Infection control measures at diagnostic imaging departments in governmental hospitals, Gaza-Strip.

INTRODUCTION: Infection prevention and control (IPC) is crucial in safeguarding patient safety and minimizing the risk of healthcare-associated infections. AIM: The study investigated infection prevention and control measures for diagnostic imaging departments at governmental hospitals in the Gaza Strip, Palestine. METHODS: The study design was a cross-sectional analytical study. The sample included all radiographers (81) and radiologists (40) working at Al Shifa Medical Complex and European Gaza Hospital (EGH). Data was collected using an interview questionnaire (121) and an observation checklist. Data analysis was conducted using SPSS 26, and the result was significant (P < 0.05). RESULTS: Only 27.3 % of the participants revealed the availability of training courses for IPC. More than half of the participants received their last training sessions one year ago, and most of them attended five basic in-service training sessions related to IPC. Radiologists' and medical radiographers' knowledge and practice scores regarding IPC measures were 85.3 % and 61.7 %, respectively, and there were statistically significant differences between the participants' practice domain and their years of experience (p-value .014). There is inadequate hand hygiene among radiographers in the radiology department, and only 29 % of the staff washed their hands immediately upon arrival at the unit. The total score of the Hand Hygiene Self-Assessment Framework domains is almost equal at the two hospitals (280/500). The total score of the eight domains of the IPC Assessment Framework is 568.5/800 for Al Shifa Hospital and 516/800 for EGH, which indicates an intermediate IPC level. CONCLUSION: Efforts are needed to enhance the scope and quality of implementation and to concentrate on creating long-term plans to sustain and promote the existing IPC program activities. IMPLICATIONS FOR PRACTICE: Regular assessments should be conducted to monitor progress, identify gaps, and guide quality improvement efforts. Assessment feedback should be used to develop targeted interventions and continuously enhance IPC measures.

Intracanalicular schwannoma of the facial nerve: a manifestation of neurofibromatosis type 2.

Primary facial nerve tumors, which are relatively uncommon, can present a diagnostic dilemma based on their location and variable pattern of symptoms. Of primary cranial nerve tumors, schwannomas of the facial nerve rank third in frequency after those of the eighth and fifth cranial nerves. We report an illustrative case of an intracanalicular schwannoma associated with several central nervous system tumors, consistent with neurofibromatosis type 2. Initially assumed to be an eighth cranial nerve tumor, the schwannoma was found intraoperatively to arise from the facial nerve. Early diagnosis and treatment enabled excision of the tumor without sacrifice of the facial nerve. Facial nerve schwannomas can resemble acoustic schwannomas in their clinical presentation. Only a heightened level of clinical vigilance will point to the correct diagnosis and result in an optimal therapeutic outcome for patients with these rare tumors.

Single unit recordings in the auditory nerve of congenitally deaf white cats: morphological correlates in the cochlea and cochlear nucleus.

It is well known that experimentally induced cochlear damage produces structural, physiological, and biochemical alterations in neurons of the cochlear nucleus. In contrast, much less is known with respect to the naturally occurring cochlear pathology presented by congenital deafness. The present study attempts to relate organ of Corti structure and auditory nerve activity to the morphology of primary synaptic endings in the cochlear nucleus of congenitally deaf white cats. Our observations reveal that the amount of sound-evoked spike activity in auditory nerve fibers influences terminal morphology and synaptic structure in the anteroventral cochlear nucleus. Some white cats had no hearing. They exhibited severely reduced spontaneous activity and no sound-evoked activity in auditory nerve fibers. They had no recognizable organ of Corti, presented >90% loss of spiral ganglion cells, and displayed marked structural abnormalities of endbulbs of Held and their synapses. Other white cats had partial hearing and possessed auditory nerve fibers with a wide range of spontaneous activity but elevated sound-evoked thresholds (60-70 dB SPL). They also exhibited obvious abnormalities in the tectorial membrane, supporting cells, and Reissner's membrane throughout the cochlear duct and had complete inner and outer hair cell loss in the base. The spatial distribution of spiral ganglion cell loss correlated with the pattern of hair cell loss. Primary neurons of hearing-impaired cats displayed structural abnormalities of their endbulbs and synapses in the cochlear nucleus which were intermediate in form compared to normal and totally deaf cats. Changes in endbulb structure appear to correspond to relative levels of deafness. These data suggest that endbulb structure is significantly influenced by sound-evoked auditory nerve activity.

On-line resources for otolaryngologists.

Advances in telecommunications technology in the last decade have fostered the development of computer networks that allow access to vast amounts of information and services. The most prominent is the Internet (Glowniak, 1995). Medical information is increasingly available on such computer networks. The purpose of the present article is to provide an update to previously published otolaryngology sites (Johns, 1996; Burton and Johns, 1996) available on the World Wide Web, and to provide the otolaryngologist with details of resources that are accessible via the Internet. However, the reader should also be aware that the uniform resource locator (URL) addresses of Web sites can change without warning.

Morphological changes in the cochlear nucleus of congenitally deaf white cats.

Investigations in animal models and humans have indicated that congenital deafness produces degenerative changes in the central auditory pathway. The cochlear nucleus is the first central structure that receives cochlear input, and may be considered the origin of ascending auditory pathways. In this context, we studied congenitally deaf white cats, who express early onset cochlear receptor loss, in order to assess the nature of structural changes in cells of the cochlear nucleus. It is conceivable that pathologic alterations in higher auditory structures are transneuronally distributed through this nucleus. The cochlear nuclei of nonwhite cats with normal hearing were compared to those of deaf white cats exhibiting hearing loss in excess of 70 dB SPL. The cochlear nuclei of the deaf white cats were smaller in volume by roughly 50%, with the ventral and dorsal divisions being equally affected. Cell body silhouette area was determined for spherical bushy cells of the anteroventral cochlear nucleus (AVCN), pyramidal cells of the dorsal cochlear nucleus (DCN), sensory neurons from the principal trigeminal nucleus, and motoneurons of the facial nucleus. We found no statistical difference in neuronal cell body size between nonauditory neurons of these two groups of cats, whereas auditory neurons of deaf white cats were 30.8-39.4% smaller than those of normal cats. These data imply that neuronal changes in congenitally deaf cats are specific to the auditory pathway. Although cochlear nucleus volume loss was uniform for both divisions, there was a differential effect on cell density: AVCN cell density increased by 40%, whereas DCN cell density was relatively unaffected (10% increase). Astrocyte density was also greater in the AVCN (52%) compared to that in the DCN (5%). These observations reveal a differential impact on cells in the cochlear nucleus to congenital deafness, suggesting selective processing impairment at this level. If similar patterns of degeneration occur in humans, such pathologies may underlie reduced processing of input from cochlear implants in congenitally deaf adults.

Dizziness in childhood.

There is a scant literature regarding vestibular evaluation of children with complaints of dizziness or vertigo. Considerable time and effort are expended on the problem and prevention of hearing loss in children, yet we often ignore concurrent or subsequent vestibular disorders. This neglect could be due to several factors, perhaps the most common being the fact that vertiginous crises in childhood are often attributed to problems of behavior or incoordination. In this article, we offer an approach to the dizzy child based on presenting symptoms. We discuss features of the history, examination, and laboratory evaluation key to determining the cause of dizziness. Finally, we discuss management, which varies according to the diagnosis.