14^th Surgical Nursing & Nurse Education Conference October 10-11, 2016 Kuala Lumpur, Malaysia

Biography:

Dr Rasika Hendahewa is consultant surgeon from Caboolture hospital, Australia with special interest in laparoscopic and colorectal surgery. He also works as a senior lecturer in University of Queensland and has published many international papers in reputed journals including a recent Randomise control trail to improve theatre efficiency.

Abstract:

Enhance recovery after Surgery (ERAS) or ‘fast track’ pathways is a multidisciplinary approach to patients undergoing colorectal surgery design to improve the quality of overall care by expediting the recovery and reducing the hospital stay. These pathways use existing evidence to streamline and standardize the perioperative management of patients to improve pain management to speed up the intestinal recovery to facilitate rapid discharge from hospital and thus to minimize overall complication rate, minimize health cost and improve patient satisfaction. The fast track protocols are evidence based and shown to positively influence the patient outcomes. The main Principles are to reduce the fasting time, optimize analgesic control, laparoscopic surgery, minimal use of drains and early postoperative feeding. We have been practicing ERAS since 2012 and our recent retrospective study revealed a reduce hospital length of stay for our patients by 1.42days. In contrast to previous studies our data reveals the benefit of ERAS even in elderly patient cohorts. The hospital facilities been on the continuous demand with ever increasing patients numbers ERAS is the way forward in colorectal surgery

Biography:

Nimira Asif has completed her BScN in 2005 from Aga Khan University School of Nursing and Midwifery (AKU-SONAM). Then she worked as Obstetrics and Gynecology Nurse and became Clinical Nurse Instructor of the unit. She joined Aga Khan University Institute for Educational Development (AKU-IED) as a student of MEd with specialization in Educational Leadership and Management. She graduated from IED in 2011 with thesis on “Creative Thinking for Educational Leaders”. Since her completion of Master’s degree, she is working at AKU-SONAM as a Senior Instructor, teaching nursing courses in undergraduate programs. Along with her teaching responsibility, she was curriculum co-chair, member of student hand book committee and currently she is serving as co-chair of Admission and Progression Committee of the school. In her voluntary capacity, she is also serving as a Chairperson of School Health program from a platform of Professional Teacher Association Network (PTAN), which was derived from a project of strengthening teachers (a government funded project). Another voluntary work is her service to Aga Khan Ismaili Council for Pakistan as an Early Child Portfolio for the community nationwide. She is also serving as Co-chair of membership Involvement committee in Sigma Theta Tau Internationa (STTI) Rho Delta Chapter.

Abstract:

In the Post RN BScN curriculum, one of the courses “Professional Development and Leadership (PDLM)” was offered as blended mode for the first time. In order to explore the students’ interactions and Cognitive Engagement (CE) in Online Discussion Forums (ODFs), the research team conducted a retrospective study for the first time at a private nursing institution of Karachi-Pakistan. The study was conducted by utilizing the retrospective qualitative paradigm of discourse analysis to understand student’s CE in ODFs. The study has addressed the following one main and three subsidiary research questions: How do threaded discussions (in the part of online forums) enable or hinder the student’s level of cognitive engagement in a blended learning course (PDLM course)? All the course enrollees were invited to participate in the study; 24 of 81 students provided the written consent to participate in the study. The participants of the research study were both males and females; of which males were (20.8%) whereas females were (79.2%). However, only (92.3%) of the participants’ completed the Online Monkey Survey tool for demographic details. The data was collected after the university’s ethical review committee’s clearance. The scripts of ODFs from two online modules (named as Module A & B) were used for this study, which were triangulated through Focus Group Discussions (FGDs). The researcher used discourse analysis to explore the interrelations between words and the context in which the words are used. This assisted in establishing the links to determine the patterns of interaction and the levels of CE of the learners. Levels and categories of CE defined by Zhu (2006) were used as a guideline for discourse analysis of the discussion forums of two modules. Categories were assigned various levels to understand the specific kinds of interactions as explained within the selected analytical framework. The categories and levels include question type I and II, statements type I-VI, reflection type I and II, mentoring and scaffolding.  It is observed from the results that majority of the participants used statements type I which is responding to the direct questions, whereas, seeking clarifications (either question type I or II) was not much observed. Mentoring and Scaffolding are higher levels of CE, however, only less number of responses observed in both the modules A and B. Moreover, study participants reported high level of engagement with the positive role of faculty facilitation and felt more comfortable in participating through a virtual learning environment. It was recommended to set netiquettes, to have sound training to those learners whose ICT skills need improvement and to consider in-depth key informant interviews with each research participant soon after they posted a comment on ODF, will bring more insight in understanding CE.

