Hepatic trauma and associated injuries- experience in a tertiary care hospital

The objective of this study was to analyze and document the presentation of liver trauma and associated injuries. Present study was conducted from January 2010 to December 2011 at Jinnah Postgraduate Center, Karachi, Pakistan. Oral and written consent was obtained from the participants before the start of the study. Inclusion criteria included all patients, aged more than 13 years with hepatic trauma admitted in the wards. The patients with co existing chronic hepatic diseases were excluded. This study comprised of 61 participants, among those [95%] were males and [5%] were females. The mean age of the participants was 31.4. The mean age for female participants was 28.3 while for male was 31.6. Amongst the patients with hepatic trauma, 67.2% had road traffic accidents [RTA] as the cause of their liver injury followed by firearm injury in 19.7%of the cases, physical assault in 9.8% and stab wound in 3.3% of the patients. Investigations done on the patients were ultrasound and C.T scan. In this study 60.7% patients were diagnosed on abdominal ultrasound and 14.8% were found to have hepatic trauma on the abdominal C.T scan. In all the patients with hepatic injury 50.8% had associated injuries. The most common associated injury was chest complications which was present in 10 [16.4%, C.I: 3.7-39.7] patients followed by gut perforation which was present in 11.4% patients. Other common injuries included forearm fracture which was present in 09.8%patients, spleen injury was found in 8.1% and diaphragm injury in 4.9% patients. In Pakistan Road traffic accident is one of the most frequent causes of Hepatic injury and middle aged men are at the highest risk of hepatic trauma

Patient satisfaction levels in surgical ward of a tertiary care hospital in Karachi

Patient satisfaction is a good yardstick to measure care giver's success. Patient satisfaction is one of the pertinent objectives of health care system. Since doctor-patient relationship is most crucial and decisive in patients' perception of care and satisfaction, from this survey, we explore various aspects of care received from doctors that determine the overall satisfaction level of patients. The objective of this study was to find out the level of patients satisfaction with various aspects of care provided by doctors in surgical ward in a tertiary care hospital in Karachi. Data was collected from a convenient sample of 174 patients, at the time of discharge from the health facility, who were admitted to surgical ward of Ziauddin Hospital, KDLB campus. Study design was cross sectional. Data collection was done from August till September 2013. Questionnaire was developed after literature review. Patient satisfaction was recorded using the 5 point Likert scale. Data analysis was done on SPSS version 19. Overall there were 57.5% males and 42.5% females participants. 41% of the participants were between 35-44 years of age. 42.5% were educated up to primary level, while 19.5% were not educated at all. Overall satisfaction level was 100%, with 66.7% noted as very satisfying while 33.3% as satisfying. Doctors' politeness, availability, provision of post operative care and discharge counseling were strong determinants of overall satisfaction. Explanation of medicines and patients' participation in their illness discussion were areas of uncertainty and dissatisfaction. Doctors' polite attitude, consultation and availability are vital to patient satisfaction. Areas that need more attention are, seeking patient views in their illness discussion, explaining them prescription drugs and lab investigations

Orally and sexually transmitted gonorrhea

Gonorrhea can be transmitted by oral sex and is known as pharyngeal gonorrhea and appears as pharyngitis. Patients with symptomatic gonorrhea infection or other STDs are commonly seen in outpatient departments. Majority of them seek treatment without having adequate understanding regarding the nature of their condition. It is important for a healthy community that the members have information regarding STDs, their spread and preventive measure. The study was conducted during the time period of six months extending from August 2013-January 2014. The data was collected from four tertiary care hospital after obtaining oral and written consent. Patients attending Urology outpatient department with a history of STD were included in the study. Overall 410 patients participated in the study with a response rate of 82%. 315[76.8%] males and 95[23.2%] female participants. 37.8% of females and 36.5 of males with total 36.8% of participants had knowledge that PID is a complication of Gonorrhea. In total 16.3% of the participants knew the correct mode of transmission of Gonorrhea with 22% females and 14.6% males with Odd ratio F/M 1.5. Regarding the best preventive measure for STD, 60.7% considers avoiding multiple sexual partners and engage in spousal relationship [53.7 and 62.8% of females and male respectively, Odds ratio F/M 0.85] is the best way followed by using condoms [20.7% of total participant with an odds F/M of 1.54]. The knowledge in patients regarding Gonorrhea is scant hence it is essential to counter educational needs of the population regarding STD in effective and timely manner