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1

Clinical Features of Acute Gastroenteritis in Children at University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu  

PubMed Central

Background: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children world-wide with the highest incidence in the developing countries. The persistence and effect of this condition require a study of the features and characteristics of the disease especially, within any (each) locality in order to offer possible control solutions. Aim: To determine, the clinical and social characteristics associated with AGE among children seen in the University of Nigeria Teaching Hospital, Enugu. Subjects and Methods: A hospital-based population study in which children admitted in the children emergency room of the University of Nigeria Teaching Hospital whose parents/caregivers gave their consent were enrolled, over a 7 month period. Appropriate statistical tools: Chi-square, t-tests, correlation and logistic regression were used to determine significant values and associations. Results: A total of 76 children with AGE were enrolled; 69.7% (53/76) were males. The mean age of the subjects was 11.3 (6.6) months. Majority 94.7%, (72/76) of cases of AGE occurred in children less than 24 months, with children 6-11 months contributing the highest percentage 42%, (32/76). The study population was predominantly urban dwellers; 78.9%, (60/76, P = 0.40) and water cistern constituted 77.6% (58/76) of waste disposal method. Those who had potable water supply were 23.7%, (18/76, P = 0.30) and 19.7% of the children were exclusively breast fed. Fever and vomiting were the commonest associated symptoms, occurring in 82.9% (63/76) and 73.7% (56/76) of the subjects respectively. A good percentage of the subjects 64.5%, (49/76) had ORS before presentation. Conclusion: AGE is more common in older infants among those who were not exclusively breast-fed and the severity was unrelated to place of domicile and waste disposal habits. PMID:24116314

Ezeonwu, BU; Ibeneme, CA; Aneke, F; Oguonu, T

2013-01-01

2

Seroprevalence and correlates of human T-cell lymphoma/leukemia virus type 1 antibodies among pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria  

PubMed Central

Background Human T-cell lymphoma/leukemia virus (HTLV)-1 is a retrovirus transmitted vertically from mother to child parenterally and sexually by infected lymphocytes. Objective The objective of this study was to determine the seroprevalence of HTLV-1 antibodies and associated risk factors for HTLV-1 infection among pregnant women in University of Nigeria Teaching Hospital, Enugu, southeast Nigeria. Materials and methods A cross-sectional study was carried out from July to October 2010. Two hundred pregnant women were recruited consecutively from the antenatal clinic. Five milliliters of blood was collected from each of the participants into a plain sterile bottle and allowed to clot. The serum obtained was stored at ?20°C until required for analysis. The serum samples were then analyzed for antibodies to HTLV-1 using a one-step incubation double-antigen sandwich enzyme-linked immunosorbent assay kit. Participants’ demographic characteristics and degree of exposure to the risk factors associated with HTLV-1 infection were captured using a questionnaire. Statistical analysis of results was done using SPSS version 17. Results The average age of the pregnant women was 28.94 years (standard deviation 4.17). The age-group with the highest representation was those between the ages of 26 and 30 years. Thirty-six percent of the population was above 30 years old. The result of the tests showed that only one respondent, a 31-year-old pregnant woman tested positive for HTLV-1 antibodies. Therefore, the seroprevalence of HTLV-1 antibodies among pregnant women attending the antenatal clinic at University of Nigeria Teaching Hospital was 0.5%, with a 95% confidence interval of 0%–2.8%. Some of the sociodemographic risk factors of HTLV-1 infection found to be applicable to the 31-year-old woman who tested positive included positive history of previous sexually transmitted diseases, high parity, low socioeconomic status, female sex, and age above 30 years. The pregnant women that participated in this study were exposed to risk factors and behaviors associated with HTLV-1 infection. Some of the pregnant women (17.5%) had contracted sexually transmitted diseases, and 80.5% did not use condoms during coitus. Conclusion The seroprevalence obtained in this study was low, though it is 100% for anyone infected. More prospective and multicenter studies are required to determine the infectivity of HTLV-1 among pregnant women in Nigeria.

Okoye, Augustine Ejike; Ibegbulam, Obike Godswill; Onoh, Robinson Chukwudi; Ezeonu, Paul Olisaemeka; Ugwu, Ngozi I; Lawani, Lucky Osaheni; Anigbo, Chukwudi Simon; Nonyelu, Charles E

2014-01-01

3

Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria - a retrospective study  

PubMed Central

Background Congenital abnormalities are not uncommon among newborns and contribute to neonatal and infant morbidity and mortality. The prevalence and pattern of presentation vary from place to place. Many a time the exact etiology is unknown but genetic and environmental factors tend to be implicated. Methods The objective of this study was to determine the prevalence of congenital malformations among newborns admitted in a tertiary hospital in Enugu, the nature of these abnormalities and the outcome/prognosis. For purposes of this study, congenital abnormalities are defined as obvious abnormality of structure or form which is present at birth or noticed within a few days after birth. A cross-sectional retrospective study in which a review of the records of all babies admitted in the Newborn Special Care Unit (NBSCU) of the University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu over a four year period (January 2007-April 2011) was undertaken. All babies admitted in the unit with the diagnosis of congenital abnormality were included in the study. Information extracted from the records included characteristics of the baby, maternal characteristics, nature/type of abnormalities and outcome. Data obtained was analyzed using SPSS 13. Rates and proportions were calculated with 95% confidence interval. The proportions were compared using students T-test. Level of significance was set at P?teaching hospital in Enugu had congenital abnormalities and that the commonest forms seen were mainly surgical birth defects and includes cleft lip/cleft palate and neural tube defects. PMID:22472067

2012-01-01

4

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery  

E-print Network

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery Fort Collins, Colorado 80523-1602 Phone: 970.297.1269 On-call Anesthesia Post-Doc Post-Doctoral Veterinary Teaching Hospital College of Veterinary Medicine and Biomedical Sciences Position Summary: The Veterinary Teaching Hospital (VTH) at Colorado State University

5

Developing Marketing Strategies for University Teaching Hospitals.  

ERIC Educational Resources Information Center

University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, consumerism, and a declining urban population base. New marketing strategies are seen as ways in which teaching hospitals can achieve better relationships with institutions, practitioners, and surrounding communities and…

Fink, Daniel J.

1980-01-01

6

VETERINARY TEACHING HOSPITAL 1620 Campus Delivery  

E-print Network

.297.1269 EQUINE FIELD SERVICE VETERINARIAN Veterinary Teaching Hospital College of Veterinary Medicine an opening for a one-year postdoctoral fellowship as an Equine Field Service Veterinarian. Equine Field

Rutledge, Steven

7

Success factors in merging teaching hospitals.  

PubMed

Merger has served as a major strategy for the leaders of academic medical centers (i.e., teaching hospitals) who are pursuing health system development for their institutions. Applying hindsight to their personal experience, the authors explore common themes in several mergers that have survived the test of time. Although many elements influence merger outcomes, experience suggests several of unique importance. These include effective leadership in the areas of creating trust, managing uncertainty, ensuring medical staff stability, and bridging cultural divides across the organizations. While a quantitative business case should support any merger, the authors' experiences underscore the importance of successfully assessing and managing organizational and individual dynamics when bringing together major teaching hospitals. PMID:24362373

Thier, Samuel O; Kelley, William N; Pardes, Herbert; Knight, Amy Wimpey; Wietecha, Mark

2014-02-01

8

Jordanian nurses' job satisfaction and intent to stay: comparing teaching and non-teaching hospitals.  

PubMed

The aims of this study were to identify variables of Jordanian nurses' job satisfaction and intent to stay, compare the phenomena of interest in teaching and non-teaching hospitals, and correlate the two concepts of nurses' job satisfaction and intent to stay. A convenience sample of 433 nurses was obtained from three teaching hospitals and two non-teaching hospitals. Nurses were "neither satisfied nor dissatisfied" and were "neutral" in reporting their intent to stay at their current jobs. Nurses who were working in non-teaching hospitals reported higher job satisfaction and intent to stay rates than those working in teaching hospitals. Nurses' job satisfaction and intent to stay were at the borderlines, which require the immediate attention of nursing and hospital administrators. Nurses' job satisfaction and intent to stay, particularly in teaching hospitals, have to be promoted; thus, interventions have to be effectively initiated and maintained at the unit and organizational levels. PMID:17540315

Mrayyan, Majd T

2007-01-01

9

Paracetamol use (and/or misuse) in children in Enugu, South-East, Nigeria  

PubMed Central

Background Paracetamol (also known as acetaminophen) is the commonest available analgesic and anti-pyretic. It is readily accessed from pharmacy, patent medicine and provision shops as over the counter drug making it a potential drug of abuse, especially in children. We sought to find its use and/or misuse in children seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu. Objective To determine the dosage, formulation, and frequency of paracetamol administration to children by caregivers and factors associated with its use and/or misuse. Method An observational prospective study involving 231 children and their caregivers seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku - Ozalla, Enugu between June and November 2011 was undertaken. Data on paracetamol use before presentation to the clinic, in addition to demographic and other data were obtained from the caregivers using a structured questionnaire. Ethical consent for the study was obtained from the Hospital Ethics and Research Committee and informed consent was further obtained from the caregivers of the children. Results A total of 231 children aged six weeks to 16?years and their caregivers participated in this study. The mean ages of the children and their caregivers were 3.8 and 33.9?years, respectively. One hundred and thirty three of the children studied were males while 98 were females. Most of the children (75.6%) received paracetamol at home before presenting. Paracetamol tablet alone or in combination with the syrup was mostly used (60%) and this observation was made across all age groups. The commonest reason for using paracetamol tablet instead of the syrup was that it was more effective. Most caregivers relied on past experience (71.2%) rather than on enclosed information leaflet to decide the appropriate dosage. Half of the children also received other medications, mainly anti-malarials and antibiotics. Conclusions Paracetamol was commonly given to children on “self prescription” basis and the tablet formulation was most frequently used, with the possibility of misuse and overdose. Caregivers need to be educated on age-appropriate formulations which are less likely to lead to overdose. PMID:22812400

2012-01-01

10

78 FR 39730 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...  

Federal Register 2010, 2011, 2012, 2013

...Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...entitled ``Notification of Closure of Teaching Hospitals and Opportunity to Apply for...of the city in which one of the closed teaching hospitals was located....

2013-07-02

11

Laparoscopic Appendectomy in a Nigerian Teaching Hospital  

PubMed Central

Objective: Laparoscopic appendectomy in a setting where resources are poor is still controversial. This study evaluates the impact of laparoscopy on the early outcome of acute appendicitis in a developing country. Methods: All patients who underwent appendectomy from January 2010 through June 2011 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were recruited for this study. Results: Of the 139 patients with acute appendicitis within the study period, 83 (59.7%) had open appendectomy (OA), 19 (13.7%) whose clinical and radiological findings suggested complicated appendicitis at presentation had laparotomy, while 37 (26.6%) had laparoscopic procedures. In the laparoscopy group, initial diagnostic laparoscopy in 4 (10.8%) patients revealed a normal appendix along with other findings that precluded appendectomy. Laparoscopic appendectomy (LA) was then performed in 33 (23.7%) patients with 2 of these (6.1%) requiring conversion to open laparotomy. Mean time for the LA procedure was higher than that observed for OA (56.2 vs 38.9 min). Patients in the LA group had a shorter mean postoperative stay (1.8 vs 3.0). Wound infection occurred in 2 (6.5%) patients from the LA group and 8 (9.6%) from OA. Conclusion: Laparoscopic appendectomy reduced the rate of unnecessary appendectomy and postoperative hospital stay in our patients, potentially reducing crowding in our surgical wards. We advocate increased use of laparoscopy especially in young women. PMID:23484567

Alatise, Olusegun I.; Arowolo, Olukayode A.; Lawal, Oladejo O.

2012-01-01

12

Duration and determinants of inter-birth interval among women in Enugu, south-eastern Nigeria.  

PubMed

The difference in fertility levels of any given two societies has a relationship with the interval between births. We determined the duration of inter-birth interval and the determinants of short inter-birth interval in Enugu, Nigeria. Questionnaires were administered to a cross-section of 420 women consecutively recruited from the family planning and antenatal clinics of two hospitals in Enugu metropolis. The mean age was 30.9 ± 5.1 (range 20-44) years. The median inter-birth interval was 21.5 months and the prevalence of modern contraceptive use among respondents was 18.1%. Women's age of 25 years or less, duration of breast-feeding of 10 months or less, and non-use of modern contraceptives had strong association (p < 0.05) with short inter-birth interval. The mean inter-birth interval in Enugu is short. Future child spacing campaign in Enugu should target the encouragement of longer breast-feeding practices and increased uptake of modern contraception among our women. PMID:23445143

Dim, C C; Ugwu, E O; Iloghalu, E I

2013-02-01

13

Psychiatry in a postgraduate teaching hospital  

PubMed Central

A study is presented of 217 adults referred for psychiatric assessment from the wards of a postgraduate teaching hospital. The pattern of referral and the disproportionate importance of disturbed behaviour amongst referrals from non-medical wards are discussed. The main diagnostic groups, namely, affective disorders, organic states, psychogenic somatic symptoms and attempted suicide, are tabulated and discussed. Complex problems of diagnosis and management were common and are considered under five headings: multiple pathology; the effects of intensive treatment procedures; language and cultural differences, and difficulties in follow-up. It is concluded that the problems met in this specialized setting are likely to become general as intensive treatment and diagnostic procedures become more widespread. The importance of organic reactions is stressed and their relative neglect by both psychiatrists and physicians commented on. The frequency of social precipitants of affective disorders and attempted suicide, however, is considered to emphasize the range of activities required of the psychiatrist in even the most technologically advanced centres. PMID:5098915

Abrahamson, David

1971-01-01

14

Environmental Ethics of Health Mission To Enugu Nigeria  

Microsoft Academic Search

\\u000a The Enugu USA Medical Mission is a humanitarian year round mission to provide free health care to the people of Enugu State\\u000a of Nigeria who are underserved and less privileged. The purpose of the Enugu USA Medical Mission is to contribute to solutions\\u000a that solve health issues. Toxic chemicals contaminate drinking waters, build up in human organs and bones, and

Godfrey A. Uzochukwu; Mary E. Uzochukwu; Ethelbert Odo

15

78 FR 32663 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...  

Federal Register 2010, 2011, 2012, 2013

...Notification of Closure of Teaching Hospitals and Opportunity To Apply for Available...announces the closure of two teaching hospitals and the initiation of an application process where hospitals must apply to the Centers for...

2013-05-31

16

Candiduria in hospitalized patients in teaching hospitals of Ahvaz  

PubMed Central

Background and Objectives Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. Materials and Methods During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. Results In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Conclusion Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy. PMID:23205252

Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

2012-01-01

17

Patient readmission to critical care units during the same hospitalization at a community teaching hospital  

Microsoft Academic Search

The incidence and cause of patient readmission, during the same hospitalization, to a critical care unit was studied in an urban community teaching hospital. During a 12-month period, there were 1069 admissions to the critical care units with 640 patients being at risk for readmission. The readmission rate was 11.7%. Prematurity of transfer out of a critical care unit may

W. Baigelman; R. Katz; Geraldine Geary

1983-01-01

18

Hurricane Katrina's Impact on Tulane's Teaching Hospitals  

PubMed Central

On Monday, August 29, 2005 Hurricane Katrina passed east of New Orleans causing minimal damage to Tulane's Medical Center. Later that day, levees that protected the city failed and several feet of water entered the hospitals and school buildings. Emergency generators provided power for 36 hours before running out of fuel. Temperatures in the hospitals soared into the upper 90's and conditions were made intolerable by 100% humidity and backed-up sewage. For several days, faculty, residents, nurses and hospital personnel performed heroically, caring for patients in appalling conditions, hand-ventilating critically ill patients in shifts. Approximately 200 patients, and 1500 additional personnel would be evacuated on Wednesday and Thursday from a makeshift heliport on Tulane's parking garage. Current disaster plans may be inadequate should facilities be inaccessible for months because of damage or contamination. Contingency plans also need to be made should outside disaster relief be markedly delayed as was the case with Katrina. PMID:18528490

Taylor, Ian L.

2007-01-01

19

Innovative Model for Information Assurance Curriculum: A Teaching Hospital  

ERIC Educational Resources Information Center

A novel idea for information security education created by the New York State Center for Information Forensics and Assurance (CIFA) is presented. This new approach incorporates a teaching hospital model originally developed for medical training. In this model, information security problems from industry and government are solved and abstracted…

Goel, Sanjay; Pon, Damira; Bloniarz, Peter; Bangert-Drowns, Robert; Berg, George; Delio, Vince; Iwan, Laura; Hurbanek, Thomas; Schuman, Sandoor P.; Gangolly, Jagdish; Baykal, Adnan; Hobbs, Jon

2006-01-01

20

Surveillance of Staphylococcus aureus in Veterinary Teaching Hospitals  

Microsoft Academic Search

Staphylococcus aureus isolates (n 70) from 65 patients (36 canine, 18 equine, 7 bovine, 2 avian, and 2 feline) at seven veterinary teaching hospitals in the United States were studied. The majority of patients (83%) with an S. aureus infection were canine and equine, but this may have reflected a sample bias based on clinic case loads and diagnostic lab

John R. Middleton; William H. Fales; Christopher D. Luby; J. Lindsay Oaks; Susan Sanchez; Joann M. Kinyon; Ching Ching Wu; Carol W. Maddox; Ronald D. Welsh; Faye Hartmann

2005-01-01

21

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.  

Code of Federal Regulations, 2013 CFR

...payment: Assistants at surgery in teaching hospitals. 415.190 Section...PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.190...

2013-10-01

22

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.  

Code of Federal Regulations, 2012 CFR

...payment: Assistants at surgery in teaching hospitals. 415.190 Section...PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.190...

2012-10-01

23

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.  

Code of Federal Regulations, 2011 CFR

...payment: Assistants at surgery in teaching hospitals. 415.190 Section...PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.190...

2011-10-01

24

A survey of digital radiography practice in four South African teaching hospitals: an illuminative study  

Microsoft Academic Search

Purpose: The purpose of this study was to assess radiographer familiarity and preferences with digital radiography in four teaching hospitals and thereafter make recommendations in line with the migration from screen film to digital radiography. Materials and Methods: A questionnaire was designed to collect data from either qualified or student radiographers from four teaching hospitals. From the four teaching hospitals,

T Nyathi; TF Chirwa

2010-01-01

25

Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital  

PubMed Central

OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ?18 years with a length of stay ?24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%), fatigue (12.3%), and chest pain (9.0%). Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases. PMID:24626940

Varallo, Fabiana Rossi; Capucho, Helaine Carneiro; da Silva Planeta, Cleopatra; de Carvalho Mastroianni, Patricia

2014-01-01

26

Six years' experience of symphysiotomy in a teaching hospital.  

PubMed

One hundred and sixty-one symphysiotomies were performed at Harari Maternity Hospital, Rhodesia, over a 6-year period. Indications for the operation are discussed and fetal and maternal results reviewed. Seventy-two patients suffered from postoperative complications but the majority of these were minor and of short duration. Multiparous patients did not have a higher morbidity than did primiparous ones. It is concluded that symphysiotomy has a useful role to play in a teaching hospital, provided it is performed by an experienced surgeon on carefully selected patients. PMID:746479

Norman, R J

1978-12-30

27

Teaching hospital performance: towards a community of shared values?  

PubMed

This paper explores the performance dimensions of Italian teaching hospitals (THs) by considering the multiple constituent model approach, using measures that are subjective and based on individual ideals and preferences. Our research replicates a study of a French TH and deepens it by adjusting it to the context of an Italian TH. The purposes of this research were as follows: to identify emerging views on the performance of teaching hospitals and to analyze how these views vary among hospital stakeholders. We conducted an in-depth case study of a TH using a quantitative survey method. The survey uses a questionnaire based on Parsons' social system action theory, which embraces the major models of organizational performance and covers three groups of internal stakeholders: physicians, caregivers and administrative staff. The questionnaires were distributed between April and September 2011. The results confirm that hospital performance is multifaceted and includes the dimensions of efficiency, effectiveness and quality of care, as well as organizational and human features. There is a high degree of consensus among all observed stakeholder groups about these values, and a shared view of performance is emerging. Our research provides useful information for defining management priorities to improve the performance of THs. PMID:24560230

Mauro, Marianna; Cardamone, Emma; Cavallaro, Giusy; Minvielle, Etienne; Rania, Francesco; Sicotte, Claude; Trotta, Annarita

2014-01-01

28

Maternity and parental leave policies at COTH hospitals: an update. Council of Teaching Hospitals.  

PubMed

Because residents' demands for parental leave are increasing, updated information about maternity and paternity leave policies was solicited from hospitals that are members of the Council of Teaching Hospitals (COTH) of the AAMC. A 20-item questionnaire, combining forced-choice categories and open-ended questions, was faxed to 405 COTH hospitals in October 1994; 45% responded. A total of 77% of the respondents reported having written policies for maternity and/or parental leave; in 1989, only 52% of COTH hospitals had reported having such policies. Forty-one percent of the 1994 responding hospitals offered dedicated paid maternity leave, with a mean of 42 days allowed. Twenty-five percent of the respondents offered paternity leave, and 15% offered adoption leave. It is encouraging that the majority of the teaching hospitals that responded to the survey had adopted written policies, but the 23% without written policies remain a source of concern. Well-defined policies for maternity, paternity, and adoption leave can reduce stress and foster equity both for trainees requiring leave and for their colleagues. PMID:7575938

Philibert, I; Bickel, J

1995-11-01

29

Use of hospital beds: a cohort study of admissions to a provincial teaching hospital.  

PubMed Central

An instrument was developed to study the use of hospital beds and discharge arrangements of a cohort of 847 admissions to the John Radcliffe Hospital, Oxford, for a three week period during February-March 1986. For only 38% of bed days were patients considered to have medical, nursing, or life support reasons for requiring a provincial teaching hospital bed. The requirements for a bed in the hospital decreased with the patient's age and length of stay in hospital. For only a tenth of patients was the general practitioner concerned in discussions with hospital staff about the patient's discharge and less than one third of patients had been given more than 24 hours' notice of discharge. Several features might increase the proportion of bed days that are occupied by patients with positive reasons for being in hospital. Among these are an increased frequency of ward rounds by consultants, or delegating discharge decisions by consultants to other staff; providing diagnostic related protocols for planning the length of stay in hospital; planned discharges; and providing liaison nurses to help with communication with primary care staff. PMID:3140977

Anderson, P.; Meara, J.; Brodhurst, S.; Attwood, S.; Timbrell, M.; Gatherer, A.

1988-01-01

30

Hospital volume, hospital teaching status, patient socioeconomic status, and outcomes in patients hospitalized with sickle cell disease  

PubMed Central

Sickle cell disease (SCD) accounts for ~100,000 hospitalizations in the US annually. Quality of care for hospitalized SCD patients has been insufficiently studied. Therefore, we aimed to examine whether four potential determinants of quality care, [1] hospital volume, [2] hospital teaching status, [3] patient socioeconomic status (SES), and [4] patient insurance status are associated with three quality indicators for patients with SCD: [1] mortality, [2] length of stay (LOS), and [3] hospitalization costs. We conducted an analysis of the 2003–2005 Nationwide Inpatient Sample (NIS) datasets. We identified cases using all ICD-9CM codes for SCD. Both overall and SCD-specific hospital volumes were examined. Multivariable analyses included mixed linear models to examine LOS and costs, and logistic regression to examine mortality. About 71,481 SCD discharges occurred from 2003 to 2005. Four hundred and twenty five patients died, yielding a mortality rate of 0.6%. Multivariable analyses revealed that SCD patients admitted to lower SCD-specific volume hospitals had [1] increased adjusted odds of mortality (quintiles 1–4 vs. quintile 5: OR, 1.36; 95% CI, 1.05, 1.76) and [2] decreased LOS (quintiles 1–4 vs. quintile 5, effect estimate ?0.08; 95% CI, ?0.12, ?0.04). These are the first data describing associations between lower SCD-specific hospital volumes and poorer outcomes. PMID:21442644

McCavit, Timothy L.; Lin, Hua; Zhang, Song; Ahn, Chul; Quinn, Charles T.; Flores, Glenn

2014-01-01

31

Dental and Oral Surgery Service Clinician Colorado State University Veterinary Teaching Hospital  

E-print Network

Dental and Oral Surgery Service Clinician Colorado State University Veterinary Teaching Hospital The Veterinary Teaching Hospital at Colorado State University is offering a one-year postdoctoral fellowship preferably in a Veterinary Hospital setting. Preference will be given to individuals with a background

32

Assistant Professor, Dentistry and Oral Surgery Department of Clinical Sciences, James L. Voss Veterinary Teaching Hospital  

E-print Network

Veterinary Teaching Hospital College of Veterinary Medicine and Biomedical Sciences Colorado State University Teaching Hospital (VTH). This includes overseeing interns as well as junior and senior PVM students while. Administrative: Participate in Hospital, Department, College, and University administrative committees as well

Stephens, Graeme L.

33

Assistant Professor, Dentistry and Oral Surgery Department of Clinical Sciences, James L. Voss Veterinary Teaching Hospital  

E-print Network

Veterinary Teaching Hospital College of Veterinary Medicine and Biomedical Sciences Colorado State University Teaching Hospital is looking for a veterinary dentist to join the dentistry team consisting of 2 faculty and surgery in the small animal hospital for up to 34 weeks per year (65% time commitment). This entails

34

Assistant Professor, Veterinary Ophthalmology Department of Clinical Sciences, James L. Voss Veterinary Teaching Hospital  

E-print Network

Veterinary Teaching Hospital College of Veterinary Medicine and Biomedical Sciences Colorado State University year of direct clinical activity in the ophthalmology hospital service. This includes overseeing assistance for all other services in the Veterinary Teaching Hospital and will provide medical and surgical

Stephens, Graeme L.

35

Ethics Consultation at a Large Urban Public Teaching Hospital  

PubMed Central

OBJECTIVES: To describe the population served and issues encountered by Hospital Ethics Committee consultation, to describe the incidence of consultation per hospital admission, and to describe the resource utilization per consult. PATIENTS AND METHODS: This is a retrospective review of all ethics consults at a large urban teaching hospital and level one trauma center in a metropolitan area from January 1, 2004, through December 31, 2006. The data points analyzed were patient demographics, time spent by consultants (resource utilization), and the choice to pursue a full consult, which differs from a brief consult by the number of ethics consultants involved and the formality of the deliberative process. RESULTS: A total of 285 consults were conducted or 0.16% (95% confidence interval, 0.14%-0.18%) of all hospital admissions. The highest incidence was 0.88% (95% confidence interval, 0.59%-1.3%) for the trauma intensive care unit. The average age of patients consulted on was 51 years, and 54% were in the intensive care unit. Of the consults, 90% were brief, and 52% were requested by house staff. Consultants logged 60,368 minutes, 38% of which were devoted to full consults (10% of total). Consults in obstetrics, general medicine, and surgery were the most time-consuming. Pregnancy and human immunodeficiency virus were more prevalent in full consults. The “classic” ethics cases of confidentiality (5%), patients requesting futile treatment (5%), brain death (4%), error disclosure (1%), and organ-donor rights (0.3%) were marginal in our series. CONCLUSION: Little data exist on the practice of ethics consultation services. To our knowledge, this series represents the largest to date. Specific issues, patient characteristics, and hospital services were more prevalent in the most time-consuming consults. These data can be used to target the education of residents and inform hospital quality initiatives. PMID:20435836

Tapper, Elliot B.; Vercler, Christian J.; Cruze, Deborah; Sexson, William

2010-01-01

36

Racial, Ethnic, and Affluence Differences in Elderly Patients' Use of Teaching Hospitals  

PubMed Central

OBJECTIVE To understand the role of race, ethnicity, and affluence in elderly patients' use of teaching hospitals when they have that option. METHODS Using a novel data set of 787,587 Medicare patients newly diagnosed with serious illness in 1993, we look at how sociodemographic factors influence whether patients use a teaching hospital for their initial hospitalization for their disease. We use hierarchical linear models to take into account differences in the availability of teaching hospitals to different groups. These models look within groups of people who live in the same county and ask what demographic factors make an individual within that county more or less likely to use a teaching hospital. RESULTS We find that blacks are much more likely than whites to use teaching hospitals (odds ratio [OR], 1.75; 95% confidence interval [95% CI], 1.73 to 1.77). However, Hispanics and Asian-Americans are less likely to use teaching hospitals than are whites (Hispanic OR, 0.92; 95% CI, 0.88 to 0.97; Asian-American OR, 0.89; 95% CI, 0.82 to 0.97). Medicaid patients are less likely to use teaching hospitals (given their opportunities) than are non-Medicaid recipients (OR, 0.91; 95% CI, 0.90 to 0.92). And we find a curvilinear relationship with affluence, with those in the poorest and those in the wealthiest neighborhoods most likely to use a teaching hospital. CONCLUSION The use of teaching hospitals is more complex that heretofore appreciated. Understanding why some groups do not go to teaching hospitals could be important for the health of those groups and of teaching hospitals. PMID:12220366

Iwashyna, Theodore J; Curlin, Farr A; Christakis, Nicholas A

2002-01-01

37

Surgical Management of Uterine Fibroids at Aminu Kano Teaching Hospital  

PubMed Central

Objective. To determine the influence of age and parity on the surgical management of uterine fibroids, clinical presentation, presence of pelvic adhesions, cadre of surgeons, and postoperative complications at the Aminu Kano Teaching Hospital, Kano, Nigeria. Methods. A retrospective analysis of 105 cases of uterine fibroids that were managed between 1st January 2003 and 31st December 2007. Results. The period prevalence of uterine fibroids was 24.7% of all major gynecological operations. The mean age was 35.8 ± 7.6 and mean parity 4.7 ± 2.8. Abdominal hysterectomy accounted for 58.1% of the cases and myomectomy 41.9%. The odd of using abdominal hysterectomy was about twice that of myomectomy. Pelvic adhesions were found in 67.6% of the cases. Menorrhagia (86.7%) was the commonest symptom, while post operative anemia and pyrexia showed significant association with myomectomy. There was no maternal mortality. Conclusion. Surgical operations for uterine fibroids are safe and common kind of gynecological operations at the Aminu Kano Teaching Hospital. Uterine fibroid is associated more with high parity and dominance of abdominal hysterectomy over myomectomy, because early girl marriage is common in our community. PMID:22135680

Omole-Ohonsi, Abiodun; Belga, Francis

2012-01-01

38

Maternal mortality in a Nigerian teaching hospital - a continuing tragedy.  

PubMed

The aim of this review is to determine the maternal mortality ratio (MMR) in a Nigerian tertiary health institution (University of Ilorin Teaching Hospital, Ilorin, Nigeria). The review was done through a retrospective analysis of maternal mortality records. The MMR for the 6-year period (1997-2002) was 825 per 100,000 live births. The common causes of maternal mortality included severe pre-eclampsia/eclampsia, 30 (27.8%); haemorrhage, 22 (20.4%) and complications of unsafe abortion 16 (14.8%). Grandmultiparous and patients aged 40 years and above were at the highest risk. This hospital-based MMR is very high and when compared with previous reports showed a 150% increase. Most of the maternal deaths are, however, preventable. Increased efforts at educating women, improvement of the socioeconomic conditions of the populace and strong political commitment in making emergency obstetric care available in rural and district hospitals are some of the measures that need to be adopted to reduce this avoidable tragedy. PMID:17540085

Aboyeji, A P; Ijaiya, M A; Fawole, A A

2007-04-01

39

Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards  

PubMed Central

Background In an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan. Methods A survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants. Results The overall response rate was 78.51% (95/121). All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76%) agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%). Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%). The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and problem-based learning sessions were less favored by radiologists than by residents. Teaching via radiology films (86%) was the most frequent mode of instruction. Salary (59%) was the most commonly cited teaching reward. The majority of respondents (88%) were not satisfied with their current level of teaching rewards. Conclusion All radiologists and residents working in an academic radiology department are involved in teaching undergraduate students at multiple levels. The most valued teaching methodology involves use of images, with one-on-one interaction between the trainer and trainee. The monetary reward for teaching is inbuilt into the salary. The methodology adopted for teaching purposes was significantly different between respondents from private hospitals and those from public teaching hospitals. Because of low satisfaction among the respondents, efforts should be made to provide satisfying teaching rewards. PMID:23745098

Nadeem, Naila; Khawaja, Ranish Deedar Ali; Beg, Madiha; Naeem, Muhammad; Majid, Zain

2013-01-01

40

Family Physicians and Teaching Hospitals: A Litany of Woes  

PubMed Central

Retreat of family physicians from caring for their patients in teaching hospitals has been partly imposed and partly passively accepted. Confusion of patient, family doctor and consultant relationships has resulted. Town/gown and family physician/specialist communication problems disrupt a proper model of care. Family physicians need to take individual and group action to initiate change, but little action has been evident. Everyone is the loser. We should reinstitute a model in which family physicians are the closest professionals to their patients, wherever they are in the health care system. Demonstrating the value of family physician coordination of care and continuity of care will positively affect the current financial `loss leader' status of this work. PMID:21279057

Hansen, Niels H.

1984-01-01

41

Caecal volvulus: ten year experience in an Australian teaching hospital.  

PubMed Central

Sixteen cases of caecal volvulus were treated surgically at a major Australian teaching hospital over a decade. Review of these cases suggests that this condition may be more common in fit people between 30 and 40 years of age than in the elderly or institutionalised. Caecal volvulus was more common in women than in men, possibly because adhesions from previous gynaecological surgery may initiate volvulus. In some other cases colonic distension due to poor muscle tone rather than distal obstruction may have been an important predisposing factor. Preoperative diagnosis was not usually made, but might have been facilitated if knowledge of the above predisposing factors had been available. This would allow colonoscopic reduction to be considered as a therapeutic alternative to laparotomy. At laparotomy, right hemicolectomy or caecal fixation (caecostomy or caecopexy) were the alternative methods of treatment. PMID:3322151

Neil, D. A.; Reasebeck, P. G.; Reasbeck, J. C.; Effeney, D. J.

1987-01-01

42

Methicillin-Resistant Staphylococcus pseudintermedius in a Veterinary Teaching Hospital?  

PubMed Central

We surveyed methicillin-resistant coagulase-positive staphylococcus (MRCPS) strains from 57 (26 inpatient and 31 outpatient) dogs and 20 veterinary staff in a veterinary teaching hospital. From the staff, three MRCPS strains were isolated, and two were methicillin-resistant Staphylococcus aureus (MRSA). In contrast, 18 MRCPS strains were detected in both inpatient (12 of 26 [46.2%]) and outpatient (6 of 31 [19.4%]) dogs. Among them, only one strain was MRSA. Using direct sequencing of sodA and hsp60 genes, the 18 MRCPS strains other than MRSA from a staff and 17 dogs, were finally identified as Staphylococcus pseudintermedius, a novel species of Staphylococcus from a cat. All of the methicillin-resistant S. pseudintermedius (MRSP) strains were multidrug resistant to erythromycin, clindamycin, trimethoprim-sulfamethoxazole, and levofloxacin. Most of the MRSP strains showed high-level resistance to oxacillin (?128 ?g/ml, 15 of 18 [83.3%]), and 10 of 15 (66.7%) high-level oxacillin-resistant MRSP strains carried type III SCCmec. DNA fingerprinting of MRSP strains by pulsed-field gel electrophoresis yielded eight clusters: clone A with four subtypes, clone B with four subtypes, clone C with three subtypes, and five other different single clones. MRSP strains from the staff and some inpatient and outpatient dogs shared three major clones (clones A, B, and C), but the strains of the other five different clusters were distributed independently among inpatient or outpatient dogs. This genetic diversity suggested that the MRSP strains were not only acquired in this veterinary teaching hospital but also acquired in primary veterinary clinics in the community. To our knowledge, this is the first report of MRSP in dogs and humans in a veterinary institution. PMID:17267624

Sasaki, Takashi; Kikuchi, Ken; Tanaka, Yoshikazu; Takahashi, Namiko; Kamata, Shinichi; Hiramatsu, Keiichi

2007-01-01

43

Airborne Microflora in the Atmosphere of an Hospital Environment of University of Benin Teaching Hospital (UBTH), Benin City, Nigeria  

Microsoft Academic Search

A study was undertaken to determine typical concentrations of airborne bacteria and fungi (microflora) in Teaching Hospital environment in Benin City in the tropical rainforest environment of Nigeria. Aerial sampling was conducted at various hospital wards each day. The air samples were collected thrice daily. Concentrations of airborne microflora exceeded available local guidelines for indoor quality in the accident and

F. O. Ekhaise; E. E. Isitor; O. Idehen; A. O. Emoghene

2010-01-01

44

Teaching hospital planning: a case study and the need for reform.  

PubMed

Academic teaching hospitals and their networks can best serve patients and other stakeholders by achieving critical mass and scope of clinical services, teaching and research. Successful hospital reconfigurations are associated with a convincing case and majority clinician buy-in. The inscrutable political decision to relocate services away from a major teaching hospital campus and into a merged Queensland Children's Hospital was determined without broad stakeholder consultation or a transparent and accountable business case. This compromised process poses a significant and enduring risk to patient care and Queensland's paediatric, perinatal, adolescent and obstetric academic teaching hospital services. As the proposed major stakeholder in Australia's public hospitals and medical workforce training, the federal government should review this decision using an effective methodology incorporating relevant criteria. National guidelines are needed to ensure best practice in the future planning and auditing of major health care projects. The medical profession is responsible for ensuring that health care policy complies with reliable evidence and good practice. PMID:20712545

Davis, Christopher K; Smith, Harry

2010-08-16

45

Congenital club foot in a teaching hospital in Lagos, Nigeria.  

PubMed

Congenital club foot has been sparsely reported in literature in Nigeria, although it has been reported as the commonest congenital musculoskeletal abnormality. This study enumerates the point prevalence of this disease in a university teaching hospital in Lagos. Better understanding of the epidemiology in our community should improve awareness, and influence management. Between June 2005 and July 2006, 72 consecutive patients with congenital club feet were seen in the orthopaedic clinic of our Hospital. Demographic data, birth weight, family history, birth facility, maternal age and associated congenital anomalies were recorded and analysed using Statistical Programme for Social Sciences (SPSS) version 15. A total of 72 patients were seen, 28 of whom had bilateral club feet resulting in a total of 100 feet. There were 38 males and 34 females. Only 29% presented in the first month of life and 28% in the second month. Maternal ages ranged between 19 and 38 years and no family history of congenital club foot was given,. Babies delivered outside the orthodox medical system (churches, traditional healers, home etc) constituted 28%. The commonest associated congenital anomalies were tibia hemimelia, hydrocephalus, inguinal hernia and umbilical hernia. A default rate of 28% was observed during treatment. Congenital club foot may not be uncommon in Nigeria. Late presentation and high default rate before correction of the deformity were observed. Establishment of special club foot clinics should reduce the default rate. Training of healthcare workers in maternity units as well as Public awareness should encourage early referral to specialists. PMID:20175426

Adewole, O A; Giwa, S O; Kayode, M O; Shoga, M O; Balogun, R A

2009-06-01

46

[Hospitalization charges for patients in the Neurology Department of Lomé Teaching Hospital].  

PubMed

For many years the cost of health care in sub-Saharan Africa was largely covered by the State. But in September 1987, in view of the economical problems those countries had to face, the WHO regional committee adopted the "Bainako's Initiative" resolution. This meant that from then on everybody was to pay for their health expenses. The purpose of this prospective study which was conducted from March 1, 1996 to February 28, 1999 among 316 patients was to assess hospitalization charges incurred for patients in the Neurology Department of Lomé Teaching Hospital with a view to improve the quality of the services provided and the accessibility of care. A questionnaire was used and every expense relating to the hospitalization of each patient was recorded on a daily basis. The average cost is 389,586 (48,485 FCFA for an average stay of 19.7 (2.5 days. This average cost is 19 times the minimal monthly salary of a state employee. It can be broken down as follows: Accommodation costs represent 52%, medical acts and tests 20.3% while drug costs amount to 21.2% and accompanist expenses represent 6.5%. The average cost of HIV-infected patients is 635,017 (190,624 FCFA for an average stay of 57 (12.9 days. The average cost of HIV-negative patients is 257,354 (12,837 FCFA for an average stay of 24.4 (1.8 days. To improve the quality of the services and the accessibility of care, it is necessary to prescribe and make drugs available in their generic form. After a few days in hospital, some disabling diseases as strokes, myelopathy and myopathy should be treated at home to reduce the length of stay in hospital or in cheaper places such as prolonged accommodation centres. PMID:15454370

Balogou, Agnon Ayélola Koffi; Tossa, Kokou Robert; Kowu, Akouavi; Belo, Mofou; Grunitzky, Kodjo Eric

2004-01-01

47

Evolution of Hospital-based Pharmacy Teaching Programs from 1989-1998.  

ERIC Educational Resources Information Center

Analyzed databases from four U.S. National Clinical Pharmacy Services Studies and the American Hospital Association for trends in hospital involvement in pharmacy education. Detailed findings indicated that clinical pharmacy services within the nation's teaching hospitals are not standardized and that financial pressures impede a full, consistent…

Raehl, Cynthia; Bond, C. A.

2000-01-01

48

Pattern of heart failure in a Nigerian teaching hospital  

PubMed Central

Background Congestive cardiac failure (CCF) has emerged as a major public health problem worldwide and imposes an escalating burden on the health care system. Objective To determine the causes and mortality rate of CCF in the University of Port Harcourt Teaching Hospital (UPTH), south Nigeria, over a five-year period from January 2001 to December 2005. Methods A retrospective study of CCF cases were identified from the admission and discharge register of the medical wards of UPTH and the case notes were retrieved from the medical records department and analyzed. Results There were 423 patients: 242 males and 181 females. Their ages ranged from 18 to 100 years with a mean of 54.4 ± 17.3. The commonest causes of CCF were hypertension (56.3%) and cardiomyopathy (12.3%). Chronic renal failure, rheumatic heart disease, and ischemic heart disease accounted for 7.8%, 4.3%, and 0.2% of CCF, respectively. Peripartum heart disease was rare despite being commonly reported in northern Nigerian females. Eighteen patients died from various complications with a mortality rate of 4.3%. Conclusion The burden of CCF in the Niger Delta is mainly attributed to hypertension. Efforts should be geared towards hypertension awareness, detection, treatment, and prevention in the region. PMID:19774215

Onwuchekwa, Arthur C; Asekomeh, Godspower E

2009-01-01

49

Prospective observational study of blood transfusion practices and outcome at the University Teaching Hospital.  

E-print Network

??To determine the incidence, common indications,appropriateness and outcome of blood transfusions and blood products among adult in-patients admitted to the University teaching Hospital, Lusaka, Zambia.… (more)

Siamuyoba, Lawrence S

2012-01-01

50

Complementary and alternative medicine use among adults in Enugu, Nigeria  

PubMed Central

Background Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them Methods The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study Results 732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance. Conclusion There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted. PMID:21375759

2011-01-01

51

Evaluation of drug administration errors in a teaching hospital  

PubMed Central

Background Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. Methods Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds). A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects. Results Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors) with one or more errors were detected (27.6%). There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501). The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%). The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission). In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC) and the number of patient under the nurse's care. Conclusion Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions. PMID:22409837

2012-01-01

52

Unplanned Emergency Department Revisits within 72 Hours to a Secondary Teaching Referral Hospital in Taiwan  

Microsoft Academic Search

Background: When patients return to the emergency department (ED) shortly after being seen, it is generally assumed that their initial evaluation or treatment was inadequate. Objectives: The purpose of this study was to determine the rates and causes of revisits to the ED of a 710-bed secondary teaching referral hospital (Kuang Tien General Hospital), to identify areas for improvement, and

Chiu-Lung Wu; Fa-Tsai Wang; Yao-Chiu Chiang; Yuan-Fa Chiu; Teong-Giap Lin; Lian-Fong Fu; Tsung-Lung Tsai

2010-01-01

53

Outcomes of a natural rubber latex control program in an Ontario teaching hospital  

Microsoft Academic Search

Background: Allergy to natural rubber latex (NRL) has been frequently reported in health care workers. However, there is little published evidence of the outcome of hospital intervention programs to reduce exposure and detect cases of sensitization early. Objective: This study assesses the effects of intervention to reduce NRL allergy in an Ontario teaching hospital with approximately 8000 employees. Methods: A

Susan M. Tarlo; Anthony Easty; Kathleen Eubanks; Craig R. Parsons; Frank Min; Stephen Juvet; Gary M. Liss

2001-01-01

54

The epidemiological analyses of trauma patients in Chongqing teaching hospitals following the Wenchuan earthquake  

Microsoft Academic Search

BackgroundWell-equipped comprehensive hospitals may provide better emergency and patient services for the recovery of injured patients from the earthquake zone. This study aimed to provide an overview of injuries among the patients admitted to the six teaching hospitals in Chongqing, China, after the 2008 Wenchuan earthquake.

Ce Yang; Hai-yan Wang; He-jiang Zhong; Lin Zhou; Dian-ming Jiang; Ding-yuan Du; Ping Hu; Jian-xin Jiang

2009-01-01

55

Colorado State University Veterinary Teaching Hospital Vol. 1 No. 1 On the cover  

E-print Network

's Communications and Creative Services department. We welcome your questions, comments, and story suggestions. You the occasional mess (spilled coffee or doggie accident), and lending an ear when needed to clients with the Veterinary Teaching Hospital. Her grey- hound dog was a donor to the hospital's blood bank. "For me

Stephens, Graeme L.

56

PERCEPTIONS ON BIOETHICS AMONG PATIENTS PRESENTING TO FAMILY PHYSICIANS AT A TEACHING HOSPITAL IN KARACHI, PAKISTAN  

Microsoft Academic Search

Objective: To study the perceptions on bioethics among patients presenting to family physicians at a teaching hospital in Karachi, Pakistan Study design: Questionnaire based cross sectional survey Settings: The study was carried out at the family practice center, the Aga Khan University Hospital, Karachi Main outcome measures: Perceptions on the broad principles of bioethics Results: Majority of the respondents were

Waris Qidwai; Hafeez Qureshi; Syed Sohail Ali; Mahboob Alam; Syed Iqbal Azam

57

Quality of dying in a New Zealand teaching hospital  

Microsoft Academic Search

Objective:Studies suggest that there is a need to improve the way we deliver care at the end of life. Based on recommendations from end-of-life experts, metrics were identified to measure the quality of dying in Dunedin Hospital.Design:A retrospective observational study was performed to assess the care provided to patients who died in the hospital in 2003.Setting:Dunedin Hospital is a 350-bed

J L Glasgow; S R McLennan; K J High; L A G Celi

2008-01-01

58

Effects of intervention on feeding practices in the intensive care unit at the University Teaching Hospital, Lusaka. Zambia.  

E-print Network

??Preintervention Knowledge, Attitudes and Practices with respect to breastfeeding among Healthworkers from Neonatal Intensive Care Unit (NICU) at the University Teaching Hospital (UTH) and mothers… (more)

Amadi, Beatrice Chifwelu

2012-01-01

59

Drug related problems after discharge from an Australian teaching hospital  

Microsoft Academic Search

Objective To reconcile patients’ medicines and to classify drug related problems identified during medication review conducted after\\u000a discharge from hospital. Setting Patients were discharged from the cardiology unit of Westmead Hospital after recruitment into the Westmead Medicines Project\\u000a which ran from 2004 to 2007. Method This retrospective study involved an analysis of drugs, diseases and drug related problems in medication

Glena R. Ellitt; Ellinor Engblom; Parisa Aslani; Tommy Westerlund; Timothy F. Chen

2010-01-01

60

The language of "Circule": discursive construction of false referral in Iranian teaching hospitals.  

PubMed

This article explores the practice of false patient out-referral by medical students in Iranian teaching hospital emergency departments. Drawing on participant-observations and interviews during eight months in six hospitals in Tehran, we investigate how discourse is appropriated to construct and legitimate out-referrals through four general strategies of sympathy, mystification, intimidation, and procrastination. Based on a critical approach to false out-referral discourse, we revisit the medical and educational functioning of teaching hospitals in Iran: Focusing on medical students involved in false out-referrals, their discursive reproduction of deception is examined along with their legitimate challenges to institutional structures. Moreover, focusing on the institution of hospital, institutional corruption is discussed along with the problematic of covert cultural defiance faced by a modernist organizational construct in a nonmainstream cultural context. Finally, we argue that the discourse of false out-referral calls for more profound public awareness in dealing with health institutions. PMID:20949838

Mirhosseini, Seyyed-Abdolhamid; Fattahi, Hossein

2010-09-01

61

Bacterial Contamination and Resistance to Commonly Used Antimicrobials of Healthcare Workers' Mobile Phones in Teaching Hospitals, Kerman, Iran  

Microsoft Academic Search

Problem Statement: The contamination rates of Health Care Worker's (HCW) mobile phones and resistance to commonly used antimicrobials were evaluated in three teaching hospitals in Kerman, Iran. So, we examined 150 randomly selected HCWs in three teaching hospitals in Kerman, Iran, 2007. For each HCW a sterile swab moistened with sterile water was rotated over the surface of both sides

Gholamreza Sepehri; Nooshin Talebizadeh; Ali Mirzazadeh

2009-01-01

62

Workload Impact of Medical Subspecialties in the Teaching Hospital  

ERIC Educational Resources Information Center

This paper documents, using a single test as a model, the significant increase in clinical laboratory workload which occurred in a university hospital when strong sections of nephrology, hematology-oncology, and immunology-rheumatology were added to the department of medicine. (Author)

Van Peenen, Hubert J.

1973-01-01

63

Perceptions of doctors to adverse drug reaction reporting in a teaching hospital in Lagos, Nigeria  

Microsoft Academic Search

BACKGROUND: Spontaneous adverse drug reaction (ADR) reporting is the cornerstone of pharmacovigilance. ADR reporting with Yellow Cards has tremendously improved pharmacovigilance of drugs in many developed countries and its use is advocated by the World Health Organization (WHO). This study was aimed at investigating the knowledge and attitude of doctors in a teaching hospital in Lagos, Nigeria on spontaneous ADR

Kazeem A Oshikoya; Jacob O Awobusuyi

2009-01-01

64

Historical evidence for the origin of teaching hospital, medical school and the rise of academic medicine.  

