Search results for: hospital stay

Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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Authors: Angelis P. Barlampas

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PURPOSE: Presentation of an interesting finding in an asymptomatic patient. MATERIAL: A patient came at hospital because of dysuric complaints and after a urologist’s prescription of a US exam of the urogenital system. The simple ultrasound examination of the lower abdomen revealed a moderate hypertrophy of the prostate and a solitary large bladder stone. The kidneys were normal. Then, the patient underwent a CT scan, which depicted the bladder stone and, as an incidental finding, a cystic lesion in contact with the upper anterior right surface of the bladder, with mural calcifications. METHOD: Abdominal ultrasound and abdominal computed tomography before and after intravenous contrast administration. RESULTS: The repeated US exam showed a cylindrical cystic lesion with a double wall and two mural hyperechoic foci, with partial posterior shadowing. Blood flow was not recognized on color doppler. The CT exam confirmed the cystic-like anechoic lesion, in the right iliac fossa, with the presence of two foci of mural calcifications. The differential diagnosis includes cases of enteric cyst, intestinal duplication cyst, chronic abscess, urachal cyst, Meckel's diverticulum, bladder diverticulum, old hematoma, thrombosed vascular aneurysm, diverticular abscess, etc. The patient refused surgical removal and is being monitored by ultrasound. CONCLUSIONS: The careful examination of the wider peri-abdominal area, especially during the routine ultrasound examination, can contribute to the identification of important asymptomatic findings. The radiologist must not be solely focused in a certain area of examination, even if the clinical doctor asks so, but should give attention to the neighboring areas, too.

Keywords: enteric cyst, US, CT, urogenital tract, miscellaneous findings

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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Authors: Jennifer E Simpson

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Background and purpose: The ubiquitous use of the Internet and social media by children and young people has had a dual effect. The first is to open a world of possibilities and promise that is characterized by the ability to consume and create content, connect with friends, explore and experiment. The second relates to risks such as unsolicited requests, sexual exploitation, cyberbullying and commercial exploitation. This duality poses significant difficulties for a generation of foster carers and social workers who have no childhood experience to draw on in terms of growing up using the Internet, social media and digital devices. This presentation is concerned with the findings of a small qualitative study about the use of digital devices and the Internet by care-experienced young people to stay in touch with their families and the way this was managed by foster carers and social workers using specific parental mediation strategies. The findings highlight that restrictive strategies were used by foster carers and endorsed by social workers. An argument is made for an approach that develops a series of balanced solutions that move foster carers from such restrictive approaches to those that are grounded in co-use and are interpretive in nature. Methods: Using a purposive sampling strategy, 12 triads consisting of care-experienced young people (aged 13-18 years), their foster carers and allocated social workers were recruited. All respondents undertook a semi-structured interview, with the young people detailing what social media apps and other devices they used to contact their families via an Ecomap. The foster carers and social workers shared details of the methods and approaches they used to manage digital devices and the Internet in general. Data analysis was performed using a Framework analytic method to explore the various attitudes, as well as complementary and contradictory perspectives of the young people, their foster carers and allocated social workers. Findings: The majority of foster carers made use of parental mediation strategies that erred on the side of typologies that included setting rules and regulations (restrictive), ad-hoc checking of a young person’s behavior and device (monitoring), and software used to limit or block access to inappropriate websites (technical). It was noted that minimal use was made by foster carers of parental mediation strategies that included talking about content (active/interpretive) or sharing Internet activities (co-use). Amongst the majority of the social workers, they also had a strong preference for restrictive approaches. Conclusions and implications: Trepidations on the part of both foster carers and social workers about the use of digital devices and the Internet meant that the parental strategies used were weighted more towards restriction, with little use made of approaches such as co-use and interpretative. This lack of balance calls for solutions that are grounded in co-use and an interpretive approach, both of which can be achieved through training and support, as well as wider policy change.

