Chronic Kidney Disease Patients Visiting Various Hospital Departments: An Analysis in a Hospital in Central Tokyo, Japan

To further improve care for chronic kidney disease (CKD) patients, healthcare providers’ awareness of CKD must be raised. Proteinuria testing is essential for CKD care, and collaboration with specialists is recommended for advanced cases. We reviewed data from the electronic medical records of outpatients at our hospital to analyze the clinical departments visited by CKD patients, and the frequency of proteinuria testing and referrals to nephrologists. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or a urine protein concentration (U-pro) ≥ +1. We found that 31.1% of the CKD tests in September 2021 were performed in clinical departments other than internal medicine. Furthermore, within 1 year, 68.0% of CKD patients identified in September 2020 underwent a urine dipstick test, and 33.7% underwent a quantitative test for urinary protein or albumin. Additionally, 27.5% of individuals with an eGFR < 30 mL/min/1.73 m2 or U-pro ≥ +1 identified by non-nephrology departments in September 2020 visited the nephrology department within 1 year. Repeated assessments of these quality indicators may be useful for progress management in improving CKD care. Because CKD patients visited various departments in our hospital, campaigns to raise CKD awareness must reach a wide range of healthcare providers in hospitals.

Evaluation of Inpatient Surgical Wards' Performance at the Hospitals Affiliated with Tehran University of Medical Sciences in 2018

Background: Surgery wards account for a significant portion of hospital costs, followed by patient costs. Improving surgery wards' performance plays a major role in enhancing the accountability and efficiency of the hospital. This study aimed to evaluate the performance of inpatient surgical wards at the hospitals affiliated with Tehran University of Medical Sciences(TUMS). Methods: A descriptive, cross-sectional, retrospective study was performed at all hospitals affiliated with TUMS in 2018. To measure the efficiency of these wards, three indicators have been considered; bed occupancy rate, the average length of stay, and bed turnover. Data have been analyzed using Excel software based on the Pabon Lasso model . Results: Among the 15 active surgical departments, 5 (33.31 %) were categorized in quadrant three, including ophthalmology, obstetrics and gynecology, vascular and trauma surgery, plastic surgery, and infertility department. The oral and maxillofacial surgery and general surgery departments were the poorest in their performance and located in quadrant one. Ten surgical wards out of 38 (26.33 %) have reported a satisfactory performance. Conclusion: Understanding and comparing the performance of clinical departments is also useful in making decisions for standardizing the patterns of health services delivery, evidence-based management in health care centers, and enhancing accountability in the health system. It is suggested that managers revise the departments in the inefficient area to reduce the number of inefficient departments or attract more patients by marketing, diversifying services, and increasing the quality of services.

The relationship between the nurses’ work environment and the quality and safe nursing care: Slovenian study using the RN4CAST questionnaire

Introduction The safety and quality of patient care are basic guidelines in finding new and improved solutions in nursing. Important and influential factors shape the nurses’ work environment in hospitals. Purpose With the study, we intended to investigate whether the perception of nurses’ work environment is related to the safety culture and the quality of patient care and whether it differs according to nurses’ level of education. Methods of work The study with a quantitative research method was conducted at the six clinical departments of the University Medical Centre, Ljubljana in 2019. We used a survey questionnaire from the European survey Nurse forecasting in Europe (RN4CAST). Results 270 nurses were included in the study. The response rate was 54%. The study confirmed that there is a correlation between the assessment of the nurses’ work environment and the general assessment of patient safety (r = 0.36; p <0.001), the general assessment of the quality of nursing care (r = 0.32; p <0.001), the confidence in patient self-care at discharge (r = 0.29; p <0.001) and the quality of patient care in the previous year (r = 0.27; p = 0.001). The results showed frequent verbal abuse of nurses, in 44.9% by patients and their relatives and in 35.4% by staff. Graduate nurses rated the work environment more negatively than healthcare technicians (p = 0.003). Discussion and conclusion We confirmed the correlation between the assessment of nurses’ work environment and patient safety and the quality of health care, and that employees’ education influences the assessment and perception of the work environment.

