Patient Satisfaction in a Tertiary Care Government Hospital

OBJECTIVES: To determine patient satisfaction in terms of various services such as ease of getting care, in-patient admission, waiting for check-up, staff interaction, medical care, cost of care, and cleanliness in a Tertiary Care Government Hospital. METHODOLOGY: The study design was cross sectional observational. A total of 200 patients meeting our inclusion criteria were enrolled through convenient sampling techniques in this research study. A well-designed questionnaire was used for data collection of admitted patients.  RESULTS: Out of 200 patients, 96 (48%) male and 104 (47%) female patients were interviewed. 72% were satisfied with clinical care services, 14% had mixed views while 14% patients were not satisfied at all. CONCLUSION: Patients in general showed their satisfaction in some of the aspects, however, keeping in view the burden a public sector hospital absorbs on a daily basis, and it was imperative to receive unsatisfactory feedback from patients in most of the aspects. Thus, the results of my study recommend to the health care leaders to take practical steps to bring further improvement by developing a proper mechanism for the uplift of public sector hospitals

Analgesic activity of various extracts of Holoptelea integrifolia (Roxb.) Planch leaves

Abstract: The various extracts of leaves Holoptelea integrifolia (Ulmaceae) were investigated for analgesic activity in mice by tail flick method. The fresh plant leaves of H. integrifolia were collected, dried, cleaned, weighed and chopped into small pieces and percolated in ethanol. The fractionation of crude extract, followed by the addition of distilled water, ethyl acetate and n-butanol to an aqueous portion of each solvent, to obtain the dried masses of each four layers. Qualitative chemical examination indicates the presence of secondary metabolites such as alkaloids, flavones, phenol, steroids, tannins and triterpenoids. No acute oral toxicity was observed and extracts considered being safe at the dose of 50-2000 mg/kg body weight. At the dose of 500 mg/kg various extracts of leaves of H. integrifolia were found statistically significant (P<0.05). A maximum effect was established at 150 min, after drug administration. Diclofenace sodium used as a standard

A survey tool for measuring evidence-based decision making capacity in public health agencies

BACKGROUND: While increasing attention is placed on using evidence-based decision making (EBDM) to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. METHODS: Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA) to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability) in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. RESULTS: In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. CONCLUSIONS: The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence-based. The survey can serve as a valuable tool for other health departments and non-governmental organizations to assess EBDM capacity within their own workforce and to assist in the identification of approaches that will enhance the uptake of EBDM processes in public health programming and policymaking. Localized survey findings can provide direction for focusing workforce training programs and can indicate the types of incentives and policies that could affect the culture of EBDM in the workplace

Association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan

<p>Abstract</p> <p>Background</p> <p>The combination of depression with type 2 diabetes is a public health problem. If diabetes is managed in its initial phase, the morbidity and mortality due to this combination may be prevented at an early stage. Therefore, we aimed to determine the association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan.</p> <p>Methods</p> <p>From July 2006 to September 2007, a matched case control study (n = 592) was conducted in Civil Hospital, Karachi. Incident cases of type 2 diabetes (n = 296) diagnosed within one month were recruited from diabetic Out Patient Department (OPD) of Civil Hospital, Karachi. They were matched on age and sex with controls (n = 296), who were attendants sitting in the medical out patient department of the same hospital, recruited on the basis of absence of classical symptoms of polyuria and polydispia along with random blood glucose level of <200 mg/dl measured by a glucometer. Depression was identified by the Siddiqui Shah Depression Scale. Conditional logistic regression was applied to examine the association of depression and other independent variables with newly diagnosed type 2 diabetes at 95% C.I. and P < 0.05.</p> <p>Results</p> <p>The study comprised of 592 subjects with 432(73%) males and 160(27%) females. Depression was significantly associated with newly diagnosed type 2 diabetes having mild level (mOR: 3.86; 95%CI: 2.22,6.71) and moderate to severe level (mOR: 3.41; 95%CI: 2.07,5.61). History of (h/o) gestational diabetes (mOR: 2.83; 95%CI: 1.05,7.64), family h/o diabetes (mOR: 1.59; 95%CI: 1.04,2.43), nuclear family (mOR: 1.75; 95%CI: 1.14,2.69), BMI (mOR: 1.62; 95%CI: 1.01,2.60 for obese and mOR: 2.12; 95%CI: 1.19,3.79 for overweight vs healthy to underweight) were also significantly associated with outcome, adjusting for age, sex, marital status, h/o smoking and h/o high BP.</p> <p>Conclusions</p> <p>Diabetics should be screened simultaneously for depression and concomitant preventive strategies for gestational diabetes, nuclear family and high BMI should also be used to prevent mortality/morbidity among patients between 25 to 60 years of age.</p

Prevalence of influenza vaccination and its association with health conditions and risk factors among Kansas adults in 2013: a cross-sectional study

Abstract Background According to the Centers for Disease Control and Prevention, approximately 5-20 % of people are affected by influenza annually, and influenza causes more than 200,000 hospitalizations each year. The purpose of this study is to estimate the prevalence of influenza vaccination among high risk adults in Kansas. Methods The 2013 Kansas BRFSS data (n = 20,712) were analyzed to assess the prevalence of receiving influenza vaccination among Kansas adults, overall and for selected demographic characteristics within the past 12 months. Crude and adjusted prevalence rate ratios were computed using univariate logistic regression models with influenza vaccination as the dependent variable and health conditions or high risk groups as the main independent variables; these models were then adjusted for potential confounding. Results Overall, influenza vaccination rate was lower than the Healthy People 2020 target (42.2 % vs. 80 %). The prevalence of receiving influenza vaccination was higher among adults 65 years and older compared to adults 64 years and younger after adjusting for gender, annual household income, education, marital status, insurance status, and race/ethnicity. Similarly, the prevalence of receiving influenza vaccination was higher among adults who have current asthma, or have ever been diagnosed with diabetes, high blood pressure, cancer (excluding skin), and COPD compared to those who did not have these health conditions, as well as pregnant women compared to women who were not pregnant. Conclusions Although high risk groups have higher rates of influenza vaccination compared to low risk groups, more concerted efforts are needed to improve seasonal influenza vaccination in Kansas

Numerical simulations of the soliton dynamics for a nonlinear biological model: Modulation instability analysis.

This article deals with studying the dynamical behavior of the DNA model proposed by Peyrard and Bishop. The proposed model is investigated using the unified method (UM). Unified method successfully extracts solutions in the form of polynomial and rational functions. The solitary wave solutions and soliton solutions are constructed. An investigation of modulation instability is also presented in this paper. 3D and 2D plots are presented to exhibit the physical behavior of some of the obtained solutions