Evaluation of quality and patient satisfaction during endoscopic procedure: a cross sectional study from south Asian country

OBJECTIVE: To assess the quality of gastrointestinal (GI) endoscopic procedures and patient satisfaction in endoscopy suite of South Asian country. METHODS: Patients coming to the endoscopic suite of Aga Khan University Hospital (AKUH) were interviewed and assessed in this cross-sectional study. Quality of GI endoscopic procedures was evaluated using assessment tools as suggested by The American Society of Gastroenterology. Patient satisfaction after the procedure was assessed using a modified GHAA-9 questionnaire. The questionnaire was statistically evaluated using Pareto analysis and Spearman rank correlation. RESULTS: In this study, 323 patients were evaluated with a mean age of 43 +/- 14.36 years. Out of all the procedures 251 (77.7%) were gastroscopies while 72 (22.3%) were colonoscopies. Patients undergoing different therapeautic procedures were 121 in number (37.46%). Pre-procedure education was rated as excellent or very good by 91.3% of the patients. Midazolam was used for sedation with an average dose of 3 mg. Technically successful procedures included 99.2% gastroscopies and 98.6% colonoscopies. Mean score of patients regarding satisfaction on mGHAA-9 questionnaire was 30 +/- 3.965. Patient dissatisfaction calculated in our study was 3.6% with the length of time spent waiting before procedure and length of time waiting to get an appointment for the procedure contributing to 90% of dissatisfaction. CONCLUSIONS: Quality of endoscopic procedures at our centre is at par with international standards with acceptable complication rate and good patient satisfaction

Peritoneal ultrafiltration: bridging the treatment gap to cardiac transplantation in refractory congestive heart failure management

Background: Peritoneal ultrafiltration needs consideration as a therapeutic option for improvement in echocardiographic parameters, tissue Doppler imaging, and patient clinical status in patients with refractory congestive heart failure.Methods: This prospective, non-randomised, two-year observational study from June 2012 to June 2014 included 19 clinic outpatients and in-patients admitted to the CARE hospital, Hyderabad. Baseline data was compared on initiation and after three months of ultrafiltration therapy. Out of 19 patients studied initially, 16 were alive and undergoing CAPD at 3 months.Results: 3 months post ultrafiltration, the ejection fraction (EF) improved significantly from 35.4±6.6 to 43.1±13.8 (p<0.01), right atrial volume index (RAVI) decreased significantly from 31.8±14.3 to 28.3±14.9 (P=0.016), inferior vena cava (IVC) diameter decreased significantly from 2.27±0.44 to 1.8±0.68 (P=0.01), pulmonary artery systolic pressure (PASP) decreased significantly from 50.7±14.4 mmHg to 38.1±15.6 mmHg (P<0.01), hospitalisation days decreased significantly from 17.5±8.3 to 1.7±3.4 days (P <0.0001) and the distance covered in the 6 minutes’ walk test (6MWT) increased significantly from 58.52 m±47.6 m to 176.4 m±80.7 m (p<0.0001). Except for 3 (17.6%) patients, significant patients that were NYHA class III and IV improved to NYHA class I and II (p <0.0001; Table 1).Conclusions: Ultrafiltration was safe and associated with significant improvements in echocardiographic parameters, NYHA functional class, physical performance (6MWT), and reduction of hospitalization days in patients with refractory congestive heart failure

Localization performance evaluation of extended kalman filter in wireless sensors network

This paper evaluates the positioning and tracking performance of Extended Kalman Filter (EKF) in wireless sensors network. The EKF is a linear approximation of statistical Kalman Filter (KF) and has the capability to work efficiently in non-linear systems. The EKF is based on an iterative process of estimating current state information from the previously estimated state. Its working is based on the linearization of observation model around the mean of current state information. The EKF has small computation complexity and requires low memory compared to other Bayesian algorithms which makes it very suitable for low powered mobile devices. This paper evaluates the localization and tracking performance of EKF for (i) Position (P) model, (ii) Position-Velocity (PV) model and (iii) Position-Velocity-Acceleration (PVA) model. The EKF processes distance measurements from cricket sensors that are acquired through time difference of arrival between ultrasound and Radio Frequency (RF) signals. Further, localization performance under varying number of beacons/sensors is also evaluated in this paper. © 2014 Published by Elsevier B.V.Peer ReviewedPostprint (published version

The Value Propositions and The Nature of The Islamic Banks Products and Services in Providing The Solution/s for The Financial Needs of Bimb Business Customer Segments

