scholarly journals Evaluation of Slit-Skin Smear Against Punch Biopsy in Diagnosing Leprosy: A Cross-sectional Study in a Tertiary Care Centre of West Bengal

2021 ◽  
Vol 8 (3) ◽  
pp. 84-88
Author(s):  
Lewith K Marak ◽  
Sudipta Roy ◽  
Tanusree Mondal ◽  
Manisha Sarkar ◽  
Tapashi Ghosh ◽  
...  

Background: Leprosy is an infectious disease which faces diagnostic challenges. Slit-skin smear (SSS) is an age simple diagnostic technique, yet not commonly applied by health care providers. The study aimed to determine the effectiveness of SSS in terms of validity, diagnostic accuracy, and percentage agreement against punch biopsy in diagnosing leprosy among leprosy patients who were diagnosed with leprosy on clinical grounds only (i.e., number of skin lesions and/or peripheral nerve thickening). Methods: An evaluation study of diagnostic tests with a cross-sectional design was conducted at a tertiary care center of Bankura. In general, 70 new untreated leprosy patients, diagnosed solely by clinical grounds (i.e., count of skin lesions and/or thickening of the nerve) and attending the dermatology outpatient department (From February 2019 to January 2020) were enrolled in this study. After excluding pure neuritic, relapse, and seriously ill patients by consecutive sampling, they were subjected to both SSS and punch biopsy using a standard process. SPSS for Windows (Version 16.0., Chicago, SPSS Inc.) was used to analyze data. Z test, chi-square test, and kappa test were conducted to test the statistical significance between the effectiveness of SSS and punch biopsy. Results: The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and diagnostic accuracy of SSS were 81.81%, 95.83%, 90%, 92%, 20%, 0.19%, 102.87%, and 91.42%, respectively. Based on the results, SSS could detect acid-fast bacilli (AFB) in clinically diagnosed leprosy cases slightly less than punch biopsy, but it was statistically insignificant (Z=0.3689, P=0.71138, df=1). Finally, Cohen’s Kappa coefficient was 0.796, representing substantial agreement between SSS and punch biopsy (95% CI: 0.641-0.951). Conclusions: Overall, SSS is more or less equally effective as compared to punch biopsy in confirming leprosy cases. Interest and training on SSS among resident doctors should be emphasized accordingly.

Author(s):  
Marianne Hatfield ◽  
Rebecca Ciaburri ◽  
Henna Shaikh ◽  
Kirsten M. Wilkins ◽  
Kurt Bjorkman ◽  
...  

OBJECTIVE: Mistreatment of health care providers (HCPs) is associated with burnout and lower-quality patient care, but mistreatment by patients and family members is underreported. We hypothesized that an organizational strategy that includes training, safety incident reporting, and a response protocol would increase HCP knowledge, self-efficacy, and reporting of mistreatment. METHODS: In this single-center, serial, cross-sectional study, we sent an anonymous survey to HCPs before and after the intervention at a 213-bed tertiary care university children’s hospital between 2018 and 2019. We used multivariable logistic regression to examine the effect of training on the outcomes of interest and whether this association was moderated by staff role. RESULTS: We received 309 baseline surveys from 72 faculty, 191 nurses, and 46 residents, representing 39.1%, 27.1%, and 59.7%, respectively, of eligible HCPs. Verbal threats from patients or family members were reported by 214 (69.5%) HCPs. Offensive behavior was most commonly based on provider age (85, 28.5%), gender (85, 28.5%), ethnicity or race (55, 18.5%), and appearance (43, 14.6%) but varied by role. HCPs who received training had a higher odds of reporting knowledge, self-efficacy, and experiencing offensive behavior. Incident reporting of mistreatment increased threefold after the intervention. CONCLUSIONS: We report an effective organizational approach to address mistreatment of HCPs by patients and family members. Our approach capitalizes on existing patient safety culture and systems that can be adopted by other institutions to address all forms of mistreatment, including those committed by other HCPs.


2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Samina Ismail ◽  
Shemila Abbasi ◽  
Sobia Khan ◽  
Abdul Monem ◽  
Gauhar Afshan

AbstractAims:The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.Methods:In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.Results:From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.Conclusions:Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.


Author(s):  
Rajiv Kumar Gupta ◽  
Bhavna Langer ◽  
Parveen Singh ◽  
Rashmi Kumari ◽  
Najma Akhtar ◽  
...  