Keywords: parental mediation strategies, risk, children in state care, online safety

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Ahmed Assem Abd El Rahim

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Background: Mechanical low back pain is serious physical and social health problem. Purpose: To examine impact of shock wave therapy versus intermittent mechanical traction on mechanical LBP, and disabilities. Subjects: 60 mechanical LBP male studied cases years old 20-35 years were assigned randomly into 3 groups, Picked up from Sohag university orthopedic hospital outpatient clinic. Methods: (Study Group) A: 20 studied cases underwent shock wave therapy plus conventional physical therapy. (Study Group) B: twenty studied cases underwent intermittent mechanical traction plus conventional physical therapy. (Control Group) C: 20 patients underwent conventional physical therapy alone. Three sessions were applied weekly for four weeks. Pain was quantified using McGill Pain Questionnaire, Roland Morris Disability Questionnaire was used for measuring disability, and the ROM was evaluated by (BROM) device pre- & post-therapy. Results: Groups (A, B & C) found a reduction in pain & disability & rise in their in flexion and extension ROM after end of 4 weeks of program. Mean values of pain scale after therapy were 15.3, 9.47, and 23.07 in groups A, B, & C. mean values of Disability scale after therapy were 8.44, 4.87, 11.8in groups A, B & C. mean values of ROM of flexion were 25.53, 29.06, & 23.9 in groups A, B & C. mean values of ROM of extension were 11.73, 15.53 & 9.85 in groups A, B & C. studied cases who received intermittent mechanical traction & conventional physical therapy (group B), found reduction in pain & disability & improvement in ROM of flexion & extension value (P<0.001) after therapy program. Conclusion: Shock wave therapy and intermittent mechanical traction, as well as conventional physical treatment, can be beneficial in studied cases with mechanical LBP.

Keywords: mechanical low back pain, shock wave, mechanical, low back pain

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Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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Authors: Christine Böckmann, Julia Rosemann

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We present an inversion algorithm that is used in the European Aerosol Lidar Network for the inversion of data collected with multi-wavelength Raman lidar. These instruments measure backscatter coefficients at 355, 532, and 1064 nm, and extinction coefficients at 355 and 532 nm. The algorithm is based on manually controlled inversion of optical data which allows for detailed sensitivity studies and thus provides us with comparably high quality of the derived data products. The algorithm allows us to derive particle effective radius, volume, surface-area concentration with comparably high confidence. The retrieval of the real and imaginary parts of the complex refractive index still is a challenge in view of the accuracy required for these parameters in climate change studies in which light-absorption needs to be known with high accuracy. Single-scattering albedo (SSA) can be computed from the retrieve microphysical parameters and allows us to categorize aerosols into high and low absorbing aerosols. From mathematical point of view the algorithm is based on the concept of using truncated singular value decomposition as regularization method. This method was adapted to work for the retrieval of the particle size distribution function (PSD) and is called hybrid regularization technique since it is using a triple of regularization parameters. The inversion of an ill-posed problem, such as the retrieval of the PSD, is always a challenging task because very small measurement errors will be amplified most often hugely during the solution process unless an appropriate regularization method is used. Even using a regularization method is difficult since appropriate regularization parameters have to be determined. Therefore, in a next stage of our work we decided to use two regularization techniques in parallel for comparison purpose. The second method is an iterative regularization method based on Pade iteration. Here, the number of iteration steps serves as the regularization parameter. We successfully developed a semi-automated software for spherical particles which is able to run even on a parallel processor machine. From a mathematical point of view, it is also very important (as selection criteria for an appropriate regularization method) to investigate the degree of ill-posedness of the problem which we found is a moderate ill-posedness. We computed the optical data from mono-modal logarithmic PSD and investigated particles of spherical shape in our simulations. We considered particle radii as large as 6 nm which does not only cover the size range of particles in the fine-mode fraction of naturally occurring PSD but also covers a part of the coarse-mode fraction of PSD. We considered errors of 15% in the simulation studies. For the SSA, 100% of all cases achieve relative errors below 12%. In more detail, 87% of all cases for 355 nm and 88% of all cases for 532 nm are well below 6%. With respect to the absolute error for non- and weak-absorbing particles with real parts 1.5 and 1.6 in all modes the accuracy limit +/- 0.03 is achieved. In sum, 70% of all cases stay below +/-0.03 which is sufficient for climate change studies.

