Project description:BackgroundPostoperative central nervous system infections (PCNSIs) represent a serious complication, and the timely use of antibiotics guided by the identification of the causative pathogens and their antibiotic sensitivities is essential for treatment. However, there are little data regarding the prevalence of PCNSI pathogens in China. The aim of this study is to investigate the features of pathogens in patients with PCNSIs, which could help clinicians to choose the appropriate empirical antibiotic therapy.MethodsWe retrospectively examined the positive CSF cultures in patients who underwent craniotomy between January 2010 and December 2015. We collected data, including demographic characteristics, type of neurosurgery, laboratory data, causative organisms and antimicrobial susceptibility testing results.ResultsA total of 62 patients with 90 isolates out of 818 patients with 2433 CSF culture samples were available for data analysis. The estimated incidence and culture-positive rate of PCNSIs were approximately 0.9 and 7.5%, respectively. The predominant organism was coagulase-negative staphylococci, of which most were methicillin-resistant coagulase-negative staphylococci (MRCoNS). All were susceptible to vancomycin, linezolid, rifampicin and amoxicillin-clavulanate. Acinetobacter baumannii was the most frequent causative Gram-negative agent and was resistant to 12 out of 18 antimicrobials tested. The sensitivity rates for tigecycline and minocycline were only 40 and 33%, respectively.ConclusionPCNSIs could lead to high mortality. Although the MRCoNS were the predominant organism, the management of Acinetobacter baumannii was a major clinical challenge with few effective antimicrobials in PCNSIs.
Project description:China has a historic system of wide cycle tracks, many of which are now encroached by cars, buses and bus stops. Even with these conditions, college students still bicycle. On campuses, students park their bikes on facilities ranging from kick-stand-plazas to caged sheds with racks, pumps and an attendant. In other countries, including Canada, some of the newer cycle tracks need to be wider to accommodate an increasing number of bicyclists. Other countries will also need to improve their bike parking, which includes garage-basement cages and two-tiered racks. China could provide lessons about cycle tracks and bike parking. This study applied the Maslow Transportation Level of Service (LOS) theory, i.e., for cycle tracks and bike parking, only after the basic needs of safety and security are met for both vehicle occupants and bicyclists can the higher needs of convenience and comfort be met. With random clustering, a self-administered questionnaire was collected from 410 students in six dormitory buildings at Peking University in Beijing and an environmental scan of bicycle parking conducted in school/office and living areas. Cycle tracks (1 = very safe/5 = very unsafe) shared with moving cars were most unsafe (mean = 4.6), followed by sharing with parked cars (4.1) or bus stop users (4.1) (p < 0.001). Close to half thought campus bike parking lacked order. The most suggested parking facilities were sheds, security (guard or camera), bicycle racks and bicycle parking services (pumps, etc.). If parking were improved, three quarters indicated they would bicycle more. While caged sheds were preferred, in living areas with 1597 parked bikes, caged sheds were only 74.4% occupied. For the future of China's wide cycle tracks, perhaps a fence-separated bus lane beside a cycle track might be considered or, with China's recent increase in bike riding, shared bikes and E-bikes, perhaps cars/buses could be banned from the wide cycle tracks. In other countries, a widened cycle track entrance should deter cars. Everywhere, bike parking sheds could be built and redesigned with painted lines to offer more space and order, similar to car parking.
Project description:ObjectivesThis study was aimed to assess the level of patient satisfaction at Government Unani & Ayurvedic Medical College Hospital in Dhaka, Bangladesh.Study designThis was a cross-sectional study conducted among 165 patients attended at the out-patient department of Government Unani & Ayurvedic Medical College Hospital, Dhaka, Bangladesh. Patients who were equally or more than 18 years with a history of at least two referral visits were eligible to participate in the study.MethodsPatients satisfaction was measured by the Patient Satisfaction Questionnaire (PSQ-18), composed of 18 items translated in Bangla.ResultsAmong 165 out-patients, 135 (81.8%) were satisfied and 30 (18.2%) were dissatisfied with medical services. The mean and standard deviation of total patient satisfaction was 69.1 (±16.9). Financial aspects were the major area of patient dissatisfaction 29 (17.6%) towards Unani and Ayurvedic treatment due to lack of free medicine supply and high cost of medicine.ConclusionThe results would shed light on the present conditions of medical services at Government Unani & Ayurvedic Medical College Hospital which could be used to influence the outlook of the policymakers of our country.
Project description:BackgroundIn pregnancy, hematological changes occur in order to meet the demands of the developing fetus and placenta, with major alterations in blood volume. Abnormal hematological profile affects pregnancy and its outcome. This study aimed to assess hematological profiles of pregnant women at a tertiary care teaching hospital.MethodThis cross sectional study was conducted among 284 consecutive pregnant women at St. Paul's Hospital Millennium Medical College. Socio-demographic characteristics were collected using pre-tested structured questionnaire. About 4 ml of venous blood was collected from each participant for hematological parameters analysis using Cell-Dyn1800 (Abbott Laboratories Diagnostics Division, USA) and peripheral blood film review.ResultThere were differences in mean hematological parameters between trimesters: specifically differences in mean values of WBC (1stand 3rd), Hb(1stand2nd and 1st& 3rd), HCT (1stand2nd), RDW (1stand2nd and 1stand3rd), neutrophil and lymphocyte (1stand 2nd and 1stand3rd, for both) were statistically significant (p?<?0.05). The prevalence rates of anemia and thrombocytopenia were 11.62 and 7.7%, respectively and were dominantly of mild type. On the bases of blood picture, we classified anemia's of pregnancy as microcytic hypochromic (51.5%), normocytic hypochromic (27.3%), normocytic normochromic (18.2%), and dimorphic (3%).ConclusionSignificant changes in selected hematological parameters between trimesters, and an anemia and thrombocytopenia of mild type were documented in this study. The commonest morphologic features were mostly characteristic features of iron deficiency anemia. These warrant the need for monitoring hematological parameters of pregnant women at any stage of the pregnancy to avoid adverse outcomes.