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Background: The adoption of infection prevention and control guidelines is crucial for the safety of healthcare workers and patients. However, healthcare workers often face several barriers in implementing these guidelines, such as lack of knowledge, inadequate training, limited resources, cultural and language differences, and attitudes and beliefs. These barriers can negatively impact the implementation of effective infection prevention and control measures, leading to increased healthcare-associated infections. It is imperative to identify and address these barriers to promote the adoption of infection prevention and control guidelines in healthcare settings. Methods: We conduct a descriptive cross-sectional study with a sample size of 228 in Saidu Group of Teaching Hospital (SGTH) of Swat, Pakistan, from October 2022 to November 2022 to assess the barriers to healthcare workers in adopting IPC guidelines. Data were collected through a self-structured questionnaire on socio-demographics, hand hygiene practices, use of PPE, NSI reporting, disinfection of injection sites and waste disposal. Non-probability consecutive sampling was used to select participants. Results: According to the study, the main barriers to healthcare workers not adopting IPC guidelines were a lack of formal training in IPC (66.7%), lack of time and increased workload (6.1%), lack of availability of PPE (21.1%), lack of interest (5.3%), discomfort with PPE (1.8%), lack of knowledge on proper disposal of used needles (74.1%), lack of disinfectants (10.5%), and lack of spill kits in wards/labs (45.2%). Additionally, a significant proportion of healthcare workers did not report needle stick injuries (20.2%) and did not take post-exposure prophylaxis (77.6%). Conclusion and Recommendations: The study findings indicate that a significant proportion of healthcare workers lack formal training in Infection Prevention and Control (IPC), and there are gaps in practices related to hand hygiene, proper use of Personal Protective Equipment (PPE), needle stick injury reporting, post-exposure prophylaxis, proper disposal of used needles, surface disinfection, and blood spill management. The study suggests the need for increased IPC training for healthcare workers, improved availability and accessibility of PPE, implementation of a robust needle stick injury reporting system, promotion of postexposure prophylaxis utilization, enhanced education on proper disposal of used needles, ensuring adequate disinfection of surfaces, provision of spill kits in wards/labs, and comprehensive training in hospital waste management program for healthcare workers
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Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 or PIMS-TS (pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection) has been presenting itself in children in connection to the SARS-CoV-2 infection. Along with a brief review of global data on MIS-C, we present two case reports of critically ill pediatric patients (aged 16 and 14 years), presenting with features of MIS-C from May 2020 to March 2021, to a tertiary-care hospital in Telangana, India. The patients with MIS-C were healthy prior to testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Clinical presentations were similar, with fever, abdominal pain, gastrointestinal complaints, or maculopapular rash. The diagnostic parameters revealed elevated levels of C-reactive protein, D-dimer, and NtProBNP. Other infectious aetiologies were ruled out. Both patients required ionotropic support, and intravenous immunoglobulin (IVIG), and were also given empiric antibiotics. Both were hemodynamically stable upon discharge. As knowledge of the various COVID-19 manifestations in children increases, reporting is essential to better-educating healthcare professionals in clarifying and streamlining the variety of symptoms connected to MIS-C and assessing the associated risk factors that predispose the pediatric population to develop severe disease.
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Aims: Hemodialysis uses a semi-permeable membrane and electrochemical gradient to balance fluid and essential nutrient levels in the body. The kidneys perform this function in healthy individuals. The study aims to analyze the biochemical parameters of patients undergoing hemodialysis. Study Design: Cross-sectional study. Place and Duration of Study: The study enrolled 130 patients with chronic renal failure undergoing hemodialysis in King Khalid Hospital Tabuk, Saudi Arabia between January 2023 and February 2023. Methodology: The study applied correlation analysis to determine the nature of the relationships between the biochemical parameters during hemodialysis. Descriptive statistics were also used to determine the mean concentrations for the parameters during hemodialysis. Results: The concentrations of urea dropped from 45.12mmol/l from week one to 5.74mmol/l in week four. While the concentration of creatinine dropped from 761.53umol/l from week one to 160.60umol/l in week four. The study used correlation analysis to establish that there was a statistically significant strong positive correlation between urea and creatinine, calcium, iron, total iron binding capacity (TIBC), and albumin had their concentrations vary during dialysis weeks, with their concentrations increasing during some weeks and decreasing during others. It was also determined that there was a significant negative correlation between urea and TIBC. Conclusion: The study established that there was a significant reduction in the concentration of urea and creatinine during the fourth week of dialysis compared to the first week of dialysis. Therefore, dialysis helps to remove toxic waste products from the bloodstream.