The present study discusses the value proposition of the presently offered by Islamic banks (IBs) products and services. It also elaborates the nature of the Islamic banks’ products and services in providing the solutions for the financial needs and investment requirements of their retail and business customer segments. The study has adopted a qualitative approach, as this research paper justifies the value propositions and the nature of the IBs's products in providing the solution for the financial needs and investment to their clients.  In collecting the data, the following sources were used, such as library research, content analysis, research articles. Journals, conference papers and websites in the literature review. With the practical implications of Islamic banking products offered by Bank Islam Malaysia Berhad (BIMB) such as the financing, deposit, and investment products, customers have now shifted more towards embracing IBs’s products due to the benefits derived through the value proposition attached on these products and services offering.  Overall, this study provides comprehensive and coherent material on the topic which will serve as a guiding principle for customers to fulfil their needs. The study discusses value proposition of the currently offered banking products and services of IBs and does not cover the Shariah compliance aspect of the products and services. The paper will be a reference for fellow researchers to study the value proposition of the currently offered banking products and services and its implication in providing the solutions for the financial needs and investment requirements. The study aims at creating awareness to the consumers that the products and services provided by the IBs are competitive and superior to the ones offered by the conventional banks. This study is a comprehensive review of the value proposition of the contemporary products and services offered by Islamic banks.

Trends of expenditure on Immunization in Pakistan since 2000.

World health organization started Expanded Program on Immunization in 1974. At that time only 5% of the children were covered globally in the first year on pro-gram. In Pakistan 16.34% of the total population is under five years’ children. In 2000 Global Alliance for Vaccines and Immunizations (GAVI) was introduced in Paki-stan. Since 2000 by the finance and HR support from GAVI, additional 370 million children have been vaccinated from deadly disease. It has been noticed that the expenditure on immunization remained inconsistent over the time period. Since 2000 the massive change is seen in the pattern of expenditure on immunization both routine and campaigns to meet the goals. In Pakistan, expenditure on immun-ization has reached to $240 million annually but still the fully immunized children are between 43-62% of all the under-five population of the country. Immunization services needed to be on time and efficiently provided to the communities. The growth in fiscal gap and need for expenditure competition in financing, has subju-gated policymaking. There is a need for reviewing the current policies for budgeting immunization program and needful risk assessment will support future financial crisis.Key Words: Immunization, Global Alliance for Vaccines and Immunization,Extended Program of Immunization

A cross-sectional assessment of health-related quality of life among healthcare providers in Alkharj, Saudi Arabia

Purpose: To determine the current level of health-related quality of life (HRQoL), and evaluate factors influencing it among health-care providers (HCPs) in Alkharj, Saudi Arabia.Methods: A prospective cross-sectional study was conducted among HCPs in Alkharj, Saudi Arabia, using the standardized research tool, BREF-WHOQOL. A self-administered questionnaire was distributed in hospitals, in the medical colleges of Prince Sattam Bin Abdulaziz University, andcommunity pharmacies in Alkharj, Saudi Arabia. Descriptive, comparative, and inferential statistics were performed using SPSS.Results: A total of 289 HCPs agreed to participate in the study, 52 % of whom were female. Most participants were married (69 %), and most had fewer than 10 years of experience (58 %). Statistically significant differences in marital status, education level, income, and year of practice were found that correlated with HCPs’ HRQoL (p ≤ 0.05). Overall, respondents reported an above-average score for all survey items.Conclusion: The results indicate that HCPs see their general quality of life as good - a particularly important consideration in view of the demanding nature of their job. This study will help the concerned authorities to exactly know the current level of HRQoL among HCPs in Alkharj, Saudi Arabia, as well as help in designing better healthcare policies in Saudi Arabia. Keywords: Healthcare providers (HCP), Health-related quality of life (HRQoL), Healthcare policies, Occupational stres

Bacterial contamination of Saudi Arabian paper currency: A report from Al-Kharj

Background: Currency is a public support tool for exchange of commodity and services. It’s prevalent practice for acquiring bread to broast and bath to bed has connected all human being together irrespective of race and occupation. Currency notes along with their denomination values also carry pathogens if contaminated and will act as an agent for infection transference. Therefore the objective of this cross-sectional study was to assess the load microbial pathogens of paper currency collected in selected public places of Al-Kharj, Saudi Arabia.Methods: Currency notes under study were assessed through microbiological culture, microscopic and biochemical visualization techniques.Results: The results from this cross-sectional study suggested that lower the currency denominations higher was the microbial contaminations, frequency percentage was lower with higher isolations. Small eateries were the biggest source of contaminated currency from the ten selected centres. Percentage microorganism occurrence for Bacillus sp., Staphylococcus sp., Klebsiella sp. and E. coli was 56.84%, 25.03%, 13.40% and 04.71% respectively in all currency notes under study.Conclusions: The outcomes of this study revealed that currency notes can be a source for microbe transmission causing infectious diseases represent public health hazards to the community and individuals