PubMed

Historical progression and the development of current teaching hospitals, medical schools and biomedical research originated from the people of many civilizations and cultures. Greeks, Indians, Syriacs, Persians and Jews, assembled first in Gondi-Shapur during the Sasanian empire in Persia, and later in Baghdad during the Golden Age of Islam, ushering the birth of current academic medicine. PMID:21233794

Modanlou, H D

2011-04-01

65

Occupational blood and infectious body fluid exposures in a teaching hospital: a three-year review  

Microsoft Academic Search

Background and Purpose: Blood and infectious body fluid (BBF) exposures are common safety problems for health care workers (HCWs). We analyzed reported BBF exposures during a 3-year period at a teaching hospital. Methods: We collected reports of BBF exposures among HCWs occurring from January 2001 to December 2003 at a 2000-bed tertiary care medical center in northern Taiwan. HCWs were

Wen-Bin Hsieh; Nan-Chang Chiu; Chun-Ming Lee; Fu-Yuan Huang

66

Accuracy of the Charlson Index Comorbidities Derived from a Hospital Electronic Database in a Teaching Hospital in Saudi Arabia  

PubMed Central

Hospital management and researchers are increasingly using electronic databases to study utilization, effectiveness, and outcomes of healthcare provision. Although several studies have examined the accuracy of electronic databases developed for general administrative purposes, few studies have examined electronic databases created to document the care provided by individual hospitals. In this study, we assessed the accuracy of an electronic database in a major teaching hospital in Eastern Province, Saudi Arabia, in documenting the 17 comorbidities constituting the Charlson index as recorded in paper charts by care providers. Using the hospital electronic database, the researchers randomly selected the data for 1,019 patients admitted to the hospital and compared the data for accuracy with the corresponding paper charts. Compared with the paper charts, the hospital electronic database did not differ significantly in prevalence for 9 conditions but differed from the paper charts for 8 conditions. The kappa (K) values of agreement ranged from a high of 0.91 to a low of 0.09. Of the 17 comorbidities, the electronic database had substantial or excellent agreement for 10 comorbidities relative to paper chart data, and only one showed poor agreement. Sensitivity ranged from a high of 100.0 percent to a low of 6.0 percent. Specificity for all comorbidities was greater than 93 percent. The results suggest that the hospital electronic database reasonably agrees with patient chart data and can have a role in healthcare planning and research. The analysis conducted in this study could be performed in individual institutions to assess the accuracy of an electronic database before deciding on its utility in planning or research. PMID:23861671

Youssef, Adel; Alharthi, Hana

2013-01-01

67

Risk Factors for Acute Respiratory Tract Infections in Under-five Children in Enugu Southeast Nigeria  

PubMed Central

Background: Acute respiratory tract infections (ARIs) constitute the major causes of mortality and morbidity among under-five children of the developing world. The prevalence of ARIs is determined individually or collectively by a number of factors which may be prevalent in our environment. Aim: The present study is aimed to determine the risk factors that affect the prevalence of ARIs in under-five children in Enugu. Subjects and Methods: A cross-sectional study of 436 under-five children diagnosed with ARI was carried out in three hospitals in Enugu. Participants were consecutively enrolled after being diagnosed as a case of ARI. Structured pro foma was used to collect sociodemographic characteristics, anthropometric data and risk profile. Data were analyzed using Epi info version 6.0 and significant probability value was 5%. Results: A total of 436 patients were enrolled for the study 224 males and 212 females M: F 1.06:1. The mean age of the population was 18.75(13.38) months and there were 31.6%(138/436) cases of pneumonia 6.9%(30/436) cases of bronchiolitis and 61.5%(268/436) cases of acute upper respiratory tract infections. Children less than 20 months accounted for 60.9% (84/138 cases) of pneumonia, 86.7% (26/30 cases) of bronchiolitis, and 64.5% (173/268 cases) of acute upper respiratory tract infections. Pneumonia was noted in about 75.7% (56/74) of inadequately nourished children compared to 22.6% (82/362) in adequately nourished children. Other risk factors identified in the study include inadequate breast feeding, poor immunization statues, attendance to daycare centers, large family size, poor parental educational statues, parental smoking, living in the urban area and use of biofuels. Conclusion: ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple strategies. It is recommended that control program for ARIs should be multifaceted with a strong political will. PMID:24669339

Ujunwa, FA; Ezeonu, CT

2014-01-01

68

The pattern of tooth loss due to dental caries and periodontal disease among patients attending dental department (OPD), Dhulikhel Hospital, Kathmandu University Teaching Hospital (KUTH), Nepal  

Microsoft Academic Search

Aims and objectives: The aim of this study was to investigate the type of tooth usually associated with extraction due to caries or periodontal disease and its relation to age at which these were lost, among patients attending dental surgery outpatient clinic, Dhulikhel Hospital, Kathmandu University Teaching Hospital (KUTH). Materials and methods: A total no of 626 patients (male-299 and

C Upadhyaya; M Humagain

2009-01-01

69

Imaging of gunshot injuries in a west Dublin teaching hospital--a ten year review.  

PubMed

There has been an increase in gun-related crime in Ireland over the last decade to gangland violence, especially in west Dublin. This places a burden on hospital services not previously encountered. The aim of this study was to examine the demographics of gunshot: injuries presenting to a Dublin teaching hospital, and the impact on radiology over a ten year period. A total of 65 gunshot injuries were seen. Mortality for high velocity wounds was much higher (10/23, 43%) than for low-velocity shotgun injuries (2/34, 6%). PMID:25282967

Murphy, I; Lavelle, L; Ni Mhurchu, E; McCarthy, R; Heffernan, E

2014-09-01

70

[Proposed updated isolation precautions guideline in a university teaching hospital in Italy].  

PubMed

Significant developments took place in the area of infection control since the Centers for Disease Control and Prevention, (CDC, USA) 1996 publication of a guideline for isolation precautions in hospitals. New guidelines were therefore published by CDC in 2007 (Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings) and by the World Health Organization in 2009 (WHO Guidelines on Hand Hygiene in Healthcare). The authors propose an updated guideline that takes into account the new recommendations made by CDC and the WHO in light of the specific requirements of a university teaching hospital. PMID:21132041

Capozzi, Claudio; Panà, Augusto

2010-01-01

71

Implementing a local area network for nursing in a large teaching hospital.  

PubMed

The authors describe the assessment, planning, implementation, and benefits of a local area network (LAN) for the nursing service of a 504-bed urban teaching hospital. The major goals of the network were to increase the efficiency and effectiveness of the nursing administrative areas and improve communication systems. A network of more than 90 workstations, spanning 12 buildings, was installed. The network provides access to multiple programs that support clinical, managerial, and research activities. Gateways provide access to the hospital's two mainframe computers. Network benefits identified by nursing management include: improved communication and access to information; increased accuracy, efficiency and timeliness of data; and improved computer literacy. PMID:8199928

Chapman, R H; Reiley, P; McKinney, J; Welch, K; Toomey, B; McCausland, M

1994-01-01

72

Noncompliance pattern due to medication errors at a Teaching Hospital in Srikot, India  

PubMed Central

Objective: To study the medication errors leading to noncompliance in a tertiary care teaching hospital. Materials and Methods: This study was conducted in a tertiary care hospital of a teaching institution from Srikot, Garhwal, Uttarakhand to analyze the medication errors in 500 indoor prescriptions from medicine, surgery, obstetrics and gynecology, pediatrics and ENT departments over five months and 100 outdoor patients of medicine department. Results: Medication error rate for indoor patients was found to be 22.4 % and 11.4% for outdoor patients as against the standard acceptable error rate 3%. Maximum errors were observed in the indoor prescriptions of the surgery department accounting for 44 errors followed by medicine 32 and gynecology 25 in the 500 cases studied leading to faulty administration of medicines. Conclusion: Many medication errors were noted which go against the practice of rational therapeutics. Such studies can be directed to usher in the rational use of medicines for increasing compliance and therapeutic benefits. PMID:23833376

Thakur, Heenopama; Thawani, Vijay; Raina, Rangeel Singh; Kothiyal, Gitanjali; Chakarabarty, Mrinmoy

2013-01-01

73

Variations in surgical rates in Quebec: does access to teaching hospitals make a difference?  

PubMed Central

OBJECTIVE: To document the geographic variations in the rates of 10 common surgical procedures in Quebec and to examine the relation between surgical rates and level of access to teaching hospitals. DESIGN: Population-based rates standardized for age and sex were calculated from 1985-88 data from MED-ECHO (the provincial hospital discharge database) for each of the 32 community health districts (départements de santé communautaire [DSCs]) in Quebec. Variation across DSCs was analysed with the use of the ratio of the highest to the lowest rate, the coefficient of variation and the systematic component of variation. On the basis of an urbanization index designed by Statistics Canada, DSCs were classified as having a low, medium, high or very high level of access to teaching hospitals. PATIENTS: All Quebec residents except those whose DSC of residence could not be traced (accounting for no more than 1.7% of patients for any study procedure) and aboriginal people from northern Quebec. SURGICAL PROCEDURES STUDIED: Appendectomy, cesarean section, cholecystectomy, coronary artery bypass grafting (CABG), hysterectomy, inguinal hernia repair, prostatectomy, tonsillectomy with or without adenoidectomy, total hip replacement and varicose vein stripping. RESULTS: There was considerable systematic variation in the surgical rates for all 10 procedures. Cesarean section, the rates of which varied the least, still exhibited almost a twofold variation between the highest and lowest rates. The rates of tonsillectomy varied the most, by a factor of more than five. With a few exceptions there was relatively little relation between the rates of the procedures within the DSCs. The rates of appendectomy, cholecystectomy, hysterectomy and tonsillectomy tended to be lower in the DSCs containing teaching hospitals, whereas the reverse was true for CABG. For the other procedures the relation between the rates and the level of access to teaching hospitals was nonsignificant. CONCLUSIONS: The overall consistency of the observed variations with those of previous studies invites a closer look at the practice patterns and the scientific basis of the clinical decisions associated with procedures showing high variations in rates. The lack of a systematic relation between the surgical rates and the level of access to teaching hospitals challenges the belief that remote regions are underserved with respect to the procedures studied. PMID:8485676

Blais, R

1993-01-01

74

A study of viral hepatitis during pregnancy in Nepal Medical College Teaching Hospital  

Microsoft Academic Search

The present study aimed to find out prevalence and severity of viral hepatitis during pregnancy in the department of Obstetrics and Gynaecology, Nepal Medical College Teaching Hospital. Out of 5602 pregnant women admitted in the ward from 2001 - 2007; viral hepatitis was seen in 29 cases. HBV was detected in 18\\/29 (62.0%), HEV in 6\\/29 (20.6%) and viral hepatitis

P Shrestha; D Bhandari; D Sharma; BP Bhandari

2009-01-01

75

A profile of ectopic pregnancy at Nepal Medical College Teaching Hospital  

Microsoft Academic Search

A retrospective study of ectopic pregnancy at Nepal Medical College Teaching Hospital between January 2001 to June 2006 was carried out to determine incidence, demographic features, clinical presentation, duration at presentation and treatment, and the management protocol. A total of 36 cases of ectopic pregnancy were treated giving the incidence of ectopic pregnancy of 10.2\\/1000 deliveries and 7.3 \\/1000 pregnancies.

Pramila Pradhan; Suman Bahadur Thapamagar; Smriti Maskey

76

Computer literacy enhancement in the Teaching Hospital Olomouc. Part I: project management techniques. Short communication.  

PubMed

Information explosion and globalization make great demands on keeping pace with the new trends in the healthcare sector. The contemporary level of computer and information literacy among most health care professionals in the Teaching Hospital Olomouc (Czech Republic) is not satisfactory for efficient exploitation of modern information technology in diagnostics, therapy and nursing. The present contribution describes the application of two basic problem solving techniques (brainstorming, SWOT analysis) to develop a project aimed at information literacy enhancement. PMID:15034614

Sedlár, Drahomír; Potomková, Jarmila; Rehorová, Jarmila; Seckár, Pavel; Sukopová, Vera

2003-11-01

77

Clinical Trials Support -Research Associate II Animal Cancer Center Oncology Clinical Trials Program -Colorado State University Veterinary Teaching Hospital  

E-print Network

Clinical Trials Support - Research Associate II Animal Cancer Center Oncology Clinical Trials Program - Colorado State University Veterinary Teaching Hospital Oncology Clinical Trials Program the daily schedule for the clinical trials rotation o Patient care including, obtaining owner history

Stephens, Graeme L.

78

Medication Errors in an Emergency Department in a Large Teaching Hospital in Tehran  

PubMed Central

Medication errors have important effects on increased length of hospitalization, increased mortality and costs. We assessed the incidence of medication errors and characterize the error types in an emergency department in a large teaching hospital in Tehran. We also investigated the effect of Emergency Department pharmacists on patient safety with regard to recovery of potentially harmful medication errors. The study was conducted in the 24 bed emergency department from February to March, 2010 at a 600-bed teaching hospital. Two hospital pharmacists and two clinical pharmacy residents observed care provision and collected data on medication errors. Demographic data, type of medication error, the recorded stage of error, date and time of occurrence and report, who made the error, probability of error were recorded from medical records. We used chi-squared and independent sample t- tests for analyzing the data. We recorded 203 medication errors during 180 hours. The incidence of medication errors was 50.5% at various levels in the emergency department. Significant difference in age means was seen between the patients with and without medication errors. Seventy four point nine percent of errors were recorded as definitely an error. Most recorded errors were made by nurses (44.5%) and occurred in administrating stage (63.6%). Given that the rate of the errors was relatively high, it seems that the presence of clinical pharmacist can be beneficial. PMID:24523775

Dabaghzadeh, Fatemeh; Rashidian, Arash; Torkamandi, Hassan; Alahyari, Sara; Hanafi, Somayaeh; Farsaei, Shadi; Javadi, Mohammadreza

2013-01-01

79

Computer-assisted instruction: a library service for the community teaching hospital.  

PubMed Central

This paper reports on five years of experience with computer-assisted instruction (CAI) at Winthrop-University Hospital, a major affiliate of the SUNY at Stony Brook School of Medicine. It compares CAI programs available from Ohio State University and Massachusetts General Hospital (accessed by telephone and modem), and software packages purchased from the Health Sciences Consortium (MED-CAPS) and Scientific American (DISCOTEST). The comparison documents one library's experience of the cost of these programs and the use made of them by medical students, house staff, and attending physicians. It describes the space allocated for necessary equipment, as well as the marketing of CAI. Finally, in view of the decision of the National Board of Medical Examiners to administer the Part III examination on computer (the so-called CBX) starting in 1988, the paper speculates on the future importance of CAI in the community teaching hospital. PMID:3518839

McCorkel, J; Cook, V

1986-01-01

80

Incidence of Potential Drug-Drug Interaction and Related Factors in Hospitalized Neurological Patients in two Iranian Teaching Hospitals  

PubMed Central

Background: Reciprocal drug interactions are among the most common causes of adverse drug reactions. We investigated the incidence and related risk factors associated with mutual drug interactions in relation to prescriptions written in the neurology wards of two major teaching hospitals in Shiraz, southern Iran. Methods: Data was collected from hand-written prescriptions on a daily basis. Mutual drug interactions were identified using Lexi-Comp 2012 version 1.9.1. Type D and X drug interactions were considered as potential drug-drug interactions. The potential risk factors associated with drug-drug interactions included the patient’s age and gender, number of medications and orders, length of hospitalization and the type of neurological disorder. To determine potential drug-drug interactions, relevant interventions were suggested to the physicians or nurses and the outcome of the interventions were documented. Results: The study comprised 589 patients, of which 53% were males and 47% females, with a mean age of 56.65±18.19 SD years. A total of 4942 drug orders and 3784 medications were prescribed among which 4539 drug-drug interactions were detected, including 4118 type C, 403 type D, and 18 type X. Using a logistic regression model, the number of medications, length of hospitalization and non-vascular type of the neurological disorder were found to be significantly associated with potential drug-drug interactions. From the total interventions, 74.24% were accepted by physicians and nurses. Conclusion: Potentially hazardous reciprocal drug interactions are common among patients in neurology wards. Clinical pharmacists can play a critical role in the prevention of drug-drug interactions in hospitalized patients.

Namazi, Soha; Pourhatami, Shiva; Borhani-Haghighi, Afshin; Roosta, Sareh

2014-01-01

81

Sequential Outbreaks of Infections by Distinct Acinetobacter baumannii Strains in a Public Teaching Hospital in Houston, Texas  

Microsoft Academic Search

Invasive disease due to Acinetobacter baumannii is an increasing problem in health care settings worldwide. Whether certain clones of A. baumannii are more likely to cause invasive disease in hospitalized patients is unknown. We studied all patients at a public teaching hospital in Houston, Texas, from whom the Acinetobacter calcoaceticus-Acinetobacter baumannii complex was isolated over a 14-month period in 2005

Samuel A. Shelburne III; Kavindra V. Singh; A. Clinton; Laura Byrne; Alexis Carmer; Celest Austin; Edward Graviss; Charles Stager; Barbara E. Murray; Robert L. Atmar

82

Bacteraemia in the Adult Intensive Care Unit of a Teaching Hospital in Nottingham, UK, 1985-1996  

Microsoft Academic Search

Bacteraemia is an important cause of morbidity and mortality in the intensive care unit. In this study the distribution of organisms causing bacteraemic episodes in patients in the adult intensive care unit of a large teaching hospital was determined. Particular emphasis was placed on the type of organisms isolated from community- and hospital-acquired bacteraemia, the suspected source of infection, the

M. Crowe; P. Ispahani; H. Humphreys; T. Kelley; R. Winter

1998-01-01

83

Bacteraemia in the adult intensive care unit of a teaching hospital in Nottingham, UK, 1985–1996  

Microsoft Academic Search

Bacteraemia is an important cause of morbidity and mortality in the intensive care unit. In this study the distribution of organisms causing bacteraemic episodes in patients in the adult intensive care unit of a large teaching hospital was determined. Particular emphasis was placed on the type of organisms isolated from community- and hospital-acquired bacteraemia, the suspected source of infection, the

M. Crowe; P. Ispahani; H. Humphreys; T. Kelley; R. Winter

1998-01-01

84

HIV serostatus disclosure pattern among pregnant women in Enugu, Nigeria.  

PubMed

This study was carried out in two medical facilities in Enugu, Nigeria, from September to November 2007. An interviewer-administered questionnaire was used to collect data from HIV-positive pregnant women accessing PMTCT (prevention of maternal-to-child transmission) services at the two centres. Ninety-two women were interviewed: 89 (96.7%) had disclosed their status, while 3 (3.3%) had not. Of the 89 women who had disclosed, 84 (94.4%) had disclosed to partners, 82 (92.1%) to husbands, 2 (2.2%) to fiancés, 18 (20.2%) to sisters, 13 (14.6%) to mothers, 10 (11.2%) to brothers, 10 (11.2%) to fathers and 10 (11.2%) to priests. Fifty-two (58.4%) gave emotional support as the reason for disclosure and 46 (51.7%) gave economic and financial support as reasons. Fifty-six (62.9%) reported understanding from partner as a positive outcome and 44 (49.4%) reported financial support. Forty-six (51.7%) reported no negative outcome. Serostatus disclosure rate in this study was high with most women disclosing to their partners. PMID:19552827

Ezegwui, H U; Nwogu-Ikojo, E E; Enwereji, J O; Dim, C C

2009-11-01

85

Blood pressure cuffs as a potential fomite for transmission of pathogenic micro- organisms: A prospective study in a university teaching hospital  

Microsoft Academic Search

Objective: To investigate the contamination of blood pressure cuffs on medical, surgical, paediatric and intensive care areas in a university teaching hospital.Design: A comprehensive, prospective study quantitatively and qualitatively evaluating the bacterial contamination on blood pressure cuffs of 100 sphygmomanometers in use in ten hospital units from June through to July 2007.Setting: A university teaching hospital with medical, surgical, paediatric

J. Baruah; S. Kumar; A. Gratrix; W. Dibb; M. Madeo

2008-01-01

86

Evaluation of parenteral nutritional support in the surgical and medical wards of a referral teaching hospital  

PubMed Central

Background and purpose Malnutrition is a common problem in patients who are hospitalized in surgical and medical wards. Surgical patients, geriatric populations and individuals with severe illness are more vulnerable to malnutrition during their hospitalization course. The purpose of this study was evaluation of parenteral nutrition services in a referral teaching hospital, Tehran, Iran. Method Medical records of 72 patients who received parenteral nutrition during one year period in different surgical and medical wards of Imam Khomeini hospital were reviewed retrospectively by clinical pharmacists. Criteria for initiation of parenteral nutrition, selection of appropriate formulation and monitoring parameters were assessed based on the American Society of Parenteral and Enteral Nutrition recommendations. Results Based on the patients' anthropometric parameters and serum albumin levels, 4.2%, 75% and 20.8% of the patients were well-nourished, moderately malnourished and severely malnourished respectively at the hospital admission and before nutritional support. Adequate calorie, protein, carbohydrate and lipid supports were achieved in 21.1%, 32.4%, 23.7% and 10.5% of the patients respectively. About 91% of the patients experienced at least one complication of the nutritional support. Conclusion In this evaluation, several errors in assessment, establishing goals, and monitoring of parenteral nutrition regimens have been detected. Approximately all of the patients did not receive to the trace elements supports goals. PMID:23351175

2012-01-01

87

Woman Health; Uterus Rupture, Its Complications and Management in Teaching Hospital Bannu, Pakistan  

PubMed Central

ABSTRACT Objectives: To evaluate risk factors, management, maternal and fetal outcomes of ruptured uterus at Women and Children Teaching Hospital Bannu, Pakistan. Study design: The prospective observational study was designed from January 2009 to December 2009. A total 64 patients were found with ruptured uterus evaluated in Women and Children Teaching Hospital Bannu, Pakistan. The aim of the study was to evaluate risk factors, management, maternal and fetal outcomes. Results: Frequency of ruptured uterus in hospital was found in 9/ 1000 deliveries, higher than most other studies. Amongst etiological factors the most important were great multiparity 27 (42.2%), injudicious use of Oxytocin 33 (51.6%), obstructed labour 8 (12.5%) and previous caesarean section 12 (18.8%). Of the total number of patients, 49 (76.6%) underwent abdominal hysterectomy (either subtotal or total), 3.1% of them needed bladder repair and 15.6% underwent repair of uterus. 5 (7.8%) died either due to irreversible shock or disseminated intravascular coagulation, 4% of patients had incontinence of urine, 53 (82.8%) of cases delivered dead babies and 9 (14.1%) had severe birth asphyxia needing neonatal intensive care. Conclusion: Uterine rupture is amongst the preventable obstetric complication that carries severe risks both to the mother as to the baby. Health education of people, training and supervision of health personal may reduce incidence especially in remote areas. PMID:23118819

QAZI, Qudsia; AKHTAR, Zubaida; KHAN, Kamran; KHAN, Amer Hayat

2012-01-01

88

Hospital clonal dissemination of Enterobacter aerogenes producing carbapenemase KPC-2 in a Chinese teaching hospital.  

PubMed

Carbapenems are first-line agents for the treatment of serious nosocomial infections caused by multidrug-resistant Enterobacteriaceae. However, resistance to carbapenems has increased dramatically among Enterobacteriaceae in our hospital. In this study, we report clonal dissemination caused by carbapenem-resistant Enterobacter aerogenes (CREA). In 2011, CREA was identified from 12 patients admitted to the neurosurgical ward. All 12 clinical isolates were non-susceptible to cefotaxime, ceftazidime, cefoxitin, ertapenem, imipenem or meropenem. All isolates carried the gene encoding Klebsiella pneumoniae carbapenemase-2 (KPC-2), except for the isolate E4. However, a remarkably lower expression level of the porin OmpF was detected in the non-KPC-2-producing isolate E4 on SDS-PAGE compared with the carbapenem-susceptible isolate. Epidemiological and molecular investigations showed that a single E. aerogenes strain (PFGE type A), including seven KPC-2-producing clinical isolates, was primarily responsible for the first isolation and subsequent dissemination. In a case-control study, we identified risk factors for infection/colonization with CREA. Mechanical ventilation, the changing of sickbeds and previous use of broad-spectrum antibiotics were identified as potential risk factors. Our findings suggest that further studies should focus on judicious use of available antibiotics, implementation of active antibiotic resistance surveillance and strict implementation of infection-control measures to avoid the rapid spread or clonal dissemination caused by carbapenem-resistant Enterobacteriaceae in healthcare facilities. PMID:24273320

Qin, Xiaohua; Yang, Yang; Hu, Fupin; Zhu, Demei

2014-02-01

89

Iron Deficiency Among Non-Anemic Under-Five Children in Enugu, South-East, Nigeria  

PubMed Central

Background: Iron deficiency has been described as the world most common nutritional deficiency and the commonest cause of nutritional anemia in infancy and childhood. The deleterious behavioral and cognitive deficit associated with iron-deficiency anemia could be irreversible. Therefore, the latter should be prevented by early detection of iron deficiency in the non-anemic groups. Aim: To determine the prevalence of iron deficiency in the non-anemic under-five children and to document its variation among the age classes of these children. Subjects and Methods: Under-five children presenting at a tertiary hospital were consecutively enrolled, Serum ferritin levels of the subjects were used to assess the iron status and serum ferrritin level of less than 12 ng/ml was considered as iron deficiency. Data were analyzed using SPSS version 15.0. Chi-square tests were employed as necessary for test of significance in each of the characteristics of the population at P ? 0.05. Results: A total of 178 non anemic under-five children were studied, their mean hematocrit and serum ferrritin values were 35.5 (2.8%) and 54.9 (76.1) ng/ml respectively. Forty-nine (27.5% [49/178]) of the study population was iron deficient and there was no significant difference in the prevalence of iron deficiency among the age classes (P = 0.75). Conclusion: This study has documented a high prevalence of iron deficiency in non-anemic under-five children presenting at the outpatient department and emergency room of a tertiary health facility in Enugu. All the age classes were relatively affected. A further research into the causes of iron deficiency in this age group is recommended. PMID:24116322

Ekwochi, U; Odetunde, OI; Maduka, IC; Azubuike, JC; Obi, IE

2013-01-01

90

Six cases of sepsis caused by Pantoea agglomerans in a teaching hospital.  

PubMed

Pantoea agglomerans is an environmental organism which may seldom cause opportunistic infections. Here we report on a 6 case outbreak in a teaching hospital. Within three months . agglomerans was isolated from blood cultures of 5 patients from oncology and 1 patient from ICU departments. P. agglomerans was in pure culture in 5 cases, while in the last one Rahnella aquatilis and Candida famata were also isolated. Therefore, P. agglomerans is able to produce nosocomial infections in patients with primary pathology often associated with immune suppression. PMID:19382678

Liberto, Maria Carla; Matera, Giovanni; Puccio, Rossana; Lo Russo, Teresa; Colosimo, Elena; Focà, Emanuele

2009-01-01

91

Impact of education and training on neonatal resuscitation practices in 14 teaching hospitals in India.  

PubMed

The impact of a neonatal resuscitation programme (NRP) on the incidence, management and outcome of birth asphyxia was evaluated in 14 teaching hospitals in India. Two faculty members from each institution attended a neonatal resuscitation certification course and afterwards trained staff in their respective hospitals. Each institution provided 3 months pre-intervention and 12 months post-intervention data. Introduction of the NRP significantly increased awareness and documentation of birth asphyxia, as judged by an increased incidence of asphyxia based on apnoea or gasping at 1 and 5 minutes (p < 0.001 and < 0.01, respectively). A significant shift towards more rational resuscitation practices was indicated by a decline in the use of chest compression and medication (p < 0.001 for each), and an increase in the use of bag and mask ventilation (p < 0.001). Although overall neonatal mortality did not decrease, asphyxia-related deaths declined significantly (p < 0.01). PMID:11284243

Deorari, A K; Paul, V K; Singh, M; Vidyasagar, D

2001-03-01

92

Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia  

PubMed Central

Background Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patients. Patients may perceive the day of surgery as the biggest and the most threatening day in their lives. There is paucity of information on predictors of anxiety in the current study area. The main objective of this study is to assess predictors of preoperative anxiety among patients scheduled for surgery in Jimma University Specialized Teaching Hospital. Methods A facility based cross-sectional study was conducted using quantitative data collection technique in Jimma University Specialized Teaching Hospital from February 13 to April 13, 2012 on 239 patients scheduled for surgery. The data were collected by five trained diploma nurses using structured interviewer administered questionnaires that were prepared based on state trait anxiety inventory measurement scale. The quantitative data were entered into SPSS for windows version 16. 0 and descriptive, simple and multiple linear regression analyses were performed. Results A total of 239 patients were enrolled in the study with a response rate of 93.0%. Their mean age was 42.7?±?1.8 years (range 16 to 85 years). Nearly over half 53.6% were females, while 48.1% illiterate, 72.4% Oromo and 56.5% were Muslim followers. Significant preoperative anxiety was seen in 70.3% patients. The most common factors that lead to anxiety were fear of death 38.1% and fear of unknown origin 24.3% and the most common strategy mentioned by patient in reducing anxiety were talking to other patient 79.8% and religious belief. Conclusions In the present study, two third 70.3% of preoperative patients had anxiety. Factors which were positively correlated with anxiety were trait anxiety, single and divorced, time of operation and income. Factors which were shown to reduce anxiety were preoperative anxiety related information provision and afternoon operation. Health professionals working in the hospital should provide anxiety related information for patients. PMID:25189274

2014-01-01

93

Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria  

PubMed Central

Background The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, South West Nigeria. Methods This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases. Results Sudden death accounted for 29 (4.0%) of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74) years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%), followed by respiratory disease (20.7%), pulmonary thromboembolism (10.4%), central nervous system disease (13.8%), gastrointestinal disorders (13.8%), severe chemical/drug poisoning (13.8%), and combined cardiovascular and central nervous system disease (13.8%). Hypertension-related causes were responsible for 14/29 (48.3%) of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe atheromatous changes occurred in the aorta in 38.5% of patients aged ?50 years. No case of myocardial infarction was found. Conclusion Hypertensive heart disease and hypertension-related disorders are the most common causes of sudden death in South West Nigeria, so effective public health strategies should be channeled towards prevention, detection, and treatment of hypertension. PMID:23836978

Akinwusi, Patience Olayinka; Komolafe, Akinwumi Oluwole; Olayemi, Olanrewaju Olayinka; Adeomi, Adeleye Abiodun

2013-01-01

94

Use of non-formulary drugs in children at a Brazilian teaching hospital: a descriptive study  

PubMed Central

Objective To characterise the prescription of non-formulary drugs to children and neonates at a Brazilian teaching hospital and identify adverse drug reactions (ADRs), drug interactions, and prescription of potentially hazardous medicines. Methods A prospective exploratory study was carried out between January and May 2011 at the general paediatric wards and paediatric oncology, paediatric intensive care, and neonatal care units of the study hospital. Non-formulary drugs were categorised as approved, off-label, or not approved for use in children according to Brazilian compendia. Electronic health records were actively searched for ADRs and the possibility of moderate to severe interactions between non-formulary drugs and other medicines was determined with the Micromedex® database. Results Overall, 109 children or neonates received non-formulary drugs. Of these drugs, 54% were approved for use in children, 12.2% were used off-label, and 33.8% were not approved for use in children. Non-formulary drugs accounted for 13.4% of total prescriptions; 5.3% of drugs had a potential for interactions and five were possibly associated with ADRs. Conclusions Prescription of non-formulary drugs not approved for use in children was common at the study hospital. Studies such as this provide information on the use of medicines for special indications and permit assessment of the relevance of hospital formularies for the paediatric population. PMID:24155845

Tramontina, Mariana Y.; Heineck, Isabela; Dos Santos, Luciana

95

An Individual-Based Model of Transmission of Resistant Bacteria in a Veterinary Teaching Hospital  

PubMed Central

Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen. PMID:24893006

Suthar, Neeraj; Roy, Sandip; Call, Douglas R.; Besser, Thomas E.; Davis, Margaret A.

2014-01-01

96

The use of sedative-hypnotic drugs in a university teaching hospital.  

PubMed Central

We reviewed the charts of 476 patients admitted to a university teaching hospital to determine whether sedative-hypnotic drugs (SHDs) were being used excessively and to examine the use of SHDs as hypnotics. The frequency of medical and surgical indications for barbiturates and benzodiazepines or other minor tranquillizers as well as the use of such drugs were compared among different groups of patients and specialty wards. Of the patients 29% had a regular order and 40% had a PRN order; only 77% of the PRN orders were administered. A total of 215 patients (45%) received an SHD during their hospital stay, and 160 (34%) received the drug as a hypnotic. Medical indications accounted for 49% of the regular orders but only 2% of the PRN orders; moreover, 89% of all the PRN orders were for insomnia. On average, patients receiving SHDs as hypnotics were older (p less than 0.05) and stayed longer in hospital (p less than 0.01) than those who did not; however, no patient on the geriatric or pediatric ward received an SHD as a hypnotic during the hospital stay. The differences in use between patient groups may have been influenced by orientation of ward staff. Physicians should review their rationale for prescribing hypnotics and avoid routine orders on admission. PMID:2369436

O'Reilly, R; Rusnak, C

1990-01-01

97

The Historical Dynamics of Migration into Enugu city, Southeastern Nigeria, 1915-1990  

Microsoft Academic Search

As one of the 'new towns' of tropical Africa which arose as a result of contact with Europe, Enugu was intended primarily for white colonial officials, then, if need be, a few native (indigenous) labourers - colliers, railway men and domestic servants - whose services were 'absolutely essential'. However, due to the pressing need for labour to service the colliery

Akachi Odoemene

98

Patients' Attitude towards Undergraduate Medical Students at University Charity Teaching Hospital in Sudan  

PubMed Central

Background The cooperation of patients and their acceptance to involve medical students in their care is vital to clinical education. Objective To explore the attitudes of patients towards medical students at University charity teaching hospital, and to explore the determinants of those attitudes. Methods This cross-sectional study was conducted at University charity teaching hospital affiliated to University of Medical Sciences and Technology (UMST). Four hundred and thirty-two patients were interviewed between January and December 2013 using a structured questionnaire. Results Four hundred and thirty-two patients had responded to all questions they were asked. Of the patients interviewed, 95.2% approved the presence of medical students during the medical consultation. 79.8% of the patients agreed to be examined by students in the presence of a doctor, while 33.5% gave agreement even in the absence of a doctor. More than half of the patients think that it is important that students examine patients as part of their training and 18 % of them were not sure about the importance of clinical examination. Conclusion The study concluded overall positive attitudes to the medical students’ involvement by patients. Patients preferred lower number of students to be involved; however, few were aware of their rights.

Alawad, Awad Ali M.; Younis, Faisal H.

2014-01-01

99

Reported incidence, causes, and reporting of medication errors in teaching hospitals in Jordan: a comparative study.  

PubMed

This research assessed the reported incidence, causes and reporting of medication errors in intensive care units (ICUs) and wards of Jordanian teaching hospitals. There are few studies about medication errors in Jordan. This survey was conducted in 2010 using a convenience sample of 212 nurses from four teaching hospitals. The response rate was 70.6% (212/300). The mean of the reported incidence of medication errors for the whole sample was 35%; 36.4% in ICUs and 33.8% in wards. An inaccurate rate of total parenteral nutrition (TPN) was the scenario most commonly classified as a drug error; for this nurses would notify the physician, and complete an incident report. Poor quality or damaged medication labels were the most commonly reported causes of errors. Nurses failed to report medication errors because they were afraid that they might be subjected to disciplinary actions. There were some significant differences between ICUs and wards in assessment of clinical scenarios, causes of medication errors as well as their reporting. Reporting of medication errors should be encouraged. Immediate interventions should be initiated by all healthcare professionals in all clinical settings, especially in wards. PMID:22800388

Mrayyan, Majd T

2012-06-01

100

Patients' receptiveness for Medical students during consultation in Out patient department of a teaching hospital in Karachi Pakistan  

PubMed Central

Objective: Patients’ attitude towards medical students’ presence during treatment depends on the cultural values of the society. This study was conducted to find out the patients’ receptiveness in our society to be involved in teaching process for medical students during consultation in out patient department of a teaching hospital in Karachi Pakistan. Methodology: This cross sectional study was conducted in the surgical Out Patient Department (OPD) at Dow University Hospital from May 2012 to June 2012. Four hundred and eleven patients consented for participation through non probability purposive sampling, in which 279 patients were from morning clinics in the presence of students for clinical teaching, while 132 patients participated through evening clinics of surgery, when students were not present for comparison in specific dimensions of care for patients’ satisfaction. Results: Majority of patients 293 (71%) agreed with the teaching of students during consultation and they feel they are contributing in future doctor’s teaching, only 24% patients disagreed. Fifty two percent of patients who disagreed reported interference in privacy, 34% reported interference in consultation and 43% felt it resulted in prolong waiting time due to teaching. Conclusion: Majority of the patients agree to be part of teaching for medical students and this study can be used to assess the educational interventions designed to improve the patient based teaching. PMID:24353555

Laiq-uz-Zaman Khan, Muhammad; Jawaid, Masood; Hafeez, Kamran

2013-01-01

101

Surveillance of ESBL producing multidrug resistant Escherichia coli in a teaching hospital in India  

PubMed Central

Objective To record nosocomial and community-acquired accounts of antibiotic resistance in Escherichia coli (E. coli) strains, isolated from clinical samples of a teaching hospital by surveillance, over a period of 39 months (November 2009-January 2013). Methods Clinical samples from nosocomial sources, i.e., wards and cabins, intensive care unit (ICU) and neonatal intensive care unit (NICU), and community (outpatient department, OPD) sources of the hospital, were used for isolating strains of E. coli, which were subjected for testing for production of ‘extended spectrum beta-lactamase’-(ESBL) enzyme as well as determining antibiotic sensitivity pattern with 23 antibiotics. Results Of the total 1642 (100%) isolates, 810 (49.33%) strains were from OPD and 832 (50.66%) were from hospital settings. Occurrence of infectious E. coli strains increased in a mathematical progression in community sources, but in nosocomial infections, such values remained almost constant in each quarter. A total of 395 (24.05%) ESBL strains were isolated from the total 810 isolates of community; of the total of 464 (28.25%) isolates of wards and cabins, 199 (12.11%) were ESBL strains; and among the total of 368 (22.41%) isolates of ICU and NICU, ESBLs were 170 (10.35%); the total nosocomial ESBL isolates, 369 (22.47%) were from the nosocomial total of 832 (50.66%) isolates. Statistically, it was confirmed that ESBL strains were equally distributed in community or hospital units. Antibiogram of 23 antibiotics revealed progressive increases of drug-resistance against each antibiotic with the maximum resistance values were recorded against gentamicin: 92% and 79%, oxacillin: 94% and 69%, ceftriaxone: 85% and 58%, and norfloxacin 97% and 69% resistance, in nosocomial and community isolates, respectively. Conclusions This study revealed the daunting state of occurrence of multidrug resistant E. coli and its infection dynamics in both community and hospital settings.

Rath, Shakti; Dubey, Debasmita; Sahu, Mahesh C.; Padhy, Rabindra N

2014-01-01

102

Drug utilization evaluation of imipenem and intravenous ciprofloxacin in a teaching hospital.  

PubMed

Drug Utilization Evaluation (DUE) studies are designed to assess drug usage appropriateness. We aim to evaluate the drug utilization of intravenous ciprofloxacin and imipenem, two of the broad spectrum antibiotics that consume a significant proportion of our hospitals' outlay, in different wards of a teaching hospital in Zabol. During a 5 months period (December 2010 to May 2011), 263 patients who received imipenem or intravenous ciprofloxacin were assigned to this study. Retrospective review of patient's records was carried out. Data were converted to Defined Daily Dose (DDD) and the ratio of prescribed daily dose per DDD was calculated. Among these records, 100 patients received either imipenem or ciprofloxacin. The ratio of prescribed daily dose to DDD was 1.5 for both antibiotics. Almost all patients received empiric therapy in both groups. Only 13 patients (26%) in ciprofloxacin group and 4 patients (8%) in imipenem group received their antibiotics consistent with American Hospital Formulary System (AHFS) mentioned indication. Baseline Blood Urea Nitrogen (BUN) and serum Creatinine were ordered for only 37 patients (74%) in both groups with 15 abnormal results but dose adjustment performed just in one case with decreased renal function. In conclusion, the majority of courses with both drugs were empirically selected and continued and required lab tests for drug monitoring and dose adjustments were not performed in most cases. Educational interventions, developing a local formulary and a strict antibiotic prescribing policy for example by prior approval by an infectious disease consultant can help significantly to overcome these problems. PMID:24250684

Mousavi, Sarah; Behi, Mehdi; Taghavi, Mohammad Reza; Ahmadvand, Alireza; Ziaie, Shadi; Moradi, Mandana

2013-01-01

103

Laparoscopic totally extraperitoneal versus Lichtenstein herniorrhaphy: cost comparison at teaching hospitals.  

PubMed

Laparoscopic hernia repair is safe and effective and may result in less postoperative pain and faster recuperation compared with traditional open hernia repairs. Controversy exists as to the increased cost associated with laparoscopic repairs. The purpose of this study was to quantify and compare the cost of the totally extraperitoneal (TEP) laparoscopic repair and the tension-free Lichtenstein repair at teaching hospitals. The records of consecutive TEP (n = 28) and Lichtenstein (n = 28) repairs performed at Parkland Memorial Hospital and Zale-Lipshy University Hospital were reviewed. A detailed cost analysis was performed. Total patient charge (5,509 US dollars vs. 3,999 US dollars) and total cost (2,861 US dollars vs. 2,009 US dollars) were higher for TEP versus Lichtenstein repairs, respectively (P < 0.05). Operative time and complications were similar for both groups. Return to full activity (15 vs. 34 days) was faster for TEP versus Lichtenstein repairs, respectively (P < 0.05). Of 9 patients in the TEP group who had previously undergone an open hernia repair, 8 (89%) preferred the laparoscopic approach. The laparoscopic TEP repair costs 852 US dollars more than the Lichtenstein repair. The TEP repair results in faster recuperation. Patient preference and faster recuperation may offset the increased cost associated with laparoscopic hernia repair. PMID:12960790

Schneider, Benjamin E; Castillo, Juan M; Villegas, Leonardo; Scott, Daniel J; Jones, Daniel B

2003-08-01

104

Fever of unknown origin at a teritiary care teaching hospital in Pakistan.  

PubMed

The aim of this study was to determine the causes of fever of unknown origin (FUO) at a tertiary care teaching hospital in Pakistan. We conducted this cross sectional descriptive study at the Department of Medicine, Civil Hospital Karachi, from January 2006 to December 2011. We reviewed the medical records of all patients aged > 12 years with a primary diagnosis of FUO. We excluded those who did not meet inclusion criteria. Two hundred five patients were analyzed, 111 (54%) were male. The mean age of patients was 38 +/-14 years. The mean duration of fever prior to hospitalization was 37 +/- 16 days and the mean time taken to reach a final diagnosis was 19 +/- 14 days. A diagnosis was established in 171 patients. Infections, especially tuberculosis, were the most common cause of FUO, followed by connective tissue diseases and malignancies. Causes of FUO and their frequencies in the population should be known because FUO is most often caused by an unusual presentation of a common disease, but may also be caused by a rare condition. Common diseases should be suspected first when investigating FUO. Factors causing delay in diagnosis should be identified and overcome to improve outcomes. PMID:24050083

Mahmood, Khalid; Akhtar, Tehseen; Naeem, Muhammad; Talib, Abu; Haider, Iftikhar; Siraj-Us-Salikeen

2013-05-01

105

A survey of digital radiography practice in four South African teaching hospitals: an illuminative study  

PubMed Central

Purpose: The purpose of this study was to assess radiographer familiarity and preferences with digital radiography in four teaching hospitals and thereafter make recommendations in line with the migration from screen film to digital radiography. Materials and methods: A questionnaire was designed to collect data from either qualified or student radiographers from four teaching hospitals. From the four teaching hospitals, there were a total of 205 potential respondents. Among other things, responses regarding experiences and preferences with digital radiography, quality control procedures, patient dose, advantages and disadvantages of digital radiography were sought. The information collected was based on self-reporting by the participants. The study is exploratory in nature and descriptive statistics were generated from the collected data using Microsoft Excel 2007 and StatsDirect software. Results: Sixty-three out of 205 (31%) radiographers from all the four radiology centers responded to the circulated questionnaire. Only 15% (8) of the qualified radiographers had 4 or more years of experience with digital radiography compared to 68% (36) for the same amount of experience with screen-film radiography. Sixty-one percent (38) of the participants had been exposed to digital radiography during their lectures while at university. A small proportion, 16% (10) of the respondents underwent formal training in quality control procedures on the digital X-ray units they were using. Slightly more than half (55%) of the participants felt it was easier for them to retake an image in digital radiography than in screen film radiography. Conclusion: The results of this survey showed that the participants are familiar with digital radiography and have embraced this relatively new technology as shown by the fact that they can identify both its advantages and disadvantages as applied to clinical practice. However, there are minimal quality control procedures specific to digital radiography being undertaken as such there is need for formal education, continuing education and manufacturer training with respect to quality control as institutions make the transition from conventional screen film radiology to digital radiology. PMID:21611065

Nyathi, T; Chirwa, TF; van der Merwe, DG

2010-01-01

106

Nurses exposure to workplace violence in a large teaching hospital in Iran  

PubMed Central

Background: Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods: We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the International Health Organization (IHO), the International Council of Nurses (ICN), and the Public Services International (PSI). Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Results: Three hundred and one nurses responded to the questionnaire (a response rate of 73%). Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%), bullying-mobbing (29% CI: 24-34%) and physical violence (12% CI: 9-16%) at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. Conclusion: We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate. PMID:25396205

Teymourzadeh, Ehsan; Rashidian, Arash; Arab, Mohammad; Akbari-Sari, Ali; Hakimzadeh, Seyyed Mostafa

2014-01-01

107

Nurses' attitudes to a medical emergency team service in a teaching hospital  

PubMed Central

Background Cultural barriers including allegiance to traditional models of ward care and fear of criticism may restrict use of a medical emergency team (MET) service, particularly by nursing staff. A 1?year preparation and education programme was undertaken before implementing the MET at the Austin Hospital, Melbourne, Australia. During the 4?years after introduction of the MET, the programme has continued to inform staff of the benefits of the MET and to overcome barriers restricting its use. Objective To assess whether nurses value the MET service and to determine whether barriers to calling the MET exist in a 400?bed teaching hospital. Methods Immediately before hand?over of ward nursing, we conducted a modified personal interview, using a 17?item Likert agreement scale questionnaire. Results We created a sample of 351 ward nurses and obtained a 100% response rate. This represents 50.9% of the 689 ward nurses employed at the hospital. Most nurses felt that the MET prevented cardiac arrests (91%) and helped manage unwell patients (97%). Few nurses suggested that they restricted MET calls because they feared criticism of their patient care (2%) or criticism that the patient was not sufficiently unwell to need a MET call (10%). 19% of the respondents indicated that MET calls are required because medical management by the doctors has been inadequate; many ascribed this to junior doctors and a lack of knowledge and experience. Despite hospital MET protocol, 72% of nurses suggested that they would call the covering doctor before the MET for a sick ward patient. However, 81% indicated that they would activate the MET if they were unable to contact the covering doctor. In line with hospital MET protocol, 56% suggested that they would make a MET call for a patient they were worried about even if the patient's vital signs were normal. Further, 62% indicated that they would call the MET for a patient who fulfilled MET physiological criteria but did not look unwell. Conclusions Nurses in the Austin Hospital value the MET service and appreciate its potential benefits. The major barrier to calling the MET appears to be allegiance to the traditional approach of initially calling parent medical unit doctors, rather than fear of criticism for calling the MET service. A further barrier seems to be underestimation of the clinical significance of the physiological perturbations associated with the presence of MET call criteria. PMID:17142592

Jones, D; Baldwin, I; McIntyre, T; Story, D; Mercer, I; Miglic, A; Goldsmith, D; Bellomo, R

2006-01-01

108

Profile of diabetic ketoacidosis at a teaching hospital in Benghazi, Libyan Arab Jamahiriya.  

PubMed

This study describes the profile of 100 cases of diabetic ketoacidosis (DKA) at a teaching hospital in 1 Benghazi, Libyan Arab Jamahiriya. DKA was more frequent in young women with type 1 diabetes and mostly due to preventable causes, e.g., disrupted insulin treatment and/or infection. DKA also occurred in type 2 diabetics, with a higher mortality rate, as they were older patients with co-morbidity. Polyurea, fatigue, abdominal pain and vomiting were the most common clinical features, while coma was rarer. A high number of cases were first presentations of type 1 diabetes; hence this diagnosis should be considered in all patients with acute abdomen or decreased level of consciousness. The reasons for high mortality rate in this study (10%) were multifactorial. PMID:20795443

Elmehdawi, R R; Elmagerhei, H M

2010-03-01

109

TRENDS IN CERVICAL CANCER INCIDENCE IN UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL (UPTH), RIVERS STATE, NIGERIA.  

E-print Network

The incidence of cervical cancer varies dramatically, both globally and within individual countries.This retrospective study was carried out to determine the trend in cervical cancer incidence in the University of Port Harcourt Teaching Hospital (UPTH) from 2007 to 2009, using the data collected from the Department of Anatomical –Pathology. A total number of 69 cases were reported. The incidence in age group 50-59 in 2007 (36.8%) and 2009 (33.3%) was the highest, the lowest incidence was in the youngest age group of 20-29 with 5 % in 2007 and no case in 2009. In 2008 the age group 50-59 was the lowest having

Onyije F. M; Eroje M. A; Fawehinmi H. B

110

PATTERN OF ADVERSE DRUG REACTIONS EXPERIENCED BY TUBERCULOSIS PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL IN WESTERN NEPAL  

Microsoft Academic Search

Tuberculosis is a common problem in developing countries including Nepal. Data regarding the safety profile of anti tubercular drugs is lacking in Nepal. The present study analyzed the pattern of ADRs caused by the antitubercular drugs. Inpatient files of all the TB patients who received treatment at the Manipal Teaching Hospital, Pokhara, Nepal during the period from 1st January 2001

KISHORE PV; SUBISH PALAIAN; PRADIP OJHA; SHANKAR PR

111

Acute Myocardial Infarction: Clinical Characteristics, Management and Outcome in a Metropolitan Veterans Affairs Medical Center Teaching Hospital  

Microsoft Academic Search

Objectives. The influence of race and age on thrombolytic therapy, invasive cardiac procedures and outcomes was assessed in a Veterans Affairs teaching hospital. The influence of Q wave evolution on the use of invasive cardiac procedures and outcome was also assessed.Background. It is not well known how early revascularization procedures for acute myocardial infarction are delivered or influence survival in

Judith K Mickelson; Cynthia M Blum; Jane M Geraci

1997-01-01

112

Montreal neurological institute and Hospital Winter 2006 a teacHing and researcH institute of Mcgill university  

E-print Network

Montreal neurological institute and Hospital ­ Winter 2006 a teacHing and researcH institute the left: Ms. Jillian Victor, Mr. Gary Victor, Mrs. Graida Victor, Ms. Hilda Thorarinsdottir and Dr. Vladymir Rymar #12;Mr. Herschel Victor 2 Mrs. Norma Singerman, Mr. Gary Victor, Mrs. Isabelle Shuster

Shoubridge, Eric

113

The mission of the hospitality management division is to educate students for management and leadership in the hospitality industry and to lead the profession through excellence in teaching, research and service.  

E-print Network

The mission of the hospitality management division is to educate students for management and leadership in the hospitality industry and to lead the profession through excellence in teaching, research and service. The Hospitality Management program at UNT features a unique laboratory environment. Students put

Mohanty, Saraju P.

114

Prospective study of medical abortion in Nepal Medical College Teaching Hospital (NMCTH). A one year experience.  