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Background: Since being declared a global pandemic, COVID-19 has ravaged many countries worldwide and has over-whelmed many healthcare systems. The pandemic has also resulted in the loss of livelihoods due to prolonged shutdowns, which have had a rippling effect on the global economy. Even though substantial progress in clinical research has led to a better understanding of SARS-CoV-2 and the management of COVID-19, limiting the continuing spread of this virus and its variants has become an issue of increasing concern, as SARS-CoV-2 continues to wreak havoc across the world, with many countries enduring a second or third wave of out-breaks of this viral illness attributed mainly due to the emergence of mutant variants of the virus. Our study tried to evaluate the fact regarding CRP and feritin parameters concentration efficacy in the detection and evaluation of inflammatory disorders, tissue injury and infections.Methods: CRP concentration measurements are useful in the detection and evaluation of inflammatory disorders, tissue injury and infections. The VITROS CRP slide method is performed using the VITROS 5600 integrated system. The VITROS CRP slide is a multi-layered, analytical element coated on a polyester support. The immune-rate format for CRP is based on enzymatic heterogeneous, sandwich immunoassay format. In this format a derivative of phosphorylcholine (PC) is covalently bound to polystyrene polymer beads and in the presence of calcium serves as a capture agent, monoclonal anti-CRP antibody conjugated to horseradish peroxidase (HRP) serves as a signal generator.Results: A total of 175 patients were selected for the study for estimate levels of C-reactive protein and serum ferritin in COVID-19 patients. The data obtained was coded and entered into Microsoft Excel Worksheet. Data was analysed and results were tabulated. In our study, serum CRP and serum ferritin values were found to be elevated in patients infected with COVID-19.Conclusions: CRP levels were positively correlated with lung lesions. CRP levels could reflect disease severity and should be used as a key indicator for disease monitoring. Serum ferritin was found to be elevated among the COVID-19 patients who could not survive the treatment as compared to the recovered patients. Therefore, serum concentrations of ferritin could be used as a prognostic marker in the management of COVID-19 patients which is easily available and cost effective too.
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Objective@#Pain following the insertion of separators and archwires varies with age, sex, race, ethnicity, threshold, and health status. This study aimed to evaluate the characteristics of pain in orthodontic patients after the insertion of elastomeric separators, its effects on daily life, and its association with age and sex in a population not previously studied in this regard. @*Methods@#A crosssectional study of 130 patients undergoing orthodontic treatment included collecting data on demographics, pain experienced following the placement of separators, time of onset, duration, characteristics, change in dietary pattern or chewing side, intake of analgesics, and severity of pain on the Wong Baker’s scale. The results are reported as counts and percentages. Associations between sex and age were evaluated using Pearson’s chi-square test. @*Results@#Among the 130 patients, 56.2% were 9–20 years old, 63.8% experienced pain following the insertion of separators, 22.9% had their first episode of pain at 4 hours, 56.6% experienced intermittent pain, and 37.3% experienced discomfort; 18.1% males and 81.9% females experienced pain following the insertion of separators.Pearson’s chi-square test showed a significant association between pain and sex (P = 0.04). Most patients (37.3%) reported “hurts little more” for pain intensity on Wong Baker’s scale and 21.7% reported all four quadrants as sites of pain. @*Conclusions@#The pain experienced after separator insertion was associated with sex and age. Females experienced more pain than males and patients between the age range of 21 and 36 years suffered more pain during mastication than between 9 and 20 years old.
