Measuring indian patients' satisfaction : a case of private hospitals

Exposure to global markets and competitors has placed increasing demands on all sectors of the Indian market. Introducing consumer choice was one of the key motivations underpinning the various healthcare utility privatization of the Indian Hospitals in 1980s, along with enhancing the quality of ser­vice provided to consumers. Customer satisfaction is becoming increasingly important for organizational survival, let alone prosperity. This paper aims to study the effect of service facilities provided to patients in private hospitals of India. Suitable satisfaction drivers are identified from the literature and talks with experts. A new customer satisfaction index is discussed. This index is based on American Customer Satisfaction Index (ACSI}. The concept is developed specially for the private hospitals operating in New Delhi and NCR market of India. A survey was carried out and 180 responses were collected. Application of factor analysis for satisfaction drivers shows that these variables are well represented by four dimensions, viz. information, process, service and expectation. From the point of view of the user, an advantage of the new customer satisfaction index, which can be named the Patients Satisfaction Index (PSI}, is that the values of the coefficients of the satisfaction drivers give clear hints on potential improvements for researchers and practitioner

The Effect of Implementing Problem Based Learning on the Result of Students’ Learning at School

After natural disasters, such as earthquakes, the community and schools’ conditions wereuncontrolled and unconducive. Students could not carry out the learning process as before. Anxiety and fearcame to students when in school. This study explained about the implementation of problem based learningon students at a shelter school after earthquake and the effect towards their learning outcomes. This studyaimed to know the effect of problem-based learning on students’ learning outcomes after an earthquakehappened. Problem based learning brought students closer to the problematic context. This researchcompared the effect of problem based learning as well as the conventional teaching on 2different groups fromdifferent emergency schools. The total number of the subject research was 120 students. The results of thestudy showed a positive influence on students’ learning outcomes. In the learning process of problem basedlearning, students were brought closer to real problems in their environment and fostered a sense ofconfidence

RCMS: Risk-Aware Crash Mitigation System for Autonomous Vehicles

We propose a risk-aware crash mitigation system (RCMS), to augment any existing motion planner (MP), that enables an autonomous vehicle to perform evasive maneuvers in high-risk situations and minimize the severity of collision if a crash is inevitable. In order to facilitate a smooth transition between RCMS and MP, we develop a novel activation mechanism that combines instantaneous as well as predictive collision risk evaluation strategies in a unified hysteresis-band approach. For trajectory planning, we deploy a modular receding horizon optimization-based approach that minimizes a smooth situational risk profile, while adhering to the physical road limits as well as vehicular actuator limits. We demonstrate the performance of our approach in a simulation environment.Comment: Presented at the 26th IEEE International Conference on Intelligent Transportation Systems (ITSC) 2023, Bilbao, Bizkaia, Spai

Cooperative Bidirectional Mixed-Traffic Overtaking

Safe overtaking, especially in a bidirectional mixed-traffic setting, remains a key challenge for Connected Autonomous Vehicles (CAVs). The presence of human-driven vehicles (HDVs), behavior unpredictability, and blind spots resulting from sensor occlusion make this a challenging control problem. To overcome these difficulties, we propose a cooperative communication-based approach that utilizes the information shared between CAVs to reduce the effects of sensor occlusion while benefiting from the local velocity prediction based on past tracking data. Our control framework aims to perform overtaking maneuvers with the objective of maximizing velocity while prioritizing safety and passenger comfort. Our method is also capable of reactively adjusting its plan to dynamic changes in the environment. The performance of the proposed approach is verified using realistic traffic simulations.Comment: Published in: 2022 IEEE 25th International Conference on Intelligent Transportation Systems (ITSC

Association of obesity and thyroid cancer at a tertiary care hospital in Pakistan

Objective: Thyroid cancer (TC) is one of the most common endocrine malignancies with a rapidly increasing worldwide presence. In Pakistan, it is more prevalent in females than males and has an incidence rate of 2.1%. Obesity and excess body mass index (BMI) has been linked to several cancers and is thought to be a risk factor for TC. We aim to investigate the incidence of TC in our population and understand it\u27s correlation with obesity. Subjects: The study was a retrospective case series conducted in the years 2000 to 2014, at the Aga Khan University Hospital (AKUH), Karachi, Pakistan where 156 patients who had been diagnosed and treated for TC were analyzed. Clinicopathological data was collected from medical records of these patients and weight and height were measured, pre-surgery, post-surgery, and at follow up. The BMI was correlated with patient variables for any significant associations. Results: The patient set comprised of 38.5% males and 61.5% females with a mean age of 47.77 (SD ± 14.35). The BMI was significantly associated with age as 72.8% of participants were obese and \u3e45 years old as compared to 27.2% who were under 45 years and obese (p-value0.999). Conclusion: The majority of-of TC patients among the Pakistani population were obese and female. Age was significantly associated with the risk of having a higher BMI. Moreover, differences in BMI pre and post-surgery could not be statistically proven

