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Hospital Practices and Research
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2476-390X - ISSN (Online) 2476-3918
Published by Baqiyatallah University of Medical Sciences Homepage  [4 journals]
  • Peer Review – Legal and Ethical Issues Faced by Medical Staff: The
           Mandate for Physician ...

    • Abstract: Physicians working in hospitals face challenges when it comes to understanding and meeting the medical, legal, and ethical subjects outlined in the hospital bylaws. Hospital staff physicians and the hospital administration both aspire for high quality medical care and the assurance of patient safety. Unfortunately, when quality concerns surface, there can be reasonable differences of opinion as to whether a physician’s practice pattern met the accepted threshold of the standard of care. Such differences of opinion can lead to conflict that fuels a physician review. One complication for physicians is that many of the issues that surface at peer reviews are veiled in legal concepts and underpinnings for which physicians lack education, training, and familiarity. It would be prudent for all physicians working in hospitals to become familiar with the hospital bylaws and regulations. Physicians must take a leadership role in assuring fair and equitable peer review.
      PubDate: Sun, 25 Aug 2019 19:30:00 +010
       
  • Hand Hygiene Compliance in a Medical-Surgical Intensive Care Unit in La
           Habana

    • Abstract: Background: Hand hygiene plays a key role in the prevention of healthcare-associated infection in critical patients.Objective: The current study aimed to evaluate compliance with hand hygiene practices.Methods: An observational and descriptive study was carried out in a 35-bed medical-surgical critical care unit in La Habana (Cuba) from January 2017 to December 2018. The observational method recommended by the World Health Organization (WHO) was used.Results: Overall compliance was 34.2% (5516/16 125), with better compliance among physicians (39%) compared with nurses (31.4%) and ancillary staff (19.5%). Better compliance was observed after patient contact (65.7%) and after contact with patients’ surroundings (42.0%) in comparison with greater focus on patient safety as before patient contact (23.3%) and before an aseptic task (11.4%). Hand washing was performed more frequently than hand rubs.Conclusion: Compliance with hand hygiene practices is low and no improvement in compliance was observed during the study period. This practice is related to the high risk of transmission of healthcare-related infections in critical patients and requires quality improvement interventions.
      PubDate: Sun, 25 Aug 2019 19:30:00 +010
       
  • Cementless Total Hip Arthroplasty After an Iatrogenic Subtrochanteric
           Fracture due to Hardware ...

    • Abstract: Introduction: Total hip arthroplasty (THA) after proximal femoral fixation is a challenging procedure due to possible hardware-related complications. Case presentation: A 78-year-old female with hip osteoarthritis had a proximal femoral osteotomy using a fixed-angle blade plate performed in the same femur 41 years ago. A two-step approach was planned. After a challenging hardware removal, an iatrogenic subtrochanteric fracture below the degenerated hip occurred after three months. THA with a tapered long stem was successfully performed with no need for additional osteosynthesis, and good results were seen two years later. Discussion: THAs in subtrochanteric fractures are technically demanding but feasible in selected cases. Hardware removal before THA implantation may carry important risks, and the surgical team should be prepared to perform arthroplasty in case of complications. Conclusion: THA in a subtrochanteric fracture below hip osteoarthritis is a feasible option in selected cases.
      PubDate: Sun, 25 Aug 2019 19:30:00 +010
       
  • Financial Burden of Border Hospital in Caring for Cross-Border Patients: A
           Short Note From Thailand

    • Abstract: n/a
      PubDate: Sun, 25 Aug 2019 19:30:00 +010
       
  • Prevalence of Antibiotic Resistance to Isonicotinylhydrazide and
           Rifampicin in Culture Positive ...

    • Abstract: Background: One third of the world’s population is infected with TB, and the disease is known as the second deadly global infection, even more severe than measles. The disease kills about 2 million people a year. Approximately 8 million people in the world are affected by advanced tuberculosis (TB). Objective: The current study aimed to determine the frequency of resistance to the antibiotics isoniazid and rifampin in positive culture pulmonary TB patients in Zahedan city during 2013-2016. Methods: This descriptive cross-sectional study studied 100 samples from patients who referred to Boo-Ali hospital of Zahedan city from 2014 to 2016. First, the isoniazid solution was prepared, and then the rifampin solution was prepared. After that, 200 μL of mycobacterium suspension was added to the antibiotic and antibiotic-free control. Results: Of 100 patients participating in the study, 50 (50%) were male and 50 (50%) were female. Participants had an average age of 51.69 ± 20.41 years (95-12 years), 79 (79%) were Iranians and 21 (21%) were Afghans. Of the 100 samples, 55 (55%) were from the year 2013, 21 (21%) were from 2014, 10 (10%) were from 2015, and 14 (14%) were from year 2016. The samples examined showed that 4 (4%) were resistant and 96% were sensitive. Conclusion: The results of the current study showed that out of 100 samples, 4 cases (4%) had resistance and 96% were sensitive; 2% were resistant to isoniazid, and 2% were resistant to isoniazid and rifampin.
      PubDate: Sun, 16 Jun 2019 19:30:00 +010
       
  • Immunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus

    • Abstract: Background: As the rate of renal transplantation increases, more immunosuppressive drugs such as cyclosporine A (CsA) are consumed, particularly during the early months following transplantation, leading to post-transplant diabetes mellitus (PTDM) which can cause death. Objective: The present study examined the role of CsA in causing PTDM and other effective factors among patients with chronic kidney disease (CKD) who had undergone renal replacement therapy. Methods: The present investigation was a quantitative case-control study carried out on 30 CKD patients who had undergone renal transplantation and 30 healthy individuals. A questionnaire was utilized to gather their demographic information, and direct interviews were conducted with the subjects. To examine random blood sugar (RBS), white blood cell (WBC) count, creatinine level, and blood urea nitrogen (BUN), blood samples were obtained from the subjects. The mentioned parameters were analyzed using SPSS 22.0. Results: According to the results, the groups were homogenous in age, body mass index (BMI), and male-to-female ratio. However, there were significant differences between the two groups in RBS (P = 0.011), WBC count (P = 0.031), creatinine level (P = 0.001), and BUN (P = 0.001). Conclusion: Failure of allograft survival of renal transplantation was found to be a leading cause of death, which has been reportedly been treated by the consumption of immunosuppressive drugs such as CsA. However, this drug can increase the patient’s chances of developing PTDM. PTDM development can be reduced by applying a dosage of 10 mg/kg/d during the first week and 8-9 mg/kg/day during weeks 2-5 following transplantation.
      PubDate: Fri, 14 Jun 2019 19:30:00 +010
       
  • The Relationship Between Performance Indicators and Readmission of
           Patients With Open Heart ...

    • Abstract: Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators and the readmission of patients with open heart surgery in a teaching hospital in Iran. Methods: This study was performed using a cross-sectional and descriptive method with a retrospective approach. Data was collected on a data collection form. The statistical population of this study comprised all patients who underwent open heart surgery from mid-September 2015 to mid-September 2016 in a teaching hospital in the north of Iran (n=849). Those patients readmitted to the hospital within 90 days after discharge, based on a review of patient records, were included in the study. Descriptive statistics and Spearman correlation coefficient were used for data analysis by SPSS 20. Results: Among the patients who had open heart surgery in the selected hospital, 12.5% were readmitted within 90 days after discharge. The most important reasons for readmission in this study were infection in surgery place (25.8%), pleural effusion (18.7%), warfarin toxicity (9.8%), and tamponade (8.9%). There were inverse relationships between patient readmission and the two performance indicators of bed occupancy percentage (r = -0.594, P = 0.042) and bed turnover rate (r = -0.664, P = 0.018). There were no statistically significant relationships between any of the other indicators (length of stay, mortality, and bed turnover interval) and readmission rate (P > 0.1). Conclusion: Hospital authorities can use these results for bed management and targeting interventions to reduce costs and readmissions as a measure of hospital quality. However, further research into readmission factors in other hospitals is recommended.
      PubDate: Fri, 14 Jun 2019 19:30:00 +010
       
  • Hurried Psychiatric Labelling: A Preventable Medical Error in an Emergency
           Department

    • PubDate: Sun, 21 Apr 2019 19:30:00 +010
       
  • Risk Factors for Surgical Site Infection After Appendectomy for Acute
           Appendicitis; Results of ...

    • Abstract: Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This cross-sectional study was carried out at The Cuban Hospital (Dukhan, Qatar) on patients who had undergone an appendectomy from January 2013 through September 2016. Data extracted from the patient files included demographics, comorbidities and toxic habits, surgery type, procedure duration, wound type, appendicitis-type, American Anesthesiology Score, body mass index, selected laboratory tests, and compliance with antibiotic prophylaxis. Results: The study variables, type of surgery performed, procedure duration, wound and appendicitis type, serum albumin, and timing of antibiotic prophylaxis, were found to be related to the occurrence of SSI in univariate analysis (P = 0.000). Logistic regression showed that open appendectomies (odds ratio [OR] = 22.90, 95% CI; 8.04-65.21), low serum albumin (OR = 0.92, 95% CI; 0.85-0.99), and improper timing of antibiotic prophylaxis (OR = 44.92, 95% CI; 3.39-594.91) were independently associated with the occurrence of SSI. Conclusion: Cases of complex appendicitis, open procedure, low serum albumin level, and improper timing of antibiotic prophylaxis constituted the risk factors for SSI in the setting of this study. The infection control program should focus on improving the quality of antibiotic prophylaxis and closely monitoring patients who undergo open surgical procedures.
      PubDate: Sun, 14 Apr 2019 19:30:00 +010
       
  • Transcervical Migration of an Essure® Coil

    • Abstract: Introduction: Essure® device malposition is a rare, but clinically significant complication, for which management is idiosyncratic. This case report describes an unusual example of Essure® migration in order to clarify reasonable management options. Case Presentation: A 50-year old G4P2022 underwent hysteroscopic sterilization using the Essure® device. Insertion was complicated by fragmentation of both coils. Two years later, one of the coils was incidentally discovered protruding through the cervical os. The visible portion was clipped when attempts to remove the entire coil were unsuccessful. Conclusion: Difficult placement increases the risk of Essure® malposition. In asymptomatic patients, conservative management with removal of only a portion of the device is a rational approach.
      PubDate: Sun, 14 Apr 2019 19:30:00 +010
       
  • Atomoxetine Induced Obsessive-Compulsive Disorder

    • Abstract: Introduction: Attention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents. Atomoxetine is a non-stimulant drug used in the treatment of ADHD. Case Presentation: In this article, a case of obsessive-compulsive disorder (OCD) which occurred in an 11-year-old boy with an increased dose of atomoxetine during ADHD treatment and disappeared with dose reduction is reported. This case is only the second OCD case resulting from the use of atomoxetine. Conclusion: The case reported herein is the second case caused by the use of atomoxetine and the first in which OCD symptoms regressed when the atomoxetine dose was reduced. OCD development due to atomoxetine consumption may occur at different doses. When OCD develops, the solution may be dose reduction, or it may be necessary to discontinue treatment with atomoxetine.
      PubDate: Fri, 25 Jan 2019 20:30:00 +010
       
 
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