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The antioxidant activity and the inhibitory potential of α-amylase of lyophilized hydroethanolic extracts of Conocarpus erectus leaves obtained by ultrasonication were determined. The most potent extract was subjected to ultra-high performance liquid chromatography system equipped with mass spectrometer for metabolite identification. The identified metabolites were docked in α-glucosidase to assess their binding mode. The results revealed that 60% ethanolic extract exhibited highest ferric reducing antioxidant power (4.08 ± 0.187 mg TE/g DE) and α-amylase inhibition (IC50 58.20 ± 1.25 µg/mL. The metabolites like ellagic acid, 3-O-methyl ellagic acid, ferujol, 5, 2 Ì-dihydroxy-6,7,8-trimethyl flavone and kaempferol glucoside were identified in the extract and subjected to molecular docking studies regarding α-amylase inhibition. The comparison of binding affinities revealed 3-O-methyl ellagic acid as most effective inhibitor of α-amylase with binding energy of -14.5911 kcal/mol comparable to that of acarbose (-15.7815 kcal/mol). The secondary metabolites identified in the study may be extended further for functional food development with antidiabetic properties.
Se determinó la actividad antioxidante y el potencial inhibidor de la α-amilasa de extractos hidroetanólicos liofilizados de hojas de Conocarpus erectus obtenidos por ultrasónicación. El extracto más potente se sometió a un sistema de cromatografía líquida de ultra alto rendimiento equipado con un espectrómetro de masas para la identificación de metabolitos. Los metabolitos identificados se acoplaron en α-glucosidasa para evaluar su modo de unión. Los resultados revelaron que el extracto etanólico al 60% exhibió el mayor poder antioxidante reductor férrico (4.08 ± 0.187 mg TE/g DE) e inhibición de la α-amilasa (IC50 58.20 ± 1.25 µg/mL. Los metabolitos como el ácido elágico, 3-O-metil elágico ácido, ferujol, 5, 2 Ì-dihidroxi-6,7,8-trimetil flavona y kaempferol glucósido se identificaron en el extracto y se sometieron a estudios de acoplamiento molecular con respecto a la inhibición de la α-amilasa. La comparación de las afinidades de unión reveló 3-O-metil El ácido elágico como inhibidor más eficaz de la α-amilasa con una energía de unión de -14,5911 kcal/mol comparable a la de la acarbosa (-15,7815 kcal/mol). Los metabolitos secundarios identificados en el estudio pueden ampliarse aún más para el desarrollo funcional de alimentos con propiedades antidiabéticas.
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Extraits de plantes/composition chimique , alpha-Amylases/antagonistes et inhibiteurs , Myrtales/composition chimique , Antioxydants/composition chimique , Benzopyranes/analyse , Techniques in vitro , Extraits de plantes/pharmacologie , Feuilles de plante/composition chimique , Simulation de docking moléculaire , Antioxydants/pharmacologieRÉSUMÉ
A systematic approach is required to diagnose acute leukemia. Most of the cases are satisfactorily diagnosed and categorized into subtypes. However, a few cases pose diagnostic dilemma secondary to immunophenotypic aberrancies which are defined as antigens that are normally restricted to a different lineage and expressed by a neoplastic population while absent from its normal non neoplastic counterpart. We report a rare case of Early T-cell PrecursorLymphoblastic Leukemia with aberrant expression of CD19. A 7-year-old boy referred to our hospital with his cervical lymph node biopsy reported as lymphoproliferative disorder. The patient was COVID-19 positive. Chest X-ray showed mild right sided pleuraleffusion with huge mediastinal mass. Flow cytometry on peripheral blood used to establish the diagnosis. The case is reported to improve knowledge regarding aberrant expression of markers. Hematopathology teams should be aware of this phenomenon so that appropriate workup can be done to reach correct diagnosis.
