scholarly journals Distribution of Trauma Care Facilities in Oman in Relation to High-Incidence Road Traffic Injury Sites: Pilot study

2018 ◽  
Vol 17 (4) ◽  
pp. 430 ◽  
Author(s):  
Sara M. Al-Kindi ◽  
Ahmed A. Naiem ◽  
Kadhim M. Taqi ◽  
Najla M. Al-Gheiti ◽  
Ikhtiyar S. Al-Toobi ◽  
...  

Objectives: Road traffic injuries (RTIs) are considered a major public health problem worldwide. In Oman, high numbers of RTIs and RTI-related deaths are frequently registered. This study aimed to evaluate the distribution of trauma care facilities in Oman with regards to their proximity to RTI-prevalent areas. Methods: This descriptive pilot study analysed RTI data recorded in the national Royal Oman Police registry from January to December 2014. The distribution of trauma care facilities was analysed by calculating distances between areas of peak RTI incidence and the closest trauma centre using Google Earth and Google Maps software (Google Inc., Googleplex, Mountain View, California, USA). Results: A total of 32 trauma care facilities were identified. Four facilities (12.5%) were categorised as class V trauma centres. Of the facilities in Muscat, 42.9% were ranked as class IV or V. There were no class IV or V facilities in Musandam, Al-Wusta or Al-Buraimi. General surgery, orthopaedic surgery and neurosurgery services were available in 68.8%, 59.3% and 12.5% of the centres, respectively. Emergency services were available in 75.0% of the facilities. Intensive care units were available in 11 facilities, with four located in Muscat. The mean distance between a RTI hotspot and the nearest trauma care facility was 34.7 km; however, the mean distance to the nearest class IV or V facility was 83.3 km. Conclusion: The distribution and quality of trauma care facilities in Oman needs modification. It is recommended that certain centres upgrade their levels of trauma care in order to reduce RTI-associated morbidity and mortality in Oman.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Rustagi ◽  
P Raghav ◽  
N Dutt ◽  
A Sinha ◽  
M S Rodha

Abstract Background Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. The present study was designed to assess the existing process of pre-hospital trauma care administered to road accident victims in a fast urbanizing city of Jodhpur, Rajasthan Methods A cross-sectional study was designed from 1st November 2018 to 30th June 2019. All cases who were admitted to tertiary level trauma care facility in the study period were reviewed and were analyzed for type of injuries suffered, prehospital care services availed and the time duration that elapsed before patient arrived at tertiary health facility. Geographic information system was used to identify clustering of accident hot spots in the Jodhpur district. Results A total of 137 patients or their caregivers were interviewed during the study period. A large proportion of patients 57(41.6%) were unconscious in post-crash phase. Private taxis contributed to maximum patient transfer (75.9%) and only 12.4% were transported through ambulance. Almost three fourth (78.1%) of patients received some form of pre-hospital care within 30 minutes of accident. About one third patients (35.7%) reached the trauma facility directly after the accident while majority (64.9%) were referred from other health facilities Conclusions Pre-hospital trauma care for road traffic accident victims is available in golden hour for majority of victims in Jodhpur district. Victims from rural area and tourists form a sizeable proportion of accident victims brought to trauma care facility. The primary health care facilities play a pivotal role in managing victims as first point of care. Future research is thus warranted to explicitly examine the role of health professionals at primary health care facilities in administering pre-hospital trauma care. Key messages The primary health care facilities play a pivotal role in managing victims as first point of care. In areas with evolving trauma systems, pre-hospital trauma care strengthening requires capacity building of all level of health professionals.


2019 ◽  
Vol 16 (02/03) ◽  
pp. 099-105
Author(s):  
Mallikarjun Gunjiganvi ◽  
Siddharth Rai ◽  
Rupali Awale ◽  
Amit Agarwal