Agronomical and analytical trait data assessed in a set of quinoa genotypes growing in the UAE under different irrigation salinity conditions

The importance of quinoa has been emphasized considerably in the recent decades, as a highly nutritional crop seed that is tolerant to salinity and amenable to arid agronomical conditions. The focus of this paper is to provide raw and a supplemental data of the research article entitled "Agronomic performance of irrigated quinoa in desert areas: comparing different approaches for early assessment of salinity stress" [1], aiming to compare different approaches for early detection, at the genotypic and crop levels, of the effect of salinity caused by irrigation on the agronomic performance of this crop. A set of 20 genotypes was grown under drip irrigation in sandy soil, amended with manure, at the International Center for Biosaline Agriculture (UAE) for two weeks, after which half of the trial was submitted to irrigation with saline water and this was continued until crop maturity. After eight weeks of applying the two irrigation regimes, pigment contents were evaluated in fully expanded leaves. The same leaves were then harvested, dried and the stable carbon and nitrogen isotope compositions (δ13C and δ15N) and the total nitrogen and carbon contents of the dry matter analyzed, together with ion concentrations. At maturity yield components were assessed and yield harvested. Data analysis demonstrated significant differences in genotypes response under each treatment, within all assessed parameters. The significant level was provided using the Tukey-b test on independent samples. The present dataset highlights the potential use of different approaches to crop phenotyping and monitoring decision making

Recent Advances in Angiogenesis Assessment Methods and their Clinical Applications

Angiogenesis, a natural phenomenon of developing new blood vessels, is an integral part of normal developmental processes as well as numerous pathological states in humans. The angiogenic assays are reliable predictors of certain pathologies in particular tumor growth, metastasis, inflammation, wound healing, tissue regeneration, ischemia, cardiovascular, and ocular diseases. The angiogenic inducer and inhibitor studies rely on both in vivo and in vitro angiogenesis methods, and various animal models are also standardized to assess qualitative and quantitative angiogenesis. Analogously, the discovery and development of anti-angiogenic agents are also based on the choice of suitable angiogenic assays and potential drug targeted sites within the angiogenic process. Similarly, the selection of cell types and compatible experimental conditions resembling the angiogenic disease being studied are also potential challenging tasks in recent angiogenesis studies. The imaging analysis systems for data acquisition from in vivo, in vitro, and in ova angiogenesis assay to preclinic, and clinical research also requires novel but easy-to-use tools and well-established protocols. The proposition of this pragmatic book chapter overviews the recent advances in angiogenesis assessment methods and discusses their applications in numerous disease pathogenesis

Characterization of cephalosporin-resistant clinical Enterobacteriaceae for CTX-M ESBLs in Bahrain

AbstractObjectiveTo detect the presence of specific CTX-M class of extended spectyum β-lactamases (ESBLs) in a collection of cephalosporin-resistant Enterobacteriaceae isolates from Bahrain.MethodsA subset of 80 cephalosporin-resistant Enterobacteriaceae collected from Salmaniya Medical Complex, Bahrain, were characterized further for the presence of specific genogroups of CTX-M β-lactamases by multiplex- and monoplex- PCRs. The primers used for the multiplex and monoplex PCRs were of genogroups- 1, 2, 8, 9 and 25. Sequencing of the representative isolates was performed to find the circulating CTX-M-types.ResultsA total of 93.8% (75/80) isolates showed the amplicons corresponding to any of the genogroups (1, 2, 8, 9, 25) and the remaining 6.2% isolates turned out negative in multiplex PCR. Some of the isolates demonstrated multiple bands corresponding to the sizes of different genogroups. Further confirmation with respective monoplex PCR on these 75 isolates demonstrated that 93.3% (70/75) harbored CTX-M genogroup-1 and 6.7% (5/75) harbored genogroup-9. We did not find the presence of genogroups 2, 8, and 25 in these isolates by monoplex PCR. Sequencing results of genogroup-1 isolates demonstrated the presence of CTX-M-15-like ESBL, however, discrepant results were noticed in genogroup-9 isolates, sequencing showed them as CTX-M-55-like ESBL.ConclusionsThis is the first report from Bahrain characterizing the CTX-M genogroups of ESBLs and reporting the emergence of blaCTX-M-55-like gene in this region