Knowledge and attitude towards identification and management of sepsis among resident physicians in tertiary care teaching hospital in Pakistan

We conducted this study to determine the compliance and knowledge of sepsis guidelines among resident physicians in tertiary care hospital of developing country. A self-structured validated questionnaire was prepared to evaluate compliance and knowledge of the SSC guidelines. A total of 76 resident physicians completed the questionnaire; 51 (67%) were Internal Medicine Residents and 25 (33%) were Emergency Medicine residents of Aga Khan University Hospital. 93% of the participants claimed to be aware of the SSC guidelines but only 26% considered themselves very knowledgeable on the subject. Less than half of them confessed to using the guidelines regularly. We concluded that the overall knowledge and compliance of sepsis guidelines was suboptimal. This highlights the need for increased awareness and teaching of sepsis and SSC guidelines to improve patient outcomes in developing countries. Keywords: Sepsis knowledge; health education, Continuous...

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Awareness, Practice, Knowledge and Attitude toward the COVID-19 among Antenatal Patients at Tertiary Care Hospital

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i37a32003 ◽

2021 ◽

pp. 228-234

Author(s):

Fahmida Parveen ◽

Samia Aijaz ◽

Sakeena Ahmed Memon ◽

Hina Akmal

Keyword(s):

Pregnant Women ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Antenatal Clinic ◽

University Hospital ◽

Care Hospital ◽

Cross Sectional Survey ◽

Preventive Practice ◽

Knowledge And Attitude ◽

Practice Knowledge

Objective: To determine the awareness, practice, knowledge and attitude toward the Covid 19 among antenatal patients at tertiary care Hospital. Methodology: This was a cross sectional survey which was conducted at Gynae and obstetrics department at Liaquat University Hospital Hyderabad. Study duration was six months from March 2020 to August 2020. All the pregnant women visited antenatal clinic age 18 to 40 years and either of parity were included. All the pregnant females were interviewed by using a questioner regarding awareness, attitude and practice toward the Covid19 after taking informed consent. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 173 pregnant women were interview regarding COVID-19, their mean age was 29.34+13.12 years. Most of the women were presented with age between 18 to 37 years. 70.5% were multigravida and majority of women were uneducated. Mostly women 75.1% had heard regarding. 72.8% women said, they should stay at home and 25.4% said should wear the face mask, while 38.7% said the women should inform the health care provider in advance before visit to Hospital if developed any symptom. Most of the women had good knowledge and attitude, while preventive practice was found to be unsatisfactory. Conclusion: knowledge and awareness were found to adequate; while preventive practice has been observed unsatisfactory among pregnant women during antenatal clinic. Clinicians should provide appropriate counseling to reassure and elucidate doubts of pregnancy females regarding COVID-19 during antenatal visits.

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Knowledge, Attitude, and Practices of Healthcare Personnel Regarding the Transmission of Pathogens via Fomites at a Tertiary Care Hospital in Karachi, Pakistan

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv208 ◽

2015 ◽

Vol 3 (1) ◽

Cited By ~ 7

Author(s):

Hassaan Bin Aftab ◽

Bushra Zia ◽

Mohammad Faizan Zahid ◽

Ahmed Raheem ◽

Mohammad Asim Beg

Keyword(s):

Medical Students ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Healthcare Personnel ◽

Care Hospital ◽

Cross Sectional ◽

Adequate Knowledge ◽

Resident Physicians ◽

Knowledge And Attitude

Abstract Background. Fomites are objects that can become colonized and serve as vectors in the transmission of pathogenic microorganisms. Literature examining the knowledge of healthcare personnel about this method of spread of infection is lacking. We conducted a study to assess the knowledge, attitude, and practices of healthcare personnel across different areas of patient care regarding the spread of infections at a tertiary care hospital in Karachi, Pakistan. Methods. A descriptive, cross-sectional study was conducted among healthcare personnel using a self-administered questionnaire. The questionnaire contained sections pertaining to demographic details and knowledge, attitude, and practices regarding fomites and their role in the transmission of pathogens. Results. Three hundred and fifty-three participants completed the questionnaire: 168 were male and 185 were female. Laboratory coats, stethoscopes, and bedside curtains were most frequently identified as fomites by the participants. Medical students had significantly lower mean scores in the knowledge and attitude sections than consultant physicians, resident physicians, and nurses. Nurses scored higher than consultant physicians, resident physicians, and medical students regarding practices that minimize fomite-borne spread of infections. 95% of the participants scored above 50% on the knowledge component of the questionnaire, but only 32.3% scored above 50% in the practices section. Conclusions. Our results show a large gap between the knowledge about fomites acting as vectors in the spread of pathogens and practices done to minimize this spread. Possessing adequate knowledge is ineffectual until and unless it is translated into the proper application of infection control practices. Incorporating awareness sessions and exercises into curricula are a reasonable way to raise awareness regarding this subject.

