Hospital Practices and Research
Volume:3 Issue: 3, Summer 2018

Periprosthetic hip infections (PHIs) are troublesome complications of hip arthroplasties. The gold standard procedure for treating chronic PHI is a 2-stage approach. Recently, however, more conservative approaches have been developed to spare the osseointegrated components and avoid sequestra, bone loss, devascularization, and difficult reconstructions. The partial two-stage approach, which leaves the well-fixed component in situ and removes the loosened component, may be an effective strategy.
This paper, a narrative mini-review, analyzed the preliminary results of a partial 2-stage approach to treating chronic hip arthroplasty infections.
Pertinent papers describing the partial 2-stage approach (leaving the well-fixed component in situ and removing the loosened component) were collected and evaluated.
Six main case series were selected. A total of 76 patients were included. Many patients were treated with socket removal and stem retention with quite similar surgical techniques. Many cases included highly virulent bacteria, and no pre-operative selection about comorbidities was performed. The first outcomes of this approach were promising, with a rate of infection control ranging from 81.3% to 100% at mid-term follow-up.
This approach proved good at mid-term follow-up; however, many concerns still exist. In particular, the indications are imprecise, and the role of biofilm is still unclear. Despite the first good outcomes, the partial 2-stage approach for chronic PHI should be validated by multicenter prospective studies.

Legionella infections caused by contaminated water are a widespread problem worldwide. Discharge lamps like mercury vapor lamps are widely known for the disinfection properties of their radiation, but they suffer technical disadvantages, like high voltages and toxic content, and are, therefore, not suitable for some infection control applications. New high-intensity ultraviolet (UV) and violet LEDs offer new approaches for Legionella control, because these bacteria are significantly light sensitive compared to other pathogens. One of the most important infection pathways is the inhalation of Legionella-containing aerosols during showering. This problem could be reduced by a single strong UV LED within the shower head, which irradiates the passing water for some milliseconds. This practice can be especially beneficial in hospitals and care facilities. UV light offers only a limited penetration depth, however, even in pure water. To disinfect larger water volumes, e.g., in water dispensers, visible violet LEDs are more appropriate. Unfortunately, up to now, neither approach has been given much attention by potential users

Infections due to the hepatitis B (HBV) and hepatitis C (HCV) viruses constitute a global public health problem. Although screening of these infections remains a pivotal tool for timely detection and management of carriers, this preventive measure has been neglected in Africa.
The current study determined the prevalence of hepatitis B surface antigen (HBsAg) and anti-HCV as well as their risk factors through a screening campaign organized in a rural setting in northern Cameroon.
A cross-sectional analytical study was conducted during a screening campaign for viral hepatitis organized at the Mokolo District Hospital, Cameroon, from January 19, 2017 to February 27, 2017. Sociodemographic data from all consenting participants was collected and examined for signs of chronic liver disease. Participants were then screened for HBsAg and anti-HCV using a rapid diagnostic test (ACON®).
Of the 364 participants enrolled, 28.6% tested positive for HBsAg and 2.2% for anti-HCV. All HBsAg-positive and anti-HCV-positive individuals were asymptomatic and unaware of their infection status prior to testing. None of the socio-demographic factors assessed was associated with a positive HbsAg status.
HBV and HCV infections are endemic in this rural health district. Participants who tested positive were apparently healthy and completely unaware of their infection status. Transmission of the hepatitis virus may be a public health concern in this district. It is recommended that community health education activities on preventive measures for HBV and HCV infections, regular screening for disease surveillance, and close follow-up of disease progression in these asymptomatic individuals be conducted.

The birth of a child with a hearing disability is a stressful event in the family. Since consanguineous marriages are associated with the incidence of congenital hearing loss, it is expected that such parents will experience greater psychological problems.
The current study investigated and compared anxiety, depression, and stress in parents of children with severe hearing loss who have undergone cochlear implantation with a focus on the relation between parents (consanguineous vs. non-consanguineous).
This cross-sectional study was conducted on all 180 couples (360 individuals) who had become parents and attended Baqiyatallah hospital’s Cochlear Implant Center from 2007 to 2009. The participants included two groups of consanguineous (125 couples) and non-consanguineous (55 couples) parents. After providing consent to participate in this study, the participants completed the short form of the Depression and Anxiety and Stress Scale questionnaire (DASS-21). Data analysis was done using SPSS 17 and t test.
The participating parents had high levels of depression, anxiety, and stress. Depression and anxiety were significantly higher among the consanguineous parents (P=0.001 and P=0.005, respectively). However, stress levels were not significantly different between the 2 groups. Moreover, compared to the fathers, the mothers had higher levels of depression, anxiety, and stress (P Based on these findings, it may be concluded that the birth of a child with hearing loss can be the source of psychological problems in parents, particularly in consanguineous parents. Furthermore, mothers are more psychologically vulnerable than fathers.

