scholarly journals Quality assessment of sputum for Acid Fast Bacilli(AFB) test in microbiology laboratories before and after implementation of Standard Operating Procedure (SOP): a comparative study

1970 ◽  
Vol 11 (1) ◽  
pp. 51-56
Author(s):  
K Khadeza ◽  
AHM Kamal ◽  
M Naima ◽  
SM Shamsuzzaman
Keyword(s):  
Present Status ◽  
Standard Operating Procedure ◽  
Secondary Level ◽  
Sputum Smear ◽  
Tertiary Level ◽  
Microbiology Laboratory ◽  
Cross Sectional ◽  
Primary Level ◽  
Laboratory Staff ◽  
Acid Fast Bacilli

Aims: To evaluate the present status of microbiology laboratory by comparing the test results of investigator with that of laboratory staff for sputum for Acid Fast Bacilli (AFB) withZiehl-NeelsenStaining (Z-N Staining) at primary and secondary level andto assess the present status of a microbiology laboratory for sputum for Acid Fast Bacilli (AFB) withZiehl-NeelsenStaining (Z-N Staining) at tertiary level. Material and Methods: Type of study : Cross sectional, descriptive type of study. Place of study: Department of Microbiology of Dhaka Medical College,Narsingdi Sadar Hospital,Narsingdi,PolashUpzilla Health Complex ,Polash, Narsingdi andDOTS centers. Duration of study: From July, 2007 to June,2008 Method of sampling: Non probability, purposive and convenient sampling Sample Size: Sputum for AFB: 300 sputum samples were collected for detection of AFB by direct Z-N staining, Z-N staining after bleach centrifugation and Auramine phenol staining before implementing SOP. After following SOP 150 sputum samples were collected and tested in direct Z-N method. Results: In the present study, before SOP out of 100 sputum smear at each level, discrepancy was found in 3% cases at primary level, 2% cases at secondary level and 1% case at tertiary level.After following SOP out of 50 sputum smear at each level, discrepancy was reduced to 2% cases at primary level and no discrepancy was found at secondary and tertiary level. Conclusion: Each laboratory must have SOP for laboratory testing to set the minimum acceptable standard for every test in order to improve and maintain the quality of laboratory services. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9824 BJMS 2012; 11(1): 51-56

scholarly journals A Comparative Study of Routine Microscopic Examination of Urine in Microbiology Laboratories at Primary and Secondary Level Before and After Implementation of Standard Operating Procedure (SOP)

2017 ◽  
Vol 25 (2) ◽  
pp. 87-93
Author(s):  
Khadeza Khatun ◽  
AHM Mostafa Kamal ◽  
Kazi Afzalur Rahman ◽  
Mohammad Zaid Hossain ◽  
Nadia Rabin ◽  
...  
Keyword(s):  
Operating Procedure ◽  
Microscopic Examination ◽  
Standard Operating Procedure ◽  
Secondary Level ◽  
Test Results ◽  
Microbiology Laboratory ◽  
Cross Sectional ◽  
Primary Level ◽  
Standard Operating

Context : Laboratory services have become an integral and inseparable component of modern medicine and public health. The use of standard operating procedure (SOP) in laboratory testing is one of the most crucial factor in achieving the quality. This cross sectional study was done to assess the quality of routine microscopic examination of urine of a microbiology laboratory at primary level and one microbiology laboratory at secondary level by evaluating the test results before SOP and re evaluating the test results after implementing SOP to see if there was any improvement in quality of those tests.Material and Methods: A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratory. The study was performed on clinically suspected patients of urinary tract infection (UTI) attending at the primary and secondary level laboratory for microscopic examination of urine. Clinically suspected cases of UTI who had taken any anti microbial treatment in the past 48 hours were excluded from the study. 60 urine samples were collected from each level before implementing SOP and 30 urine samples were collected from each level and tested after following SOP.Result : In routine microscopic examination of urine at primary and secondary level, before SOP, regarding significant number of Pus cells discrepancy was found in 21.67% cases at primary level and 18.33% cases at secondary level. After implementing SOP, discrepancy in the result was reduced to 10% from 21.67% at primary level and 0% from 18.33% at secondary level. This difference in results was statistically significant (p< 0.05).Conclusion: Implementing SOP and after practicing appropriate and standard techniques for collection and examination of urine at primary and secondary level, discrepancy in the results of routine microscopic examination of urine between investigator and Medical Officer (MOPathology) was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 87-93

scholarly journals Use of antibiotics in selected tertiary and primary level health care centers of Bangladesh

