Rapid review of hand hygiene efficacy in reduction catheter associated urinary tract infections

Background: This review has been undertaken to evaluate the effectiveness of the hand hygiene in the prevention of catheter associated urinary tract infections among patients admitted in the acute care settings. Catheter associated infections are totally preventable and the morbidity and mortality associated with these infections cause a burden on the healthcare system and the economy of the country. Hand hygiene of the health care personnel’s is the most effective and economical way in the prevention of infections associated with the urinary catheters. Objective: This review to find out the effectiveness of hand hygiene for the prevention or reduction in the rate of catheter associated urinary tract infections among patients admitted in the acute care setting. Result: Five different experimental studies identified the effectiveness of hand hygiene of healthcare workers on the rates of catheter associated urinary tract infections. Conclusion: Hand hygiene is effective in the prevention of catheter associated urinary tract infections when health care workers perform it as per the five moments of hand hygiene given by WHO.

Managerial Economics – Family Medicine Care

Supply and demand are amongst the essential requirements before starting up a business. Understanding the quantity of a commodity wished to be sold by producers based on different prices and the item needed by consumers wish purchasing is essential in coming up with ideas. Based on the understanding of this and background research on costs in healthcare, specifically family medicine, it is found that healthcare is amongst the essential requirements, and thus the critical focus of the business idea in a physician’s practice focusing on family medicine care in the US. Starting up the business is based on healthcare demands in the market and further the pricing strategy utilized by most family medicine clinics. Through a connection to the business based on visits in hospitals and the quality offered by these service providers, it is noted that the demand is high and is the most expensive sector in the world, but care is ineffective (The Peterson Center on Healthcare, n.d.) thus leading to searching for effective alternatives by consumers. This creates a potential for offering the most effective services to cater to the demands, and as noted by the Peterson Center on Healthcare (n.d.), the US healthcare system is the most expensive, and costs are projected to grow dramatically in the coming years thus creating the most significant business opportunity to entrepreneurs. By adjusting the resources and trying to cater to the demand in various locations, the key idea is to cater to the need and profit from the sector. The concern of gaining information in the market is research on different healthcare websites and the prices offered and the quality of their services. This will aid in adjusting the prices effectively and thus retaining the demand and supply chain.

Students’ Perception on Government Policy of Routine HIV Testing: A Case of University of Zambia Ridgeway Campus

Background HIV Routine testing to all hospital attendants offers testing to all patients irrespective of their presenting illness even if it has nothing to do with HIV. This approach differs from voluntary counselling and testing, which is client-initiated. Adolescents and young adults especially those in colleges are a sexually active group of people which makes them prone to HIV infection. Therefore, there was need to conduct this study to determine the perception of students on routine HIV testing at the University of Zambia (Ridgeway campus) to determine their attitude towards HIV testing. Design and Methods A cross sectional quantitative study was conducted at UNZARidgeway hostels using stratified random sampling to select study participants which included all males and females who were on campus. A semi-structured interview questionnaire was applied to collect data which was analyzed using SPSS version 23software. A Chi-square test was applied for descriptive analysis and results were presented in tables and charts. Results Majority indicated that routine HIV testing was a good policy and supported it; though surprisingly 94% of the students were knowledgeable about routine HIV testing and yet their knowledge did not affect their perception of the policy. However, their experiences, expectations and beliefs affected students’ perception on routine HIV testing. Conclusion Health practitioners should have positive attitude and good work culture in order to uphold students’ positive perception so as to encourage a culture of HIV testing and is free from stigma.

Obesity Myths & Facts

Obesity is a chronic, relapsing, multifactorial and neurobehavioral disease. An increase in body fat endorses abnormal fat mass physical forces and dysfunction, resulting in unfavorable metabolic, biomechanical, and psychosocial health consequences.1,2 Examples of adverse metabolic consequences: Hypertension, diabetes mellitus type 2, hyperlipidemia.1 Examples of adverse biomechanical consequences: Obstructive sleep apnea, osteoarthritis, back pain, cancer, deep vein thrombosis, carpal tunnel syndrome.1 Examples of adverse psychosocial health consequences: Depression, anxiety, panic attack, bullying.1

Examination of the impacts of e-cigarettes smoking on the tobacco non-smokers

Significance and Aim: The effects of cigarettes smoking on both smokers and non-smoker have been an issue of global public health concern. This led to the emergence of e-cigarettes as an alternative to help smokers in their smoking quitting journey. However, it has remained unclear on the public health costs this has on the non-smokers. The ILR Review is developed to examine the public health the use of e-cigarettes have on non-smokers. Methods: The ILR sourced data from four databases Scopus, Medline, CINAHL, and Google Scholar. This was through a keyword search process using the ‘e-cigarettes’ or ‘vaping’ AND ‘addiction’ AND ‘non-smokers’ AND ‘effects OR ‘consequences, search phrases. The search protocol was replicated for all the databases. The findings from the search process were Scopus (419), Medline (283), CINAHL (311), and Google Scholar (321). The ILR applied inclusion and exclusion criteria and the GRADE model to assess the quality of the articles. Consequently, only 23 articles remained for analysis and inclusion in the ILR findings. Finally, the articles were screed through the EQUATOR PRISMA tool and extracted in readiness for analysis. Findings and Analysis: The results demonstrate that the use of e-cigarettes has two leading public health implications on non-smokers, namely (i) the risk of new addictions and (ii) the risk of health-related illnesses. The findings affirm that the ease of accessing the e-cigarettes, the marketing craze, and the low cost of acquiring them has exposed a rising number of young people to its new addiction. The addiction could at times progress into tobacco smoking addiction. Secondly, the findings indicate that second hand smoke exposure, also known as passive smoking exposes the public to increased lung cancer, lung diseases and COPD illnesses. Conclusion: The ILR concludes that e-cigarettes have far-reaching public health concerns on non-smokers. This necessitates the need for increased restrictions and control on the e-cigarettes access and availability. This is in addition to enacting strict regulations on smoking areas and freedom.

