International Medical Journal

Journal ID : IMJ-28-02-2021-770

Total View : 476

Title : A Study on Gap Analysis in preventive health check-up department in context of JCI standards (Case of Apollo Hospitals, Gandhinagar)

Abstract : This study aims to identify the gaps in Quality Standards implemented in the Preventive Health Check department of the hospital and to justify the importance of adherence to the standards for quality care, staff motivation, patient satisfaction and ultimately brand value. The approach to the study was qualitative. Through mere observation and interaction with staff and patients and by the data collected. Appropriate literature reviews and studies of client satisfaction and managerial issues were also identified along with it. There are certain gaps in the considered standards and actual implementation that leads to lapses in Laboratory, Radiology department and that affects the client satisfaction rate. The compliance rate of the departments has a relation with the client satisfaction. The slight deviations from the set standards can reduce the client satisfaction due to lack of expected quality care and also affects the employee morale. The adherence to the standards encourages the employee to be updated in their fields and that in turn helps achieving greater satisfaction rate of the clients. For a hospital to adhere to the set standards mentioned in the JCI standards becomes every important to maintain the quality care service. This helps in Continuous Quality Improvement which is an important factor that determines the success of a hospital in these days. Improvement in quality is believed to result in fewer mistakes, shorter delays, improvements in productivity, increased market share and lower costs..
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International Medical Journal

Journal ID : IMJ-28-02-2021-768

Total View : 469

Title : The outcome of fixation failure in adult limb fracture: Experience of seventeen patients

Abstract : Fixation failure is a common issue in orthopedic practice that carries negative impact specially on patients, in addition to burden on both doctor and health system. Our aim the most common pattern of failure, and the most common possible factor for fixation failure. An observational was conducted at the orthopedic surgery department in Imam Al Hussein medical city in Karbala from April 2018 to December 2019. Seventeen patients with 20 fixed fractures met the criteria for entry and were eligible to be included in the study, where recent significant trauma near the fixation area, pathological fractures, spine and per prosthetic fractures were excluded.17 patients with 20 fixation failures were reviewed and 11 of them were male and 6 were female. 70% of fixation failure occurred in lower limb while 30% in upper limb, plates constituted 75% (15 cases) meanwhile 10% found in dynamic hip screws and cannulated hip screws and 5% (1 case) was external fixation. Inadequate surgical technique was the most common cause of fixation failure (80%), others like obesity (35.2%), poor patient compliance (17.6%), and infection (10%) were contributed to fixation failure in lesser extent. Among technical issue; improper implant was 65%, meanwhile inadequate reduction was found in 60%, and improper Implant application was found in 85% of cases. Among plate-screw group (15 cases); the commonest pattern fixation failure was; screws cutout (53.3%) followed by broken plate (46.6%) and screws pullout (46.6%) and we relied on AO principles in evaluating these aspects of fracture management. Improper implant choice, incorrectly performed fixation techniques, deficient post-operative care and underestimation of fracture morphology all were possible causes..
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International Medical Journal

Journal ID : IMJ-26-02-2021-767

Total View : 508

Title : The Helpfulness on the Assessment of Guidance and Counselling Services in Helping Undergraduate and Post Graduate Students with Psychiatric Problems

Abstract : The objectives of this study were to examine the helpfulness on assessment of guidance and counselling services in helping undergraduate and post graduate students with psychiatric problems and found out the actual factors causing psychiatric problems among undergraduate and post graduate students who were studying at Rajamangala University of Technology Thanyaburi. The researcher used quantitative and qualitative methods to investigate the assessment of guidance and counselling services in helping undergraduate and post graduate students with psychiatric problems at Rajamangala University of Technology Thanyaburi. The respondents who participate in this study were 139 Undergraduate and post graduate students, they agreed that the assessment of guidance and counselling services were helpful to them in coping with psychiatric problems at Rajamangala University of Technology Thanyaburi. As a result of the reliability coefficients (Cronbach Alpha) the helpfulness on assessment of guidance and counselling services by undergraduate and post graduate students) n = 139, the Crobach Alpha ranged from 0.88 to 0.95. Semi-structured interviews were used to gather data from three undergraduate students and three post graduate students who faced psychiatric problems..
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International Medical Journal