PubMed

A combination of antiprogesterone mifepristone and prostaglandin analogue misoprostol provides an effective non surgical method for termination of pregnancy up to gestational age of 63 days. The objective of this study was to assess the efficacy of this medical regimen for termination of pregnancy up to 63 days of pregnancy. A hospital based prospective study was carried out in department of obstetrics and gynecology at Nepal Medical College Teaching Hospital (NMCTH) for a period of one year where 100 women requesting for medical abortion were enrolled. The medical regimen used was mifepristone 200 mg orally followed 24 hours later by misoprostol 800 micrograms administered buccally. Most of the women were in age group 20-29 years (50%), were nulliparous (81%) and were within 42 days of pregnancy (47%). The overall success rate of this regimen was 93.6%. Where success was defined as achieving complete abortion without needing surgical evacuation. Surgical evacuation was needed in 6 (6.4%) patients i.e. 5 for incomplete abortion and one for continued viable pregnancy. The combination of oral mifepristone 200mg followed 24 hours later by buccal misoprostol 800mcg is effective method of medical termination of pregnancy. PMID:22808819

Giri, A; Tuladhar, H; Tuladhar, A S; Maharjan, M; Dhakal, N

2011-09-01

115

Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India  

PubMed Central

Aim: To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Materials and Methods: Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer's criteria (2012) and PRISCUS list (2010). Results: A total of 676 geriatric patients (52.12% females) were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer's criteria, at least one inappropriate medicine was prescribed in 590 (87.3%) patients. Metoclopramide (54.3%), alprazolam (9%), diazepam (8%), digoxin > 0.125 mg/day (5%), and diclofenac (3.7%) were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) in heart and renal failure patients was the commonly identified drug–disease interaction. According to PRISCUS list, at least one inappropriate medication was prescribed in 210 (31.06%) patients. Conclusion: Use of inappropriate medicines is highly prevalent in elderly patients.

Jhaveri, Binit N.; Patel, Tejas K.; Barvaliya, Manish J; Tripathi, Chandrabhanu

2014-01-01

116

Empathy from the Nurses' Viewpoint in Teaching Hospitals of Tabriz University of Medical Sciences, Iran  

PubMed Central

Introduction: Empathy is the ability to put one in the place of others and to better understand their feelings and experiences. According to researchers, there is a type of challenge in using this concept in nursing field. In most cases, the term empathy substitutes other concepts. Regarding this point, it seems quite necessary to research and discuss different dimensions of this concept in different studies. This study aimed to determine empathy regarding the nurses' point of view. Methods: In this descriptive study sample size was selected according to study population or in the other hand all the nurses in 3 general hospital was selected because they are the most important teaching hospital in Tabriz. LEP (La Monica Empathy Profile) was used as empathy tool. Data were analyzed by SPSS Ver. 13.0. Results: In nonverbal behavior dimension, touching the patient was considered as the most effective methods. On the other hand, nurses could not always be able to control stress and they could not always being with patients to show their empathy. Many people believe that nurses showed very little feelings while raggedly the reflective enclosure and they occasionally had to change their schedules to talk to patients. Conclusion: In most cases the nurses support nonverbal behavior, such as reflective, close and touching encountering in establishing relationship with the patient. However, to improve this situation, planning for nurses to become familiar with the ways through which they can express their interest to show empathy would be effective

Parvan, Kobra; Ebrahimi, Hossein; Zamanzadeh, Vahid; Seyedrasooly, Alehe; Dadkhah, Delavar; Jabarzadeh, Faranak

2014-01-01

117

Comparison of percutaneous coronary intervention safety before and during the establishment of a transradial program at a teaching hospital.  

PubMed

This study sought to examine the safety of percutaneous coronary intervention (PCI) before and during de novo establishment of a transradial (TR) program at a teaching hospital. TR access remains underused in the United States, where cardiology fellowship programs continue to produce cardiologists with little TR experience. Establishment of TR programs at teaching hospitals may affect PCI safety. Starting in July 2009 a TR program was established at a teaching hospital. PCI-related data for academic years 2008 to 2009 (Y1) and 2009 to 2010 (Y2) were prospectively collected and retrospectively analyzed. Of 1,366 PCIs performed over 2 years, 0.1% in Y1 and 28.7% in Y2 were performed by TR access. No major complications were identified in 194 consecutive patients undergoing TR PCI, and combined bleeding and vascular complication rates were lower in Y2 versus Y1 (0.7% vs 2.0%, p = 0.05). Patients treated in Y2 versus Y1 and by TR versus transfemoral approach required slightly more fluoroscopy but similar contrast volumes and had similar procedural durations, lengths of stay, and predischarge mortality rates. PCI success rates were 97% in Y1, 97% in Y2, and 98% in TR cases. TR PCIs were performed by 13 cardiology fellows and 9 attending physicians, none of whom routinely performed TR PCI previously. In conclusion, de novo establishment of a TR program improved PCI safety at a teaching hospital. TR programs are likely to improve PCI safety at other teaching hospitals and should be established in all cardiology fellowship training programs. PMID:22245405

Leonardi, Robert A; Townsend, Jacob C; Bonnema, D Dirk; Patel, Chetan A; Gibbons, Michael T; Todoran, Thomas M; Nielsen, Christopher D; Powers, Eric R; Steinberg, Daniel H

2012-04-15

118

Comparison of Percutaneous Coronary Intervention Safety Before and During the Establishment of a Transradial Program at a Teaching Hospital  

PubMed Central

This study sought to examine the safety of percutaneous coronary intervention (PCI) before and during the de novo establishment of a transradial (TR) program at a teaching hospital. TR access remains underused in the United States, where cardiology fellowship programs continue to produce cardiologists with little TR experience. The establishment of TR programs at teaching hospitals may affect PCI safety. Starting in July of 2009, a TR program was established at teaching hospital. PCI-related data for the 2008–2009 (Y1) and 2009–2010 (Y2) academic years were prospectively collected and retrospectively analyzed. Of 1,366 PCIs performed over two years, 0.1% in Y1 and 28.7% in Y2 were performed via TR access. No major complications were identified in 194 consecutive patients undergoing TR PCI, and combined bleeding and vascular complication rates were lower in Y2 vs. Y1 (0.7 vs. 2.0%, p = 0.05). Patients treated in Y2 vs. Y1 and by the TR vs. transfemoral approach required slightly more fluoroscopy but similar contrast volumes and had similar procedural durations, lengths of stay, and pre-discharge mortality rates. PCI success rates were 97% in Y1, 97% in Y2, and 98% in TR cases. TR PCIs were performed by 13 cardiology fellows and 9 attending physicians, none of whom routinely performed TR PCI previously. In conclusion, the de novo establishment of a TR program improved PCI safety at a teaching hospital. TR programs are likely to improve PCI safety at other teaching hospitals and should be established in all cardiology fellowship training programs. PMID:22245405

Leonardi, Robert A.; Townsend, Jacob C.; Bonnema, D. Dirk; Patel, Chetan A.; Gibbons, Michael T.; Todoran, Thomas M.; Nielsen, Christopher D.; Powers, Eric R.; Steinberg, Daniel H.

2012-01-01

119

A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya  

PubMed Central

Objective To measure the incidence of maternal and early neonatal mortality in women who gave birth at Moi Teaching and Referral Hospital (MTRH) in Kenya and describe clinical and other characteristics and circumstances associated with maternal and neonatal deaths following deliveries at MTRH. Methods A retrospective audit of maternal and neonatal records was conducted with detailed analysis of the most recent 150 maternal deaths and 200 neonatal deaths. Maternal mortality ratios and early neonatal mortality rates were calculated for each year from January 2004 to December 2011. Results Between 2004 and 2011, the overall maternal mortality ratio was 426 per 100,000 live births and the early neonatal mortality rate (<7?days) was 68 per 1000 live births. The Hospital record audit showed that half (51%) of the neonatal mortalities were for young mothers (15–24?years) and 64% of maternal deaths were in women between 25 and 45?years. Most maternal and early neonatal deaths occurred in multiparous women, in referred admissions, when the gestational age was under 37?weeks and in latent stage of labour. Indirect complications accounted for the majority of deaths. Where there were direct obstetric complications associated with the delivery, the leading cause of maternal death was eclampsia and the leading cause of early neonatal death was pre-mature rupture of membranes. Pre-term birth and asphyxia were leading causes of early neonatal deaths. In both sets of records the majority of deliveries were vaginal and performed by midwives. Conclusion This study provides important information about maternal and early neonatal mortality in Kenya’s second largest tertiary hospital. A range of socio demographic, clinical and health system factors are identified as possible contributors to Kenya’s poor progress towards reducing maternal and early neonatal mortality. PMID:23421605

2013-01-01

120

Increasing access to legal termination of pregnancy and postabortion contraception at the University Teaching Hospital, Lusaka, Zambia.  

PubMed

The Zambian Association of Gynecology and Obstetrics is one of the International Federation of Gynecology and Obstetrics (FIGO) member societies participating in the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences from the East, Central, and Southern Africa region. The activities included in this country's plan of action were to provide access to safe abortion within the full extent of the law to women receiving care at the University Teaching Hospital in Lusaka, and to increase the proportion of women leaving the hospital with a contraceptive method. Zambian law regarding abortion is liberal, but in general it was not applied until very recently. The proportion of legal terminations of pregnancy among patients receiving abortion care at the hospital increased from 3.2% in 2009 to 7.7% in 2011, while the percentage of women leaving the hospital with a contraceptive method increased from 25.3% to 69.4% over the same period. PMID:24786142

Macha, Swebby; Muyuni, Mutinta; Nkonde, Scholastica; Faúndes, Anibal

2014-07-01

121

Hepatobiliary Complications of Sickle Cell Disease among Children Admitted to Al Wahda Teaching Hospital, Aden, Yemen  

PubMed Central

Objectives: This study aimed to describe the pattern of hepatobiliary complications among patients with sickle cell disease (SCD) and to assess their correlation with age, gender and other risk factors. Methods: This cross-sectional study assessed 106 patients with SCD who were admitted to Al Wahda Teaching Hospital in Aden, Yemen, between January and June 2009. A full history, thorough examination, essential laboratory investigations (including a complete blood count, liver function test and viral markers test) and an abdominal ultrasound were performed on all patients. The clinicopathological characteristics of the hepatobiliary complications were analysed for their correlation to different risk factors such as age and gender. Results: It was found that 46.2% of the patients with SCD had hepatobiliary complications. Of these, 36.7% had viral hepatitis, 26.0% had cholecystitis and 20% had gallstones. A total of 60.4% of the affected patients were male. The mean levels of alanine aminotransferase (59.4 and 56.0 U/L) and aspartate transaminase (40.1 and 38.3 U/L) were significantly elevated in patients with viral hepatitis and cholecystitis, respectively. Hepatitis B virus surface antigen showed higher positivity (10.4%) than anti-hepatitis A and anti-hepatitis C antibodies. Hepatobiliary complications increased significantly with age and were notably higher among those who were often admitted to hospital and/or underwent frequent blood transfusions. Conclusion: This study suggests that hepatobiliary complications are common among SCD patients and the likelihood of developing such complications increases as patients age. Thus, regular clinical follow-ups, abdominal ultrasound studies and periodic liver function tests, as well as serological tests for viral hepatitis, are strongly recommended. These can help in the early detection of these complications and allow opportunities for their management and prevention. PMID:25364561

Qhalib, Hana A.; Zain, Gamal H.

2014-01-01

122

Bioaerosol sampling for airborne bacteria in a small animal veterinary teaching hospital  

PubMed Central

Background Airborne microorganisms within the hospital environment can potentially cause infection in susceptible patients. The objectives of this study were to identify, quantify, and determine the nosocomial potential of common airborne microorganisms present within a small animal teaching hospital. Methods Bioaerosol sampling was done initially in all 11 rooms and, subsequently, weekly samples were taken from selected rooms over a 9-week period. Samples were collected twice (morning and afternoon) at each site on each sampling day. The rooms were divided into two groups: Group 1, in which morning sampling was post-cleaning and afternoon sampling was during activity, and Group 2, in which morning sampling was pre-cleaning and afternoon sampling was post-cleaning. The total aerobic bacterial plate counts per m3 and bacterial identification were done using standard microbiological methods. Results A total of 14 bacterial genera were isolated with the most frequent being Micrococcus spp. followed by species of Corynebacterium, Bacillus, and Staphylococcus. There was a significant interaction between location and time for rooms in Group 1 (p=0.0028) but not in Group 2 (p>0.05). Microbial counts for rooms in Group 2 were significantly greater in the mornings than in the afternoon (p=0.0049). The microbial counts were also significantly different between some rooms (p=0.0333). Conclusion The detection of significantly higher airborne microbial loads in different rooms at different times of the day suggests that the probability of acquiring nosocomial infections is higher at these times and locations. PMID:23930156

Harper, Tisha A. M.; Bridgewater, Shelley; Brown, Latoya; Pow-Brown, Patricia; Stewart-Johnson, Alva; Adesiyun, Abiodun A.

2013-01-01

123

Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria  

PubMed Central

Introduction Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. Methods The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. Results 537 (15%) patients were admitted into the study out of 3546 patients {females 1756 and 1790} admitted into medical wards. 322 (60%) of study population were males and 215 (40%) females. 359(67.5%) were discharged, 170 (32%) died and 8 (0.5%) were discharged against medical advice. The majority of the deaths 105(61.8%), were in patients with CVA. Most of the deaths (111 or 65.3%) occurred within the first seven days of admission. The mean age of the population was 60.7 years ±15.9 with a range of 18 to 110 years. The length of stay in hospital ranged between 1 and 140 days with a mean of 13.5 ± 13.9 days and a median of 10 days. 33 of the subjects were single, 406 were married, 94 were widowed (11 males and 83 females) and 4 were divorced. 46.7% (251) were admitted for CVA and 30.9% (166) for heart failure. Cardiomyopathy/valvular heart diseases (clinical diagnosis due to absence of echocardiography) constituted 3.9%, hypertension 20.5% and pre-existing hypertension with uremia 1.9%. Conclusion The study has shown that cardiovascular disease contributed significantly to medical admissions the elderly accounting for a significant proportion. There is thus the need for intensification of primary preventive strategies for cardiovascular diseases. PMID:25120860

Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

2014-01-01

124

Study of Attitudes and Practice of Physicians Regarding Consultation-Liaison Psychiatry in Teaching Hospitals of Mazandaran, Iran  

PubMed Central

Objective: Consultation-liaison (CL) psychiatry interfaces between psychiatry and other medical disciplines to promote integrated care of patients. The purpose of this study is evaluation of attitudes and practice of Mazandaran University of Medical Sciences physicians of teaching hospitals regarding CL psychiatry. Methods:In this descriptive study, all of the general practitioners, specialist and subspecialist physicians and assistants working in teaching hospitals of Mazandaran University of Medical Sciences were requested to fill in a questionnaire which was designed based on previous studies and observations to assess their attitudes and practice. Data were analysed by SPSS-16 software, using chi square. Results: One hundred and forty nine (62.6%) physicians had very positive attitudes and 89 cases (37.4%) had positive attitudes; 234 physicians (98.3%) had acceptable practice, and 4 cases (1.7%) had unacceptable practice. There were no significant differences between physicians with positive and very positive attitudes and between physicians with acceptable and unacceptable practice regarding gender, age, education, specialty and place of work (hospital). The most common reasons of physicians for not requesting psychiatric consultation were lack of time, forgetfulness, lack of access to psychiatrist, and lack of belief in the need for psychiatric consultation respectively. Conclusion: The findings of this study indicate the successful psychiatric educations and psychiatrists practice in formation of positive attitudes and acceptable practice regarding CL Psychiatry in these university hospitals. No significant differences between different specialties and work place hospitals indicate that they are similarly affected. PMID:25053955

Zarghami, Mehran; Farnia, Samaneh; Khalilian, Ali-Reza; Amirian, Tahereh

2014-01-01

125

A descriptive survey of the different management practices for peripheral IV catheters among Greek, Jordanian, and Australian teaching hospitals.  

PubMed

Peripheral IV catheters (PIVCs) are commonly placed in hospital patients. However, there is a lack of evidence on which to base this practice. The aim of this study was to assess current knowledge and practice for this procedure in 3 different cultures. The study collected information from a postal questionnaire sent to physicians and nurses in teaching hospitals in Greece, Jordan, and Australia. The results gathered from the questionnaire depict a number of misconceptions with regard to the management of PIVCs in the 3 healthcare organizations selected for the study. PMID:16569999

Walker, Stuart R; Farraj, Rami; Papavassiliou, Vassilios; Arvanitis, Dimitrios

2006-01-01

126

Profile of neonates born to adolescent mothers at Nepal medical college teaching hospital.  

PubMed

Pregnancy in adolescence is often associated with maternal complications as well as preterm delivery, low birth weight babies and small for date babies. A retrospective study was carried out in 350 adolescent women who delivered child at Nepal Medical College Teaching Hospital (NMCTH), Attarkhel, Kathmandu from April 2005 to February 2009. Data were obtained from the case record register. Prevalence of pregnancy in adolescence was 11.1%. Majority of adolescent mother were aged between 17-19 years, belonging to Mongolian ethnicity, Hindu by belief and residing within Kathmandu Valley. More than 90.0% mothers were primigravida and 85.4% had complete antenatal check up (ANC). Normal vaginal delivery was the predominant mode of delivery (84.6%), followed by lower section caesarean section (LSCS) (14.0%) and instrumental delivery (1.1%). In newborn, male outnumbered female (59.7% versus 40.3%). A reasonable number of preterm (10.9%), low birth weight (12.3%), small for gestational age babies (7.4%) and neonates with birth asphyxia (10.3%) were noted. These newborns are often associated with high morbidity and mortality. Therefore, it is imperative to prevent teenage pregnancy by providing adequate access to health facilities and raising awareness about the sex and reproductive health amongst this population. PMID:24579537

Lama, L; Rijal, P; Budathoki, S; Shrestha, A D

2012-12-01

127

Prescription Patterns of Hypolipidaemic Drugs in a Tertiary Care Teaching Hospital of Southern India  

PubMed Central

Objective: To evaluate the prescribing patterns of hypolipidaemic drugs which were prescribed to patients who visited the department of General Medicine in a tertiary care teaching hospital of southern India. Materials and Methods: A cross-sectional study was done for three months in the department of General Medicine. A total of 506 prescriptions of hypolipidaemic drugs were evaluated, based on the various inclusion and exclusion criteria. The different disease patterns, the types of drugs which were prescribed in those diseases and the WHO prescription indicators, Anatomical Therapeutic Classification as well as the PDD (prescribing daily dose) /DDD (daily defined dose) ratio were calculated. Results: While analyzing the prescriptions, it was found that patients having abnormal lipid profiles (56.9%) and normal lipid profiles (43.1%) were prescribed hypolipidaemic drugs. Diabetes with hypertension (37%) was the most common disease for which hypolipidaemic drugs were prescribed. The average number of drugs per prescription was 3.3±1.33. Atorvastatin was the most common hypolipidaemic drug which was prescribed as monotherapy (53.4%), whereas atorvastatin with aspirin was the most common drug which was prescribed as combination therapy (20%). Atorvastatin was prescribed as underdosed and Rosuvastatin was prescribed as overdosed. Conclusion: This study depicts the use of statins in various disease conditions, both as primary and secondary preventive measures. Such studies should be done to educate the physicians on good prescribing practices and on rational use of hypolipidaemic drugs. PMID:24959461

Mohapatra, Satyajit; Kumar, J.S; Rani, R Jamuna

2014-01-01

128

Role-Reversal Exercise with Deaf Strong Hospital to Teach Communication Competency and Cultural Awareness  

PubMed Central

Objective To implement a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing patients. Design Volunteers from the local deaf community conducted Deaf Strong Hospital, a role-reversal exercise in which students were the “patients.” Students navigated through a reception area, encounter with a physician, and having a prescription filled at a pharmacy without receiving or using any spoken language. Assessment A debriefing session was held in which small groups of students had the opportunity to ask questions of a panel of deaf and hard-of-hearing volunteers. On a survey administered to assess students' learning, 97% agreed or strongly agreed that the experience would likely impact their attitudes and behavior in future interactions with patients who did not speak English. Conclusions The role-reversal exercise was an effective method of teaching students that the delivery of health care is dependent on adequate communication between health care providers and the patient. PMID:21655407

Parkhill, Amy L.; Schlehofer, Deirdre A.; Starr, Matthew J.; Barnett, Steven

2011-01-01

129

Management information needs of clinician managers in a metropolitan teaching hospital.  

PubMed

Clinician managers need relevant, current and integrated information to assist them in their managerial roles. This study examined the management information needs of clinician managers (doctors, nurses, data managers and a business manager) from a metropolitan teaching hospital. A purposive sample, of 15 clinician managers and five Information Unit staff who provide the clinicians with management reports, was interviewed by one researcher between July and September, 2001. The clinician managers indicated a preference for up-to-date, tabular or graphic management reports specific to their clinical specialty, and for education in interpreting the reports. The Information Unit staff members were willing to assist in these respects, and to present at Clinical Unit meetings to facilitate communication between the information providers and users. Clinician managers also required data for comparison with similar units within the area health service, or state-wide; they used the management reports mainly to assist with staffing and budgetary management. Continuous communication between providers and users of management information is essential to support the management function of clinicians. PMID:19468145

Shand, Sarah; Callen, Joanne

2003-01-01

130

Drug use in primary open angle glaucoma: A prospective study at a tertiary care teaching hospital  

PubMed Central

Objective: To study drug use pattern in patients of primary open angle glaucoma (POAG) and to analyze the cost of different anti-glaucoma medications. Materials and Methods: This prospective study was carried in the glaucoma clinic of a tertiary care teaching hospital over a period of 9 months. The data collected for patients with POAG included the patient's demographic details and the drugs prescribed. Data were analyzed for drug use pattern and cost drugs used. Results: In a total 180 prescriptions (297 drugs) analyzed, most drugs (83.83%) were prescribed by topical route as eye drops. ? blockers (93.88%) were found to be the most frequently prescribed for POAG. Timolol (82.22%) was the most frequently prescribed drug and timolol with acetazolamide (17.22%) was the most commonly prescribed drug combination. Fixed dose combinations constituted 26.66% of prescriptions. ? blockers were found to be cheaper than other anti-glaucoma drugs while prostaglandins analogs were the costliest. Instructions about the route, frequency and duration of treatment were present in all prescriptions. However, instructions regarding instillation of eye drops were missing in all prescriptions. PMID:23716884

Yadav, Arvind Kumar; Patel, Varsha

2013-01-01

131

Drug utilization in emergency medicine department at a tertiary care teaching hospital: A prospective study  

PubMed Central

Background and Objectives: The practice of emergency medicine has the primary mission of evaluating, managing and providing treatment to those patients with unexpected injury or illness. Instituting appropriate therapy is necessary for safety of the patients and to decrease mortality and morbidity. The objectives were to study the drug utilization pattern and direct cost of therapy in emergency medicine department of a tertiary care teaching hospital. Materials and Methods: Data of the patients admitted to emergency medicine department was collected prospectively for 48 h from the time of admission over 2 months. The prescriptions were analyzed for drug use pattern and direct cost of therapy was calculated. Results: A total of 156 patients received 1635 drugs with the mean of 9.99 ± 2.55 drugs/patient. Most common diagnosis was acute coronary syndrome 35 (21.79%). Ondansetron 135 (86.53%) was most frequently prescribed drug followed by pantoprazole 133 (85.25%) and furosemide 68 (43.58%). Amongst antimicrobials ceftriaxone 51 (32.69%) was the most commonly prescribed drug. Direct cost of treatment per patient for the first 48 h was ? 4051 ± 1641. Conclusion: Ondansetron and pantoprazole were the most commonly prescribed drugs in the emergency department. However, their use in all patients was not justified. Polypharmacy was prevalent. A closer look at the rationality of therapy would help in highlighting issues involved and would be helpful to authorities in deciding prescribing policies. PMID:24808677

Barot, Preksha A.; Malhotra, Supriya D.; Rana, Devang A.; Patel, Varsha J.; Patel, Kamlesh P.

2013-01-01

132

Pharmacovigilance Knowledge among Patients at a Teaching Hospital in Lalitpur District, Nepal  

PubMed Central

Background: Consumer’s knowledge and perception towards adverse drug reactions (ADR) can play an important role in ensuring a healthy lifestyle and proper use of medicines. Aims: This study aimed to assess the knowledge and perception towards pharma covigilance in general and consumer pharmacovigilance in particular among out patients in a teaching hospital of Nepal. Settings and Design: A descriptive cross-sectional study using qualitative and quantitative methods was carried out from 1st May to 3 June 2013. Methods: Every fifth patient visiting the outpatient pharmacy was interviewed using a semi-structured questionnaire. Gender, age, educational qualification, profession and ethnicity were noted. Twenty-three patients were interviewed. Results: There were 10 males and 13 females. The age of the respondents ranged from 11 to 50 years with a mean age of 27.8 (SD = 5.61) years. Seven (30.43%) respondents were students studying in different levels. Thirteen (56.52%) participants were from the Newar community. Majority of the patients (86.95%) knew ADRs may be caused by the medicines they consume and 18 (78.26%) were of the opinion that ADRs should be reported to doctors and other health care professionals including pharmacists. Conclusion: Knowledge and perception were low in certain areas. There is a need for educational interventions for improving the awareness of patients and general public for ensuring medicine safety and promoting rational use of medicines. PMID:24783073

Jha, Nisha; Rathore, Devendra S; Shankar, P Ravi; Gyawali, Sudesh

2014-01-01

133

Drug Utilization Study in Ophthalmology Outpatients at a Tertiary Care Teaching Hospital  

PubMed Central

In view of the advancement in drug development and availability of new ocular therapeutics in the discipline of ophthalmology, we attempted to study the drug utilization and describe the prescribing practices of ophthalmologists in a tertiary care teaching hospital. Method. A prospective, cross-sectional, observational study was conducted on patients attending Outpatient Department of Ophthalmology for curative complaints. Prescriptions of 600 patients treated were analyzed by the WHO prescribing indicators and additional indices. Results. Analysis showed that the average number of drugs per prescription was 1.49. Percentage of drugs prescribed by generic name was 2.35%. Percentage of encounters with antibiotics was 44.83%. Percentage of drugs prescribed from National Essential drug list (NEDL)/National Formulary of India (NFI) was 19.48%. Patient's knowledge of correct dosage was 93.83%. Antimicrobial agents were the most commonly prescribed drugs followed by antiallergy drugs and ocular lubricants. Fluoroquinolones accounted for 60% of the total antimicrobial drugs, of which gatifloxacin was the most frequently prescribed fluoroquinolone. Conclusion. The study indicated an awareness of polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologists to prescribe by generic name and selection of essential drugs from NEDL/NFI. PMID:24455298

Jadhav, Pradeep R.; Moghe, Vijay V.; Deshmukh, Yeshwant A.

2013-01-01

134

Surgical Management of Vascular Thoracic Outlet Syndrome: A Teaching Hospital Experience  

PubMed Central

Objectives: Thoracic outlet syndrome (TOS) consists of a group of distinct disorders that are caused by compression of the brachial plexus and/or subclavian artery and vein. The aim of this study was to highlight the different modalities of diagnosing and treating vascular TOS and evaluate outcomes. Methods: We conducted a retrospective cohort study between 1999 and 2011 using the medical records database from a teaching hospital. Results: During the study period, 54 cases with vascular TOS were identified in 38 patients. Bilateral TOS was in 16 patients. The median age of the patients was 33 years (range 12–49), and the majority (79%) were female. Arterial TOS represented forty-nine cases (90.7%). Preoperative information derived from plain x-ray, duplex scanning and in selected cases computed tomography (CT) and/or angiography. Decompression of the TOS was performed through a supraclavicular approach in all cases with scalenectomy coupled with either cervical rib excision (70%), 1st rib excision alone (15%) and excision of both cervical and 1st ribs (15%). Adjunctive vascular reconstructive procedures were done in 11 cases (20.3%); 9 arterial cases and 2 venous cases. There was no mortality; however, postoperative complications occurred in 7 cases (13%). Conclusion: The use of advanced radiological imaging and careful surgical planning for Vascular TOS in a high volume center resulted in good outcomes. PMID:23641288

Al-Omran, Mohammed

2013-01-01

135

Salmonella enterica serovar Oranienburg outbreak in a veterinary medical teaching hospital with evidence of nosocomial and on-farm transmission.  

PubMed

Nosocomial salmonellosis continues to pose an important threat to veterinary medical teaching hospitals. The objectives of this study were to describe an outbreak of salmonellosis caused by Salmonella enterica serovar Oranienburg within our hospital and to highlight its unique features, which can be used to help mitigate or prevent nosocomial outbreaks in the future. We retrospectively analyzed data from patients that were fecal culture-positive for Salmonella Oranienburg between January 1, 2006, and June 1, 2011, including historical, clinical, and pulsed-field gel electrophoresis (PFGE) data. Salmonella Oranienburg was identified in 20 horses, five alpacas, and three cows during this time frame, with dates of admission spanning the period from August, 2006, through January, 2008. We consider most of these patients to have become infected through either nosocomial or on-farm transmission, as evidenced by molecular subtyping results and supportive epidemiologic data. Interpretation of PFGE results in this outbreak was challenging because of the identification of several closely related Salmonella Oranienburg subtypes. Furthermore, a high percentage of cases were fecal culture-positive for Salmonella Oranienburg within 24 h of admission. These patients initially appeared to represent new introductions of Salmonella into the hospital, but closer inspection of their medical records revealed epidemiologic links to the hospital following the index case. Cessation of this outbreak was observed following efforts to further heighten biosecurity efforts, with no known cases or positive environmental samples after January, 2008. This study demonstrates that a Salmonella-positive culture result within 24 h of admission does not exclude the hospital as the source of infection, and it underscores the important role played by veterinary medical teaching hospitals as nodes of Salmonella infection that can promote transmission outside of the hospital setting. PMID:24902121

Cummings, Kevin J; Rodriguez-Rivera, Lorraine D; Mitchell, Katharyn J; Hoelzer, Karin; Wiedmann, Martin; McDonough, Patrick L; Altier, Craig; Warnick, Lorin D; Perkins, Gillian A

2014-07-01

136

Scrub typhus cases in a teaching hospital in Penghu, Taiwan, 2006-2010.  

PubMed

Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi (previously called Rickettsia tsutsugamushi). The severity of this disease varies from only mild symptoms to death, and its manifestations are nonspecific. Therefore, clinicians may not correctly diagnose scrub typhus early enough for successful treatment. Reports of infections in travelers returning from Asia to their home countries are increasingly common. Thus, it is important that even clinicians in nonepidemic regions be alert for this disease. Here we describe the epidemiological aspects and clinical manifestations of scrub typhus encountered at a teaching hospital in Penghu, Taiwan, over the past 5 years. A total of 126 patients were confirmed to be positive for scrub typhus at the hospital from 2006 to 2010. All cases were confirmed by the Centers for Disease Control and Prevention or its contract laboratory through pathogen isolation and an indirect immunofluorescence assay. Medical records of these patients were reviewed, and demographic and clinical characteristics, laboratory data, seasonal data, geographic distribution, complications, and outcome were analyzed. The incidence of scrub typhus peaked in individuals aged 0-10 and 51-60 years, with the highest incidence among those ?10 years of age. No significant difference was noted between sexes. Fever was the most common symptom (93.6%), followed by chills (23.8%), cough (18.3%), and headache (14.3%). Eschars were observed in 78 (61.9%) patients, with the axilla being the most frequent site (n=17; 21.8%). Most patients were retirees (n=63; 50%), followed by students (n=16; 12.7%). Patients were more likely to live in rural areas than urban areas. Scrub typhus was epidemic in the spring (April to June) and fall (October to December) in a bimodal distribution similar to that observed in Japan. Leukocytosis was not common, but most patients had abnormal C-reactive protein levels, thrombocytopenia, and elevated liver function test results. Residents of Penghu, particularly Makung City and Husi Township, as well as travelers to the region during the spring and fall seasons should be educated about the signs and symptoms of scrub typhus. All physicians who come into contact with individuals residing in or traveling to or from epidemic regions should remain alert about the manifestations of this disease. PMID:23421889

Wang, Ying-Chuan; Chen, Po-Chuan; Lee, Kwai-Fong; Wu, Yu-Cheng; Chiu, Chun-Hsiang

2013-03-01

137

Immediate neonatal outcome of adolescent pregnant mother at Nepal Medical College Teaching Hospital.  

PubMed

Pregnancy in teenage period of life is often associated with maternal complications as well as preterm delivery, low birth weight babies and small for date babies. The purpose of this study was to know the immediate outcome of neonates delivered by adolescent pregnant mother at Nepal Medical College Teaching Hospital (NMCTH), Attarkhel, Kathmandu. A retrospective comparative study was carried out in 350 adolescent pregnant mother who had delivered newborn at NMCTH from April 2005 to February 2009. Data were obtained from the case record register from Archive. Prevalence of adolescent pregnancy was 11.1%. Majority of adolescent mother were aged between 17-19 years, belonging to Mongolian ethnicity, Hindu by belief and residing within Kathmandu Valley. More than 90.0% mothers were primigravida and 85.4% had complete antenatal check up (ANC). Normal vaginal delivery was the predominant mode of delivery in both group (84.6% vs 80.0%), followed by lower section caesarean section (LSCS) (14.0% vs 18.8%) and instrumental delivery (1.1% Vs 1.2%). In newborn, male outnumbered female (59.7% vs 40.3%). A reasonable number of preterm (10.9% Vs 6.3% p = 0.029), low birth weight (12.3% vs 9.1% P = 0.259) and small for gestational age babies (7.4% vs 5.1% p = 0.318)) and birth asphyxia (10.3% Vs 5.1% p = 0.009%) were found in this study. These newborns are often associated with high morbidity and mortality. Therefore, it is imperative to prevent teenage pregnancy by providing adequate access to health facilities and raising awareness about the sex and reproductive health amongst this population. PMID:24696930

Lama, L; Shrestha, S; Sharma, A; Upadhyay, S; Pathak, M R

2013-06-01

138

Situation Analysis of Patients Attending TU Teaching Hospital after Medical Abortion with Problems and Complications.  

PubMed

Introduction: In Nepal medical abortion has been approved for use since 2009. There were many cases coming to Tribhuvan University Teaching Hospital coming with problems and complications following medical abortion. Thus the objective of this study was to analyze the cases that came to TUTH following medical abortion with problems and complications. Methods: This is a prospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Study was carried from 1st August 2011 to 30th November 2012. Women who came to TUTH with any complaints following medical abortion were interviewed, examined and treatment provided. Relevant clinical finding were noted. Results: There were a total of 57 cases during the study. Most (66.6%) of the women were in age group 20-29 years age. There were 45 (79%) women who had abortion up to 9 weeks. Medical shop was the main place where most of the women (45.6%) directly come to know about medical abortion. More than 34 (77.2%) received the service from medical shops without any supervision. Most 31 (54.4%) presented with incomplete abortion. There were three cases of continuing pregnancy and four presented with ectopic pregnancy. Eighteen (31.6%) cases needed admission. Fifty six percent of the cases were treated with manual vacuum aspiration, six cases underwent laparotomy and there was one maternal mortality. Conclusions: There is a need for proper dissemination and implementation of guideline for management of these women and adequate supervision to reduce the problems and complications. Keywords: complications; incomplete abortion; medical abortion; problems. PMID:24907952

Ojha, N; Bista, K Db

2013-01-01

139

Adherence to preventive medications in asthmatic children at a tertiary care teaching hospital in Malaysia  

PubMed Central

Purpose Asthma affects an estimated 300 million people worldwide. Poor adherence to prescribed preventive medications, especially among children with asthma, leads to increased mortality and morbidity. The purpose of this study was to assess the adherence and persistence levels of asthmatic children at the Universiti Kebangsaan Malaysia Medical Center (UKMMC), a tertiary care teaching hospital, and to determine the factors that influence adherence to prescribed preventive medications. Patients and methods Participants were asthmatic patients aged 18 years and younger with at least one prescription for a preventive medication refilled between January and December 2011. Refill records from the pharmacy dispensing database were used to determine the medication possession ratio (MPR) and continuous measure of gaps (CMG), measures of adherence and persistence levels, respectively. Results The sample consisted of 218 children with asthma from the General and Respiratory pediatric clinics at UKMMC. The overall adherence level was 38% (n=83; MPR ?80%), and the persistence level was 27.5% (n=60; CMG ?20%). We found a significant association between the adherence and persistence levels (r=0.483, P<0.01). The presence of comorbidities significantly predicted the adherence (odds ratio [OR] =16.21, 95% confidence interval [CI]: 7.76–33.84, P<0.01) and persistence level (OR =2.63, 95% CI: 0.13–52.79, P<0.01). Other factors, including age, sex, ethnicity, duration of asthma diagnosis, and number of prescribed preventive medications did not significantly affect adherence or persistence (P>0.05). Conclusion In conclusion, the adherence level among children with asthma at UKMMC was low. The presence of comorbidities was found to influence adherence towards preventive medications in asthmatic children. PMID:24600208

Md Redzuan, Adyani; Lee, Meng Soon; Mohamed Shah, Noraida

2014-01-01

140

Proton Beam Radiotherapy for Uveal Melanomas at Nice Teaching Hospital: 16 Years' Experience  

SciTech Connect

Purpose: To present the results of uveal melanomas treated at Nice Teaching Hospital. Methods and Materials: This retrospective study included 886 consecutive patients referred to our clinic for the treatment of uveal melanomas by proton beam radiotherapy from June 1991 to December 2007. Survival rates were determined by using Kaplan-Meier estimates, and prognostic factors were evaluated using the log-rank test or Cox model. Results: The number (percent total) of subjects staged according to the TNM classification system (6th edition) of malignant tumors included 39 stage T1 (4.4%), 420 stage T2 (47.40%), 409 stage T3 (46.16%), and 18 stage T4 (2.03%) patients. The median follow-up was 63.7 months. The Kaplan-Meier overall survival rate at 5 years according to the sixth edition TNM classification was 92% for T1, 89% for T2, 67% for T3, and 62% for T4; and at 10 years, 86% for T1, 78% for T2, 43% for T3, and 41% for T4. Five factors were found to be associated with an increased death rate: advanced age, tumor thickness, largest tumor basal diameter, tumor volume, and tumor volume-to-eyeball volume ratio. The metastasis-free survival rates were 88.3 % at 5 years and 76.4 % at 10 years. The local control rates were 93.9% at 5 years and 92.1% at 10 years. The ocular conservation rates were 91.1% at 5 years and 87.3% at 10 years. Conclusions: We report the results of a large series of patients treated for uveal melanomas with a very long follow-up. Despite the large tumor volume treated, our results were similar to previously published findings relating to proton beam therapy.

Caujolle, Jean-Pierre, E-mail: ncaujolle@aol.co [Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, 5 rue Pierre Devoluy, BP 319, 06006 Nice cedex 01 (France); Mammar, Hamid [Department of Radiation Oncology, Protontherapy Center, Centre Antoine Lacassagne, 33 avenue Valombrose, 06189 Nice cedex 02 (France); Chamorey, Emmanuel Phar [Department of Biostatistics and Epidemiology, Centre Antoine Lacassagne, 33 avenue Valombrose, 06189 Nice cedex, 02 (France); Pinon, Fabien [Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, 5 rue Pierre Devoluy, BP 319, 06006 Nice cedex 01 (France); Herault, Joel [Department of Radiation Oncology, Protontherapy Center, Centre Antoine Lacassagne, 33 avenue Valombrose, 06189 Nice cedex 02 (France); Gastaud, Pierre [Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, 5 rue Pierre Devoluy, BP 319, 06006 Nice cedex 01 (France)

2010-09-01

141

Medication Errors Among Geriatrics at the Outpatient Pharmacy in a Teaching Hospital in Kelantan  

PubMed Central

The main aim of this study was to determine the medication errors among geriatrics at the outpatient pharmacy in a teaching hospital in Kelantan and the strategies to minimize the prevalence. A retrospective study was conducted that involved screening of prescription for a one-month period (March 2001). Only 15.35% (1601 prescription) of a total 10,429 prescriptions were for geriatrics. The prescriptions that were found to have medication errors was 403. Therefore, the prevalence of medication errors per day was approximately 20 cases. Generally, the errors between both genders were found to be comparable and to be the highest for Malays and at the age of 60–64 years old. Administrative errors was recorded to be the highest which included patient’s particulars and validity of the prescriptions (70.22%) and drugs that available in HUSM (16.13%). Whereas the total of prescribing errors were low. Under prescribing errors were pharmaceutical error (0.99%) and clinical error (8.68%). Sixteen cases or 3.98% had more than 1 error. The highest prevalence went to geriatrics who received more than nine drugs (32.16%), geriatrics with more than 3 clinical diagnosis (10.06%), geriatrics who visited specialist clinics (37.52%) and treated by the specialists (31.07%). The estimated cost for the 403 medication errors in March was RM9,327 or RM301 per day that included the cost of drugs and humanistic cost. The projected cost of medication errors per year was RM 111,924. In conclusion, it is very clear that the role of pharmacist is very great in preventing and minimizing the medication errors beside the needs of correct prescription writing and other strategies by all of the heath care components. PMID:22973127

Abdullah, Dellemin Che; Ibrahim, Noor Shufiza; Ibrahim, Mohamed Izham Mohamed

2004-01-01

142

Drug utilization in pediatric neurology outpatient department: A prospective study at a tertiary care teaching hospital  

PubMed Central

Background: Neurological disorders are a significant cause of morbidity, mortality and adversely affect quality of life among pediatric patients. In India, more than 30% population is under 20 years of age, many of whom present late during the course of illness. Several drugs prescribed to pediatric population suffering from neurological disorders may be off label or unlicensed. Aims and Objectives: To study drug use pattern, identify off-label/unlicensed drug use and to check potential for drug-drug interactions in patients attending outpatient department of pediatric neurology at a tertiary care teaching hospital. Methodology: Prescriptions of patients attending pediatric neurology outpatient department were collected prospectively for 8 weeks. They were analyzed for prescribing pattern, WHO core prescribing indicators, off-label/unlicensed drug use and potential for drug-drug interactions. Result: A total of 140 prescriptions were collected, male female ratio being 2:1. Epilepsy was the most common diagnosis (73.57%) followed by breath holding spells, migraine and developmental disorders. Partial seizure was the most common type of epilepsy (52.42%). Average number of drugs prescribed per patient was 1.56. Most commonly prescribed drug was sodium valproate (25.11%) followed by phenytoin (11.41%). About 16% of the prescriptions contained newer antiepileptic drugs. More than 60% of the drugs were prescribed from WHO essential drug list. In 8.57% of cases drugs were prescribed in off-label/unlicensed manner. Twenty-six percent prescriptions showed potential for drug interactions. Conclusion: Epilepsy is the most common neurological disease among children and adolescents. Sodium valproate is the most commonly prescribed drug. A few prescriptions contained off-label/unlicensed drugs. PMID:25278669

Bhatt, Krutika M.; Malhotra, Supriya D.; Patel, Kamlesh P.; Patel, Varsha J.

2014-01-01

143

Evaluation of the peer teaching program at the University children?s hospital Essen - a single center experience  

PubMed Central

Since 1986 medical students at the University Children’s Hospital Essen are trained as peers in a two week intensive course in order to teach basic paediatric examination techniques to younger students. Student peers are employed by the University for one year. Emphasis of the peer teaching program is laid on the mediation of affective and sensomotorical skills e.g. get into contact with parents and children, as well as manual paediatric examination techniques. The aim of this study is to analyse whether student peers are able to impart specific paediatric examination skills as good as an experienced senior paediatric lecturer. 123 students were randomly assigned to a group with either a senior lecturer or a student peer teacher. Following one-hour teaching-sessions in small groups students had to demonstrate the learned skills in a 10 minute modified OSCE. In comparison to a control group consisting of 23 students who never examined a child before, both groups achieved a significantly better result. Medical students taught by student peers almost reached the same examination result as the group taught by paediatric teachers (21,7±4,1 vs. 22,6±3,6 of 36 points, p=0,203). Especially the part of the OSCE where exclusively practical skills where examined revealed no difference between the two groups (7,44±2,15 vs. 7,97±1,87 of a maximum of 16 points, p=0,154). The majority of students (77%) evaluated peer teaching as stimulating and helpful. The results of this quantitative teaching study reveal that peer teaching of selected skills can be a useful addition to classical paediatric teaching classes. PMID:23737922

Buscher, Rainer; Weber, Dominik; Buscher, Anja; Holscher, Maite; Pohlhuis, Sandra; Groes, Bernhard; Hoyer, Peter F.

2013-01-01

144

Bacteriuria and urinary schistosomiasis in primary school children in rural communities in Enugu State, Nigeria, 2012  

PubMed Central

Introduction According to a study conducted in1989, Enugu State has an estimated urinary schistosomiasis prevalence of 79%. Recently, studies have implicated bacteriuria co-infection in bladder cancer. These bacteria accelerate the multi-stage process of bladder carcinogenesis. Knowledge about the prevalence of this co-infection is not available in Enugu and the information provided by the 1989 study is too old to be used for current decision making. Methods We carried out a cross-sectional survey of primary school children aged5-15years, who were randomly selected through a multi stage sampling method using guidelines recommended by WHO for schistosomiasis surveys. An interviewer administered questionnaire was used to collect data on demography, socioeconomic variables and clinical presentations. Urine samples were collected between 10.00am and 2.00pm. Each sample was divided into two: (A) for prevalence and intensity using syringe filtration technique and (B) for culture. Intensity was categorized as heavy (>50ova/10mls urine) and light (<50ova/10mls urine). Significant bacteriuria was bacteria count ? 105 colony forming units/ml of urine. Results Of the 842 pupils, 50.6% were females. The prevalence of urinary schistosomiasis was 34.1%. Infection rate was higher(52.8%) among 13-15 years(Prevalence Ratio = 2.45, 95% Confidence Interval 1.63-3.69). Heavy infections wad 62.7% and egg count/10mls urine ranged from 21-1138. Significant bacteriuria among pupils with urinary schistosomiasis was 53.7% compared to 3.6% in the uninfected(PR = 30.8,95% CI 18.91- 52.09). The commonest implicated organism was Escherchia coli. Conclusion We found high prevalence of bacteriuria co-infection among children with urinary schistosomiasis in Enugu State. This underscores the need for concurrent antibiotics administration and follow-up to avert later complications.

Ossai, Okechukwu Paulinus; Dankoli, Raymond; Nwodo, Chimezie; Tukur, Dahiru; Nsubuga, Peter; Ogbuabor, Daniel; Ekwueme, Osaeloka; Abonyi, Godwin; Ezeanolue, Echezona; Nguku, Patrick; Nwagbo, Douglas; Idris, Suleiman; Eze, George

2014-01-01

145

Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting  

PubMed Central

Background Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. Methods A cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients’ record files for informed consent documentation was done. Results A total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0–39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient’s disease. Conclusions Informed consent administration and documentation for surgical health care is still inadequate at University teaching hospitals in Uganda. PMID:24885609

2014-01-01

146

Molecular characterization of Staphylococcus epidermidis strains isolated from a teaching hospital in Shanghai, China  

Microsoft Academic Search

Staphylococcus epidermidis is a leading cause of hospital-acquired infections, mostly associated with the use of medical devices in seriously ill or immunocompromised patients. Currently, the clonal characteristics of S. epidermidis in the hospital environment in China are unknown; neither is it known why these sequence types are easily disseminated in the hospital setting. In this study, multilocus sequence typing (MLST)

Min Li; Xing Wang; Qian Gao; Yuan Lu

2009-01-01

147

Teaching Cost-Conscious Medicine: Impact of a Simple Educational Intervention on Appropriate Abdominal Imaging at a Community-Based Teaching Hospital  

PubMed Central

Background Rising costs pose a major threat to US health care. Residency programs are being asked to teach residents how to provide cost-conscious medical care. Methods An educational intervention incorporating the American College of Radiology appropriateness criteria with lectures on cost-consciousness and on the actual hospital charges for abdominal imaging was implemented for residents at Scripps Mercy Hospital in San Diego, CA. We hypothesized that residents would order fewer abdominal imaging examinations for patients with complaints of abdominal pain after the intervention. We analyzed the type and number of abdominal imaging studies completed for patients admitted to the inpatient teaching service with primary abdominal complaints for 18 months before (738 patients) and 12 months following the intervention (632 patients). Results There was a significant reduction in mean abdominal computed tomography (CT) scans per patient (1.7–1.4 studies per patient, P < .001) and total abdominal radiology studies per patient (3.1–2.7 studies per patient, P ?=? .02) following the intervention. The avoidance of charges solely due to the reduction in abdominal CT scans following the intervention was $129 per patient or $81,528 in total. Conclusions A simple educational intervention appeared to change the radiologic test-ordering behavior of internal medicine residents. Widespread adoption of similar interventions by residency programs could result in significant savings for the health care system. PMID:24404274

Covington, Matthew F.; Agan, Donna L.; Liu, Yang; Johnson, John O.; Shaw, David J.

2013-01-01

148

Relationship Between Nutritional Status and Intensity of Common Intestinal Helminths Among Children in Enugu, South-East Nigeria  

PubMed Central

Background: Intestinal helminthiasis is associated with malnutrition in children. Aim: The objective of this study was to determine the intensity and effect of the common intestinal helminths on the nutritional status of children in Enugu, Nigeria. Subjects and Methods: A cross-sectional study of 460 children conducted in Enugu metropolis, south-east Nigeria between August and September 2003. Their stools were analyzed at the research laboratory of the Federal Ministry of Health, National Arbovirus and Vector Research Center, Enugu. The intensity of the common intestinal helminths was determined using the standard Kato-Katz method of fresh stool samples. The classification intensity of helminthic infestation was according to the World Health Organization classification. Data were analyzed using Statistical Software for Social Sciences version 11.0 (Chicago IL, USA). P < 0.05 was regarded as statistically significant. Results: 452 of 460 children (98.3%) had normal height for age, weight for age and weight for height Z-scores. Six of the 460 children (1.3% were wasted), 1/460 stunted (0.2%) and 1/460 wasted and stunted (0.2%). 150 out of 460 (32.6%) studied were infected with helminths. There was no significant relationship between the intensity of helminth infection and the nutritional status of the children. Conclusion: Although the prevalence of helminthiasis in children in Enugu was high, intensity of helminthiasis in these children was mainly mild. Hence, majority of them had normal weight and height measurements for age and sex.

