Abstract: The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.
Abstract: Plants as therapeutic agents are used as drug in many parts of the world. Medicinal plants are mostly used in developing countries due to culture acceptability, belief or due to lack of easy access to primary health care services. Jatropha curcas is a plant from the Euphorbiaceae family which is widely used in Northern Nigeria as an anti-diarrheal agent. This study was conducted to determine the anti-diarrheal effect of the leaf extract on castor oil induced diarrhea in albino rats. The leaves of J. curcas were collected from Balanga Local government in Gombe State, north-eastern Nigeria; due to its bioavailability. The leaves were air-dried at room temperature and ground to powder. Phytochemical screening was done and different concentrations of the extract was prepared and administered to the different categories of experimental animals. From the results, aqueous leaf extract of Jatropha curcas at doses of 200mg/Kg and 400mg/Kg was found to reduce the mean stool score as compared to control rats, however, maximum reduction was achieved with the standard drug of Loperamide (5mg/Kg). Treatment of diarrhea with 200mg/Kg of the extract did not produce any significant decrease in stool fluid content but was found to be significant in those rats that were treated with 400mg/Kg of the extract at 2hours (0.05±0.02) and 4hours (0.01±0.01). A significant reduction of diarrhea in the experimental animals signifies it to possess some anti-diarrheal activity.
Abstract: Healthcare waste management continues to present an
array of challenges for developing countries, and Liberia is of no
exception. There is insufficient information available regarding the
generation, handling, and disposal of health care waste. This face
serves as an impediment to healthcare management schemes. The
specific objective of this study is to present an evaluation of the
current health care management practices in Liberia. It also presented
procedures, techniques used, methods of handling, transportation, and
disposal methods of wastes as well as the quantity and composition
of health care waste. This study was conducted as an investigative
case study, covering three different health care facilities; a hospital, a
health center, and a clinic in Monrovia, Montserrado County. The
average waste generation was found to be 0-7kg per day at the clinic
and health center and 8-15kg per/day at the hospital. The composition
of the waste includes hazardous and non-hazardous waste i.e. plastic,
papers, sharps, and pathological elements etc. Nevertheless, the
investigation showed that the healthcare waste generated by the
surveyed healthcare facilities were not properly handled because of
insufficient guidelines for separate collection, and classification, and
adequate methods for storage and proper disposal of generated
wastes. This therefore indicates that there is a need for improvement
within the healthcare waste management system to improve the
existing situation.
Abstract: Introduction: To update ourselves and understand the
concept of latest electronic formats available for Health care
providers and how it could be used and developed as per standards.
The idea is to correlate between the patients Manual Medical Records
keeping and maintaining patients Electronic Information in a Health
care setup in this world. Furthermore, this stands with adapting to the
right technology depending upon the organization and improve our
quality and quantity of Healthcare providing skills. Objective: The
concept and theory is to explain the terms of Electronic Medical
Record (EMR), Electronic Health Record (EHR) and Personal Health
Record (PHR) and selecting the best technical among the available
Electronic sources and software before implementing. It is to guide
and make sure the technology used by the end users without any
doubts and difficulties. The idea is to evaluate is to admire the uses
and barriers of EMR-EHR-PHR. Aim and Scope: The target is to
achieve the health care providers like Physicians, Nurses, Therapists,
Medical Bill reimbursements, Insurances and Government to assess
the patient’s information on easy and systematic manner without
diluting the confidentiality of patient’s information. Method: Health
Information Technology can be implemented with the help of
Organisations providing with legal guidelines and help to stand by
the health care provider. The main objective is to select the correct
embedded and affordable database management software and
generating large-scale data. The parallel need is to know how the
latest software available in the market. Conclusion: The question lies
here is implementing the Electronic information system with
healthcare providers and organization. The clinicians are the main
users of the technology and manage us to “go paperless”. The fact is
that day today changing technologically is very sound and up to date.
Basically, the idea is to tell how to store the data electronically safe
and secure. All three exemplifies the fact that an electronic format
has its own benefit as well as barriers.
Abstract: The research aims to investigate the occurrence of
multidrug-resistant Acinetobacter, in carrot and estimate the role of
carrot in its transmission in a rapidly growing urban population.