COVID-19 Infection among the Health Care Staff at Frontier Medical and Dental College and Hospital

Background: First case of pandemic COVID-19 was diagnosed in December 2019 in China from where it spread throughout the world. In Pakistan, first case was diagnosed in February 2020 which resulted in a complete and several smart national lockdowns. National Command and Operation Center (NCOC) and Ministry of Health published guidelines for patient’s treatments during pandemic which includes: 1) providing only emergency Treatments 2) Patient’s pre-admittance Questioning, 3) Increasing intervals between appointment, 4) prevent crowding in waiting rooms, 5) Wearing masks at all times. 6) Wearing PPE. Methods: Data from all clinical departments of Frontier Medical and Dental College and Hospital Abbottabad was collected between March and December 2020 which included Number of; 1) Patients treated 2) Medical Staff 3) patients with positive COVID-19 reports 4) healthcare workers suffering from COVID-19. And 6) Post treatment Virus Infected patients. Results: 291 health care staff including 135 medical and dental doctors, 4 dental hygienists, 82 paramedics and 70 Administrative staff worked during the study period and 3280 procedures were performed. Out of these, thirty-eight (38) staff members treated 190 verified COVID-19 patients. During the study period 6 dentists (2.06%) and 9 (3.09%) medical doctors, 2 (0.7%) assistants and 3 (1.03%) admin staff were tested positive for the virus. Conclusion: Present study highlights the importance of education and stickiness to the infection control guidelines thus minimizing the risk of transmission of corona virus among the Healthcare professionals in hospitals. Keywords: COVID-19; Infection control, PPE, NCOC

Mental Health Status of the Professionals Working With Covid-19 atHospital in Dhaka

Background:The recent COVID-19 pandemic caused by the new strain of coronavirus (SARS-CoV-2) was first diagnosed in Wuhan, China in late December of 2019. Coronavirus disease (COVID-19) has a large negative psychological effect and mental health issues worldwide due to its high morbidity and mortality rates. The unexpectedly rapid spread of COVID -19 endowed HCWs with increased work burden, lack of personal protective equipment, high risk of exposure and contracting the diseases, as well as increased mortality amongst HCWs. Materials and Methods: This cross-sectional study was carry out to assess the Mental Health status of the professionals working with Covid-19 at Hospital in Dhaka. Primary data were collected through field survey including the observation and interview method. This survey, were covered doctors, nurses and Medical technicians in all clinical departments of Kuwait Bangladesh Friendship Government Hospital, Uttara, Dhaka between 1st May to July 30th, 2021. Mental health variables were assessed via Somatic Symptom scale-8 (SSS-8).

National Rare Diseases Registry System (NRDRS): China’s first nation-wide rare diseases demographic analyses

Background China has made tremendous progresses in serving the needs of its people living with rare diseases in the past decade, especially over the last 5 years. The Chinese government’s systematic approach included a series of coordinated initiatives, amongst these are: forming the Rare Disease Expert Committee (2016), funding the “Rare Diseases Cohort Study” (2016–2020), and publishing its first “Rare Disease Catalog” (2018). Herein, we present the National Rare Diseases Registry System (NRDRS)—China’s first national rare diseases registry, and the analysis of cases registered in the first 5 years ending Dec 31, 2020. Results The total 62,590 cases covered 166 disease/disease types, forming 183 disease cohorts. The data from nearly 22% of them (13,947 cases) is also linked to valuable biological samples. The average age of definitive diagnosis was 30.88 years; 36.07% of cases were under 18 years of age. Regional distribution analysis showed 60% of cases were from the more developed, wealthier East and North China, suggesting the local availability of quality care and patients’ financial status were key access factors. Finally, 82.04% of cases were registered from the five clinical departments: Neurology, Endocrine, Hematology, Cardiovascular, and Nephrology, suggesting that either these are most affected by rare diseases, or that there were disease non-specific ascertainment factors. Conclusions The preliminary analysis of the first 5-year’s data provides unique and valuable insight on rare disease distribution in China, and higlights the directions for enhancing equity, scale and utility.

