ABSTRACT
To evaluate the quality of referral letters and feedback reports written according to the standards of Quality Assurance Manual of Ministry of Health from primary health care centers [PHCC's] in Buraidah. This stwiy was conducted during October and November 2004. A total of 330 referral letters md feedback reports were randomly selected from six PHCCs [20% from PHCCs in Buraidah City], About 55 referral and feedback letters were selected from each PHCC by systematic sampling method. The referral letters and feedback reports were reviewed thoroughly for the main items required in Ideal referral letters and feedback reports according to the standard of Quality Assurance Manual of Ministry of Health, and a scoring system was used Many of the referral letters lacked such important information as the history in 36%, vital signs in 30% results of clinical examination in 45%, results of basic investigations in 52%, provisional diagnosis in 50% and treatment given in PHCCs in 47%. The legibility of referral letters ami feedback reports was good in 75% and 63% respectively, and the quality of referral letters and feedback reports was good in 63% and 39% respectively. The rate of feedback reports received by PHCCs was 30% of total number of referrals to the hospitals. The referral rate was [4%] from total number of patients seen m PHCCs, The most frequent reasons for referrals were for general treatment 36.7% for general diagnostic evaluation 28%, and far laboratory investigation 18.8%, the referral rate from PHCCs in Buraldah fell within the standard set in Quality. Assurance Manual However the quality of referral letters ami feedback reports was poor in 17.6% and 29.7% respectively. The quality of both referral letters and feedback reports should improve to guarantee the quality of patient care
Subject(s)
Humans , Primary Health Care , Correspondence as Topic , FeedbackABSTRACT
Assessment of right ventricular function is important. However, this is not easy to achieve due to the complex anatomy and geometry of the right ventricle, making the evaluation of its function limited. Therefore, a simple reliable and easy method is needed. This work was to evaluate the use of right ventricular outflow tract fractional shortening obtained by M-mode echocardiography as a measure of right ventricular systolic function in patients having inferior wall myocardial infarction with or without evidence of right ventricular infarction [as a model of right ventricular disease]. Fifty patients with first acute inferior wall myocardial infarction, their ages ranged from 30 to 80 years with [mean +/- SD = 54.56 +/- 11.5], were investigated. Ten healthy controls also were studied. M-mode echocardiography was used to measure right ventricular outflow tract fractional shortening and right ventricular long axis excursion. Two-dimension echocardiography was used to measure right ventricular ejection fraction. Ventricular outflow tract fractional shortening [p<0.0001], right ventricular long axis excursion [p<0.0001] and right ventricular ejection fraction [p<0.0001] were reduced in patients compared to controls. Also were reduced in patients in group [B] compared to patients in group [A]. Right ventricular outflow tract fractional shortening correlated with long axis excursion [r=0.86, p<0.0001], right ventricular ejection fraction [r=-0.84, p<0.0001]. Right ventricular outflow tract fractional shortening provides a simple and non-invasive measure of right ventricular systolic function and could be helpful in diagnosis of right ventricular infarction in patients have inferior wall MI. In combination with long axis excursion and Doppler velocities, they should provide comprehensive assessment of right ventricular function
Subject(s)
Humans , Male , Female , Echocardiography, Doppler , Myocardial InfarctionABSTRACT
To determine whether abnormalities in left ventricular geometry due to right ventricular enlargement result in abnormalities in left ventricular diastolic filling pattern, the pulsed Doppler transmitral recording was obtained from 13 patients with right ventricular dilatation and right ventricular systolic pressure estimated to be <40 mmHg [group I], 22 patients with right ventricular dilatation and right ventricular systolic pressure >/40 mmHg [group II] and 8 normal subjects served as control group. Results were discussed in detail
Subject(s)
Humans , Male , Female , Ventricular Function, Left/physiopathologyABSTRACT
Quantification of pulmonary artery pressure in patients with ventricular septal defect [VSD] is essential in clinical or surgical management. Systolic pulmonary artery pressure [SPAP] was estimated by 3 methods: Estimation of the pressure drop [DP] across VSD using continuous wave Doppler [CWD] guided by color flow mapping [CFM], pulmonary flow velocity curve, right ventricular isovolumic relaxation time [RVIT] using phonocardiography and tricuspid diastolic flow, then predicted SPAP is derived from Burstin's monogram. 35 patients aged 2-24 years [mean +/- SD 8.3 +/- 5.2] with VSD were studied by 2D echo-CWD/CFM within 72 hours of cardiac catheterization [CC]. The use of RVIT proved to be the best method to predict SPAP in the absence of severe TR. The other methods are effective when tricuspid regurgitation is severe