Foodservice is an important issue in hospital settings, and patients’ levels of satisfaction are often indicated by consumption and plate waste.
The current study compared patient satisfaction in hospital areas and other factors and determined the relationship between patient satisfaction and plate waste.
This quantitative research was performed in four East Malaysian public hospitals. Patients at these hospitals were asked to complete a questionnaire which had three parts: A) general information, B) patient satisfaction questionnaire (Acute Care Hospital Foodservice Patient Satisfaction Questionnaire), and C) plate waste scale (Comstock 6-point scale).
A total of 189 patients participated. The results indicated that overall, 53.3%, 29.3%, 14.1%, 2.7%, and 0.5% of respondents rated the hospital foodservice as okay, good, poor, very good, and very poor, respectively. Average plate waste was 35% for all hospitals, and only 11% of patients finished all the food served. Satisfaction with hospital food differed according to the catering system (in-house and outsourced). However, the results also indicated that satisfaction with hospital foodservice was not significantly related to food wastage (r=-0.018, n=189, P=0.809).
Various factors in hospital foodservice, especially food quality, should be improved to motivate patients to consume hospital food.

In providing optimum medical and health services, great pressure is put on the physical and mental health of family physicians. Job burnout is damaging to the health of family physicians and medical treatment personnel. It leads to reduced job productivity, increased absenteeism, increased healthcare costs, elevated turnover rates, a reduced level of service provided to patients, and ultimately, patient dissatisfaction.
The current research investigated job burnout among family physicians in rural areas of Isfahan province during the years 2017-2018.
This cross-sectional study was carried out in Isfahan province during the years 2017-2018. The research population included all family physicians working in Isfahan province, and 155 of whom met the inclusion criteria and participated in this research. Questionnaires were used as the data collection tool. Data was analyzed using SPSS software, and the analytical variables were analyzed using the independent t test and Pearson correlation coefficient.
A total of 45 men (29%) and 110 women (71%) comprised the research population. Participants’ mean age and mean duration of work experience were 35.3±8.1 and 7.5 years, respectively. The scores for overall job burnout, emotional exhaustion, depersonalization, and lack of personal accomplishment dimensions were low among the family physicians in Isfahan. The results showed no significant difference between male and female, single and married participants in any of the dimensions. The results also revealed a direct relationship between years of work experience and the overall job burnout and lack of personal accomplishment scores.
According to the findings of the present research and considering the stressful nature of a family physician’s job, healthcare authorities need to pay special attention to job burnout and implement measures to prevent it or at least reduce its subsequent adverse effects.

Broad ligament hernia was first reported post-autopsy by Quain in 1861. In a 1995 review article, only 61 cases had ever been reported. This paper presents a case report of broad ligament hernia and explores the literature surrounding this topic.
The patient presented with no significant past medical history, acute lower abdominal pain (several hours), nausea, and vomiting. Clinical examination showed a heart rate of 85 beats per minute; normal temperature, blood pressure, and respiratory rate; and a mildly distended abdomen with tenderness across the right lower quadrant. A plain abdominal X-ray showed dilated small bowel loops, and a blood test showed leukocytosis. Urgent diagnostic laparoscopy showed a broad ligament strangulated hernia with small bowel infarction. Reduction of the small bowel, resection, and side-side anastomosis were performed. The patient had an uneventful recovery, and follow up reported no postoperative complications.
Laparoscopic management of small bowel obstruction due to broad ligament internal hernia is a safe and effective option.

Many years ago, clinicians worked in various fields of medicine, and they made the vast majority of medical judgments and procedures. Today, the increasing population and growth in medical sciences has resulted in the development of many new medical subspecialties. Commonly, medical treatment begins with a general practitioner and progresses to a specialist in cases of complexity. Atypically, a clinician may confront an emergency situation that requires prompt action in order to save the victims. A crowd disaster at a mass gathering could easily change the normal condition of a hospital into one of crisis. This may be more apparent when it occurs on a battlefield with few medical personnel. In other words, if triage is not properly managed in an acute care setting, the other steps of the survival chain would soon be disrupted. Having organized behavior in medical teams could save time and increase efficacy... (Read more...)