2016 ◽  
Vol 9 (2) ◽  
pp. 42-44
Author(s):  
Abdullah Akhtar Ahmed ◽  
Md Shariful Alam Jilani ◽  
Osul Ahmed Chowdhury ◽  
KM Shahidul Islam ◽  
Md Akram Hossian ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Tertiary Level ◽  
Antibiotic Administration ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Level ◽  
Parenteral Route ◽  
The People ◽  
Time Of Admission ◽  
Health Care Centers

A cross sectional study was conducted in inpatient department of seven primary level hospitals care centers (PLHCs) and six tertiary level hospitals (TLHs) of the country. Total 2058 hospitalized patients were interviewed over a six month period from October 2012. Most of the patients (85.9% in TLH and 100% in PLH) were prescribed with antibiotics at the time of admission. Only 6.4% patients of TLHs treated with antibiotic had culture proven infection and rest of the patient of TLH and all the patients of PLH were treated with antibiotic empirically. Top prescribed antibiotic was ceftriaxone (39.64% in TLH, 59.64% in PLH). Parenteral route of antibiotic administration was preferred for both at TLHs and PLHCs (63.3% and 76.9%). The results of the present study indicated that antibiotics were widely and inappropriately used without following standard guidelines or based on any rationality. This is an alarming situation, and needs to be addressed by the relevant authority to save the people from growing antibiotic resistance.Ibrahim Med. Coll. J. 2015; 9(2): 42-44

scholarly journals Utility of Bronchoalveolar Lavage in the Diagnosis of Sputum Negative Pulmonary Tuberculosis

2020 ◽  
Vol 8 (1) ◽  
pp. 19-22
Author(s):  
Subodh Sagar Dhakal ◽  
Ashmita Neupane ◽  
Shatdal Chaudhary ◽  
Navin Mishra ◽  
Damber Bdr Karki
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Diagnostic Yield ◽  
Cross Sectional Study ◽  
Fibreoptic Bronchoscopy ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Acid Fast Bacilli ◽  
Smear Negative

INTRODUCTION: Sputum smear examination for acid fast bacilli (AFB) by Ziehl-Neelsen stain (ZN stain) is the initial approach to the diagnosis of pulmonary tuberculosis (PTB). But 50% of the cases are reported to be sputum smear negative. This study was aimed to investigate the diagnostic yield of fibreoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis. The sample was tested for Mycobacterium tuberculosis using the XpertMTB/RIF assay, which is a new test that detects Mycobacterium tuberculosis complex and resistance to rifampin in less than two hours. MATERIAL AND METHODS: This is a prospective cross sectional study carried out on 58 sputum smear negative patients who were clinically suspected to have pulmonary tuberculosis from April 2017 to January 2019. All patients are subjected to FOB, BAL and BAL specimens were stained for AFB and also sent for Xpert (MTB)/RIF. RESULTS: Among 58 patients enrolled for the study 26 patients were positive for acid fast bacilli (AFB) through BAL stain and Xpert (MTB)/RIF combined. CONCLUSION: FOB guided BAL is a reliable, alternative and rapid method for diagnosing smear negative pulmonary tuberculosis with minimal complications.

scholarly journals Knowledge and Practices of Doctors About Patient Safety Working at Primary and Secondary Level Health Care Facilities in Bangladesh

2019 ◽  
Vol 38 (1) ◽  
pp. 5-11
Author(s):  
MHK Talukdera ◽  
Rumana Nazneen ◽  
S ABDULLA SA
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Medical Errors ◽  
Clinical Teaching ◽  
Secondary Level ◽  
Health Care Facilities ◽  
Cross Sectional ◽  
Primary Level ◽  
Ensure Patient Safety ◽  
Care Facilities