Key words: Cognitive engagement, online discussion forum, blended learning

Biography:

To develop the student nurses’ competency based on the Thai Qualification Framework for nursing, a study of the students’ sense of the life congruence is necessary. This descriptive research aimed to examine sense of life congruence and to investigate the correlation of selected factors with the sense of life congruence of student nurses in the faculty of nursing of Saint Louis College. The purposive sampling was collected from October 1-15, 2015 among 350 second to fourth year nursing students. The research instruments comprised a demographic data form, reasoning-oriented child rearing form, instructor social support form, life experience form, and sense of the life congruence form. Reliability of instruments by using Cronbach’s alpha coefficient was 0.889, 0.895, 0.894, and 0.826 respectively. Data was analyzed by using descriptive statistic, Pearson’s coefficient of correlation and point bi-serial correlation.                        The results of this study showed that: The overall mean score of sense of life congruence was at rather high level (X=104.38, S.D=1.30). Factor of academic achievement, reasoning-oriented child rearing and instructor social support had a significantly positive low level in relation with the sense of life congruence (r=167**, 0.318** and 0.181** respectively). Additionally, factors of gender, academic year, family type and life experience were not correlated with the sense of life congruence.

Abstract:

Supawadee Krua-Chottikul has completed her Bachelor of Science in Nursing from Chiang Mai University, Thailand and Master’s degree in Education from Chulalongkorn University. During 1976–2013, she was an instructor in the field Antenatal Care and Postpartum Care at Faculty of Nursing, Navamindhadhiraj University. Now, she is Head of Maternal Nursing and Midwifery Department of Faculty of Nursing, Saint Louis College, Thailand.

Biography:

Prof. Dr. Mohd. Anisur Rahman Forazy, RN, PhD is a Bangladeshi citizen who has publications nationally and internationally and is the pioneer doctorate in the field of Nursing in his country obtained from University of New Castle, USA. He did is M.Sc. from University of Adelaide, Australia. He has experience in overseas jobs as a clinical nursing supervisor as well as a Nurse Educator. Currently he is the Principal of a renowned Nursing College in Bangladesh, Begum Rabeya Khatun Chowdhury Nursing College. He raised the voice & image of nursing globally. He is having a regular correspondence with the President of “International Council of Nurses”. He has been trying to buildup nurses work capacity, Global standard, handsome wages and honor of nurses.

Abstract:

Prospects & problems of nursing is a burning issue in Bangladesh and currently a subject of discussion. A review article is compiled with various research papers and from the speeches of dignitaries. In Bangladesh, nurses and the nursing profession are both largely neglected. We must find out the root of every problem and solve the problem at the very root. The nurses in Bangladesh are facing a lot of problems including their status, dignity, work benefits, working environment, service guaranty and social stigma. Risk of nursing service is high and nurses have no defined work policies. The prospects of nurses are only seen in international arena. But there is also lot of constraints in terms of immigration and recruitment of qualified nurses in Bangladesh. The health care sector is expanding worldwide day-by-day. The shortages of nurses are increasing in comparison to increasing number of patient and population. It is one of the major problems to establish quality patient care due to lack of qualified nurses. A new dimension is to be opened for the nurses in both public and private sector to uphold the position of nurses in Bangladesh.