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Abstract Degenerative diseases diabetes and oxidative stress constitute a major health concern worldwide. Medicinal plants are expected to provide effective and affordable remedies. The present research explored antidiabetic and antioxidant potential of extracts of Carissa opaca roots. Methanolic extract (ME) was prepared through maceration. Its fractions were obtained, sequentially, in hexane, chloroform, ethyl acetate and n-butanol. An aqueous decoction (AD) of the finely ground roots was obtained by boiling in distilled water. The leftover biomass with methanol was boiled in water to obtain biomass aqueous decoction (BAD). The extracts and fractions showed considerable porcine pancreatic α-amylase inhibitory activity with IC50 in the range of 5.38-7.12 mg/mL while acarbose had 0.31 mg/mL. The iron chelating activity in terms of EC50 was 0.2939, 0.3429, 0.1876, and 0.1099 mg/mL for AD, BAD, ME, and EDTA, respectively. The EC50 of beta-carotene bleaching activity for AD, BAD, ME, and standard BHA were 4.10, 4.71, 3.48, and 2.79 mg/mL, respectively. The total phenolic content (TPC) and total flavonoid content (TFC) of AD and BAD were also considerable. In general, ethyl acetate fraction proved to be the most potent. Thus, the C. opaca roots had excellent antioxidant activity while having moderate α-amylase inhibitory potentia
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Plantes médicinales/effets indésirables , Extraits de plantes/analyse , Agents chélateurs du fer/analyse , Bêtacarotène/analyse , Apocynaceae/classification , Maladie , Concentration inhibitrice 50 , Hypoglycémiants/pharmacologie , AntioxydantsRÉSUMÉ
Search for safe antioxidants and novel nutraceuticals urged to evaluate the antioxidant, anti-acetylcholine esterase and anti-lipoxygenase activity of various leaf extracts of Conocarpus lancifolius. Extraction was optimized from freeze dried plant extracts quenched with liquid nitrogen using water, ethanol, methanol, hexane, ethyl acetate and chloroform. Maximum extract yield, total phenolic contents and total flavonoid contents were obtained in case of ethanolic extraction. The highest 2,2-diphenyl-1-picrylhydrazylradical scavenging in terms of IC50 value of 55.26 µg/mL was observed for ethanolic leaf extract. The acetylcholine esterase and lipoxygenase inhibitory activities (IC50) were also observed for ethanolic extract. These findings for ethanolic extract were statistically significant when compared with other extracts (ρ<0.05). The haemolytic % values indicated that all extracts were associated with very low or negligible toxicity. The epicatechin, isorhamnetin, rutin, scopoleptin, skimmianine, quercetin-3-O-α-rhamnoside, quercetin-3-O-ß-glucoside, cornoside, creatinine, choline, pyruvic acid, α-hydroxybutyric acid, phyllanthin and hypophyllanthin were identified as major functional metabolites in ethanolic leaf extract of C. lancifoliusby 1H-NMR. The identified metabolites were probably responsible for the pharmacological properties of C.lancifolius. The findings may be utilized as pharmacological leads for drug development and food fortification.
Se insta a la búsqueda de antioxidantes seguros y nuevos nutracéuticos para evaluar la actividad antioxidante, anti-acetilcolina esterasa y anti-lipoxigenasa de varios extractos de hojas de Conocarpus lancifolius. La extracción se optimizó a partir de extractos de plantas liofilizados enfriados con nitrógeno líquido usando agua, etanol, metanol, hexano, acetato de etilo y cloroformo. En el caso de extracción etanólica se obtuvo el rendimiento máximo de extracto, el contenido de fenoles totales y el contenido de flavonoides totales. La mayor eliminación de radicales 2,2-difenil-1-picrilhidrazilo en términos de valor de CI50 de 55,26 µg/mL se observó para el extracto de hoja etanólico. También se observaron las actividades inhibidoras de la acetilcolina esterasa y lipoxigenasa (CI50) para el extracto etanólico. Estos hallazgos para el extracto etanólico fueron estadísticamente significativos en comparación con otros extractos (ρ<0.05). Los valores del % hemolítico indicaron que todos los extractos estaban asociados con una toxicidad muy baja o insignificante. Se identificaron la epicatequina, isorhamnetina, rutina, escopoleptina, skimmianina, quercetina-3-O-α-ramnosido, quercetina-3-O-ß-glucósido, cornosido, creatinina, colina, ácido pirúvico, ácido α-hidroxibutírico, filantrina e hipofillantina. como metabolitos funcionales principales en el extracto etanólico de hojas de C. lancifoliuspor 1H-NMR. Los metabolitos identificados probablemente fueron responsables de las propiedades farmacológicas de C. lancifolius. Los hallazgos pueden utilizarse como pistas farmacológicas para el desarrollo de fármacos y la fortificación de alimentos.