Common reasons patients are being referred from primary to secondary care, their journey and its impact on patient flow in the Emergency Department

A longstanding issue common to all Emergency Departments (ED), worldwide, is that of crowding. In recent years, prior to the CoVid-19 pandemic this was a national problem with trolleys lined up in ED corridors and waiting rooms filled with acutely unwell patients who have only received basic triage and no other clinician assessment. Many solutions have been put forward such as the concept of “reverse queueing”, the use of urgent treatment centres [1-4] and the use of ambulatory areas, particularly for medical patients. A clearly recognized strategy in managing overcrowding in the emergency department is prehospital assessment and judicious use of secondary care by primary care colleagues. “Initial Assessment” and referral to the correct area of secondary care promotes good patient flow and directs the patient to an appropriate area of the hospital, avoiding the emergency department altogether. One of the busiest clinical specialty within most hospitals is General Medicine. This specialty generally receives twice (if not more) the referrals than any other specialties but often has the same level of staffing. We undertook an audit of a cohort of patient referred by their GPs to acute specialties over a 2-week period to see if there are lessons to be learnt in order ease pressure on the emergency department and acute medical take.

Laparoscopic removal of giant gallbladder stone: A rare case report in Kuwait

Gallbladder stones are a typical surgical diagnosis, with over a million procedures performed worldwide. Laparoscopic cholecystectomy is considered the firstchoice treatment and procedure. The size of gallbladder stones varies from a few millimetres to giant/large stones. Larger stones have complex anatomy and adhesions, so the laparoscopic approach can be challenging, rare, and requires higher surgical experience.

Rare cause of lightning gastrointestinal haemorrhage: pseudoaneurysm of superior mesenteric artery caused by gunshot wound

Comparing to aneurysms, pseudoaneurysms carry a higher frequency of complications, early rupture being the most frequent and dangerous, as it can lead to a life-threatening shock. Traditionally, they are associated with trauma, infection, and inflammatory disease. SMA and branchespseudoaneurysms are the rarest forms of visceral pseudo-aneurysms. Unlike true aneurysms that have all three arterial wall layers, pseudoaneurysms develop from the disruption of intimal and medial layers of the arterial wall and do not contain any epithelized wall, hence the high risk of complications, they are typically outlined by thin fibrous tissue and are usually surrounded by periarterial hematoma. Presentation of pseudoaneurysms may vary from the absence of symptoms to life-threatening haemorrhage and death, but in context of Abdominal penetrating trauma, it can lead to hemorrhagic shock and ischemic colitis. Computed tomography angiography is considered the gold standard for diagnostics.

Locally Advanced Colorectal Cancer Diagnosed by Pathology From Abdominal Wall Necrotic Tissue

Colon cancer can present with variable clinical manifestations. An unusual finding is the direct dissemination of colon adenocarcinoma through the abdominal wall and skin. We present a rare case of complicated diverticulitis with abscess formation that demonstrates diagnosis of colonic adenocarcinoma from necrotic skin tissue upon debridement. In the modern world of widespread use of colonoscopy screening, the initial diagnosis of colon cancer is declining. This particular case, however, illustrates the value of maintaining a high index of suspicion in patients with diver-ticulitis complicated by abscess formation

ABO A frequency in caucasians in US and liberal politics

Background Genes and environment shape personality and behavior. Environment effects seem harder to pin down, but genetic effects may be studied with some precision and used to understand behavior better. So in looking at political behaviors and attitudes, genes can be helpful. The current political change in the US is toward more liberal policies heightened by the most recent national elections. Observation of the well-studied gene ABO in populations and their political voting behavior suggests that ABO A may be higher in caucasians that vote liberal politics than in caucasians that vote conservative. ABO A is high in frequency in populations of western Europe and especially eastern Europe, and socialism is more prevalent in those countries thus raising the suggestion that ABO A could be relevent in understanding liberalism in the US. Methods Since the US president and thus administration of the government is elected by state electoral votes, surveying the frequency of ABO A in each state population was done through review of the medical literature. Results Caucasians have a significantly higher frequency of ABO A than other ethnicities. Minorities historically vote significantly higher for liberal policies, but the Caucasian majority vote, theoretically more status quo and thus conservative would be necessary to have some voters choose liberal if liberals have a chance at winning an election. Since caucasians are in the majority in US population and since ethnicity of ABO frequencies in each state is not readily available information, an adjustment for ethnicity was applied by dividing each state’s frequency of ABO A blood type by the frequency of caucasians in that state’s population thus ABO A among caucasians in the red states (conservative) vs the blue states (liberal). Conclusion Higher ABO A frequency in caucasians in states that vote liberal was thus inferred