Assessment of knowledge, attitude and practices pattern of hand washing in some major public sector hospitals of Pakistan [a multi-center study]

To assess knowledge, attitude and practices of hand washing in major Public sector Hospitals of Pakistan and see the differences in practices in different levels of health care workers. Cross sectional hospital based survey conducted in all provinces of Pakistan in major tertiary care hospitals. A Cross sectional hospital based survey was conducted on knowledge, attitude and practices of hand washing in doctors, nurses and paramedical staff. From each hospital 10 OPD's and 10 wards i.e. 2 medical, 2 Surgical, Gynae, Peads, Dermatology, Eye, ENT, and Causality/ICU were selected and from each unit. Four doctors, four nurses and two paramedical staff were interviewed. A total of 3243 respondents were interviewed. Of these 87.3% had knowledge of hand washing. Hand washing facilities were available at 75% places and 69% respondents practiced hand hygiene, but only 58.8% washed their hands for more than 20 seconds. Majority used antibacterial soap bought by them. Rush of the patients, shortage of time, non availability of soap and water and lack of encouragement by seniors were the major causes for low hand hygiene practice. Almost 25% sites in major public sector tertiary hospitals did not have hand washing facilities but where available most health care providers were using them. Majority despite having knowledge, need motivation and continuous education of hand hygiene. Facilities of hand hygiene should be made available

District hospital [DHQ] capable to treat snake bite cases

1, To know the proportion of Haemotoxie and Nuerotoxic snake bite cases admitted in DHQ Hospital, 2. To collect data about victims and their cure rate by ASV injectable serum, 3. To determine that DHQ hospital is capable to treat snake bite victims or not, 4. To recommend improvements for snake bite treatment on basis of this study, Cross sectional study, This study was conducted at Medical ward of District Hospital Mirpurkhas, Sindh from January to December 2005 on snake bite cases. 135 patients of snake bite were taken in this study. Patients were taken of both sexes and all ages. Only patients with snake bite history and clinical signs of bite fang punctures were included. Snake bite cases with only history no fang puncture marks and no clinical envenomation signs or treated by private hospital or GPs were excluded. 1. 135 Cases admitted during 12 months of the year 2005, 120 [86.2%] were male and 20 [14.8%] females [Table-1]. 2. The age distribution of snake bite cases showed that 12 [8.9%] were small children age 01-04 years showing a miserable situation of neglect by mother and family. An other group 38 [28.1%] were also children aged between 05 -09 years, the third group is also children between 9-14 years, which is 20 [14.8%], there were 11 [8.1%] in teen age [15 to 19] years. There were 39 [28.9%] cases in age of 30 and above [Table-8]. 3. The type or species of snake bite as stated by patients or their attendants revealed that 112 [83. 0%] said viper [lundi] have bitten which is haemotoxic and 23 [17.0%] snake bite cases were bitten by Cobra [Nanagor sanp] which is neurotoxic. 4. After ASV treatment all snake bite cases were cured, and no death or referral was reported. Hence DHQ hospitals are capable to deal with snake bite cases of all types. 5. Stock of ASV and supply in DHQ hospital was satisfactory as per data 134 [99.3%] cases when admitted. But for 01 case it was not available. This shows that this Vaccine should be available in excess quantity. Snake bite is endemic and common public health problem in district Mirpurkhas adolescents and teenagers are bitten in large number but cure rate with Anti Snake Venom [ASV] injection is highly satisfactory, viper and cobra are frequently stated species present in Mirpurkhas. DHQ hospitals are capable to deal all the cases of snake bite. Anti snake Venom supplied in Pakistan is very effective against cobra and viper

Utilization pattern of health delivery system at primary and secondary level and problems encountered by users in mirpur khas division

To know the current utilization status of the health facilities at primary and secondary level in Mirpur Khas Division. Information was collected on a specially designed questionnaire which was also translated in local language for easiness of the patients. Data were collected from 47.7% [84] out of 176 primary health care facilities and 81.8% [09] out of 11 secondary level health care facilities. The users and doctor's incharges were interviewed. The data were collected from the field were compiled, entered and analyzed at PMRC Research Centre, LMC Jamshoro, The questionnaire covered basic information of the health facilities. Staff strength, provision of medicines and consumable supplies from DHO, officers, operation and maintenance of equipments provided and other general problems highlighted. The project was conducted during 1998-99 under the HSR Grant received from PMRC Islamabad. The population of Mirpur Khas Division was 45, 56, 570. The total health care facilities were 176 [165 + 11] primary and secondary respectively. Data were collected from PHC facilities 47.7% and 81.8% secondary level. The study showed 23.7 users visited primary health care facilities while 251.33 visited secondary level. The primary and secondary care health facilities are under utilized due to shortage of staff, particularly WMOs in this division. Tharparkar desert is 22,000 km area and there are no ambulance services to transport serious patients and pregnant ladies to some tertiary care hospital for urgent surgeries or neonatal care. Most of the deaths are observed while transporting pregnant mothers on the back of the camel which is frequent traditional mode of transport in desert

Removal of kidney stones by open surgery to evaluate the biochemical changes and metabolic disorders to reduce the rate of recurrence of the disease

To evaluate the biochemical changes in patients analyzing pre and postoperative samples and to update the current clinical practices. PMRC Research Centre, LUMHS Jamshoro, Department of Urology, LUH, Jamshoro. Urolithiasis patients admitted at the department of urology, LUH Jamshoro were registered for this clinical based research study. A total of '25' patients were selected for open surgery procedure during carrying out this study in 2005. Out of which '20' were registered who were willing to participate and given written consent. A proforma with detail history and investigations related to the objectives of the study was filled in each case. The pre- and postoperative blood and urine samples were collected and analyzed. Results are given in detail from Table No.1 to Table No.06. The results of this study show that patients suffering from kidney stones were feeling stressful in the early morning [pre-operative] before shifting to the operation theatre for open surgery. Thinking of a surgery is itself a painful experience. However, on the next morning i.e. 1[st] postoperative day felt more comfortable and subsequently on 3[rd] and 5[th] postoperative day felt quite normal and ready to be discharged. Open surgery is required if other physical interventions such as shock-wave lithotripsy to breakup the stones is unsuccessful. However, extra corporeal shock-wave lithotripsy [ESWL] and [PCNL] modalities have solved the problems to the extent in the cases in which kidney stones can be broken easily. Attention should also he paid to the prevention of stone formation by counseling with the patients by adopting preventive measures