Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre

Introduction: Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). Conclusions: The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings

Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States

Abstract Background Differences in experiences of care reported by Asian Americans (Asians) compared to non-Hispanic Whites (Whites) may be due to lack of measurement invariance. Methods We evaluated the three-factor structure and the equivalence of responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinical and Group (CG-CAHPS) Adult Visit Survey 1.0 and compared care experiences of Asians and Whites. Thirteen questions were used to elicit reports about specific aspects of care and two questions assessed overall care perceptions. This analysis of the CAHPS database included 769 providers and 266,327 respondents. Most surveys (98%) were administered by mail and the rest (2%) by phone. Only 0.5% of the surveys were administered in Spanish. The sample was 64% female, 89% White and 2% Asian, 39% 65 years or older, and 32% were high school graduates or less. Results A three-factor model was supported by categorical confirmatory factor analysis using weighted least squares with mean and variance adjustment: confirmatory fit index (CFI) = 0.99 and root mean squared error of approximation (RMSEA) = 0.03). A multi-group configural invariance model also fit the data well: (CFI = 0.993, RMSEA = 0.031). Regression models indicated that Asians reported worse access, lower scores on office staff courtesy and helpfulness and rating their doctors and were less likely to recommend their doctors to family/friends than did Whites. Conclusions Use of the CG-CAHPS Adult Visit Survey 1.0 to assess perceptions of care by Asians and Whites is supported. Quality improvement efforts are needed to address worse experiences of care among Asians in the United States. </jats:sec

Prioritization of Storm Water Drain Construction for an Urban Area in the Chittagong Hill Tracts Region of Bangladesh

Developing the urban drainage system is now a common issue in most developing countries like Bangladesh. Due to rapid urbanization, drainage related problems are identified as high priority by Municipal residents. Therefore, Municipal Drainage System needs to be developed in such a way that it functions in the long term resulting optimization of the used resources. Storm water flood hazard due to inadequate drain is a major concern in the Municipalities in the Chittagong Hill Tracts (CHT) Regions of Bangladesh. To address the issue, drainage master plans have been prepared for the three Municipalities in the CHT under the Urban Governance and Infrastructure Improvement Project (UGIIP) of Local Government Engineering Department (LGED) funded by Asian Development Bank (ADB). Under this master plan, 78 independent drains are proposed that would be implemented over a period of 10 years. The problem of the master plan implementation is that the available fund for drain construction in each year is a fraction of the total requirement. Considering the situation, the aim of the study is to develop a priority ranking schedule for drain construction. Development of the Multi-Criteria framework for prioritization of storm drain works is the methodology for this research. The outcome of the research is the year-wise implementation schedule of drain construction over the planning period based on available funds for a particular year

Watershed prioritization for soil and water conservation aspect using GIS and remote sensing: PCA-based approach at northern elevated tract Bangladesh

AbstractThe current study has been derived to understand morphometric parameters to pledge the reduction in the proclaimed drought influence for climate change. Watershed prioritization has been studied using the geographical information system and remote sensing techniques for soil erosion and water preservation measure at Plio–Pleistocene elevated tract in Bangladesh. Secondary data, i.e., SRTM DEM and the topographical sheets, have been used for the drainage network identification. Seventeen watersheds of fifth order and three watersheds of sixth order are selected for the whole study. Sixteen basic morphometric parameters that are categorized as areal, linear and relief aspects have been used for the study area. The study area comprises sixth stream order that has been obtained using a stream threshold value of 100-m length. Morphometric analysis is suitable for water and soil conservation practice where groundwater and relevant data sets are not available. For the categorization and correlation of the morphometric parameters, principal component analysis (PCA) has been used in the present study. PCA analysis is more suitable, well-known and widely used method for its simplicity to choose more influencing parameters (correlated parameters) that are responsible for watershed prioritization. Strongly correlated components (Dd, Rc, Re and Rb) are used for the compound parameter (Cp) and final priority (Rp) calculation. Low Cp value is suitable for water and soil conservation measure. Therefore, the corresponding low Cp has been taken as one for final priority ranking (Rp) purpose, then second lowest value as two, and so on.</jats:p

Uzbekistan: health system review.

Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly self-financing through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern. Quality of care is another area that is receiving increasing attention