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Extraits de plantes/pharmacologie , Combretaceae/composition chimique , Antioxydants/pharmacologie , Phénols/analyse , Flavonoïdes/analyse , Techniques in vitro , Extraits de plantes/composition chimique , Anticholinestérasiques/pharmacologie , Anticholinestérasiques/composition chimique , Piégeurs de radicaux libres , Inhibiteurs de la lipoxygénase/pharmacologie , Inhibiteurs de la lipoxygénase/composition chimique , Éthanol , Antioxydants/composition chimiqueRÉSUMÉ
Overview: Hemorrhoidal disease (HD) is a common surgical disorder. The treatment modalities can be surgical or nonsurgical. Every surgical option has its own indications and limitations. Postsurgical symptomatic recurrence rates are low and vary between different techniques. The ideal way to deal with recurrent HD is not clear. Material and Methods: The present prospective case series enrolled a total of 87 patients (54male/33 female). Thirteen out of 87 patients (15%) had history of previous intervention for HD. Amodification of the standard technique was adopted for patients with recurrent HD. A mean follow-up of 22 months was achieved. Results: Stapled hemorrhoidectomy (SD)was performedin13patientswho had historyof previous surgical intervention for HD. There were no adverse events related to the technique. Patients with recurrent HD had severe pain scores with SH as compared to patients who underwent SH at the first time. There were no wound related complications. Conclusion: Stapled hemorrhoidectomy can be performed easily and offers good results in patients with recurrent HD. (AU)
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Humains , Mâle , Femelle , Récidive , Agrafage chirurgical , Hémorroïdectomie/méthodes , Hémorroïdes/chirurgie , Hémorroïdes/thérapie , Résultat thérapeutique , Hémorroïdes/épidémiologieRÉSUMÉ
Epstein-Barr virus (EBV) is a member of the herpes virus family that can infect humans. Common manifestations of Epstein-Barr virus infection include fever, lymphadenopathy and pharyngitis with some rare complications including mediastinitis, myocarditis, pancreatitis, acute kidney failure and neurological disorders. Clinical findings along with serological evidences are needed to diagnose the infection. Early investigation for EBV in febrile patients can expedite both diagnosis and treatment.
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Coronavirus 2019 (COVID-19) is an enveloped ribonucleic acid (RNA) virus that is diversely found in humans and wildlife. A total of six species have been identified to cause disease in humans. The most recent outbreak initially presented as pneumonia of unknown etiology in a cluster of patients in Wuhan, China. The epicenter of infection was linked to seafood and exotic animal wholesale markets in the city. SARS-CoV-2 is highly contagious and is a declared global pandemic. This review will introduce a general overview of virology and describe the clinical features, diagnostic testing, and management of COVID-19 patients. There are multiple drug trials going on with some positive results. However, since no vaccine is available, the best way to combat the virus is by preventive methods. Our review will also provide a means to raise awareness among primary and secondary healthcare providers during the current pandemic.