AbstractTrauma is a major public health problem across the world with significant morbidity and mortality. Broadly, it is a disease of middle-aged population and is assuming the status of an epidemic in the 21st century. Road traffic injuries are most common followed by railway injuries, industrial, farming, and domestic injuries, and many others in low- and middle-income countries. Severe traumatic brain injuries are the major proportion with concern for long-term cognitive impairment and high spinal cord injuries due to complete dependence. There is no comprehensive trauma care system covering all geography in India at present. The Government of India (GOI), in 2006, established Jai Prakash Narayan Apex Trauma Center, which is run by All India Institute of Medical Sciences at New Delhi as an apex center to provide quality care, training, research, and registry development. It acts as a role model center for the establishment of new centers and helps in upgradation of existing hospitals to provide quality care trauma services. To curb this epidemic of trauma, GOI envisioned National Trauma Care program during the 11th and 12th Five-Year Plans to strengthen the emergency facilities in government hospitals. Many new centers are coming up with various levels of trauma care across the country. Here we discuss the establishment, resources, initial challenges, trauma burden, and a year of report card of the Uttar Pradesh’s first Level I Apex Trauma Center of Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, established with a vision of providing state of the art Level I trauma care to the injured victims.


2019 ◽  
Vol 20 (8) ◽  
pp. 658-664 ◽  
Author(s):  
Marco Di Paolo ◽  
Luigi Papi ◽  
Paolo Malacarne ◽  
Federica Gori ◽  
Emanuela Turillazzi

Background: Healthcare-associated infections (HCAIs) occur when patients receiving treatment in a health care setting develop an infection. They represent a major public health problem, requiring the integration of clinical medicine, pathology, epidemiology, laboratory sciences, and, finally, forensic medicine. Methods: The determination of cause of death is fundamental not only in the cases of presumed malpractice to ascertain the causal link with any negligent behavior both of health facilities and of individual professionals, but also for epidemiological purposes since it may help to know the global burden of HCAIs, that remains undetermined because of the difficulty of gathering reliable diagnostic data. A complete methodological approach, integrating clinical data by means of autopsy and histological and laboratory findings aiming to identify and demonstrate the host response to infectious insult, is mandatory in HCAIs related deaths. Results: Important tasks for forensic specialists in hospitals and health services centers are the promotion of transparency and open communication by health-care workers on the risk of HCAIs, thus facilitating patients’ engagement and the implementation of educational interventions for professionals aimed to improve their knowledge and adherence to prevention and control measures. Conclusion: HCAIs are a major problem for patient safety in every health-care facility and system around the world and their control and prevention represent a challenging priority for healthcare institution and workers committed to making healthcare safer. Clinicians are at the forefront in the war against HCAIs, however, also forensic pathologists have a remarkable role.


2020 ◽  
Vol 41 (S1) ◽  
pp. s304-s305
Author(s):  
Angela Chow ◽  
Wei Zhang ◽  
Joshua Wong ◽  
Brenda Ang

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a growing clinical problem in rehabilitation hospitals, where patients stay for extended periods for intensive rehabilitation therapy. In addition to cutaneous sites, the nares could be a source for nosocomial MRSA transmission. Decolonization of nasal and cutaneous reservoirs could reduce MRSA acquisition. We evaluated the effectiveness of topical intranasal octenidine gel, coupled with universal chlorhexidine baths, in reducing MRSA acquisition in an extended-care facility. Methods: We conducted a quasi-experimental before-and-after study from January 2013 to June 2019. All patients admitted to a 100-bed rehabilitation hospital specialized in stroke and trauma care in Singapore were screened for MRSA colonization on admission. Patients screened negative for MRSA were subsequently screened at discharge for MRSA acquisition. Screening swabs were obtained from the nares, axillae, and groin and were cultured on selective chromogenic agar. Patients who tested positive for MRSA from clinical samples collected >3 days after admission were also considered to have hospital-acquired MRSA. Universal chlorhexidine baths were implemented throughout the study period. Intranasal application of octenidine gel for MRSA colonizers for use for 5 days from admission was added to the hospital’s protocol beginning in September 2017. An interrupted time series with segmented regression analysis was performed to evaluate the trends in MRSA acquisition before the intervention (January 2013–July 2017) and after the intervention (September 2017–June 2019) with intranasal octenidine. August 2017 was excluded from the analysis because the intervention commenced midmonth. Results: In total, 77 observational months (55 before the intervention and 22 after the intervention) were included. The mean monthly MRSA acquisition rates were 7.0 per 1,000 patient days before the intervention and 4.4 per 1,000 patient days after the intervention (P < .001), with a mean number of patient days of 2,516.3 per month before the intervention and 2,427.2 per month after the intervention (P = .0172). The mean monthly number of MRSA-colonized patients on admission to the hospital decreased from 24.8 before the intervention to 18.7 after the intervention (P < .001). Mean monthly hand hygiene compliance rate increased significantly from 65.7% before the intervention to 87.4% after the intervention (P < .001). After adjusting for the number of MRSA-colonized patients on admission and hand hygiene compliance rates, a constant trend was observed from January 2013 to July 2017 (adjusted mean coefficient, 0.012; 95% CI, −0.037 to 0.06), with an immediate drop in September 2017 (adjusted mean coefficient, −2.145; 95% CI, −0.248 to −0.002; P = .033), followed by a significant reduction in MRSA acquisition after the intervention from September 2017 through June 2019 (adjusted mean coefficient, −0.125; 95% CI, -4.109 to -0.181; P = .047). Conclusions: Topical intranasal octenidine, coupled with universal chlorhexidine baths, can reduce MRSA acquisition in extended-care facilities. Further studies should be conducted to validate the findings in other healthcare settings.Funding: NoneDisclosures: None