Journal ID : IMJ-23-02-2021-766

Total View : 497

Title : COMPARISON OF EFFICACY OF DIFFERENT DOSES OF 30 MG AND 60 MG 1%2-CHLOROPROCAINE IN SHORT DURATION SURGERIES AND FOR EARLY AMBULATION

Abstract : “To compare efficacy of 30 mg v/s 60 mg of 1% 2- Chloroprocaine as a spinal anaesthetic agent for short duration surgeries and early ambulation of patient” Observational double blind study was carried out on 60 patients (equal in both groups) belonging to ASA (American Society of Anaesthesiologists) grade I and II, aged between 18 to 65 years, including either gender, and meeting all inclusion exclusion criteria scheduled for elective lower abdominal surgical procedures under spinal anaesthesia after obatining Institute Ethics Committee Clearance. All cases will be completed within the stipulated time. The statistical analysis will be done by using ‘T Test’ for at 95% confidence interval. The sensory block onset, motor block onset, peak sensory and motor block, regression of sensory block by two segments and complete sensory block regression was quite fast with low dose of drug. The wearing off of motor block, mode of rescuse analgesia and voiding of urine was statistically non-significant. Urinary retention was not seen in any cases. The dermatomal level achieved with low dose was lower as comapred to the higher dose. Preservative free 1% 2-Chloroprocaine can be used as a drug for sub arachnoid block especially for day care surgeries. Inj 1% 2-Chloroprocaine has shorter onset and duration of action. This property makes it an ideal agent for day care surgeries..
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International Medical Journal

Journal ID : IMJ-22-02-2021-765

Total View : 470

Title : Comparison of efficacy of gabapentin, fentanyl and a combination of both in attenuation of hemodynamic responses to tracheal intubation

Abstract : Laryngoscopy and subsequent tracheal intubation causes a fugitive tachycardia and hypertension as a result of sympathoadrenal stimulation. Many modalities have been proposed and practiced to attenuate this pressor response to laryngoscopy and intubation. It includes both pharmacological and non-pharmacological methods. This randomized double blind prospective study had been designed to compare the efficacy of oral gabapentin 800mg, IV fentanyl 2 µg/kg and a combination of both the drugs in obtunding the hemodynamic responses such as HR, SBP, DBP & MAP during laryngoscopy and intubation and also to observe the adverse effects of the above mentioned study drugs, if any. After approval from medical ethics committee, Dr D Y Patil Medical College and Hospital, Pune, the study was carried out on seventy-five (75) patients undergoing elective surgeries under standard general anaesthesia after obtaining consent from the patients. Group G patients received cap. gabapentin 800mg 2h prior to intubation, Group F patients received Inj. fentanyl 2µg/kg IV given 5mins prior to intubation, Group GF patients received Cap. gabapentin 800mg given 2h prior to intubation and Inj. fentanyl 2µg/kg IV given 5mins prior to intubation. All hemodynamic measurements like HR, SBP, DBP & MAP were recorded at 1 min, 3 min, 5 min, 10 min & 15 min after intubation. The patients were monitored for any adverse effects of the drugs. There was no statistically considerable difference between the study groups with respect to baseline parameters of HR, SBP, DBP, MAP and SpO2.There was substantial difference in mean HR, SBP, DBP & MAP values at laryngoscopy, at 1, 3, 5, 10 and 15mins following laryngoscopy and intubation between the three groups. Patients belonging to group GF showed significant attenuation of all the above said parameters effectively and the values were statistically significant when compared to other groups. (p < 0.05). The observed side effects were minimal and not significant statistically (p > 0.05). Based on the current clinical study, Oral gabapentin 800mg given 2 hours prior to intubation along with fentanyl at dose of 2µg/kg IV given 5mins before intubation is effective in attenuating the hemodynamic responses to laryngoscopy and tracheal intubation when compared to individual administration of either oral gabapentin 800mg or IV fentanyl 2µg/kg. Incidence of adverse effects is very less in all three groups and was not statistically significant..
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International Medical Journal

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Submission Deadline ( Vol 30 , Issue 09 )
20 Sep 2023

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Publish On ( Vol 30 , Issue 07 )
31 Jul 2023