Keywords: aerosol particles, inverse problem, microphysical particle properties, regularization

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Authors: Nassim Belkacem, Amina Azzam, Dalila Haouchine, Kahina Bennacer, Samira Soufit

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Objective: To evaluate the antioxidant activity of the methanolic extract along with the antimicrobial activity of the essential oil of the aerial parts of Rosmarinus officinalis L. collected in the region of Bejaia (northern center of Algeria). Materials and methods: The polyphenols and flavonoids contents of the methanolic extract were measured. The antioxidant activity was evaluated using two methods: the ABTS method and DPPH assay. The antimicrobial activity was studied by the agar diffusion method against five bacterial strains (Three Gram positive strains and two Gram negative strains) and one fungus. Results: The total polyphenol and flavonoid content was about 43.8 mg gallic acid equivalent per gram (GA Eq/g) and 7.04 mg quercetin equivalent per gram (Q Eq/g), respectively. In the ABTS assay, the rosemary extract has shown an inhibition of 98.02% at the concentration of 500ug/ml with a half maximal inhibitory concentration value (IC50) of 194.92ug/ml. The results of DPPH assay have shown that the rosemary extract has an inhibition of 94.67 % with an IC50 value of 17.87ug/ml, which is lower than that of Butylhydroxyanisol (BHA) about 6.03ug/ml and ascorbic acid about 1.24μg/ml. The yield in essential oil of rosemary obtained by hydrodistillation was 1.42%. Based on the determination of the diameter of inhibition, different antimicrobial activity of the essential oil was revealed against the six tested microbes. Escherichia coli from the University Hospital (UH), Streptococcus aureus (UH) and Pseudomonas aeruginosa ATCC have a minimum inhibitory concentration value (MIC) of 62.5µl/ml. However, Bacillus sp (UH) and Staphylococcus aureus ATCC have an MIC value of 125μl/ml. The inhibition zone against Candida sp was about 24 mm. The aromatograms showed that the essential oil of rosemary exercises an antifungal activity more important than the antibacterial one.

Keywords: Rosmarinus officinalis L., maceration, essential oil, antioxidant, antimicrobial activity

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Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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Authors: Xu Yifei, Le Yining, Yang Qingluan, Tu Yanjie

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Objective: This study aims to investigate the distribution features of Traditional Chinese Medicine (TCM) syndromes and syndrome elements in Epstein-Barr virus-associated diseases and then explores the relations between TCM syndromes or syndrome elements and laboratory indicators of Epstein-Barr virus-associated diseases. Methods: A cross-sectional study of 70 patients with EBV infection was described. We assessed the diagnostic information and laboratory indicators of these patients from Huashan Hospital Affiliated to Fudan University between November 2017 and July 2019. The disease diagnosis and syndrome differentiation were based on the diagnostic criteria of EBV-associated diseases and the theory of TCM respectively. Confidence correlation analysis, logistic regression analysis, cluster analysis, and the Sankey diagram were used to analyze the correlation between the data. Results: The differentiation of the 4 primary TCM syndromes in the collected patients was correlated with the indexes of immune function, liver function, inflammation, and anemia, especially the relationship between Qifen syndrome and high lactic acid dehydrogenase level. The common 11 TCM syndrome elements were associated with the increased CD3+ T cell rate, low hemoglobin level, high procalcitonin level, high lactic acid dehydrogenase level, and low albumin level. Conclusion: The changes in immune function indexes, procalcitonin, and liver function-related indexes in patients with EBV-associated diseases were consistent with the evolution law of TCM syndromes. This study provides a reference for judging the pathological stages of these kinds of diseases, predicting their prognosis, and guiding subsequent treatment strategies based on TCM syndrome type.

