This book discusses the perception of clients/patients on quality of Health Care services and examines the issues affecting Quality of Care in our hospitals that led to a steady decline of patients’ attendances to the hospital between 1998 -2000, after the introduction of TQM in 1998. It also reflected on the situation prior to the introduction of Total Quality Management (TQM) between 1995 and 1997. The study considers the possible solutions to improve the quality of care that clients would be satisfied and patronize the hospital again, by this; it was recommended that; the hospital authorities should always make drugs and other services available and affordable to clients. The high cost of other services should also be reduced such that the poor and vulnerable can afford as well as patronize the hospital. The author intended this book to be read and used by all professionals both in management and Health Services administration and every field as well as corporate organizations that may want to assess the views of their clients on the services they render to them.
Stroke is located in first places of nontraumatic causes of death worldwide. Although significant improvements in the treatment of patients with acute stroke in recent years, stil was not observed significant fall in morbidity and mortality rate. Critical care of patients with acute stroke is a process that should be continued against time. Not just for ischemic strokes, for hemorrhagic strokes, with rapid diagnoses and with appropriate treatment practice in the pre-hospital and emergency services critical care can provide significant decrease in morbidity and mortality rates. This book provides information supported by recent guidelines related to pre-hospital and hospital diagnosis, treatment and critical care of acute ischemic and hemorrhegic stroke patients. The book light are holders to physicians working in emergency department, neurology and critical care areas.
Tuberculosis and human immunodeficiency virus co-infection is a major source of morbidity and mortality in Ethiopia. Routine offering of provider initiated HIV testing and counseling for TB patients is necessary to increase access to HIV care packages. However little is known about utilization of PITC service among tuberculosis patients in Ethiopia The main objective of this study is to assess the utilization of PITC service among TB patients in Ethiopia. Health facility based cross sectional survey was conducted from January to March 2010. A total of 385 participants were included in the study from seven health facilities. The study utilized both quantitative and qualitative study designs. Study participants were interviewed using structured questionnaire and three focus group discussions were conducted among TB patients.The utilization of PITC service among TB patients in the studied health facilities was 78.1%.
HIV-1 infection in children is an important public health problem. Unlike adults, they get infected at the time of their birth itself. This leads to severe infection in children. There is a paucity of studies on the immune responses elicited against HIV-1 in children. This study conducted on naive and treated HIV-1 infected children from north India revealed the heterologous viral neutralization potential of the plasma of these patients. Higher viral neutralization potential was observed in patients on antiretroviral therapy as compared to naive patients, while the plasma antibodies to the immunogenic regions of the viral envelope were lesser in the treated patients. The viruses infecting the patients included in this study belonged to clade C as identified by the sequencing of a segment of HIV-1 envelope gene. Patients whose plasma showing high viral neutralization potential are good candidates for generation of neutralizing monoclonal antibodies against HIV-1. Further, determining their neutralization specificities will help in identifying epitopes crucial for vaccine design. This is the first study on evaluating the humoral immune responses in HIV-1 infected children.
The use of reperfusion strategies and their efficacy are inversely correlated with the time between the onset of symptoms suggestive of acute coronary disease and patients’ arrival at the hospital for treatment. Patients seeking medical care within the first hour of the onset of symptoms are more than 6 times more likely to receive thrombolytic therapy than the patients who delayed seeking medical care for more than 6 hours. Early thrombolytic therapy, especially within the first “golden hour”, can reduce both infarct size and subsequent disability and mortality. Despite the known importance of early intervention, delay in seeking medical care is common and constitutes a major unresolved public health problem. Therefore, the primary focus of the present study was to examine the extent of the delay and to delineate associated factors in seeking medical care for patients hospitalized with acute coronary syndromes and also to examine avoidable delay in initiation of the intervention at the health care facility. Further our study was also aimed to find out whether delay either in reporting or in intervention and its associated factors has any role in the health outcome.
People with AIDS often suffer from major physical and psychosocial distress due to their experience of serious life-threatening illness. The palliative care needs of AIDS patients at Tikur Anbessa hospital are very high and interrelated. Their palliative care needs are not addressed by the existing health care services due to limited access. Besides the available services are not holistic and they are not integrated with other services. Therefore promoting standard palliative care services for patients and their families is important to alleviate their distress and improve their quality of life. This book focuses on exploring the palliative care needs of AIDS patients from the perspectives of the AIDS patients and health care providers. The book came up with workable recommendations which could be used as an input in designing and implementing appropriate palliative care services in existing heath care system.
Tuberculosis (TB) is the most common opportunistic infection among HIV-infected and one of the major global public health challenges of this era.In Nepal, the burden of TB among HIV infected had been seen range from 10% - 20 % mainly the people of productive age. This study was designed to assess the public health burden of opportunistic TB infection among HIV infected. Information was collected from 144 HIV/AIDS patient who had visited the ART clinic of Bharatpur Hospital, Chitwan during the period of 10th May to 30th May 2012. Study showed the 9.7 percent prevalence of opportunistic TB among HIV infected and extra pulmonary TB rate was higher. The status of TB co-infection during the diagnosed HIV infected period was 28.4 percent including prevalence TB cases. The common health problems faced by HIV-TB co-infected were weakness , fever, weight loss and cough. Having history of TB infection before HIV diagnosis were at 4.8 times greater risk of getting opportunistic TB. Access to health related local non government organization in the community had a great impact for significantly low risk of HIV-TB co-infection.