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A STUDY ON FREQUENCY OF ANTIBIOTIC DE-ESCALATION PRACTICES AND IMPLEMENTATION OF ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN A TERTIARY CARE HOSPITAL

10.36106/ijsr/0707583 ◽

2021 ◽

pp. 56-59

Author(s):

K.Ravi sankar

Keyword(s):

Patient Outcomes ◽

Antimicrobial Stewardship ◽

Antimicrobial Agents ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Healthcare Settings ◽

Study Results ◽

Outpatient Settings ◽

Improve Patient

Introduction: De-escalation of empirical antibiotic therapy is an essential part of antimicrobial stewardship programmes. It involves streamlining antibiotics to lower broad-spectrum antibiotic exposure based on microbiological cultures. This leads to effective targeting of the causative pathogen and at the same time, reduce the development of resistant microorganisms. As antibiotic-resistant microorganisms have become a clinical challenge in both inpatient and outpatient settings, such practices are increasingly employed in healthcare settings. Aim: The study aims to promote and measure the use of an appropriate agent, dose, duration, and route of administration of antimicrobial agents in order to improve patient outcomes while minimizing adverse events, including toxicity. Methods:Aprospective observational study was conducted in a tertiary care hospital. The sample size was 500 patients. The study was performed from October 2019 to September 2020. The participant's details were collected from patient medical records. The data obtained was analysed with MS Excel and the study results were expressed in number and percentages. Results and discussion: The number of blood samples and cultures obtained during the study period was noted. In our study, the percentage of single antibiotic prescriptions was highest in July 2020 (68.75%) as compared to other months while multiple antibiotic prescriptions were highest in January 2020 (82.75%). The number of antibiotics continued after obtaining the culture report was highest in February (30) while the highest percentage was seen in August 2020 (89.65%). The percentage appropriate de-escalation was highest in the month of April (82.35%) while September saw the highest number of multiple antibiotic prescriptions (25). Conclusion: The present study revealed positive results towards antibiotic de-escalating practices in the clinical settings to improve patient outcomes and reduce the use of antimicrobials which, in turn, can contribute to slowing down the further development of antibiotic resistance in hospitals.

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Cochlear Implant Research and Development in the Twenty-first Century: A Critical Update

Journal of the Association for Research in Otolaryngology ◽

10.1007/s10162-021-00811-5 ◽

2021 ◽

Vol 22 (5) ◽

pp. 481-508

Author(s):

Robert P. Carlyon ◽

Tobias Goehring

Keyword(s):

Research And Development ◽

Patient Outcomes ◽

Speech Processing ◽

Turn Of The Century ◽

First Century ◽

Directional Microphones ◽

Wide Range ◽

The Subject ◽

Processing Algorithms ◽

Improve Patient

AbstractCochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.

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Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India

Journal of Laboratory Physicians ◽

10.4103/0974-2727.163123 ◽

2015 ◽

Vol 7 (02) ◽

pp. 108-111 ◽

Cited By ~ 1

Author(s):

Tuhina Banerjee ◽

Shampa Anupurba ◽

Joel Filgona ◽

Dinesh K Singh

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Tertiary Care ◽

Significant Risk ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Hospitalized Patients ◽

University Hospital ◽

North India ◽

Care Hospital

ABSTRACT Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one. Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India. Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization. Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis. Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

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Impact of pregnancy on cancer survival: Experience at a tertiary care hospital

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.2.3525 ◽

2021 ◽

Vol 37 (2) ◽

Author(s):

Dur-e- Shahwar ◽

Sheikh Irfan Ahmed ◽

Zaheena Shamsul Islam ◽

Lumaan Sheikh

Keyword(s):

Overall Survival ◽

Cancer Survival ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Gestational Trophoblastic Disease ◽

University Hospital ◽

Care Hospital ◽

Creative Commons ◽

Hematological Cancers ◽

Expectant Mothers

Objectives: To assess the overall survival of pregnant women diagnosed with cancer during pregnancy or became pregnant thereafter. Methods: A retrospective medical record review of 90 patients who were diagnosed with cancer when pregnant or who became pregnant thereafter between 1996 and 2015 in Aga Khan University Hospital, Karachi. Results: A total of 90 patients were analyzed. The malignancies that expectant mothers had were, breast cancer 38 (42.2%), hematological cancers 29 (32.2%), brain cancer 10 (11.1%), and other malignancies 13 (14.4%) that included thyroid cancers, gestational trophoblastic disease and synovial tumor of foot. We observed only four deaths out of 90 patients and mean survival time in pregnant patients with malignancies was 17.98 years [CI 16.35-19.31]. Conclusions: The diagnosis of most cancer types before or during pregnancy does not influence on overall survival of patients. doi: https://doi.org/10.12669/pjms.37.2.3525 How to cite this:Dur-e-Shahwar, Irfan S, Islam ZS, Sheikh L. Impact of pregnancy on cancer survival: Experience at a tertiary care hospital. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3525 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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An evaluation of knowledge, attitude and practice of pharmacovigilance among medical students and doctors at a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20180107 ◽