2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Enerst C. Ohanu ◽  
Paul C. Inyang-Etoh

Amebiasis caused by <em>Entamoeba histolytica</em> is a major public health problem in tropical and subtropical countries. Treatment failure with specific chemotherapy has been reported suggesting the possibility of drug resistance. This study investigated the anti-amoebic effects of four plant extracts on cecal amebiasis in rats. The cecal amebiasis was induced by the injection of 3.0×105 troph/mL of <em>E. histolytica</em> parasite directly into the rat’s caecum. A total of 137 rats were used for these studies; five rats in each group for both positive and negative control, 15 rats in each group to test the four plant extracts and metronidazole. The infected rats were treated for cecal amebiasis using each of the four plant extracts at graded doses of 100 mg/kg, 200 mg/kg and 400 mg/kg and with metronidzole at a dose of 62.5 mg/kg,100 mg/kg and 125 mg/kg for five consecutive days. The efficacy of the four plant extracts were evaluated based on Neal’s, 1951 method. The plant extracts of Garlic, <em>Guava</em>, Pawpaw and Pumpkin at 400 mg/kg and 200 mg/kg body-weight gave a cure rate of 80%, 100%, 60%, 40% and 40%, 80%, 40%, 0%, respectively. The mean parasite count in the cecal contents of the treated rats at a dose 400 mg/kg were 18.5±1.6, 0.0±0.0, 33.3±1.8 and 49.5±4.0, respectively. The difference was statistically significant (P&lt;0.05). This study has revealed that Guava at a high dosing level (400 mg/kg body weight) is as good as the standard drug in reducing the both parasite load (probably with limited side effect).


Author(s):  
Muhammad Abrar ◽  
Mazhar Nadeem ◽  
Sunila Fatima

Introduction: Chronic kidney disease (CKD) is a major public health problem worldwide, and its main consequences include loss of renal function leading to end-stage renal disease (ESRD), increased risk of cardiovascular disease (CVD), significant increase in morbidity and mortality, and a decrease in health-related quality of life. Aims and Objectives: The basic aim of the study is to analyze the oxidative stress and total antioxidant capacity as a biomarker of cardiovascular risk in those children who are on regular hemodialysis. Materials and Methods: This cross sectional study was conducted at DHQ hospital, Faisalabad during July 2020 to January 2021. The data were collected from the age of less than 18 years children of both sexes. There were 50 children who was selected for this study. At the time of the study, all the patients were on regular three HD sessions per week. In HD patients, venous blood samples were drawn immediately before and after hemodialysis session. Baseline laboratory investigations were carried out for all patients and controls including complete blood count, serum urea and creatinine, arterial pH, arterial blood gases and infection screening, which included blood and urinary cultures by standard methods.  Results: The data were collected from 50 dialysis patients. The mean age of this study is 15years. We collected all the demographic data of patients. The mean value of Urea is 64.34±2.44 mg/dl). At before-dialysis session, duration of disease positively correlated with TPX (r = 0.969, P <0.001), but, negatively correlated with TAC (r = −0.469, P <0.002). At after-dialysis session, HIF-1α negatively correlated with each of TPX (r = −0.529, P <0.001) and OSI (r = −0.459, P <0.003); while, OSI positively correlated with TPX (r = 0.944, P <0.001). Conclusion: It is concluded that HD patients, the clinical and prognostic significance of oxidative status associated with cardiovascular risk factors is very different from the general population. Although a direct causality cannot be inferred from such kind of correlative investigations.