Ilechukwu, GC; Ilechukwu, CGA; Ubesie, AC; Onyire, NB; Emechebe, G; Eze, JC

2014-01-01

149

Suboptimal use of risk reduction therapy in peripheral arterial disease patients at a major teaching hospital  

PubMed Central

BACKGROUND AND OBJECTIVES: Current evidence suggests that modification of atherosclerosis risk factors plays an important role in reducing adverse cardiovascular outcomes in patients with peripheral arterial disease (PAD). This study was undertaken to determine whether patients in this high-risk group were adequately using risk factor modification therapy. DESIGN AND SETTING: Prospective study of consecutive patients with PAD from a teaching hospital. PATIENTS AND METHODS: The collected data included information about atherosclerotic risk factors and utilization of risk factor modification therapy RESULTS: The 391 patients had a mean (standard deviation of 3 (1) atherosclerotic risk factors. Hypertension was identified in 56.8% of patients (222/391), of whom only 37.4% (83/222) had adequate blood pressure control (BP <140/90 mm Hg). The prevalence of diabetes mellitus (DM) was 35 % (137/391). Among patients with DM, only 49% (67/137) had adequate blood glucose control (glycosylated hemoglobin, HbA1c <7%). Statins were currently prescribed in 61% of patients (238/391), 38.7% (92/238) of whom continued to have low-density lipoprotein (LDL) >2.5 mmol/L, compared to a rate of 76.5% (117/153) among non-statin users (P<.001). The majority of patients of patients ( 72.4%; 283/391) were overweight/obese. Many patients (67.3%; 263/391) were nonsmokers; however, most (73.4%; 193/263) had a history of smoking. Antiplatelets were prescribed for 78.3% of patients (306/391), of whom 70.6% (216/306) were taking aspirin. Angiotensin converting enzyme (ACE) inhibitors were prescribed for 44.8% of patients (175/391). Among rampril users, only 36.8% of patients (53/144) were on an optimal dose. CONCLUSION: Although atherosclerotic risk factors were prevalent in patients with PAD, we found that patients received sub-optimal use of risk reduction treatments. Effective strategies to encourage health professionals to use these adjunctive therapies need to be developed. PMID:21808113

Al-Omran, Mohammed; Verma, Subodh; Lindsay, Thomas F.

2011-01-01

150

Burns functional disabilities among burn survivors: a study in Komfo Anokye Teaching Hospital, Ghana  

PubMed Central

Aim: To determine the types of functional disabilities in adult and paediatric burns survivors, with specific emphasis on potential risk and socio-economic factors of burn disabilities present in Ghana. Patients and Methods: The descriptive study was carried out in Komfo Anokye Teaching Hospital, Kumasi, Ghana from May 2011 to April 2012. Burn survivors who came for follow-up visits after been discharged home and had functional disability were the participants of the study. They were physically examined and interviewed using a pre-tested questionnaire after their informed consent/or that of their parents (in the cases of paediatrics burns survivors) was sought. Results: A total of 70 participants consented for the study. Their ages ranged from 8/12 – 78 years, with a mean age of 12±1.7 years. Majority (60.0%, N=42) of the participants had third degree burns. The nature of disabilities of participants were mostly scar contractures (42.9%, N=30) of which 36.7% (N=11) had impeded arm elevation; 23.3% (N=7) could not fold the palm or move the digits. From the multiple regression analysis risk factors for burn victim to have disability were paediatric age (OR=11.1, P=0.043), third degree of burn (OR=6.2, P=0.001) and anatomical part affected (OR=18.3, P=0.031). Socio-economic factors that affected burn disability victims were nuclear family compensation (OR=4.2, P=0.021), community mockery/stigmatization (OR=0.1, P=0.052) and caretakers time and finance (OR=5.2, P=0.033). Conclusion: The commonest functional disabilities recorded were scar contractions of the axilla region which had impeded the ability of the patients to lift the arm. Risk factors for burns disability included childhood age, third degree of burn incurred and anatomical part affected. Social factors influencing the lives of burn survivors with disability were good family and negative community interactions. Significant economical factors recorded were caretakers’ time and financial constrains. PMID:23638325

Agbenorku, Pius

2013-01-01

151

Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria  

PubMed Central

Background Hypertension is a prevalent cardiovascular disease risk factor among blacks and adolescent hypertension can progress into adulthood. Objective To determine the prevalence of hypertension and prehypertension among secondary school adolescents in Enugu South East Nigeria. Methodology A study of 2694 adolescents aged 10-18 years in Enugu metropolis was carried out. Socio-demographic profile anthropometric and blood pressure readings were obtained. Derived measurements such as Prehypertension, hypertension and BMI were obtained. Results The results showed that the mean systolic blood pressure and diastolic blood pressure for males were 106.66+ 11.80 mmHg and 70.25?+?7.34 mmHg respectively. The mean SBP and DBP for females were 109.83+ 11.66 mmHg and 72.23?+?8.26 mmHg respectively (p?

2013-01-01

152

Acceptability of artificial donor insemination among infertile couples in Enugu, southeastern Nigeria  

PubMed Central

Background Male factor infertility presents one of the greatest challenges with respect to infertility treatment in Africa. Artificial insemination by donor semen (AID) is a cost-effective option for infertile couples, but its practice may be influenced by sociocultural considerations. The purpose of this study was to determine the awareness and acceptability of AID among infertile couples in Enugu, southeastern Nigeria, and identify the sociocultural factors associated with its practices. Methods Questionnaires were administered to a cross-section of 200 consecutive infertile couples accessing care at the infertility clinics of two tertiary health institutions in Enugu, Nigeria, between April 1, 2012 and January 31, 2013. Results Among the 384 respondents, the level of awareness and acceptability of AID were 46.6% (179/384) and 43% (77/179), respectively. The acceptability rate was significantly higher among female respondents, women with primary infertility, and those whose infertility had lasted for 5 years and beyond (P<0.05). The major reasons for nonacceptance of AID were religious conviction (34.7%, n=33), cultural concern (17.9%, n=17), fear of contracting an infection (17.9%, n=17), and fear of possibility of failure of the procedure (12.6%, n=12). Conclusion Health education and public enlightenment are advocated to increase awareness and dispel the current misconceptions about AID in our environment. PMID:24611022

Ugwu, Emmanuel O; Odoh, Godwin U; Obi, Samuel N; Ezugwu, Frank O

2014-01-01

153

Profile of Under-Five Malnourished Children Admitted in a Tertiary Care Teaching Hospital in Pune, India  

PubMed Central

Background: Malnutrition is a major public health problem in a developing country like India. Keeping this in mind a study was carried out to find the proportion of under–five children suffering from malnutrition among the under-five hospitalized children and to study co-morbid illnesses and epidemiological factors associated with malnutrition. Methods: This was a hospital-based cross sectional study carried out in the pediatric ward of a tertiary care teaching hospital in Pune, India. All under–five children suffering from malnutrition were studied over a period of 1 month. Results: Total number of under five children diagnosed as malnourished were 47 (39.83%). Moderate and severe/very severe malnutrition was statistically significantly higher in a girl child. The proportion of moderate and severe/very severe malnutrition was higher in low birth weight babies, children who were incompletely immunized for age. Faulty infant feeding practice was observed in 28 (59.6%) children. Some of the co-morbid illnesses contributing to morbidity in the malnourished child were acute diarrheal diseases, acute respiratory infection, anemia, and septicemia. Conclusion: A large proportion of hospitalized children were malnourished. Girl child suffered from moderate to severe forms of malnutrition as compared to male child and this was the only statistically significant association. This may be due to neglect of girl child. PMID:25105000

Debnath, Dhrubajyoti J; Parulekar, Chandrakant V

2014-01-01

154

Evaluation of antimicrobial resistance pattern of nosocomial and community bacterial pathogens at a teaching hospital in Tehran,Iran.  

PubMed

Antimicrobial resistance in pathogens not only in hospitals but also in the community has become an important public health problem. The aim of this study was to determine the antimicrobial resistance patterns of predominant pathogens from hospitalized and outpatients in a university hospital in Tehran, Iran. A total of 820 samples of common Gram-negative and Gram-positive bacteria were collected from a major referral and teaching hospital affiliated to Tehran University of Medical Sciences in Iran during April 2010 to February 2011. The pattern of antibiotic resistance was determined by disk diffusion test as recommended by the Clinical Laboratory and Standards Institute (CLSI). Gram-negative bacilli were the most isolated pathogens. Acinetobacter spp. and Pseudomonas aeruginosa (P. aeruginosa) was the most antibiotic-resistant pathogens. Imipenem and piperacillin/tazobactam were the most active antimicrobials against gram-negative bacilli whereas vancomycin was the antimicrobial agent most consistently active against the Gram-positive cocci. Community-acquired organisms were more susceptible to antimicrobial drugs tested than nosocomial isolates. The rates of antibiotic resistance among isolated pathogens in this study were approximately similar to other studies. However, high rates of antibiotic resistance among Acinetobacter spp and P. aeruginosa, the most isolated pathogens, indicating that antibiotic policy is urgently needed to prevent the resistance development ago. PMID:24901718

Zamani, Samin; Nasiri, Mohammad Javad; Khoshgnab, Behshad Noorazar; Ashrafi, Abbas; Abdollahi, Alireza

2014-01-01

155

Drugs use pattern for uncomplicated malaria in medicine retail outlets in Enugu urban, southeast Nigeria: implications for malaria treatment policy  

PubMed Central

Background Malaria treatment policy recommends regular monitoring of drug utilization to generate information for ensuring effective use of anti-malarial drugs in Nigeria. This information is currently limited in the retail sector which constitutes a major source of malaria treatment in Nigeria, but are characterized by significant inappropriate use of drugs. This study analyzed the use pattern of anti-malarial drugs in medicine outlets to assess the current state of compliance to policy on the use of artemisinin-based combination therapy (ACT). Methods A prospective cross-sectional survey of randomly selected medicine outlets in Enugu urban, southeast Nigeria, was conducted between May and August 2013, to determine the types, range, prices, and use pattern of anti-malarial drugs dispensed from pharmacies and patent medicine vendors (PMVs). Data were collected and analyzed for anti-malarial drugs dispensed for self-medication to patients, treatment by retail outlets and prescription from hospitals. Results A total of 1,321 anti-malarial drugs prescriptions were analyzed. ACT accounted for 72.7%, while monotherapy was 27.3%. Affordable Medicines Facility-malaria (AMFm) drugs contributed 33.9% (326/961) of ACT. Artemether-lumefantrine (AL), 668 (50.6%) was the most used anti-malarial drug, followed by monotherapy sulphadoxine-pyrimethamine (SP), 248 (18.8%). Median cost of ACT at $2.91 ($0.65-7.42) per dose, is about three times the median cost of monotherapy, $0.97 ($0.19-13.55). Total cost of medication (including co-medications) with ACT averaged $3.64 (95% CI; $3.53-3.75) per prescription, about twice the mean cost of treatment with monotherapy, $1.83 (95% CI; $1.57-2.1). Highest proportion 46.5% (614), of the anti-malarial drugs was dispensed to patients for self-treatment. Treatment by retail outlets accounted for 35.8% while 17.7% of the drugs were dispensed from hospital prescriptions. Self-medication, 82%, accounted for the highest source of monotherapy and a majority of prescriptions, 85.6%, was adults. Conclusion Findings suggest vastly improved use of ACT in the retail sector after eight years of policy change, with significant contributions from AMFm drugs. However the use of monotherapy, particularly through self-medication remains significant with increasing risk of undermining treatment policy, suggesting additional measures to directly target consumers and providers in the sector for improved use of anti-malarial drugs in Nigeria. PMID:24961280

2014-01-01

156

Teaching evidence-based medicine skills can change practice in a community hospital  

Microsoft Academic Search

OBJECTIVES: Several studies have evaluated whether evidence-based medicine (EBM) training courses can improve skills such as literature\\u000a searching and critical appraisal but to date, few data exist on whether teaching EBM skills and providing evidence-based resources\\u000a result in change in behavior or clinical outcomes. This study was conducted to evaluate whether a multifaceted EBM intervention\\u000a consisting of teaching EBM skills

Sharon E. Straus; Chris Ball; Nick Balcombe; Jonathon Sheldon; Finlay A. McAlister

2005-01-01

157

Complications and short-term outcomes associated with total hip arthroplasty in teaching and community hospitals  

Microsoft Academic Search

We followed 1,810 consecutive admissions for elective total hip arthroplasty (excluding hip fracture repair and revisions) to 27 Minnesota hospitals in a prospective study to assess the factors associated with better outcomes. Patients were interviewed before surgery and at 6 months, and their medical records were reviewed. The operative complication rate was 6.1%. In general, neither surgeon nor hospital volume

Roby Thompson; Robert L. Kane; Terry Gromala; Barbara McLaughlin; Shannon Flood; Nora Morris; Catherine Borbas

2002-01-01

158

Medication errors in a paediatric teaching hospital in the UK: five years operational experience  

Microsoft Academic Search

BACKGROUNDIn the past 10 years, medication errors have come to be recognised as an important cause of iatrogenic disease in hospital patients.AIMSTo determine the incidence and type of medication errors in a large UK paediatric hospital over a five year period, and to ascertain whether any error prevention programmes had influenced error occurrence.METHODSRetrospective review of medication errors documented in standard

L M Ross; J Wallace; J Y Paton

2000-01-01

159

Human enteroviruses are not the cause of neurological impairments in children at the Korle-Bu Teaching Hospital  

PubMed Central

Introduction Convulsions associated with fever and acute onset of unknown aetiology with case fatalities have become a long observed medical condition at the Child Health Department of the Korle-Bu Teaching Hospital. Children admitted to the department with seizures of undetermined origin and fever has been a source of diagnostic confusion. Studies from the Asia Pacific region suggest a link with non-polio enteroviruses. The aim of the study was to investigate the association between non-polio enterovirus and acute encephalopathy causing neurological morbidity in children. Methods One hundred and fifty cerebrospinal fluid (CSF), throat swab and serum samples were collected from participants at the Child Health Department of the Korle-Bu Teaching Hospital for virus isolation and characterization. Samples were cultured on cells and positive culture assayed by microneutralisation. Direct PCR as well as multiplex PCR were used to detect other viral agents present. Results Enterovirus isolation rate was approximately 0.67%. Intratypic differentiation by molecular characterization identified a poliovirus from vaccine origin. Further screening by real-time RT-PCR identified the virus as normal Sabin and not vaccine-derive poliovirus. No arbovirus was however detected. Conclusion Non-polio enteroviruses and chikugunya virus were found not to be the etiologic agent responsible for the convulsion with neurologic morbidity observed in the Ghanaian children. Investigation for other viral agents is recommended.

Tettey, Prudence; Badoe, Ebenezer; Adiku, Theophilus; Obodai, Eva; Odoom, John Kofi

2014-01-01

160

Graduate Medical Education's New Focus on Resident Engagement in Quality and Safety: Will It Transform the Culture of Teaching Hospitals?  

PubMed

The Accreditation Council for Graduate Medical Education recently announced its Clinical Learning Environment Review (CLER) program, which is designed to catalyze and promote the engagement of physician trainees in health care quality and patient safety activities that are essential to the delivery of high-quality patient care in U.S. teaching hospitals.In this Commentary, the authors argue that a strong organizational culture in quality improvement and patient safety is a necessary foundation for resident engagement in these areas. They describe residents' influence via their social networks on the behaviors and attitudes of peers and other health care providers and highlight this as a powerful driver for culture change in teaching hospitals. They also consider some of the potential unintended consequences of the CLER program and offer strategies to avoid them.The authors suggest that the CLER program provides an opportunity for health care and graduate medical education leaders to closely examine organizational quality and safety culture and the degree to which their residents are integrated in these efforts. They highlight the importance of developing collaborative interprofessional strategies to reach common goals to improve patient care. By sharpening the focus on patient safety, supervision, professionalism, patient care transitions, and the overall quality of health care delivery in the clinical learning environment during residents' formative training years, the hope is that the CLER program will inspire a new generation of physicians who possess and value these skills. PMID:25054414

Myers, Jennifer S; Nash, David B

2014-10-01

161

Molecular Diagnostics for Lassa Fever at Irrua Specialist Teaching Hospital, Nigeria: Lessons Learnt from Two Years of Laboratory Operation  

PubMed Central

Background Lassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH) in the central senatorial district of Edo State struggled with this challenge for many years. Methodology/Principal Findings A laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12%) tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization—often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p?=?0.005), had lower body temperature (p<0.0001), and had higher creatinine (p<0.0001) and blood urea levels (p<0.0001) than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed—within lineage II—a separate clade that could be further subdivided into three clusters. Conclusions/Significance Lassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients. PMID:23029594

Hass, Meike; Gabriel, Martin; Olschlager, Stephan; Becker-Ziaja, Beate; Folarin, Onikepe; Phelan, Eric; Ehiane, Philomena E.; Ifeh, Veritas E.; Uyigue, Eghosasere A.; Oladapo, Yemisi T.; Muoebonam, Ekene B.; Osunde, Osagie; Dongo, Andrew; Okokhere, Peter O.; Okogbenin, Sylvanus A.; Momoh, Mojeed; Alikah, Sylvester O.; Akhuemokhan, Odigie C.; Imomeh, Peter; Odike, Maxy A. C.; Gire, Stephen; Andersen, Kristian; Sabeti, Pardis C.; Happi, Christian T.; Akpede, George O.; Gunther, Stephan

2012-01-01

162

The Roles of Teaching Hospitals, Insurance Status, and Race/Ethnicity in Receipt of Adjuvant Therapy for Regional-Stage Breast Cancer in Florida  

PubMed Central

Objectives. We examined the roles of teaching hospitals, insurance status, and race/ ethnicity in women’s receipt of adjuvant therapy for regional-stage breast cancer. Methods. Data were taken from the Florida Cancer Data System for cases diagnosed from July 1997 to December 2000. We evaluated the impact of health insurance status and hospital type on use of adjuvant therapy (after adjustment for age, race/ethnicity, and marital status). Interaction terms for hospital type, insurance status, and race/ethnicity were entered in each model. Results. Teaching facilities diagnosed 12.5% of the cases; however, they cared for a disproportionate percentage (21.3%) of uninsured and Medicaid-insured women. Among women who received adjuvant chemotherapy only, those diagnosed in teaching hospitals were more likely than those diagnosed in nonteaching hospitals to receive therapy regardless of insurance status or race/ethnicity. Among women who received chemotherapy with or without hormonal therapy, Hispanics were more likely than White non-Hispanic women to receive therapy, whereas women with private insurance or Medicare were less likely than uninsured and Medicaid-insured women to receive this type of therapy. Conclusions. Teaching facilities play an important role in the diagnosis and treatment of regional-stage breast cancer among Hispanics, uninsured women, and women insured by Medicaid. PMID:16317209

Richardson, Lisa C.; Tian, Lili; Voti, Lydia; Hartzema, Abraham G.; Reis, Isildinha; Fleming, Lora E.; MacKinnon, Jill

2006-01-01

163

University teaching hospital and private clinic collaboration to enhance veterinary educational opportunities at Mississippi State University.  

PubMed

The College of Veterinary Medicine at Mississippi State University established a not-for-profit corporation (MSU-CVM-COS) to develop and manage private specialty clinics that would enhance teaching and student learning, increase caseload, and generate revenue. The corporation currently operates the Animal Emergency and Referral Center (AERC) and the Veterinary Specialty Center (VSC) as affiliates of Mississippi State University. These privately managed facilities provide access to advanced medical equipment, enhance clinical service and teaching, and promote the College's One Health initiative. PMID:24384387

Tyner, C Lee; Harkness, John; Hoblet, Kent; Zumwalt, Lauren; Templeton, Karen; McLaughlin, Ron

2014-01-01

164

Institutional and production characteristics among smallholder pig producers in Enugu State, Nigeria.  

PubMed

A study on the institutional and production characteristics of pig farming in Enugu State, Nigeria, was conducted using 80 randomly selected smallholder pig producers. Data were collected by using an interview schedule. Descriptive statistics were used to analyze data. The mean number of pigs owned by smallholder producer was 18. Only 20.0 and 6.3 % of the producers had access to credit and to extension services, respectively. Ninety percent of the respondents practiced intensive management system. The major housing type used by producers was cement brick walls with aluminum roofing sheets (97.6 %). The majority (80 %) of producers reared mostly crossbred pigs and family labor (68.7 %) was most prevalent. Fourteen (50 %) of the 28 routine management practices were always performed by the pig producers. Extension service providers should intensify efforts to provide producers with appropriate management practices and training for effective disease control and improve productivity. PMID:24906223

Chah, Jane M; Dimelu, Mebel U; Ukwuani, Stella U

2014-10-01

165

Molecular analysis of Clostridium difficile at a university teaching hospital in Japan: a shift in the predominant type over a five-year period  

Microsoft Academic Search

Clostridium difficile isolates recovered from patients admitted to a teaching hospital in Japan over a 5-year period were analyzed. Two molecular\\u000a typing systems, PCR ribotyping and pulsed-field gel electrophoresis (PFGE) analysis, were used. Twenty-six PCR ribotypes were\\u000a found among the 148 isolates. The predominant type at our hospital appeared to shift during the study period, from PCR ribotype\\u000a a in

E. Sawabe; H. Kato; K. Osawa; T. Chida; N. Tojo; Y. Arakawa; N. Okamura

2007-01-01

166

What Teachers Learn From Students: Focusing on the Use of Student Products and Qualitative Methods in the Scholarship of Teaching and Learning in Hospitality and Tourism  

Microsoft Academic Search

The Scholarship of Teaching and Learning (SoTL) is a term that is frequently used for discipline-based studies in higher education, and yet it is not commonly described in hospitality and tourism education. This article presents a case for the use of SoTL in hospitality and tourism education, specifically using student-generated products as sources of evidence or data and via qualitative

Cynthia S. Deale

2010-01-01

167

Vulnerability and Knowledge of Sexually Transmitted Infections Among Female Traders of Reproductive Age in Enugu, Nigeria  

PubMed Central

Background: Sexually transmitted infections (STIs) constitute major public health concern and enigma. A comprehensive knowledge of the modes of transmission is necessary to evolve an effective preventive strategy. Aim: The aim of the study is to assess the vulnerability, knowledge and prevention of STIs among female traders of reproductive age in Enugu, Southeast Nigeria. Subjects and Methods: This was a cross-sectional descriptive study carried out on female traders aged 15-49 years at Ogbete Main Market, Enugu, Southeast Nigeria. Data was analyzed using Epi-Info 2000 version 3.3.1 Centers for Disease Control and Prevention Atlanta USA) was used to analyze the data and results were presented in tabular form. Results: A total of 200 female traders of reproductive age participated in the study. The mean (standard deviation) age was 26 (7.4) years. 16% (32/200) were adolescents. Knowledge of specific STIs was highest for human immunodeficiency virus/acquired immune deficiency syndrome 90% (130/200). Parents were poor sources of information as only 28.5% (57/200) respondents heard about STIs from their parents compared with 46% (92/200) from friends and peers. Risk factors identified were multiple sexual partners 75.5% (151/200), non-use of condoms 62% (124/200) and early debut 58% (116/200). Majority 67.5% (135/200) were aware that STIs could be treated by a visit to the doctor while 21.5% (43/200) preferred traditional/herbal healers. Conclusion: The inclusion of health education in schools’ curricula to ensure that adolescents are adequately aware of STIs, their modes of transmission, prevention and treatment before embarking on any vocation out-of-school is advocated. PMID:24669343

Ikeako, LC; Ekwueme, OC; Ezegwui, HU; Okeke, TOC

2014-01-01

168

Colorado State University Veterinary Teaching Hospital Post Doc Fellow: Emergency & Critical Care Clinician  

E-print Network

Services. Colorado State University is committed to providing a safe and productive learning and living Clinician will have clinical and teaching responsibilities within the Emergency and Critical Care Service. The annual salary for this position is $55,000 plus benefits. Minimum qualifications for this position

Rutledge, Steven

169

Prevalence and determinants of pre-term deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria  

PubMed Central

In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60–70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71–7.30), antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06–19.78), premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33–9.67), maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16–27.57), pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09–4.99), type of labor (P=0.000; OR=6.44; 95%CI=4.42–9.38) and booking status (P=0.000; OR=4.67; 95%CI=3.33–6.56). The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital. PMID:21589839

Mokuolu, Olugbenga A.; Suleiman, BM; Adesiyun, OO; Adeniyi, A

2010-01-01

170

Medical and surgical ward rounds in teaching hospitals of Kuwait University: students' perceptions  

PubMed Central

Background Teaching sessions for medical students during ward rounds are an essential component of bedside teaching, providing students with the opportunity to regard patients as actual people, and to observe their physical conditions directly, allowing a better understanding of illnesses to be developed. We aim to explore medical students’ perceptions regarding medical and surgical ward rounds within the Faculty of Medicine at Kuwait University, and to evaluate whether this teaching activity is meeting the expectation of learners. Methods A pretested questionnaire was used to collect data from 141 medical students during the 2012–2013 academic year. They were asked to provide their current and expected ratings about competencies that were supposed to be gained during ward rounds, on a scale from 1 (lowest) to 5 (highest). Mean scores were calculated, and the Student t-test was used to compare results. P < 0.05 was the cut-off level for significance. Results Only 17 students (12.1%) declined to participate in the study. The students’ current competency scores (for competencies taught within both disciplines – medical and surgical) were significantly lower than the scores indicating students’ expectations (P < 0.001). The best-taught competency was bedside examination, in both medical (mean: 3.45) and surgical (mean: 3.05) ward rounds. However, medical ward rounds were better than surgical rounds in covering some competencies, especially the teaching of professional attitude and approach towards patients (P < 0.001). Conclusion Both medical and surgical ward rounds were deficient in meeting the students’ expectations. Medical educators should utilize the available literature to improve the bedside teaching experience for their students. PMID:24101889

AlMutar, Sara; AlTourah, Lulwa; Sadeq, Hussain; Karim, Jumanah; Marwan, Yousef

2013-01-01

171

The impact of receiving treatment for cancer at a large metropolitan teaching hospital as recorded by patients using unstructured journals.  

PubMed

The aim was to obtain patients' experiences of the cancer treatment pathway at a tertiary teaching hospital using unstructured journals to enable health care professionals to be educated on how to improve patient care. Most of 38 patients (22 females and 16 males), average age of 58 (range 29-80), who returned diaries were starting chemotherapy for a range of cancers. Data entries were transcribed and entered into the NVIVO software to facilitate thematic analysis. Women wrote more, and more often than men, and disclosed more. For most, physical side effects dominated, comprising 25-75 % of diary entries. The most commonly mentioned were fatigue (74 %), pain (63 %), sleep disturbances (50 %), nausea (45 %) and changes in appetite (45 %). Collectively, 22 patients reported 261 separate emotional reactions including depression, anger, guilt, shame, grief, panic and confusion. The treatment environment, including personnel, impacted upon patients. Where survival is unpredictable, evidence of consistency of practitioners' approaches attains heightened significance. PMID:23007854

Olver, Ian N; Eliott, Jaklin A; Long, Leslye; McKinnon, Michele; Rumsby, Graham

2012-12-01

172

The problems of management of gestational trophoblastic neoplasms at the University of Benin Teaching Hospital, Benin City, Nigeria.  

PubMed

Analysis of 31 cases of gestational trophoblastic neoplasms at the University of Benin Teaching Hospital, Benin City, over a 7 1/2 year period (1/1/75 to 6/30/82) was carried out. The incidence of this disease was 1:656 deliveries. Although it was more prevalent in grandmultipara, it occurred in all parities and ages. The main clinical features were secondary amenorrhea, vaginal bleeding, uterine enlargement, and vaginal secondaries. The most common gestational antecedent event of gestational trophoblastic disease was a normal pregnancy. This was believed to have contributed to the high overall mortality of 35.5%. Numerous shortcomings during the management of these cases (inadequate laboratory facilities, shortage of reagents, shortage of drugs) were highlighted. PMID:6093472

Diejomaoh, F M; Omu, A E; Okpere, E E; Ezimokhai, M; Tabowei, O; Ajabor, L N

1984-01-01

173

Assessment of SocioEconomic Characteristics and Quality of Life Expectations of Rural Communities in Enugu State, Nigeria  

Microsoft Academic Search

This study examined the social, infrastructural and economic conditions prevalent in some rural communities of Enugu State,\\u000a Nigeria, where recent oil and gas prospecting activities have generated concerns for the environment and quality of rural\\u000a life. Mixed but complimentary methods of data collection employed include consultations with key stakeholders, focus group\\u000a discussions, questionnaire survey, field observations, key-informant interviews and secondary

Thaddeus Chidi Nzeadibe; Chukwuedozie Kelechukwu Ajaero

2010-01-01

174

An outbreak of a nosocomial NDM-1-producing Klebsiella pneumoniae ST147 at a teaching hospital in mainland China.  

PubMed

A total of 1,870 nonduplicate clinical Enterobacteriaceae from 13 teaching hospitals located in 11 provinces of mainland China from 2011 to 2012 were screened for the presence of the blaNDM gene. The high-throughput MiSeq sequencing method and comparative genomics were used to analyze the genetic environment of blaNDM among these isolates. Three blaNDM-1-carrying Klebsiella pneumoniae (0.16%, 3/1,870), isolated from a teaching hospital in Xi'an, exhibited high levels of resistance to all ?-lactams, but remained susceptible to amikacin, tigecycline, and polymyxin B. These three isolates, belonging to ST147, presented an identical pulsed-field gel electrophoresis pattern. The IncX3 plasmid, pNDM-SX04 (KC876051) showed 99% identity with plasmid pNDM-HN380 (JX104760). Comparative analysis of the genetic environment of blaNDM-1 with previously published plasmids revealed the same 7,830-bp basic mobile element, which may have been derived from Acinetobacter spp. Partial ISAba125, ISAba125 promoter, blaNDM-1, and bleMBL could serve as the minimal mobile vehicle facilitating horizontal transfer of the blaNDM-1 gene. To our knowledge, this is the first report of an outbreak of blaNDM-1-carrying ST147 K. pneumoniae. Although the prevalence spread by the blaNDM-1 gene prevalence is at a low frequency in mainland China, a dynamic national surveillance of this gene is needed due to its potential transferability. PMID:24199986

Wang, Xiaojuan; Xu, Xiuli; Li, Zongwei; Chen, Hongbin; Wang, Qi; Yang, Peihong; Zhao, Chunjiang; Ni, Ming; Wang, Hui

2014-04-01

175

Maternal mortality at Nnamdi Azikiwe University Teaching Hospital, Southeast Nigeria: a 10-year review (2003-2012)  

PubMed Central

Background Maternal mortality is high the world over, especially in sub-Saharan Africa, including Nigeria. Nigeria has consistently demonstrated one of the most abysmally poor reproductive health indices in the world, maternal mortality inclusive. This is a sad reminder that, unless things are better organized, Southeast Nigeria, which Nnamdi Azikiwe University Teaching Hospital (NAUTH) represents, may not join other parts of the world in attaining Millennium Development Goal 5 to improve maternal health in 2015. Objectives This study was conducted to assess NAUTH’S progress in achieving a 75% reduction in the maternal mortality ratio (MMR) and to identify the major causes of maternal mortality. Materials and methods This was a 10-year retrospective study, conducted between January 1, 2003 and December 31, 2012 at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeast Nigeria. Results During the study period, there were 8,022 live births and 103 maternal deaths, giving an MMR of 1,284/100,000 live births. The MMR was 1,709 in 2003, reducing to 1,115 in 2012. This is to say that there was a 24.86% reduction over 10 years, hence, in 15 years, the reduction should be 37%. This extrapolated reduction over 15 years is about 38% less than the target of 75% reduction. The major direct causes of maternal mortality in this study were: pre-eclampsia/eclampsia (27%), hemorrhage (22%), and sepsis (12%). The indirect causes were: anemia, anesthesia, and HIV encephalopathy. Most of the maternal deaths occurred in unbooked patients (98%) and within the first 48 hours of admission (76%). Conclusion MMRs in NAUTH are still very high and the rate of reduction is very slow. At this rate, it will take this health facility 30 years, instead of 15 years, to achieve a 75% reduction in maternal mortality. PMID:23901299

Obiechina, NJ; Okolie, VE; Okechukwu, ZC; Oguejiofor, CF; Udegbunam, OI; Nwajiaku, LSA; Ogbuokiri, C; Egeonu, R

2013-01-01

176

Surgical wound infection surveillance in general surgery procedures at a teaching hospital in Pakistan  

Microsoft Academic Search

Background: A surveillance system was established at the Aga Khan University Hospital in Karachi, Pakistan, to determine surgical wound infection (SWI) rates, trends, and risk factors; and to compare rates with those reported by the National Nosocomial Infection Surveillance (NNIS) system of the Centers for Disease Control and Prevention. Methods: Surveillance was performed from January 1997 to December 1999. Risk

Turab Pishori; Amna Rehana Siddiqui; Mushtaq Ahmed

2003-01-01

177

The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital  

Microsoft Academic Search

Background: The outbreak of severe acute respiratory syndrome (SARS) in Toronto, which began on Mar. 7, 2003, resulted in extraordinary public health and infection control measures. We aimed to describe the psychological and occupational im- pact of this event within a large hospital in the first 4 weeks of the outbreak and the subsequent administrative and mental health response. Methods:

Robert Maunder; Jonathan Hunter; Leslie Vincent; Jocelyn Bennett; Nathalie Peladeau; Molyn Leszcz; Joel Sadavoy; Lieve M. Verhaeghe; Rosalie Steinberg; Tony Mazzulli

2003-01-01

178

Complications and short-term outcomes associated with total hip arthroplasty in teaching and community hospitals.  

PubMed

We followed 1,810 consecutive admissions for elective total hip arthroplasty (excluding hip fracture repair and revisions) to 27 Minnesota hospitals in a prospective study to assess the factors associated with better outcomes. Patients were interviewed before surgery and at 6 months, and their medical records were reviewed. The operative complication rate was 6.1%. In general, neither surgeon nor hospital volume had any significant association with the likelihood of operative complications. For the cementless prosthesis group, significantly more operative complications were associated with being in Health Maintenance Organizations or with insurance other than Medicare. General complications were associated positively with a higher caseload per surgeon for patients receiving cemented prostheses. Hospital volume had no significant relationship to the general complication rate. Hospital and surgical volume and most other provider characteristics were not associated with walking and pain outcomes; however, follow-up pain scores for patients with cementless prostheses were lower for board-certified orthopaedists even after adjusting for risk factors. PMID:11805922

Thompson, Roby; Kane, Robert L; Gromala, Terry; McLaughlin, Barbara; Flood, Shannon; Morris, Nora; Borbas, Catherine

2002-01-01

179

THE AFFILIATED TEACHING HOSPITALS AND DENTISTRY, SCHULICH SCHOOL OF MEDICINE & DENTISTRY OF  

E-print Network

: ( ) EMAIL: EMAIL: CITIZENSHIP* DATE OF BIRTH: _/ _ / STATUS: Day Month Year *Note: Residencies are available, in chronological order, from date of graduation or qualification. Use back page if necessary.) MONTH and YEAR of the affiliated Hospitals in effect and those which may be adopted during my term of service. If appointed, I

Sinnamon, Gordon J.

180

High-level handwashing compliance in a community teaching hospital: a challenge that can be met!  

Microsoft Academic Search

Handwashing is the most important and least expensive measure for preventing the transmission of hospital-acquired infection. Compliance, however, rarely exceeds 40%, even in intensive care units. The present study evaluated the effectiveness of the authors' infection control programme in relation to handwashing compliance of healthcare workers. Ten nursing students observed 300 uninformed staff members and recorded their handwashing practices throughout

R. Sharir; N. Teitler; I. Lavi; R. Raz

2001-01-01

181

Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia  

PubMed Central

Background Therapeutic drug monitoring (TDM) makes use of serum drug concentrations as an adjunct to decision-making. Preliminary data in our hospital showed that approximately one-fifth of all drugs monitored by TDM service were gentamicin. Objective In this study, we evaluated the costs associated with providing the service in patients with bronchopneumonia and treated with gentamicin. Methods We retrospectively collected data from medical records of patients admitted to the Hospital Universiti Sains Malaysia over a 5-year period. These patients were diagnosed with bronchopneumonia and were on gentamicin as part of their treatment. Five hospitalisation costs were calculated; (i) cost of laboratory and clinical investigations, (ii) cost associated with each gentamicin dose, (iii) fixed and operating costs of TDM service, (iv) cost of providing medical care, and (v) cost of hospital stay during gentamicin treatment. Results There were 1920 patients admitted with bronchopneumonia of which 67 (3.5%) had TDM service for gentamicin. Seventy-three percent (49/67) patients were eligible for final analysis. The duration of gentamicin therapy ranged from 3 to 15 days. The cost of providing one gentamicin assay was MYR25, and the average cost of TDM service for each patient was MYR104. The average total hospitalisation cost during gentamicin treatment for each patient was MYR442 (1EUR approx. MYR4.02). Conclusions Based on the hospital perspective, in patients with bronchopneumonia and treated with gentamicin, the provision of TDM service contributes to less than 25% of the total cost of hospitalization. PMID:24644520

Ibrahim, Mohamed Izham Mohamed; Abdelrahim, Hisham Elhag Ahmed; Ab Rahman, Ab Fatah

182

Molecular epidemiology of environmental MRSA at an equine teaching hospital: introduction, circulation and maintenance  

PubMed Central

The role that environmental contamination might play as a reservoir and a possible source of Methicillin-resistant Staphylococcus aureus (MRSA) for patients and personnel at equine veterinary hospitals remains undefined, as the environment has only been monitored during outbreaks or for short periods. Therefore, the objectives of this study were to determine the monthly presence, distribution, and characteristics of environmental MRSA at an equine hospital, and to establish patterns of contamination over time using molecular epidemiological analyses. For this purpose, a yearlong active MRSA surveillance was performed targeting the environment and incoming patients. Antimicrobial susceptibility testing, SCCmec typing, PFGE typing, and dendrographic analysis were used to characterize and analyze these isolates. Overall, 8.6% of the surfaces and 5.8% of the horses sampled were positive for MRSA. The most common contaminated surfaces were: computers, feed-water buckets, and surgery tables-mats. Ninety percent of the isolates carried SCCmec type IV, and 62.0% were classified as USA500. Molecular analysis showed that new pulsotypes were constantly introduced into the hospital throughout the year. However, maintenance of strains in the environment was also observed when unique clones were detected for 2 consecutive months on the same surfaces. Additionally, pulsotypes were circulating throughout several areas and different contact surfaces of the hospital. Based on these results, it is evident that MRSA is constantly introduced and frequently found in the equine hospital environment, and that some contact surfaces could act as “hot-spots”. These contaminated surfaces should be actively targeted for strict cleaning and disinfection as well as regular monitoring. PMID:24641543

2014-01-01

183

Knowledge and Performance about Nursing Ethic Codes from Nurses' and Patients' Perspective in Tabriz Teaching Hospitals, Iran  

PubMed Central

Introduction: Nursing profession requires knowledge of ethics to guide performance. The nature of this profession necessitates ethical care more than routine care. Today, worldwide definition of professional ethic code has been done based on human and ethical issues in the communication between nurse and patient. To improve all dimensions of nursing, we need to respect ethic codes. The aim of this study is to assess knowledge and performance about nursing ethic codes from nurses' and patients' perspective. Methods: A descriptive study Conducted upon 345 nurses and 500 inpatients in six teaching hospitals of Tabriz, 2012. To investigate nurses' knowledge and performance, data were collected by using structured questionnaires. Statistical analysis was done using descriptive and analytic statistics, independent t-test and ANOVA and Pearson correlation coefficient, in SPSS13. Results: Most of the nurses were female, married, educated at BS degree and 86.4% of them were aware of Ethic codes also 91.9% of nurses and 41.8% of patients represented nurses respect ethic codes. Nurses' and patients' perspective about ethic codes differed significantly. Significant relationship was found between nurses' knowledge of ethic codes and job satisfaction and complaint of ethical performance. Conclusion: According to the results, consideration to teaching ethic codes in nursing curriculum for student and continuous education for staff is proposed, on the other hand recognizing failures of the health system, optimizing nursing care, attempt to inform patients about Nursing ethic codes, promote patient rights and achieve patient satisfaction can minimize the differences between the two perspectives.

Mohajjel-Aghdam, Alireza; Hassankhani, Hadi; Zamanzadeh, Vahid; Khameneh, Saied; Moghaddam, Sara

2013-01-01

184

[Pharmaceutical analysis of antibiotic drug prescription in the burns and plastic surgery departiment of the Mohammed Military Teaching Hospital].  

PubMed

Infection has long been the main cause of mortality in severely burned patients. The aim of this work is to assess the prescription of antibiotics in our Burns and Plastic Surgery Department in relation to the recommendations of the manufacturers. A summary is provided of the specific features of these products. Patients hospitalized in the Mohammed V Military Teaching Hospital, Rabat, Morocco, during the period January 2008/May 2009 and treated with antibiotics were considered. This retrospective study concerned 227 nominal medical prescriptions of antibiotics to 41 patients: 70% of the prescriptions were nondocumented. The commonest method of administration was by injection (89%). Various groups of therapeutic drugs were used: betalactamines (65%), glycopeptides (10.5%), aminosides (9%), quinolones (7%), and colistin (4.3%), plus 4.2% from other groups (metronidazole 500 mg, perfusion; fluconazol 100 mg/50 ml, injection; rifampicin 600 mg, perfusion; silver sulphadiazine, 2% fusidic acid cream). A total of 227 nominal medical prescriptions were analysed: the dosages and counter-indications were correctly respected. Three drug interactions were recorded (fluconazol-rifampicin, fluconazol-Saccharomyces boulardii, amikacin-vancomycin). This study shows the importance of the pharmaceutical analysis of prescriptions for antibiotics used in a burns unit, which are active but therefore very toxic. PMID:22396670

Benziane, H; Karfo, R; Siah, S; Taoufik, J

2011-09-30

185

A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru  

PubMed Central

Introduction: The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital. Objectives of the Study: To identify existing practices and occupational safety and health (OSH) measures in the Laundry Department and to assess the use of personal protective equipments (PPEs) among health care workers. Materials and Methods: A cross-sectional study was carried out in a private tertiary care teaching hospital. An observation checklist was developed, which was partially based on occupational hazard checklist of OSHA for Laundry Department. This was field tested and validated for applicability for this study. Results: The potential biological hazards are infections through exposure to aerosols, spills and splashes during various activities, fungal infection due to wet clothes and environment and infections through fomites. The potential physical hazards are injuries due to slips and falls, exposure to heat, humidity, dust, noise, and vibration. The potential chemical hazards are contact dermatitis and allergic asthma due to exposure to detergents, phenyl solution, bleaching powder, and soap oil solution. The potential ergonomic hazards are musculoskeletal diseases and repetitive stress injuries at the shoulder, elbow, and small joints of the hands. PPEs were not used consistently in most areas of the department. PMID:25006311

Kumar, M. Shashi; Goud, B. Ramakrishna; Joseph, Bobby

2014-01-01

186

The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital  

PubMed Central

Background The outbreak of severe acute respiratory syndrome (SARS) in Toronto, which began on Mar. 7, 2003, resulted in extraordinary public health and infection control measures. We aimed to describe the psychological and occupational impact of this event within a large hospital in the first 4 weeks of the outbreak and the subsequent administrative and mental health response. Methods Two principal authors met with core team members and mental health care providers at Mount Sinai Hospital, Toronto, to compile retrospectively descriptions of the experiences of staff and patients based on informal observation. All authors reviewed and analyzed the descriptions in an iterative process between Apr. 3 and Apr. 13, 2003. Results In a 4-week period, 19 individuals developed SARS, including 11 health care workers. The hospital's response included establishing a leadership command team and a SARS isolation unit, implementing mental health support interventions for patients and staff, overcoming problems with logistics and communication, and overcoming resistance to directives. Patients with SARS reported fear, loneliness, boredom and anger, and they worried about the effects of quarantine and contagion on family members and friends. They experienced anxiety about fever and the effects of insomnia. Staff were adversely affected by fear of contagion and of infecting family, friends and colleagues. Caring for health care workers as patients and colleagues was emotionally difficult. Uncertainty and stigmatization were prominent themes for both staff and patients. Interpretation The hospital's response required clear communication, sensitivity to individual responses to stress, collaboration between disciplines, authoritative leadership and provision of relevant support. The emotional and behavioural reactions of patients and staff are understood to be a normal, adaptive response to stress in the face of an overwhelming event. PMID:12743065

Maunder, Robert; Hunter, Jonathan; Vincent, Leslie; Bennett, Jocelyn; Peladeau, Nathalie; Leszcz, Molyn; Sadavoy, Joel; Verhaeghe, Lieve M.; Steinberg, Rosalie; Mazzulli, Tony

2003-01-01

187

Prevalence and pattern of childhood blindness in a resource limited teaching hospital in Nigeria  

Microsoft Academic Search

Objective: To determine the prevalence and identify the causes of childhood blindness and visual impairment in a resource-limited tertiary hospital. Results: The prevalence of severe visual impairment and blindness was 2.0% and 1.4% respectively. 345 (29.3%) children: 203 males, 142 females had vision below 6\\/18 in at least one eye, 117(9.9%) had severe visual impairment and blindness in at least

TAIWO Olufunmilola

188

Implementation of a Radiology Electronic Imaging Network: The community teaching hospital experience  

Microsoft Academic Search

Because of their typically small in-house computer and network staff, non-university hospitals often hesitate to consider\\u000a picture archiving and communication system (PACS) as a solution to the very demanding financial, clinical, and technological\\u000a needs of today’s Radiology Department. This article presents the experiences of the 3-year process for the design and implementation\\u000a of the Radiology Electronic Imaging Network (REIN) in

Manuel Arreola; Harvey L. Neiman; Amy Sugarman; Larry Laurenti; Ron Forys

1997-01-01

189

Accelerated discharge of patients in the event of a major incident: observational study of a teaching hospital  

PubMed Central

Background Since October 2002 in the UK Primary Care Trusts (PCTs) have had statutory responsibility for having and maintaining a Major Incident plan and since 2005 they have been obliged to co-operate with other responders to an incident. We aimed to establish the number of beds in our Trust which could be freed up over set periods of time in the event of a major incident and the nature and quantity of support which might be required from PCTs in order to achieve this. Methods Repeated survey over 12 days in 3 months of hospital bed occupancy by type of condition and discharge capacity in an 855-bed UK tertiary teaching hospital also providing secondary care services. Outcome measures were bed spaces which could be generated, timescale over which this could happen and level and type of PCT support which would be required to achieve this. Results Mean beds available were 78 immediately, a further 69 in 1–4 hours and a further 155 in 4–12 hours, generating a total of 302 beds (36% of hospital capacity) within 12 hours of an incident. This would require support from a PCT of 150,000 population of 10 nursing care beds, 20 therapy-supported intermediate care beds, and 25 care packages in patients' own homes. Conclusion In order to fulfill the requirements of the Civil Contingencies Act 2004, PCTs should plan to have surge capacity in the order of 30 residential placements and 25 community support packages per 150,000 population to support Acute Trusts in the event of a major incident. PMID:16638157

Challen, Kirsty; Walter, Darren

2006-01-01

190

Adverse Drug Reaction Monitoring of Antidepressants in the Psychiatry Outpatients Department of a Tertiary Care Teaching Hospital  

PubMed Central

Background and Introduction: Depression is a prevalent mental disorder and the 4th leading cause of disability in the world as per the World Health Organization (WHO). The adverse Drug Reactions (ADRs) to antidepressants are common and they can lead to a non compliance or even a discontinuation of the therapy. This study entitled us to monitor the ADR profile of the antidepressants in a tertiary care teaching hospital. Patients and Methods: A longitudinal, observational study was conducted in the Outpatients Department of Psychiatry in S.C.B. Medical College and Hospital l in collaboration with the I.M.S and SUM Hospital. A total of 160 cases were studied for ADRs by using a predesigned CDSCO form. The patients who were on TCAs, SSRIs and newer antidepressants (SNRIs/NDRIs) were assessed by doing physical examinations, neurological examinations and relevant lab tests. The causalities were assessed by the criteria of the WHO-UMC. The analysis of ADRs was done by using the Chi square test. Results: Among the 160 patients who took antidepressants, 26.87% reported ADRs, with at least one possible causality.None were labeled as certain, as a rechallenge was not performed.ADRs were mostly observed in polytherapy (14.37%) and with antidepressants like TCAs (58.84%). Conclusions: Agitation, anxiety and insomnia were the common ADRs which were associated with the use of antidepressants. This study offers a representative profile of the ADRs which can be expected in the Psychiatry Outpatients Department and due care must be taken to avoid these ADRs. PMID:23905119

Mishra, Swati; Swain, Trupti Rekha; Mohanty, Manjushree

2013-01-01

191

Cost-outcome description of clinical pharmacist interventions in a university teaching hospital  

PubMed Central

Background Pharmacist interventions are one of the pivotal parts of a clinical pharmacy service within a hospital. This study estimates the cost avoidance generated by pharmacist interventions due to the prevention of adverse drug events (ADE). The types of interventions identified are also analysed. Methods Interventions recorded by a team of hospital pharmacists over a one year time period were included in the study. Interventions were assigned a rating score, determined by the probability that an ADE would have occurred in the absence of an intervention. These scores were then used to calculate cost avoidance. Net cost benefit and cost benefit ratio were the primary outcomes. Categories of interventions were also analysed. Results A total cost avoidance of €708,221 was generated. Input costs were calculated at €81,942. This resulted in a net cost benefit of €626,279 and a cost benefit ratio of 8.64: 1. The most common type of intervention was the identification of medication omissions, followed by dosage adjustments and requests to review therapies. Conclusion This study provides further evidence that pharmacist interventions provide substantial cost avoidance to the healthcare payer. There is a serious issue of patient’s regular medication being omitted on transfer to an inpatient setting in Irish hospitals. PMID:24742158

2014-01-01

192

Adherence to American society of health-system pharmacists surgical antibiotic prophylaxis guidelines in a teaching hospital  

PubMed Central

Objective: Surgical site infections are the second most common type of adverse events occurring in hospitalized patients, whereas an estimated 40-60% of these infections are thought to be preventable. Choice of regimen, administration timing or duration of antibiotic prophylaxis is reported to be inappropriate in approximately 25-50% of cases. We tried to evaluate an antibiotic administration pattern for surgical antibiotic prophylaxis in a teaching hospital. Methods: This study was conducted at the general surgery and orthopedic wards of a teaching hospital affiliated with Mazandaran University of Medical Sciences. The medical records of admitted patients who underwent different surgical procedures were reviewed. Compliance was assessed with the recommendations of the American Society of Health-System Pharmacists' guidelines for every aspect of antibiotic prophylaxis. All data were coded and analyzed by SPSS16 software using Student's t-test and Chi-square test. Findings: During 1 year, 759 patients who underwent different surgeries were included in the study. Mean age of patients was 32.02 ± 18.79 years. Hand and foot fractures repair were the most frequent surgery types. About 56.4% of administered prophylactic antibiotics were in accordance with the American Society of Health System Pharmacists (ASHP) guidelines regarding prophylaxis indication. The most commonly antibiotic used was cefazolin and antibiotic choices were appropriate in 104 of 168 surgical procedures (62%). Gentamicin, metronidazole and ceftriaxone were the most frequently antibiotics that used inappropriately. Only in 100 of 168 procedures, duration was concordant with the ASHP guideline, whereas in 68 procedures, duration was longer than recommended time. In 98 procedures, the dose was lower and in one procedure, it was higher than recommended doses. Conclusion: Although such guidelines have been in place for many years, studies showed that much inappropriate antibiotic use as prophylaxis and poor adherence to guidelines are still major issues. It is essential for surgeons to be aware to consider the best antibiotic choices, dose and duration based on reliable guidelines for antibiotic prophylaxis. PMID:25114939

Rafati, Mohammadreza; Shiva, Afshin; Ahmadi, Amirhosein; Habibi, Omran

2014-01-01

193

Clinico-Pathological Profile of Adnexal Torsion Cases: A Retrospective Analysis from A Tertiary Care Teaching Hospital  

PubMed Central

Introduction: Torsion of the adnexa is a rare condition which can be potentially lethal for the women. The clinical presentation can be varied and can be seen in any age group. Understanding the clinical and pathological profile of patients suffering from adenexal torsion can guide the clinicians in diagnosing and managing the condition. Objective: To analyze the clinical and pathological profile of adnexal torsion cases in a tertiary care teaching hospital. Materials and Methods: The study was a retrospective analysis of hospital records. It included all cases of adnexal torsion that underwent laprotomy between January 2007 to December 2012 in a tertiary care teaching hospital. The study was approved by the Institute’s human Ethics Committee. Results: A total of 18 patients were included in the study. Majority (66.7%) of participants were in the reproductive age group. Abdominal pain was the most common symptom seen in 77.8% of patients. The other symptoms were abdominal distension, back ache and dysuria. Majority of the women belonged to Para 2 (44.4%) and Para 3 (27.8%). The proportion of women with one and two LSCS was 11.1% and 16.7% respectively. Tenderness (38.9%), mass (22.2%) were the common per abdomen findings. Perspeculum findings were normal in majority (88.9%) of the participants. About 39.2% of the patients presented with a mass in either fornices or pouch of Douglas on pervaginal examination. The side of lesion was only on right in 9 (50%) , only left in 7(38.9%) and both sides in 2 (11.1%) of cases. On histopathological examination, of the lesions there were mucinous cystadenoma (33.3%) serous cystadenoma (16.7%) and benign cystic teratoma (16.7%) as most common lesions. Conclusion: Adnexal torsion, though a rare clinical condition can present as an emergency most of the times. High index of suspicion is required for diagnosis, as the clinical presentation can be varied. But the diagnosis can be made certain only on the operating table, either by laparoscopy. Avoiding a delay in operating upon the patient will help prevent complications, and aid in conserving the ovary. PMID:25121032

Reddy, Gopireddy Murali Mohan; Subbiah, Vasantha Nagamma; Sathiya, Saktivel; Arjun, Balasubramanian

2014-01-01

194

American Hospital Association  

MedlinePLUS

... Health Information Technology Health Reform Moving Forward Teaching Hospitals - Medical Education Quality and Patient Safety Tools & Resources ... Amicus Briefs Legal Resources: Litigation State Issues Forum (Hospital Association Executives Only) Key Initiatives America’s Hospitals: Caring ...