Aim: This descriptive type of cross sectional study was conducted with an objective to evaluate the views of doctors regarding knowledge and practices about patient safety working at primary and secondary level health care facilities in Bangladesh. Methods: Study period was from August 2016 to December 2016. Multistage, convenience sampling was done . Sample size was 550. Self administered semi structured questionnaire was used for data collection after pre testing. Data was collected by principle investigator , co-investigator & data collectors. Data was also collected by sending questionnaire by postage followed by a focal group discussion. Results: Result showed 70 % were male and 57% were primary level medical officers. 44.9% understands patients safety. 51.1% understands medical errors . 37.5% agreed that less duty hours will reduce medical errors . 62% strongly agreed that Learning about patient safety will enhance competency. 44.5% agreed that undergraduate course prepared them to ensure patient safety. 37.5 % agreed that they learned about medical errors during their undergraduate course. 40.6% stated that they were assigned to perform the tasks for which they were not trained competently, 34% said that they were assigned to perform the tasks which could have resulted easily in medical errors . Most of the respondents strongly agreed that teaching about patient safety should be an important priority. 46% stated that these should be in clinical teaching and 40% stated the same to be in bed side teaching . 24% stated that there were not enough topics in the existing curriculum regarding patient safety. 46% confessed that they made medical errors during their practices. 33% stated that they want patient safety education in their professional practice, 76.9% strongly agreed that patient safety is an important issue in their professional practices and 44% sensitizes their colleagues about patient safety to learn & practices. 54.7% stated that they did not have error reporting system/ death review/ medical audit in their hospital, 89.7% did not have attended any training on patient safety . 90% thought that training on patient safety is essential for doctors 67.2% respondents opined that there should be a competent organization / body who can take care of patient safety & medical errors in Bangladesh. Conclusion: The study reflects that many primary level medical officers do not understand patients safety and medical errors. The study also showed that most of them has a positive attitude torwards patient safety. Study recommended that doctors serving at primary and secondary level healthcare facilities to be oriented/ trained on different aspects of patient safety J Bangladesh Coll Phys Surg 2020; 38(1): 5-11

scholarly journals Quality Assessment of Widal Test in Microbiology Laboratories at Primary and Secondary Level Before and After Implementation of Standard Operating Procedure (SOP): A Comparative Study

2015 ◽  
Vol 23 (2) ◽  
pp. 227-233
Author(s):  
Khadeza Khatun ◽  
Naima Muazzam ◽  
SM Shamsuzzaman ◽  
AHM Mostafa Kamal ◽  
Mohammad Shaiful Islam
Keyword(s):  
Operating Procedure ◽  
Enteric Fever ◽  
Standard Operating Procedure ◽  
Secondary Level ◽  
Standard Operating Procedures ◽  
Microbiology Laboratory ◽  
Widal Test ◽  
Blood Samples ◽  
Standard Operating ◽  
Before And After

Context: The use of standard operating procedures (SOP) in laboratory testing is one of the most crucial factors in achieving the quality. In primary and secondary level laboratory, the scope for microbiological test is limited. Enteric fever is one of the major public health problem in the developing countries, including Bangladesh. An undiagnosed and maltreated case of enteric fever may result in serious complication and even prove fatal. Widal test is the very extensively used serological test in laboratory at all level to aid in the diagnosis of enteric fever. It is the only available practical test for demonstrating antibodies to Salmonella typhi and S. paratyphi. In this study, an attempt has been made to evaluate the present status of microbiology laboratory by comparing the test results of investigator with that of laboratory staff for widal test at primary and secondary level before and after implementation of standard operating procedure (SOP) .Methods: The present study was performed on clinically suspected cases of enteric fever attending at the primary and secondary level laboratories for widal test. A 120 blood samples were collected before implementing SOP and 50 blood samples were collected and tested after following SOP. A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratoryResults: Before standard operating procedures (SOP), significant titre of widal test was found more by the investigator than the staff at both primary and secondary level. This difference in results was statistically significant (p<0.05). After SOP difference in the results of significant titre of widal test between investigator and staff was not statistically significant (p>0.05).Conclusion: Implementing SOP for widal test and after practicing appropriate and standard techniques for dilution of serum at primary and secondary level, discrepancy in the results of widal test between investigator and staff was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 227-233

scholarly journals Molecular Epidemiology of Mycobacterium tuberculosis strains isolated from pulmonary tuberculosis patients in south Ethiopia