This study examines the risk factors related to HIV infection among 400 female sex workers (FSWs) aged 16-57 years in Vinh Long Proovince, Viet Nam. It uses secondary data from a cross-sectional study about knowledge, attitude, beliefs, and practice on HIV/AIDS. The main purpose is to determine the impacts of risk factors on HIV infection. Binary logistic regression showed perception of risk, perceived pay value, and using drug were significantly associated with HIV infection. FSWs who used drug were 32 times more likely to be infected with HIV than their counterparts. FSWs who reported that they had high risk of HIV infection were more likely to be infected with HIV than the ones reported that they had low risk or no risk of HIV infection. In addition, low income FSWs were more likely to be infected with HIV than high income FSWs. The findings suggested setting up a Drop-in-Center for FSWs who come to share both difficulties and experiences to protect themselves from HIV infection. Furthermore, strengthening the peer educators’ channels to provide HIV/AIDS information, knowledge, living skills and condom, needles and syringes directly to FSWs is strongly recommended.
Intestinal microsporidia has been classified as an obligate intracellular parasite which associated with a significant morbidity and mortality particularly in immunocompromised patients. Intestinal microsporidia infection is an emerging and opportunistic infection to a wide range of human. The infection is commonly reported in HIV-infected individuals previously. However, it had been found to infect the immunocompetent patients as well recently. This review provides a comprehensive information on intestinal microsporidiosis which covers the various aspects of microsporidiosis such as the life cycle, the source and modes of transmission, the symptoms,the diagnosis and others.
Hospital, known to provide medical and healthcare facility to the disease and injured people. Each and every department of the hospital, starting from a storeroom to medical wards, is responsible for providing better medical and healthcare facilities to the patients. But a huge burning question arises here, it does not matter what has been done for the patients but the important thing is, are the patients satisfied with the healthcare facilities provided? If not, then no matter, what facilities are provided and what is done for the patients, each and everything is just scrap and a lot of attention is needed to this issue. In this regard, this study was conducted to assess and compare patient satisfaction attending the OPD'S of public and private hospitals.
The HIV pandemic has continued to spread especially in sub Sahara Africa, while Multi drug resistance HIV has emerged rendering the current conventional treatment of HIV ineffective. There is a need for new treatment regime which is cheap, effective and not prone to resistance development by HIV. Reactive oxygen species (ROS) activates Nuclear Factor kappa B this stimulates Tissue Necrosis Factor (TNF) receptors, which activates the cytokine system including Apoptosis Signaling Kinase. In absence of seleno-enzyme GSHpx this process leads to apoptosis of CD4 T cells in Selenium Deficient HIV positive patients. The study looks at the effect of increased selenium intake by HIV patients. This study targets HIV clinicians, medical students, community health practitioners working with HIV/AIDS patients and Health Policy Makers.
Though the experience of living with HIV and AIDS is unique to each individual, a common factor is dealing with the chronic pain associated with the condition. HIV and AIDS patients may experience pain in more than one area simultaneously; the pain may be caused by the disease itself or the therapies used to treat the disease. The most frequent reason for HIV and AIDS patients seeking health care in a primary health care clinic is pain. The purpose of this study was to determine the effectiveness of chronic pain management for HIV and AIDS patients in a primary health care clinic in Tshwane District. The design was a quantitative survey with a qualitative exploratory component. The data-gathering method was self-report using a semi-structured interview format and observation using a checklist. Data analysis was done with descriptive statistics and content analysis using open coding. The study revealed that patients’ pain was not effectively assessed, though more than 95% of the AIDS patients using the primary health clinic experienced moderate to severe pain.
Zambia has one of the world’s most devastating HIV/AIDS epidemics and nurses work hard to spread information about how to prevent the infection. Females are more vulnerable since they often marry early to older men who already have a sexual past and also because they have larger permeability of the mucous membrane compared to men. The nurses play an important role in the prevention work and how it’s done. The aim of the study is to explore the nurse’s prevention work against HIV among women at the Mpongwe Mission Hospital. A qualitative study with a semistructured design has been used. The result of this study is divided in five different categories. The interviews show that the Nurses in this study at Mpongwe Mission Hospital are working hard to prevent HIV among women. They have come a long way in their prevention work although there is much left to do. The wide spread of knowledge among the nurses and the lack of staff is a big obstacle. Because of the shortage of finances the hospital can't afford to send nurses for further education or hire enough staff to be able to give the right care and to reach out to the population.
The second edition of Dentist's Guide to Medical Conditions, Medications and Complications continues to provide quick-access, clinical information on the dental treatment of patients with common systemic conditions and medical complications. Expanded in this second edition is information about patient medications. Ideal for general practitioners and students in advanced general dentistry programs, the book outlines protocols for treating patients with common conditions, presents essential drug interaction information, and guides the dental professional through prevention and management of in-office medical emergencies.