2018 ◽

Vol 7 (2) ◽

pp. 324 ◽

Cited By ~ 1

Author(s):

Ravindra S. Beedimani ◽

Sameer Uz Zaman ◽

Subrahmanyam Darb ◽

Sharat Chandra Potturi

Keyword(s):

Medical Students ◽

Statistical Significance ◽

Tertiary Care ◽

Care Hospital ◽

Medical Doctors ◽

Cross Sectional ◽

Attitude And Practice ◽

Validated Questionnaire ◽

Correct Definition ◽

Knowledge Attitude And Practice

Background: Drugs are one of the most commonly used interventions in medical therapeutics. Spontaneous reporting of adverse drug reactions (ADRs) is the backbone of pharmacovigilance (PV) program. Under-reporting of ADRs by prescribers was possibly due to lack of knowledge, attitude and practices regarding PV. This study was done to assess the knowledge, attitude, and practice (KAP) of medical students (grouped to sixth and eighth semester) and medical doctors about PV in a tertiary care hospital.Methods: It was a questionnaire based cross-sectional study administered to 246 medical students and doctors. Study tool was a validated questionnaire containing 15 questions to evaluate KAP of PV among medical students and doctors. A descriptive analysis of data was done where necessary, statistical significance for associations between the group and their responses to questionnaire was provided using Pearson Chi square test and Fisher exact test.Results: Sixty-eight percent of the participants (90% doctors; 76% eighth-semester and 46% sixth-semester medical students) know the correct definition of PV. Sixty-one percent of the participants (67% sixth-semester, 61% doctors and 53% eighth-semester) think that reporting is a professional obligation for them. Only 15% of the participants have ever been taught or trained on how to report an ADR.Conclusions: Medical doctors and students lack adequate knowledge and practice of reporting ADRs, but they seem to have a positive attitude towards the PV program. Our study findings strongly suggest that there is a great need to create awareness amongst them to promote reporting of ADRs.

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Knowledge and awareness of basic life support among MBBS students in tertiary care hospital in Uttar Pradesh

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205304 ◽

2020 ◽

Vol 8 (12) ◽

pp. 4352

Author(s):

Bikram K. Gupta ◽

Shubham Tomar ◽

Anukul Karn ◽

Jassimran Singh ◽

Aditi Agrawal ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Basic Life Support ◽

Life Support ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Uttar Pradesh ◽

Average Score ◽

Care Hospital ◽

Maximum Score ◽

Validated Questionnaire

Background: Every medical student in India have to undergo a compulsory rotatory internship for completion of their course where they encounter various medical emergencies and apply their medical knowledge. An early encounter to a basic life support course and training will increase the efficacy of cardiopulmonary resuscitation and thus the outcome of the patient. This study was designed to test knowledge of MBBS students in a tertiary care hospital.Methods: This observational study was conducted in a tertiary care hospital in Uttar Pradesh and used a preformed validated questionnaire to test awareness and knowledge of basic life support and cardiopulmonary resuscitation in a sample of 500 MBBS students. Descriptive analysis was performed on the questionnaire responses. All data obtained from the questionnaire was evaluated and statistically analysed using software IBM SPSS Statistics software version 24 (IBM Corp., Armonk, NY, USA) for MS windows.Results: With a response rate of 47% among 500 MBBS students, the mean score obtained was 2.34±1.066 out of a maximum score of five. A maximum score of 2.804±1.055 obtained by 5th-year students. Surprisingly, first-year students achieved an average score of 2.66±0.97, which was higher than that of 2nd, 3rd, and 4th year students. 87% of students were like-minded to participate in the cardiopulmonary resuscitation (CPR) awareness program. Only 45% of students correctly answered the order of CPR as C-A-B (chest compression-airway-breathing).Conclusions: The study showed that though the awareness and importance of basic life support (BLS) are high among the medical students, the accurate knowledge required in performing BLS is inadequate. This study also showed that the National medical commission has taken a positive step in the incorporation of BLS in the curriculum.

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MATERNAL SEPSIS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.05.3239 ◽

2019 ◽

Vol 26 (05) ◽

Author(s):

Fehmida Parveen Memon ◽

Majida Khan ◽

Samya Aijaz

Keyword(s):

Maternal Morbidity ◽

Tertiary Care ◽

Morbidity And Mortality ◽

University Hospital ◽

P Value ◽

Care Hospital ◽

Maternal Complications ◽

Cross Sectional ◽

Maternal Morbidity And Mortality ◽

Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

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