Biography:

Myself Binu Joe Has Completed Msc. N. From vinayaka missions university in the year 2009. I studied my graduation from rajiv gandhi university of health sciences. Presently i am working in nootan college of nursing , Visnagar, Gujarat, India

Abstract:

Hydrotherapy is the use of water to treat a disease or to maintain health. The theory behind it is that water has many properties that give it the ability to heal.

PROPERTIES OF WATER

• Water can store and carry heat and energy.
• Water can dissolve other substances, such as minerals and salts.
• Water cannot hurt you, even if you are sensitive to your surroundings.
• Water is found in different forms, such as ice, liquid, or steam. Ice may be used to cool, liquid is used in baths and compresses at varying pressures or temperatures, and steam is used in steam baths or when breathing in.
• Water can help blood flow.
• Water has a soothing, calming, and relaxing effect on people, whether in a bath, shower, spray, or compress.
• Exercise in water takes the weight off a painful joint while also providing resistance.

USES OF HYDROTHERAPY

People use hydrotherapy to treat many illnesses and conditions, including acne; arthritis; colds; depression; headaches; stomach problems; joint, muscle, and nerve problems; and stress. People also use it for relaxation and to maintain health. You can also use hydrotherapy to reduce or relieve sudden or long-lasting pain.

HEALTH BENEFITS OF HYDROTHERAPY

1. Reduces muscle tension and relieves pain: The weightlessness you feel when under water relieves tension in the limbs, supporting aching muscles and easing the movement as opposed to when on land. Plus, hydrotherapy stimulates the release of endorphins, acting as a natural pain reliever which will further reduce muscle soreness. Incorporating hydrotherapy as part of your fitness holiday is a great way to recover after a day's training.
2. Rehabilitates injured muscles: Being immersed in warm or hot water raises the body temperature, increasing blood flow around the circulatory system and so alleviating pain. The improved circulation will in turn help to heal injured tissues and rehabilitate damaged muscles or joints.
3. Boosts the immune system: The increased blood flow and circulation of white blood cells around the body allows lymph (an immune system fluid that helps collect and get rid of unwanted materials from the body) to be moved through the body more efficiently and therefore strengthens the immune system, helping to fight colds and illnesses.
4. Encourages detoxification: Saunas and steam rooms induce considerable sweating. This is the body's primary way of eliminating toxins and therefore the impurities and toxins are flushed out through the skin helping to detoxify the body.
5. Relieves stress: Hydrotherapy treatment can be effectively used whilst on a distress holiday. Hydrotherapy can help to reduce blood pressure caused by stress. It may also slow down the body's reaction to anxiety and release endorphins - a natural stress fighter.

Biography:

Ms. Sheela Devi, a Registered Nurse, whose education includes earning Bachelor in Nursing at Monash University, Certificate in Teaching at Indiana University and Master in Nursing from Northumbria University. She is the Head of Department of Nursing in Faculty of Medicine and Health Sciences at University Tunku Abdul Rahman, a private education industry. Her nursing background includes clinical practice, nursing supervision and management, programme implementation and development. She is a member in the Malaysian Nursing Associationa and Malaysian Diabetes Association. She considers herself very privileged to have the opportunity to be part of this conference.