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Evans syndrome (ES) is an autoimmune disorder characterized by the simultaneous or sequential development of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP) and/or immune neutropenia in the absence of any underlying cause. Evans syndrome is a rare disorder although the exact frequency is unknown. No sex predilection is known and Evans syndrome has been described in all ethnic groups and at all ages. Classification of ES includes primary, with this being an exclusion diagnosis with no underlying condition, and secondary in the presence of an underlying disease. Clinical features are associated with anemia and thrombocytopenia including pallor, weakness, fatigue, jaundice, petechiae, ecchymosis, gingivorrhagia and epistaxis. First, a detailed history must be taken from the patient to determine the risk factors for developing ES then a family history of immune disorders along with a thorough physical examination. The management of Evans syndrome remains a challenge. Steroids with and without IVIG are recommended as front-line therapy. Red blood cell/platelet transfusion is indicated only in severe symptomatic patients due to the risk of exacerbations. Splenectomy may also be considered a second-line treatment.
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Introduction: Coronary artery disease (CAD) contributessignificantly to the development of Heart failure in bothdeveloped and developing countries. Recognition of CAD inthese patients significantly alters the management strategy.This study was aimed at assessing the prevalence of coronarydisease in the patient with Left Ventricular systolic dysfunctionof unknown causeMaterial and Methods: This prospective study enrolledall the consecutive patients with LV systolic dysfunction ofunknown cause and Status of coronary arteries of eligiblepatients was assessed with coronary angiogram.Results: A total of 145 patients were enrolled in this study.Mean age of the patients was 53.4±7.43 years. There were91(62.8%) males and 54(37.2%) females. Dyspnea on exertion(DOE) was presenting symptom in 71(51.7%), Angina onexertion (AOE) in 15(10.3%), DOE & AOE in 47(32%), andUnstable angina (UA) in 08(5.5%) of cases. Hypertensionwas the risk factor in 88(60.7%), diabetes in 35(24.13%),smoking in 60(41.4%) and dyslipidemia in 32(22.06%)cases. Echocardiography of study patients revealed, mild LVdysfunction (EF=40%-49%) in 57 (39.7%) patients, moderateLV dysfunction (EF=30%-39%) in 71 (49%) patients andsever LV dysfunction (EF<30%) in 17 (11.7%) patients.Conclusion: coronary artery disease contributes significantlyto development of LV systolic dysfunction of unknown causeand its presence significantly alters the management andprognosis in these patients.
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Background: Diabetic wound is a major socioeconomic debilitating problem in this society. Various treatment options are available but still it requires better treatment option. In diabetes mellitus the oxygenation to the tissues is reduced. In this study effects of low level laser therapy were compared with topical application of Streptococcus thermophilus on diabetic wounds that induces formation of new blood vessel and free radical scavenging system, a comparative study to get better treatment option for diabetic wounds.Methods: 18 male rats were selected and divided randomly into three groups. Diabetes was induced in all the rats by using the Alloxan monohydrate at a dose of 120mg/kg of the body weight. Group A was treated with normal saline, group B was treated with low level laser therapy and group C was treated with Streptococcus thermophilus topically. Skin tissues were collected on day three and seven, slides were prepared for microscopic examination to observe the new blood vessels formation.Results: Mean number of new blood vessel formation was observed in group B compared with group A and C. Significant vasculogenesis was seen in group B when treated with Low level laser therapy.Conclusions: In the group of low level laser therapy new blood vessel formation was seen with better wound healing. It means LLLT provides better oxygenation to the tissues by generation of new blood vessels compared with Streptococcus thermophilus and normal saline.
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Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.
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Background: Acute coronary syndromes (ACS) are an imbalance between myocardial oxygen supply and demand, and the presence of anaemia further potentiates this imbalance. The burden of anaemia in patients presenting with acute coronary syndromes (ACS) is significant. Anaemia has the potential to worsen myocardial ischemic insult by decreasing the oxygen content of the blood supplied to the jeopardized myocardium. Present study investigates the prevalence of anaemia in ACS patients attending a tertiary health care institute.Methods: A total of 148 patients with ACS were recruited in the study from July 2018 to October 2018 in Multan institute of cardiology, Pakistan. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent. Patient having any other diseases known to cause anaemia were excluded.Results: Mean age of patients was 49 years. Out of 148, 114 (77%) were males and 34(23%) were females. Prevalence of anaemia was 38% in Male and 58.8% in Female. Among Male, 18.8% were microcytic, 4.54% were macrocytic and 77.27% were normocytic. Among Female, 50% were microcytic and 50%% were normocytic. Prevalence of ACS was higher is patients with diabetes and hypertension combined (31%) than in patient with diabetes alone (17.56%) or hypertension alone (21.62%). 13.51% were pure vegetarians while 78.37% were on mixed diet consisting of vegetables+meat+pulses.Conclusions: Higher incidence of anaemia was reported in subjects having acute coronary syndrome. Incidence of anaemia in STEMI patients was greater than NSTEMI and unstable angina patients. Severe form of acute coronary syndrome i.e. STEMI was associated with higher incidence of anaemia.