195

[Hepatitis B virus: serum response to vaccine in teaching hospital cleaners].  

PubMed

Viral hepatitis B is one of the major public health problems in all continents. The hepatitis-B virus is transmitted parenterally and mainly sexually. The objective of this study was to evaluate the population composing the active cleaning staff of the Botucatu School of Medicine Hospital - UNESP who had received a complete vaccination scheme against hepatitis B, to measure their levels of antibodies against AgHBs (anti-HBs) and to evaluate their relationship with general epidemiological conditions, personal and professional life conditions and risk of infection by the hepatitis-B virus. PMID:20640293

Osti, Cristina; Marcondes-Machado, Jussara

2010-06-01

196

Nosocomial infections by Klebsiella pneumoniae carbapenemase producing enterobacteria in a teaching hospital.  

PubMed

Objective To analyze the profile of patients with microorganisms resistant to carbapenems, and the prevalence of the enzyme Klebsiella pneumoniae carbapenemase in interobacteriaceae. Methods Retrospective descriptive study. From the isolation in bacteriological tests ordered by clinicians, we described the clinical and epidemiological characteristics of patients with enterobacteria resistants to carbapenems at a university hospital, between March and October 2013. Results We included 47 isolated patients in this study, all exhibiting resistance to carbapenems, including 9 patients who were confirmed as infected/colonized with K. pneumoniae carbapenemase. Isolation in tracheal aspirates (12; 25.5%) predominated. The resistance to ertapenem, meropenem, and imipenem was 91.5%, 83.0% and 80.0%, respectively. Aminoglycosides was the class of antimicrobials that showed the highest sensitivity, 91.5% being sensitive to amikacin and 57.4% to gentamicin. Conclusion The K. pneumoniae carbapenemase was an important agent in graun isotaling in hospital intection. The limited therapeutic options emphasize the need for rapid laboratory detection, as well as the implementation of measures to prevent and control the spread of these pathogens. PMID:25295446

Seibert, Gabriela; Hörner, Rosmari; Meneghetti, Bettina Holzschuh; Righi, Roselene Alves; Forno, Nara Lucia Frasson Dal; Salla, Adenilde

2014-09-01

197

Prevalence of Nosocomial Wound Infection Among Postoperative Patients and Antibiotics Patterns at Teaching Hospital in Sudan  

PubMed Central

Background: Postoperative nosocomial infections remain a major problem in health care facilities, resulting in extended length of stay, substantial morbidity and mortality, high excess of cost, and less frequent cause of death in the surgical patient. Aims: To determine the prevalence of aerobic nosocomial pathogens among patients with postoperative wound infections at Gadarif state which located in Eastern part of Sudan. Materials and Methods: 109 wound swabs were collected from patients who had developed postoperative wound infection. Conventional technique for isolation of bacteria was applied with analytical profile index (API system) for identification to confirm primary and secondary isolates. Antibiotics susceptibility was applied for all isolated bacteria. Results: Aerobic bacterial isolates were S. aureus (n=55, 55.0%), P. mirabilis (n=35, 35.0%), E. coli (n=5, 5.0%), Ps. aeruginosa (n=3, 3.0%), and Pr. vulgaris (n=2, 2.0%). The prevalence rate of hospital acquired infection were 25.23% Conclusion: The highest prevalence rate of nosocomial postoperative wound infection, in Sudan was due to poor antibiotic selection, for prophylaxis during and after surgery and increased level of contamination in most part of the hospital. PMID:22393545

Ahmed, Mohamed Issa

2012-01-01

198

Geriatric Education in a Teaching Hospital: The Role of Geriatric Services  

PubMed Central

Geriatric education and training are most successful when taught in a setting that provides the medical and social services that elderly persons often require. At Mount Zion Hospital and Medical Center, medical students and trainees participate in several geriatric services that introduce them to the special health needs of the elderly, including the ambulant and the homebound. In the Mount Zion/University of California, San Francisco, geriatric education and training program, we have defined three principles of geriatric medicine that are unique to the field and are best applied directly within the service setting. This setting emphasizes (1) the special body of knowledge regarding aging and health care of the elderly, (2) the importance of assessing functional capacity and (3) the role of the health team. Our experience indicates that when students and trainees observe the application of these principles in a range of geriatric services they begin to understand the complex health problems with which geriatric medicine is concerned. PMID:7336715

Feigenbaum, Lawrence Z.; Allen, Carol L.; Brownstein, Harold

1981-01-01

199

Five-year experience of clinical ethics consultations in a pediatric teaching hospital.  

PubMed

Our retrospective study presents and evaluates clinical ethics consultations (CECs) in pediatrics as a structure for implementing hospital-wide ethics. We performed a descriptive and statistical analysis of clinical ethics decision making and its implementation in pediatric CECs at Zurich University Children's Hospital. Ninety-five CECs were held over 5 years for 80 patients. The care team reached a consensus treatment recommendation after one session in 75 consultations (89 %) and on 82 of 84 ethical issues (98 %) after two or more sessions (11 repeats). Fifty-seven CECs recommended limited treatment and 23 maximal treatment. Team recommendations were agreed outright by parents and/or patient in 59 of 73 consultations (81 %). Initial dissensus yielded to explanatory discussion or repeat CEC in seven consultations (10 %). In a further seven families (10 %), no solution was found within the CEC framework: five (7 %) required involvement of the child protection service, and in two families, the parents took their child elsewhere. Eventual team-parent/patient consensus was reached in 66 of 73 families (90 %) with documented parental/patient decisions (missing data, n?=?11). Patient preference was assessable in ten CECs. Patient autonomy was part of the ethical dilemma in only three CECs. The Zurich clinical ethics structure produced a 98 % intra-team consensus rate in 95 CECs and reduced initial team-parent dissensus from 21 to 10 %. Success depends closely on a standardized CEC protocol and an underlying institutional clinical ethics framework embodying a comprehensive set of transparently articulated values and opinions, with regular evaluation of decisions and their consequences for care teams and families. PMID:24323344

Streuli, Jürg C; Staubli, Georg; Pfändler-Poletti, Marlis; Baumann-Hölzle, Ruth; Ersch, Jörg

2014-05-01

200

Antibiotic sensitivity pattern and cost-effectiveness analysis of antibiotic therapy in an Indian tertiary care teaching hospital  

PubMed Central

Objective: The purpose of this study is to analyze the antibiotic sensitivity pattern of microorganisms, to study the antibiotic usage pattern, and to conduct a cost-effectiveness analysis (CEA) for the antibiotics prescribed in a tertiary care teaching hospital in south India. Methods: This prospective study was carried out in the General Medicine and Pulmonology departments of the hospital for a period of 6 months. The study was carried out in three phases: A prospective analysis to check the sensitivity pattern of microorganisms to various antibiotics, data extraction and determining the cost of antibiotics and finally evaluation of the sensitivity pattern of microorganisms and the antibiotic usage. A total of 796 documented records were analyzed. Findings: It was found that Escherichia coli was the major organism identified in 36.4% of the isolated specimens, followed by Klebsiella sp. (18.9%), Streptococcus pneumoniae (15.8%), Staphylococcus aureus (12.4%), and Pseudomonas (9.3%). The sensitivity pattern data of the prospective study revealed that E. coli was highly sensitive to Amikacin (99.3%), Klebsiella to Amikacin (93.8%), Pseudomonas to Meropenem (97.6%), and S. pneumoniae to Ofloxacin (93.8%). In the prescribing pattern study, it was found that the most common disease (21.2%) was found to be lower respiratory tract infection in 51 patients. Cephalosporins (73%), in particular Ceftriaxone (63.5%) was highly prescribed, followed by fluoroquinolones (53.9%). In the CEA, it was revealed that Ceftriaxone was the cost-effective antibiotic with a cost-effectiveness ratio (CER) of 78.27 compared to Levofloxacin, which had a CER of 95.13. Conclusion: Continuous surveillance of susceptibility testing is necessary for cost-effective customization of empiric antibiotic therapy. Furthermore, reliable statistics on antibiotic resistance and policies should be made available. PMID:24991607

Sriram, Shamungum; Aiswaria, Varghese; Cijo, Annie Eapen; Mohankumar, Thekkinkattil

2013-01-01

201

Overdose Rate of Drugs Requiring Renal Dose Adjustment: Data Analysis of 4 Years Prescriptions at a Tertiary Teaching Hospital  

PubMed Central

OBJECTIVE To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose. SUBJECTS Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005. METHODS A clinical data mart was constructed. A knowledge base containing dose adjusting information about 56 drugs was built. One day dose was compared to the reference dose adjusted to the patient’s renal function. RESULTS Considering the patient’s renal function, 5.3% of drug doses were excessive. The overdose rate in the patients with moderate to severe renal insufficiency was 28.2%. Only 25% of physicians were responsible for 50.6% of the overdoses. Of 56 drugs studied, 10 drugs, including ranitidine, amoxicillin, and piperacillin/tazobactam, were involved in 85.4% of the overdoses. The physicians with high overdose rate had patients with more impaired renal function (correlation coefficient?=?0.192, P?hospital data. Drug overdose is quite common among inpatients with renal insufficiency. Only a few drugs are responsible for most of drug overdoses. The physicians’ clinical experience, workload of prescriptions, and patients’ renal function are correlated with drug overdose. PMID:18373140

Sheen, Seung Soo; Choi, Ji Eun; Kim, Eun Yub; Lee, Young Ho; Kang, Un Gu

2008-01-01

202

Assessment of Prevalence and Mortality Incidences Due to Poisoning in a South Indian Tertiary Care Teaching Hospital  

PubMed Central

WHO reports estimate poisoning as one of the most common causes of increased morbidity and mortality rate world-wide. Various agents such as pesticides, drugs have been used for intentional and accidental poisoning in different countries. In the Indian scenario, pesticides are the most commonly used poisoning agents. To assess the prevalence and mortality incidence rate due to various poisoning agents a retrospective and prospective study conducted over a period of nine months in a tertiary care teaching hospital. Retrospective data of poisoning cases was collected from the medical records section and the prospective data of poisoning cases was collected from the emergency and causality departments. A total of 1045 poisoning related admissions were identified during the period January 2005 to September 2008. Among them, 68.40% of cases were due to intentional poisoning and 31.60% were due to accidental poisoning. Of the poisoning related admissions, 84.4% of patients recovered, whereas in 7.6% of cases condition did not improve. Mortality rate was observed 4%. Intentional poisoning was observed more in male population (60.2%) in the age group of 18-29 years. Accidental poisoning was seen more in children in the age group of 1-3 years. Incidence of overall poisoning cases were high due to pesticides (39.5%) followed by medicines (26.1%), household products (22.1%), environmental poisoning (12.1%) and heavy metals (0.2%). It was observed that availability of centralised poison information centre and treatment protocols will improvise poison management practices in tertiary care hospitals by the clinicians. PMID:21694990

Jesslin, J.; Adepu, R.; Churi, S.

2010-01-01

203

Evaluation of the impact of asbestos wastes on soils in Emene-Enugu, Southeastern Nigeria.  

PubMed

This study investigated the impacts of asbestos wastes on soils in Emene-Enugu, southeastern Nigeria, generated by the activities of a major asbestos products manufacturing company in southeastern Nigeria. The methods of investigation included vertical electrical sounding (VES), 2-D horizontal resistivity profiling (HRP), induced polarization (IP) survey, chemical analysis of plant tissues and standard penetration tests of soil samples. The 2-D HRP and IP identified six closed waste pits alongside the two active pits. The VES revealed four geoelectrical layers in the area: from bottom to top; the inferred lithologies included dark shale, clay, gravel and recent sands. The geochemical data results revealed that Cd concentration of the soils of the waste pits is above the contaminated land exposure assessment soil guideline value for residential and allotment land uses. The geochemical pollution indices classified the soils as "unpolluted" to "extremely polluted". Bioconcentration factor of Pb in plant tissues was found to be above recommended limits of 0.045. The geotechnical parameters indices revealed that the soils varied from "very soft" to "stiff" and "very loose" to "medium". Soils of the active pits have very low strength and bearing capacity while closed pits have high strength and bearing capacity. It may be safe, therefore, to conclude that as the wastes are completely turned into soils, they will assume geotechnical properties similar to those of natural soils. PMID:25098901

Igwe, O; Omonona, O V; Onwuka, O S; Nnebedum, O D

2014-12-01

204

Assessing Controlled Substance Prescribing Errors in a Pediatric Teaching Hospital: An Analysis of the Safety of Analgesic Prescription Practice in the Transition From the Hospital to Home  

Microsoft Academic Search

Iatrogenic errors producing serious and often preventable injury occur frequently in hospitalized patients, particularly in children. Little is known about the epidemiology of analgesic medication errors in patients being discharged from the hospital. The goal of this study was to describe the epidemiology of controlled substance prescription errors by physicians-in-training for children being discharged from the hospital. We conducted a

Benjamin H. Lee; Christoph U. Lehmann; Eric V. Jackson; Sabine Kost-Byerly; Sharon Rothman; Lori Kozlowski; Marlene R. Miller; Peter J. Pronovost; Myron Yaster

2009-01-01

205

Hirschsprung's disease in children: a five year experience at a University teaching hospital in northwestern Tanzania  

PubMed Central

Background Hirschsprung’s disease (HD) is the commonest cause of functional intestinal obstruction in children and poses challenges to pediatricians and pediatric surgeons practicing in resource-limited countries. This study describes the clinical characteristics and outcome of management of this disease in our setting and highlights challenges associated with the care of these patients and proffer solutions for improved outcome. Methods This was a descriptive prospective study of children aged ? 10 years who were histologically diagnosed and treated for HD at our centre between July 2008 and June 2013. Results A total of 110 patients (M: F ratio= 3.6:1) with a median age of 24 months were studied. Six (5.5%) patients were in the neonatal period. Sixty-four (58.2%) patients had complete intestinal obstruction whereas 42 (38.2%) and 4 (3.6%) patients had chronic intestinal obstruction and intestinal perforation respectively. No patient had enterocolitis. Constipation (94.5%) was the most common complaints. 109 (99.1%) patients had colostomy prior to the definitive pull-through. The median duration of colostomy before definitive pull-through was 4 months. The majority of patients (67.3%) had short segment of aganglionosis localized to the recto-sigmoid region. The definitive pull-through was performed in 94 (85.5%) patients (Swenson’s pull-through 76 (80.9%), Duhamel’s pull-through (12.8%) and Soave’s pull-through 4 (4.3%) patients). Postoperative complication rate was 47.3%. The median length of hospital stay was 26 days. Patients who developed complications stayed longer in the hospital and this was statistically significant (p <0.001). Mortality rate was 21.8%. The age < 4 weeks, delayed presentation and surgical site infection were the main predictors of mortality (p < 0.001). During the follow-up period, the results of Swenson’s and Duhamel’s pull through procedures were generally good in 87.8% and 42.9% of patients respectively. The result of Soave’s procedures was generally poor in this study. Conclusion HD remains the commonest cause of functional intestinal obstruction in children and contributes significantly to high morbidity and mortality in our setting. The majority of patients present late when the disease becomes complicated. Early diagnosis and timely definitive pull through procedure are essential in order to decrease the morbidity and mortality associated with this disease. PMID:24973940

2014-01-01

206

Innovative teaching for health law: a case study of a hospital medical malpractice lawsuit simulation.  

PubMed

In this article we describe a case study of a learning exercise for healthcare management students to more effectively understand how the legal process impacts healthcare organizations and healthcare professionals. Through a semester-long mock trial, we illustrate how healthcare executives can better understand and prepare their employees, their organization, and fellow administrators for the financial, emotional, and time investment that a lawsuit requires. Students participate as a member of the plaintiff team, defendant team, or juror in a simulated lawsuit brought by a patient against a hospital. We explain how students who participate in the simulated lawsuit gain a better understanding of difficult legal principles discussed throughout the course. We further indicate how the mock trial simulation may support achievement of current Commission on Accreditation of Healthcare Management Education (CAMHE) criteria. Next, we highlight how the mock trial allowed students to put into practice many of the health law principles discussed in class through role playing the different stages of medical malpractice trial. The article concludes with examples of how a simulated mock trial may also provide similar interdisciplinary educational, performance improvement, and cost saving benefits to healthcare professionals and their organizations. PMID:17847866

Jenkins, Randall Carter; Lemak, Christy Harris

2007-01-01

207

Twenty-four-hour intensivist staffing in teaching hospitals: tensions between safety today and safety tomorrow.  

PubMed

There is an inherent tension between the training needs of inexperienced clinicians and the safety of the patients for whom they are responsible. Our society has accepted this tension as a necessary trade-off to maintain a competent workforce of physicians year after year. However, recent trends in medical education have diminished resident autonomy in favor of the safety of current patients. One dramatic example is the rapid increase in the number of academic ICUs that provide coverage by attending physicians at all hours. The potential benefits of this staffing model have strong face validity: improved quality and efficiency from the constant involvement of experienced intensivists, increased family and staff satisfaction from the immediate availability of attending physicians, and reduced burn-out among intensivists from reduced on-call responsibilities. Thus, many hospitals have moved toward 24-h coverage by attending intensivist physicians without evidence that these benefits actually accrue and perhaps without full consideration of possible unintended consequences. In this article, we discuss the potential benefits and risks of nocturnal intensivist staffing, considering the needs of current and future patients. Furthermore, we suggest that there remains sufficient uncertainty about these benefits and risks that it is both necessary and ethical to study the effects in earnest. PMID:22553264

Kerlin, Meeta Prasad; Halpern, Scott D

2012-05-01

208

Phenotypic and Molecular Characterization of Multidrug Resistant Klebsiella pneumoniae Isolated from a University Teaching Hospital, China  

PubMed Central

The multidrug-resistant rate of Klebsiella pneumoniae has risen rapidly worldwide. To better understand the multidrug resistance situation and molecular characterization of Klebsiella pneumoniae, a total of 153 Klebsiella pneumoniae isolates were collected, and drug susceptibility test was performed to detect its susceptibility patterns to 13 kinds of antibiotics. Phenotypic tests for carbapenemases ESBLs and AmpC enzyme-producing strains were performed to detect the resistance phenotype of the isolates. Then PCR amplification and sequencing analysis were performed for the drug resistance determinants. The results showed that 63 strains harbored blaCTX-M gene, and 14 strains harbored blaDHA gene. Moreover, there were 5 strains carrying blaKPC gene, among which 4 strains carried blaCTX-M, blaDHA and blaKPC genes, and these 4 strains were also resistant to imipenem. Our data indicated that drug-resistant Klebsiella pneumoniae were highly prevalent in the hospital. Thus it is warranted that surveillance of epidemiology of those resistant isolates should be a cause for concern, and appropriate drugs should be chosen. PMID:24740167

Liu, Helu; Lu, Dongyue; Liang, Hong; Dou, Yuhong

2014-01-01

209

Quality Control in Linen and Laundry Service at A Tertiary Care Teaching Hospital in India  

PubMed Central

Introduction: The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department Methods: Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff working, their qualification, training, promotion avenues, motivation and job satisfaction. Process was studied by carrying out observations in linen and laundry service through a predesigned flow chart which was supplemented by interviews with different category of staff. Patient satisfaction, staff satisfaction and microbial count of laundered linen (quality dimensions) were studied in the outcome. Results: The current study found that in spite of certain deficiencies in the equipment, manpower and process, the linen and laundry service is providing a satisfactory service to its users. However the services can be further improved by removing the present deficiencies both at structure and process level. PMID:21475509

Singh, Dara; Qadri, GJ; Kotwal, Monica; Syed, AT; Jan, Farooq

2009-01-01

210

Primary germ cell tumors of the mediastinum: 10 years of experience in a tertiary teaching hospital.  

PubMed

Germ cell tumors occur mostly in the gonad. Extragonadal germ cell tumors are rare, and most occur in the retroperitoneum and mediastinum. Primary mediastinal germ cell tumors are often found in the anterior portion of the mediastinum and include teratomas and non-teratomatous tumors. Non-teratomatous tumors include seminomas and malignant non-seminomatous germ cell tumors (MNSGCTs). MNSGCTs include yolk sac tumors, choriocarcinomas, embryonal carcinomas, and mixed type germ cell tumors. Teratomas are the most common germ cell tumors of the mediastinum, and seminomas are the most common non-teratomatous germ cell tumors of the mediastinum. Cases of primary mediastinal MNSGCT reported in the literature are rare. In this report, we review all primary mediastinal germ cell tumors from a 10-year period at the Chung-Ho Memorial Hospital of Kaohsiung Medical University. A total of 14 cases were reviewed, including 11 patients with mature teratomas, two with yolk sac tumors, and one with seminoma. We discuss the differences in clinical presentation, histopathologic characteristics, treatment, and prognosis. PMID:16248122

Yang, Chih-Jen; Cheng, Meng-Shuan; Chou, Shah-Hwa; Tsai, Kun-Bow; Huang, Ming-Shyan

2005-09-01

211

Prevalence of Anaemia among Pregnant Women at Booking in the University of Uyo Teaching Hospital, Uyo, Nigeria  

PubMed Central

Background. Anaemia with an estimated prevalence of 35–75% among pregnant women is a major cause of maternal deaths in Nigeria. Objective. To determine the prevalence of anaemia, associated sociodemographic factors and red cell morphological pattern among pregnant women during booking at the University Teaching Hospital, Uyo. Material and Methods. A cross-sectional analytical study of 400 women at the booking clinic over a 16-week period. The packed cell volume and red cell morphology of each pregnant woman were determined. Their biodata, obstetric and medical histories, and results of other routine investigations were obtained with questionnaires and analyzed with SPSS Package version 17.0. Results. The mean packed cell volume was 31.8% ±3.2 and 54.5% of the women were anaemic. The commonest blood picture was microcytic hypochromia and normocytic hypochromia suggesting iron deficiency anaemia. Anaemia was significantly and independently related to a history of fever in the index pregnancy (OR = 0.4; P = 0.00; 95% CI = 0.3–0.7), HIV positive status (OR = 0.2; P = 0.01; 95% CI = 0.1–0.6), and low social class (OR = 0.3; P = 0.00; 95% CI = 0.2–0.7). Conclusion. Women need to be economically empowered and every pregnant woman should be encouraged to obtain antenatal care, where haematinics supplementation can be given and appropriate investigations and treatment of causes of fever and management of HIV can be instituted. PMID:24982910

Olatunbosun, Olujimi A.; Abasiattai, Aniekan M.; Bassey, Emem A.; James, Robert S.; Morgan, Anyiekere

2014-01-01

212

Prevalence of vanC vancomycin-resistant enterococci in the teaching hospitals of the University of Debrecen, Hungary.  

PubMed

Vancomycin-resistant enterococci (VRE) are common nosocomial pathogens; however, until now they have been rarely encountered in Hungary. In the present study, we investigated the prevalence of VRE in the teaching hospitals of the University of Debrecen. Of 7,271 Enterococcus-containing clinical samples collected between 2004 and 2009, we identified 16 VRE. Species-specific polymerase chain reaction was used to detect Enterococcus faecalis, Enterococcus faecium, Enterococcus casseliflavus, and Enterococcus gallinarum. Multiplex polymerase chain reaction was performed to identify the vancomycin resistance genes: vanA, vanB, vanC1/C2, vanD, vanE, and vanG. Restriction digestion with SalI and HindIII was introduced to differentiate the vanC1 and vanC2 genes from each other. Genetic relationships between the strains were investigated by pulsed-field gel electrophoresis. Overall, we identified the vanC1 resistance gene in 14 E. gallinarum and the vanC2 resistance gene in two E. casseliflavus strains. Except for two samples, the isolates had different pulsed-field gel electrophoresis types, suggesting sporadic emergence of the resistant bacteria. In addition, antibiotic resistance profile was determined by E-test. Three E. gallinarum strains proved to be resistant to gentamicin because of the presence of the aacA-aphD gene. Although the prevalence of VRE in Debrecen is rather low, the appearance of multiple resistances is of concern. PMID:21649462

Dombrádi, Zsuzsanna; Dobay, Orsolya; Nagy, Károly; Kozák, Anita; Dombrádi, Viktor; Szabó, Judit

2012-02-01

213

Sensitivity profile of Staphylococcus spp. and Streptococcus spp. isolated from toys used in a teaching hospital playroom?  

PubMed Central

Objective: To evaluate the presence of microorganisms of the genus Staphylococcus and Streptococcus on toys in the playroom of a teaching hospital, as well to as analyze the antimicrobial resistance from isolated strains. Methods: Samples were collected from 60 toys, using wet swabs, soon after being used by the children. The samples were inoculated in enriched and selective agar for isolation and later identification of the microorganisms. Antibiogram testing was performed by agar diffusion technique. Results: The genus Staphylococcus was present in 87.0% (52/60) of the toys. Seventy-three strains were isolated, with 29.0% (21/73) coagulase-positive and 71.0% (52/73) coagulasenegative. Among the coagulase-negative strains, 90.4% were resistant to penicillin, 65.4% to oxacillin, 28.8% to clarithromycin, 61.5% to clindamycin, and none to vancomycin. Among the coagulase-positive strains, 76.2% were resistant to penicillin, 23.8% to oxacillin, 23.8% to clarithromycin, 47.6% to clindamycin, and none to vancomycin. The genus Streptococcus was not detected in any of the evaluated toys. Conclusions: Toys can be contaminated with potentially pathogenic bacteria with antimicrobial resistance, representing a possible source of nosocomial infection for patients who are already debilitated.

Boretti, Vanessa Stolf; Corrêa, Renata Nunes; dos Santos, Silvana Soléo Ferreira; Leão, Mariella Vieira Pereira; Silva, Célia Regina Gonçalves e

2014-01-01

214

Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria  

PubMed Central

Background Malaria in pregnancy (MIP) is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers’ and consumers’ perspectives. Methods The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses) providing ante-natal care (ANC) services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP). The data was collected from May to June 2010. Results Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p?

2012-01-01

215

How well prepared are medical students for their first year as doctors? The views of consultants and specialist registrars in two teaching hospitals  

Microsoft Academic Search

Objective:To evaluate (1) the extent to which first year doctors (foundation year 1 doctors, F1s) in two teaching hospitals in the Trent Deanery were rated by specialist registrars (SpRs) and consultants as being well prepared for practice; (2) the importance ascribed by SpRs and consultants to the various items of core knowledge, skills and attitudes outlined in the publication of

C Matheson; D Matheson

2009-01-01

216

Physician's practices and perspectives regarding tobacco cessation in a teaching hospital in Mysore City, Karnataka  

PubMed Central

Context: Tobacco is a leading cause of disease and premature death. Most of the smokers visit a doctor for various health related ailments and thus such clinic visits provide many opportunities for interventions and professional tobacco cessation advice. Aims: The primary aim of the following study is to assess the physician practices, perspectives, resources, barriers and education relating to tobacco cessation and their perceived need for training for the same. The secondary aim is to compare the physician's cessation practices from patient's perspective. Settings and Design: A descriptive study was conducted in a hospital attached to Medical College in Mysore city, Karnataka. Materials and Methods: Information about doctor's practices, perspectives and their perceived need for training in tobacco cessation were collected using pre-structured self-administered Questionnaire, which were distributed in person. Patient's practices and perspectives were assessed using a pre-structured Oral Questionnaire. Results: Almost 95% of physicians said that they ask patients about their smoking status and 94% advise them to quit smoking, but only 50% assist the patient to quit smoking and only 28% arrange follow-up visits. Thus, they do not regularly provide assistance to help patients quit, even though 98% of the physicians believed that helping patients to quit was a part of their role. Only 18% and 35% of the physicians said that Undergraduate Medical Education and Post Graduate Medical Education respectively prepared them very well to participate in smoking cessation activities. Conclusions: Tobacco cessation requires repeated and regular assistance. Such assistance is not being provided to patients by attending doctors. Our medical education system is failing to impart the necessary skills to doctors, needed to help patients quit smoking. Reforms in education are needed so as to prepare the physician to effectively address this problem. PMID:24574555

Saud, Mohammed; Madhu, B; Srinath, K M; Ashok, N C; Renuka, M

2014-01-01

217

A Survey on the Users' Satisfaction with the Hospital Information Systems (HISs) based on DeLone and McLean's Model in the Medical-Teaching Hospitals in Isfahan City  

PubMed Central

Background and purpose: The user’s satisfaction with information system in fact denotes the extent the user is satisfied with the system’s achievement in fulfilling his/her information requirements. This study tries to explore the users’ satisfaction with hospital information systems (HISs) based on DeLone and McLean’s model focusing on the medical-teaching hospitals of Isfahan city. Methodology: This study which was applied and descriptive-analytical in nature was carried out in the medical-teaching hospitals of Isfahan city in 2009. Research population consisted of the system users from which a sample was selected using random sampling method. The size of the sample was 228. Data collection instrument was a self-developed questionnaire produced based on the satisfaction criterion in the DeLone and McLean’s model. Its content validity was assessed based on the opinions given by the computer sciences professionals with its estimated Cronbach’s alpha found to be 92.2%. The data were analyzed using SPSS software. Findings: As the findings of the study showed, the differences among the mean scores obtained for the satisfaction with different kinds of HISs in use in the hospitals were statistically significant (p value?0.05). Generally, Kowsar System (old version) and Pouya Samaneh Diva system gained the highest and lowest mean scores for the criterion in question, respectively. The overall mean score for the satisfaction was 54.6% for different types of systems and 55.6% among the hospitals. Conclusion: Given the findings of the study, it can be argued that based on the used model, the level of users’ satisfaction with the systems in question was relatively good. However, to achieve the total optimum condition, when designing the system, the factors affecting the enhancement of the users’ satisfaction and the type of hospital activity and specialty must be given special consideration. PMID:25132711

Saghaeiannejad-Isfahani, Sakineh; Jahanbakhsh, Maryam; Habibi, Mahboobeh; Mirzaeian, Razieh; Nasirian, Mansoreh; Rad, Javad Sharifi

2014-01-01

218

Marjolin's ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases  

PubMed Central

Background Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Although many individual case reports exist, no comprehensive evaluation of Marjolin's ulcer patients has been conducted in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our local setting and to identify predictors of outcome. Methods This was a retrospective study of histologically confirmed cases of Marjolin's ulcer seen at Bugando Medical Centre over a period of 10-years between January 2001 and December 2010. Data were retrieved from patients' files and analyzed using SPSS computer software version 15.0 Results A total of 56 patients were studied. Male to female ratio was 2.1:1. Burn scars (89.3%) were the most common causative lesions of Marjolin's ulcer. The mean latent period between original injury and diagnosis of Marjolin's ulcer was 11.34 ± 6.14 years. Only 12.0% of the reported cases were grafted at the time of injury (P < 0.00). Most patients (48.2%) presented between one and five years of onset of illness. The lower limb (42.9%) was the most frequent site for Marjolin's ulcers. The median tumor size at presentation was 8 cm and the vast majority of patients (85.7%) presented with large tumors of ? 5 cm in diameter. Lymph node metastasis at the time of diagnosis was recorded in 32.1% of cases and distant metastasis accounted for 26.9% of cases. Squamous cell carcinoma (91.1%) was the most common histopathological type. Wide local excision was the most common surgical procedure performed in 80.8% of cases. Post-operative complication rate was 32.1% of which surgical site infection was the most common complication in 38.9% of patients. Local recurrence was noted in 33.3% of cases who were treated surgically. The mean length of hospital stay for in-patients was 7.9 ± 2.3 days. Mortality rate was 7.1%. According to multivariate logistic regression analysis, stage and grade of the tumor and presence of local recurrence were the main predictors of death (P < 0.001). Conclusion Marjolin's ulcers are not rare in our environment and commonly occur in burn scars that were not skin grafted and were left to heal secondarily. A high index of suspicion is required in the management of chronic non-healing ulcers and all suspected lesions should be biopsed. Early recognition and aggressive treatment of Marjolin's ulcers and close follow-up are urgently needed to improve outcomes in our environment. PMID:22336561

2012-01-01

219

An assessment of readiness for pre-implementation of electronic health record in Iran: a practical approach to implementation in general and teaching hospitals.  

PubMed

Readiness assessment provides a proper image of the existing conditions and an explanation of facilitated operational plans and functional approaches to successful implementation of electronic health record. Readiness assessment requires indices adjusted to particular conditions in each country. Therefore, the present study attempts to provide an acceptable model in Iran and to provide an assessment of public and teaching hospitals in medical education university. After reviewing related papers and descriptive study of five selected countries, the initial model was designed in the form of a questionnaire for analysis through Delphi and distributed among 30 experts nationwide. Along identification of components in the proposed method, a 7-point Likert scale was used to determine priority of each component. Then, all general -education hospitals at Tehran University of Medical Education were examined based on this model in terms of total, relative, or no readiness. The final model was designed in five dimensions: cultural, leadership and management, technical infrastructure, governance and operational dimensions; Educational Hospitals were evaluated in this dimension. 28.6 % of general--teaching hospitals are ready for pre-implementation. It seems to establish uniform strategic and executive team in Health center is essential for the preparation them in abovementioned area in the least possible time. PMID:25135263

Ghazisaeidi, Marjan; Ahmadi, Maryam; Sadoughi, Farahnaz; Safdari, Reza

2014-01-01

220

Estimation of subsurface hydrological parameters around Akwuke, Enugu, Nigeria using surface resistivity measurements  

NASA Astrophysics Data System (ADS)

As few boreholes may be available and carrying out pumping tests can be expensive and time consuming, relationships between aquifer characteristics and the electrical parameters of different geoelectric layers exist. Data from 19 vertical electrical soundings (VESs; 13 of these selected for evaluation) was recorded with a Schlumberger electrode configuration in the area around Akwuke, Enugu, Nigeria. The data was interpreted by computer iterative modelling with curve matching for calibration purposes. Geoelectric cross-sections along a number of lines were prepared to ascertain the overall distribution of the resistivity responses of the subsurface lithology. Identified probable shallow aquifer resistivity, thickness and depth values are in the range of 28-527 ?m, 2.1-22.5 m and 3.1-28.3 m respectively. As our aquifer system consists of fine-grained, clay-silty sand materials, a modification of the Archie equations (Waxman-Smits model) was adopted to determine the true formation factor using the relationship between the apparent formation factor and the pore water resistivity. This representation of the effects of a separate conducting path due to the presence of clay particles in the aquifer materials was used in making reliable estimations of aquifer properties. The average hydraulic conductivity of 8.96 × 10-4 m s-1 transmissivity ranging between 1.88 × 10-3 and 2.02 × 10-3 m2 s-1 estimated from surface resistivity measurements correlated well with the available field data. Results of the study also showed a direct relationship between aquifer transmissivity and modified transverse resistance (R2 = 0.85).

Utom, Ahamefula U.; Odoh, Benard I.; Egboka, Boniface C. E.; Egboka, Nkechi E.; Okeke, Harold C.

2013-04-01

221

FREQUENCY, URINALYSIS AND SUSCEPTIBILITY PROFILE OF PATHOGENS CAUSING URINARY TRACT INFECTIONS IN ENUGU STATE, SOUTHEAST NIGERIA  

PubMed Central

Objective: This study was designed to determine the frequency and causative agent(s) of urinary tract infections (UTIs) in individuals with symptoms of urinary tract infections in Enugu State of Southeast Nigeria, and to determine the antibiotic susceptibility pattern of microbial agents isolated from urine culture. Methods: The study involved 211 individuals (149 females and 62 males) clinically suspected for UTI. Urine samples were collected by the mid-stream ‘clean catch’ method and tested using standard procedures. Antibiotic susceptibility of the isolated pathogens was tested using the Kirby-Bauer technique according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Microscopy of centrifuged urine samples showed 16 patients had pyuria while 54 had pus cells. Calcium oxalate crystals were found in 14 samples. Urinalysis performed with urine samples showed 17 had protein; seven were nitrite positive and three had moderate to high glucose concentration. Fifty-four urine samples (36.2%) from females and 12 (19.4%) from males showed significant growth upon culture. Gram stain and biochemical tests identified nine different organisms with Escherichia coli as the most common isolated species. Forty three randomly selected strains were further tested for their susceptibility against a panel of antibiotics. Thirty isolates (81.08%) were resistant to four or more antibiotics with the highest resistance shown by E. coli (76.67%). All the Gram- negative isolates were resistant to Ampicilox, Cefuroxime and Amoxicillin. Conclusion: Urinary tract infections were found more in females in the area under study. As found in other studies, E. coli was the most predominant isolate, although other organisms seem to be on the increase. PMID:24553609

Dibua, Uju M.E.; Onyemerela, Ifeoma S.; Nweze, Emeka I.

2014-01-01

222

Epidemiological profiling of methicillin-resistant Staphylococcus aureus-positive dogs arriving at a veterinary teaching hospital.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important zoonotic and nosocomial pathogen in veterinary settings. Even though human risk factors for MRSA infection and colonization are well known, this information in animals is lacking. The objective of this study was to identify risk factors associated with MRSA carrier dogs on their arrival at a veterinary teaching hospital. A total of 435 dogs were enrolled in the MRSA active surveillance program at The Ohio State University-Veterinary Medical Center over a 1-year period. Dogs were screened for MRSA on arrival, regardless of health status, sex, breed, or age. In addition, an epidemiological survey and medical history were obtained for each dog to identify potential risk factors up to 1 year prior to the appointment. Of 435 dogs included in the study, 25 (5.7%) were MRSA positive, with 86.5% of the isolates classified staphylococcal chromosome cassette mec (SCCmec) type II and USA100. Four of the 25 MRSA carrier dogs were healthy, 20 had health issues unrelated to MRSA, and 1 had an active MRSA infection. MRSA was detected in the nares (72%, 18/25), skin lesions (24%, 6/25), and the perianal area (16%, 4/25). Except for previous surgery <90 days (odds ratio [OR]=4.9; 95% confidence interval [CI] 1.4-17.6; p value 0.01), none of the variables related to the previous medical history, dog's management, home environment, and other potential exposures were associated with the MRSA carrier status. However, the profession of the owner was significantly associated, and dogs owned by veterinary students were 20.5 times (95% CI 4.5-93.6; p value?0.01) more likely to be MRSA positive than dogs owned by clients with different occupations. MRSA-positive dogs were dispersed in different categories, preventing the creation of an epidemiological profile that would allow their early recognition upon arrival to a veterinary hospital. However, the association between veterinary students with MRSA-positive dogs is a concern that deserves further evaluation. PMID:23473222

Hoet, Armando E; van Balen, Joany; Nava-Hoet, Rocio C; Bateman, Shane; Hillier, Andrew; Dyce, Jonathan; Wittum, Thomas E

2013-06-01

223

Use of the Internet for health information by physicians for patient care in a teaching hospital in Ibadan, Nigeria  

PubMed Central

Background The Internet is the world's largest network of information, communication and services. Although the Internet is widely used in medicine and has made significant impact in research, training and patient care, few studies had explored the extent to which Nigerian physicians use Internet resources for patient care. The objective of this study was to assess physicians' use of the Internet for health information for patient care. Method 172 physicians at the University College hospital (UCH) Ibadan, Nigeria; completed a 31-item, anonymous, standardized questionnaire. The Epi-Info software was used for data analysis. Results The mean age of the respondents was 31.95 years (SD 4.94). Virtually all (98%) the respondents had used the Internet; 76% accessed it from cyber cafes. E-mail was the most commonly used Internet service (64%). Ninety percent of the respondents reported they had obtained information from the Internet for patient care; of this number, 76.2% had searched a database. The database most recently searched was MEDLINE/PubMed in 99% of cases. Only 7% of the respondents had ever searched the Cochrane Library. More than half (58.1%) perceived they had no confidence to download full-text articles from online sources such as the Health Internetwork Access to Research Initiative (HINARI). Multiple barriers to increased use of the Internet were identified including poor availability of broadband (fast connection speed) Internet access, lack of information searching skills, cost of access and information overload. Conclusion Physicians' use of the Internet for health information for patient care was widespread but use of evidenced-based medicine resources such as Cochrane Library, Up-to-date and Clinical Evidence was minimal. Awareness and training in the use of EBM resources for patient care is needed. Introduction of EBM in the teaching curriculum will enhance the use of EBM resources by physicians for patient care. PMID:17163991

Ajuwon, Grace A

2006-01-01

224

Intraoperative Cardiac Arrest and Mortality in Trauma Patients. A 14-Yr Survey from a Brazilian Tertiary Teaching Hospital  

PubMed Central

Background Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009. Methods Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related. Findings Fifty–one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (P<0.001) and young adults (18–35 years) (P?=?0.04) with ASA physical status IV or V (P<0.001) undergoing gastroenterological or multiclinical surgeries (P<0.001). Motor vehicle crashes and violence were the main causes of trauma (P<0.001). Uncontrolled hemorrhage or head injury were the most significant associated factors of intraoperative cardiac arrest and mortality (P<0.001). All cardiac arrests and deaths reported were totally related to trauma patient condition. Conclusions Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence. PMID:24587237

Carlucci, Marcelo T. O.; Braz, Jose R. C.; do Nascimento, Paulo; de Carvalho, Lidia R.; Castiglia, Yara M. M.; Braz, Leandro G.

2014-01-01

225

Clinical profile & outcome of H1N1 infected pregnant women in a tertiary care teaching hospital of northern India  

PubMed Central

Background & objectives: H1N1 influenza is a recognized cause of febrile respiratory infection worldwide. There are not many studies to show its impact on pregnancy. In the present study we aimed to assess clinical characteristics, obstetric and perinatal outcome of pregnant women with H1N1 infection. Methods: A retrospective observational study was conducted at a tertiary care teaching hospital in New Delhi, India. A total of 24 pregnant women microbiologically positive for H1N1 were included. Maternal characteristics and outcome were recorded. Perinatal outcome which was defined as presence of any of the indicators such as abortion, preterm delivery, intrauterine death and neo natal death was noted. Results: The mean age of the study group was 25.2 ± 3 yr with a mean gestational age of 34.9 ± 4.6 wk. Six patients (25%) had associated co-morbidities. Nine patients (37.5%) presented within 48 h of onset of symptoms and 15 (62.5%) reported after 48 h. In 17 (70.83%) patients treatment was delayed by >48 h. ICU admission was needed in 20.8 per cent patients and mortality rates was 8.3 per cent. There were seven cases of adverse perinatal outcome. Interpretation & conclusions: The presenting symptoms of pregnant women with H1N1 were similar to that of general population. Acquiring infection in late trimester, late initiation of antiviral treatment and presence of co-morbid illness were high risk factors for developing critical illness. Pregnant women with suspected H1N1 influenza should be started on antiviral therapy at the earliest. This is likely to help reduce the ICU admission rates and mortalities in this group of women. PMID:24820841

Singhal, Seema; Sarda, Nivedita; Arora, Renu; Punia, Nikky; Jain, Anil

2014-01-01

226

An etiological reappraisal of pancytopenia - largest series reported to date from a single tertiary care teaching hospital  

PubMed Central

Background Peripheral pancytopenia is not a disease by itself; rather it describes simultaneous presence of anemia, leucopenia and thrombocytopenia resulting from a number of disease processes. Only a few systematic studies have been published on the topic of pancytopenia, although extensive studies have been done for its different etiological factors like aplastic anemia, megaloblastic anemia, leukemia, etc. Thus, this study was carried out to investigate for and to identify the causes of pancytopenia, to find out the frequency of different causes, to determine the incidence of pancytopenia in relation to sex and age and to compare our findings with those of other similar studies from this part of the world. Methods This was a prospective study conducted in the Department of Pathology of a teaching institute and a tertiary care hospital in southern Maharashtra, India, over a period of two years. All the patients referred to the central clinical laboratory for routine complete blood count (CBC) and peripheral smear (PS) examination, from both - the outpatient and the inpatient departments, were screened for pancytopenia. Of these, a total number of 250 cases that fulfilled the diagnostic criteria were selected. Detailed hematological investigations followed by bone marrow aspiration wherever indicated and possible were performed according to standard methods to ascertain the causes of pancytopenia. Results A definite male preponderance was observed, the male to female ratio being 2.6 : 1. The majority of cases were encountered in 3rd and 4th decades. Hypersplenism (29.2%), Infections (25.6%), Myelosuppressants (16.8%) and Megaloblastosis (13.2%) were the four most common causes in this large series on pancytopenia from a single centre in India. Conclusion Detailed clinical history and meticulous physical examination along with baseline hematological investigations, provides invaluable information in the complete workup of pancytopenic patients, helping in systematic planning of further investigations to diagnose and ascertain the cause, avoiding a battery of unnecessary tests. PMID:24238033

2013-01-01

227

High prevalence of metallo-?-lactamase among carbapenem-resistant Klebsiella pneumoniae in a teaching hospital in China.  

PubMed

The aim of this study was to characterize the carbapenemases in carbapenem-resistant Klebsiella pneumoniae (CR-KP) from a Chinese teaching hospital. A total of 40 CR-KPs were screened for the presence of carbapenemases. Minimum inhibitory concentrations were determined by agar dilution. The modified Hodge test was used for the detection of carbapenemase production. Carbapenemase, extended-spectrum ?-lactamase, and AmpC genes were detected using polymerase chain reaction (PCR) and sequencing. A conjugation test was performed using a broth culture mating method, transferred plasmids were typed by PCR-based replicon typing, and clonal relatedness was investigated by enterobacterial repetitive intergenic consensus sequences PCR (ERIC-PCR) and multilocus sequence typing (MLST). The results revealed that modified Hodge test was positive for 28 CR-KPs, and CR-KPs exhibited high resistance rates against various antibiotics, except colistin (5.0%) and tigecycline (22.5%). ERIC and MLST profiles showed no clonal outbreak. PCR demonstrated a high prevalence rate (55.0%, 22/40) of metallo-?-lactamases (MBLs) in CR-KPs. IMP-4, IMP-8, NDM-1, and KPC-2 were identified in 14 (35.0%), 7 (17.5%), 2 (5.0%), and 7 (17.5%) isolates, respectively. Notably, 2 CR-KPs coproduced 2 carbapenemases simultaneously (IMP-8/NDM-1 and IMP-4/KPC-2). In vitro transfer of carbapenem resistance was successful for 11 MBL-producing CR-KPs. The extended spectrum ?-lactamase genes were detected in 30 (75.0%) of these CR-KPs. To the best of our knowledge, this is the first report focusing on carbapenem resistance in K. pneumoniae due to metalloenzymes in China. Screening and surveillance of MBLs in Enterobacteriaceae is urgently needed in this region to control and prevent the spread of these resistance determinants. PMID:25285938

Li, Bin; Xu, Xiao-Hong; Zhao, Zhi-Chang; Wang, Mei-Hua; Cao, Ying-Ping

2014-10-01

228

Drug utilization evaluation of meropenem and correlation of side effects with renal status of patients in a teaching based hospital.  

PubMed

Meropenem is a restricted, broad spectrum and expensive antibiotic. The major consequences of irrational use of restricted antibiotics are increase drug resistance and drug expenditure. The use of antibiotics, specifically restricted antibiotics, must be monitored continuously to increase its adherence to the standard guidelines to avoid such problems. The objective of this study was to evaluate the appropriateness of meropenem use with respect to renal status of patients in a teaching based hospital. A retrospective study was carried out from 1st January 2013 to 30th June 2013 to determine the evaluation of meropenem use in accordance to the criteria developed through national (Infectious disease society of Pakistan) and international guidelines (Health care infection control practices advisory committee). The data was recorded on data collection form by thorough reviewing of patients' medical records. Main outcomes measured were indication, dose, interval, duration, creatinine clearance, complete blood count and culture sensitivity test. Correlation of different variable (side effects and generalized health) was also observed with reference to renal status of patients. Statistical analyses were performed using descriptive statistics. A total of 201 cases of meropenem prescription were identified during the study period. The variable, which was most consistent with the criteria was 'indication', in which 97.52% of meropenem prescription was indicated in diseases encouraged by guidelines. However, the use of meropenem as an empirical therapy was the major problem reported in this study as it adhered to in only 43% of the cases. It was also noted that prevalence of side effects increased when meropenem was prescribed in renal compromised patients, and also observed that generalized health of patients decreased with meronem use in renal unstable patients. Thrombocytopenia was the major problem associated with the meropenem use (37.81%). The study detected various areas where use of meropenem was not according to the standards. Strict policies and procedures need to be implemented to use meropenem in line with the standard guidelines. PMID:25176244

Khan, Muhammad Umair; Yousuf, Rabia Ismail; Shoaib, Muhammad Harris

2014-09-01

229

Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria  

PubMed Central

Introduction Cancer care is devastating to families. This research studied the informal caregivers’ perceptions of burden of caregiving to cancer patients attending University of Calabar Teaching Hospital, Calabar. Methods The research adopted a cross-sectioned descriptive design and 210 caregivers providing care to advanced cancer patients were purposively selected. Data were collected using a researcher developed questionnaire and standardized Zarit Burden Interview scale (ZBIS). Data collected were analysed using descriptive and chi-square statistics with the help of SPSS 18.0 and PAS 19.0 softwares. Results The results indicated that the caregivers were in their youthful and active economic age, dominated by females, Christians, spouses, partners and parents. The burden levels experienced by the caregivers were as follows: severe (46.2%), moderate (36.2%) and trivial of no burden (17.6%). The forms of burden experienced were physical (43.4%), psychological (43.3%), financial (41.1%) and social (46.7%), quite frequently and nearly always. Psychological and social forms of burden had the highest weighted score of 228 in terms of magnitude of burden. The result further showed that there was a significant (P = 0.001) and inverse association between caregivers’ burden and the care receivers’ functional ability. The level of burden also increased significantly (P = 0.000) with the duration of care, while there was also a significant (P = 0.01) relationship between caregivers’ experience of burden and their desire to continue caregiving. Conclusion Caregiving role can be enhanced by provision of interventions such as formal education programme on cancer caregiving, oncology, home services along side with transmural care. PMID:25419297

Akpan-Idiok, Paulina Ackley; Anarado, Agnes Nonye

2014-01-01

230

Mental illness stigma among nurses in psychiatric wards of teaching hospitals in the north-west of Iran  

PubMed Central

Background: Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran. Materials and Methods: This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics. Results: Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views. Conclusions: The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested. PMID:23922602

Ebrahimi, Hossein; Namdar, Hossein; Vahidi, Maryam

2012-01-01

231

Prevalence of antimicrobial residues in raw table eggs from farms and retail outlets in Enugu State, Nigeria.  

