Factors influencing outcome of head injury patients at a tertiary care teaching hospital in India

Trauma is the most common cause of morbidity and mortality in people younger than 45 years and head injury is mostly highly weighted predictor of outcome in trauma population, anything than can improve the outcome from severe head injury has the potential of improving the lives of many accident victims. A study regarding factors influencing outcome of traumatic brain injury patients was conducted at a tertiary care hospital of Srinagar [India]. The basic predictors in this study included age, sex, rural/urban, time taken from site of trauma to arrival at hospital, mode of transportation, referral from other hospitals, referral to other hospitals, and Glasgow Coma Scale. Traumatic Brain Injury [TBI] patients [n 547] were taken prospectively by simple random sampling method for a period of one year [2004] for this study. Majority of patients belonged to age group 0 to 10 years [25.5%] and a maximum death [8] were seen in age group 51 to 60 years. Maximum number of patients were males [75.9%] and [71.1%] TBI patients were from rural areas. [26.7%] reached this hospital within a period of one hour. [66%] were shifted through ambulance service. 6.4% expired after treatment. Factors responsible for improved outcome in severe head injury patients are improvement in early recognition, resuscitation and triage, coupled with prompt computed tomography [CT] scanning and aggressive surgical management

Patient's perception of nursing care at a large teaching hospital in India

As focus has shifted from the healthcare providers to the healthcare consumers; patient satisfaction is being increasingly used worldwide for the assessment of quality of services provided by healthcare institutions. To understand patient satisfaction, [patient's perception] of care must first be understood. Of all the healthcare workers nurses spend maximum time with the patients. Therefore, the nurse is in a unique position to influence and promote effective consumer relationships. Though patient satisfaction surveys with nursing care are routinely conducted in the developed world to monitor and improve the quality of care, the same is not true for the developing world especially in the Indian subcontinent. To conduct a study of patient's perception of nursing care in a large teaching hospital. A prospective study spread over a period of one year was carried out. Sample size consisted of seven percent of patients each admitted as emergency and routine. All the randomly selected patients were administered questionnaires, thus obtaining a sample size of 2600. Of these 2500 questionnaires were usable for data analysis [valid response rate of 81.65]. The results of the study revealed a relatively higher percentage of patients with poor perception regarding [explanation and information], and [caring attitude] aspects of nursing care [31.6% and 11.5% respectively]. However more than 95% patients had good perception of [responsiveness], [availability] and [ward organization] capability of the nurse. Patient satisfaction surveys should become a regular outcome monitoring feature in all the hospitals. Also in-service training programs for nurses, with special emphasis on communication are need of the hour and should become a regular exercise

Safety in laboratories: Indian scenario

Health and safety in clinical laboratories is becoming an increasingly important subject as a result of emergency of highly infectious diseases such as Hepatitis and HIV. A cross sectional study was carried out to study the safety measures being adopted in clinical laboratories of India. Heads of laboratories of teaching hospitals of India were subjected to a standardized, pretested questionnaire. Response rate was 44.8%. Only 60% of laboratories had person in-charge of safety in laboratory. Seventy three percent of laboratories had safety education program regarding hazards. In 91% of laboratories staff is using protective clothing while working in laboratories. Hazardous material regulations are followed in 78% of laboratories. Regular health check ups are carried among laboratory staff in 43.4% of laboratories. Safety manual is available in 56.5% of laboratories. 73.9% of laboratories are equipped with fire extinguishers. Fume cupboards are provided in 34.7% off laboratories and they are regularly checked in 87.5% of these laboratories. In 78.26% of laboratories suitable measures are taken to minimize formation of aerosols. In 95.6% of laboratories waste is disposed off as per bio-medical waste management handling rules. Laboratory of one private medical college was accredited with NABL and safety parameters were better in that laboratory. Installing safety engineered devices apparently contributes to significant decrease in injuries in laboratories; laboratory safety has to be a part of overall quality assurance programme in hospitals. Accreditation has to be made necessary for all laboratories

Bilateral duplication of renal vessels: anatomical, medical and surgical prespective

A sound knowledge of variations of blood vessels is important during operative, diagnostic and endovascular procedures in the abdomen. Knowledge of the variations in the renal arteries is important for urologists, radiologists and surgeons in general. The objective of the case report is to bring awareness to clinicians about the variations in the blood supply of the kidney. This report may also be useful to clinicians performing invasive techniques and vascular surgeries and in cases of trauma