Abstract:

There has been much false impression among nurses on use of physical restraint thus contributing to the persistent practice. The purpose of this review is to appraise evidence for the effectiveness qualitative studies on knowledge and perception of nurses in contributing to use of physical restraint among elderly care. It also aims to determine the factors contributing to barriers of restraint-free care adherence. The synthesis of qualitative research was done to produce a “new” form of research evidence, which impacts clinical decision making. A comprehensive search strategy was developed to increase the possibility of finding all relevant studies through major databases and reference list of relevant papers. Four major themes were identified: knowledge on use of physical restraint; reasons for use of physical restraint; feelings and perceptions on use of physical restraint; and barriers to restraint-free care. Interpretation of the themes produced a synthesis describing how four major factors interact to affect adherence to restraint-free care. Through a process of reciprocal translation, there is a patterning of practice to use of physical restraint that is common among nurses from different countries and healthcare settings. Non-adherence to restraint-free care was found to be strongly associated with factors related to personal, organisational and family. In using the meta-ethnographic method, it provided information that should be helpful to nurses, management and policy makers in trying to understand the phenomena. The findings of the review could help inform the development of patient-centered interventions and to address structural barriers to treatment adherence

Biography:

Biography : Mrs. Sophia Vijayananthan , completed Bsc nursing and Msc Nursing from college of nursing, Christian Medical College, Vellore, Tamil Nadu. At present working as professorcum Nurse manager at college of nursing, Christian Medical College, Vellore, India. Also an assessor of National accreditation Board for Hospitals and a member of scientific committee of the International Journal of psychiatric nursing.

Abstract:

Aim:

 Nursing students’ perception of their clinical experience provides information to the nurse educators for designing more effective strategies to improve the clinical learning of the nursing students. The main objective of this study was to assess the nursing students’ perception about their clinical experience in College of Nursing, Christian Medical College, Vellore to provide recommendations based on the findings to improve the clinical experience of the students.

Methods

Qualitative study design was adopted with the use of focus group discussions to assess the students’ perception about their clinical experience. The participants were the group of volunteers consisting of 7 to 10 students from each class of undergraduate nursing students of both Degree and Diploma programmes excluding the first year. The focus group interviews were conducted at midyear month and last month of the academic year. Debriefing notes were made by the observer after each focus group discussion. The discussions were tape recorded and later transcribed.

Data Analysis

The content of the tape and the notes of the observer were compared and checked to include the nonverbal cues of the participants. The researcher analyzed the data looking for the significant statements and codes and categorized them into different themes.

Results

The following six themes emerged from the data: Clinical anxiety, clinical supervision, clinical teaching, clinical requirement, professional role and clinical environment which were considered important factors in clinical experience

Discussion

The result of the study showed that the nursing students were not completely satisfied with their clinical experience. They experienced anxiety and stress and brought out suggestions to improve their clinical learning.

Biography:

 RUBINA JOHN completed MPH Baqai Medical University Karachi in 2002, MSC:  Nursing College of Nursing Jinah Postgraduate Medical Center, Karachi         2011, head Nurse in Nawabshah Civil Hospital, Nawabshah            Dec. 1984 To June. 1986, Director People’s Nursing School, Liaquat University of Medical & Health Sciences, Jamshoro 13.11.2015, Chief Nursing     Civil Hospital Karachi Nov. 2014 To Nov. 2015

Program Co-ordinater Said Waleed Fatima Medical & Hospital College of Nursing Lahore Dec. 2007 To Dec. 2009

Abstract:

Background:

Domestic Abuse as physical violence or assault on a partner is a very common phenomena not in our country but throughout the world irrespective of age, races, developing or developed countries.

Domestic violence is the summary of physically, sexually and psychologically abusive behaviors directed by one partner against another irrespective of their marital status or gender. Domestic violence has no borders, it occurs in all sphere of life.

Generally it is very hard to accept or feel domestic abuse, since someone notice first time in her life and unaware of such kind of abuses it will take some time to feel or observed such abusive behavior of the partner  

Domestic abuse usually seems absence of the relationship between the partners and the majority of victims feel that they have found their perfect life partner or soul mate, but gradually partner feels abusive behavior increases

Rational:

The purpose of this research study is to explore women feelings who were  suffering from violence by their husbands. It is a very common perception in our society that most of the cases married women considered like a servant or inferior as compared with her husband.

It has been observed in our society that married women consistently discriminated and brutally abused by her husband.

