Urinary trypsinogen-2 dipstick test for point-of-care screening of acute pancreatitis

Background: Acute pancreatitis (AP) is associated with high mortality in its severe form. Conventional laboratory tests used in its diagnosis are fraught with multiple shortcomings. Early institution of intravenous fluid resuscitation can reduce morbidity and mortality. Measurement of urinary trypsinogen-2 using a bedside urine dipstick test may prove useful in early identification of AP.Methods: Patients with symptoms consistent with AP, attending the emergency department, at a tertiary care hospital in southern India, between November 2014 and November 2016, were included in a prospective observational study. The patients underwent routine investigations and additionally were tested with a urinary trypsinogen-2 dipstick test (UTT). The diagnostic performance and the time to reporting of the different investigations were compared with those of UTT. Final diagnosis of AP, made by clinicians, served as the standard.Results: The sensitivities of serum amylase, serum lipase, UTT, ultrasonography (USG) and contrast-enhanced computed tomography (CECT) were 97.1%, 94.1%, 92.7%, 98.3% and 100%, respectively. The respective specificities were 92.4%, 98.5%, 98.5%, 100% and 100%. The average time required to obtain the test report was about half hour from admission in case of UTT, compared to about 3 hours for serum amylase/lipase, 4 hours for USG and 6 hours for CECT.Conclusions: The results indicate that UTT test, due to its high performance indices, simplicity and faster availability of reports, can serve as an ideal screening test for AP and help in early institution of treatment.

Contamination of environmental surfaces by methicillin-resistant Staphylococcus aureus (MRSA) in rooms of inpatients with MRSA-positive body sites

ABSTRACT Methicillin-resistant Staphylococcus aureus (MRSA) can contaminate environmental surfaces that are frequently touched by the hands of patients with MRSA colonization/infection. There have been many studies in which the presence or absence of MRSA contamination was determined but no studies in which MRSA contamination levels were also evaluated in detail. We evaluated MRSA contamination of environmental surfaces (overbed tables, bed side rails, and curtains) in the rooms of inpatients from whom MRSA was isolated via clinical specimens. We examined the curtains within 7-14 days after they had been newly hung. The environmental surfaces were wiped using gauze (molded gauze for wiping of surface bacteria; 100% cotton, 4 cm × 8 cm) moistened with sterile physiological saline. The MRSA contamination rate and mean counts (range) were 25.0% (6/24 samples) and 30.6 (0-255) colony-forming units (cfu)/100 cm2, respectively, for the overbed tables and 31.6% (6/19 samples) and 159.5 (0-1620) cfu/100 cm2, respectively, for the bed side rails. No MRSA was detected in 24 curtain samples. The rate of MRSA contamination of environmental surfaces was high for the overbed tables and bed side rails but low for the curtains. Therefore, at least until the 14th day of use, frequent disinfection of curtains may be not necessary.

3. Medical Education in Japan and National Medical Practitioner Examination / 医学教育

<p>　It has been suggested that bed-side learning in Japanese medical schools may be not sufficient in its term and content, compared to that in European and American medical schools, although medical knowledge of Japanese medical students is on a par with that of European and American medical students. AJMC (Association of Japanese Medical Colleges) is now trying to certify medical students as Student Doctors based on a uniform standard with the use of CBT and OSCE. The quality assurance of medical students before proceeding to bed-side learning can make satisfying participation in such training possible with the understanding of patients. The National Medical Practitioner Examination poses a considerable burden to medical students because of a large number of problems. It is desirable for the National Medical Practitioner Examination to become a test to evaluate students' ability on bed-side practice in the future. If post-clinical clerkship OSCE is conducted in all medical schools in Japan with fairness and objectivity, the burden on medical students due to the National Medical Practitioner Examination may be alleviated.</p>

Study on correlation between residual urine volume after catheterization and body positions for patients with spinal cord injury using B-ultrasonography / 中国实用护理杂志

Objective To discuss the correlation between residual urine volume after catheterization and body positions for patients with spinal cord injury using B-ultrasonography. Methods 34 patients with spinal cord injury were randomly selected, the residual urine volume in urinary bladder was detected with bed-side B-ultrasonography under different body positions such as supine position, lateral position and fowler position, the results underwent variance analysis. Results No significant difference was seen in residual urine volume in urinary bladder under different body positions. Conclusions Body positions play no significant influence on residual urine volume in urinary bladder after catheterization.

Research on the application of multimedia technology in the clinical teaching of pediatric Surgery / 中华医学教育探索杂志

Pediatric surgery is the important part of the paediatrics,and the complicated content,limited time and many difficulties are the main problems of pediatric surgery teaching.The bed side teaching is the supplement for the class teaching,which could solve those problems.Multi-media technique is used in bed side teaching of Pediatric surgery,which is convenient for preparing lesson and teaching of teachers and review and summary of students.After the technique is used,the teaching efficiency and the quality are obviously improved.

Dilemma and Strategy in the Bed Side Teaching of Gynaecology and Obstetrics / 中华医学教育探索杂志

From the current situations and problems on bed side teaching of gynaecology and obstetrics,the paper discusses the strategy and the development trend of gynaecology and obstetrics bed side teaching in the future.