RESUMEN
Background: Gestational age (GA) is a critical-factors in the decision making and predicting mortality and morbidities of neonates. In low resource settings where affordability and availability of first trimester scan is limited, assessment is often done by postnatal methods like expanded new Ballard score (ENBS) which are often clinical skill dependent and complex. Hence, there is a need of a simple and cost-effective method which can be readily adopted by frontline health care workers at periphery. One such method is assessment of foot length (FL). Methods: This prospective cross-sectional study was conducted in the level 3 NICU of Central India over a period of 18 months. Included neonates were assessed for GA by measuring FL by vernier calliper within 48 hours of birth and its validity was tested against ENBS as reference standard. Other anthropometric measurements like birth weight, head circumference and length were obtained within 48 hours of birth. Results: Total 700 neonates were included in the study. For, determining preterm newborn, the potential cut-off of FL of ?6.86 cm, with a sensitivity of 94.6% and specificity of 73.8%. The area under ROC (receiver operating characteristic) curve is 0.92. Conclusions: FL measurement is a cost-effective and time-saving simple intervention that can facilitate early identification of preterm newborns as well as help in initiating timely interventions and hence improving neonatal outcomes in resource-poor settings
RESUMEN
Spontaneous subcutaneous emphysema is the presence of gas or air beneath the skin and soft tissues. Pneumothorax and pneumomediastinum are identified by the existence of free gas or air in the associated spaces. 4-year-old with progressive body swelling of 12-hour duration, started just after nebulisation with bronchodilators prescribed for his cough and cold. Examination revealed conscious, anxious, irritable child and obvious superficial swelling of face, scalp, neck, chest and both upper limbs. tachycardia, tachypnoea and his oxygen saturation were 82% at the time of admission. There was crepitus on palpation. Investigations were done; A diagnosis of spontaneous pneumomediastinum, left pneumothorax with spontaneous subcutaneous emphysema was made. Managed with emergency implantable cardioverter-defibrillator (ICD) insertion, oxygen, intravenous antibiotics, intravenous fluids, analgesics, and nebulisation.
RESUMEN
Background: Patient satisfaction is a good indicator for measuring the quality of nursing care delivered by a nurse to a hospitalized patient. This will help the nursing administrator to identify ways of improving nursing and health care services. The study aims to assess the level of patient’s satisfaction towards quality of nursing care among the patients. Methods: A descriptive survey study was carried on 100 patients selected using non-probability purposive sampling, who were discharged from the selected private hospitals at Jodhpur, Rajasthan. A Modified form of Dr. Laschinger’s “Patient Satisfaction with Nursing Care Quality Questionnaire” (PSNCQQ) was used to measure patient satisfaction. A written permission was obtained to conduct study from the authority and an informed consent was taken from each participant. Results: The study findings indicate that majority (70%) of the sample were highly satisfied with nursing care with mean patient satisfaction score 61.38±9.692 (76.72%). Majority (66%) patients were satisfied with “Information given regarding investigations and treatments” and only (26%) were satisfied with “Coordination of care after discharge.” Patients aged 18-30 years, belonged to urban area, up to secondary educated and admitted through OPD were found more satisfied. Conclusions: The study showed that majority of the participants were highly satisfied with quality of nursing care provided in private hospital. The PSNCQQ is a useful instrument for evaluating and improving nursing care. The nurse administrator can contribute to quality service provision by evaluating patient satisfaction to develop and improve nursing care based on patients' expectations.