Our newspapers have been flashed with stories of rape victims, honor killings, bride burning and domestic violence for a long time.

The women are killed in the name of honor and religion, customs and traditions and mostly because of man’s arrogance and ego. Therefore, I will make an effort to research on this highly important issue.

Study Objectives

General objective:

To documents’ the perspectives and responses of married women undergoing domestic violence

Specific objective:

To determine factors for compromise on situation among married women suffered from domestic violence. 

To determine reason for physical violence against women

The study objectives are:

To explore of lived experience of the women  and analysis on violence against women in Pakistan

Explore what strategies women use to end violence or to reduce  its consequences.

Gain insights into women’s perceptions about what behaviors are abusive in what circumstances;

To build consensus on recommendations

Methodology

In-depth qualitative interviews were undertaken in person with 180women victims of domestic violence living in Karachi who are suffering violence by their husbands. The study involved collecting Qualitative data through structured Questionnaire.

The sampling aim was to locate women from diverse social backgrounds and with different demographic characteristics. The interview guide included a series of broad, open-ended questions about women’s experiences of abuse.

The analysis of the interviews followed the technique of thematic decomposition, guided. The interviews have taken from women included items on socio-economic details and domestic violence experience.

To assess domestic violence exposure, women were asked several questions on various behaviors of violence by phenomenological and discourse analysis. The spss:20 package computer software was used to manage code and explore the data.
Data collection tools and Techniques

Sampling Method.

Target Population: Married women Suffering from Domestic Violence

tudy design: Qualitative Cross-Sectional Study.
Study setting: Karachi City
Inclusion criteria: Women who married 5 to 10 years ago
Exclusion criteria:Women who disagree to give consent?

Sampling technique.

A Convenience sampling Design is used in this study

Data Analysis Data collection tool Face to face interviews taken in Urdu from the respondents

Statistical analysis :  Descriptive Analysis is conducted by SPSS version 20 is used to analysed the data

Results:

There were total 180 participants were taken into this research study, it is a descriptive study conducted in the city of Karachi. Table1 shows the level of education among the subjects and this will represented in Figure1. Table2 shows the education level of participants husbands which graphically represented in Figure2.

Results

It was observed that most of the subjects were belonging to housewife 81.67% showed in table3. The distribution of their children showed inTtable4, which showed that distribution of children were equally distributed. Table5 and Table6 showing the distributions of sons and daughters which were also equally distributed.

CONCLUSIONS

The distribution of different types of the abuses shown in the Table11, it was observed that 30.6% of the women were brutally abused physically, 28.3% were abused sexually, 25% financially and 16.1% of the women were verbally abused by their husbands.  These findings also showed that the morally, ethically and religiously society is totally collapsed.

 It also indicates that there is no difference between a broken family and a family in which mother is suffering from such brutal abused by her husband. Naturally when someone especially women were suffering from such terrible condition sought some unnatural solution as in this research 37.2% of the victim women were deciding to suicide in order to rid off this horrible life.

28.4% thought to escape from the home but didn’t escape Finally mother has taken only one possible decision in order to save the life of her innocent children from this evil world to scarify her life for her children see Table12.

DISCUSSION

This research study reflects the picture or face of the society that behaves brutally with her family members and an innocent mother.  People forget the meaning of a good moral and ethical society in which children were suffering from such domestic violence.

Discussion

This will put a long lasting impact on their minds and psychological they were in depressing state of living that untimely disturbs their education as well health. It was observed that one in four women has a victim of brutal domestic violence.

Family member were also affected by such kind of situation in the family. Children were also on at high risk in these families which ultimately causes negative impacts on the development on the children.

The thoughtless attitude of the abusers husbands distressed women “Instead of being ashamed, they seemed proud when they talked about abusing their wives”

Biography:

Mousa Mahdizadeh is Faculty member and Instructor of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. He completed his doctorate in field of nursing in 2016. collaborating in Evidence Based Care Research Centre, in Nursing School and Midwifery.