Limited effectiveness of home drinking water purification efforts in Karachi, Pakistan

Objective: In many developing-country urban areas, municipally supplied water is not microbiologically safe. This study evaluated drinking water quality and effect of home water purification efforts in Karachi, Pakistan.Methods: Members of 300 households, including 100 households who used the Aga Khan University Hospital Laboratory and 200 of their neighbors were interviewed. In 293 consenting households, structured observations were performed and drinking water was analyzed for the presence of coliforms, using the multiple tube fermentation technique.Results: Although 193 of the 293 households (66%) reported using some method to purify their drinking water, including 169 (58%) who boiled their water, only 48 (16%) of the drinking water samples were free of coliforms. Although a combination of boiling and filtering was the most effective method of purification, only 38% of samples that had been boiled and filtered were free of coliforms.CONCLUSIONS: Further refinements and evaluations of home-based efforts to purify and store water are needed

Epidemiological characteristics of acute dehydrating diarrhea during an epidemic of cholera: a study from North India

Background: Cholera is an acute diarrheal disease which continues to be a public health problem since inception. It is a disease related to poverty, overcrowding, poor sanitation and inaccessibility to clean water. India forms a fertile ground for the sustenance and transmission of cholera. However the diagnosis of cholera doesn’t easily come to mind when dealing with cases of dehydrating diarrheas.Methods The study was a prospective cohort study conducted in a tertiary care center of North India. All patients presenting to the medicine department of this hospital with acute dehydrating diarrhea were enrolled for the study. Stool samples for hanging drop test and culture were sent in all patients to rule this cholera.Results: Eighty four patients presenting to the medicine department of this hospital with acute dehydrating diarrhea were included in this study. All the patients had loose watery stools but classical rice water stools were seen in only 20.2% of patients. Patients with rice water stools were more likely to be positive for stool culture (70.6%, n = 12/17) and hanging drop preparations (82.3%, n = 14/17) as compared to those with watery stools. The difference was found to be statistically significant for culture (70.6% vs 40.3%, p-value = 0.02) as well as hanging drop preparation (82.3% vs 47.8%, p-value = 0.01).Conclusions: The prevalence of culture positive cholera cases was found to be 46.4% out of all the cases presenting with acute dehydrating diarrhea which is quite high. Rice water stools which are considered characteristic for cholera were found in less than half of culture positive cases of cholera (43.6%, n = 17/39). Hanging drop preparation was found to have a sensitivity of 87.2% and a specificity of 86.5% in comparison to stool culture which is regarded as gold standard for diagnosis of cholera. Cholera may be considered as an ongoing epidemic with periodic surge in cases and should be suspected whenever cases of acute watery diarrhea present in increased numbers with features of severe dehydration, especially when the cases are clustered together and from a poor socio-economic background

Clinical profile of dengue fever infection in patients admitted in NC Medical College, Haryana in the year 2019

Background: Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The study was aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at NCMC.Methods: This retrospective study included 24 patients infected with dengue virus, aged 19 years to 45 years. Laboratory and haematological data were included.Results Peak of infection occurred in November 2019 and no cases were recorded in October 2019. Common clinical symptoms were fever, joint pains, headache and rash. Common haematological abnormalities were thrombocytopenia. All patients survived. There was no case of dengue hemorrhagic fever or dengue shock syndrome.Conclusions: Significant differences in the clinical profile is possibly because of infection with different serotypes of dengue virus (DENV), concurrent/sequential infection of more than one serotype, and differences in host immune responses associated with host genetic variations

Mumps myocarditis: a forgotten disease?

Mumps is an acute viral illness that follows a self-limiting course but up to 10% of cases have a complicated course with the involvement of other organ systems. Myocarditis is reported as a complication but the incidence has greatly fallen ever since the development of the mumps vaccine. A child presented to our department with parotid swelling and fever. Persistent tachycardia with irregular pulse led to further cardiac work up which showed decreased ejection fraction and raised serum cardiac enzymes, indicating myocardial damage. With ionotropic agents and supportive care, there was complete normalization of ejection fraction and serum cardiac enzyme levels. He was discharged within a week of admission. This case highlights the importance of suspecting myocarditis in the setting of mumps, a diagnosis that precludes early suspicion in mumps patients suffering from cardiac symptoms not explained by other potential aetiologies. Early suspicion and timely supportive care are essential to ensure favourable outcomes