User satisfaction with child psychiatry outpatient care: implications for practice.

INTRODUCTION: Satisfaction with outpatient care is determined by the extent to which the expectations of users are met. Obtaining the opinion of users is considered a reliable method of assessing the quality of service. The objective of our study was to assess the degree of satisfaction expressed by users of a child psychiatry outpatient service and to match degree of satisfaction with the dropout rate. METHOD: A questionnaire was used to assess the users' expectation of the service and degree of satisfaction. Dropout rate was determined from the clinical records. RESULTS: 165 new referrals to the outpatient service were recruited for the study. 41.2% expected a cure for the child's mental health problem. 65.5% expressed satisfaction with the treatment intervention and time provided at the first consultation. Positive free text comments supported this opinion, but were incongruent with the 32.8% dropout rate after the first and second visits to the clinic. Behaviour problems in children and serious social problems in the families increased the risk of dropout from treatment. CONCLUSIONS: Initial expression of satisfaction with the service by the users does not guarantee continued co-operation with follow up care. Sensitivity in the approach to treatment is needed where there is a higher risk of dropout.

Emergence of penicillin resistant pneumococci in Sri Lanka.

Two strains of penicillin resistant (PR) pneumococci were isolated recently from cerebrospinal fluid of two children with meningitis. Penicillin resistance was detected by using a lug disc of oxacillin in the Stokes disc diffusion method. The strains were tested quantitatively for sensitivity to penicillin by an agar dilution technique. The minimum inhibitory concentration (MIC) to penicillin of these strains were 2 micrograms/ml and 0.12 microgram/ml, indicating that respectively they were of frank and intermediate resistance to penicillin. However these strains were sensitive to other antibiotics tested, namely, erythromycin, tetracycline, chloramphenicol, amoxycillin, cephalexin and cefotaxime. Penicillin resistant pneumococci are here in Sri Lanka. Though one strain was of intermediate resistance, therapeutic failure during treatment with penicillin was evident in this case.

A secondary analysis of determinants of low birth weight.

Data from 245 children of low birth weight on estates in Kalutara and Nuwara Eliya are analysed in relation to age, parity, and work load of the mother during pregnancy. A multivariate analysis shows that the last birth interval and the number of visits to the clinic are important variables besides variables like duration of pregnancy, poor weight gain and previous abortions.

Eficacia del fluconazol en dermatofitosis / Efficacy of fluconazole in dermatophytes

Se efectuó un estudio abierto no comparativo para determinar la dosis mínima del fluconazol en el tratamiento de 20 pacientes con Tinea pedis y Tinea corporis/cruris. Se seleccionaron 20 pacientes, 10 con Tinea pedis y 10 con Tinea corporis/cruris, siendo 15 del sexo masculino y 5 del sexo femenino con edad promedio de 31.8 años (rango 18-65 años). Los pacientes recibieron una dosis única semanal de fluconazol 150 mg, con evaluaciones clínicas y micológicas a los 7-10 días después de cada dosis y luego una evaluación final a los 28-30 días. Se anotaron todos los hallazgos clínicos y microbiológicos en la fórmula respectiva de cada paciente. Los resultados finales indicaron que 8 (80 por ciento) de 10 pacientes con Tinea pedis alcanzaron curación y que ocho (80 por ciento) de los 10 casos con Tinea corporis/cruris también fueron curados. La mayoría de los casos de Tinea corporis/cruris requirieron solo dos dosis de tratamiento, en tanto que la mitad de los casos de Tineas pedis requirieron de las 4 dosis/semanas de tratamiento. No se presentaron efectos adversos severos debido al tratamiento. Finalmente, el autor concluye que el fluconazol en dosis semanales de 150 mg, es un recurso terapéutico de gran eficacia y buena tolerancia en el tratamiento de las dermatofitosis.