[This corrects the article DOI 10.1155/2020/2675940.].Background and Objectives. Several anesthesia techniques were applied to hemorrhoidectomy, but postoperative pain and urinary retention were still two unsolved problems. The aim of this prospective randomized study was to evaluate the effect of ultrasound-guided pudendal nerve block (PNB) combined with deep sedation compared to spinal anesthesia for hemorrhoidectomy. Methods. One hundred and twenty patients undergoing Milligan-Morgan hemorrhoidectomy were randomized to receive PNB combined with deep sedation using propofol (Group PNB, n = 60) or spinal anesthesia (Group SA, n = 60). Pain intensity was assessed using the visual analogue scale (0 no pain to 10 worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on walking at 12, 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, and patient satisfaction after surgery. Results. Ultrasound-guided bilateral PNB combined with deep sedation using propofol could successfully be applied to Milligan-Morgan hemorrhoidectomy. Postoperative pain intensity was significantly lower in Group PNB compared to Group SA at rest at 3, 6, 12, 24, 36, and 48 h (p less then 0.001) and during mobilization at 12, 24, 36, and 48 h (p less then 0.001) postoperatively. Sufentanil consumption in Group PNB was significantly lower than that in Group SA, during 0-24 h (p less then 0.001) and during 24-48 h (p less then 0.001) postoperatively. Urinary retention was significantly lower in Group PNB compared to Group SA (6.9% vs 20%, p=0.034). The patients in Group PNB had higher satisfaction compared to Group SA (p less then 0.001). Conclusions. Ultrasound-guided PNB combined with propofol sedation is an effective anesthesia technique for Milligan-Morgan hemorrhoidectomy.
Healthcare workers (HCWs) may be using their mobile phones (MPs) to carry microbes that cause hospital-acquired and community infections in general. With antibiotic resistance problem emergence, these infections can be challenging to eradicate. Hence, this study aimed to determine the microbial contamination of HCW MPs and identify and classify bacterial isolates in Palestine.
This was a 7-month comparative cross-sectional analysis of 200 HCW MPs from 2 hospitals and 100 MPs from university students (non-HCWs). Data collection was done using a self-administrated questionnaire, and a swab sample from both HCW and non-HCW MPs was obtained and transferred to An-Najah National University (NNU) microbiology lab for bacterial identification and antibiotic susceptibility. Data were analyzed using Social Sciences Statistical Package (SPSS) version 22.0.
Among HCWs, the microbial contamination was 87.5%. Coagulase-negative
(CoNS; 67.3%), methicillin-sensitive
(MSSA; 17.5%), Gram-positive bacilli (4.1%), medrug-resistant pathogens from HCW MPs.
Significant numbers of bacteria have been isolated from HCW MPs. Working in a hospital environment frequently raises the probability of presence of antibiotic-resistant bacteria on a MP. Therefore, infection control teams should discuss methods to prevent the transmission of drug-resistant pathogens from HCW MPs.In the past years, several factors such as evidence-based healthcare culture, quality-linked incentives, and patient-centered actions, associated with an important increase of financial constraints and pressures on healthcare budgets, resulted in a growing interest by policy-makers in enlarging pharmacists' roles in care. Numerous studies have demonstrated positive therapeutic outcomes associated with pharmaceutical services in a wide array of diseases. Yet, the evidence of the economic impact of the pharmacist in decreasing total health expenditures, unnecessary care, and societal costs relies on well-performed, reliable, and transparent economic evaluations, which are scarce. Pharmacoeconomics is a branch of health economics that usually focuses on balancing the costs and benefits of an intervention towards the use of limited resources, aiming at maximizing value to patients, healthcare payers and society through data driven decision making. These decisions can be guide by a health technology assessment (HTsome recommendations for future studies, including the use of Value of Assessment Frameworks.
Pharmacists are commonly tasked with recommending the appropriate dietary supplement and advising the patients of their correct and safe use. Previous research, conducted on pharmacy students, showed that they did not always use the evidence based sources of information, with personal use identified as a significant predictor influencing the decision to recommend a supplement.
To compare use, perceptions and knowledge of dietary supplements of pharmacists with different years of work experience and to explore factors that could influence their recommendation of supplements.
A questionnaire based cross-sectional study was conducted on Croatian community pharmacists in September 2017. The questionnaire explored pharmacists' demographic characteristics, use, perceptions and knowledge of dietary supplements. Pharmacists (N=102) were divided in two groups based on their work experience P0 (<10 years) and P1 (≥10 years).
All included pharmacists had high knowledge scores without differences between grouppharmacists who might have missed that aspect during their formal education.
Pharmacists did not use the high quality sources when recommending dietary supplements and their decision to recommend the supplement was not based on objective evaluation of evidence. Further education about the practice of evidence-based pharmacy is necessary, with special emphasis on senior pharmacists who might have missed that aspect during their formal education.
Misuse of antibiotics and antimicrobial resistance are global concerns. Antibiotic stewardship programs (ASP) are advocated to reduce pathogens resistance by ensuring appropriate antimicrobial use. Several factors affect the implementation of ASPs in hospitals. The size and types of care provided, as well as the complexity of antibiotic prescription, are all issues that are considered in designing an effective hospital-based program.
To examine physicians' attitude on implementation of an antimicrobial stewardship program in Lebanese hospitals.
A descriptive cross-sectional survey was carried out using an online questionnaire. Survey items assessed ASP implementations, physicians' attitudes, usefulness of the tools, and barriers of implementation. The questionnaire was based on the Center for Disease Control core-elements.
158 physicians completed the survey with a response rate of 4%. Our results showed that the majority (66%) of physicians were familiar with the ASP concept. https://www.selleckchem.com/products/3-3-cgamp.html Most respondents reported a lack of regular educational programs (41%), as well as a lack of support from the medical staff (76%).