Background: Emergency Contraception (EC) is a method of contraception used within 72 hours of unprotected sex to prevent unwanted pregnancy. More than ten years since its use, a study was conducted among health care providers to assess their knowledge, attitudes and perceived barriers towards EC.Methods: The current cross-sectional study was conducted among the health care providers (HCPs) in all the health institutions of Jammu city, one of which included a tertiary care teaching hospital. The HCPs for the purpose of the current study included Medical Officers (MOs), Lady Health Visitors/ Staff Nurses (LHV/ SNs) and pharmacists. A 24 item pre-tested questionnaire was administered to the respondents to gather the relevant information.Results: MOs and LHV/SNs were found to have better knowledge than the pharmacists. Higher proportion of LHV/SNs and pharmacists were willing to learn more about EC (p<0.05). About two-third of MOs and LHV/SNs agreed about shortage of time during clinic schedule to counsel the users about EC (p<0.05).Conclusions: Gaps in the knowledge of the respondents need to be taken care of with continuing in-service trainings along with behaviour change communication. Role of pharmacists as health care provider especially in the context of family welfare services needs to be reassessed.


Author(s):  
Sunil K. Guleri ◽  
Ram K. Panika

Background: Health care workers (HCW) are at risk of an occupational exposure to blood borne diseases like HIV and Hepatitis B through accidental needle stick injuries. This study was conducted to assess the awareness regarding needle prick injuries among health care providers and their exposure to NSIs in a tertiary care medical college hospital with 750 bed capacity.Methods: This cross sectional observational study was conducted on 300 voluntarily participated HCWs out of total 650 HCWs. A semi structured questionnaire was used to assess their knowledge about exposure to blood and body fluids, needle stick injuries and associated risks and post exposure prophylaxis. Details of previous exposures to NSIs in last one year (2017-18) were also asked and their opinion about role and responsibilities of hospital administration for management of NSI was also recorded.Results: More than 90% HCWs were aware of exposure to blood and body fluids, 80.7% were aware of needle stick injuries, all 100% were aware of transmission of HIV and Hepatitis B from NSis and 78% were aware of post exposure prophylaxis. 97 cases of NSIs occurred in last one year which was higher than estimated EPInet data. Injection needle was most commonly (93.8%) involved in causing accidental NSIs.Conclusions: Practice of universal precautions and standard injection procedures by HCWs should be followed and education, training, and group insurance should be provided by hospital administration for prevention of NSIs.


2021 ◽  
Vol 11 (9) ◽  
pp. 172-177
Author(s):  
Padmini Kumari B ◽  
G Vijay Kumar ◽  
K. Ravi Babu

Purpose of Study: To study the radiological and imaging services in terms of Quality Assurance in relation to accreditation norms. Methods: We performed cross sectional evaluation of the data obtained from the participants in the study Semi structured both open and closed ended questionnaire were administered among the participants who were agreed to participate in the study. The questionnaire was formulated to evaluate different parameters of Quality Assurance Programme (QAP). The parameters were divided into structure, process and outcome measures and were derived from literature [National Accreditation Board for Hospitals and Health care Providers during accreditation of healthcare institutions]. Results: The radiology and imaging services of Vydehi Medical College Hospital was established in the year 2002, and was approved by AERB (Atomic Energy Regulatory Board) in the year 2007. The department was renewed by AERB in the year 2012. Checklist was formulated which includes several parameters in terms of structure, process and outcome measures. Conclusion: Quality assurance programme is to provide good patient timely care and the policies adopted by the department of radiology and imaging service in terms of quality are on par with standard guidelines in our study. Safe and sustainable quality care is the need of the hour and it can be practically achieved by regular monitoring of the quality assurance programme. Key words: Quality assurance; Imaging services; Utilisation; Guidelines; Healthcare


Author(s):  
Nishant Sharma ◽  
Anant Gupta ◽  
Makhdoom Killedar ◽  
Ashish Bindra ◽  
Asmita Patil ◽  
...  

ABSTRACT Objective: This study was conducted to assess the feasibility of extended use of N95 masks in our hospital during the coronavirus disease 2019 (COVID-19) pandemic. We also studied the use pattern, user satisfaction, and issues faced during extended use of the mask. Methods: This cross-sectional study was conducted among health-care providers in a large tertiary care teaching hospital in northern India from April 1 to May 31, 2020. A list was prepared from the institute’s register, and participants were chosen by random sampling. The data collected from the physical forms were transferred to excel sheets. Results: A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer “cup-shaped N95 mask with respirator”. The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each. Conclusions: It was concluded that the extended use of N95 masks was acceptable, with more than 96% of the participants using these masks.