PubMed

The use of antimicrobial agents in poultry production results in their accumulation in the body tissues and products such as milk and egg. The subsequent accumulation of these drugs and their metabolites in body cells is known as drug residue. This study was designed to determine the prevalence of antimicrobial residues in eggs from poultry farms and retail outlets in Enugu State, Nigeria. Eggs from 25 selected commercial farms and ten retail outlets were screened for the prevalence of antimicrobial residue. Also, structured questionnaires were administered to 25 commercial farms in the state to determine the management practices and the most widely used antimicrobial drugs in farms and possible association between the management practices and the occurrence of antimicrobial residues in eggs from these farms. All the 25 farms surveyed use oxytetracycline. Eggs from nine of the surveyed farms tested positive for antimicrobial residue and three of the ten surveyed farms also tested positive for antimicrobial residue. No association was observed (p?0.05; Fisher's exact test) between the occurrence of antibiotic residues in eggs and farm size, feed source and housing systems. This study was able to demonstrate the presence of antimicrobial residues in eggs destined for human consumption. Drugs like nitrofurans which has been banned for use in food animals are still very much in use in Enugu State, Nigeria. Antibiotics given as feed additives may give rise to drug residues in food animals. PMID:21104128

Ezenduka, Ekene V; Oboegbulem, Steve I; Nwanta, John A; Onunkwo, Joseph I

2011-03-01

232

Knowledge, attitude and practice of private medical practitioners towards abortion and post abortion care in Enugu, South-eastern Nigeria.  

PubMed

The objective of this study was to determine the knowledge, attitude and practice of private medical practitioners in Enugu, South-eastern Nigeria, on abortion and post-abortion care. It was a cross-sectional study of private medical practitioners in the study area using self-administered structured questionnaires. The results showed that 32.3% of the doctors terminate unwanted pregnancies when requested to do so. The majority of them (51.6%) use D&C in combination with manual vacuum aspiration for the termination of pregnancies in the first trimester. A total of 61 (63.5%) respondents offered various types of post-abortal care (PAC) services, while 42 (43.8%) of them screened women with abortion complications for sexually transmitted infections. For the doctors who do not terminate unwanted pregnancies, their main reasons were religious and moral considerations rather than obedience to the Nigerian abortion laws. We conclude that the majority of private medical practitioners in Enugu, South-eastern Nigeria, do not terminate unwanted pregnancies because of their religious beliefs. PMID:19603321

Onah, H E; Ogbuokiri, C M; Obi, S N; Oguanuo, T C

2009-07-01

233

Optimal allocation of public water supply to the urban sectors of Enugu, Nigeria: a linear programming approach  

NASA Astrophysics Data System (ADS)

Recent studies in water supply in Enugu urban area have observed that there is a persistent water supply shortage relative to demand. One of the strategies for achieving a good water supply under the circumstance is through efficient water allocation to consumers. The existing allocation system by the Enugu State Water Corporation is not achieving the desired goal, because it is not based on any scientific criteria. In this study, we have employed the linear programming modelling technique to optimise the allocation of 35,000,000 L of water produced daily by the State Water Corporation and supplied to the four sectors of the town. The result shows that the model allocated 27,470,000 L to the residential sector, 3,360,000 L to commercial, 3,120,000 L to industrial and 882,000 L to public institutions sectors leaving a balance of 168,000 L to be utilised in emergency situations. This allocation pattern departs sharply from the present management technique adopted by the corporation. It is then suggested that for urban water supply to be sustainable in the town, the corporation should rely on this technique for water supply.

Ezenwaji, Emma E.; Anyadike, Raymond N. C.; Igu, Nnaemeka I.

2014-03-01

234

Evaluation of a primary-care setting at a veterinary teaching hospital by a student business group: implementing business training within the curriculum.  

PubMed

This article provides an introduction to the use of students' business skills in optimizing teaching opportunities, student learning, and client satisfaction in a primary health care setting at a veterinary teaching hospital. Seven veterinary-student members of the local chapter of the Veterinary Business Management Association (VBMA) evaluated the primary-care service at the University of Georgia (UGA) veterinary teaching hospital and assessed six areas of focus: (1) branding and marketing, (2) client experience, (3) staff and staffing, (4) student experience, (5) time management, and (6) standard operating procedures and protocols. For each area of focus, strengths, weaknesses, opportunities, and threats were identified. Of the six areas, two were identified as areas in need of immediate improvement, the first being the updating of standard operating protocols and the second being time management and the flow of appointments. Recommendations made for these two areas were implemented. Overall, the staff and students provided positive feedback on the recommended changes. Through such a student-centered approach to improving the quality of their education, students are empowered and are held accountable for their learning environment. The fact that the VBMA functions without a parent organization and that the primary-care service at UGA functions primarily as a separate entity from the specialty services at the College of Veterinary Medicine allowed students to have a direct impact on their learning environment. We hope that this model for advancing business education will be studied and promoted to benefit both veterinary education and business practice within academia. PMID:24531532

Louisa Poon, W Y; Covington, Jennifer P; Dempsey, Lauren S; Goetgeluck, Scott L; Marscher, William F; Morelli, Sierra C; Powell, Jana E; Rivers, Elizabeth M; Roth, Ira G

2014-01-01

235

Organizational and human behavioral factors on performance of a hospital information system : a case study from a large teaching hospital in the Boston area  

E-print Network

Improvement in efficiency of healthcare in the United States is an urgent issue. Information technology is seen as one of key solutions to improve efficiency. As such, hospitals in the United States are rapidly adopting ...

Hozumi, Dairiku

2007-01-01

236

Pattern of paediatric corneal laceration injuries in the University of port Harcourt teaching hospital, Rivers state, Nigeria  

PubMed Central

Background Corneal lacerations mostly affect younger children, commonly males, who will constitute the majority of the workforce. Clinical outcomes are reviewed and compared so that measures to reduce their occurrence and improve outcome can be proffered. Methods Records of all children between the ages of 1-18?yrs, who presented with penetrating eye injuries at the eye clinic of the University of Port Harcourt teaching Hospital, Rivers state, Nigeria between January 2002 and December 2009 were included. Information retrieved -patient’s Bio data, presenting symptoms, presenting visual acuity (VA), source of injury, surgical intervention and outcome using VA. All data analysed with EPI Info version 6 with the aid of a statistician. Results Folders of thirty-six children (36 eyes) between the ages of 0–18?years diagnosed with corneal laceration over a period of 8?years out of 65 cases managed within that period available. Other folders reported as missing. Male female ratio 3:1, the mean age is 8.7?years (SD?±?3.67). Only one presented within 24?hours. Objects causing injury mainly missiles with stones/catapult injuries (n?=?8, 22.2%). Presenting VAs in those that could be measured, ranged from 6/24 to 6/60 (n?=?4, 11%) to no light perception (NLP) (n?=?5, 13.9%). Associated injuries include lid laceration, cataract, vitreous haemorrhage and retinal detachment. Twenty one patients had primary corneal repair (58.3%) carried out within 7?days of presentation. Four had endophthalmitis. After 3?months follow up, VA of 6/60 and better was achieved in 11 of 18 eyes left in follow up (6/60-6/24 in 8 eyes (22.2%), 6/18 and better in 3 eyes (8.3%). Conclusion Most eye injuries in children are preventable. In this study, the prognosis was better in those whose injuries were confined to a peripheral part of the cornea, with no other associated injury, who presented within 5?days and who did not have any intraocular infection at the time of presentation. The importance of health education, adult supervision of play and application of appropriate measures that is necessary for reducing the incidence and severity of trauma is emphasized. PMID:23234255

2012-01-01

237

Mammotome® biopsy system for the resection of breast lesions: Clinical experience in two high-volume teaching hospitals  

PubMed Central

Ultrasound-guided vacuum-assisted breast biopsy (VABB) is regarded as a feasible, effective, minimally invasive and safe method for the removal of benign breast lesions, without the occurrence of serious complications. The aim of this study was to evaluate the feasibility, efficacy and safety of ultrasound-guided VABB using the Mammotome® biopsy system in the treatment of breast lesions. The clinical outcomes of 3,681 patients with breast lesions were evaluated following excisions by ultrasound-guided VABB in two high-volume teaching hospitals. From January 2008 to December 2012, a total of 4,867 ultrasound-guided VABB procedures were performed in the 3,681 patients, who had a mean age of 37.8 years (range, 16–73 years). The parameters examined in this analysis included lesion size, lesion location in the inner breast, Breast Imaging Reporting and Data System (BI-RADS) ultrasound category and histopathological diagnosis. Ultrasonography follow-up was performed at 3–6 month intervals in order to assess recurrence. The size of the investigated lesions ranged between 6 and 62 mm and a histopathological diagnosis was made in 100% of cases. The results indicated that the majority of specimens (98.89%) were benign. On average, the ultrasound-guided VABB was performed in 10.3 min (range, 7.5–43 min) and the mean number of cores removed in the procedure was 8.1 (range, 3–32). A complete excision was achieved in the majority of cases (99.7%). The presence of a hematoma was the most common complication following the biopsy, and was observed in 27.5% of patients. The mean follow-up period was 25.5 months (range, 1–60 months), during which the rate of recurrence was 4.4%. The results indicated that ultrasound-guided VABB using the Mammotome biopsy system is an effective and safe procedure that is able to rapidly remove the majority of benign breast lesions using a small incision and without the occurrence of scarring or complications. PMID:24137261

JIANG, YANGPING; LAN, HUANRONG; YE, QIAN; JIN, KETAO; ZHU, MIN; HU, XIAOYAN; TENG, LISONG; CAO, FEILIN; LIN, XIANFANG

2013-01-01

238

Anti-hypertensive medicines prescribing for medical outpatients in a premier teaching hospital in Nigeria: a probable shift of paradigm  

PubMed Central

Background Previous studies of anti-hypertensive medicines utilization pattern in Nigeria showed that Angiotensin converting enzyme inhibitors (ACEIs) were often the least prescribed. However, the appropriate use of ACEIs in the black population achieves good blood pressure control and provides additional long term cardio- and renovascular protection benefits. Objective To assess the current utilization pattern of antihypertensive medicines with specific emphasis on identifying possible shift in the frequency of use of ACEIs. Methods A prospective cross-sectional assessment of the current utilization pattern of anti-hypertensive medicines was conducted among 300 randomly selected cohort at a 900-bed premier Teaching Hospital located in Ibadan, Southwestern Nigeria. The current utilization pattern was compared with the results of a study conducted at the same site and published 10 years ago. Results Of the 300 random cohorts, a majority (79%) were females (237) with mean age 58.7 years (SD=2.81 years. Stage 2 hypertension was the most frequent diagnosis (54.3%). The utilization of ACEIs and long acting CCB (amlodipine) significantly increased from 8.6% and 21% (Ten years ago) to 29.93% and 36.68% respectively (p < 0.0001). The use of thiazide diuretic and methyldopa declined significantly from 39.4% and 23.3% (Ten years ago) to 16.12% and 9.7% respectively (p < 0.0001). Adverse drug reactions due to ACEIs were documented in 1.5% (3), while laboratory monitoring of serum potassium, urea and creatinine was conducted in only 37% (111) of cohort. Potentially harmful drug-drug interactions were identified in 25% (75) of cohorts, and the most frequent were ACEIs + NSAIDs (53.3%), ACEIs + amiloride / hydrochlorothiazide (22.6%). Conclusions Anti-hypertensive medicines utilization has significantly shifted towards the increased use of ACEIs and long acting dihydropyridine CCBs. The use of thiazides and methyldopa has declined significantly. Physicians appeared more cognizant of the long term cardio- and renovascular benefits inherent in using ACEIs in a high cardiovascular risk group such as black hypertensive. PMID:25035720

Eshiet, Unyime I.; Yusuff, Kazeem B.

2014-01-01

239

Experiences of leaders in the implementation of Lean in a teaching hospital--barriers and facilitators in clinical practices: a qualitative study  

PubMed Central

Objectives To date, experiences of leaders in the implementation of Lean after a Lean Training Programme have not been systematically investigated within teaching hospitals. Existing studies have identified barriers and facilitators only from an improvement programme perspective and have not considered the experiences of leaders themselves. This study aims to bridge this gap. Design Semistructured, indepth interviews. Setting One of largest teaching hospitals in the Netherlands. Participants 31 medical, surgical and nursing professionals with an average of 19.2?years of supervisory experience. All professionals were appointed to a Lean Training Programme and were directly involved in the implementation of Lean. Results The evidence obtained in this study shows that, from the perspectives of participants, leadership management support, a continuous learning environment and cross-departmental cooperation play a significant role in successful Lean implementation. The results suggest that a Lean Training Programme contributed to positive outcomes in personal and professional skills that were evident during the first 4?months after programme completion. Conclusions Implementing Lean in a teaching hospital setting is a challenge because of the ambiguous and complex environment of a highly professionalised organisation. The study found that leadership management support and a continuous learning environment are important facilitators of Lean implementation. To increase the successful outcomes of leadership actions, training should be supplemented with actions to remove perceived barriers. This requires the involvement of all professionals, the crossing of departmental boundaries and a focus on meaning-making processes rather than simply ‘implementing’ facts. Therefore, this research suggests that programme participants, such as staff members and leaders, can mutually explore the meanings of Lean thinking and working for their own contexts. By entering this shared learning process (eg, learning on the job) the ownership of Lean implementation could also increase. PMID:24171938

Aij, Kjeld Harald; Simons, Frederique Elisabeth; Widdershoven, Guy A M; Visse, Merel

2013-01-01

240

Prospects of using community directed intervention strategy in delivering health services among Fulani Nomads in Enugu State, Nigeria  

PubMed Central

Background The Community Directed Interventions (CDI) strategy has proven effective in increasing access to health services in sedentary populations. It remains to be seen if CDI strategy is feasible among nomads given the dearth of demographic and medical data on the nomads. This study thus characterized the nomadic populations in Enugu State, Nigeria and outlined the potentials of implementing CDI among nomads. Study design and methods This exploratory study adopted qualitative methods. Forty focus group discussions (FGD) were held with members of 10 nomadic camps in 2 LGAs in Enugu State, as well as their host communities. Thirty in-depth interviews (IDIs) were held with leaders of nomadic camps and sedentary populations. Ten IDIs with traditional healers in the nomadic camps and 14 key informant interviews with health workers and programme officers were also conducted. Documents and maps were reviewed to ascertain the grazing routes of the nomads as well as existing health interventions in the area. Results Like sedentary populations, nomads have definable community structures with leaders and followers, which is amenable to implementation of CDI. Nomads move their cattle, in a definite pattern, in search of grass and water. In this movement, the old and vulnerable are left in the camps. The nomads suffer from immunization preventable health problems as their host communities. The priority health problems in relation to CDI include malaria, measles, anemia, and other vaccine preventable infections. However, unlike the sedentary populations, the nomads lack access to health interventions, due to the mutual avoidance between the nomads and the sedentary populations in terms of health services. The later consider the services as mainly theirs. The nomads, however, are desirous of the modern health services and often task themselves to access these modern health services in private for profit health facilities when the need arises. Conclusion Given the definable organizational structure of the nomads in Enugu State and their desire for modern health intervention, it is feasible to test the CDI strategy for equitable healthcare delivery among nomads. They are willing and capable to participate actively in their own health programmes with minimal support from professional health workers. PMID:23566078

2013-01-01

241

Evaluation of the process of introducing a quality development program in a nursing department at a teaching hospital: the role of a change agent.  

PubMed

The CIPP model of evaluation was used through its Context, Input, Process and Product elements, to evaluate the process of introducing a quality development program established in a nursing department within a teaching referral hospital in Amman, Jordan. The evaluation was intended to test whether the development program had achieved its overall goals: Management within a static state of nursing manpower; improvement in the general patterns of communication; management of some operational and organizational level problems and enhancement of measures to facilitate staff development. Several sets of action were suggested and implemented within the period of the quality development program. The results indicated partial achievement of the overall goals with certain difficulties remaining. The hospital's overall strict budget remained the major operational problem to be resolved. Other research was recommended to be carried out to specifically test the effectiveness of each set of actions (measures) included in the study. PMID:8970858

Petro-Nustas, W

1996-12-01

242

Strategic planning and designing of a hospital disaster manual in a tertiary care, teaching, research and referral institute in India  

PubMed Central

BACKGROUND: As per the “Disaster Management Act, 2005” of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders. METHODS: A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual. RESULTS: The prepared departmental standard operating procedures involved 116 people (doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual. CONCLUSIONS: The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills.

Talati, Shweta; Bhatia, Prateek; Kumar, Ashok; Gupta, A. K.; Ojha, Col. D

2014-01-01

243

Individual Potentials Related to Evidence-Based Nursing among Nurses in Teaching Hospitals Affiliated to Tabriz University of Medical Sciences, Tabriz, Iran  

PubMed Central

Introduction: Knowledge, attitude, and skills of nurses regarding evidence-based medicine are some of the important individual potentials in the implementation of these cares. There is no evidence indicating Iranian nurses to have these individual potentials. Therefore, the aim of this study was to determination the perceptions of nurses about individual potentials in evidence-based nursing and its related factors. Methods: In this descriptive correlational study, all nurses (n = 600) working in teaching hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran were included. Valid and reliable translated questionnaires were used to collect data. Descriptive and inferential statistics were employed in SPSS to analyze the data. Results: Based on our findings, moderate levels of knowledge, attitude, and skills were possessed by 274 (45.7%), 394 (65.7%), and 411 (68.5%) nurses, respectively. In addition, male nurses (p = 0.002) and those with a master's degree (p = 0.001) were more knowledgeable. Likewise, more positive attitudes were demonstrated by females (p = 0.004) and nurses with a master's degree (p = 0.04). A statistically significant difference was found between skills and employment status of nurses (p = 0.002). Conclusion: The moderate level of attitude among nurses can provide a good potential in promoting evidence-based nursing in teaching hospitals affiliated to Tabriz University of Medical Sciences. Therefore, more attention should be paid to enhance the awareness and skills of nurses toward evidence-based care.

Seyyedrasooli, Alehe; Zamanzadeh, Vahid; Valizadeh, Leila; Tadaion, Farideh

2012-01-01

244

Epidemiology of Multi-Drug Resistant Organisms in a Teaching Hospital in Oman: A One-Year Hospital-Based Study  

PubMed Central

Background. Antimicrobial resistance is increasingly recognized as a global challenge. A few studies have emerged on epidemiology of multidrug resistant organisms in tertiary care settings in the Arabian Gulf. Aim. To describe the epidemiology of multi-drug resistant organisms (MDRO) at Sultan Qaboos University Hospital, a tertiary hospital in Oman. Methods. A retrospective review of MDRO records has been conducted throughout the period from January 2012 till December 2012. Organisms were identified and tested by an automated identification and susceptibility system, and the antibiotic susceptibility testing was confirmed by the disk diffusion method. Results. Out of the total of 29,245 admissions, there have been 315 patients registered as MDRO patients giving an overall prevalence rate of 10.8 (95% CI 9.3, 12.4) MDRO cases per 1000 admissions. In addition, the prevalence rate of MDRO isolates was 11.2 (95% CI 9.7, 12.9) per 1000 admissions. Overall, increasing trends in prevalence rates of MDRO patients and MDRO isolates were observed throughout the study period. Conclusion. Antimicrobial resistance is an emerging challenge in Oman. Continuous monitoring of antimicrobial susceptibility and strict adherence to infection prevention guidelines are essential to prevent proliferation of MDRO. Along such quest, stringent antibiotic prescription guidelines are needed in the country. PMID:24526881

Balkhair, Abdullah; Al-Farsi, Yahya M.; Al-Muharrmi, Zakariya; Al-Rashdi, Raiya; Al-Jabri, Mansoor; Neilson, Fatma; Al-Adawi, Sara S.; El-Beeli, Marah

2014-01-01

245

Patient safety culture in a large teaching hospital in Riyadh: baseline assessment, comparative analysis and opportunities for improvement  

PubMed Central

Background In light of the immense attention given to patient safety, this paper details the findings of a baseline assessment of the patient safety culture in a large hospital in Riyadh and compares results with regional and international studies that utilized the Hospital Survey on Patient Safety Culture. This study also aims to explore the association between patient safety culture predictors and outcomes, considering respondent characteristics and facility size. Methods This cross sectional study adopted a customized version of the HSOPSC and targeted hospital staff fitting sampling criteria (physicians, nurses, clinical and non-clinical staff, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers). Results 3000 questionnaires were sent and 2572 were returned (response rate of 85.7%). Areas of strength were Organizational Learning and Continuous Improvement and Teamwork within units whereas areas requiring improvement were hospital non-punitive response to error, staffing, and Communication Openness. The comparative analysis noted several areas requiring improvement when results on survey composites were compared with results from Lebanon, and the United States. Regression analysis showed associations between higher patient safety aggregate score and greater age (46 years and above), longer work experience, having a Baccalaureate degree, and being a physician or other health professional. Conclusions Patient safety practices are crucial toward improving overall performance and quality of services in healthcare organizations. Much can be done in the sampled organizations and in the context of KSA in general to improve areas of weakness and further enhance areas of strength. PMID:24621339

2014-01-01

246

Rising cesarean deliveries among apparently low-risk mothers at university teaching hospitals in Jordan: analysis of population survey data, 2002-2012  

PubMed Central

Background: Cesarean delivery conducted without medical indication places mothers and infants at risk for adverse outcomes. This study assessed changes in trends of, and factors associated with, cesarean deliveries in Jordan, from 2002 to 2012. Methods: Data for ever-married women ages 15–49 years from the 2002, 2007, and 2012 Jordan Population and Family Health Surveys were used. Analyses were restricted to mothers who responded to a question regarding the hospital-based mode of delivery for their last birth occurring within the 5 years preceding each survey (2002, N?=?3,450; 2007, N?=?6,307; 2012, N?=?6,365). Normal birth weight infants and singleton births were used as markers for births that were potentially low risk for cesarean delivery, because low/high birth weight and multiple births are among the main obstetric variables that have been documented to increase risk of cesareans. Weighted descriptive and multivariate analyses were conducted using 4 logistic regression models: (1) among all mothers; and among mothers stratified (2) by place of delivery; (3) by birth weight of infants; and (4) by singleton vs. multiple births. Results: The cesarean delivery rate increased significantly over time, from 18.2% in 2002, to 20.1% in 2007, to 30.3% in 2012. Place of delivery, birth weight, and birth multiplicity were significantly associated with cesarean delivery after adjusting for confounding factors. Between 2002 and 2012, the rate increased by 99% in public hospitals vs. 70% in private hospitals; by 93% among normal birth weight infants vs. 73% among low/high birth weight infants; and by 92% among singleton births vs. 29% among multiple births. The changes were significant across all categories except among multiple births. Further stratification revealed that the cesarean delivery rate was 2.29 times higher in university teaching hospitals (UTHs) than in private hospitals (P< .001), and 2.31 times higher than in government hospitals (P< .001). Moreover, in UTHs, the rate was higher among normal birth weight infants (adjusted OR?=?2.15) and singleton births (adjusted OR?=?2.39). Conclusion: The rising cesarean delivery rate among births that may have been at low risk for cesarean delivery, particularly in UTHs, indicates that many cesarean deliveries may increasingly be performed without any medical indication. More vigilant monitoring of data from routine health information systems is needed to reduce unnecessary cesarean deliveries in apparently low-risk groups.

Rifai, Rami Al

2014-01-01

247

Implementing an Online Reporting System in the Anatomical Pathology Department of a Tertiary Care Teaching Hospital in India: A Case Study  

PubMed Central

This article presents a case study in designing, developing, and implementing a web-enabled reporting application for the anatomical pathology (histopathology) department of a tertiary care teaching hospital in India. The article describes workflows, requirements assessment, and implementation methods that the investigators adopted for deploying the solution. The primary focus of the study was to demonstrate the requirements assessment performed, the strategies adopted, and the challenges encountered during the development and implementation. The study demonstrates a successful deployment as well as successful adoption of healthcare information technology by the end users. Factors that played a crucial role in adoption included the combination of people, processes, and technology. The lessons learned from this study would help application developers design efficient systems that suit the requirements of the end users while keeping in mind the ever-changing need for workflows and scalability in a developing country. PMID:23861673

Radhakrishna, Kedar; Correa, Marjorie; Thounaojam, Deepak; Raj, Tony D. S.

2013-01-01

248

A Cost Analysis of an Introduction to Clinical Medicine Course in a Non-University Teaching Hospital.  

ERIC Educational Resources Information Center

Analysis of direct costs to teach a 10-week Introduction to Clinical Medicine course to 26 students in the spring of 1995 found that attending physicians worked a total of 736.5 hours, for a cost of $37,303; residents worked 314 hours, at a cost of $4,396; and miscellaneous costs totaled $2,019. The per-student cost was $1,681. (Author/MSE)

Tai, Lee W.; Tulley, John E.

1997-01-01

249

A Comparative Study of Team and Primary Nursing Care on Two Surgical Inpatient Units of a Teaching Hospital.  

National Technical Information Service (NTIS)

This is a report of the activities, findings, and recommendations of a project aimed at comparing team and primary nursing care on two surgical inpatient units in a short-term, acute-care hospital. Data were obtained in 1976 and 1979 that related to direc...

J. P. Young, P. B. J. Giovannetti, D. Lewison

1980-01-01

250

The Veterinary Teaching Hospital at Colorado State University has an opening for a position as an Equine Field Service Veterinarian. Equine Field Service provides general medical care, preventive health, herd  

E-print Network

as an Equine Field Service Veterinarian. Equine Field Service provides general medical care, preventive health, professional integrity, a solid work ethic and a desire to teach veterinary medical students. #12;Reporting Relationship: The Equine Field Service Veterinarian reports directly to the Hospital Director but is expected

251

Evaluating the Frequency of Errors in Preparation and Administration of Intravenous Medications in Orthopedic, General Surgery and Gastroenterology Wards of a Teaching Hospital in Tehran  

PubMed Central

The aim of this study was to determine the frequency of medication errors happened during the preparation and administration of intravenous (IV) drugs. This study was designed as prospective cross-sectional evaluations by direct unconcealed observation in a setting consisted of orthopedic, general surgery and gastroenterology wards of a teaching hospital. Participants were those patients hospitalized in these wards along with nurses responsible for preparation and administration of IV medications. Medication errors occurred in the process of preparation and administration of IV drugs, were recorded by a pharmacist. The frequency of medication errors with suggesting a solution to overcome was the main outcome of this study. Details of the preparation and administration stages of the observed drugs were compared to an instructed checklist prepared by an expert clinical pharmacist. From a total of 357 preparation and administration episodes, the most common type of error (%20.6) was the injection of bolus doses and infusion faster than the recommended rate. Metronidazole had the highest rate of error (%24.3). IV rounds conducted at 12 p.m. had the most rate of error (%26.3). Errors happened in the administration process were more prevalent than those in the preparation. No significant correlation was found between the frequency of errors and nurses’ demographic data. This study revealed that the errors happened in the preparation and administration of IV drugs is prevalent. Improving the medication safety by the implementation of clinical pharmacists’ prepared protocols at the point of care is an important concern. PMID:24250594

Abbasinazari, Mohammad; Hajhossein Talasaz, Azita; Mousavi, Zahra; Zare-Toranposhti, Samaneh

2013-01-01

252

Left in the dark: Seven years after Katrina, Sandy is teaching hospitals more lessons on how to survive nature's fury.  

PubMed

In the wake of the devastation Sandy wreaked along the Atlantic Coast, some hospitals were forced to close. But others took on new roles, whether as makeshift phone-charging stations or dealing with healthcare needs patients usually turned to outpatient centers for. "The biggest challenge is making up for the other services that are not available in the community," says Steven Littleson, of Jersey Shore University Medical Center. PMID:23198308

Evans, Melanie; Carlson, Joe; Barr, Paul; Kutscher, Beth; Zigmond, Jessica

2012-11-01

253

Knowledge, attitude and practice of family planning amongst women in a high density low income urban of Enugu, Nigeria.  

PubMed

A total of 334 Nigerian, non-pregnant women, living in a high density, low-income urban area of Enugu, Nigeria, were interviewed on knowledge, attitude and practice of family planning. About 97.6% were found literate. Knowledge and approval of family planning was high, 81.7% and 86.2% respectively, but the practice of family planning was low, as only 20% of the women were on a family planning method. The commonest methods for both ever use and current use were safe period/Billings, condom, IUCD and injectables. The commonest source of family planning information was health workers, while the commonest single reason for non-practice of a method was rejection by the husband. It is concluded that despite their high level of education/literacy, with the attendant high knowledge and approval rate of family planning, the socio-cultural influence of men on their wives is a major stumbling block to the use of modern family planning in this part of Nigeria. Policy makers should, therefore, increase male involvement in family planning programs. PMID:12471916

Onwuzurike, B K; Uzochukwu, B S

2001-08-01

254

Patterns of Complementary and Alternative Medicine Use, Perceived Benefits, and Adverse Effects among Adult Users in Enugu Urban, Southeast Nigeria  

PubMed Central

The use of complementary and alternative medicine (CAM) is now on the increase. Evidence from studies carried out globally has established that CAM use is very common and varies among populations. This study investigated patterns of CAM use, perceived benefits, and associated harm with CAM use among adults. A cross-sectional study was conducted in three local government areas of Enugu urban, Southeast Nigeria. An interviewer-administered questionnaire was used to collect data from all consenting adult participants aged between 18 and 65 years. Of the 732 participants interviewed, 62.8% were females while 37.2% were males. Majority (84.7%) of the participants had used CAM at one time or another. The most commonly used CAM product was the biological products, followed by spiritual therapy. The major route of administration for CAM products was oral and about 40% of the participants combined CAM with conventional medicine. Majority (78.6%) of CAM users benefited from CAM products after using them while a few complained of adverse reactions. As CAM is gaining widespread acceptance and use, there is need for clinical trial on the benefits and adverse effects associated with the use of CAM to facilitate proof of efficacy and safety of the products. PMID:24803945

Okoronkwo, Ijeoma; Onyia-pat, Jane-lovena; Okpala, Pat; Agbo, Mary-Ann; Ndu, Afam

2014-01-01

255

Beyond management by objectives: the implementation of a goal-directed performance management system in an Australian teaching hospital.  

PubMed

This paper describes management by objectives (MBO) as an approach by which organisations can be managed, with particular reference to health care institutions. An evaluation of MBO is presented and the disadvantages of MBO are discussed. A more comprehensive performance management system than MBO is advocated. The experience of St Vincent's Hospital, Sydney, in designing and implementing a goal-directed performance management program which builds on MBO methodology, is described. This experience provides guidelines by which senior managers may successfully implement goal-directed performance management programs in health care institutions in order to enhance organisational effectiveness and the goal-oriented behaviour of managers. PMID:10116921

Braithwaite, J; Westbrook, J I; Lansbury, R D

1991-01-01

256

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India  

PubMed Central

Objective To investigate the infection of hospital- and community-acquired “erythromycin-induced clindamycin resistant” strains or D-test positives of clinical isolates of Staphylococcus aureus (S. aureus) (with and without methicillin resistance) in a hospital. Methods Strains of S. aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling. Results Of the total 278 isolates, 140 (50.35%) were D-test positives and the rest were D-test negatives. Further, of 140 (100%) positives, 87 (62.14%) and 53 (37.85%) strains were from males and females, respectively. Of 140 (100%) positives, 117 (83.57%) were methicillin resistant S. aureus and 23 (16.42%) were methicillin sensitive S. aureus; of 140 strains, 103 (73.57%) strains from persons with and 37 (26.42%) were without related infections; of 140 strains, 91 (65%) and 49 (35%) were from hospital- and community-acquired samples, respectively. In 140 strains, 118 (84.28%) with comorbidities and 22 (15.71%) without comorbidities cases were recorded; similarly, persons with prior antibiotic uses contributed 108 (77.14%) and without 32 (22.85%) positive strains. These binary data of surveillance were analyzed by a univariate analysis. It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity, corroborated by low P values, P=0.001?1 and 0.002?4, respectively. All isolates (278) were resistant to 17 antibiotics of nine groups, in varying degrees; the minimum of 28% resistance for vancomycin and the maximum of 97% resistance for gentamicin were recorded. Further, of 278 strains, only 42 (15.1%) strains were resistant constitutively to both antibiotics, erythromycin resistant and clindamycin resistant, while 45 (16.2%) strains were constitutively sensitive to both antibiotics (erythromycin sensitive and clindamycin sensitive). Further, of the rest 191 (68.7%) strains were with erythromycin resistant and clindamycin resistant, of which only 140 (50.35%) strains were D-test positives, while the rest 51 (18.34%) strains were D-test negatives. Conclusions In view of high prevalence of D-test positive S. aureus strains, and equally high prevalence of multidrug resistant strains both in community and hospital sectors, undertaking of D-test may be routinely conducted for suppurative infections. PMID:23593595

Dubey, Debasmita; Rath, Shakti; Sahu, Mahesh C.; Rout, Subhrajita; Debata, Nagen K.; Padhy, Rabindra N.

2013-01-01

257

Colorectal cancer in patients seen at the teaching hospitals of Guadeloupe and Martinique: discrepancies, similarities in clinicopathological features, and p53 status  

PubMed Central

Background In Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential public health issue. However, little is known about CRC characteristics and the p53 status in these populations, particularly in Guadeloupe, whereas certification of a cancer registry has been recently validated. Methods This was a descriptive retrospective study of 201 patients who, between 1995 and 2000, underwent surgery for CRC in the Guadeloupe Teaching Hospital (GlpeTH; 83 patients) and in the Martinique Teaching Hospital (MqueTH; 118 patients). The clinicopathological features and the p53 expression, evaluated with immunohistochemistry, were compared at the time of diagnosis. A relationship between these parameters and the p53 expression was also studied. Data were analysed, using the SPSS computer software version 17.0. Results No statistical difference was found between the two groups of patients regarding age (p?=?0.60), percentage of young patients (?50 years; p?=?0.94)), sex (p?=?0.47), histological type (p?=?0.073) and tumour sites (p?=?0.65), although the GlpeTH patients were diagnosed with more distal colon cancers (54.2%) than the Mque TH patients (47.4%). By contrast, a significant difference was found regarding the tumour grade (p?

2014-01-01

258

Birth and emergency planning: a cross sectional survey of postnatal women at Korle Bu Teaching Hospital, Accra, Ghana.  

PubMed

Birth and emergency planning encourages early decision making, helps overcome barriers to skilled maternity care and reduces preventable maternal and newborn deaths. A facility based postnatal survey of 483 childbearing women in Accra, Ghana determined birth and emergency planning steps, awareness of obstetric danger signs, reported maternal and newborn complications and birth outcome based on length of hospital stay. Supervised antenatal care and delivery were nearly universal. Overall, 62% had a birth plan, 74% had adequate knowledge of danger signs, while 64% and 37% reported maternal and newborn complications respectively. Accompaniment by a birth companion and saving money were considered the most useful planning steps. Knowledge of danger signs was associated with birth and emergency planning, and birth and emergency planning was associated with reported birth outcome. Birth and emergency planning as a critical component of antenatal care can influence birth outcomes and should be extended to all pregnant women. PMID:24069732

Udofia, Emilia A; Obed, Samuel A; Calys-Tagoe, Benedict N L; Nimo, Kwasi Poku

2013-03-01

259

Emergence of Pseudomonas aeruginosa with KPC-type carbapenemase in a teaching hospital: an 8-year study.  

PubMed

An outbreak of Klebsiella pneumoniae carbapenamase (KPC)-producing K. pneumoniae occurred at our institution. Multiresistant Pseudomonas aeruginosa could have acquired this transmissible resistance mechanism, going unnoticed because its phenotypic detection in this species is difficult. We compared P. aeruginosa isolates obtained before and after the KPC-producing K. pneumoniae outbreak. No bla(KPC) genes were detected in the isolates obtained before the outbreak, whereas 33/76 (43%) of the isolates obtained after the outbreak harboured the bla(KPC) gene. P. aeruginosa may thus become a reservoir of this transmissible resistance mechanism. It is very important to understand the epidemiology of these multiresistant isolates, in order to achieve early implementation of adequate control measures to contain and reduce their dissemination in the hospital environment. PMID:23831767

García Ramírez, Dolores; Nicola, Federico; Zarate, Soledad; Relloso, Silvia; Smayevsky, Jorgelina; Arduino, Sonia

2013-10-01

260

Assessment of clinico-immunological profile of newly diagnosed HIV patients presenting to a teaching hospital of eastern India  

PubMed Central

Background & objectives: Newly diagnosed HIV patients may be asymptomatic or present with a wide range of symptoms related to opportunistic infections, acute seroconversion illness or other medical illnesses. This study was designed to evaluate the socio-demographic parameters, spectrum of the presenting clinical conditions and concurrent immunological status of newly diagnosed HIV patients and document the WHO clinical stages at the time of HIV diagnosis. Methods: This cross-sectional, observational study was undertaken over a 12 month period at a tertiary referral hospital in eastern India. Three hundred sixty consecutive newly diagnosed HIV patients were selected for the study from the HIV clinic and medicine wards of this hospital. Demographic and clinical data and relevant laboratory investigations of the patients were recorded and analyzed. Results: Mean age of patients was 36.38 ± 10.62 yr, while 63.89 per cent were males. The main mode of transmission of HIV for males and females were unprotected exposure to commercial sex (139, 60.44%) and intercourse with HIV seropositive spouses (89, 68.46%), respectively. Fever (104, 28.89%), weight loss (103, 28.61%) and generalized weakness (80, 22.22%) were the predominant symptoms. Overall mean CD4 count was 176.04 ± 163.49 cells/?l (males 142.19 ± 139.33 cells/?l; females 235.92 ± 185.11 cells/?l). Overall, 224 opportunistic infections were documented in 160 patients, opportunistic diarrhoea (44, 12.22%) and pulmonary tuberculosis (39, 10.83%) being the commonest. There were 83 and 133 patients in WHO clinical stages 3 and 4, respectively; 291 (80.83%) patients were eligible for initiation of first-line antiretrovirals at presentation. Interpretation & conclusions: Advanced immunodeficiency and burden of opportunistic infections characterize newly diagnosed HIV patients in eastern India. The physicians should keep in mind that these patients may have more than one clinical condition at presentation. PMID:25109725

Bishnu, Saptarshi; Bandyopadhyay, Dipanjan; Samui, Samiran; Das, Indrani; Mondal, Pradip; Ghosh, Pramit; Roy, Deeptarka; Manna, Sukanta

2014-01-01

261

Level of awareness of mammography among women attending outpatient clinics in a teaching hospital in Ibadan, South-West Nigeria  

PubMed Central

Background Mammography has been used in developed countries with considerable success but very little is known about this imaging modality in low resource settings. This study examined the level of awareness of mammography and determined factors influencing the level of awareness. Methods We conducted a hospital based cross sectional study to investigate the level of awareness of mammography among 818 randomly selected women attending the General Outpatient clinics (GOP) of the University College Hospital (UCH), Ibadan, Nigeria. Independent predictors of level of awareness of mammography were identified using multiple logistic regression analysis. Results The proportion of women who ever heard of mammography was 5%, and they demonstrated poor knowledge of the procedure. Those with primary or secondary levels of education were about three times less likely to be aware of mammography when compared with those with tertiary level of education (OR?=?0.3, 95% CI, 0.12 – 0.73). Also, participation in community breast cancer prevention activities (OR?=?3.4, 95% CI, 1.39 – 8.36), and previous clinical breast examination (OR?=?2.34, 95% CI, 1.10 – 4.96) independently predicted mammography awareness. Newspapers and magazines appeared to be the most important sources of information about mammography screening. Conclusion The level of awareness of mammography is poor among women attending outpatient clinics in the studied population. Interventions promoting awareness of this screening procedure should give particular attention to the illiterate and older women while clinicians performing breast examinations should utilize the opportunity to inform women about the mammography procedure. Promotion of educational articles on breast cancer and its screening methods via media remains vital for the literate. PMID:23324312

2013-01-01

262

Current status of e-health awareness among healthcare professionals in teaching hospitals of Rawalpindi: a survey.  

PubMed

The purpose of this survey was to determine the number of healthcare professionals with knowledge about e-health and how many people would like to use e-health in their practice. A hospital-based cross-sectional study was conducted from September to November 2007 in Rawalpindi Medical College and allied hospitals. E-health survey questionnaires were designed and distributed among healthcare professionals, and their knowledge and attitudes toward e-health were assessed. Of 186 healthcare professionals, 41.4% were doctors, 31.7% were medical students, and 26.9% were nurses. Of this total, 57% had heard of e-health prior to the survey; 28% were of the opinion that healthcare professionals should hear about e-health in medical college; 50.5% believed that e-health services for developing countries were useful in general. According to 40.3%, more information on successful e-health projects would be necessary to introduce e-health services into medical practice. Self-education, and better diagnosis and treatments were the main motivational factors to use e-health. Of those surveyed, 67.2% had access to Internet but most of them had not used an online database for reaching a diagnosis, preferring other doctors as their main source of expert advice. Recommendation by doctors and respected medical experts was considered most important for buying an e-health service. The present study demonstrates a lack of adequate knowledge about e-health among healthcare specialists. However, a majority believed that e-health has a very important role to play in present and future healthcare. PMID:19441953

Shoaib, Syeda Fizza; Mirza, Shirin; Murad, Faisal; Malik, Asif Zafar

2009-05-01

263

A Six-Year Study of the Clinical Presentation of Cervical Cancer and the Management Challenges Encountered at a State Teaching Hospital in Southeast Nigeria  

PubMed Central

Cervical cancer is still a major contributor to cancer-related mortality amongst women living in poor, rural communities of developing countries. The objective of this study is to establish the clinical presentation of cervical cancer and the management challenges encountered in Abakaliki, southeast Nigeria, with a view to finding intervention strategies. This study is a retrospective descriptive assessment of cases of clinically diagnosed cervical cancer managed at a state teaching hospital over six years. Of 76 cases managed, 61 (80.3%) cases notes were available for study. The mean age and parity of patients were 53.8 years and 6.8 years, respectively. The majority (75.4%) were illiterate. All had been married, but 42.6% were widowed. The main occupations were farming or petty trading. One patient (1.6%) had had a single Pap smear in her life. The major presenting complaints were abnormal vaginal bleeding (86.9%), offensive vaginal discharge (41.0%), and weight loss. Twenty patients (32.8%) were lost to follow-up prior to staging. Of the remaining 41 patients, 16 (39.0%) had stage III disease and 17.1% stage IV. Fifteen patients (24.6%) with late stage disease accepted referral, and were referred for radiotherapy. Those who declined were discharged home on request, though 4 (9.8%) died in the hospital. There was no feedback from referred patients confirming that they went and benefitted from the referral. The presentation followed known trends. Illiteracy, poverty, early marriages, high parity, widowhood, non-use of screening methods, late presentation, non-acceptance of referral, and lack of communication after referral were some of the major challenges encountered. These underscore the needs for health education and awareness creation, women educational and economic empowerment, legislation against early marriages and in protection of widows, and creation of a well-staffed and well-equipped dedicated gynecologic oncology unit to forestall further referral. PMID:23843724

Eze, Justus N.; Emeka-Irem, Esther N.; Edegbe, Felix O.

2013-01-01

264

Prenatal screening for sickle cell anemia: awareness among health professionals and medical students at the Lagos University Teaching Hospital and the concept of prevention by termination.  

PubMed

Nigeria has the highest population of sickle cell anemia (SCA) patients in the whole world. This condition manifests with frequent episodes of aches and pains, recurrent infections, and frequent hospitalization. Prenatal screening is one of the methods of reducing the prevalence of this disease. The study aimed to determine the awareness and acceptability of prenatal screening for SCA among health professionals and students at the Lagos University Teaching Hospital. It was a descriptive and cross-sectional study carried out between August and September 2006, involving 403 health professionals and students using structured questionnaires. The study revealed that 91.3% of the respondents had heard about prenatal screening for SCA, whereas 8.7% of the respondents had not. In addition, the majority of the respondents (75.3%) knew that SCA can be prevented by prenatal screening for SCA, whereas 13.7% and 11.3% were not aware or not sure, respectively. Up to 48.2% of the respondents were not aware that prenatal screening for SCA is available in Nigeria with the nurses being the least aware (?=11.9, P=0.00). 42.1% of the respondents will not allow preventive termination of pregnancy if prenatal screening confirms SCA. For those who will not allow preventive termination, up to 79% of them decided on the basis of their religious beliefs. There is a poor level of awareness of the availability of prenatal screening services in Nigeria among health workers in Lagos, and religion is a major factor militating against its acceptability. PMID:22538322

Adeola Animasahun, Barakat; Nwodo, Urowoli; Njokanma, Olisamedu Fidelis

2012-05-01

265

Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital - From Outbreak Control to Outbreak Prevention  

PubMed Central

Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR?=?6.2; CI95% 2.3–17.0, P?=?0.0003), antimicrobial treatment (OR?=?3.8, CI95% 1.0–13.9, P?=?0.0442), cumulative number of days in the intensive care unit (OR?=?1.3, CI95% 1.1–1.6, P?=?0.0007) or in the surgery ward (OR?=?1.1, CI95% 1.0–1.3, P?=?0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control measures were needed to control the outbreak. We recommend the implementation of a search-and-isolate policy to reduce the burden of MRSP. PMID:25333798

Gronthal, Thomas; Moodley, Arshnee; Nykasenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

2014-01-01

266

An evaluation of prenatal ultrasound screening for CTEV: accuracy data from a single NHS University Teaching Hospital.  

PubMed

Congenital Talipes Equinovarus (CTEV) is one of the most common congenital limb deformities. We reviewed the records of infants who had received treatment for structural CTEV between 1 January 2007 and 30 November 2012. This was cross-referenced with the prenatal scans of mothers over a corresponding period of time. We investigated the sensitivity, specificity, and positive and negative predictive values of the fetal anomaly scan for the detection of CTEV and explored whether the publication of Fetal Anomaly Screening Programme guidelines in 2010 affected the rate of detection. During the study period there were 95 532 prenatal scans and 34 373 live births at our hospital. A total of 37 fetuses with findings suggestive of CTEV were included in the study, of whom 30 were found to have structural CTEV at birth. The sensitivity of screening for CTEV was 71.4% and the positive predictive value was 81.1%. The negative predictive value and specificity were more than 99.5%. There was no significant difference between the rates of detection before and after publication of the guidelines (p = 0.5). We conclude that a prenatal fetal anomaly ultrasound screening diagnosis of CTEV has a good positive predictive value enabling prenatal counselling. The change in screening guidance has not affected the proportion of missed cases. This information will aid counselling parents about the effectiveness and accuracy of prenatal ultrasound in diagnosing CTEV. PMID:24986955

Pullinger, M; Southorn, T; Easton, V; Hutchinson, R; Smith, R P; Sanghrajka, A P

2014-07-01

267

HIV/AIDS Knowledge, Attitude and Risk Perception among Pregnant Women in a Teaching Hospital, Southwestern Nigeria  

PubMed Central

Aim: The rising HIV infection rates among women especially of child bearing age particularly in Sub-Saharan Africa expose children to increased HIV risk even before they are born. Without effective measures or awareness campaigns to deal with mother-to-child transmission, 390 000 out of the global 430 000 children newly infected with HIV during 2008 were from sub-Saharan Africa This study was undertaken to assess HIV/AIDS related knowledge, attitude and risk perception among pregnant women in Tertiary hospital, Southwestern Nigeria Method: The study was carried out using a 43- item self administered questionnaire, pretestd and administered to 403 pregnant women during ante-natal clinic sessions Results: High HIV/AIDS awareness level (97%) was recorded, 77.7% had correct knowledge of the cause of the disease but knowledge on the modes of vertical transmission during pregnancy (57.5%) and prevention during breast-feeding (62.3%) was not encouraging A lot of misconceptions about the cause of the HIV/AIDS, modes of contact, transmission, prevention and anti-retroviral therapy were recorded Conclusion: The survey revealed that a lot needed to be done to improve the knowledge, attitude, perception and behavioral changes among the populace especially in this particular group. This calls for urgent and proper response in order to stem the tide of HIV/AIDS. PMID:24826022

Ojieabu, Winifred Aitalegbe; Femi-Oyewo, M. N.; Eze, Uchenna I.

2011-01-01

268

Criterion-referenced evaluation of day one clinical competencies of veterinary students: VOLES-the VMTH (Veterinary Medicine Teaching Hospital) Online Evaluation System.  

PubMed

This article describes an extensive online criterion-referenced evaluation system for the assessment of veterinary students' achievement during their final year's Doctor of Veterinary Medicine (or equivalent) clinical education. Data are reported for the 2001 to 2009 University of California at Davis veterinary graduates, for a total of more than 1,100 students. These criterion-referenced evaluations extensively document the level of clinical skills attained and demonstrated during the individual clinical rotations that comprise the fourth-year curriculum. On average, in each of the 17,500 clinical rotations undertaken during this time period, student performance was assessed in at least 11 separate areas of skills, knowledge, and professional attributes. This provided more than 200,000 criterion-referenced judgments of the individual clinical attributes of graduates over nine years. The system is based on a previously detailed and validated definition of the skills, knowledge, and professional attributes that students should have demonstrated before graduation. The extensive database that this system has provided has established that this system, termed VOLES (VMTH [Veterinary Medicine Teaching Hospital] On-Line Evaluation System), is an effective tool to assess the clinical capabilities of veterinary students and their achievement of the "Day One" skills required for entering clinical practice. These expected proficiencies are balanced according to the differing expectations that each area of veterinary clinical practice demands. PMID:22430080

Zeck, Steven; Wall, Judy A; Smith, Bradford P; Wilson, W David; Walsh, Donal A

2012-01-01

269

A study on the standard of documentation of lumbar puncture in neurology department of a major Irish Teaching Hospital in Ireland  

PubMed Central

Objective: Poor documentation following lumbar puncture (LP) had always been a matter of concern. This study aimed to investigate the documentation pattern of neurology house officers, registrars (Regs), and specialist Regs following LP in a major teaching hospital. Materials and Methods: Total hundred patient records were examined in the light of a carefully designed proforma containing 15 important indicators of good-quality LP documentation. Result: Mean number of indicators overall documented by doctors was found to be 6.24 ± 3.0037. The mean number of indicators recorded by house officers was 5.11 ± 3.01 and Regs was 7.56 ± 3.28. A total of 33% LPs were performed without a documented consent. Only 36% performers documented the type and size of needle they used during the procedure. Only 46% documents revealed the strength and name of the local anesthetic used. Statistically significant difference between senior house officers and Regs in terms of numbers of indicators documented was noted. Conclusion: The documentation standard among neurology junior doctors remained poor. PMID:24339594

Bhattacharjee, Shakya; Kaur, Gurpreet

2013-01-01

270

Hospital diversification strategy.  

