This was a Retrospective Case-Control study conducted at the Antiretroviral department, Rajiv Gandhi Institute of Medical Sciences(RIMS),Kadapa,India.The study was conducted to assess the incidence, prevalence, severity pattern, predictability, preventability of adverse drug reactions (ADRs) to HAART, and to identify the risk factors for ADRs in HIV-positive patients receiving HAART. Patients between 2010 and May 2011 newly registered HIV patients on HAART therapy of either sex were included. Demographic details, occupations details, education, CD4 cell count, weight and hemoglobin (Hb),Laboratory data, drugs used and suspected ADRs observed were collected.This is the First Retrospective Case-Control study that was designed to evaluate the incidence of ARV therapy-induced ADRs in Indian HIV-positive patients.
Since its creation in 1978 the Italian health care system has been delivering a wide range of services and interventions and it is considered one of the most advanced health organizations among the industrialized countries. In accordance with the Italian Constitution, it provides services free of charge to all, without any discrimination. The affirmation of the free choice principle, the progressive introduction of private hospitals and the significant increase in health spending have induced the legislator to introduce cost - effective measures to limit costs and satisfy patients' needs. After having examined the profound changes that have been generally influencing the Italian health care system, discover how the San Carlo Hospital of Potenza in Italy is trying to rearrange its strategy to detect patients' needs, reduce costs and face challenges posed by emerging competitors.
Healthcare-associated infections (HAIs) are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting. HAI is the most common complication or comorbidity of hospitalized patients, and is becoming major worldwide causes of death and disability. Also, there are associated financial costs substantial to both patients and healthcare systems. HAIs are critical patient safety and healthcare quality issues. Prevention and reduction of such infection has become one of the top priorities for health care. We focused on healthcare-associated urinary tract infection (HAUTI), which is the most common type of HAI. We proposed an approach to build a detection model for HAI surveillance based on the variables extracted from the electronic medical records (EMRs). Moreover, we developed an integrated HAI surveillance information system (called iHAUTISIS) based on existing EMR systems of the hospital for improving the work efficiency of infection control professionals (ICPs). Therefore, the system can further facilitate the HAI surveillance and reduce ICPs’ surveillance workload.
This manuscript analyses the interface between medicine and colonial society through the lens of gender. The work traces the growth of hospital medicine in nineteenth century Bengal and shows how it created a space-albeit small-for providing western health care to female patients. The book also explores the growth of Western medical education among women in Bengal.
Medical ethics is a specialized branch of applied ethics. It deals with the ethical problems arising from interaction between health care professionals and patients, and the way in which medical technology should be used in the existing health care system. Much of the controversy in contemporary medicine is resulted from rapid developments in technological devices. Medical ethics is concerned with the ethical values appropriate to the professionals working in the area of medicine. Medical profession has a code of conduct of its own, which is obligatory to all medical practitioners. Every medical practitioner is expected to subordinate his or her personal interests in the pursuit of professional goals. This book provides adequate knowledge about ethical principles and problems confronted by doctors in their daily practice. It is extremely useful to medical students as a required course material and to medical practitioners to create a sense of professional responsibility. This text is an invaluable guide to the students of philosophy interested in applied ethics. The medical problems are presented in a simple and lucid manner with appropriate examples, arguments and references.
Patient-centred care in contemporary nursing refers to prioritising the patient and their experience through communication, discussion of treatment options, potential outcomes and possible psychological effects. These are the expectations of a professional nurse practicing in the 21st century. Proper nursing care, therefore, should take into account the experiences of patients during the care process in the health facility. In teaching hospitals, while the focus of care is the patient, attention is sometimes diverted to the nursing students rather than on the patients who are undergoing care at the hands of both the nursing professionals and students. The study was thus designed to explore and describe the experiences of patients nursed by student nurses in a teaching hospital; identify patterns in the experiences of patients receiving patient care from student nurses; conceptualise these experiences within a framework; and analyse aspects of the experiences that may need further attention for the training of student nurses. Three main themes were discovered: methods of identification of student nurses by patients; positive and negative perceptions of student nurses by patients.
The emergence of human immunodeficiency virus (HIV) has led to the growth of co-infection with other illnesses including tuberculosis. Many states are now attempting to address the problems presented with co-infected patients from a variety pathogens. In particular sub-Saharan Africa has suffered exponentially more from HIV and TB co-infection than other parts of the world. Thus, why have Botswana and South Africa not created national health policies to treat these diseases together? The following describes the process of how World Health Organization recommendations are translated into state policy. While donorship and international policy alterations create strong punctuations, the incremental processes continues to determine when policy emerges in a state.
HIV/AIDS has diverse implications pertaining to Medical, Social, Legal and Economical aspects of human existence. Our knowledge of HIV/AIDS has increased; but sufferers and scientists are still perplexed. Communities’ awareness can be clouded by cultural and traditional attitudes; which are more relevant in diverse, multicultural and multilingual communities. Physical, emotional, social and spiritual suffering of disease defies description. The realities of the condition need to be explained to all stakeholders. Effective dealing is based on integrity to deliver confident, competent and compassionate care. Governments need to fulfill adequate health and social measures. People have right and duty to participate individually and collectively in the planning and implementation of health care. HIV/AIDS carries discrimination, marginalization and stigmatization with it. By adopting the parameters balanced with medical, social, ethical and legal issues, one can definitely counter the diverse effects of the disease. This work is a humble effort to put forth the dilemmas associated with medical, social and legal aspects of HIV/AIDS so that we learn, treat, teach, regulate and legislate.
