Spectrum of ventilator associated pneumonia with effect on intensive care unit's patient outcome

Objective: To evaluate the spectrum of ventilator-associated pneumonia [VAP] and relation of length of intensive care unit [ICU] stay, patient's age and gender on the likelihood of being discharged from the ICU

Study Design: A cross sectional study

Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan over a period of 12 months extending, from Apr 2015 to Apr 2016

Material and Methods: We included 470 patients out of whom only 106 patients were diagnosed with VAP while on mechanical ventilation in ICU for >48 hours. A positive culture of tracheo-bronchial secretions, with any one of these; >48-h infiltrate on chest radiograph, fever of >38.3[degree]C, leukocytosis of >12 x 10[9]/ml and increase in tracheo-bronchial secretions established the diagnosis of VAP

Results: The mean age of the male and female patients was 49.8 +/- 18 years and 50.6 +/- 21.4 years respectively with 16.6 +/- 13 days as the mean duration of ICU stay. About 30.2% VAP patients had Acinetobacterbaumanni with 96.8% sensitivity to colistin, 27.4% patients had Klebsiella pneumonia with 72% and 62% sensitivity to colistin and carbapenems respectively and 15.1% patients had methicillin-resistant Staphylococcus aureus with 100% sensitivity to vancomycin. There was an increased incidence 60.4% of late-onset VAP compared to 39.6% early onset VAP. The overall mortality in VAP patients was 28.6%

Conclusion: We recommend the empirical combination therapy of colistin, carbapenem, and vancomycin in VAP. No statistical significant association was found between length of ICU stay and patient's mortality. The odds of getting discharged were found to be 3.2 times greater for male participants as opposed to female patients. Decreasing age was associated with an increased likelihood of being discharged

Relationship of corporate social employees responsibility [CSR] with job attitude and behavior: employee's perception.[a study of public and private hospitals in Lahore Pakistan]

The main objective of the study to find out the relationship between Corporate Social Responsibility [CSR] with Job attitude and behavior that how employee [paramedical and administration] of a hospital take care of their patients. Cross sectional study: This study was carried out in the Global Institute [CFE Campus] Lahore from March 2014 to July 2014. Sampling frame collected from employees and managers who are working in various hospitals of Lahore. Non-probability sampling techniques are used which does not involve random selection. Questionnaire was conducted in the form of closed ended question. Survey was conducted from June. During the survey, overall 204 questionnaires were distributed. Participant responded on the questionnaire on a scale of 1 to 5. The highest value is job behavior [0.763] factor which is 76.3% and it shows that the employee perception of CSR has greater influence by the job behavior factor as compare to the other variables. Mostly employee behavior with their organization is effective and their work with their colleague is done efficiently to guide and help the staff.The ratio of job attitude factor is 5.2% which shows that this factor also influences the employee perception of CSR less than the job behavior factor. Moreover the ratio of job attitude factor is 5.2% which means that job attitude toward organization is not positive. Adjusted R square 0.347 are the dependent variable. Overall whole dependent variable is significant. The R-square of the regression is 35.3% which shows the variation in dependent variable that is predicted by independent variables. The adjusted r-square is 34.7%.This study found that employees CSR perception has effects on employees work outcomes. Employees play an important role in their organizations and their perception of CSR will influence their subsequent work outcomes. The CSR programs would benefit both corporations and their employees. Organizations would also benefit from effectively interacting with their employees on CSR issues

Comparison of use of ultrasonic dissector with electrocautery in thyroid surgery

Objective: to determine whether use of ultrasonic dissector [UD] in thyroid surgery results in shorter operative time, hospital stay and reduced average drainage and to compare the incidence of postoperative complications with electrocautery [EC]

Material and Methods: hundred patients with thyroid disease were inducted in the study. The patients were randomized in two groups. Group A [EC], and Group B [UD]

Results: the study carried out on patients undergoing ultrasonic dissector group B [UD] for thyroid surgery revealed meager post-operative complications attributable to harmonic scalpel but on the contrary the benefits were decrease in operative time, less post-operative pain, less drainage, early hospital discharge and very few complications as compared to Electrocautery group A [EC]

Conclusion: the complete ultrasonic dissection of thyroid gland with Harmonic scalpel is not only safe but it also reduces pain, hematoma formation and drainage. Hospital stay and operative time is also shortened