PubMed

To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

Eastaugh, Steven R

2014-01-01

271

In vitro antibacterial activity of doripenem against clinical isolates from French teaching hospitals: proposition of zone diameter breakpoints.  

PubMed

The aims of the study were to determine the in vitro activity of doripenem, a new carbapenem, against a large number of bacterial pathogens and to propose zone diameter breakpoints for clinical categorization in France according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) minimum inhibitory concentration (MIC) breakpoints. The MICs of doripenem were determined by the broth microdilution method against 1,547 clinical isolates from eight French hospitals. The disk diffusion test was performed (10-?g discs) according to the Comité de l'Antibiogramme de la Société Française de Microbiologie (CASFM) method. The MIC(50/90) (mg/L) values were as follows: methicillin-susceptible Staphylococcus aureus (MSSA) (0.03/0.25), methicillin-resistant Staphylococcus aureus (MRSA) (1/2), methicillin-susceptible coagulase-negative staphylococci (MSCoNS) (0.03/0.12), methicillin-resistant coagulase-negative staphylococci (MRCoNS) (2/8), Streptococcus pneumoniae (0.016/0.25), viridans group streptococci (0.016/2), ?-hemolytic streptococci (?0.008/?0.008), Enterococcus faecalis (2/4), Enterococcus faecium (128/>128), Enterobacteriaceae (0.06/0.25), Pseudomonas aeruginosa (0.5/8), Acinetobacter baumannii (0.25/2), Haemophilus influenzae (0.12/0.25), and Moraxella catarrhalis (0.03/0.06). According to the regression curve, the zone diameter breakpoints were 24 and 19 mm for MICs of 1 and 4 mg/L, respectively. This study confirms the potent in vitro activity of doripenem against Pseudomonas aeruginosa, Acinetobacter, Enterobacteriaceae, MSSA, MSCoNS, and respiratory pathogens. According to the EUCAST MIC breakpoints (mg/L) ?1/>4 for Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter, and ?1/>1 for streptococci, pneumococci, and Haemophilus, the zone diameter breakpoints could be (mm) ?24/<19 and ?24/<24, respectively. PMID:21088861

Lascols, C; Legrand, P; Mérens, A; Leclercq, R; Armand-Lefevre, L; Drugeon, H B; Kitzis, M D; Muller-Serieys, C; Reverdy, M E; Roussel-Delvallez, M; Moubareck, C; Lemire, A; Miara, A; Gjoklaj, M; Soussy, C-J

2011-04-01

272

Hospitality Services. Curriculum Guide.  

ERIC Educational Resources Information Center

This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

273

Sister Mary Joseph's nodule at a University teaching hospital in northwestern Tanzania: a retrospective review of 34 cases  

PubMed Central

Background Sister Mary Joseph’s nodule is a metastatic tumor deposit in the umbilicus and often represents advanced intra-abdominal malignancy with dismal prognosis. There is a paucity of published data on this subject in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our environment and highlight challenges associated with the care of these patients, and to proffer solutions for improved outcome. Methods This was a retrospective study of histologically confirmed cases of Sister Mary Joseph’s nodule seen at Bugando Medical Centre between March 2003 and February 2013. Data collected were analyzed using descriptive statistics. Results A total of 34 patients were enrolled in the study. Males outnumbered females by a ratio of 1.4:1. The vast majority of patients (70.6%) presented with large umbilical nodule > 2 cm in size. The stomach (41.1%) was the most common location of the primary tumor. Adenocarcinoma (88.2%) was the most frequent histopathological type. Most of the primary tumors (52.9%) were poorly differentiated. As the disease was advanced and metastatic in all patients, only palliative therapy was offered. Out of 34 patients, 11 patients died in the hospital giving a mortality rate of 32.4%. Patients were followed up for 24 months. At the end of the follow-up period, 14(60.9%) patients were lost to follow-up and the remaining 9 (39.1%) patients died. Patients survived for a median period of 28 weeks (range, 2 to 64 weeks). The nodule recurred in 6 (26.1%) patients after complete excision. Conclusion Sister Mary Joseph’s nodule of the umbilicus is not rare in our environment and often represents manifestation of a variety of advanced intra-abdominal malignancies. The majority of the patients present at a late stage and many with distant metastases. The patient's survival is very short leading to a poor outcome. Early detection of primary cancer at an early stage may improve the prognosis. PMID:23826688

2013-01-01

274

Failure of hospital employees to comply with smoke-free policy is associated with nicotine dependence and motives for smoking: a descriptive cross-sectional study at a teaching hospital in the United Kingdom  

E-print Network

of hospital employees. Seven hundred and four members of staff at Addenbrooke's Hospital, Cambridge, UK, completed the questionnaire, of whom 101 were smokers. Comparison between compliant and non-compliant smokers was made based on calculated scores...

Parks, Tom; Wilson, Clare V R; Turner, Kenrick; Chin, Joel W E

2009-07-15

275

Knowledge, Attitude, and Practice of Voluntary Blood Donation among Healthcare Workers at the University of Benin Teaching Hospital, Benin City, Nigeria  

PubMed Central

Introduction. Adequate and safe blood supply has remained a challenge in developing countries like ours. There is a high dependency on family replacement and remunerated blood donors in our environment which carries an attendant increased risk of transfusion transmissible infection. Objectives. The objectives of this study were to assess the knowledge, attitude, and practice of voluntary blood donation among healthcare workers (nonphysicians) and to identify and recruit potential voluntary blood donors. Methodology. This was a cross-sectional descriptive study carried out at the University of Benin Teaching Hospital, Benin City. A total of 163 staffs were recruited. Pretest questionnaires were used to assess their knowledge, attitude, and practice of voluntary blood donation. Statistical Analysis. The responses were collated and analyzed with the Statistical Package for Social Sciences (SPSS) 16. The association between blood donation practice and gender of respondents, category of staff, and level of education was tested using Chi-square and Fisher's tests where appropriate. P < 0.05 were considered statistically significant. Results. The median age of the respondents was 32 years (18–56) with females accounting for 55.6% (90). A total of 74.8% (122) attained tertiary education, and 55.8% (91) of respondents were senior staffs. The majority has good knowledge and positive attitude towards donation; however, only 22.1% (36) have donated blood with 41.7% (15) of these being voluntary. Male workers were more likely to donate (P < 0.05). There is no significant association between blood donation and level of education. Conclusion. There is a strong disparity between the knowledge, attitude, and practice of voluntary donation amongst healthcare workers. PMID:24222890

Nwogoh, Benedict; Aigberadion, Usimenahon; Nwannadi, Alexander Ikenna

2013-01-01

276

Awareness of HIV Testing Guidelines Is Low among Swiss Emergency Doctors: A Survey of Five Teaching Hospitals in French-Speaking Switzerland  

PubMed Central

Background In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH) updated ‘Provider Induced Counseling and Testing’ (PICT) recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed. We examined awareness of these updated recommendations among emergency department (ED) doctors. Methods We conducted a questionnaire-based survey among 167 ED doctors at five teaching hospitals in French-Speaking Switzerland between 1st May and 31st July 2011. For 25 clinical scenarios, participants had to state whether HIV testing was indicated or whether patient consent or pre-test counseling was required. We asked how many HIV tests participants had requested in the previous month, and whether they were aware of the FOPH testing recommendations. Results 144/167 doctors (88%) returned the questionnaire. Median postgraduate experience was 6.5 years (interquartile range [IQR] 3; 12). Mean percentage of correct answers was 59 ± 11%, senior doctors scoring higher (P=0.001). Lowest-scoring questions pertained to acute HIV infection and scenarios where patient consent was not required. Median number of test requests was 1 (IQR 0-2, range 0-10). Only 26/144 (18%) of participants were aware of the updated FOPH recommendations. Those aware had higher scores (P=0.001) but did not perform more HIV tests. Conclusions Swiss ED doctors are not aware of the national HIV testing recommendations and rarely perform HIV tests. Improved recommendation dissemination and adherence is required if ED doctors are to contribute to earlier HIV diagnoses. PMID:24039804

Fishman, Daniel; Kehtari, Reza; Rutschmann, Olivier T.; Cavassini, Matthias; Hugli, Olivier

2013-01-01

277

A study of snake bite among children presenting to a paediatric ward in the main Teaching Hospital of North Central Province of Sri Lanka  

PubMed Central

Background Snake bite is a common problem in the North Central province of Sri Lanka. Common krait (Bungarus careuleus), Ceylon krait (Bungarus ceylonicus), Cobra (Naja naja), Russell’s viper (Daboia russelii), Saw-scaled viper (Echis carinatus) and Hump-nosed pit viper (Hypnale hypnale) are the six species of venomous land snakes in Sri Lanka. A significant number of adults and children are bitten by snakes every year. However, the majority of research studies done in Sri Lanka and other countries show adults bitten by snakes and studies describing children bitten by snakes are very sparse. Methods A descriptive cross sectional study was performed in the Teaching Hospital Anuradhapura in the North Central Province of Sri Lanka from May 2010 to 2011 May to describe the characteristics associated with cases of snake bite. Results There were 24 males and 20 females. The highest numbers of bites (48%) were in the range of ages 6-12 years. The majority of the bites occurred between 6 pm to 6 am (59%).The foot was the most common bitten site (48%). Out of all the venomous bites, the Hump-nosed pit viper (Hypnale hypnale) accounted for the highest number (44%) and Russell’s viper (Daboia ruselii) accounted for the second highest number (27%). A significant number of venomous bites occurred indoors while sleeping (22%). Antivenom serum was given to (39%) of venomous bites. Deaths occurred in (11%) of the venomous bites. Conclusions Hump-nosed pit viper (Hypnale hypnale) accounted for the highest number of venomous bites. Majority of the bites occurred between 6 pm and 6 am. Foot was the most common bitten site. A significant number of venomous bites occurred indoor while sleeping. Antivenom serum was given to a significant number of venomous bites. Educating the public on making their houses snake proof and using a torch when going out during night time will help in the prevention of getting bitten by snakes. PMID:25073710

2014-01-01

278

A Study on the Usage Pattern of Antimicrobial Agents for the Prevention of Surgical Site Infections (SSIs) in a Tertiary Care Teaching Hospital  

PubMed Central

Context: Inappropriate antimicrobial use increases the incidence of drug resistance, drug toxicity and superinfections, thereby increasing the healthcare costs. Various approaches for rationalizing the antimicrobial therapy, have been suggested. Collection of baseline data on the pattern of the antimicrobial use is usually suggested as the first step in this direction, which will help in identifying the problem areas, which demand our attention. Aims: To study the usage pattern of prophylactic antimicrobials in surgical patients, in order to detect any inappropriateness concerning the selection, timing, redosing and the duration of antimicrobial administration. Settings and Design: A retrospective review of the randomly selected medical records of general surgical cases over an 8 month period in a tertiary care teaching hospital. Methods and Material: The medical records of 258 patients who had undergone surgical procedures were verified for the appropriateness of the antimicrobial prophylaxis, with respect to the choice of the antimicrobial agent, the time of its administration, the intraoperative dosing, and the duration of the postoperative use. The obtained data was analyzed and conclusions were drawn with the help of descriptive statistics. Results: Third generation cephalosporins were used preoperatively in all the 258(100%) patients through the intravenous route. In addition, 77(30%) patients received metronidazole or amikacin. The antimicrobials were administered half an hour to one hour before the surgery. No intraoperative redosing was given. The duration of the postoperative prophylaxis was extended to 36 hours or more in 248(96%) of the cases. Conclusions: The timing of administration of the preoperative dose was appropriate and well delegated to the operating room nurse. The intra operative dose was appropriately omitted. The main concern was the increasing use of the third generation cephalosporins and the unnecessary prolonged duration of the postoperative prophylaxis, which needed to be addressed. PMID:23730643

Khan A.K, Afzal; P.V, Mirshad; Rashed, Mohammed Rafiuddin; Banu, Gausia

2013-01-01

279

Knowledge and attitude of physicians in a major teaching hospital towards atherosclerotic risk reduction therapy in patients with peripheral arterial disease  

PubMed Central

Background Peripheral arterial disease (PAD) is a marker of advanced atherosclerosis with an elevated risk of cardiovascular mortality and morbidity. Although intensive risk reduction therapy is critical in reducing the adverse cardiovascular outcomes in patients with PAD, the awareness of this information among all physicians is felt to be low. Given the role of family physicians (FP), general internists (GI), cardiologists (C), and vascular surgeons (VS) in treating patients with PAD, we sought to determine their perceptions and knowledge of risk reduction therapy in these patients. Methods and results We conducted a cross-sectional self-administered survey of 84 physicians who work at a major teaching hospital. FP, GI, C, and VS represent 39%, 33%, 16%, and 12% of the surveyed physicians, respectively. The recommended targets of LDL-cholesterol, blood glucose and blood pressure in PAD patients were known to 37.3%, 94.1% and 35.3% of physicians, respectively. The majority of physicians reported to screen for risk factors in PAD. Although 86.3% of physicians would recommend antiplatelets therapy in PAD, only 17.6% would recommend angiotensin converting enzyme (ACE) inhibitors; 25.5% would recommend nicotine replacement therapy for smokers and 62.7% would recommend statins. Compared to other specialties, cardiologists had the lowest threshold, whereas GI had the highest threshold for initiating antiplatelets and statins for patients with PAD. Conclusion The perceptions towards risk reduction in PAD identify glaring knowledge and action gaps. Effective strategies to encourage health professionals to use risk reduction therapy are needed. PMID:18200820

Al-Omran, Mohammed

2007-01-01

280

Selected Micronutrient Levels and Response to Highly Active Antiretroviral Therapy (HAART) Among HIV/AIDS Patients Attending a Teaching Hospital in Addis Ababa, Ethiopia.  

PubMed

Poor micronutrient levels are associated with an increased risk of progression to AIDS and are also suggested to influence outcome of highly active antiretroviral therapy (HAART), though existing data are inconclusive to support the latter. Few published data are available on micronutrient levels in Ethiopian HIV/AIDS patients taking HAART. The objective of the study was to determine the association of micronutrient levels and response to HAART (CD4(+) T cell count) among adult HIV/AIDS patients attending a teaching Hospital in Addis Ababa. CD4(+) T cell counts and micronutrient (retinol, zinc, and iron) levels for 171 subjects were determined using standard procedures. Some proportions of the study participants were found deficient for retinol (14.03 %), zinc (47.3 %), and iron (2.8 %). Patients who were deficient in retinol had a significantly lower median CD4(+) T cell counts (P?=?0.002) compared to non-deficient subjects. Association of micronutrient quartiles with CD4+ T cell count was assessed using adjusted multivariate regression by taking quartile 4 as a reference category. Accordingly, patients who had retinol levels in quartile 4 had a significantly lower mean CD4(+) T cell count compared to quartile 3 (P?=?0.02). The significantly higher CD4(+) T cell counts in patients who were non-deficient in retinol imply the role of retinol in improving the production of CD4(+) T cells. However, both lower and higher retinol levels were associated with suppressed immunity (CD4?

Eshetu, Amare; Tsegaye, Aster; Petros, Beyene

2014-12-01

281

Evaluation of antidiabetic prescriptions, cost and adherence to treatment guidelines: A prospective, cross-sectional study at a tertiary care teaching hospital  

PubMed Central

Introduction: Diabetes mellitus is on alarming rise in India. Drug utilization studies help to identify the adherence to standard treatment guidelines and to evaluate the rational drug usage. Objective: To study prescription pattern, calculate the cost of antidiabetic drugs and to evaluate the adherence to treatment guidelines in diabetic patients attending the medicine outpatient department in a tertiary care teaching hospital. Materials and Methods: A prospective observational study was carried out for a period of 5 months. The diabetic patients who visited the medicine outdoor department were included. Demographic data and complete prescription details were recorded in the structured case record form. Cost of the drug therapy was calculated from the patient's bills. Indian Council for Medical research guidelines-2005 for diabetes management was used to evaluate the adherence. Results: A total of 250 patients were enrolled in the study with mean age 57.91 ± 9.37. Out of 250 patients 126 (50.4%) were male and rest were female. A total of 1,391 drugs were prescribed, with mean of 5.56 ± 2.52 drugs and out of which 539 drugs were antidiabetics with mean of 2.18 ± 0.96. In monotherapy, metformin was frequently 218 (40.45%) prescribed. Glimepiride and metformin was the most frequently prescribed in 119 (76.28%) out of 156 antidiabetic drug combinations. Most commonly used drugs other than antidiabetics were aspirin 146 (18.9%) and atorvastatin 119 (15.41%). Mean cost of therapy for a month for a diabetic patient was 354.60 ± 305.72 INR. Majority 209 (83.6%) of prescriptions was in accordance to guidelines. Conclusion: Metformin was the most frequently prescribed drug in the diabetes patient. Metformin and glimeperide being the most frequent combination used. Majority of the prescriptions followed standard guidelines. PMID:24808678

Acharya, Khushali G.; Shah, Kartik N.; Solanki, Nilay D.; Rana, Devang A.

2013-01-01

282

Evaluation of control of blood pressure in chronic kidney disease patients with hypertension attending echo-lab of Nepal Medical College Teaching Hospital.  

PubMed

Hypertension and Chronic kidney disease (CKD) are common in Nepal. Control of blood pressure (BP) in general hypertensive patients is poor. Evaluation of adequacy of BP control in CKD patients with hypertension is rare. All consecutive indoor patients (52) with CKD and hypertension, attending echo-lab of Nepal Medical College Teaching Hospital during prospective study of 3 years period from 16th April 2008 to 15th April 2011, were evaluted. Mean age was 45.3 +/- 16.7 years. Male female ratio was 8:5. Brahman and Chhetri (22, 42.3%) were the usual sufferers. There were two peaks in the age group wise distribution; one in age group 20-29 years and the next in 50-59 years. One hypertensive patient's BP was normalized after starting hemodialysis without antihypertensive therapy and was excluded from this study. Others' BP (n = 51) were followed up during admission for the evaluation of the adequacy of their BP control and their antihypertensive medications were reviewed. The control of hypertension in CKD patients was difficult. More than two third of the patients (68.6%) had BP > 140/90 mm Hg. Intensive BP control was present in less than one tenth (7.9%) of the patients. In comparison to intensive group, uncontrolled group received more antihypertensive agents (3.0 +/- 1.3 vs. 2.0 +/- 0.8, p < 0.05). Amlodipine (39, 76.5%) and frusemide (39, 76.5%) were very popular antihypertensives used followed by Prazocin (20, 39.2%) and Metoprolol (11, 21.6%). Despite good efforts, BP control of Nepalese CKD patients with hypertension, were poor. PMID:23671961

Shrestha, B; Dhungel, S

2012-06-01

283

Nepal's noble echocardiography-database with video clips and color still images: a single individual's 6 years' experience at the Echocardiography Lab of Nepal Medical College, Teaching Hospital.  

PubMed

Echocardiographic reporting system is very poor in Nepal. No long-term feasibility and efficacy data about the echocardiography database with video clips has been studied. Snazzi Movie Studio S4 was used to convert analog video signals into MPEG2 and color photographs were converted into JPEG format for storage and use for the database. All together 2272 patients' echocardiography were performed by one individual prospectively at the Nepal Medical College Teaching Hospital from 10th January 2007 to 9th January 2012. Echocardiographic findings of these patients were evaluated. Mean age +/- SD were 44.4 +/- 28.7 years. Male female ratio was 0.8:1. Brahman/Chhetri were the usual ethnic group to undergo echocardiography (943, 41.5%), followed byjanajati (631, 27.8%) and newar (496, 21.8%). Age group of 60-69 years was the most common echo users (519, 22.8%). Total time for echocardiography/report writing with database compared to non database was 13.9 +/- 2.4 minutes vs. 12.3 +/- 0.8 minutes, p = 0.51. Out of all lesions, valvular lesions were the most common lesions detected (4885, 215%). Mild tricuspid regurgitation (1213, 53.4%) was the most common valvular lesion followed by mild mitral regurgitation (742, 32.7%). Patent foramen ovale was the most common congenital heart disease (32, 45.7%) followed by atrial septal defect (12, 17.1%). About one seventh of the total patients (318, 13.9%) had systolic dysfunction. Out of total chronic cor pulmonale (383, 16.9%), severe Pulmonary arterial dysfulction (PAH) was noted in more than one third of the patients (169, 44.1%). PMID:24047011

Shrestha, B

2012-09-01

284

The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria  

PubMed Central

Background Malaria is the number one public health problem in Nigeria, responsible for about 30% of deaths in under-fives and 25% of deaths in infants and 11% maternal mortality. This study estimated the economic burden of malaria in Nigeria using the cost of illness approach. Methods A cross-sectional study was undertaken in two malaria holo-endemic communities in Nigeria, involving both community and hospital based surveys. A random sample of 500 households was interviewed using interviewer administered questionnaire. In addition, 125 exit interviews for inpatient department stays (IPD) and outpatient department visits (OPD) were conducted and these were complemented with data abstraction from 125 patient records. Results From the household survey, over half of the households (57.6%) had an episode of malaria within one month to the date of the interview. The average household expenditure per case was 12.57US$ and 23.20US$ for OPD and IPD respectively. Indirect consumer costs of treatment were higher than direct consumer medical costs. From a health system perspective, the recurrent provider costs per case was 30.42 US$ and 48.02 US$ for OPD and IPD while non recurrent provider costs were 133.07US$ and 1857.15US$ for OPD and IPD. The mode of payment was mainly through out-of-pocket spending (OOPS). Conclusion Private expenditure on treatment of malaria constitutes a high economic burden to households and to the health system. Removal of user fees and interventions that will decrease the use of OOPS for treatment of malaria will significantly decrease the economic burden of malaria to both households and the health system. PMID:24223796

Onwujekwe, Obinna; Uguru, Nkoli; Etiaba, Enyi; Chikezie, Ifeanyi; Uzochukwu, Benjamin; Adjagba, Alex

2013-01-01

285

Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: a cross sectional study of cost and birth outcomes  

PubMed Central

Background In many countries midwives act as the main providers of care for women throughout pregnancy, labour and birth. In our large public teaching hospital in Australia we restructured the way midwifery care is offered and introduced caseload midwifery for one third of women booked at the hospital. We then compared the costs and birth outcomes associated with caseload midwifery compared to the two existing models of care, standard hospital care and private obstetric care. Methods We undertook a cross sectional study examining the risk profile, birth outcomes and cost of care for women booked into one of the three available models of care in a tertiary teaching hospital in Australia between July 1st 2009 December 31st 2010. To control for differences in population or case mix we described the outcomes for a cohort of low risk first time mothers known as the 'standard primipara'. Results Amongst the 1,379 women defined as 'standard primipara' there were significant differences in birth outcome. These first time ‘low risk’ mothers who received caseload care were more likely to have a spontaneous onset of labour and an unassisted vaginal birth 58.5% in MGP compared to 48.2% for Standard hospital care and 30.8% with Private obstetric care (p < 0.001). They were also significantly less likely to have an elective caesarean section 1.6% with MGP versus 5.3% with Standard care and 17.2% with private obstetric care (p < 0.001). From the public hospital perspective, over one financial year the average cost of care for the standard primipara in MGP was $3903.78 per woman. This was $1375.45 less per woman than those receiving Private obstetric care and $1590.91 less than Standard hospital care per woman (p < 0.001). Similar differences in cost were found in favour of MGP for all women in the study who received caseload care. Conclusions Cost reduction appears to be achieved through reorganising the way care is delivered in the public hospital system with the introduction of Midwifery Group Practice or caseload care. The study also highlights the unexplained clinical variation that exists between the three models of care in Australia. PMID:24456576

2014-01-01

286

The long walk to universal health coverage: patterns of inequities in the use of primary healthcare services in Enugu, Southeast Nigeria  

PubMed Central

Background Knowledge and understanding of health service usage are necessary for health resource allocation, planning and monitoring the achievement of universal coverage (UHC). There is limited information on patterns of utilization among adult users of primary health care (PHC) services. Lack of understanding of current and past utilization patterns of health services often hinders the improvement of future Primary Health Care (PHC) delivery in the remote areas of developing countries. This paper presents new knowledge on the patterns of utilization of PHC services among adults in Enugu metropolis southeast Nigeria. Methods A cross-sectional study was conducted in 15 PHC facilities of Enugu North Local Government Area (LGA) from June to July 2012. A total of 360 consenting adult users aged 18 years and above were consecutively recruited as they attended the health facilities. An interviewer-administered questionnaire was used to collect data from the respondents. A modified Likert scale questionnaire was used to analyze data on patterns of utilization. Utilization of PHC services was compared by gender, socio-economic status (SES) and level of education. Results Out of the 360 respondents, (46.9%) utilized PHC services regularly. The components of PHC mostly utilized by respondents were immunization with a mean score of 3.05, treatment of common ailments (2.99) and maternal and child health (2.64). The least poor SES group utilized PHC services the most while the very poor and poor SES groups used PHC services least. There were statistically significant relationships between utilization of PHC services and gender (p?=?0.0084), level of education (p?=?0.0366) and income (p?=?0.0001). Conclusions Most adult users in this study did not utilize the health facilities regularly and there were gender, educational and SES inequities in the use of PHC services. These inequities will negate the achievement of universal health coverage with PHC services and should be remedied using appropriate interventions. PMID:24655898

2014-01-01

287

Intraoperative and Anesthesia-Related Cardiac Arrest and Its Mortality in Older Patients: A 15-Year Survey in a Tertiary Teaching Hospital  

PubMed Central

Background Little information is known about factors that influence perioperative and anesthesia-related cardiac arrest (CA) in older patients. This study evaluated the incidence, causes and outcome of intraoperative and anesthesia-related CA in older patients in a Brazilian teaching hospital between 1996 and 2010. Methods During the study, older patients received 18,367 anesthetics. Data collected included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA) physical status, anesthesia type, medical specialty team and outcome. All CAs were categorized by cause into one of four groups: patient's disease/condition-related, surgery-related, totally anesthesia-related or partially anesthesia-related. Results All intraoperative CAs and deaths rates are shown per 10,000 anesthetics. There were 100 CAs (54.44; 95% confidence intervals [CI]: 44.68–64.20) and 68 deaths (37.02; 95% CI: 27.56–46.48). The majority of CAs were patient's disease-/condition-related (43.5; 95% CI: 13.44–73.68). There were six anesthesia-related CAs (3.26; 95% CI: 0.65–5.87) - 1 totally and 5 partially anesthesia-related, and three deaths, all partially anesthesia-related (1.63; 95% CI: 0.0–3.47). ASA I-II physical status patients presented no anesthesia-related CA. Anesthesia-related CA, absent in the last five years of the study, was due to medication-/airway-related causes. ASA physical status was the most important predictor of CA (odds ratio: 14.52; 95% CI: 4.48–47.08; P<0.001) followed by emergency surgery (odds ratio: 8.07; 95% CI: 5.14–12.68; P<0.001). Conclusions The study identified high incidence of intraoperative CAs with high mortality in older patients. The large majority of CAs were caused by factors not anesthesia-related. Anesthesia-related CA and mortality rates were 3.26 and 1.63 per 10,000 anesthetics, with no anesthesia-related CA in the last five years of the study. Major predictors of intraoperative CAs were poorer ASA physical status and emergency surgery. All anesthesia-related CAs were medication-related or airway-related, which is important for prevention strategies. PMID:25117481

Nunes, Juscimar C.; Braz, Jose R. C.; Oliveira, Thais S.; de Carvalho, Lidia R.; Castiglia, Yara M. M.; Braz, Leandro G.

2014-01-01

288

Characterization of carbapenemases, extended spectrum ?-lactamases, quinolone resistance and aminoglycoside resistance determinants in carbapenem-non-susceptible Escherichia coli from a teaching hospital in Chongqing, Southwest China.  

PubMed

Carbapenem-resistant Escherichiacoli isolates harboring carbapenemases or combining an extended-spectrum ?-lactamase (ESBL) enzyme with loss of porins present an increasingly urgent clinical danger. Combined resistance to aminoglycosides and fluoroquinolones in carbapeneme non-susceptible (CNS) isolates will inevitably create problems. In the current study, we characterized the carbapenemases and ESBLs, and the prevalence of quinolone resistance determinants and aminoglycoside resistance determinants in carbapenem-non-susceptible (CNS) E.coli isolates from a teaching hospital in Chongqing, Southwest China in 2012. Thirty non-duplicated CNS E.coli isolates were screened via antimicrobial susceptibility testing, and the drug resistance profiles of the 30 strains were analyzed. Carbapenemase genes blaKPC-2, ESBL genes including blaCTX-M-3, blaCTX-M-14, blaCTX-M-55 and blaTEM, ARD genes including aac(6')-Ib, armA and rmtB, and QRD genes including qnrA, qnrB, qnrC, qnrD, qnrS and aac(6')-Ib-cr were identified and clonal relatedness was investigated by pulsed-field gel electrophoresis. Of the 30 isolates, 2 (6.7%) harbored carbapenemase gene blaKPC-2; 29 (96.7%) carried ESBLs; 20 (66.7%) were QRD positive; and 11 (36.7%) were ARD positive. Between the two blaKPC-2 positive strains, one contained ESBL, QRD and ARD genes, while the other expressed ESBL genes but was negative for both QRD and ARD genes. Of the 29 ESBLs positive isolates, 2 (6.9%) were carbapenemase positive, 19 (65.5%) were QRD positive, and 11 (37.9%) were ARD positive. PFGE revealed genetic diversity among the 30 isolates, indicating that the high prevalence of CNS E. coli isolates was not caused by clonal dissemination. Production of ESBLs was associated with the carbapenem resistance and QRD genes were highly prevalent among the CNS E. coli isolates. Multiple resistant genes were co-expressed in the same isolates. This is the first report of a multidrug resistant carbapenem-non-susceptible E.coli co-harboring resistant determinants blaKPC-2, blaCTX-M-14, blaCTX-M-55, blaTEM, aac(6')-Ib-cr, qnrB, aac(6')-Ib and rmtB from Chongqing, mainland China. PMID:25107431

Zhang, Chuanming; Xu, Xiuyu; Pu, Shuli; Huang, Shifeng; Sun, Jide; Yang, Shuangshuang; Zhang, Liping

2014-10-01

289

Hospitality in hospitals?  

Microsoft Academic Search

Purpose – The purpose of this paper is to explore an organization-wide philosophy of hospitality in a hospital setting. Design\\/methodology\\/approach – An exploratory case study method approach matched the research purpose. First, a hospitality centric philosophy (HCP) was defined from the literature review. Next, a triangulation of unstructured visits, structured visits and key informant interviews is used to further explore

Denver Severt; Taryn Aiello; Shannon Elswick; Cheryl Cyr

2008-01-01

290

In this issue Spotlight on the Veterinary Teaching  

E-print Network

In this issue Spotlight on the Veterinary Teaching Hospital By Herb Whiteley For many alumni and friends of the College, the Veterinary Teaching Hospital is the most visible and tangible aspect of our, the Veterinary Teaching Hospital participates in all aspects of our mission and vision, contributing

Gilbert, Matthew

291

What motivates senior clinicians to teach medical students?  

Microsoft Academic Search

BACKGROUND: This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. METHODS: The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia). Their motivations to teach medical students

Jane Dahlstrom; Anna Dorai-Raj; Darryl McGill; Cathy Owen; Kathleen Tymms; D Ashley R Watson

2005-01-01

292

Genotyping of skin and soft tissue infection (SSTI)-associated methicillin-resistant Staphylococcus aureus (MRSA) strains among outpatients in a teaching hospital in Japan: application of a phage-open reading frame typing (POT) kit.  

PubMed

We aimed to elucidate the current epidemiological features of outpatient skin and soft tissue infection (SSTI)-associated methicillin-resistant Staphylococcus aureus (MRSA) in Japan. Altogether, we evaluated the performance of a phage-open reading frame typing (POT) kit for genotyping these MRSA strains. We collected 57 MRSA strains from all outpatients with SSTIs attending a teaching hospital in Japan. Drug susceptibility measurement and genotyping including SCCmec typing, spa typing, multilocus sequence typing, pulsed-field gel electrophoresis, and commercial POT-kit were performed. The majority of strains (39 strains, 68 %) had the SCCmec-II element. Seventeen strains (30 %) with SCCmec-IV accounted for the second largest population. Strains with SCCmec-IV and SCCmec-V appeared multiclonal, and a predominance of Panton-Valentine leukocidin (PVL) gene-negative CC8/spa-CC008 strains, as well as the first isolate of an ST93 strain in Japan, was observed among them. Only one USA300 strain was identified. Strains with SCCmec-IV and SCCmec-V were significantly susceptible to antimicrobials. The PVL gene was found in 5 SCCmec-IV strains and 1 SCCmec-V strain. The POT-kit successfully predicted the SCCmec type in 54 strains (95 %), and typing by POT1 scores was highly concordant with SCCmec typing and spa typing. Moreover, three PVL-positive strains fell into a particular POT type (POT scores, 106-77-113). Simpson's index of the POT-kit was 0.977. In conclusion, the present study clarified the multiclonal nature of outpatient SSTI-associated MRSA in a teaching hospital in Japan. These data also underscore the utility of the POT-kit for non-outbreak surveillance through its simple platform consisting of two multiplex PCRs without sequencing. PMID:23150115

Maeda, Tadashi; Saga, Tomoo; Miyazaki, Taito; Kouyama, Yuichi; Harada, Sohei; Iwata, Morihiro; Yoshizawa, Sadako; Kimura, Soichiro; Ishii, Yoshikazu; Urita, Yoshihisa; Sugimoto, Motonobu; Yamaguchi, Keizo; Tateda, Kazuhiro

2012-12-01

293

Complexity and Diversity of Klebsiella pneumoniae Strains with Extended-Spectrum  -Lactamases Isolated in 1994 and 1996 at a Teaching Hospital in Durban, South Africa  

Microsoft Academic Search

b-Lactamase production was investigated in cultures of 25 Klebsiella pneumoniae isolates isolated at a hospital in Durban, South Africa, in 1994 and 1996. Twenty of these isolates gave ceftazidime MIC\\/ceftazidime plus clavulanate MIC ratios of >8, implying production of extended-spectrum b-lactamases (ESBLs), and DNA sequencing identified an ESBL gene (blaTEM-53) in a further two isolates. Pulsed-field gel electrophoresis (PFGE) defined

SABIHA Y. ESSACK; LUCINDA M. C. HALL; DEVADAS G. PILLAY; MARGARET LYNN MCFADYEN; DAVID M. LIVERMORE

2001-01-01

294

This article has been retracted and is available online only: Religion, culture and male involvement in the use of family planning: evidence from Enugu and Katsina States of Nigeria.  

PubMed

The following article from the International Nursing Review, 'Religion, culture and male involvement in the use of family planning: evidence from Enugu and Katsina States of Nigeria', by C. Ujuju, J. Anyanti, S.B. Adebayo, F. Muhammad, O. Oluigbo and A. Gofwan, published online on 6 September 2010 on Wiley Online Library (http://wileyonlinelibrary.com) has been retracted by agreement between the authors, the journal Editor in Chief, Jane J.A. Robinson and Blackwell Publishing Ltd. The retraction has been agreed as not all copyright permissions had been cleared. Jane J.A Robinson Editor International Nursing Review. PMID:21848764

Robinson, Jane J A

2011-09-01

295

Emergence and dissemination of a highly vancomycin-resistant vanA strain of Enterococcus faecium at a large teaching hospital.  

PubMed Central

We prospectively identified patients at the Massachusetts General Hospital from whom vancomycin-resistant enterococci (VRE) were isolated from a clinical specimen from 1 January 1991 through 31 December 1995. VRE strains were available from 139 (82%) of the 169 patients with clinical cases. Of these, 39 (28%) were identical or closely related by pulsed-field gel electrophoresis (i.e., VRE type A strain), including 38 (43%) of 89 VRE strains in 1995. By multivariate analysis, acquisition of the VRE type A strain was associated with receipt of clindamycin (odds ratio [OR] = 10.5), 15 or more days of hospitalization before the first isolation of VRE (OR = 2.9), and residence on one of the general medical floors (OR = 7.8). The VRE type A strain was a vanA strain of Enterococcus faecium and was highly resistant to all antimicrobial agents tested except chloramphenicol. These findings document the rapid dissemination of a highly resistant strain of E. faecium among patients and among other extant VRE strains at the Massachusetts General Hospital in 1995. PMID:9163483

Pegues, D A; Pegues, C F; Hibberd, P L; Ford, D S; Hooper, D C

1997-01-01

296

Compare Hospitals  

MedlinePLUS

2014 Leapfrog Hospital Survey Results Now Available Thank you for visiting the Leapfrog Hospital Survey Results Website. These results are based on surveys submitted by hospitals across the country that have demonstrated a commitment ...

297

Research on Clinical Teaching.  

ERIC Educational Resources Information Center

Medical education research indicates little has been done to improve teaching effectiveness of attending physicians on hospital wards. Moreover, there have been few studies to determine what the attending physician should attempt to accomplish with medical school trainees. More data collected in clinical settings are needed. (RD)

And Others; Daggett, Christopher J.

1979-01-01

298

Bacteriological quality of foods and water sold by vendors and in restaurants in Nsukka, Enugu State, Nigeria: a comparative study of three microbiological methods.  

PubMed

Bacterial count in prepared food or water is a key factor in assessing the quality and safety of food. It also reveals the level of hygiene adopted by food handlers in the course of preparation of such foods. This comparative study evaluated the bacteriological quality of food and water consumed in Nsukka, Enugu state, Nigeria, using three bacteria enumeration methods. Data obtained are assumed to reflect the level of personal and environmental hygiene in the study population. Ten types of foods--beans, yam, abacha, okpa, moimoi, pear, cassava foofoo, rice, agidi, and garri--and 10 water samples were evaluated for bacteriological quality, precisely determining the level of coliform contamination, using the most probable number (MPN), lactose fermentation count (LFC), and Escherichia coli count (ECC) methods. Bacterial counts differed significantly (p < 0.05) among the various food samples. However, this did not differ significantly in the three methods used for the enumeration of coliforms, suggesting that any of the three methods could be validly used for such studies with confidence. Escherichia coli and Klebsiella pneumoniae were the two major coliforms identified among 98 coliform isolates obtained from the various food samples, of which 78 (79.6%) were assumed to be of human origin on account of their ability to grow at 44 degrees C. The level of coliform contamination in the food samples from vendors and restaurants (geometric mean count 7.64-9.21; MPN > or = 50) were above the accepted 10(4) colony-forming unit/g or MPN < or = 10 limits. The results of the study, therefore, call for stringent supervision and implementation of food-safety practices and regular education on food and personal hygiene among food vendors. PMID:22283029

Nkere, Chukwuemeka K; Ibe, Nnenne I; Iroegbu, Christian U

2011-12-01

299

Water disinfection with ozone, copper and silver ions, and temperature increase to control Legionella: seven years of experience in a university teaching hospital.  

PubMed

The efficacy of ozonation, copper-silver ionization and increased temperature in controlling Legionella spp. in the hot water distribution networks of a university hospital was evaluated. Two separate water distribution networks were studied; network 1 which supplies the surgical intensive care units, and network 2 which supplies the medical intensive care units and the emergency room. Network 1 has been disinfected by ozonation since 1995, and network 2 has been disinfected by ionisation since 1999. The hot water temperature was increased from 50 to 65 degrees C in 1998 and 2000 in networks 1 and 2, respectively. Water samples and swabs of the water outlets were cultured for Legionella spp. between four and six times each year, providing data before and after implementation of the disinfection procedures. There was no significant difference in the proportion of samples positive for Legionella spp. after ozonation in network 1 or after ionization in network 2. In both networks, there was a significant reduction in legionella isolates after increasing the hot water temperature to 65 degrees C. Maintaining the hot water temperature above 50 degrees C throughout both networks proved to be the most effective control measure in our hospital. PMID:15823660

Blanc, D S; Carrara, Ph; Zanetti, G; Francioli, P

2005-05-01

300

Impact of an educational intervention on errors in death certification: An observational study from the intensive care unit of a tertiary care teaching hospital  

PubMed Central

Background: A high incidence of errors occur while filling up death certificates in hospitals. The purpose of this study was to analyze the impact of an educational intervention on errors in death certification in an intensive care unit (ICU). Patients admitted to ICUs by virtue of being critically ill have a higher mortality than other hospitalized patients. This study was designed to see if any improvement could be brought about in filling death certificates. Materials and Methods: Educating sessions, interactive workshops, and monthly audits for the department resident doctors were conducted. One hundred and fifty death certificates were audited for major and minor errors (75 before and 75 after the educational intervention) over a period of 18 months. Fisher's exact test was applied to statistically analyze the data. Results: There was a significant decrease in major errors like mechanism without underlying cause of death (60.0 vs. 14.6%, P < 0.001), competing causes (88.0 vs. 13.3%, P < 0.001), and improper sequencing (89.3 vs. 36.0%, P < 0.001). There was also a significant decrease in minor errors such as use of abbreviations (89.3 vs. 29.3%, P < 0.001) and no time intervals (100.0 vs. 22.6%, P < 0.001). Conclusion: Authors conclude that death certification errors can be significantly reduced by educational interventional programs. PMID:24574598

Azim, Afzal; Singh, Parikshit; Bhatia, Parmeet; Baronia, Arvind K; Gurjar, Mohan; Poddar, Banani; Singh, Ratender K

2014-01-01

301

Mathematical-Statistical Models of Generated Hazardous Hospital Solid Waste  

Microsoft Academic Search

This research work was carried out under the assumption that wastes generated from hospitals in Irbid, Jordan were hazardous. The hazardous and non-hazardous wastes generated from the different divisions in the three hospitals under consideration were not separated during collection process. Three hospitals, Princess Basma hospital (public), Princess Bade’ah hospital (teaching), and Ibn Al-Nafis hospital (private) in Irbid were selected

A. R. Awad; M. Obeidat; M. Al-Shareef

2004-01-01

302

Hospital Greenspace Lawson Memorial Hospital,  

E-print Network

H Hospital Greenspace Lawson Memorial Hospital, Golspie ­ Greenspace Case Study Background to hospital greenspace to be carried out in the Highlands. This project is now entering its third phase. Phase of Phase 2. This resulted in the identification of the Lawson Memorial Hospital as the site

303

Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China  

PubMed Central

The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People’s Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. PMID:24669192

Zhu, Ling-ling; Li, Wei; Song, Ping; Zhou, Quan

2014-01-01

304

Impact of Plasmodium falciparum and hookworm infections on the frequency of anaemia in pregnant women of rural communities in Enugu, South East Nigeria  

PubMed Central

Introduction Malaria and hookworm infections are common in sub-Saharan Africa and they increase the prevalence of anaemia in pregnancy with resultant poor pregnancy outcomes. This study was carried out to assess the impact of Plasmodium falciparum and hookworm infections on the frequency of anaemia among pregnant women in two rural communities in Enugu, South East Nigeria. Methods A cross sectional descriptive study was carried out in a total of 226 women attending antenatal clinics at two rural Primary Health Centres (PHC) from April 2011 to July 2011(each PHC with 113 subjects). Socio-demographic data were collected through a structured questionnaire. Blood and stool samples were evaluated for haemoglobin estimation and malaria parasites, and stool samples examined for parasitic infection in all the women. Data was analyzed using STATA 10 software statistical analysis package. Student t-test was used for comparing mean values and chi square test for comparing categorical variables and level of significance set at p<0.05 and logistic regression was used to identify the risk factors associated with malaria in pregnancy. Results The mean age of the women was 27years with range 18 - 38years and SD of 5years. Most of the women were housewives and over 50% in their second trimester. 53% of them had malaria parasites while 27% had hookworm infection. About 40% of the women were anaemic (haemoglobin < 0.001). Similar association was found between hookworm infection and anaemia (p <0.001). Though both malaria and hookworm infections greatly increase the odds for anaemia (AOR 18.06, CI 18.15 -39.99, P<0.001) and (AOR 5.28, CI 2.26-12.38, P<0.001) respectively, the odds for having anaemia in pregnancy was higher for malaria than hookworm infections. Conclusion Plasmodium falciparum and hookworm infections have significant impact on the high frequency of anaemia in pregnancy in our rural communities. There is need to strengthen the control program that has been in place with an integrated intervention to combat these parasitic infections in our rural communities, with mass distribution of antihelminthics as one of the included relevant methods, among others. PMID:23503560

Agu, Polycarp Uche; Ogboi, Johnbull Sonny; Akpoigbe, Kesiena; Okeke, Tochukwu; Ezugwu, Euzebus

2013-01-01

305

Dosing practice of low molecular weight heparins and its efficacy and safety in cardiovascular inpatients: a retrospective study in a Chinese teaching hospital  

PubMed Central

Background Low-molecular-weight heparins (LMWHs) are safe and effective anticoagulant options for cardiovascular patients when applied as body weight-adjusted doses. However, there are some barriers that make it difficult to implement weight-adjusted doses in clinical practice. Therefore, it is vital to learn the dosing practices of LMWH and its efficacy and safety in clinical practice. Methods A retrospective study was conducted in cardiovascular inpatients who had received at least one dose of LMWH during a 6-month period. Appropriateness of LMWH dosing was determined and major clinical outcomes (major adverse vascular events and major bleeding) during hospitalization were evaluated. Results A total of 376 admissions representing 364 patients received LMWH treatment. Of these, 17.0% (64/376) of admissions did not have body weight records. Of the 312 admissions included for the outcome study, only 34 cases (10.9%) received the recommended doses of LMWH, while 51 cases (16.3%) received mild underdoses, 223 cases (71.5%) received major underdoses and 4 (1.3%) received excess doses. There were 10 major adverse vascular events, which occurred more often in patients receiving excess doses of LMWH than in patients receiving recommended, mild or major underdoses (50%, 2.9%, 2.0% and 2.7%, respectively, P < 0.001). After multivariable analysis, severe renal insufficiency was an independent risk factor for major adverse vascular events [odds ratio (OR), 31.93; 95% confidence interval (CI), 5.99-170.30; P < 0.001]. No major bleeding was recorded. Conclusions Underdose of LMWH is commonly used in cardiovascular inpatients, which was suboptimal according to guidelines. Using LMWH at a fixed, low dose for treatment purposes in patients without severe renal insufficiency was not associated with a higher risk of adverse vascular events in the current study, though larger studies with extended follow-ups are required to fully assess the long-term consequences of LMWH underdosing. PMID:23217192

2012-01-01

306

Rural hospitals  

PubMed Central

The 340B Drug Pricing Program has the potential to reduce outpatient pharmaceutical costs for qualifying hospitals—hut many rural hospital administrators are unaware of their organization’s eligibility. PMID:18637547

Radford, Andrea; Slifkin, Rebecca; Schur, Claudia; Cheung, Karen; Baernholdt, Marianne

2013-01-01

307

Norovirus - hospital  

MedlinePLUS

... be severe, becoming dehydrated (dried out) is common. Hospital patients who are very old, very young, or ... to understand an outbreak (for instance in a hospital setting). This test is done by collecting and ...

308

Maternal and perinatal outcomes of delivery after a previous Cesarean section in Enugu, Southeast Nigeria: a prospective observational study  

PubMed Central

Background Obstetricians in developing countries appear generally reluctant to conduct vaginal delivery in women with a previous Cesarean because of lack of adequate facilities for optimal fetomaternal monitoring. Objective To describe delivery outcomes among women with one previous Cesarean section at a tertiary hospital in Southeast Nigeria. Methods This was a prospective observational study to determine maternal and perinatal outcomes of attempted vaginal birth after Cesarean sections (VBAC) following one previous Cesarean section. Analysis was done with SPSS statistical software version 17.0 for Windows using descriptive and inferential statistics at 95% level of confidence. Results Two thousand six hundred and ten women delivered in the center during the study period, of whom 395 had one previous Cesarean section. A total of 370 women with one previous Cesarean section had nonrecurrent indications, of whom 355 consenting pregnant women with one previous Cesarean section were studied. A majority of the women (320/355, 90.1%) preferred to have vaginal delivery despite the one previous Cesarean section. However, only approximately 54% (190/355) were found suitable for trial of VBAC, out of whom 50% (95/190 had successful VBAC. Ninety-five women (50.0%) had failed attempt at VBAC and were delivered by emergency Cesarean section while 35 women (9.8%) had emergency Cesarean section for other obstetric indications (apart from failed VBAC). There was no case of uterine rupture or neonatal and maternal deaths recorded in any group. Apgar scores of less than 7 in the first minute were significantly more frequent amongst women who had vaginal delivery when compared to those who had elective repeat Cesarean section (P=0.03). Conclusion Most women who had one previous Cesarean delivery chose to undergo trial of VBAC, although only about half were considered suitable for VBAC. The maternal and fetal outcomes of trial of VBAC in selected women with one previous Cesarean delivery for non-recurrent indications were good. Obstetricians in this area should do more to allow VBAC in women with one previous Cesarean section for nonrecurrent indications. PMID:24648774

Ugwu, George O; Iyoke, Chukwuemeka A; Onah, Hyacinth E; Egwuatu, Vincent E; Ezugwu, Frank O

2014-01-01

309

Effects of a combination of amlodipine and imipenem on 42 clinical isolates of Acinetobacter baumannii obtained from a teaching hospital in Guangzhou, China  

PubMed Central

Background The clonal spread of Acinetobacter baumannii is a global problem, and carbapenems, such as imipenem, remain the first-choice agent against A. baumannii. Using synergy to enhance the antibiotic activity of carbapenems could be useful. Here, amlodipine (AML) was tested alone and with imipenem against A. baumannii isolates. Methods Forty-two isolates of A. baumannii were collected. Multilocus sequence typing (MLST) assessed the genetic relationship of the isolates. The resistance phenotypes were determined using disc diffusion. The minimum inhibitory concentrations (MICs) of the drugs were determined by broth microdilution. The combined effects of the drugs were determined by a checkerboard procedure. Metallo-?-lactamase (MBL) was determined using the MBL Etest. Results Forty-two A. baumannii isolates were collected from 42 patients who were mostly older than 65 years and had long inpatient stays (?7 days). A. baumannii was mostly recovered from the respiratory system (N?=?35, 83.3%). Most patients (N?=?27, 64.3%) received care in intensive care units (ICUs). Disc diffusion testing demonstrated that A. baumannii susceptibility to polymyxin B was 100%, while susceptibility to other antimicrobial agents was less than 30%, classifying the isolates into 10 MDR and 32 XDR strains. MLST grouped the A. baumannii isolates into 4 existing STs and 6 new STs. STn4 carried allele G1, with a T ? C mutation at nt3 on the gpi111 locus. STn5 carried allele A1, possessing A ? C mutations at nt156 and nt159 on the gltA1 locus. ST195 and ST208 accounted for 68.05% (29/42) of the isolates. Clonal relation analysis showed that ST195 and ST208 belonged to clonal complex (CC) 92. The inhibitory concentration of imipenem ranged from 0.5 to 32 ?g/ml, and that of AML ranged from 40 to 320 ?g/ml. In combination, the susceptibility rate of A. baumannii isolates increased from 16.7% to 54.8% (P?=?0.001). In the checkerboard procedure, half of the isolates (N?=?21, 50.0%) demonstrated synergy or partial synergy with the drug combination. The MBL Etest revealed that 1 A. baumannii strain (N?=?1, 2.4%) produced MBL. Conclusions CC92 was the major clone spreading in our hospital. AML improved the activity of imipenem against A. baumannii isolates in vitro but did not inhibit MBL. PMID:24238357

2013-01-01

310

Hospital response to implementation of medical directives  

Microsoft Academic Search

This sandwich thesis presents the findings of a qualitative nested case study that explored the introduction of medical directives into clinical practice within a southern Ontario teaching hospital. The purpose of this study was to describe and explore the factors influencing the development and implementation of medical directives in the hospital. In-depth, semi-structured interviews were conducted with a purposive sample

Kimberley Ann Alvarado

2007-01-01

311

Diagnostic Teaching  

ERIC Educational Resources Information Center

Contends that teaching would be more effective if it became "diagnostic" teaching, that such teaching is not possible unless backed up with an adequate system of record keeping by the teacher, and that, conversely, the establishment by a school of such a record keeping system is likely to encourage diagnostic teaching. (Author/RK)

Cooper, Keith

1977-01-01

312

Teaching Shakespeare.  