Quality may appear to be a nebulous term. The U.S. Office of Technology Assessment has defined the quality of medical care as “evaluation of the performance of medical providers according to the degree to which the process of care increases the probability of outcomes desired by patients and reduces the probability of undesired outcomes, given the state of medical knowledge”. The Institute of Medicine (IOM), in a report entitled, “Medicare: A Strategy for Quality Assurance,”stated that “quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”, whereas Ovretveit (1992) simply states, “A quality health service/system gives patients what they want and need.” All of these definitions may provide the best explanation of the concept of quality in health care. Each provides additional insight into quality, what we can expect from quality, and how quality can be perceived. Pharmacy service quality has been measured by assessing its structure, process, and outcomes.
Neonatal care is a specialist area that often requires health professionals new to the field to acquire a specific set of skills and knowledge. This means that, even for experienced nurses, there is a need for clear and practical learning resources to ensure care of neonates is safe and accurate. This book provides health professionals working with neonates with the core information they need to understand and deliver the care practices to neonates and their families in the hospital setting. Written in an accessible A-Z format, it acts as a bedside guide to the key areas in practice, including Airway and Assessment, Drugs and Developmental Care, Infection, Jaundice, Psycho-emotional care of the family and Umbilical Care. Each practice area explored is supplemented with a range of tools to help guide delivery of the different procedures, including: • Checklists that provide a clear, bullet pointed list of important practice points for each procedure• Flow charts which illustrate clearly the different stages of each procedure• Summary Tables which collate key points in an abridged format about particular practice areas• Signposts to highlight links between different practice areas throughout the book• Stop and Think boxes that alert the reader to important practice points and areas of caution• Standard precautions to flag important infection control reminders• Local variations to remind the reader to check and make note of local variations and practice points• A topic-specific Glossary that appears at the end of each key term to provide concise explanations
The problem was to determine the extent to which patients were satisfied with the care they received at the University and Community Health Centres. In observing both International and Local trends regarding the rising cost of health care services , coupled with the increasing demands of patients, it is imperative that care and services offered and received are sustainable and in keeping with the expectation of the patients. As such, this book will highlight ways in which patients can become active partners in their care, thereby increasing their satisfaction and confidence in the health system. The target groups were patients accessing care and services at two Primary Health Care Centres located on the compound of the university of the West Indies ,Mona Jamaica .
This book has been aimed to apply the cox proportional hazard model to assess the determinant factors of survival time and discrete time homogeneous semi markov model to predict the clinical progression of AIDS disease using secondary data obtained from the antiretroviral therapy unit of Jimma University Specialized Hospital. The data were extracted from standard patient medical registration. A retrospective study was undertaken on a sample of 456 HIV/AIDS patients. Patients were followed for a median of 34 months. Of total sample, 312 (68.4%) were female and 144 (31.6%) were male. In the followed up period, 66 (14.5%) patients died and 390 (85.5%) patients were censored. The cox regression result indicated that the survival time of the HIV patient was significantly related with adherence level, age, alcohol use, CD4, condom use, functional status, marital status and WHO stage. The results of homogenous semi-markov model showed that the survival probability of a patient increased when CD4 count increased.
Most of the studies done in the field of HIV were focused around patients who are taking Anti Retro viral drugs .There are very limited number of studies are available for patients who are not under the treatment of Anti- Retro viral drugs. This work incorporates most of the recent findings that are relevant to the HIV/AIDS patients who are not an Anti-Retro Viral drugs. While formulating the health policies, it has been deemed necessary about that the clear understanding of the demographic profile and socio economic status of the people who are affected by the disease. This book deals with the demographic profile of HIV/AIDS patients ,route of transmission of HIV among the patients, Behavioural pattern of the patients, discordant couples ,hygienic practises followed by the patients, clinical profile of the patients and prevalence of opportunistic infections among them.So this will give the clear idea about the profile of the HIV/AIDS patients who are not on Anti- Retroviral drugs in Chennai, India.
The devastating impact of HIV as a chronic infectious agent on human kind has forced a consideration of the rationale of administering combined drug therapies that incorporate fusion inhibitors, reverse transcriptase inhibitors and protease inhibitors in chronically infected HIV patients. It is also worth considering using alternative therapies, such as antioxidants, as anti-retroviral therapies are limited for economic reasons and their associated toxicity.This study models and analyzes pre-treatment dynamics of viral production and progression with cellular-mediated immune responses in chronic HIV infection. The pre-treatment model is then extended to investigate the impact of administering a three drug combination regimen of reverse transcriptase inhibitors, protease inhibitors and fusion inhibitors to chronically infected HIV-positive patients. Again from the pretreatment model we develop the antioxidant therapy model that considers HIV-induced free radicals as promoters of apoptosis and viral replication, incorporating antioxidants as agents of oxidative defense against the oxidative pressures caused by the free radical molecules in chronically infected HIV patients..