Assessment of the knowledge of paraplegic persons regarding self-care activity

Background and objective: Knowledge for getting self-care activity is the one important issue in the quality of life for a paraplegic person to live independently. This study aimed to assess the level of knowledge of persons with complete paraplegia regarding how to do self-care activity during daily living

Methods: This cross-sectional study involved 58 cases with complete paraplegia out of 202 cases with spinal injuries that were admitted to the Emergency Management Centre in Hawler from 2008 to 2014. Information data on paraplegic persons was collected from August 15[th] to October 15[th], 2014 through the interview by using a questionnaire

Results: The majority of persons with paraplegia were young [32.8%], male [84.5%], married [58.6%], secondary school graduates [35.3%], unemployed [72.4%], having income exceeding the needs [50%] and live in the urban area [77.6%]. Most of them had thoracic injury at level 9 to 12 [70.7%]. The most common cause of injury was fall from high [41.4%] and the majority of readmissions were for bedsores [87%]. The knowledge of paraplegic persons of self-care activity was at a high level [87.9%]. Those living in urban areas had a significantly higher knowledge than those living in rural areas [93.3% vs 69.2%, P = 0.019]

Conclusion: Persons with paraplegia had good knowledge for self-care activity, but still need continuous knowledge and practical training. Urban areas need more help and knowledge

Disability assessment of diabetic patients in Erbil city

Background and objectives: The disabling effects of diabetes mellitus are multi-factorial, which can result in the high prevalence of long term complications. The aim of this study was to assess disability levels of diabetic patients

Methods: A quantitative design descriptive study was conducted in Leila Qasim Center in Erbil City in the Kurdistan Region of Iraq from February 2012 to February 2013. A non-probability purposive sample of 400 diabetic patients for more than 5 years was selected. A questionnaire was designed and divided into three parts: sociodemographic data, clinical data, and the standardized questionnaire developed by World Health Organization for disability assessment

Results: The highest percentage [57%] of diabetic patients had a moderate level of disability, while 23% had a mild level of disability. Severe level of disability was present in 20% of sample. No one had not disability or extreme level of disability

Conclusion: More than half of diabetic patients were in the moderate level of disability

Hepatic trauma and associated injuries- experience in a tertiary care hospital

The objective of this study was to analyze and document the presentation of liver trauma and associated injuries. Present study was conducted from January 2010 to December 2011 at Jinnah Postgraduate Center, Karachi, Pakistan. Oral and written consent was obtained from the participants before the start of the study. Inclusion criteria included all patients, aged more than 13 years with hepatic trauma admitted in the wards. The patients with co existing chronic hepatic diseases were excluded. This study comprised of 61 participants, among those [95%] were males and [5%] were females. The mean age of the participants was 31.4. The mean age for female participants was 28.3 while for male was 31.6. Amongst the patients with hepatic trauma, 67.2% had road traffic accidents [RTA] as the cause of their liver injury followed by firearm injury in 19.7%of the cases, physical assault in 9.8% and stab wound in 3.3% of the patients. Investigations done on the patients were ultrasound and C.T scan. In this study 60.7% patients were diagnosed on abdominal ultrasound and 14.8% were found to have hepatic trauma on the abdominal C.T scan. In all the patients with hepatic injury 50.8% had associated injuries. The most common associated injury was chest complications which was present in 10 [16.4%, C.I: 3.7-39.7] patients followed by gut perforation which was present in 11.4% patients. Other common injuries included forearm fracture which was present in 09.8%patients, spleen injury was found in 8.1% and diaphragm injury in 4.9% patients. In Pakistan Road traffic accident is one of the most frequent causes of Hepatic injury and middle aged men are at the highest risk of hepatic trauma

Patient satisfaction levels in surgical ward of a tertiary care hospital in Karachi

Patient satisfaction is a good yardstick to measure care giver's success. Patient satisfaction is one of the pertinent objectives of health care system. Since doctor-patient relationship is most crucial and decisive in patients' perception of care and satisfaction, from this survey, we explore various aspects of care received from doctors that determine the overall satisfaction level of patients. The objective of this study was to find out the level of patients satisfaction with various aspects of care provided by doctors in surgical ward in a tertiary care hospital in Karachi. Data was collected from a convenient sample of 174 patients, at the time of discharge from the health facility, who were admitted to surgical ward of Ziauddin Hospital, KDLB campus. Study design was cross sectional. Data collection was done from August till September 2013. Questionnaire was developed after literature review. Patient satisfaction was recorded using the 5 point Likert scale. Data analysis was done on SPSS version 19. Overall there were 57.5% males and 42.5% females participants. 41% of the participants were between 35-44 years of age. 42.5% were educated up to primary level, while 19.5% were not educated at all. Overall satisfaction level was 100%, with 66.7% noted as very satisfying while 33.3% as satisfying. Doctors' politeness, availability, provision of post operative care and discharge counseling were strong determinants of overall satisfaction. Explanation of medicines and patients' participation in their illness discussion were areas of uncertainty and dissatisfaction. Doctors' polite attitude, consultation and availability are vital to patient satisfaction. Areas that need more attention are, seeking patient views in their illness discussion, explaining them prescription drugs and lab investigations

Impact of preoperative anxiety intervention on postoperative pain

Numerous prospective randomized studies demonstrate the effectiveness of simple preoperative anxiety intervention in improving surgery outcomes as measured by decreased anxiety, decreased pain and reduced need for pain medications. The objective of study is to find out the effect of simple preoperative anxiety intervention on postoperative pain. A sample of 300 patients who were admitted in general surgery units of two teaching hospitals [Rezgari and Hawler] in Erbil city from 5[th] April 2009 to the 10[th] November 2009 were allocated randomly into two groups; 150 patients received preoperative anxiety intervention before surgery [which includes giving information about surgery, anesthesia and post operative management of pain] and another 150 patients as a control group received no intervention. The assessment tool included a special questionnaire about socio-demographic information and the anxiety level was measured before surgery by state-trait anxiety inventory scale of Spilberger which includes 20 items while measurement of pain score was obtained during 48 hours after surgery by visual analog scale [VAS] which is composed of a [10 cm] horizontal line. The patients in intervention group showed low pain scores; the Mean score and standard deviation of VAS scale for intervention group was [4.47 +/- 0.692] while for control group the Mean score and standard deviation was [6.55 +/- 1.121]. based on the results of the study the investigators conclude that giving information to patient before surgery can reduce the preoperative anxiety level which leads to decrease postoperative pain level

Anxiety among patients undergoing major general surgery

It has been recognized for more than 40 years that patients experience different levels of anxiety when faced with impending surgery. The degree to which each patient manifests anxiety is related to many factors; this study aims to assess the level of anxiety among patients undergoing major general surgery and to identify the effect of gender on preoperative anxiety. A sample of 300 patients who were admitted from 5th April 2009 to the 10th November 2009; in general surgery units of teaching hospitals [Rezgari and Hawler] in Erbil city were interviewed to assess their level of anxiety before surgery. The instrument used for this purpose was a questionnaire that included socio-demographic information and the State-Trait Anxiety Inventory [STAI] of Spilberger. Most of the patients showed moderate to severe anxiety level; [moderate=50% and severe=38.3%] others showed mild anxiety level [11.7%]. A statistically significant relationship was seen between preoperative anxiety and gender; female patients showed high levels of anxiety [severe anxiety=46.9%] while male patients showed less severe anxiety level [severe anxiety=28.6%]. According to the results of the study patients undergoing major general surgery need to be assessed regarding level of anxiety before surgery. This anxiety should be reduced through appropriate interventions, especially in women who have been found to experience high levels of anxiety