Thus, 50 carrot samples were collected from Jakara wastewater
irrigation farms and are analyzed on MacConkey agar and screened
by Microbact 24E (Oxoid) and susceptibility of isolates is tested
against 10 commonly used antibiotics. Acinetobacter baumannii and
A. lwoffii were isolated in 22.00% and 16% of samples respectively.
Resistance to ceporex and penicillin of 36.36% and 27.27% in A.
baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and
co-trimoxazole were observed. However, for A. lwoffii apart from
37.50% resistance to ceporex, it was also resistant to all other drugs
tested. There were similarities in the resistances shown by A.
baumannii and A. lwoffii to fluoroquinolones and β- lactame drug
families in addition to between sulfonamide and animoglycoside
demonstrated by A. lwoffii. Significant correlation in similarities were
observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%)
A. baumannii and A. lwoffii respectively and high multi drug
resistance (MDR) of 27.27% and 62.50% by A. baumannii and A.
lwoffii respectively. The occurrence of multidrug-resistance pathogen
in carrot is a serious challenge to public health care, especially in a
rapidly growing urban population where subsistence agriculture
contributes greatly to urban livelihood and source of vegetables.
Abstract: The health care must be a right for people around the
world, but in order to guarantee the access to all, it is necessary to
overcome geographical barriers. Telemedicine take advantage of
Information Communication Technologies to deploy health care
services around the world. To achieve those goals, it is necessary to
use existing last mile solution to create access for home users, which
is why is necessary to establish the channel characteristics for those
kinds of services. This paper presents an analysis of network
performance of last mile solution for the use of IPTV broadcasting
with the application of streaming for telemedicine apps.
Abstract: Urinary Tract Infections are considered as one of the
most common bacterial infections with an estimated annual global
incidence of 150 million. Antimicrobial drug resistance is one of the
major threats due to wide spread usage of uncontrolled antibiotics. In
this study, a total number of 9149 urine samples were collected from
R.H Patiala and processed in the Department of Microbiology G. M.
C Patiala (January 2013 to December 2013). Urine samples were
inoculated on MacConkey’s and blood agar plates and incubated at
370C for 24 hrs. The organisms were identified by colony characters,
Gram’s staining, and biochemical reactions. Antimicrobial
susceptibility of the isolates was determined against various
antimicrobial agents (Hi – Media Mumbai India) by Kirby Bauer
DISK diffusion method on Muller Hinton agar plates. Maximum patients were in the age group of 21-30 yrs followed by
31-40 yrs. Males (34%) are less prone to urinary tract infections than
females (66%). Culture was positive in 25% of the samples.
Escherichia coli was the most common isolate 60.3% followed by
Klebsiella pneumoniae 13.5%, Proteus spp. 9% and Staphylococcus
aureus 7.6%. Most of the urinary isolates were sensitive to,
carbepenems, Aztreonam, Amikacin, and Piperacillin + Tazobactum.
All the isolates showed a good sensitivity towards Nitrofurantoin
(82%). ESBL production was found to be 70.6% in Escherichia coli
and 29.4% in Klebsiella pneumonia. Susceptibility of ESBL
producers to Imipenem, Nitrofurantoin and Amikacin were found to
be 100%, 76%, and 75% respectively. Uropathogens are increasingly
showing resistance to many antibiotics making empiric management
of outpatient UTIs challenging. Ampicillin, Cotrimoxazole and
Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin
could be used in lower urinary tract infection. Knowledge of
uropathogens and their antimicrobial susceptibility pattern in a
geographical region will help in appropriate and judicious antibiotic
usage in a health care setup.
Abstract: Health workforce is a fundamental component of
health system and plays a significant role in delivering effective
health care services. However, there is a crucial shortage of skilled
personnel which make them prone to work in stressful conditions. In
spite of excessively high workload and burnout among the staff, little
attention is given to their job satisfaction level which has serious
implications on the productivity and effective performance of staff to
achieve organizational goals. Therefore, this study aims to explore
the job satisfaction of midwives working in the labor ward of the
Lady Dufferin Hospital, Karachi. A cross-sectional survey was
conducted. The short version of Minnesota Job Satisfaction
Questionnaire was administered on a convenient sample group of 22
midwives to gather information on their job satisfaction. The results
demonstrated that midwives were overall satisfied with their job. The
level of job satisfaction was however found different in various
positions within midwifery cadre. The head of midwives was highly
satisfied as compared to midwifery staff who works under the
supervision of head. The level of satisfaction of team leaders fall
between the head and staff of midwifery. Similar trends were
observed for both intrinsic and extrinsic job satisfaction. Such
evidences on these issues are essential and useful as it helps explore
the attitudes of individuals towards work which has direct
implications on access to quality care services. Strategic interventions
are required at organizational level to provide motivators and
satisfiers to health workers for their work related satisfaction and
enhanced motivation.
Abstract: A teeming set of doctors that graduated from various
universities within and outside Nigeria with the hope of practicing in
the country, has their hope shattered because of poor financing, lack
of medical equipments and a very weak healthcare systems. Such
hydra headed challenges, allows room for quackery which
increasingly contributes to the cause of mortality in Nigeria. With a
view of reversing the challenges of healthcare delivery and financing
in Nigeria, African Health Market for Equity (AHME), a project
funded by the Bill and Melinda Gates foundation [With contribution
from Department For International Development (DFID)] and
currently implemented in three African Countries (Nigeria, Kenya
and Ghana) over a Five (5) year period supports the healthcare sector
via Medical credit fund (MCF). The study examines the impact of
credit policy and medical credit funding on Nigerian health market.
