scholarly journals Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa

Author(s):  
D Schuster ◽  
JJ Fagan ◽  
M Flint ◽  
W Basera ◽  
O Porrill ◽  
...  

Background: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics, and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spreadsheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5–58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted.

2021 ◽  
pp. 57-59
Author(s):  
Hakimuddin Malvi ◽  
Syed Maqsood Husain

Background: India has been recognized as the diabetes capital of the world by the year of 2025 Hypertension is a signicant danger factor for cardiovascular infection, stroke and ischemic coronary illness. Objective: The aim of this paper is prevalence of hypertension amid patients with type 2 diabetes mellitus- at a tertiary level hospital in central India. Methods: Present work is hospital based cross-sectional study was conduct in Chirayu Medical College & Hospital, Bhopal. The study population consisted of total 300 subjects. Data obtained directly from patients and patients medical les, and the following data were included in the study . Results: The results showed that the after using chi-square test we found that hypertension was signicantly higher p value(<0.05) among female patients (69%),patients with long duration diabetes (77%)10 years and more, also it was signicantly higher among patients with current smokers (69%). Conclusion: In this study the prevalence of hypertension is increasing in patient with T2DM. Hypertension was the most danger factor for micro vascular and macro vascular confusion of T2DM.


Author(s):  
Jason September ◽  
Leon Geffen ◽  
Kathryn Manning ◽  
Preneshni Naicker ◽  
Cheryl Faro ◽  
...  

Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.


PLoS Medicine ◽  
2012 ◽  
Vol 9 (8) ◽  
pp. e1001281 ◽  
Author(s):  
Katharina Kranzer ◽  
Stephen D. Lawn ◽  
Gesine Meyer-Rath ◽  
Anna Vassall ◽  
Eudoxia Raditlhalo ◽  
...  

2021 ◽  
Vol 4 (1) ◽  
pp. 44-50
Author(s):  
Nisha Mehta ◽  
Saroj Singh

Introduction: Cervical cancer is the fourth most common cause of cancer in women in the world and the second most common cancer among Indian women. About 23% of the global cervical cancer burden is beard by India alone. The screening of cervical cancer is commonly done by a pap smear, visual inspection of acetic acid, human papillomavirus DNA testing etc. These identify precancerous changes which when treated can prevent the development of cancer. The objectives of the study were to screen the patient at Gynecology OPD by visual Inspection with acetic acid (VIA) and Pap smear for early detection of cervical cancer and to evaluate the efficacy of visual inspection with acetic acid and Pap smear in the early detection of cervical cancer. Methods: A descriptive cross-sectional study was conducted among 60 women attending Gynecology O.P.D of a Tertiary Level Hospital, Gwalior (India) by non-probability purposive sampling technique between 1st August to 30th August 2017. Pap smear was taken from each woman followed by VIA. Women with positive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. Results: After the application of 3% VIA among 60 women, 16 (26.67%) developed acetowhite while 44 (73.33%) didn’t. While the result of Pap smear shows, 22 (36.66%) had an inflammatory smear, 6(10%) shows benign smear, 9(15%) bacterial vaginosis, 1(1.66%) squamous metaplastic cells, 12 (20%) shows adenocarcinoma and 10(16.66%) normal pap smear.  Conclusion: The study concludes that VIA and pap smear were effective methods for the early detection of cervical cancer. Visual inspection of the cervix after acetic acid application (VIA) is widely recommended as the method of choice in cervical cancer screening programs in resource-limited settings and developing countries because of its simplicity, cost-effectiveness and ability to link with immediate treatment.


2014 ◽  
Vol 4 (2) ◽  
pp. 49-52 ◽  
Author(s):  
MH Zaman ◽  
S Ferdouse

Objectives: To find out the proportion, to determine the average length of stay at hospital and to estimate the cost of treatment for hospital-acquired infections in a tertiary level hospital of Rangpur City. Materials and Methods: This descriptive type of cross sectional study was conducted on purposively selected 200 admitted patients in a tertiary level hospital. Among them 100 were HAI patients and 100 were non HAL Data were collected through duly pretested interviewer administered questionnaire and observation checklist. Place and period of study: This study was conducted in Rangpur Medical College Hospital (RpMCH), Rangpur from January to June2011. Results: In this cross sectional study the highest percentage of HAI (42%) belonged to the surgery ward and the lowest percentage (19.%) belonged to medicine ward of the study hospital. According to the type of infections the surgical wound infection was found on the top (23%) and the cannula-associated infection at the bottom (5%) of the list. Respondents of both the polar age groups (<21 years and > 60 years) were found to be equally (27%) affected by HAI. Occurrence of HAI was found higher (57%) among the female respondents than their male (43%) counterparts. Highest number (48%) of HAI and lowest number (14%) of non- HAI patients were found to be visited by maximum number (?5) of visitors. Among the respondents who developed HAI, 42% had to stay at hospital for longest duration (21-25 days) but only 13% of their non- HAI counterparts had to stay for same duration. Among HAI patients 26% had to spend highest amount of money (Tk.20,0011- 25,0001-) but among non- HAI patients only 10% had to spend same amount of money for their treatment purpose. Conclusion: It has been revealed from this study that the occurrence of HAI was found higher among the patients with maximum number of visitors. Average length of hospital stay and cost of treatment of HAI patients were found higher than those of their non-HAI counterparts. DOI: http://dx.doi.org/10.3329/bjdre.v4i2.20247 Bangladesh Journal of Dental Research and Education Vol.4(2) 2014: 49-52


2020 ◽  
Vol 14 (2) ◽  
pp. 200-202
Author(s):  
Feroz Ahmed Sohel ◽  
Sanzida Jahan ◽  
Saifullah Russel ◽  
Farzana Zafreen

Introduction: Abortion in Bangladesh is illegal under most situations, but menstrual regulation is often used as a substitute. Abortion can be legally performed by a physician in a hospital if it is necessary to save the life of the mother. A person, who performs an abortion under any other circumstances, including a woman who self-aborts, can be punished by a fine and imprisonment. Objective: To assess the socio-demographic profile of abortion cases attending a tertiary level hospital of Bangladesh. Materials and Methods: This cross-sectional descriptive type of study was carried out among 80 patients at the Gynae ward and out patient department of Dhaka Medical College Hospital from March 2012 to June 2012. The study population was women attending the selected hospital for an abortion or abortion-related complications. Results: Most of the respondents 35(43.8%) were below 25 years of age and all patients were housewives. The maximum number of patients 63(78.8%) had spontaneous abortion, low socio-economic status and majority were multigravidas. It was also found that patients with abortion were mostly in their second (43.8%) and third (21.3%) decade of life. Conclusion: In this study, the commonest reason for termination of pregnancy was unplanned pregnancy. Creating awareness and timely intervention might decrease the number of abortion cases. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 200-202


Sign in / Sign up

Export Citation Format

Share Document