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Background: Bipolar affective disorder is cyclic swinging of mood between mania or hypo-mania and depression. Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 1 to 3% in the general population. Despite a growing body of knowledge on bipolar spectrum disorder (BSD), relatively little is known about the clinical characteristics of BSD in medical students. This study evaluates the prevalence and severity of BSD in medical students in relation to certain socio-demographic factors like age, sex and class of education.Methods: A questionnaire based study was done on 298 medical students of Nishtar Medical University, Multan and Shaikh Zayed Medical College, Rahim Yar Khan chosen on basis of random sampling to test the prevalence of bipolar spectrum disorders using Mood Disorder questionnaire (MDQ). Out of these students 161 were males and 137 were females. Students were interviewed to obtain information about age, sex and academic year of education.Results: According to mood disorder questionnaire scoring, of the total 298 students 80 (26.84%) screened positive for bipolar spectrum disorder (BSD). Among 80 students who screened positive for BSD 43 (53.75%) are males while 37 (46.25%) are females. Class-wise distribution of BSD is as follows: Out of 80 students screened positive 15 (18.75%) are from 2nd year, 22 (27.5%) from 3rd year and 43 (53.75) from 4th year. Age-wise distribution of BSD is as following: Students of age 19, 20, 21, 22 and 23 years suffering from BSD were 5 (6.25%), 17 (21.25%), 23(28.75),22 (27.5%) and 13 (16.25%) respectively.Conclusions: In our study, the estimated rate of prevalence for bipolar spectrum disorder among medical students of Pakistan is 26.84%. There was no significant difference in prevalence on the basis of gender. Prevalence was increasing with both age and class wise distribution.
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Introduction: There has been a vigorous change in the healthcare sector with increased patient expectations, technological advancements, and growing competition in the healthcare market. Therefore hospitals have to shift from traditional management approach to more diverse aspects like TQM practices and effective quality management system to augment the performance level. Relationship between TQM practices and performance is multipronged and widely discussed in the literature. Aim: Main purpose of this study was to evaluate the impact of TQM practices on nonfinancial performance elements of performance in different quality management system settings. Methods: This study used an empirical approach to identify and explain the TQM practices and non-financial performance relationship. A cross-sectional survey was conducted in 5 hospitals from different regions with either Joint Commissioned International (JCI) or ISO 9001 based quality management system. Data were collected from 150 hospital managers between October 2018 and February 2019. Descriptive and inferential statistical analysis was conducted using IBM SPSS 20 version. Results: Finding of the study support that TQM practices have a statistically significant and positive relationship with non-financial performance (p<0.05). Result of multiple linear regression analysis shows that TQM practices are a strong predictor of non-financial performance (Beta=0.793, t=15.837, R2=0.629, and p=0.000) and explain 63% variation in the model. TQM practices demonstrate higher overall and individual mean values for JCI accredited hospitals. T-test shows that there is a significant difference (p<0.05) in TQM practices between JCI and ISO-based quality management system. Conclusion: It can be inferred from this study that TQM practices have a leading role in the improvement of the non-financial performance of hospitals. Hospital managers at a different level can achieve improved results with effective implementation of identified TQM practices. TQM practices significantly contribute towards individual dimensions as well as an overall improvement in non-financial performance.