Ordinary least square analysis, correlation and granger causality tests
were employed to measure the extent to which the Nigerian
healthcare market has been influenced. Medical credit fund
significantly and positively influenced average monthly turnover of
private healthcare providers and Commercial bank’s lending rate had
a weak relationship with access to credit/approved loans (13.46%).
The programme has so far made 13.91% progress, which is very
poor, considering the minimum targeted private health care providers
(437.6) and expected number of loan approvals (180.4) for the two
years. Medical credit policy in Nigeria should be revised to include
private healthcare providers in rural area for more positive impact
and increased returns. Good brand advert and sensitization of the
programme to stakeholders and health pressure group, and an
extension of the programme beyond five years is necessary to better
address the issues raised in the study.
Abstract: The availability to deploy mobile applications for
health care is increasing daily thru different mobile app stores. But
within these capabilities the number of hacking attacks has also
increased, in particular into medical mobile applications. The security
vulnerabilities in medical mobile apps can be triggered by errors in
code, incorrect logic, poor design, among other parameters. This is
usually used by malicious attackers to steal or modify the users’
information. The aim of this research is to analyze the vulnerabilities
detected in mobile medical apps according to risk factor standards
defined by OWASP in 2014.
Abstract: Leishmaniasis is the collective name for a number of
diseases caused by protozoan flagellates of the genus Leishmania,
which is transmitted by Phlebotomine sandfly, the disease has diverse
clinical manifestations and found in many areas of the world,
particularly in Africa, Latin America, South and Central Asia, the
Mediterranean basin and the Middle East. This study was done to
assess primary health care physicians’ knowledge (PHP) and attitude
about leishmaniasis and to assess awareness of local inhabitants
about the disease and its vector in four areas in west Alexandria,
Egypt. It is a cross sectional survey that was conducted in four PHC
units in west Alexandria. All physicians currently working in these
units during the study period were invited to participate in the study;
only 20 PHP completed the questionnaire. 60 local inhabitants were
selected randomly from the four areas of the study, 15 from each
area; Data was collected through two different specially designed
questionnaires. Results showed that 11 (55%) percent of the
physicians had satisfactory knowledge; they answered more than 9
(60%) questions out of a total 14 questions about leishmaniasis and
sandfly. On the other hand when attitude of the primary health care
physicians about leishmaniasis was measured, results showed that 17
(85%) had good attitude and 3 (15%) had poor attitude. The second
questionnaire showed that the awareness of local inhabitants about
leishmaniasis and sandfly as a vector of the disease is poor and needs
to be corrected. (90%) of the interviewed inhabitants had not heard
about leishmaniasis, Only 3 (5%) of them said they know sandfly and
its role in transmission of leishmaniasis. Thus we conclude that
knowledge and attitudes of physicians are acceptable. However, there
is, room for improvement and could be done through formal training
courses and distribution of guidelines. In addition to raising the
awareness of primary health care physicians about the importance of
early detection and notification of cases of leishmaniasis, health
education for raising awareness of the public regarding the vector and
the disease is necessary because related studies have demonstrated
that for inhabitants to take enough protective measures against the
vector, they should perceive that it is responsible for causing a
disease.
Abstract: This article briefly reviews the role of Indian
Pharmacopoeia Commission (IPC) for publications of Indian
Pharmacopoeia (IP) and National formulary of India (NFI) to some of
these anticipated changes, informs constituents about how they can
remain updated about progress and upcoming modifications to
official texts, and invites participation in the standards-setting
process, which are helpful to the practitioners, researchers, educators
and policy makers in the field of health care profession.
Abstract: Advances in the use of health care technology have
resulted in increased adverse events (AEs) related to the use of
medical devices. The study focused on the existing reporting systems.
This study was conducted in a tertiary care public sector hospital.
Devices included Syringe infusion pumps, Cardiac monitors, Pulse
oximeters, Ventilators and Defibrillators. A total of 211 respondents
were recruited. Interviews were held with 30 key informants. Medical
records were scrutinized. Relevant statistical tests were used.
Resident doctors reported maximum frequency of AEs, followed
by nurses; and least by consultants. A significant association was
found between the cadre of health care personnel and awareness that
the patients and bystanders have a risk of sustaining AE. Awareness
regarding reporting of AEs was low, and it was generally done
verbally. Other critical findings are discussed in the light of the
barriers to reporting, reasons for non-compliance, recording system,
and so on.