Keywords: EBV-associated diseases, traditional Chinese medicine syndrome, syndrome element, diagnostics

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Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

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Authors: Almutazballlah Qablan, Jihan M. Muhaidat, Bana Abu Rajab

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Background: Acne vulgaris is the most common skin condition that general practitioners and dermatologists encounter. It represents a chronic inflammatory disease affecting the pilosebaceous unit. Although acne vulgaris is not a life-threatening condition, it has a considerable psychological impact on the affected person. Acne patients have poor body image, low self-esteem, social isolation, and restricted activities. As part of the emotional impact, increased levels of anxiety, anger, depression, and frustration have also been observed in acne patients. (1) In this study, we want to assess the association between two modifiable risk factors; BMI and smoking, regarding acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Irbid, north Jordan in 2019/2020. A total number of 163 Acne cases were collected and interviewed by the author; on the other hand, there were 162 control cases. Anthropometric measures for Acne patients and control individuals were taken, and BMI was calculated. Both groups were asked about smoking habits. Data on subjects between 14 and 33 years of age were extracted. The characteristics of people who reported acne were compared with those with no acne using univariate and multivariate analysis. The Statistical Package for Social Sciences (SPSS) was relied on to analyze the collected data. The crosstabs methods (chi-square) and odd ratios were relied on to test the study hypothesis. Results: Cigarette smoking was highly associated with no-acne, with an odds ratio of 0.4 (95% CI: 0.2–0.9), P-value = 0.018. BMI and waterpipe smoking were not significantly associated with acne in the multivariate analysis. Conclusion: Cigarette smoking was found to be protective from Acne. No significant relation between BMI nor waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, BMI, smoking, case-control

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Authors: Isomar Lima da Silva, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Biological isolation capsules are equipment commonly used in the control and prevention of infectious diseases in the hospital environment. This type of equipment, combined with pre-established medical protocols, contributes significantly to the containment of highly transmissible pathogens such as COVID-19. Due to its hermetic isolation, it allows more excellent patient safety, protecting companions and the health team. In this context, this work presents the development, testing, and validation of a medical capsule to treat patients affected by COVID-19. To this end, requirements such as low cost and easy handling were considered to meet the demand of people infected with the virus in remote locations in the Amazon region and/or where there are no ICU beds and mechanical ventilators for orotracheal intubation. Conceived and developed in a partnership between SAMEL Planos de Saúde and Instituto Conecthus, the device entitled "Vanessa Capsule" was designed to be used together with the NIV protocol (non-invasive ventilation), has an automatic exhaust system and filters performing the CO2 exchange, in addition to having BiPaps ventilatory support equipment (mechanical fans) in the Cabin Kit. The results show that the degree of effectiveness in protecting against infection by aerosols, with the protection cabin, is satisfactory, implying the consideration of the Vanessa capsule as an auxiliary method to be evaluated by the health team. It should also be noted that the medical observation of the evaluated patients found that the treatment against the COVID-19 virus started earlier with non-invasive mechanical ventilation reduces the patient's suffering and contributes positively to their recovery, in association with isolation through the Vanessa capsule.

Keywords: COVID-19, mechanical ventilators, medical capsule, non-invasive ventilation

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

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Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

