Résumé
Background: Along with several significant factors in chemotherapy treatment management’s nurses plays the pivotal role. The objective of this study was to evaluate the knowledge of nurses in relation to handling chemotherapy and the current practice of cancer centers in different hospitals in Bangladesh.Methods: The cross-sectional study was designed based on anonymous self-administered questionnaire. The questionnaire was developed from literature and expert input and validated by subject experts.Results: A total of 96 nurses were the respondents in this study. Around half of them already exposed directly with chemotherapy agents. Some 72.9% of nurses had not any training and 58.3% of respondents were not aware about use of closed system transfer devise in chemotherapy. A greater proportion 58.3% of nurses did not know the same health hazard of both oral and parenteral drugs. One third (33.3%) respondents used biological safety cabinet for doing preparation. Nurses’ did not use especial personal protective equipment and the designed treatment room also was absent. None of nurses went through regular medical checkup.Conclusions: The evidence-based results suggested that nurses have average knowledge about chemotherapy handling, however, use of personal protective equipment and biological safety cabinet, follow guidelines, medical surveillance and training are appeared to be a hindrance. More fundamentally, nurses need more education and professional training about chemotherapy agents handling in nursing school and through in-service continuing education as well as adopt required facilities are necessary.
Résumé
Objectives: to study and to establish the overall trends of computed tomography [CT] use and associated outcomes in the pediatric emergency department [PED] at Royal Hospital, Oman, from 2010 to 2014
Methods: the hospital electronic medical record was retrospectively searched to find children [from birth to 12 years old] who had visited the PED and the number of CT requests between 1 January 2010 and 31 December 2014. The types of CT examinations ordered were analyzed according to anatomical location and were as follows; head, abdomen/pelvis, chest, cervical spine/neck, and others
Results: there were a total of 67 244 PED visits during the study period, 569 of which received 642 CT scans. There was a remarkable rise in CT uses per 1000 visits from 7 in 2010 to 12 in 2014. There was a 56% hike in CT requests from 87 in 2010 to 175 in 2014 while the number of pediatric emergency visits rose by about 28% from 11 721 to 15 052. Although head CT scans were the most common, cervical spine CT scans had the highest rate of increase [600%] followed by the chest [112%], head [54%] and abdomen [13%]. There were no significant changes in other CT scan requests. The cost of CT scans increased from $18 096 to $36 400 during the study period, which increased the average PED cost by about $2 per visit. The average time between a CT being requested and then performed was 1.24 hours
Conclusions: CT use in the pediatric emergency department has risen significantly at a rate that markedly exceeds the growth of emergency visits. This is associated with an increase in PED costs and longer waiting times
Résumé
Analysis of management in 22 ectopic pregnancies clinically presented as an atypical form. Twenty two patients with suspected ectopic pregnancy were successfully managed laparoscopically during three years period at Victory Nursing and infertility management centre, Khulna, Bangladesh. All patients had dull ache pain in lower abdomen or any one of the iliac fossa. All cases were hemodynamically stable and ambulatory. Ultrasonography findings were complex Heterogeneous mass without any free fluid in 8 cases, definitive gestational sac in 6, and sac like structure in 8 cases. Urinary beta"hCG was positive in 40.9% and negative in 59% cases. Pre-operative diagnoses were chronic ectopic pregnancy in 11, ruptured corpus luteum in six and chocolate cyst in five cases. Operating diagnosis were chronic ectopic pregnancy 14, unruptured tubal and cornual pregnancy 5, ovarian ectopic in three cases. Surgical procedures were salpingostomy, salpingectomy, salpingo-ophrectomy, partial ovarian resection and only sac removal with peritoneal toileting. Operating time was 30"120 minutes. The average post- operative stay was 24"48 hours without any complications. Unruptured early ectopic may present with minimal symptomotology. Hence in all women of child bearing age the provisional diagnosis of ectopic pregnancy may be kept in mind while examining and investigating a patient