Abstract: In Brazil, neonatal mortality rate is considered
incompatible with the country development conditions, and has been
a Public Health concern. Reduction in infant mortality rates has also
been part of the Millennium Development Goals, a commitment
made by countries, members of the Organization of United Nations
(OUN), including Brazil. Fetal mortality rate is considered a highly
sensitive indicator of health care quality. Suitable actions, such as
good quality and access to health services may contribute positively
towards reduction in these fetal and neonatal rates. With appropriate
antenatal follow-up and health care during gestation and delivery,
some death causes could be reduced or even prevented by means of
early diagnosis and intervention, as well as changes in risk factors
and interventions. Objectives: To study the quality of maternal and
infant health care based on fetal and neonatal mortality, as well as the
possible actions to prevent those deaths in Botucatu (Brazil).
Methods: Classification of prevention according to the International
Classification of Diseases and the modified Wigglesworth´s
classification. In order to evaluate adequacy, indicators of quality of
antenatal and delivery care were established by the authors. Results:
Considering fetal deaths, 56.7% of them occurred before delivery,
which reveals possible shortcomings in antenatal care, and 38.2% of
them were a result of intra- labor changes, which could be prevented
or reduced by adequate obstetric management. These findings were
different from those in the group of early neonatal deaths which were
also studied. Adequacy of health services showed that antenatal and
childbirth care was appropriate for 24% and 33.3% of pregnant
women, respectively, which corroborates the results of prevention.
These results revealed that shortcomings in obstetric and antenatal
care could be the causes of deaths in the study. Early and late
neonatal deaths have similar characteristics: 76% could be prevented
or reduced mainly by adequate newborn care (52.9%) and adequate
health care for gestational women (11.7%). When adequacy of care
was evaluated, childbirth and newborn care was adequate in 25.8%
and antenatal care was adequate in 16.1%. In conclusion, direct
relationship was found between adequacy and quality of care
rendered to pregnant women and newborns, and fetal and infant
mortality. Moreover, our findings highlight that deaths could be
prevented by an adequate obstetric and neonatal management.
Abstract: Knowledge management is considered as an important
factor in improving health care services. KM facilitates the transfer of
existing knowledge and the development of new knowledge in
hospitals. This paper reviews practices adopted by doctors in Kuwait
for capturing, sharing, and generating knowledge. It also discusses
the perceived impact of KM practices on performance of hospitals.
Based on a survey of 277 doctors, the study found that KM practices
among doctors in the sampled hospitals were not very effective. Little
attention was paid to the main activities that support the transfer of
expertise among doctors in hospitals. However, as predicted by
previous studies, good km practices were perceived by doctors to
have a positive impact on performance of hospitals. It was concluded
that through effective KM practices hospitals could improve the
services they provide. Documentation of best practices and capturing
of lessons learnt for re-use of knowledge could help transform the
hospitals into learning organizations.
Abstract: The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.
Abstract: Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.
Abstract: The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1st, 8th, and 32nd weeks after finishing the program such as child exercise behavior (F(2,97) = 3.98, p = .02) and child dietary behavior (F(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.
Abstract: In Singapore, there are about 1 million baby boomers, defined as those born between 1947 and 1964. They constitute a sizeable proportion (about 30 per cent) of the resident population comprising Singapore citizens and permanent residents. The first batches of these baby boomers have already 65 years old by 2012. Thereafter, baby boomers will swell the ranks of the elderly population in Singapore until 2030. The baby boomers in this study are divided into broad groups, namely, the early baby boomers (born 1947-54) and late baby boomers (1955-64). Continuing decline in fertility and mortality rates in the past three decades as well as improvements in health care facilities and services have changed the demography of Singapore from a “pyramid-shape” young, post war baby boomers population to a rapidly ageing population. With the ageing of the baby boom generation, the population of Singapore is about to grey rapidly over the next three decades. As such, there is a need for Singapore to understand the profile, perceptions and aspirations of this group, and devise strategies to address the needs and concerns as well as opportunities that arise with the ageing of baby boomers are discussed and presented in this work.
Abstract: Hospitals, everywhere, are considered heavy energy consumers. Hospital Intensive Care Unit spaces pose a special challenge, where design guidelines requires the provision of external windows for daylighting and external view. Window protection strategies could be employed to reduce energy loads without detriment effect on comfort or health care. This paper addresses the effectiveness of using various window strategies on the annual cooling, heating and lighting energy use of a typical Hospital Intensive Unit space. Series of experiments were performed using the EnergyPlus simulation software for a typical Intensive Care Unit (ICU) space in Cairo, located in the Egyptian desert. This study concluded that the use of shading systems is more effective in conserving energy in comparison with glazing of different types, in the Cairo ICUs. The highest energy savings in the West and South orientations were accomplished by external perforated solar screens, followed by overhangs positioned at a protection angle of 45°.