ERIC Educational Resources Information Center

This issue of "Focus: Teaching English in Southeastern Ohio" contains articles about teaching Shakespeare, student summaries of a Shakespeare conference held at Ohio University-Zanesville in April 1976, and suggested projects for teaching poetry writing. It also contains lists of materials and articles related to the teaching of Shakespeare, and…

Davis, James E., Ed.

1976-01-01

313

Hospital support.  

PubMed

Setting up a successful trauma system requires a significant amount of hospital support. This includes personnel and programs to assist with quality assurance programs, clinical compliance, and rural support and development. It is imperative that orthopaedic trauma surgeons are well versed in the types of hospital support available and the costs associated with each support measure. With this understanding, a strong, sustainable physician-hospital relationship can be created. PMID:24918831

O?Mara, Timothy J; Hill, Austin D; Althausen, Peter L

2014-07-01

314

Quality Assurance Through In-House Hospital Inspections  

PubMed Central

Hospitals, particularly those that are teaching institutions, must function at a high level of efficiency and effectiveness if they are to render excellent patient care, maintain accreditation, and provide a sound environment for learning and research. An urban 500-bed teaching hospital found that conducting its own internal monthly inspections produced several benefits in the areas of patient care, infection control, maintenance, safety, and administration. This hospital's in-house inspections also reduced anxiety in preparing for visits from various licensing agencies and review boards. Generally, this hospital has found that an in-house inspection program is a valid means of quality assurance in all areas of hospital work. PMID:4046058

Swamidoss, P.

1985-01-01

315

Hospital diversification.  

PubMed

Hospital diversification and its impact on the operating ratio are studied for 168 hospitals during the period from 1999 to 2004. Diversification and the operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependent. Institutional diversification is found to yield a better financial position, and the better operating ratio allows the institution the wherewithal to diversify. The impact of external government planning and hospital competition are also measured. An institution lifecycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. Management's attitude concerning risk and reward is considered. PMID:18972998

Eastaugh, Steven R

2005-01-01

316

Teaching physics in Latin America  

NASA Astrophysics Data System (ADS)

A review is made of current teaching practice in Latin America. The impact of research about teaching is assessed. It is argued that the usual role of teaching laboratories as a place just to measure physical constants is a sad waste of time and resources. Also the usual format of lectures is considered inefficient and a plea is made for the return to some kind of personalized instruction. Universities are compared to hospitals. This similitude suggest that the most important changes are related to administrative decisions. The conclusion is rather pessimistic, since the main educational defects arise from factors not easily dealt with.

Moreno, Darío

1995-08-01

317

Financial Performance of Academic Health Center Hospitals, 1994-2000.  

ERIC Educational Resources Information Center

This study examined how competitive market dynamics between 1994 and 2000 have affected the financial stability of Academic Health Center (AHC) hospitals and their ability to support their academic and social missions. It looked at the financial challenges facing AHC hospitals through a survey involving 1,138 teaching hospitals. Findings…

Dobson, Allen; Koenig, Lane; Sen, Namrata; Ho, Silver; Gilani, Jawaria

318

Hospitality\\/tourism job applications and educational expectation  

Microsoft Academic Search

Relatively little is known about basic educational goals and preferences among prospective hospitality\\/tourism industry employees. Relationships between hospitality\\/tourism career preferences and educational expectations have generally not been explored among this important group of people. Hospitality\\/ tourism job application letters prepared by 319 Australian secondary school students have been examined, together with a range of educational and teaching values so as

Glenn F. Ross

1997-01-01

319

The evolution of trauma services at Beaumont Hospital  

Microsoft Academic Search

Objective To review and examine the epidemiology, severity and management of trauma admissions at the national neurosurgical teaching hospital. Methods An extensive audit of volume, type and severity of injury and the management requirements of the trauma population admitted to the hospital. Results The vast majority of severely injured patients were referred from outside the catchment area of the hospital

M. C. Fitzgibbon; M. Donnelly; J. P. Phillips; P. Murray; R. Moran; D. J. Bouchier-Hayes

2007-01-01

320

Using a Computer to Teach Nursing.  

ERIC Educational Resources Information Center

A computer-based education system, PLATO (Programed Logic for Automatic Teaching Operations), has been used to teach nursing students at Mercy Hospital School of Nursing in Urbana, Illinois since 1963. PLATO III, the model now being used in a maternity nursing course, has 70 student terminals (20 of which can be used at any one time) connected to…

Bitzer, Maryann D.; Boudreaux, Martha C.

1969-01-01

321

The context of clinical teaching and learning in Australia.  

PubMed

Gaining clinical experience for an extended period of time in teaching hospitals is one of the enduring strengths of medical education. Teaching hospitals have recently faced significant challenges, with increasing specialisation of services and workload pressures reducing clinical learning opportunities. New clinical teaching environments have been established in Australia, particularly in rural and regional areas; these are proving to be ideal contexts for student learning. The new clinical teaching environments have shown the importance of developing symbiotic relationships between universities and health services. Symbiotic clinical learning is built around longitudinal, patient-based learning emphasising priority health concerns. The symbiotic framework provides a basis for reconstructing clinical teaching in teaching hospitals so th@they continue to play a vital role in Australian medical education, with additional clinical experience provided by primary care and community, rural and regional hospitals. PMID:22509881

Ash, Julie K; Walters, Lucie K; Prideaux, David J; Wilson, Ian G

2012-04-16

322

Determining the quality of educational climate across multiple undergraduate teaching sites using the DREEM inventory  

Microsoft Academic Search

BACKGROUND: Our obstetrics and gynaecology undergraduate teaching module allocates 40–50 final year medical students to eight teaching hospital sites in the West Midlands region. Based on student feedback and concerns relating to the impact of new curriculum changes, we wished to objectively assess whether the educational environment perceived by students varied at different teaching hospital centres, and whether the environment

Rajesh Varma; Ekta Tiyagi; Janesh K Gupta

2005-01-01

323

Teaching Heritage  

NSDL National Science Digital Library

Subtitled "a professional development Website for teachers," Teaching Heritage is an impressive collection of information and resources for teaching Australian history and culture. There are eight main sections to the site: four offer teaching resources and four provide teaching units. The resource sections include an examination of different ways of defining heritage, an Australian heritage timeline, discussions of different approaches to teaching heritage through media, and outcomes-based approaches in teaching and assessing heritage coursework. The teaching units deal in depth with issues of citizenship, nationalism, Australian identities, and new cultural values. A Heritage Gallery features images of various culturally significant or representative places in Australia, such as New Italy, the Dundullimal Homestead, Australian Hall, Kelly's Bush, and many more. Obviously, teachers of Civics on the southern continent will find this site extremely useful, but the teaching units -- rich with texts and images -- also offer fascinating introductions for anyone interested in the issues of Australian nation-making.

324

Teaching Artistry  

ERIC Educational Resources Information Center

The profession of teaching artist is an increasingly accepted career path. Teaching artists have generated plentiful testimonials to support what was once only backed up by anecdote and is now increasingly supported by objective data. They are finding that very definite and specific benefits await the artist who teaches. While the impacts are not…

Reeder, Laura

2007-01-01

325

Community hospital versus tertiary hospital comparison in the treatment and outcome of patients with acute coronary syndrome: a New Zealand experience  

Microsoft Academic Search

Aims To compare the baseline characteristics, use of evidence-based medications, rate of revascularisation, and mortality of acute coronary syndrome (ACS) patients managed in a community hospital (Invercargill Hospital) without, and a tertiary teaching hospital (Dunedin Hospital) with, catheterisation and an interventional facility. Methods All patients with ACS admitted into Dunedin and Invercargill coronary care units (CCUs) between 2000-2002 inclusive were

Eng Wei Tang; Cheuk-Kit Wong; Peter Herbison

326

Hospital ownership type and treatment choices.  

PubMed

In the face of increasing health care costs, taxing not-for-profit hospitals may be seen as the right choice to increase government revenues if not-for-profit hospitals are not different from their for-profit counterparts. This study investigates how hospital ownership type affects treatment choices to show whether ownership type and teaching status are correlated with choosing a procedure as the treatment and how these choices relate to patient insurance type. Not-for-profit hospitals significantly differ from for-profits in terms of treatment choices of less profitable patients and all hospitals are more likely to accord the procedure when the patient is privately insured than uninsured though teaching government hospitals are the most likely to accord the procedures for all insurance types. Considering treatment choices, not-for-profit hospitals have different objectives than for-profit and government hospitals and in terms of profit-seeking behavior, not-for-profit hospitals seem to lie between for-profit and government hospitals. PMID:22425769

Bayindir, Esra Eren

2012-03-01

327

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery  

E-print Network

to provide comprehensive leadership in developing and executing nursing care strategies in support in the areas of nursing care; quality assurance; case management and throughput; service excellence; nursing/Duties: Develop, implement and support nursing care in alignment with the VTH vision, mission, values

328

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery  

E-print Network

related procedures such as bandaging, bladder expression, and therapy and assistance carts. o Maintain of the VTH and will assist with treatments, instruction, and organization of patients being seen for rehabilitation therapies. This person performs exams, develops plan of care, directly provides rehabilitation

Birner, Thomas

329

Hospital fundamentals.  

PubMed

Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID:24918827

Althausen, Peter L; Hill, Austin D; Mead, Lisa

2014-07-01

330

Use of the Xpert(R) MTB/RIF assay for diagnosing pulmonary tuberculosis comorbidity and multidrug-resistant TB in obstetrics and gynaecology inpatient wards at the University Teaching Hospital, Lusaka, Zambia  

PubMed Central

OBJECTIVES In high-tuberculosis (TB)-endemic countries, comorbidity of pulmonary TB in hospitalised patients with non-communicable diseases is well documented. In this study, we evaluated the use of the Xpert® MTB/RIF assay for the detection of concomitant pulmonary TB in patients admitted to the University Teaching Hospital, Lusaka, Zambia, with a primary obstetric or gynaecological condition. METHODS The Study population were inpatients admitted with a primary obstetric or gynaecological problem who had a concomitant cough and were able to expectorate a sputum sample. Sputum samples from 94 patients were analysed for the presence of Mycobacterium tuberculosis (M.tb) by standard smear microscopy, MGIT culture, MGIT drug-susceptibility testing (DST) and the Xpert® MTB/RIF assay. The sensitivity and specificity of the Xpert® MTB/RIF assay were evaluated against the culture gold standard. RESULTS Twenty-six of 94 (27.7%) patients had culture-confirmed pulmonary TB. The Xpert® MTB/RIF assay had a sensitivity of 80.8% [95% CI: 60.0–92.7%]) compared against MGIT culture. The Xpert® MTB/RIF assay was more sensitive than sputum smear microscopy (21/26 (80.8%) vs. 13/26 (50.0%), P = 0.02) and detected an additional eight culture-confirmed cases. Culture DST analysis identified two monoresistant M.tb strains: one resistant to rifampicin (rifampicin sensitive by the Xpert® MTB/RIF assay) and one to ethambutol. HIV infection was linked with a 3-fold increase in risk of TB, accounting for 87.5% (21/24) of TB cases. 50% of cases presented as comorbidities with other communicable diseases (CDs) and non-communicable diseases (NCDs). CONCLUSIONS As an alternative to sputum microscopy, the Xpert® MTB/RIF assay provides a sensitive, specific and rapid method for the diagnosis of pulmonary TB in obstetric or gynaecological inpatients. Pulmonary TB is an important cause of concomitant comorbidity to the obstetric or gynaecological condition necessitating admission. TB and HIV comorbidities with other communicable and non-communicable diseases were also common. More proactive screening for TB comorbidity is required in obstetric and gynaecological wards. PMID:23834035

Bates, Matthew; Ahmed, Yusuf; Chilukutu, Lophina; Tembo, John; Cheelo, Busiku; Sinyangwe, Sylvester; Kapata, Nathan; Maeurer, Markus; O'Grady, Justin; Mwaba, Peter; Zumla, Alimuddin

2013-01-01

331

Teaching Chemical Engineers about Teaching  

ERIC Educational Resources Information Center

The Chemical and Biomolecular Engineering Department at The Ohio State University in collaboration with the University Center for the Advancement of Teaching developed the Chemical Engineering Mentored Teaching Experience. The Mentored Teaching Experience is an elective for Ph.D. students interested in pursuing faculty careers. Participants are…

Heath, Daniel E.; Hoy, Mary; Rathman, James F.; Rohdieck, Stephanie

2013-01-01

332

Teaching Morally and Teaching Morality  

ERIC Educational Resources Information Center

In this article, the authors introduce what they believe is an important distinction between teaching morality and teaching morally. In P-12 schools, the moral education debate often focuses on character education programs or other moral curricula. Such programs and curricula are championed as a means of teaching morality and transmitting moral…

Fenstermacher, Gary D.; Osguthorpe, Richard D.; Sanger, Matthew N.

2009-01-01

333

Mexican hospitals.  

PubMed

In order to understand current medical and hospital care in Mexico, we need to know first their past and then compare that past to their present situation. We can attempt to glimpse into what their future should be. The evolution of Mexican health services from the time of the Spanish Conquest until the the post-revolutionary period involved the creation of hospitals for both the poor and the rich. This continues to be the present goal. Public and private medical institutions evolved in part along with the legal reforms that were enacted through the passage of the Reform Laws in 1937. The Public Assistance Secretariat was established, which was dedicated to assist hospitals, nurseries, asylums and orphanages. In 1943, this Public Assistance Secretariat joined with the Public Health Department, forming what today is the actual Secretary of Health. The formation of private social health care for major medical needs together with governmental Social Security Health Care brought about a radical improvement in medical and hospital care; however, it is insufficient, overpopulated and outdated. It will be necessary during the coming decades that other alternatives to the models of hospitals and medical care that exist today in Mexico be enacted. The present models have not been able to satisfy the medical and hospital demands for present-day needs of the population. PMID:20433794

Loyo-Varela, Mauro; Díaz-Chazaro, Horacio

2009-01-01

334

Assessing and Managing Caregiver Stress: Development of a Teaching Tool for Medical Residents  

ERIC Educational Resources Information Center

Forty medical residents from major teaching hospitals in Boston, Massachusetts, participated in small group teaching sessions about caregiver stress. A teaching tool was developed that included a teaching handout, interactive cases, standard instruments for assessing caregiver stress, peer-reviewed articles about caregiving, and a list of…

Famakinwa, Abisola; Fabiny, Anne

2008-01-01

335

Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results  

Microsoft Academic Search

OBJECTIVE--To determine the circumstances, incidence, and outcome of cardiopulmonary resuscitation in British hospitals. DESIGN--Hospitals registered all cardiopulmonary resuscitation attempts for 12 months or longer and followed survival to one year. SETTING--12 metropolitan, provincial, teaching, and non-teaching hospitals across Britain. SUBJECTS--3765 patients in whom a resuscitation attempt was performed, including 927 in whom the onset of arrest was outside the hospital.

H. Tunstall-Pedoe; L. Bailey; D. A. Chamberlain; A. K. Marsden; M. E. Ward; D. A. Zideman

1992-01-01

336

Treatment of patients with acute myocardial infarction at a veterans affairs (VA) hospital and a non-VA hospital  

Microsoft Academic Search

Comparisons of care in Veterans Affairs (VA) hospitals with care in non-VA hospitals are needed to define the future role\\u000a of the VA health care system. Therefore, the authors conducted a retrospective cohort study of 385 patients who had acute\\u000a myocardial infarctions and were admitted to a private nonprofit teaching hospital and to a university-affiliated VA hospital,\\u000a which were staffed

Gary E. Rosenthal; Denise J. Larimer; Kerry E. Owens

1994-01-01

337

CLINICAL/HOSPITAL VOLUNTEER CONTACTS Local Hospitals  

E-print Network

CLINICAL/HOSPITAL VOLUNTEER CONTACTS Local Hospitals: Crouse Hospital Pennie Stagnitta (315) 470 Rhonda M. Butler (315) 464-5180 ButlerR@upstate.edu http://www.upstate.edu/hospital/volunteers/ VA University Hospital at Community General http://www.cgh-home.org/ St. Joseph's Hospital Health Center http

McConnell, Terry

338

Hospitality Menu Royal Infirmary of Edinburgh Hospital  

E-print Network

Hospitality Menu ­ Royal Infirmary of Edinburgh Hospital Version 4 Updated March 2013 BOOKING PROCEDURE CONTACT DETAILS When requesting hospitality from the catering department any written, faxed for conference/meeting support. Hospitality Office 0131 242 7051 / 7052 Hospitality e-mail rie.hospitality

Maizels, Rick

339

The internal organization of hospitals: a descriptive study.  

PubMed Central

This study presents descriptive information on several dimensions of the internal organization of hospitals, with particular emphasis on medical staff, using data from two unique national surveys. Three alternative theories of hospital behavior by economists are described and evaluated with these data. The study also shows how standard bed size, teaching, and ownership categories relate to important features of hospital organization. In this way, understanding of these standard "control" variables is enhanced. For example, systematic organizational differences between proprietary and other hospitals are reported, holding bed size and teaching status constant. No single theory of hospital behavior emerges as dominant. The tables demonstrate the diversity of hospitals and the likelihood that no single model can adequately describe the behavior of all hospitals. PMID:7204062

Sloan, F A

1980-01-01

340

Multidimensional Teaching  

ERIC Educational Resources Information Center

Multidimensional mathematics teaching, as discussed in this article encourages the use of context in mathematics teaching and learning to help teachers better recognize and build upon the cultural and social resources students bring to the classroom. Such efforts can impact students' performance and can help students make sense of decisions…

Berry, Robert Q., III; Ellis, Mark W.

2013-01-01

341

Team Teaching.  

ERIC Educational Resources Information Center

Recounts one Montessori teacher's experience team teaching in a secondary Montessori classroom. Illustrates how a conflict over decision making with a co-teacher helped to create better relationships with students in the classroom and better communication on the teaching team. Contends that resolving issues of conflict between teachers is vital…

Fisher, Stephen

2003-01-01

342

Rational Teaching.  

ERIC Educational Resources Information Center

The recognition of teaching as a special relationship among individuals is currently being overlooked in much contemporary educational research and policymaking. The author examines the philosophy of rationality in teaching and relates it to the educational vision presented in George Orwell's novel, "Nineteen Eighty-Four." (CB)

Macmillan, C. J. B.

1985-01-01

343

[Teaching Improvement].  

ERIC Educational Resources Information Center

The theme of this Indiana University-Bloomington newsletter is campus teaching improvement. Anya Royce outlines efforts of the Dean of Faculties Office to help improve teaching overall and especially the training of graduate student instructors, called associate instructors (AIs). Training AIs in three departments is described: Cathy Pons for…

Campus Report, 1987

1987-01-01

344

Academic Hospitality  

ERIC Educational Resources Information Center

Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

Phipps, Alison; Barnett, Ronald

2007-01-01

345

Quality Communication in Hospitality: Language Skills or Culture Transfer?  

ERIC Educational Resources Information Center

This paper focuses on English language teaching for the hospitality industry in Hong Kong, presenting a brief statement on the concept of transfer and its relevance to teaching English as a Foreign Language (EFL) for the world of work. The observable changes in the nature of language in the world of work in a service-oriented economy are…

Leung, Peggy; Lo, Terence

346

Clinical/Hospital Volunteer Contacts Local Hospitals  

E-print Network

Clinical/Hospital Volunteer Contacts Local Hospitals: Crouse Hospital Pennie Stagnitta Reverend Center - http://www.schcny.com/volunteers/ Community General Hospital - http://cgh-home.org/site2/index.php?option=com_content&view=article&id=86&Itemid=57 St. Joseph's Hospital Health Center - http://www.sjhsyr.org/sjhhc/stj_about_8.asp

Kovalev, Leonid

347

Midwife Learns Lessons as a Hospital Patient  

PubMed Central

After her first-time experience as a patient in a hospital, a midwife and childbirth educator reflects on the vulnerability and dependence of women who undergo operative birth. Continuous support for these women during the early postpartum period is imperative. Childbirth educators are encouraged to advocate for these women's needs and to teach them how to advocate for themselves. PMID:19436416

Rosensweig, Nancey

2008-01-01

348

Going to Jail: Finding Hospitable Space.  

ERIC Educational Resources Information Center

Describes how a teacher achieved professional renewal through teaching adult education class in a federal prison. Notes that it may be easier to create hospitable space and a sense of community in an inmate classroom than in any other kind. (RS)

Wenzel, Judy

1990-01-01

349

Effect of Residents' Use of Laboratory Tests on Hospital Costs.  

ERIC Educational Resources Information Center

The extent to which laboratory investigation by interns and residents could be considered "excessive" on general medical floors at a teaching hospital is assessed. The ordering of tests by attending physicians was compared with that of residents at the Royal Victoria Hospital, Montreal, Canada. (MLW)

Boice, John L.; McGregor, Maurice

1983-01-01

350

Predictors of Medication Errors Among Elderly Hospitalized Patients  

Microsoft Academic Search

Medication errors are a serious safety concern and most errors are preventable. A retrospective study design was employed to describe medication errors experienced during 10187 hospitalizations of elderly patients admitted to a Midwest teaching hospital between July 1, 1998 and December 31, 2001 and to determine the factors predictive of medication errors. The model considered patient characteristics, clinical conditions, interventions,

Debra Matsen Picone; Marita G. Titler; Joanne Dochterman; Leah Shever; Taikyoung Kim; Paul Abramowitz; Mary Kanak; Rui Qin

2008-01-01

351

Depressed Mood and Survival in Seriously Ill Hospitalized Adults  

Microsoft Academic Search

Objectives: To assess the relationship among depressed mood, physical functioning, and severity of illness and to determine the relationship between depressed mood and survival time, controlling for severity of illness, baseline functioning, and characteristics of patients. Methods: Prospective cohort study of data for 3529 se- riously ill hospitalized adults who received care at 5 ter- tiary care teaching hospitals and

Mary Joan Roach; Alfred F. Connors; Neal V. Dawson; Neil S. Wenger; Albert W. Wu; Joel Tsevat; Norman Desbiens; Kenneth E. Covinsky; Daniel S. P. Schubert

1998-01-01

352

Incidence of hospital-acquired infections associated with caesarean section  

Microsoft Academic Search

A retrospective cohort study was conducted to determine the incidence of post-caesarean infections in a Canadian community teaching hospital using computer algorithms designed for the diagnosis of nosocomial infections. Inferential chart review was done on 1335 women delivered by lower-segment caesarean section (793 primary and 542 secondary) at the Calgary General Hospital between January 1985 and April 1988. The overall

E. Henderson; E. J. Love

1995-01-01

353

Teaching Aids  

ERIC Educational Resources Information Center

Provides evaluations of several aids for teaching chemistry. Included are The Use of Chemical Abstracts, Practical Technical Writing, Infrared Spectroscopy Programs, and a film titled "You Can't Go Back." (RH)

Barnard, W. Robert, Ed.

1976-01-01

354

Teaching Materials  

ERIC Educational Resources Information Center

A review of teaching materials, including filmstrips on writing skills, on Hawthorne, Melville, and Poe; and a review of paperback series on Black literature and contemporary literature--all geared primarily to grades seven through twelve. (JB)

Early, Margaret; Searles, John R.

1971-01-01

355

Nursing-related patient safety events in hospitals  

Microsoft Academic Search

Summary  To explore the method of identifying nursing-related patient safety events, types, contributing factors and evaluate consequences\\u000a of these events in hospitals of China, incident report program was established and implemented in 15 patient units in two\\u000a teaching hospitals of China to get the relevant information. Among 2935 hospitalized patients, 141 nursing-related patient\\u000a safety events were reported by nurses. Theses events

Yilan Liu; Guanghong Zhao; Fen Li; Xingzhi Huang; Deying Hu; Juan Xu; Shanglong Yao; Liang Zhang

2009-01-01

356

Effect of reactive pharmacy intervention on quality of hospital prescribing  

Microsoft Academic Search

OBJECTIVE--To evaluate the medical impact of reactive pharmacy intervention. DESIGN--Analysis of all interventions during 28 days by all 35 pharmacists in hospitals in Nottingham. SETTING--All (six) hospitals in the Nottingham health authority (a teaching district), representing 2530 mainly acute beds, 781 mental illness beds, and 633 mainly health care of the elderly beds. PATIENTS--Hospital inpatients and outpatients. INTERVENTIONS--Recording of every

C J Hawkey; S Hodgson; A Norman; T K Daneshmend; S T Garner

1990-01-01

357

Pattern of ophthalmological accidents and emergencies presenting to hospitals  

Microsoft Academic Search

STUDY OBJECTIVE--To investigate the numbers and characteristics of patients with ophthalmological accidents and emergencies presenting to hospitals. DESIGN--Prospective survey over eight weeks. SETTING--Two general and one ophthalmic accident and emergency departments, two general outpatient departments, and an eye hospital ward consulting room (all in two teaching hospitals) in Newcastle upon Tyne. MEASUREMENTS AND MAIN RESULTS--Consultation numbers by age, sex, health

R S Bhopal; D W Parkin; R F Gillie; K H Han

1993-01-01

358

Teaching Resource Guide Center for Teaching Excellence  

E-print Network

Teaching Resource Guide 2013-2014 Center for Teaching Excellence Office of Undergraduate Studies for Teaching Excellence Reproduce with permission only Center for Teaching Excellence, University of Maryland, 2301 Marie Mount Hall, College Park, MD 20742 #12;1 Teaching Resource Guide August 2013 Welcome

Aydilek, Ahmet

359

Adult Partial Hospitalization JOHN DEMPSEY HOSPITAL  

E-print Network

Adult Partial Hospitalization Program JOHN DEMPSEY HOSPITAL CONTACT US For further information.uchc.edu. The Adult Partial Hospitalization Program is available Monday through Friday from 9 a.m. to 2:05 p.m. OUR LOCATION AND DIRECTIONS The Adult Partial Hospitalization Program is located on the 5th floor of the John

Oliver, Douglas L.

360

“Bridging the gap” between hospitality management programmes and the private club industry  

Microsoft Academic Search

The private club industry is undergoing major change as it forges new links with academia in the areas of research, teaching and management development. This bodes well for hospitality management programmes. Indeed, the primary mission of most hospitality programmes in North America includes the dissemination of information in ways that will translate into tangible benefits for the greater hospitality industry.

Clayton W. Barrows; John Walsh

2002-01-01

361

Factors critical to the success of a Six-Sigma quality program in an Australian hospital  

Microsoft Academic Search

While there is substantial evidence from manufacturing industries, there is limited empirical evidence demonstrating the relationship between factors associated with a Six-Sigma quality program and the performance of organisations in the health sector. In this paper we examine this relationship, drawing on data obtained from the Royal Victorian Eye & Ear Hospital. The hospital is an acute tertiary teaching hospital

Roger Hilton; Margaret Balla; Amrik S. Sohal

2008-01-01

362

An Epidemiologic Study on Aging and Dysphagia in the Acute Care Hospitalized Population: 2000–2007  

Microsoft Academic Search

Objectives: To describe total and yearly demographic trends relative to aging, dysphagia referral rates and oral feeding status in hospitalized patients from 2000 through 2007. Methods: We evaluated a prospective, consecutive, referred sample of 4,038 hospitalized patients in an urban, tertiary, acute care teaching hospital. Dysphagia referral rates are described according to year, age (decade), sex, admitting diagnostic category, results

Steven B. Leder; Debra M. Suiter

2009-01-01

363

On Teaching.  

ERIC Educational Resources Information Center

This collection of lectures includes the following contributions from faculty at the University of Colorado at Boulder: (1) "Aloof Professors and Shy Students" (Patricia Nelson Limerick); (2) "Teaching the Thundering Herd: Surviving in a Large Classroom" (Charles R. Middleton); (3) "The Scientist as a Story Teller" (R. Igor Gamow); (4) "Active…

Shea, Mary Ann, Ed.

364

Teaching Roberto  

Microsoft Academic Search

This paper is a case study in the form of a teacher's personal diary of experiences during a semester teaching a class of academically at-risk high school students. It focuses on the interactions among the teacher, the class, and Roberto, a student with negligible English skills. Because of his lack of proficiency in English, discovered later, Roberto began the semester

Michael Courtney

2005-01-01

365

Teaching Tennis  

ERIC Educational Resources Information Center

This article describes an approach to teaching the basic skills of tennis to students in grades 4 and 5. It relates a five-lesson unit suitable to a near-weekly class schedule. The author found it effective when seeing his students as infrequently as once every four days for fifty minutes.

Breag, Daniel

2005-01-01

366

Teaching Symbiosis.  

ERIC Educational Resources Information Center

Argues that the meaning of the word "symbiosis" be standardized and that it should be used in a broad sense. Also criticizes the orthodox teaching of general principles in this subject and recommends that priority be given to continuity, intimacy, and associated adaptations, rather than to the harm/benefit relationship. (Author/JN)

Harper, G. H.

1985-01-01

367

Teaching Integrity  

ERIC Educational Resources Information Center

Articles about academic honesty seem either to begin with an example of egregious deceit in American schools or to claim that dishonesty is worse than ever. However great may be the forces influencing students to lie or cheat, educators, at all levels and in all settings, must push back by holding students accountable and by teaching about…

Dichtl, John

2003-01-01

368

Teaching Strings.  

ERIC Educational Resources Information Center

Intended primarily for use by instrumental music teachers who do not have a major concentration in strings, this guide provides pertinent basic resources, materials, teaching--learning expectation, and a general overall guide to achievement levels at various stages of development. Discussions are presented of Choosing the Proper Method Book,…

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

369

A Practicum for Oral Cancer Teaching.  

ERIC Educational Resources Information Center

A hospital-based method for teaching general practice dental residents, involving patients for whom the residents are responsible, is described. Residents present prepared cases of dental patients according to a predetermined protocol: a talk, complete documentation of clinical history and laboratory findings, and discussion of therapy and…

Barr, Charles E.; Goldberg, Marshal D.

1983-01-01

370

Teaching War Literature, Teaching Peace  

ERIC Educational Resources Information Center

This article explores literature taught in three different courses and the peace education approaches used for each, including epics in literature courses, Vietnam War literature, and literature of anger and hope. The author recommends the teaching of war literature as an essential part of a peace education curriculum. Devastating events such as…

Powers, Janet M.

2007-01-01

371

MASSACHUSETTS GENERAL HOSPITAL  

E-print Network

MASSACHUSETTS GENERAL HOSPITAL Page 1 of 4 HARVARD MEDICAL SCHOOL Position: Quality & Safety and efficacy of our practice, reporting this data out to department clinicians, senior leadership and hospital hospital and department groups, exceptional interpersonal, communication, project organization, time

Adams, Mark

372

Latex allergies - for hospital patients  

MedlinePLUS

Latex products - hospital; Latex allergy - hospital; Latex sensitivity - hospital ... Common hospital items that may contain latex include: Surgical and exam gloves Catheters and other tubing Sticky tape or ...

373

The effects of hospital-physician integration strategies on hospital financial performance.  

PubMed Central

STUDY QUESTION. This study investigated the longitudinal relations between hospital financial performance outcomes and three hospital-physician integration strategies: physician involvement in hospital governance, hospital ownership by physicians, and the integration of hospital-physician financial relationships. DATA SOURCES AND STUDY SETTING. Using secondary data from the State of California, integration strategies in approximately 300 California short-term acute care hospitals were tracked over a ten-year period (1981-1990). STUDY DESIGN. The study used an archival design. Hospital performance was measured on three dimensions: operational profitability, occupancy, and costs. Thirteen control variables were used in the analyses: market competition, affluence, and rurality; hospital ownership; teaching costs and intensity; multihospital system membership; hospital size; outpatient service mix; patient volume case mix; Medicare and Medicaid intensity; and managed care intensity. DATA COLLECTION/EXTRACTION. Financial and utilization data were obtained from the State of California, which requires annual hospital reports. A series of longitudinal regressions tested the hypotheses. PRINCIPAL FINDINGS. Considerable variation was found in the popularity of the three strategies and their ability to predict hospital performance outcomes. Physician involvement in hospital governance increased modestly from 1981-1990, while ownership and financial integration declined significantly. Physician governance was associated with greater occupancy and higher operating margins, while financial integration was related to lower hospital operating costs. Direct physician ownership, particularly in small hospitals, was associated with lower operating margins and higher costs. Subsample analyses indicate that implementation of the Medicare prospective payment system in 1983 had a major impact on these relationships, especially on the benefits of financial integration. CONCLUSIONS. The findings support the validity of hospital-physician financial integration efforts, and to a lesser extent the involvement of physicians in hospital governance. The results lend considerably less support for strategies built around direct physician ownership in hospitals, particularly since PPS implementation. RELEVANCE/IMPACT. These findings challenge prior studies that found few financial benefits to hospital-physician integration prior to PPS implementation in 1983. The results imply that financial benefits of integration may take several years after implementation to emerge, are most salient in a managed care or managed competition environment, and vary by hospital size and multihospital system membership. PMID:7591779

Goes, J B; Zhan, C

1995-01-01

374

Teaching Math  

NSDL National Science Digital Library

Four courses, one at each NCTM grade band (Pre-K-2, 3-5, 6-8, and 9-12), help teachers develop effective ways to use the five NCTM Process Standards to teach all students. The goals of the courses are: to increase understanding of the NCTM process standards; to model effective application of the process standards and their integration with content goals; to help teachers develop habits and practices that improve their teaching and strengthen their students' mathematical process and content skills. Text, illustrations, animations, video, and interactive activities are used to present the material. The courses may be used in various scenarios, e.g., as a self-paced course, in a facilitated online mode, in a face-to-face course or workshop.

Boston, Wgbh

2003-01-01

375

Teaching Engineering  

NSDL National Science Digital Library

Purdue University has one of the strongest schools of engineering in the United States, and they remain committed to providing new and interesting materials about the art and science of teaching engineering to their students. Professors Phillip C. Wankat and Frank S. Oreovicz recently created this very helpful textbook to aid engineering educators in the classroom, and it is exciting to see that it is available online here for free. Visitors can download the entire book, or they can just browse around through some of the seventeen chapters. These chapters include "Problem Solving and Creativity", "Lectures", and "Learning Theories". Additionally, there are several helpful appendices, such as "Obtaining an Academic Position" and "Sample Teaching Course Outline". Overall, it's an exemplary resource, and one that will be most useful to engineering educators. These materials can be used in a variety of engineering courses, including those that deal with chemical and mechanical engineering.

376

Teaching Standards  

NSDL National Science Digital Library

The Standards vision guides the discussion in this chapter on science teaching standards for the postsecondary level. The discussion centers on the importance of goal setting, designing experiences to meet students' needs, assessment, and collegiality. There is a strong recommendation that students be given opportunities to engage in meaningful scientific inquiry--to ask scientific questions, design experiments to collect evidence, and make critical interpretations of observations. This free selection includes an Introduction and Table of Contents.

2001-01-01

377

Teaching Medicine to Non-English Speaking Background Learners in a Foreign Country  

Microsoft Academic Search

Teaching abroad exposes medical educators to unfamiliar teaching methods and learning styles that can enhance their overall\\u000a teaching repertoire. Based on the author’s experience teaching residents for one month at a community hospital in Japan and\\u000a a review of the non-English speaking background (NESB) educational literature, pedagogical principles and lessons for successful\\u000a international NESB instruction are outlined. These methods include

Gurpreet Dhaliwal

2009-01-01

378

Safe working practices and HIV infection: knowledge, attitudes, perception of risk, and policy in hospital  

Microsoft Academic Search

OBJECTIVES--To assess the knowledge, attitudes, and perceptions of risk of occupational HIV transmission in hospital in relation to existing guidelines. DESIGN--Cross sectional anonymous questionnaire survey of all occupational groups. SETTING--One large inner city teaching hospital. SUBJECTS--All 1530 staff working in the hospital in October 1991 and 22 managers. MAIN MEASURES--Knowledge of safe working practices and hospital guidelines; attitudes towards patients

G Davidson; P Gillies

1993-01-01

379

Nosocomial Infections at Kenyatta National Hospital Intensive-Care Unit in Nairobi, Kenya  

Microsoft Academic Search

The objective of this study was to identify the common bacteria isolated from patients, antibiotics used, sensitivity patterns, therapeutic procedures and cleaning protocols practised in Kenyatta National Hospital Intensive-Care Unit (ICU). Kenyatta National Hospital is a 1,800-bed referral and tertiary-care hospital which is also the Teaching University Hospital. The ICU has 20 beds. Two members of staff, a consultant and

Z. W. W. Ngumi

2006-01-01

380

English Teaching Assistantships  

E-print Network

teaching, and teaching in elementary and secondary schools world- wide. · Was established in 1946 by the UEnglish Teaching Assistantships English Teaching Assistantships (ETAs) are offered in many Western Hemisphere For more information visit: http://us.fulbrightonline.org/thinking_teaching

Karonis, Nicholas T.

381

Children's Hospital Medical Center  

E-print Network

WherryHall Veterans Affairs Medical Center VAMC VAMC VAMC VAMC VAMC Holmes CHMC CHMC Children's HospitalUNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center Hoxworth Blood Center ShrinersHospital forChildren Shriners Garage Cincinnati Dept of Health Logan

Papautsky, Ian

382

The Young Hospitalized Child.  

ERIC Educational Resources Information Center

This literature review examines the effects of hospitalization on the young child and suggests ways in which parents and hospital personnel can protect children from the potentially harmful emotional and intellectual effects of hospitalization. The history of attitudes toward the hospitalization of children is discussed. Children's emotional…

Winters, Anne

383

Measuring Rural Hospital Quality  

ERIC Educational Resources Information Center

Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

2004-01-01

384

AS REPRESENTAÇÕES SOCIAIS DOS TRABALHADORES DE ENFERMAGEM NÃO ENFERMEIROS (TÉCNICOS E AUXILIARES DE ENFERMAGEM) SOBRE O TRABALHO EM UNIDADE DE TERAPIA INTENSIVA EM UM HOSPITAL-ESCOLA* SOCIAL REPRESENTATIONS OF ICU AUXILIARY NURSING PERSONNEL FROM A TEACHING HOSPITAL ABOUT THEIR PRACTICE LAS REPRESENTACIONES SOCIALES DEL PERSONAL NO ENFERMERO (TÉCNICOS Y AUXILIARES DE ENFERMERÍA) SOBRE EL TRABAJO EN UN CENTRO DE TERAPIA INTENSIVA EN UN HOSPITAL ECUELA  

Microsoft Academic Search

Shimizu HE, Ciampone MHT. As representações sociais dos trabalhadores de enfermagem não enfermeiros (técnicos e auxiliares de enfermagem) sobre o trabalho em Unidade Intensiva em um hospital-escola. Rev Esc Enferm USP 2002; 36(2): 148-55. RESUMO Este estudo tem como objetivos conhecer as representações sociais dos trabalhadores de enfermagem não enfermeiros acerca do trabalho na UTI, os modos de expressão do

Helena Eri Shimizu; Maria Helena Trench Ciampone

385

Two Integrated Teaching Buildings Two Integrated Teaching Buildings  

E-print Network

Draft Plan Two Integrated Teaching Buildings #12;Two Integrated Teaching Buildings Effort to avoid sightline and to reduce screening effect. #12;Two Integrated Teaching Buildings Perspective #12;Two Integrated Teaching Buildings Perspective #12;Two Integrated Teaching Buildings Perspective #12;Two

Huang, Jianwei

386

Teaching Fractions  

NSDL National Science Digital Library

This research guide provides suggestions for specialists and teachers looking to improve fraction instruction in their classrooms or schools. The guide starts with ideas for introducing fraction concepts in kindergarten and early elementary school and continues with activities and teaching strategies designed to help older students understand fraction magnitudes and computational procedures involving fractions. It then examines ways of helping students use fractions to solve rate, ratio, and proportion problems. Each recommendation includes a brief summary of supporting research and descriptions of classroom activities that can be used to implement the recommendation.

Fazio, Lisa; Siegler, Robert

2012-01-01

387

National Hospital Discharge Survey  

Cancer.gov

The National Hospital Discharge Survey (NHDS), which has been conducted annually since 1965, collects data from a sample of approximately 270,000 inpatient records acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days for all patients, general hospitals, or children's general hospitals are included in the survey. Information collected includes diagnoses, surgical and nonsurgical procedures, prescription and over-the-counter drugs, immunizations, allergy shots, anesthetics, and dietary supplements.

388

Children's Hospital and Health System  

MedlinePLUS

... Children's Hospital main campus Coming to Children's Hospital Fox Valley Billing and payments Compliments and concerns Medical ... of town? Locations Children's Hospital locations Milwaukee hospital Fox Valley hospital Primary care Specialty clinics Community services ...

389

76 FR 13515 - Medicare Program; Revisions to the Reductions and Increases to Hospitals' FTE Resident Caps for...  

Federal Register 2010, 2011, 2012, 2013

...Revisions to the Reductions and Increases to Hospitals' FTE Resident Caps for Graduate Medical...relating to the treatment of teaching hospitals that are members of the same Medicare...methodology for determining payments to hospitals for the direct costs of approved...

2011-03-14

390

[Quality assurance in student training. Prerequisites for DIN EN ISO 9001:2000 in teaching].  

PubMed

Standards of quality assurance according to DIN EN ISO 9001:2000 have been implemented in many university hospital departments, but often teaching activities are not included. This work presents a method that allows, after having defined the various teaching activities as sub-processes of one single core process, to include the manifold teaching activities of university hospital departments into the certification process. The stepwise description of the prerequisites for including teaching activities into ISO 9001 certification is illustrated by a concrete implementation example. PMID:17297598

Ochsner, W; Kaiser, C; Schirmer, U

2007-07-01

391

Does delirium contribute to poor hospital outcomes?  

Microsoft Academic Search

OBJECTIVE: To determine the independent contribution of admission delirium to hospital outcomes including mortality, institutionalization,\\u000a and functional decline.\\u000a \\u000a \\u000a DESIGN: Three prospective cohort studies.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Three university-affiliated teaching hospitals.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: Consecutive samples of 727 patients, aged 65 years and older.\\u000a \\u000a \\u000a \\u000a \\u000a MEASUREMENTS AND MAIN RESULTS: Delirum was present at admission in 88 (12%) of 727 patients. The main outcome measures at hospital

Sharon K. Inouye; Julia T. Rushing; Marquis D. Foreman; Robert M. Palmer; Peter Pompei

1998-01-01

392

The Chinese hospital.  

PubMed

The Chinese hospital serves three separate but overlapping functions. Like Western hospitals, the Chinese hospital provides patient care in a wide range of settings and with various levels of facilities. The Chinese hospital is also a danwei or work unit, that employs not only health care personnel, but also day-care teachers, builders, drivers, repairmen, and other auxiliary personnel. The third function is political and organizational. Hospital leaders act as local representatives of the Chinese Communist Party and the state, with jurisdiction over personal, professional, legal, and political activities of the workers in the hospital. PMID:6625391

Cohen, M S; Henderson, G E

1983-10-01

393

Academic Senate Distinguished Teaching  

E-print Network

1 UCLA Academic Senate 2011-2012 Distinguished Teaching Award Program #12;2 TABLE OF CONTENTS About the Distinguished Teaching Award Program 3 Eligibility 4 Criteria 4 Entry Instructions 5 Teaching Award Recipients 7 #12;3 ABOUT THE DISTINGUISHED TEACHING AWARD PROGRAM Purpose The goal of the UCLA Academic Senate

Grether, Gregory

394

Teaching or Learning?  

ERIC Educational Resources Information Center

This article, the 6th in a series of AAHE research reports, summarizes research on teaching and learning. Most studies on teaching methods conclude that there are no significant differences between the various teaching methods and student achievement. The problem with these studies is that they have concentrated on teaching and have ignored…

Milton, Ohmer

395

On Teaching. Volume II.  

ERIC Educational Resources Information Center

This collection of essays, which evolved from the Professional Lecture Series on Teaching and Learning and Instructional Workshops on Teaching and Learning held at the University of Colorado (Boulder), addresses a variety of styles and situations for teaching and learning. The following essays are included: (1) "Teaching as Architecture:…

Shea, Mary Ann, Ed.

396

Teaching Portfolios: Another Perspective.  

ERIC Educational Resources Information Center

Argues that teaching portfolios are time consuming and have not been shown to improve college faculty teaching skills. Raises some unanswered questions concerning teaching portfolios and reviews what is known about effective teaching at the college level. Suggests that constructing the portfolio often becomes the focus instead of instructional…

Candace W. Burns

2000-01-01

397

Post-exposure rate of tuberculosis infection among health care workers measured with tuberculin skin test conversion after unprotected exposure to patients with pulmonary tuberculosis: 6-year experience in an Italian teaching hospital  

PubMed Central

Background This study assesses the risk of LTBI at our Hospital among HCWs who have been exposed to TB patients with a delayed diagnosis and respiratory protection measures were not implemented. Methods All HCWs exposed to a patient with cultural confirmed pulmonary TB and respiratory protection measures were not implemented were included. Data on TST results performed in the past (defined as T0) were recorded. TST was performed twice: first, immediately after exposure to an index patient (T1) and three months later (T2). The period of time between T0 and T1 was used to calculate he annual rate of tuberculosis infection (ARTI), while le period of time between T1 and T2 was used to calculate the post exposure annual rate of tuberculosis infection (PEARTI). Results Fourteen index patients were admitted; sputum smear was positive in 7 (58.3%), 4 (28.6%) were non-Italian born patients. 388 HCWs were exposed to index patients, a median of 27 (12-39) HCW per each index patient. One hundred eighty (46.4%) HCWs received BCG in the past. One hundred twenty two HCWs (31%) were TST positive at a previous routine screening and not evaluated in this subset. Among the remaining 255 HCWs with negative TST test in the past, TST at T1 was positive in 11 (4.3%). ARTI was 1.6 (95% CI 0.9-2.9) per 100 PY. TST at T2 was positive in 9 (3.7%) HCWs, that were TST negative at T1. PEARTI was 26 (95% CI 13.6-50) per 100 PY. At univariate analysis, older age was associated with post exposure latent tuberculosis infection (HR 1.12; 95% CI 1.03-1.22, p=0.01). Conclusions PEARTI was considerably higher among HCWs exposed to index patients than ARTI. These data underscore the overwhelming importance of performing a rapid diagnosis, as well as implementing adequate respiratory protection measures when TB is suspected. PMID:24919953

2014-01-01

398

HOSPITALITY APPROVAL FORM DATE: __________________________  

E-print Network

) _____ Recruiting: Travel meals lodging for position candidates and prospective athletes. Not Advertising (See 62316HOSPITALITY APPROVAL FORM DATE: __________________________ PERMISSION IS REQUESTED TO USE & 62317 for advertising.) Hospitality form and participant list required for food over $30.00. (Account

Dyer, Bill

399

Surviving Your Child's Hospitalization.  

ERIC Educational Resources Information Center

The parent of a young child who required major open heart surgery shares his suggestions for coping with a young child's hospitalization including parent visitation, relating to the hospital staff, getting answers to questions, and utilizing available services. (DB)

Cohen, David A.

1988-01-01

400

The renewable hospital.  

PubMed

While medical technology and reimbursement policies continue to change, the hospitals that are supposed to change with them are increasingly outdated. In recent years, hospital architects have begun adopting designs aimed at preventing obsolescence. PMID:10127682

Stein, T

1993-01-01

401

Help prevent hospital errors  

MedlinePLUS

A hospital error is when there is a mistake in your medical care. Errors can be made in your: ... Surgery Diagnosis Equipment Lab and other test reports Hospital errors are a leading cause of death. Doctors ...

402

Virtual Pediatric Hospital  

MedlinePLUS

... PediatricEducation.org | GeneralPediatrics.com | Pediatric Commons Virtual Pediatric Hospital is a digital library of pediatric information and ... information for all students of medicine Virtual Naval Hospital - a digital library of naval medicine and military ...

403

Central line infections - hospitals  

MedlinePLUS

... and increase how long you are in the hospital. Your central line needs special care to prevent ... The hospital staff will use aseptic technique when a central line is put in your chest or arm. Aseptic ...

404

Implementation of antibiotic management teams in Belgian hospitals.  

PubMed

In 2002-03, the Belgian government subsidized in part the activities of local Antibiotic Managers (AMs) in 36 hospitals selected based on the presence of an operational multidisciplinary Antibiotic Management Team (AMT). AMs were trained as Internists (28), Microbiologists (13) and Hospital Pharmacists (13). The hospitals were representative of Belgian hospitals in affiliation, regional origin and size. The financing scheme allowed the implementation of 175 antibiotic management interventions, with a mean of 5 interventions/hospital. The activities reported in the first 9-month progress reports were analyzed according to national guidelines for AMTs. All hospitals irrespective of size or affiliation had undertaken a wide range of measures: review of formulary (29), implementation of new clinical guidelines (24), restricted access to selected antibiotics (25), improvement of antibiotic susceptibility testing methods (12), development of antibiotic consumption database (35) and analysis of antibacterial susceptibility data (31). Advertisement type categorization of communication methods showed that education of prescribers was based on multimodal communication. All hospitals used at least one passive method, 39% at least one active method and 55% at least one personalized method. The quality of communication was higher in hospitals with teaching affiliation. In conclusion, hospitals that received a fin