PERCEPTION OF PATIENTS REGARDING QUALITY OF HEALTHCARE SERVICES AT PUBLIC AND PRIVATE TERTIARY CARE HOSPITALS

Objectives: Patient satisfaction is a significant marker for estimating the quality of medical services being provided at a clinical facility. It also influences the opportune, proficient, and patient-focused provision of quality medical services. Methods: Data from 768 outdoor patients were collected from four tertiary care hospitals in Islamabad, Pakistan. Half of the patients were from public sector hospitals, while others were from private hospitals. A self-administered questionnaire (Cronbach’s alpha=0.896) was structured for data collection. Using SPSS, descriptive statistics, independent t-test, and Chi-square test were used to analyze data. Results: Overall, 51.4% of patients were satisfied with the services provided to them at hospital Outpatient department. Patients who experienced private sector hospitals (74%) were significantly more satisfied than those who visited the public sector hospitals (29%) (p<0.001). Gender-wise, female patients were more satisfied (58%) than male patients (47%). Insufficient attention of the doctor, the behavior of the supporting staff and inadequate management of disease record were the red flags highlighted by the patients. Conclusion: The current investigation has shown that quality healthcare is significantly associated with economic conditions; patients’ perspective have expressed that the private sector provides satisfactory medical services at a high expense, whereas the public sector is a less expensive alternative but it lags in the provision of high-quality services and patient satisfaction

Factors Leading to an Unexpected Early Control of Covid-19 in Pakistan

Introduction Different types of planning and strategies have been formulated following the up rise of Covid-19 in an attempt to limit the spread and to minimize both the crisis but the situation is still getting worse even in the developed states. Unexpectedly the rate of rise of Covid-19 declined after June 2020 in Pakistan and the slope decreased to 8,884 active cases out of 313,984 confirmed cases till September 2020. In addition to this unexpected decline, number of covid-19 related deaths. The fall in the covid-19 was unforeseen in this area and it led to the curiosity regarding the factors that were responsible for this scenario Methodology A country based research project was carried out in the Northwest School of Medicine for a period of 6 months. A sample group of 877 individuals of both the genders, age range from 15 to 80 years, belonging to various occupations, educational and socioeconomic backgrounds were included. Questionnaire on probable responsible factors for early control and shared with the participants. Results Most of the participants had an adequate level of knowledge and positive attitude towards Covid-19. The most prominent factor identified was the lack of stress and optimistic attitude. Conclusion  The optimistic attitude and low stress levels not only decreased the disease spread but also reduced its morbidity level. Key words; Covid-19, unexpected control, morbidity, factor

Factors Leading to an Unexpected Early Control of Covid-19 in Pakistan

Introduction Different types of planning and strategies have been formulated following the up rise of Covid-19 in an attempt to limit the spread and to minimize both the crisis but the situation is still getting worse even in the developed states. Unexpectedly the rate of rise of Covid-19 declined after June 2020 in Pakistan and the slope decreased to 8,884 active cases out of 313,984 confirmed cases till September 2020. In addition to this unexpected decline, number of covid-19 related deaths. The fall in the covid-19 was unforeseen in this area and it led to the curiosity regarding the factors that were responsible for this scenario Methodology A country based research project was carried out in the Northwest School of Medicine for a period of 6 months. A sample group of 877 individuals of both the genders, age range from 15 to 80 years, belonging to various occupations, educational and socioeconomic backgrounds were included. Questionnaire on probable responsible factors for early control and shared with the participants. Results Most of the participants had an adequate level of knowledge and positive attitude towards Covid-19. The most prominent factor identified was the lack of stress and optimistic attitude. Conclusion  The optimistic attitude and low stress levels not only decreased the disease spread but also reduced its morbidity level. Key words; Covid-19, unexpected control, morbidity, factor

Internet Addiction and Its Relationship with Depression and Academic Performance: A Cross-Sectional Study at a Medical School in Pakistan

Background: Excessive Internet use may induce depression, influence relationships, and decrease academic performance. There is scarce information about Internet addiction in Pakistan. This study aimed to determine prevalence of Internet addiction and its relationship with depression and academic performance. Methods: A study based on a self-administered survey was carried out at a medical school in Peshawar, Pakistan. Participants were medical students (MBBS) and a non-randomized convenience sampling technique was utilized for data collection. We collected demographic information, last professional exam score, Internet addiction, and depression scores using the Young’s Internet Addiction Test (YIAT) and the Beck’s Depression Inventory (BDI), respectively. The analysis included binomial 95% confidence intervals (95% CI) estimations and linear and logistic regressions to assess variables relations. Results: We analyzed responses from 231 participants (380 students approached and 250 responded: response rate=65.79%, 19 excluded), 64.07% were male and the age average was 21±2 years. Profound and slight addiction to the Internet was found in 9.09% (95%CI=5.71-13.56) and 41.99% (95%CI=35.55-48.64) of students, respectively. Frequency of depression (mild-severe) was 59.74% (95%CI=53.11-66.12). Levels of Internet addiction and depression were found associated after adjusting by sex and age (?=0.27, R2=0.03, p-value=0.009). Internet addiction (OR=0.54, 95%CI=0.2-1.49, p-value=0.23) and depression (OR=0.62, 95%CI=0.36-1.09, p-value=0.10) were not significantly associated with low grades after adjusting by sex and age. Conclusion: More than half of the students are having excessive Internet usage which could result in despondency and academic performance deterioration. Internet addiction should be considered an emerging challenge and appropriate mitigation measures should be taken opportunely

