ABSTRACT
Background: The occurrence of life-threatening events in hospitalized patients with tracheostomies are often preventable. Nurses have a vital role in providing consistent tracheostomy care to patients, thereby avoiding complications. This study was conducted to assess the knowledge of nurses in high dependency areas at a tertiary care hospital with regards to tracheostomy care, to train them and to assess the impact of a tracheostomy care teaching module. Methods: Purposive sampling techniques were used to recruit 65 nurses from high dependency areas in Father Muller Medical College Hospital. With appropriate informed, a detailed evaluation was conducted with a pre-validated questionnaire that assesses the knowledge, attitude and practices with regards to tracheostomy care. The nurses then underwent a tracheostomy training programme with a teaching module that emphasizes on tracheostomy care, a demonstration and hands on experience in the simulation lab, followed by an OSCE and a post-test. Statistical analysis was done using SPSS version 28 for paired T test and crosstabulation. Results: There was a mean increase in test scores, from 7.74 in pretest to 10.66 in post-test which was statistically significant. The comfort and confidence level of nurses after the module, increased by 80% and the OSCE scores were averaged around 73% giving a satisfactory outcome. Conclusion: This module significantly increased the quality of tracheostomy tube care provided by nurses thereby improving patient outcome. Small modifications to existing training programs can have a significant impact on overall health care as demonstrated by our study. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04489-y.
ABSTRACT
This article deals with a rare occurrence of Ganglioneuroma of the left cervical sympathetic chain in a 9-year-old girl, presenting with painless paracervical swelling noticed since 7 months. Imaging studies showed a left parapharyngeal mass extending from C1 to C6, displacing the posterior pharyngeal wall and anterolaterally displacing the contents of the carotid sheath, with no significant vascular feeders. A provisional diagnosis of? Neurogenic tumour was established and the patient underwent surgical excision. Histopathologically, the diagnosis of Ganglioneuroma was confirmed.
ABSTRACT
OBJECTIVES: Posterior urethral valves (PUV) is the commonest obstructive uropathy with varied consequences. Though valve fulguration is the treatment of choice, appropriate bladder management modifies outcome and includes rational use of anticholinergics. Here, we aim to evaluate the effects of oxybutynin on the bladder and urinary tract morphology and function. Concurrently, we document adverse effects encountered, patient compliance, and medication adherence. METHODS: A retrospective study of children below 5 years of age (2012-2017) post fulguration and on oxybutynin for at least 6 months. Patient demographics, clinical features, renal ultrasound, micturating cystourethrogram, dimercaptosuccinic acid scan, adverse effects, and pill count for medication adherence were collated. RESULTS: 48 children below the age of 5 years were included, and 12 were excluded either due to the presence of concomitant problems or were not on oxybutynin. Of the 36, four were lost to follow-up and one had died due to an unrelated condition. Thus, a total of 31 children were analyzed. At follow-up, 28/31 patients were asymptomatic, two had daytime incontinence, and one had recurrent urinary tract infection. All patients except one have preserved renal function tests. On ultrasonography, hydroureteronephrosis worsened in only 1/25 children and two showed significant post void residues. The resolution of vesicoureteral reflux was noted in almost 50%. 4/31 renal units had progressive scars. Only two parents defaulted medication. Urodynamic study done in half of these children showed stable bladder pressures except in two. CONCLUSION: Oxybutynin therapy following adequate valve fulguration aids upper tracts preservation by stabilizing deranged bladder dynamics. The medication is well tolerated with minimal or no side effects.
