Misunderstanding of the term [DNR] in a middle-eastern teaching hospital

Do-not-resuscitate [DNR] order has been practiced for many years; though it is one of the most commonly misunderstood and misinterpreted orders in medical practice. It has many ethical, legal, geographic, religious and cultural aspects that contribute to this misunderstanding. To assess the perception amongst the acute specialties who deal with DNR orders. A Cross-Sectional Questionnaire Type Study. Setting: King Hamad University Hospital, Bahrain. Anonymous questionnaire was designed. Physicians working in the acute specialties were included. The questionnaire included several general questions about when DNR should be implemented and what are the appropriate aspects of management that should be given. Fifty doctors completed the questionnaire; 49 [98%] of the physicians thought that a hospital should have a DNR policy, 23 [46%] of the physicians believed that the DNR decision lies in the hands of the responsible doctor, 10 [20%] of the participants thought that it is a family decision only, whilst 17 [34%] thought that it is a joint decision by the family and the physician. All of the physicians agreed that there should be no code blue activation in case of cardiopulmonary arrest of a DNR labeled patients. The term DNR should not be used as it is confusing and liable to misunderstanding. In addition, we need to educate healthcare professionals about the terminology of the management of end-of-life situations

Awareness of healthcare workers to total parenteral feeding in neonatal units

The partnership between hospital policy and staff procedures needs to be coordinated. In the case of neonatal care, failures of this partnership can result into complications. To evaluate staff awareness, hospital policy and current procedures relating to total parenteral nutrition [TPN] in Neonatal Intensive Care Units in Bahrain. A Self-Administered Questionnaire. NICU, King Hamad University Hospital [KHUH] and Salmaniya Medical Center [SMC], Bahrain. The study population consisted of nurses and neonatal doctors in NICUs in King Hamad University Hospital and Salmaniya Medical Center. Participation in the study implied consent; and the survey was anonymous. The self-administered questionnaire was distributed in August 2013 and consisted of 10 multiple-choice and open-ended questions. Sixty-two [80%] were aware of the risks of administering TPN. Different policies and guidelines were followed depending on the institution. Fifty-four [69%] respondents thought that TPN preparation should be carried out under sterile conditions; 63 [80%] preferably by a pharmacist rather than in the ward by doctors or nurses. Low staff satisfaction was found in 19 [67%] because the pharmacy did not prepare the TPN. Although staff may have high knowledge and awareness to reduce TPN risks, there is a clear need for hospital policy to consider the needs of the end user to reduce the neonatal infections

Sero-prevalence of dengue infections in the Kassala state in the eastern part of the Sudan in 2011

Dengue fever is a vector-borne disease that is transmitted to humans by infected Aedes aegypti mosquitoes. The eastern part of the Sudan is one of the regions that is affected by dengue virus circulation. In this study, we estimated the prevalence of dengue infections in the Kassala state in the eastern part of the Sudan. The study objective was to estimate the sero-prevalence of dengue IgG/IgM antibodies in the Kassala locality in 2011. This was a cross sectional community-based study that utilized a multi-stage cluster sampling technique regarding the probability sampling the study participants. Capture ELISA serological techniques were used for both IgM and IgG, with the specific cut-offs for each set by the manufacturer. The prevalence of dengue infection was found to be 9.4% [95% CI: 7.1-12.3]. In conclusion, there is evidence that the dengue virus is being transmitted in Kassala. Disease surveillance, including the clinical, serological and entomological components, should be strengthened, and additional epidemiological studies are needed to better understand of the disease burden and effects in the area

To click or not to click: introducing audience response system during undergraduate teaching to improve academic performance

To determine if the use of audience response system [ARS] during large group teaching to undergraduate medical students promotes active learning, improves retention of information and leads to an improvement in academic performance. A Prospective Interventional Study. Setting: RCSI Bahrain. ARS was used during a 12-week teaching period in the first semester of the first year of the medical program from October 2012 to December 2012. Lecturers integrated Multiple Choice Questions [MCQs] into their PowerPoint presentations together with ARS during Anatomy and Physiology lectures. Students were asked to discuss and respond to the MCQs during the lectures. Using ARS did not improve academic performance in Anatomy and Physiology, but students reported that using clickers during lectures provided a more interactive learning environment increasing student engagement, promoted active-learning and helped students identify gaps in knowledge. Using ARS in large group teaching had no impact on academic performance in the Anatomy and Physiology rich modules. However, students overwhelmingly enjoyed using clickers during lectures as they promoted active learning and helped them identify gaps in their knowledge