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Authors: Sajjad Jafari

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Background and Aim: The use of herbal medicines has a long history. Today, due to the resistance of microorganisms to antibiotics and antimicrobial substances, herbal medicines have attracted attention due to their significant antimicrobial effects and low toxicity. This study aims to systematically review the antimicrobial effects of different plant extracts (Quercus infectoria) as possible candidates for treating infectious diseases. Material and Methods: The present study is a review study by searching reputable scientific databases such as PubMed, Google Scholar, Scopus, and Web of Science from 2000 to 2023 using the keywords Antimicrobial, Quercus infectoria, Medicinal herbal, Infectious diseases the latest information obtained. Results: In this study, 45 articles were found and reviewed. Quercus infectoria is a small tree native to Greece, Asia Minor, and Iran. Quercus is a plant genus in the family of Fagaceae. This species is generally known under the name ‘‘baloot” in Iran and is commonly used as a medicinal plant. The extracts used included water, hydro-alcoholic, ethanol, methanol. This plant had high inhibition activity and a lethal effect on gram-positive and gram-negative bacteria of ATCC strains, hospital, and resistant strains. Therefore, in addition to antibacterial effects, antiparasitic and antifungal effects. The seed of the plant was the most used and the most effective antimicrobial extract among the ethanol and methanol extracts. Conclusion: The findings of this study suggest that Quercus infectoria has significant antimicrobial effects against a wide range of microorganisms. This makes it a potential candidate for the development of new antimicrobial drugs. Further research is needed to confirm the efficacy and safety of Quercus infectoria in clinical trials.

Keywords: antimicrobial, Quercus infectoria, medicinal herbal, infectious diseases

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Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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Authors: Loveline Ambo Angwah

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The processing of cassava from tubers or roots into food using crude and rudimentary method (hand peeling, grating, frying and to sun drying) is a very cumbersome and difficult process. The crude methods are time consuming and labour intensive. While on the other hand, modern processing method, that is using machines to perform the various processes as washing, peeling, grinding, oven drying, fermentation and frying is easier, less time consuming, and less labour intensive. Rudimentarily, cassava roots are processed into numerous products and utilized in various ways according to local customs and preferences. For the people of Ngwo village, cassava is transformed locally into flour or powder form called ‘cumcum’. It is also sucked into water to give a kind of food call ‘water fufu’ and fried to give ‘garri’. The leaves are consumed as vegetables. Added to these, its relative high yields; ability to stay underground after maturity for long periods give cassava considerable advantage as a commodity that is being used by poor rural folks in the community, to fight poverty. It plays a major role in efforts to alleviate the food crisis because of its efficient production of food energy, year-round availability, tolerance to extreme stress conditions, and suitability to present farming and food systems in Africa. Improvement of cassava processing and utilization techniques would greatly increase labor efficiency, incomes, and living standards of cassava farmers and the rural poor, as well as enhance the-shelf life of products, facilitate their transportation, increase marketing opportunities, and help improve human and livestock nutrition. This paper presents a general overview of crude ways in cassava processing and utilization methods now used by subsistence and small-scale farmers in Ngwo village of the North West region in Cameroon, and examine the opportunities of improving processing technologies. Cassava needs processing because the roots cannot be stored for long because they rot within 3-4 days of harvest. They are bulky with about 70% moisture content, and therefore transportation of the tubers to markets is difficult and expensive. The roots and leaves contain varying amounts of cyanide which is toxic to humans and animals, while the raw cassava roots and uncooked leaves are not palatable. Therefore, cassava must be processed into various forms in order to increase the shelf life of the products, facilitate transportation and marketing, reduce cyanide content and improve palatability.

Keywords: cassava roots, crude ways, food system, poverty

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Authors: Francesco Ceresia

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Workplace aggression is broadly recognized as a main work-related risk for healthcare organizations the world over. Scholars underlined that nonfatal workplace aggressions can be also produced by Type II workplace aggression, that occur when the aggressor has a legitimate relationship with the organization and commits an act of hostility while being served or cared for by members of the organization. Several reviews and meta-analysis highlighted the main antecedents and consequences of Type II verbal and physical workplace aggression in the healthcare sector, also focusing on its economic and psychosocial costs. However, some scholars emphasized the need for a systemic and multi-factorial approach to deeply understand and effectively respond to such kind of aggression. The main aim of the study is to propose a qualitative model of Type II workplace aggression in a health care organization in accordance with the system thinking and multi-factorial perspective. A case study research approach, conducted in an Italian non-hospital healthcare organization, is presented. Two main data collection methods have been adopted: individual and group interviews with a sample (N = 24) of physicians, nurses and clericals. A causal loop diagram (CLD) that describes the main causal relationships among the key-variables of the proposed model has been outlined. The main feedback loops and the causal link polarities have been also defined to fully describe the structure underlining the Type II workplace aggression phenomenon. The proposed qualitative model shows how the Type II workplace aggression is related with burnout, work performance, job satisfaction, turnover intentions, work motivation and emotional dissonance. Finally, strategies and policies to reduce the strength of workplace aggression’s drivers are suggested.