Examining patient trust towards physicians between clinical departments in a Chinese hospital

The purpose of this cross-sectional survey study is to quantitatively examine the differences in patient trust towards physicians between four different clinical departments in a Chinese hospital. Using a validated modified Chinese version of the Wake Forest Physician Trust Scale, we measured patient trust in each department, and also collected data on patient demographics. A total of 436 patients or family members were surveyed in the departments of emergency medicine, pediatrics, cardiology, and orthopedic surgery. Significant differences were found between the departments, especially between pediatrics (trust score 43.23, range 11–50) and emergency medicine and cardiology (trust scores 45.29 and 45.79, respectively with range of 11–50). The average total score across all four departments was 44.72. There are indications that specifically comparing departments, such as patient demographics or department structure, could be helpful in tailoring patient care to improve physician-patient relationships.

A Large Sample Retrospective Study on the Distinction of Voriconazole Concentration in Asian Patients from Different Clinical Departments

Voriconazole (VRZ) is widely used to prevent and treat invasive fungal infections; however, there are a few studies examining the variability and influencing the factors of VRZ plasma concentrations across different clinical departments. This study aimed to evaluate distinction of VRZ concentrations in different clinical departments and provide a reference for its reasonable use. From 1 May 2014 to 31 December 2020, VRZ standard rates and factors affecting the VRZ trough concentration were analyzed, and a multiple linear regression model was constructed. The standard rates of VRZ in most departments were above 60%. A total of 676 patients with 1212 VRZ trough concentrations using a dosing regimen of 200 mg q12h from seven departments were enrolled in the correlation analysis. The concentration distribution varied significantly among different departments (p < 0.001). Fifteen factors, including department, CYP2C19 phenotype, and gender, correlated with VRZ concentration. A multiple linear regression model was established as follows: VRZ trough concentration = 5.195 + 0.049 × age + 0.007 × alanine aminotransferase + 0.010 × total bilirubin − 0.100 × albumin − 0.004 × gamma-glutamyl transferase. According to these indexes, we can predict possible changes in VRZ trough concentration and adjust its dosage precisely and individually.

Distance education in the professional training of future doctors: pro et contra

The article shows problems of distance education at a medical university. It is proved that despite the specifics of the training of medical professionals, distance education should exist, although in a limited form. The pros and cons of distance education at a medical university were highlighted and analyzed. Particular attention is paid to the problems of introducting distance education in the studying process of disciplines at clinical departments. The selected advantages are aimed at forming a theoretical basis in the training of future doctors. The shortcomings of distance education at a medical university were reviewed in detail, including general (mostly technical and organizational aspects) and inherent only in medical university (lack of immersion in the professional environment, the impossibility of forming clinical thinking, etc.).

IMAGING OF INTRACRANIAL SPACE OCCUPYING LESIONS

Introduction: With advanced MRI techniques such as perfusion, diffusion, and spectroscopy, it is now possible to differentiate between various intracranial lesions. Materials and Methods: This prospective cohort study was conducted on 50 patients referred by various clinical departments with clinical suspicion of intracranial space occupying lesions, evaluated by computed tomography & magnetic resonance imaging. Result: Solitary lesions were present in 35 patients (70%) & multiple lesions in 15 patients (30%). 68.00% lesions were Supratentorial & 32.00% infratentorial in location. Most common supratentorial location in adults was frontal lobe 40% followed by parietal lobe 30%. Most common supratentorial locations in children were frontal lobe. Infratentorially, cerebellum & posterior fossa were found to be most common location in adults & children respectively. Supratentorial lesions were most common both in adults & children. 60% lesions were intraaxial & 40 % extra axial in location. In adults, intraaxial lesions were more common than in children. Conclusion: Intracranial space occupying lesions comprise of a diverse group of lesions. With the introduction of CT & MRI scanning, imaging of lesions has acquired a new dimension whereby excellent anatomical detail in axial, sagittal & coronal planes as well as lesion characterization has become possible. Key words: Brain, CT, MRIs