2007 ◽  
Vol 26 (5) ◽  
pp. 301-311 ◽  
Author(s):  
Krystal Hanrahan ◽  
Mohammad-Ali Attar ◽  
Alice Frohna ◽  
Molly Gates ◽  
Sylvia Lang ◽  
...  

Purpose: To examine parents’ and health care providers’ perceptions of back transport from a tertiary care neonatal intensive care unit to a community hospital.Design: Qualitative, hypothesis-generating, cross-sectional study utilizing focus group methodology.Sample: Participants included 12 parents of back-transported infants insured by Medicaid, 6 regional NICU health care providers, and 17 community hospital special care nursery health care providers.Main Outcome Measures: Participant perceptions of factors that support or impede successful back transport.Results: Data from the focus groups were analyzed to identify five main themes: early communication about back transport, preparing parents for back transport, communication between hospitals at the time of back transport, follow-up and information exchange after back transport, and improving the back-transport experience for parents.


2019 ◽  
Vol 8 (2) ◽  
pp. 59-65
Author(s):  
S. Subedi ◽  
K. Paudel ◽  
M. Koirala ◽  
P. Chhetri

Introduction: Anxiety is a vague, uneasy feeling, the source of which is often non-specific but known to cause abnormal hemodynamic changes as a consequence of sympathetic, parasympathetic and endocrine stimulation. Most patients awaiting elective surgery experience anxiety. The degree, to which patient develops anxiety depends on many factors like age, gender, type and extent of the proposed surgery, previous surgical experience, and personal susceptibility to stressful situations. This study was conducted to find out the prevalence of preoperative anxiety and factors contributing to it. Material and Method: This is a cross-sectional study done among 74 pre-operative patients admitted the day before elective surgery in Department Of Surgery Universal College Of Medical Sciences Teaching Hospital, Bhairahawa. Socio-demographic as well contributing factor questionnaire, semi structured pro forma by interview method and Beck Anxiety Inventory Scale (BAI) Nepali Version were used to collect the data. Results: The findings of the study revealed that 90.54%, had very low level of anxiety and 2.70% of patients had severe pre-operative anxiety. The bivariate logistic regression analysis showed statistically significant association between family income (p= 0.004, AOR=2.03, CI= 0.009-2.567), family support (p< 0.001, AOR= 2.34, CI= 0.003-3.368), expected duration of hospital stay (p= 0.049, AOR=8.889, CI= 78.051-78.051), clarity on given information by health care providers (p< 0.001, AOR= 53.33, CI=7.165-396.99), staffs friendliness (p< 0.001, AOR= 21.01, CI= 3.450-127.82), fear of nil per oral (p= 0.015, AOR= 2.32, CI= 0.26-3.67) and level of pre-operative anxiety. Conclusion: It is concluded that varying degree of pre-operative anxiety were found in patients undergoing surgery. Providing adequate information about Peri-Operative procedure can help in reducing these anxiety.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Rajesh Meena ◽  
Alok Hemal ◽  
Shilpa Khanna Arora

Background. With improving standards of care of children living with HIV (CLHIV), pediatric HIV related mortality rates are declining. New challenges like HIV status disclosure are emerging which need to be addressed to ensure their smooth transition into adulthood. Poor disease disclosure rates are observed in CLHIV globally. Aims. This study was done to assess the prevalence of HIV disclosure in North Indian CLHIV, know the perceptions of caregivers regarding disclosure, and evaluate the impact of disclosure on CLHIV. Methods. It was a questionnaire based cross-sectional study carried out amongst 144 caregivers of CLHIV aged 6-16 years attending the pediatric HIV clinic of a tertiary care teaching hospital. Results. Though the majority (93.8%) caregivers felt that it is important to disclose but only 33% of the children were actually disclosed. Eighty five percent felt that disclosure must be done by one of the family members and correspondingly 73% of the disclosed children were actually disclosed by their parents. Forty seven percent believed that the most appropriate age for disclosure is 10-12 years. The mean age at which disclosure was actually done was 11.06 ± 1.62 years. Comparison of the disclosed and undisclosed CLHIV revealed that the disclosed group had significantly higher age, longer duration of taking ART, and higher proportion of paternal orphans. Age of the CLHIV was the only significant factor for disclosure. Several reasons were cited by the caregivers for nondisclosure. The caregivers observed improved drug adherence in 47.9% of the children following disclosure. Conclusions. There is a need to develop region specific pediatric HIV disclosure guidelines keeping in mind the caregivers’ perceptions. The guidelines must be age appropriate, systematic, and socioculturally acceptable. The most suitable age for disclosure appears to be 10-12 years. Involvement of caregivers and health care providers in the process is a must.


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