Keywords: healthcare, system thinking, work motivation, workplace aggression

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Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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Authors: Brindha Senthil Kumar, Payel Chakraborty, Senthil Kumar Nachimuthu, Arindam Maitra, Prem Nath

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Gastric cancer is predominantly caused by demographic and diet factors as compared to other cancer types. The aim of the study is to predict Early Gastric Cancer (ECG) from diet and lifestyle factors using supervised machine learning algorithms. For this study, 160 healthy individual and 80 cases were selected who had been followed for 3 years (2016-2019), at Civil Hospital, Aizawl, Mizoram. A dataset containing 11 features that are core risk factors for the gastric cancer were extracted. Supervised machine algorithms: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Multilayer perceptron, and Random Forest were used to analyze the dataset using Python Jupyter Notebook Version 3. The obtained classified results had been evaluated using metrics parameters: minimum_false_positives, brier_score, accuracy, precision, recall, F1_score, and Receiver Operating Characteristics (ROC) curve. Data analysis results showed Naive Bayes - 88, 0.11; Random Forest - 83, 0.16; SVM - 77, 0.22; Logistic Regression - 75, 0.25 and Multilayer perceptron - 72, 0.27 with respect to accuracy and brier_score in percent. Naive Bayes algorithm out performs with very low false positive rates as well as brier_score and good accuracy. Naive Bayes algorithm classification results in predicting ECG showed very satisfactory results using only diet cum lifestyle factors which will be very helpful for the physicians to educate the patients and public, thereby mortality of gastric cancer can be reduced/avoided with this knowledge mining work.

Keywords: Early Gastric cancer, Machine Learning, Diet, Lifestyle Characteristics

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Authors: Darko Prebežac, Josip Mikulić, Maja Šerić, Damir Krešić

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Camping tourism is recognized as a growing segment of the broader tourism industry, currently evolving from an inexpensive, temporary sojourn in a rural environment into a highly fragmented niche tourism sector. The trends among public-managed campgrounds seem to be moving away from rustic campgrounds that provide only a tent pad and a fire ring to more developed facilities that offer a range of different amenities, where campers still search for unique experiences that go above the opportunity to experience nature and social interaction. In addition, while camping styles and options changed significantly over the last years, coastal camping in particular became valorized as is it regarded with a heightened sense of nostalgia. Alongside this growing interest in the camping tourism, a demand for quality servicing infrastructure emerged in order to satisfy the wide variety of needs, wants, and expectations of an increasingly demanding traveling public. However, camping activity in general and quality of camping experience and campers’ satisfaction in particular remain an under-researched area of the tourism and consumption behavior literature. In this line, very few studies addressed the issue of quality product/service provision in satisfying nature based tourists and in driving their future behavior with respect to potential re-visitation and recommendation intention. The present study thus aims to investigate the drivers of positive and negative campsite experience using the case of Croatia. Due to the well-preserved nature and indented coastline, camping tourism has a long tradition in Croatia and represents one of the most important and most developed tourism products. During the last decade the number of tourist overnights in Croatian camps has increased by 26% amounting to 16.5 million in 2014. Moreover, according to Eurostat the market share of campsites in the EU is around 14%, indicating that the market share of Croatian campsites is almost double large compared to the EU average. Currently, there are a total of 250 camps in Croatia with approximately 75.8 thousands accommodation units. It is further noteworthy that Croatian camps have higher average occupancy rates and a higher average length of stay as compared to the national average of all types of accommodation. In order to explore the main drivers of positive and negative campsite experiences, this study uses principal components analysis (PCA) and an impact-asymmetry analysis (IAA). Using the PCA, first the main dimensions of the campsite experience are extracted in an exploratory manner. Using the IAA, the extracted factors are investigated for their potentials to create customer delight and/or frustration. The results provide valuable insight to both researchers and practitioners regarding the understanding of campsite satisfaction.