Author(s):  
R. Ratheesh ◽  
Bindu Mohandas ◽  
P. P. Venugopalan ◽  
A. K. Sarada ◽  
Suprej K. ◽  
...  

Background: Quality of life (QOL) is individuals' perceptions of their position in life. QOL of alcohol dependent patients is an area that has received relatively less attention compared to other alcohol related problems.Methods: A deaddiction centre based cross sectional study was done on 370 individuals using a predesigned questionnaire during the period of 2012-2013. The data was analyzed using SPSS version 17. Spearman’s rank correlation test was used to find association between the study variables.Results: The mean age of the study subjects was 38.08±8.46 years. The mean duration of drinking was 12.62±7.47 years. The overall score of the QOL and the perceived health in alcohol dependent patients was 3.19±0.89 and 3.01±0.98 respectively. The mean of the transformed scores of physical, psychological, social and environmental domains are 69.12±12.82, 57.84±12.81, 58.52±17.05, 68.62±10.23 respectively. Statistical analysis of age with physical, environmental and social domains showed a significant negative correlation; literacy status with QOL, perceived health, physical, psychological, social and environmental domains showed a significant positive correlation; socio economic status with QOL and psychological domain showed a significant positive correlation; duration of drinking with QOL, perceived health, physical and psychological domain showed a significant negative correlation.Conclusions: Harm from alcohol use is a major public health problem. Reducing the level of social and health harms from alcohol requires preparation and planning.


Author(s):  
Shriram V. Gosavi ◽  
Anil R. Koparkar ◽  
Supriya A. Giri ◽  
Komal D. More

Background: This study was to enlighten the prevalence, different types & impact of injuries in elderly population in rural area of middle income country (India).Methods: It was a community based descriptive cross-sectional study, conducted in all 24 villages under one Primary Health Centre of central India. The study was carried out from June 2009 to May 2011.Results: In the present study, prevalence of injury was 17.1%, which was highest among elderly ageing 65-69 years (36.8%) followed by elderly ageing 60-64 years (27.4%). Prevalence of injury was higher (20%) among males as compared to females (14%). Association of age, gender and injury was not statistically significant. Fall was the most common cause (34.7%) of injury followed by occupational (34.0%) and road traffic accidents (15.8%). Superficial injuries were the most common (32.6%) type of injuries followed by fracture (27.3%). Hospital admission required by 24.2% of elderly. We found 34.7% elderly was physically impaired and 26.3% physically disabled due to various injuries.Conclusions: In the present study we found injuries pose a major public health problem in elderly. Therefore there is a need of community based assessment on impact of injury among elderly in various parts of country to formulate appropriate health initiatives for prevention and optimum treatment of injuries in elderly.


Author(s):  
Syed Muhammad Yousaf Farooq ◽  
Guido C Robot ◽  
Syeda Khadija Tul Sughra Murrium ◽  
Aima Gilani ◽  
Hafiz Syed Arsalan Gilani ◽  
...  

Breast cancer in women in both developed and developing countries is the most common cancer, and remains a major public health problem. Methods: Analytical cross-sectional studies and only highquality studies were included. The searched databases were: Pub Med (2008-2020), Google scholar (2008-2020) and science direct (20082020). The key terms searched were ultrasound imaging, Breast solid mass or lesions, papillary lesions, Fibro-adenoma, breast cancer. Using these key terms, researchers found total 101 studies from the above-mentioned databases. Among these researchers found 56 studies from Google scholars, 11 from science direct and 34 from Pub Med. After this, researchers separated the relevant and irrelevant data. Results: Table 1 shows the Descriptive results of age from 12 studies, 17641 individuals. The mean age was 46.14697 SD 10.56736. The mean Sensitivity was 91.0200 and mean specificity was 89.35. The pooled results of 8 studies and 2612 individuals, out of 2612 individuals we found 1220 (46.71) benign lesions and 1392 (53.29%) malignant lesions are also shown. Conclusions: In conclusion, Ultrasound can differentiate benign and malignant breast lesions to great extent. This technique has the potential ability to altering the handling of cases in where a biopsy may be recommended, but the risk of carcinoma is known to be relatively low. Ultrasound accuracy is recommended as the first option for follow-up examinations of lesions because of its high sensitivity and ability to detect lesions outside of breast density.


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