A staff questionnaire study of MRSA infection on ENT and general surgical wards.

Methicillin-resistant Staphyloccocus aureus (MRSA) infection has received much attention in both the medical and non-medical press. However, it is not widely encountered on ENT wards, given the profile of short-stay, relatively well patients, although its impact seems to be increasing. We wished to explore the knowledge and attitudes towards MRSA on general surgical and ENT wards, and see if there were any significant differences between specialties, or between doctors and nurses. A 13-item questionnaire with a Likert scale response with six knowledge questions and seven attitude questions was prepared. It was completed anonymously by all nursing and medical staffs on the ENT and general surgical wards of a large District General Hospital. ENT doctors displayed the lowest knowledge and attitude scores; however, this only attained significance in terms of the knowledge of the difference between infection and colonization. Overall, nurses displayed significantly more positive attitudes towards MRSA patients than doctors, but knowledge scores were not significantly different between professions. The study suggests a lack of knowledge about and preponderance of negative attitudes towards MRSA amongst ENT doctors. The difference between colonization and infection is not well understood. Reasons for this may include the relative rarity of MRSA cases on ENT wards.

Potential effects of herbal medicines and nutritional supplements on coagulation in ENT practice.

BACKGROUND: Herbal remedies and other natural supplements have become popular alternative medical therapy. Patients using these products may present to ENT surgeons with epistaxis or with unexpected, excessive peri-operative bleeding. OBJECTIVE: The purpose of this review was to consolidate the available data regarding herb-drug interactions and the direct effects of herbal medicines and nutritional supplements in isolation, regarding disturbance in haemostasis, so as to emphasise their individual importance. METHOD: A literature review was performed using the Medline (PubMed) and UKMi databases. RESULTS: Searches of these databases revealed 24 herbal products with documented interactions with anticoagulants and 98 herbal products with theoretical interactions with the coagulation system. Herbal products with effects on coagulation when given alone were also documented. CONCLUSION: When encountering patients presenting with epistaxis, or in the elective surgical setting, a thorough enquiry about the use of herbal medicines is of great importance.