 DBD respectively.&#x0D; Conclusion: Establish benchmarking at the facility level. We observed the use of ceftriaxone is more as surgical prophylaxis, which is a Watch group of antibiotics, however there is zero use of restricted antimicrobials. Increase in parenteral fluroquinolone especially levofloxacin needs monitoring, which is not included in WHO essential list of medication. There is a scope to measure the appropriateness of antibiotics, as well as the duration of therapy. The goal of WHO Target ≥60% of total antibiotic consumption being Access group antibiotics can be used as an index to analyse the comparative use Watch and Access group of antibiotics.

Blood Products Utilization Status in Off-Pump Cardiac Surgery Patients.

Background: Transfusion support has an essential role in coronary artery bypass graft (CABG). The time-honored gold standard for CABG is the on-pump procedure (ONCAB); however, off-pump coronary artery bypass (OPCAB) is also a safe, cost-benefit procedure with fewer blood transfusion requirements. This study was performed to evaluate transfusion patterns in OPCAB due to the diversity of transfusion practices. Materials and Methods: This retrospective study was performed to determine the transfusion rate and triggers in OPCAB patients. Medical files of all patients undergoing OPCAB surgery at Sanandaj Tohid Hospital in 2014 were reviewed. Patients' demographics data, preoperative laboratory tests (PT, aPTT, Hb, Hct, Platelet count), underlying medical conditions, and their possible relation to further transfusions and the ward department in which the transfusion had taken place were extracted. SPSS 16 Chicago software, T-student Test, One Way Anova, and χ2 exam were applied for data analysis. P values ≤0.05was considered significant. Results: Among 91 elective OPCAB patients: 28(30.8%) women and 63(69.2%) men with mean age of 64.80±9.02 years, 63(69.23%) received a blood product. Mean utilization of PRBC, FFP, Platelet, and Cryoprecipitate were 2.17±2.044, 2.46±2.86, 2.86±3.80 and 0.40±2.10 units, respectively. ICU revealed the highest consumption rate for all products. Female sex (p<0.001), Hypertension (P=0.002), and low hemoglobin(P=0.004) were noted as predictive factors for transfusion. Conclusion: This study concluded that the transfusion rate in OPCAB is still very high in Iran (regarding a study in a countryside hospital) and that the highest utilization rate is seen in the ICU.