Teikyo Medical Journal

Archive-

Teikyo Medical Journal

Journal ID : TMJ-30-12-2021-10938

Total View : 382

Title : Effect National Patient Safety Goals on Nurses Performance and Patients outcomes

Abstract :

Background: The International Patient Safety Goals are used to improve the quality of care and patient outcomes. Aim: The aim of this study to assess the effect of national patient safety goals application on nurses’ performance and patient's outcomes. Subjects and Methods: Research Design: A quasi-experimental design had used to achieve the aims of the study. Setting: This study was conducted at The Academy of chest and Heart Surgery affiliated from Ain Shams University hospital. Subjects: A convenient sample of sixty nursing staff and 120 patient divided into two group from the previous mentioned setting. Tools of data collection: I: self-administer questionnaire, II: Nurses Observational checklist, III: Hospital staff Patient Safety attitude and culture. Results: More than three quarters of the studied nursing staff were between the age group of (18-35). Regarding gender more than half of the studied nurses were male. Total level of knowledge was one third pre and improved more than four fifth post implementation of intervention, and two fifth of nurses had total satisfactory level of practice pre implementation of educational program and more than three quarters of them had total satisfactory level of practice post implementation. Three quarters of nurses revealed negative attitude and impression regarding patient safety culture, while one quarter of them had positive attitude and impression regarding patient safety culture. Significant positive correlations were revealed among knowledge, satisfaction, and practice scores. Conclusion: The study intervention was a statistically significant independent positive predictor of all three scores and improved patient outcomes post implementation of educational program. Recommendations: The hospital administration should encourage the application of International Patient safety goal procedures to improve nurse's safety performance.

Full article

Journal ID : TMJ-30-12-2021-10937

Total View : 458

Title : Non-invasive mechanical ventilation vs. oxygen mask following successful weaning from invasive mechanical ventilation in a pediatric tertiary center

Abstract :

Objective: This study aimed to evaluate outcome measures in pediatric patients who underwent non-invasive mechanical ventilation (NIMV), as compared to conventional oxygen mask recipients, following successful invasive mechanical ventilation (IMV). Methods: This randomized observational trial included 110 pediatric patients with respiratory failure and connected to IMV. Patients were randomly categorized into two groups of equal numbers (n=55). Group (I) included oxygen mask recipients, while group (II) included patients who underwent NIMV. The outcome measures were assessed in both groups. Results: The differences between groups as regards age, sex, causes of connection, and duration of IMV were not significant; however, the mean length of stay at the PICU post disconnection of IMV, was significantly shorter for group II compared to group I (2.55 ± 1.42 vs. 4.76 ± 2.01 days, p<0.01). The number of patients with the normal respiratory rate (RR) was higher in group II as compared to group I (p<0.05 at 3, 12, and 48 hours). Group II had significantly fewer patients requiring reconnection to the ventilator than group I patients (4 cases vs. 12 cases, p=0.03). Conclusion: NIMV was superior to conventional oxygen delivery by facemask; NIMV significantly decreased the duration of hospital stay and the risk of patient's reconnection to IMV. Moreover, NIMV led to a significant improvement in RR post successful IMV weaning.

Full article

Journal ID : TMJ-30-12-2021-10936

Total View : 458

Title : Effect of third-generation bisphosphonates in patients with osteogenesis imperfecta: A prospective single-center genetic study

Abstract :

To evaluate the efficacy of the third-generation bisphosphonate in Egyptian patients with OI and determine the molecular genetic analysis of some cases. The study was prospectively conducted for >1.5 years between December 2017 and April 2019. This study enrolled 70 cases with OI (age range, between 2 months - 15 years). Through history taking and clinical evaluation were done. Moreover, all patients received zoledronic acid every 3–6 months based on age. Patients were assessed using dual-energy X-ray absorptiometry and plain X-ray before and after therapy. Gene sequencing analysis was performed in only 15 cases. The patients were followed up at 1.5 years from therapy. 60% of patients included in the study were males. Fracture onset started at >5 years old in three patients, whereas 32 (45.7%) patients suffered from fracture since the neonatal period. All patients had lower limb deformity, whereas 15 (21.1%) and 19 (27.1%) patients had upper limb deformity and scoliosis respectively. A significant improvement in Z-score was noted during follow-up, and 67 (95.7%) patients had improved. Appendix 1 shows the genetic analysis of selected cases. Third-generation bisphosphonates showed better results in patients with OI. However, future large-scale studies are warranted to confirm these results. Also, genetic analysis is necessary for the development of the much-needed targeted therapies to improve the outcome in affected individuals.

Full article

Journal ID : TMJ-30-12-2021-10935

Total View : 467

Title : Biological evaluation of spatially fractionated radiotherapy versus three-dimension conformal radiotherapy for organs at risk in the bulky sarcoma tumors

Abstract :

Spatially fractionated radiotherapy (SFRT) is one of the radiotherapy techniques utilized to treat patients with advanced bulky tumours. This study aims to estimate the difference in biological and dosimetric parameters of the SFRT technique and compare it to the three-dimension conformal radiotherapy (3D-CRT) of bulky shoulder and pelvic sarcoma tumours. 3D-CRT and SFRT were designed by the Monaco treatment planning system. Sex bulky shoulder and pelvic sarcoma cases were selected, a single fraction 15Gy were used. Dose-volume histogram of the organs at risk (OARs) was used to calculate the equivalent uniform dose (EUD) (Gy) by Matlab program. SFRT achieves more EUD (Gy) for OARs were compared to 3D-CRT. In SFRT, where organs at risk in close to the tumours and the shielding it by multi-leaf (1 cm) that leads to more effective than other techniques, and lead to a decrease of EUD(Gy) according to its definition by Niemierko. EUDs showed significant differences between the two methods for OARs in right and left lungs and heart as p-value = 0.001,0.001 and 0.03, respectively. While, others OARs, right and left femurs, bladder, rectum and bowel is non-significant different between them as p-valve > 0.05. The OARs have differed from patient to patient, that is due to differences in tumours site, shape, size, depth and how far from OARs, such as pelvic sarcoma tumours. SFRT achieves more sparing and fewer complications for OARs and provides an accurate assessment of the radiation dose that is actually received.

Full article

Journal ID : TMJ-29-12-2021-10934

Total View : 428

Title : The correlation of clinico-demographic variance with the endoscopic and histopathologic yields for patients with dyspepsia; a prospective observational study

Abstract :

General practitioners and gastroenterologists often see patients with dyspepsia. It is the gold standard for diagnosis to perform an upper GIT endoscopy with biopsy, however it is not available in all hospitals, plus many patients don't accept its invasive nature. Studying endoscopic and histopathologic changes in dyspepsia patients was the purpose of this study. The study included 132 patients with dyspeptic symptoms attending the gastroenterology clinic for an endoscopy. An in-depth history was taken in all cases included, clinical examination and laboratory investigation. Abdominal ultrasonography, H.pylori stool antigen testing, and upper GIT endoscopy and biopsy were performed on all the cases. Their ages ranged from 20 to 58, with 56 males and 76 females. As compared with histological findings, the stool antigen test had 63.2% sensitivity, 71.4% specificity, a PPV of 75% and a NPV of 58.8% in detecting H pylori. Gastritis was the most detected pathological finding in the included cases, and endoscopic findings were normal in most of them. Most of the cases were positive for H. pylori stool antigens indicating high prevalence among cases with upper GIT symptoms. Most of them had benign pathology on histopathological analysis. Stool antigen test for H. Pylori revealed high sensitivity in comparison with histopathological findings in diagnosis of cases with upper GIT symptoms.

Full article

Archive-