2021 ◽  
Vol 15 (09) ◽  
pp. 1299-1307
Author(s):  
Yared Merid ◽  
Elena Hailu ◽  
Getnet Habtamu ◽  
Melaku Tilahun ◽  
Markos Abebe ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Southern Ethiopia ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Acid Fast Bacilli

Introduction: Understanding the epidemiology of tuberculosis is limited by lack of genotyping data. We sought to characterize the drug susceptibility testing patterns and genetic diversity of M. tuberculosis isolates in southern Ethiopia. Methodology: A cross-sectional study was conducted among newly diagnosed sputum smear positive patients with tuberculosis visiting nine health facilities in southern Ethiopia from June 2015 to May 2016. Three consecutive sputum samples (spot-morning-spot) per patient were examined using acid-fast bacilli smear microscopy with all smear positive specimens having acid-fast bacilli cultures performed. M. tuberculosis isolates had drug susceptibility testing performed using indirect proportion method and were genotyped with RD9 deletion analysis and spoligotyping. Mapping of strain was made using geographic information system. Results: Among 250 newly diagnosed patients with tuberculosis, 4% were HIV co-infected. All 230 isolates tested were M. tuberculosis strains belonging to three lineages: Euro-American, 187 (81%), East-African-Indian, 31 (14%), and Lineage 7 (Ethiopian lineage), 8 (4%); categorized into 63 different spoligotype patterns, of which 85% fell into 28 clusters. M. tuberculosis strains were clustered by geographic localities. The dominant spoligotypes were SIT149 (21%) and SIT53 (19%). Drug susceptibility testing found that 14% of isolates tested were resistant to > 1 first line anti- tuberculosis drugs and 11% to INH. SIT 149 was dominant among drug resistant isolates. Conclusions: The study revealed several clusters and drug resistant strains of M. tuberculosis in the study area, suggesting recent transmission including of drug resistant tuberculosis. Wider monitoring of drug susceptibility testing and geospatial analysis of transmission trends is required to control tuberculosis in southern Ethiopia.

scholarly journals MEMAHAMI KONSEP MAṢLAHAH IMAM AL-GAZALI DALAM PELAJARAN USUL FIKIH

2019 ◽  
Vol 9 (2) ◽  
pp. 419
Author(s):  
Darul Faizin
Keyword(s):  
Secondary Level ◽  
Tertiary Level ◽  
Primary Level ◽  
The Third ◽  
Good Will ◽  
Legal Discovery

Maṣlahah is an expression of taking advantage and rejecting harm, but that is not what is meant by al-Gazali; according to him, taking benefits and rejecting harm is human’s purpose, and humans good will be realized by achieving his goals. But what is meant by maṣlahah is maintaining the purpose of the Shari’a (al-muhāfaẓah ‘ala maqsūdi asy-syarī’ah). When dealing with texts (naṣ) maṣlahah is divided into three; there is a problem that is confirmed by the text (maṣlahah mu’tabarah), there is a problem that is canceled by the text (maṣlahah mulgah), and there is a problem that is unconfirmed and not canceled by the text (maṣlahah mursalah). Maṣlahah mursalah, when seen from the needs, are divided into three levels; first, the primary level (ḍarūriyāt) in the form of guarding religion (hifẓu ad-din), soul (hifẓu an-nafs), reason (hifẓu al-‘aql), descent (hifẓu an-nasl), and property (hifẓu al-māl) ), the second secondary level (hajiyāt) and the third tertiary level (tahsīniyāt). Maṣlahah mursalah can be used as a proposition for istimbāṭ by considering three characteristics, namely, maṣlahah is primary (ḍarūriyāt), certain (qath'iyyāt), and general (kulliyāt). According to al-Gazali, the purpose of the Shari’a (maqāsid asy-syarī’ah) can be known through the Qur’an, Sunnah, and consensus (ijma’). Then every maṣlahah that does not function to maintain the objectives of the Shari’a which is understood from the Qur’an, Sunnah, and the consensus (ijma') is a strange maṣlahah (gharībah), that is, a maṣlahah that is not in line with the Shari’a action, then the maṣlahah cannot be made into the proposition of legal discovery (istimbāṭ).

