Knowledge, attitude, practices of inhalational therapy among nursing staff posted at tertiary care teaching hospital

Background: Inhalational therapy for patients with chronic respiratory disorder can greatly benefit. Nurses are one of the major components of health care system of hospital and have an important role in education and training of patients. This study was planned to assess knowledge, attitude, and practices of inhalational therapy among nurses.Methods: This questionnaire based cross sectional study was conducted after taking permission from the institutional ethics committee in all the nurses of a tertiary care teaching hospital. This questionnaire consists of few socio-demographic questions and other questions for assessing level of knowledge, attitudes, and practices related to inhalational therapy. Incompletely filled questionnaire were excluded out for data analysis. Data was interpreted in percentage.Results: Total 344 (87.31%) questionnaires were analysed. 334 (97.09%) have heard the term inhalational therapy and 310 (90.12%) responded that it is preferred in respiratory disease. 117 (34.01%) nurses could not mention single side effect of inhalational therapy. 178 (51.74%) nurses always assess/observe the patient and 211 (61.34%) always train the patients for correct inhalational technique. 165 (47.97%) nurses responded that knowledge of inhaler use came from attending meetings, courses or workshops organized by scientific bodies. 163 (47.38%) nurses considered ‘Disease to be treated’ the most important variable while prescribing an inhalational device.Conclusions: The knowledge of inhalational therapy was satisfactory while the demonstration of inhaler techniques to patients was moderate in this study. So regular training courses and workshop should be conducted for the nurses about inhalational therapy practical approach

A gender based comparative analysis of laboratory investigations in scrub typhus patients at tertiary care teaching hospital of Southern Rajasthan, India

Background: Scrub typhus is an acute febrile infectious disease which is common in both male and female patients. This study was done to compare the laboratory tests of the scrub typhus patients with reference to sex.Methods: This retrospectively study was carried out in diagnosed scrub typhus patients who were admitted to intensive care unit of a tertiary care teaching hospital of Southern Rajasthan. Diagnosis was done by testing for specific IgM antibodies against Orientia tsutsugamushi using a commercial ELISA kit.Results: Out of total 72 undiagnosed acute febrile illness patients, 26 (36.11%) were diagnosed as scrub typhus. Mean age of the patients was 39.5±12.1. There were 12 (46.15%) males and 14 (53.5%) females. Out of all 26 patients, 3 (11.54%) patients died. All laboratory tests were having non-significant difference between male and female values except haemoglobin, platelets count, serum Na and alkaline phosphatase. Raised creatinine, SGOT, SGPT and decreased albumin was found in all patients. Thrombocytopenia was found in all 12 males (100%) and 11 females (78.57%). Raised bilirubin level was found more in males (10, 83.33%) as compared to females (5, 35.71%) which were statistically significant. Raised alkaline phosphatase level was found more in female (12, 85.71%) as compared to male (5, 50%) which was also significant.Conclusions: Scrub typhus should be considered in differential diagnosis for both male and female acute febrile illness patients due to its non-significant difference in their laboratory values.

Comparative study of computed tomography guided fine needle aspiration cytology and trucut biopsy in diagnosis of lung cancer: a report of 81 cases

Background: Lung cancer is the major cause of cancer related deaths all over the world. CT guided FNAC and/or Biopsy of lung mass is an effective modality to diagnose lung cancer, especially in peripherally situated lesions. This study was planned to compare the role of CT guided lung FNAC and Biopsy in diagnosis of Lung cancer.Methods: This is a cross sectional study, done in department of respiratory medicine of a tertiary care teaching hospital of Rajasthan over a period one year. All the patients with suspected mass lesion on chest X-ray and clinical symptoms suggestive of lung cancer were included in the study. CT guided FNAC and biopsy were done in each patient after explaining the risks.Results: CT guided procedures were done in 81 patients of suspected lung cancer. CT guided FNAC yielded positive results in 75 patients while it was negative in 6 patients. CT guided lung biopsy was positive in all patients. Squamous cell carcinoma was most common type encountered malignancy.  Conclusions: CT guided lung FNAC and Biopsy is a simple and safe method with high diagnostic accuracy for diagnosis of Lung cancer

Effect of blood culture reports on antibiotics use by physicians in septic patients of intensive care unit

Background: To limit the emergence and spread of antibiotic resistance, adjustments in the antibiotic regimen should be done according to the results of blood cultures as soon as they are available. This study was planned to determine the effect of blood culture and sensitivity tests on the antibiotics use in ICU patients of a tertiary care teaching hospital.Methods: This chart review retrospective study was carried out in ICU patients of a tertiary care teaching hospital. The data was collected from patients’ medical record file in a case record form which included patient’s demographic details, provisional diagnosis/or diagnosis, blood culture reports, and antimicrobial treatment (both the empiric treatment as well as the change made after the release of the blood culture results). The effect of blood culture results on antibiotic treatment was analysed.Results: A total of 245 patients were subjected to blood culture during the period of 6 months with an average of 40.8/month. 86 (35.1%) patients showed positive blood culture results, while 159 (64.9%) patients showed negative blood culture results. 55 patients discharged after the release of blood culture and sensitivity results. Antibiotic regimens were modified or changed in 26 (47.27%), and in 29 (52.72%) there was no modification. Most commonly used antibiotic after blood culture reports were meropenem (34.62%) followed by 11.54% of each teicoplanin, piperacillin+ tazobactum and tigecyclin.Conclusions: Blood culture reports help in management of critically ill patients if bacteria are resistant to previously used antibiotic, but do not help in narrowing the therapy in ICU patients.