Potential degradation of norfloxacin using UV-C/Fe2+/peroxides-based oxidative pathways

The removal of norfloxacin (NOR), a widely used pharmaceutical and emerging water pollutant, was studied using UV-C and Fe2+ catalyzed peroxides-based oxidative processes (e.g., UV-C/Fe2+/H2O2, UV-C/Fe2+/S2O8 2− and UV-C/Fe2+/HSO5 −) and compared with UV-C and UV-C/Fe2+. The UV-C and UV-C/Fe2+ degraded NOR to 38 and 55%. However, use of peroxides, i.e., H2O2, S2O8 2−, HSO5 − with UV-C and UV-C/Fe2+ promoted NOR %degradation to 75, 83, and 90% using [peroxides]0 = 50 mg/L, [Fe2+]0 = 1 mg/L, and [NOR]0 = 10 mg/L, respectively. The significant impact of peroxides on NOR degradation was due to their decomposition into ●OH and SO4 ●− which showed high activity towards NOR degradation. The ●OH and SO4 ●− formation from peroxides decomposition and their contribution in NOR degradation was verified by different scavenger studies. Among the UV-C/Fe2+/peroxides processes, UV-C/Fe2+/HSO5 − showed better performance. The changing concentrations of peroxides, Fe2+, and NOR affected degradation of NOR. The use of different pH and inorganic anions also influenced NOR degradation. The degradation pathways of NOR were established and analyzed acute as well as chronic toxicities of NOR and its DPs

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

COVID-19 Vaccination Hesitancy and Associated Factors among Pakistani Population

COVID-19 pandemic has caused global healthcare and economic crises and mass vaccination to acquire herd immunity seem to be the only solution. Present study aimed to evaluate the intent of Pakistani population towards vaccination and to uncover the barriers associated with vaccine reluctance. This cross-sectional study included responses of 855 Pakistani residents. Respondents’ knowledge of COVID-19 infection, intent of vaccination and barriers towards vaccine refusal were evaluated. Participants were categorized on the basis of knowledge score, risk of disease and other demographic characteristics. Descriptive statistics were used for calculating frequencies and percentages, means and Chi-square test was utilized for cross-tabulation. A multinomial logistic regression model was executed to identify the predictors of vaccination intention. Significance level was set at the p-value of ? 0.05. Prevalence of vaccine refusal was 40%. COVID-19 vaccine is not Halal, negative propaganda on social media against the vaccine, discouraging advice from social circle and clerics, concerns regarding efficacy, fear of immediate and late adverse reactions were the major barriers identified towards vaccine hesitancy. Around one-third of the study population did not consider COVID-19 as a serious disease and associate it with conspiracy theory. The mean score of participants towards COVID-19 knowledge was 5.5±1.6 (range: 0-9). Having a college degree, living in an urban area, working in a healthcare field and being in a higher risk category increases the chances of vaccine acceptability

Airway fires during surgery: Management and prevention

Airway fires pose a serious risk to surgical patients. Fires during surgery have been reported for many years with flammable anesthetic agents being the main culprits in the past. Association of airway fires with laser surgery is well-recognized, but there are reports of endotracheal tube fires ignited by electrocautery during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially grave consequences. While airway fires are relatively uncommon occurrences, they are very serious and can often be fatal. Success in preventing such events requires a thorough understanding of the components leading to a fire (fuel, oxidizer, and ignition source), as well as good communication between all members present to appropriately manage the fire and ensure patient safety. We present a case of fire in the airway during routine adenotonsillectomy. We will review the causes, preventive measures, and brief management for airway fires

Unforeseen complications: a case of dengue shock syndrome presenting with multi-organ dysfunction in a subtropical region

Abstract Overview Dengue fever, a viral illness transmitted by the Aedes mosquito, is capable of causing a range of serious complications, including fulminant hepatic failure, renal dysfunction, encephalitis, encephalopathy, neuromuscular and ophthalmic disorders, seizures, and cardiomyopathy. Case description This report details the case of a 30-year-old lactating woman with no notable medical history who presented to the emergency department with symptoms of high-grade fever, altered mental status, and seizures. Upon imaging, bilateral infarcts in the thalami and cerebellar hemispheres were observed, consistent with cerebellitis and dengue encephalitis. Patient treatment and outcome The patient was admitted to the intensive care unit and received appropriate treatment. Following a critical phase and successful patient stabilization, she was transferred to a high dependency unit for a week before being discharged with recommendations for follow-up care. Conclusion This case illustrates the broad spectrum of complications that can arise as a result of dengue infection and the importance of timely diagnosis and management in improving patient outcomes. Further investigation is required to better understand the mechanisms underlying these complications and to formulate specific guidelines for the prevention and treatment of dengue shock syndrome