Keywords: Camping tourism, campsite, impact-asymmetry analysis, satisfaction

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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Authors: B. Kenny

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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: A. Uludağ, F. G. Tufekci, N. Ceviz

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Aim: The research has been carried out in order to evaluate caregiver burden, life satisfaction and received social support level of the parents whose children have congenital heart disease; to examine the relationship between the social supports received by them and caregiver burden and life satisfaction. Material and Method: The research which is descriptive and which is searching a relationship has been carried out between the dates June 7, 2012- June 30, 2014, in Erzurum Ataturk University Research and Application Hospital, Department of Pediatrics and Children Cardiology Polyclinic. In the research, it was collaborated with the parents (N = 157) who accepted to participate in, of children who were between the ages of 3 months- 12 years. While gathering the data, a questionnaire, Zarit Caregiver Burden, Life Satisfaction and Social Support Scales have been used. The statistics of the data acquired has been produced by using percentage distribution, mean, and variance and correlation analysis. Ethical principles are followed in the research. Results: In the research, caregiver burden, life satisfaction and social support level received from family (p < 0.05), have been determined higher in the parents whose children have serious congenital heart disease than that of parents whose children have slight disease and social support received from friends has been found lower. It has been determined that there is a strong relation (p < 0.001) through negative direction between both social support levels and caregiver burden of parents; and that there is a strong relation (p < 0.001) through positive direction between both support levels and life satisfaction. Conclusion: That Social Support is in a strong relation with Caregiver Burden through a negative direction and a strong relation with Life Satisfaction through positive direction in parents of all the children who have congenital heart disease requires social support systems to be reinforced. Parents can be led or guided so as to prompt social support systems more.

Keywords: congenital heart disease, child, parents, caregiver burden, life satisfaction, social support

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Authors: Sopana Wongtawee

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Purpose: Adequate bowel cleansing is essential for a high quality, effective and safe colonoscopy. The aims of this study were to compare the efficacy of bowel preparation based on a low-residue diet before 8:00 followed by a clear-liquid diet, and a low-residue diet until 16:00 one day before colonoscopy using sodium phosphate solution (Xubil ®), the side effects of the two protocols and the patient satisfaction with them. Method: This was an endoscopist-blinded, prospective, randomized, controlled trial. A total of 224 patients (112 in each group) scheduled for outpatient colonoscopy met the criteria.They were randomized to either a low-residue diet consisting of white rice porridge with either fish, chicken or eggs before 8:00 followed by a clear-liquid diet (Group 1) or a low-residue diet consisting of the same food and drink, until 16:00 the day before colonoscopy(Group 2). All of them received 45 ml of sodium phosphate solution (Xubil ®) and three glasses of water (300 ml/glass) the evening before and the morning of the procedure. The cleansing efficacy of bowel preparation was rated according to the modified Rajawithi hospital bowel preparation score scale, patient satisfaction with bowel preparation was rated using Likert scale, and side effects of the 2 protocols was assessed using a patient questionnaire. Results: The cleansing efficacy between the two groups was significantly different (p=0.02). Satisfaction with bowel preparation and side effects were not different, except for the feeling of hunger in the first group (p=0.001). Conclusion: The low-residue diet consisting of white rice porridge with fish, chicken or eggs until 16:00 one day before colonoscopy achieved a better bowel-cleansing efficacy than the protocol consisting of clear liquid all day and rice porridge only before 8:00 one day before colonoscopy.

Keywords: bowel preparation, colonoscopy, sodium phosphate solution, nursing management

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

Procedia PDF Downloads 155