Quality control in linen and laundry service at a tertiary care teaching hospital in India

The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department. Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff working, their qualification, training, promotion avenues, motivation and job satisfaction. Process was studied by carrying out observations in linen and laundry service through a predesigned flow chart which was supplemented by interviews with different category of staff. Patient satisfaction, staff satisfaction and microbial count of laundered linen [quality dimensions] were studied in the outcome. The current study found that in spite of certain deficiencies in the equipment, manpower and process, the linen and laundry service is providing a satisfactory service to its users. However the services can be further improved by removing the present deficiencies both at structure and process level

Clinical management of patients with minor head injuries

Injuries are a focus of public health practice because they pose a serious health threat, occur frequently, and are preventable. Globally, thousands of people attend their local Emergency Department daily after suffering a head injury. Early diagnosis and appropriate management improves outcomes but is sometimes more difficult to achieve than might be imagined. Of all types of injury, those to the brain are among the most likely to result in death or permanent disability. Estimates of traumatic brain injury [TBI] incidence, severity, and cost reflect the enormous losses to individuals, their families, and society. The reduction in the number and severity of injuries offers a cost-effective manner in which to improve the health status of populations. We prospectively studied 485 consecutive patients of traumatic brain injury out of which 280 with GCS of 13, 14, and 15 were subjected to routine early CT scan of head after 4 hours of reporting to Emergency Department. Patients with penetrating head injury were excluded. 15% of patients had abnormal CT Scans and only 4% needed surgical intervention. Though a small number of patients harbour potentially lethal intracranial lesions yet, most of these cases are salvageable if diagnosed early and proper treatment. This study reveals that the current practice in the some countries of risk stratification of adult MHI based on skull radiography need to be replaced by slightly modified versions of the Canadian CT rule/NICE guidelines. This will result in a large reduction in skull radiography and will be associated with modest increases in CT and admissions rates. The authors also believe that early CT Scanning can detect intracranial lesions and will reduce unnecessary hospital admissions

Association of Beta-catenin gene mutations and human papillomavirus in Carcinoma of Esophagus in a high-risk population of India

Background: Esophageal cancer [EC] is the sixth leading cause of death from cancer. In high-risk regions, squamous cell carcinoma is the most common type of EC, and its etiology remains poorly understood. It shows uneven geographical distribution in its occurrence, reflecting the influence of local environmental conditions, lifestyle and genetic predisposition in the development of the cancer. Kashmir, in the north of India, has been described as a high-risk area for esophageal squamous cell carcinoma [ESCC]. In the present investigation an attempt was made to study the role of -catenin mutations and human papillomavirus in 62 ESCC patients from Kashmir

Methods: The hot spot mutation region of -catenin exon 3 was evaluated in matched tumor and normal tissues using a combination of PCR-SSCP and direct sequencing. We used two different sets of consensus primers viz., GP5+ and GP6+; PGMY09 and PGMY11 in conjunction with reverse line blot assay to screen for human papillomavirus[HPV]

Results: None of the tumors showed the presence of commonly reported mutations in -catenin. In view of the fact that HPV has been linked to pathogenesis of EC, we screened all the tumor and control specimens for the presence of HPV and we didn't detect HPV in any of the matched tumor and control specimens in contrast to the positive controls we used

Conclusion: In conclusion our results suggest that squamous cell carcinoma of esophagus in Kashmir may arise independent of oncogenic Beta-catenin mutations and HPV is unlikely to be an etiologic factor for ESCC in this region

association of beta-catenin gene mutations and human papillomavirus in carcinoma of esophagus in a high-risk population of India

Esophageai cancer [EC] is the sixth leading cause of death from cancer. In high-risk regions, squamous cell carcinoma is the most common type of EC, and its etiology remains poorly understood. It shows uneven geographical distribution in its occurrence, reflecting the influence of local environmental conditions, lifestyle and genetic predisposition in the development of the cancer. Kashmir, in the north of India, has been described as a high-risk area for esophageal squamous cell carcinoma [ESCC]. In the present investigation an attempt was made to study the role of p-catenin mutations and human papillomavirus in 62 ESCC patients from Kashmir. The hot spot mutation region of p-catenin exon 3 was evaluated in matched tumor and normal tissues using a combination of PCR-SSCP and direct sequencing. We used two different sets of consensus primers viz., GP5+ and GP6+; PGMY09 and PGMY11 in conjunction with reverse line blot assay to screen for human papillomavirus [HPV]. None of the tumors showed the presence of commonly reported mutations in p-catenin. In view of the fact that HPV has been linked to pathogenesis of EC, we screened all the tumor and control specimens for the presence of HPV and we didn't detect HPV in any of the matched tumor and control specimens in contrast to the positive controls we used. In conclusion our results suggest that squamous cell carcinoma of esophagus in Kashmir may arise independent of oncogenic p-catenin mutations and HPV is unlikely to be an etiologic factor for ESCC in this region