scholarly journals Sputum Smear Non-conversion at the End of Intensive Phase of Tuberculosis Treatment at a Tertiary Center: A Descriptive Cross-sectional study

2021 ◽  
Vol 59 (243) ◽  
pp. 1090-1093
Author(s):  
Naveen Prakash Shah ◽  
Anil Regmi ◽  
Aakash Acharya ◽  
Jwala K.C. ◽  
Bidur Khatiwada ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Tuberculosis Treatment ◽  
Sputum Smear ◽  
Sectional Study ◽  
Cross Sectional ◽  
Intensive Phase ◽  
Acid Fast Bacilli ◽  
Tertiary Center

Introduction: Sputum non-conversion is smear positive tuberculosis despite anti-tubercular therapy. Various factors may lead to sputum non-conversion including resistance to anti-tubercular drugs, age, gender, disease severity, non-compliance, drugs unavailability etc. Little is known and studied about the contribution of these individual factors. Our study sought to determine the prevalence of sputum smear non-conversion in patients at the end of intensive phase of tuberculosis treatment visiting a tertiary-level institution in Nepal. Methods: A descriptive cross-sectional study was conducted among recorded data of patients undergoing sputum Acid Fast Bacilli staining at the end of intensive phase at National Tuberculosis Control Center from April 2018 to April 2020. The study was approved by Nepal Health Research Council (Registration no: 76012020 P). The convenient sampling method was adopted. The data were analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Our study found that out of 830 samples that were tested by Acid Fast Bacilli stain at the end of intensive phase, 40 (4.82%) (3.37-6.28 at 95% Confidence Interval) were sputum smear non-converters. The mean age of sputum non-converters was 41.25±15.543 years. Conclusions: The study shows that a significant proportion of patients remain acid-fast stain positive despite the treatment. However, the proportion is low compared to other similar studies around the globe. This study provides program managers with evidence to support the development of more tailored tuberculosis care and need to conduct more intensive studies about various factors that may lead to non-conversion.

Services Provided for Lactating Mothers at Lactation Management Clinic in Selected Tertiary Level Hospitals

2020 ◽  
Vol 38 (2) ◽  
pp. 68-73
Author(s):  
Tarannum Tasnim ◽  
ANM Shamsul Islam ◽  
Mehedi Hasan Azad ◽  
Farhana Sharmin
Keyword(s):  
Breast Milk ◽  
Milk Production ◽  
Public Awareness ◽  
Cross Sectional Study ◽  
Dietary Advice ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Breast Milk Production ◽  
Lactating Mothers ◽  
Structured Questionnaire

Background: Children are the precious gift from the Almightily Allah and breast milk is an ideal product given to the human being by nature to fulfill all requirements of the offspring until they are matured enough to take adult food. Objective: To assess the services provided for lactating mothers at lactation management centre in selected tertiary level hospitals. Materials and Methods: This cross sectional study was conducted among 100 Lactating mothers who were selected conveniently and were interviewed by pre-tested semi-structured questionnaire and an observational checklist. Collected data were processed and analyzed using SPSS (Statistical Packages for Social Science) software. Results: Lactation management centre (LMC) is supervised by a consultant and separate room is allotted in both out-patient and in-patient departments. Mothers came with lactation problems were more likely in the first month of the baby (73%) and feeling of not enough milk production was common (49%).Highly significant relationship was found between breast problems of lactating mother and age of child (p<0.001). About 84% respondents received practical demonstration on position and attachment of the baby during lactation. About 91% respondents got dietary advice for enough breast milk production, 75% got dietary advice regarding their child’s weaning food chart and69% got health education. Maximum mothers were informed about LMC by doctor & nurse (82%). Conclusion: Information about LMC services should be disseminated across the country. Lactating mothers should be familiarized with LMC and public awareness should be enhanced for effective management of breastfeeding problem to promote, protect and support the breastfeeding. JOPSOM 2019; 38(2): 68-73

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

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