Knowledge and practice regarding prevention of hepatitis b among non-gazzeted staff of tertiary care teaching hospital in private sector, Lahore

A descriptive and cross sectional study was conducted among non-gazzeted staff of a Tertiary Care Hospital in Lahore from January 2012 to July 2012. The objective was to assess the level of knowledge and practice regarding prevention of Hepatitis B and explore the gaps between knowledge and actual practice for disease prevention. A sample of fifty six non-gazzeted staff [appointed 3 months earlier on regular basis] was taken through systematic random sampling. A pre-tested structured questionnaire was used after taking verbal consent from the respondents. Out of total fifty six, 26 [46.4%] were females. The mean age was 27.45 +/- 08.41 years and 34 [60.7%] were having income / capita / month < Rs. 3000. Good knowledge regarding this viral disease was present in 30 [53.6%] respondents. But 47 [83.9%] were well informed that disease spreads through blood transfusion and from person to person. Also 48 [85.7%] were aware that needle stick injury can lead to disease transmission. Knowledge of disease transmitting sexually was positive among 44 [78.6%] respondents and through unhygienic dental procedure was positive among 45 [80.4%] respondents. Regarding practices 25 [44.6%] had full course of immunization and 53 [94.6%] were properly disposing off used needles and 31 [55.4%] were insisting on change of razors at barber's shop. It was also observed that 38 [67.9%] respondents were using gloves before handling the instruments and 28 [50%] got accidental needle prick in last calendar year. Out of total fifty six, 46 [82.14%] had satisfactory / good knowledge. However paramedics as compared to auxiliary staff showed good knowledge [P-value = .0036] and also good practice [P-value = .0031]. These significant statistics of the hospital staff are very encouraging, as they revealed satisfactory / good knowledge [82.14%] satisfactory / good practice [69.94%], the gap of 12.50% can be overcome by continuous awareness campaigns by hospital authorities. However full course of immunization doesn't depend on income / capita / month [P-value - 0.0602] and on gender [P-value - 0.775]. The present study concludes that there is a gap between knowledge and practices among non-gazzeted staff. Repeated awareness sessions should be launched to overcome this gap and subsidized full immunization package should be provided at recruitment time to hospital non-gazzeted staff

Assessment of process measures of quality of care through client flow analysis

Background: Quality of health care services is emerging as a field with multifaceted approach. Measuring the quality is tricky and needs standards. Many global standards are in place but still the contextual applications of standards need research on the measurable aspects of the quality of care

Material and Methods: A cross-sectional study was conducted at general medical out patient departments of two tertiary care hospitals of Lahore, one from the public sector and the other from the private sector selected using multi-stage sampling. 93 patients were selected from each hospital. Process measures of quality of care delivered in medical out patient departments were assessed using client flow analysis technique, performed by trained personnel

Results: Access to the hospital OPD, waiting time outside the consultant room, physical environment of the OPD and provision of relevant information to the patient were observed for adherence to standards and statistical association found with the patient satisfaction on these aspects

Conclusion: The process measures must be assessed in order to evaluate the quality of care in a specific service or hospital as patient satisfaction [outcome measure] alone is not enough to judge the quality of care

Awareness of DOTS regarding management of pulmonary tuberculosis, among resident doctors and final year medical students in tertiary level health care facility

To assess and compare the awareness level regarding management of pulmonary tuberculosis including DOTS among resident doctors of JHL and final year medical students of AIMC and to find weak areas regarding it which need interventions according to WHO recommendations, at tertiary care level hospitals. It is a cross sectional comparative, study carried out from May 2010 to Sept. 2010, of Jinnah Hospital Lahore. In this study regarding awareness of DOTS strategy among doctors and medical students, doctors had designation as SRs 8, PGs 36, SHOs 56 and final year students were 110 [Total 210]. A semi - structured questionnaire was filled by the trained medical students. Regarding sputum microscopy for AFB as standard test for diagnosis of new case of pulmonary TB, 50% resident doctors and 51% students answered in favour of it, while 20% doctors and 12% students preferred x-ray chest as 1[st] choice and rest 15% preferred isolation by culture, mycodot and severity of symptoms [P = 0.04]. Regarding the knowledge about time taken for growth of AFB on culture media 70% doctors and 61% students answered correctly [P = 0.2122], whereas 83.8% students and 89% residents knew what 'DOTS' stands for? Both 84% doctors and students gave multiple reasons in favour of "why DOTS" as it is cost effective, better patient's compliance and stops MDR. Only 10% said that it is WHO'S recommended strategy [P = 0.002]. Only 30% doctors follow the complete standard management regime as described by DOTS for different categories of patients with pulmonary tuberculosis while only 16% 5th year medical students were able to classify patients according to drug regimen and category. Sixty% doctors 34% SRs, 20% PGs and 6% house officers chose "sputum microscopy" as best tool to monitor the progress of case 3 under treatment for pulm. TB. while 20% preferred chest X-ray for this purpose. There are multiple weak areas about knowledge and practices of doctors in tertiary care level hospitals about DOTS and its strategies for patients of pulmonary tuberculosis. Majority of the doctors were not awared that DOTS facility is available in JHL. Hence education of hospital doctors is important because private practitioners [pps] generally tend to follow the prescription written by doctors in the teaching hospitals

Weaning practicses and their deteminants among mothers of infants

This study was designed to assess the weaning practices among mothers of infants 6-12 months of age and to compare these practices among different socio-economic and demographic variables. This is a cross-sectional study conducted in D and E blocks of AIMC residential colony, from May 2006 to September 2006. A total of 50 infants [6-12m of age] were included in the study. Their feeding pattern and weaning practices were studied using self-administered questionnaire. They were grouped in two categories according to their age of commencement of weaning. Forty two [84%] infants were receiving weaning foods in addition to milk. Recommended age [6 months] was noticed in 42 cases [84%], while delayed weaning was seen in 8 [16%]. Timely weaning was noticed in breastfed infants, 34 [70%]. Even if weaning was started at the correct age, several problems were observed. This included infrequent feeding, use of expensive commercial cereals given in diluted form instead of home prepared foods and improper food preparation practices were also observed. The quality, type and choice of food was not ideal for an adequate growth. Recommended weaning time [4-6 m] and delayed weaning was analysed in relation to socio-economic and demographic characteristics of the infant's mothers and their families. Delayed commencement of weaning had a statistical significant relationship with age, education, family income, occupation of father and mother, parity of mother and also large family size [p<0.05]. Bottle-fed babies had significantly delayed weaning i.e more than 9 months. Sex of the child was not significantly related to early or delayed weaning [p> identification Incorrect weaning practices are an issue of public health in developing countries. The identification and analysis of weaning practices prevalent in low socioeconomic households can lead to remedial strategies for improving the nutritional status of infants and, thereby, help to reduce infant mortality and morbidity rate