Akhtar NejatMohammad MSc in Pediatric Nursing has compeleted in 2016 in the Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract:

Eighty percent of hospitalized children receive invasive procedures; in spite of being short-term, they could lead to an undesirable experience and subsequent stress for the child, the parents, and health care personnel (HCP) as well [1,2].

Lumbar puncture test is one of these invasive procedures leading to extreme parental anxiety [3].

This diagnostic method is an extremely necessary as well as urgent measure in all children and infants suspected of having brain infection or infection of the brain membrane [4, 5].

LP test is highly recommended by researchers for all children referring to hospital with febrile and seizures. Due to the aforementioned fact, LP test is believed to be the best and most valid means as well as a golden standard in diagnosing Meningitis in children [6, 7]. According to the reports, approximately 2000 new patients affected by Meningitis are annually undergone the Lumbar puncture test by health care centers and hospitals of the country [8]. However, in spite of its significant role in recognizing some diseases in children, Lumbar puncture test frequently creates parental anxiety leading to avoidance and un-satisfaction of the latter to agree the aforementioned test for the children due to its invasiveness compared to other routine tests [6, 9]. 

The Aim of this study was to determine the impact of supportive educational program on the anxiety of mothers whose children are undergoing lumbar puncture (LP).

the present study is a randomized controlled clinical trial carried out in 2015. Sixty mothers of children undergoing lumbar puncture and hospitalized 3educational hospitals of Mashhad, Iran, were randomly divided to control group (n=30) and intervention group (n=30). The intervention group received supportive program during a session of 60 min. Spielberger State-Trait Anxiety Inventory (STAI) was selected as the research tool. Finally, data were analyzed by Chi-square test, independent t-test using SPSS v.16 software.

In this study The mean age of the mothers was 27.3±5.3 and 26.0±3.1, respectively. The mean pre-interventions maternal manifest anxiety was 51.9±6.2 and 53.4±4.3 out of 80, respectively, in the intervention and control groups. The mean post-interventions maternal manifest anxiety was 44.9±5.1 and 52.7±4.2, respectively, in the intervention and control groups. According to the results of independent t-test, significant difference was observed statistically for the mean maternal manifest anxiety between the two groups (p> 0.001).

Regarding the reduction of maternal anxiety in the intervention group, which is possible because of the attention to the emotional needs of mothers, this program can be considered as an effective method to reduce maternal anxiety before the LP test.

Biography:

Matina Kampra is a Jurist, with MSc in Social Science and Health Research (University of Newcastle upon Tyne, U.K) and a PhD from the National & Kapodistrian University of Athens, School of Medicine. She works at the Internal Unit of the Ministry of Health in Greece. Her publication refers to the discipline of epilepsy and education.

Abstract:

Introduction: It is well documented that epilepsy is a disorder which carries the burden of its nature. Not only does it affect the patients’ life, but their socials’ as well. With regards to children and youth with epilepsy during their school years, it is very important for their teachers to have an expert’s advice on the management of several issues raised during the school day. Aim: A survey was conducted to explore teachers’ perceptions about the school nurse’s role, especially when there were children with epilepsy (CWE) in their school. Methods: A total of 70 head-teachers of regular schools from all Greek counties were phone-interviewed with open-ended questions. The data were grouped and analyzed in depth. Results: Of the 70 interviewed head-teachers: 68 insisted that schools need nurses (amongst other experts). 65 recognized that the role of the school nurse encompasses both educational and health goals. 67 insisted that school nurses could become a liaison between schools, family, health care professionals and the CWE. 66 referred to the nurses’ role for health policies and programs. 69 underlined the school nurses’ direct care to CWE. Conclusion: The existence of school nurse was found to be essential for the Greek teachers especially in the case of CWE, since their absence was considered crucial. An urgent need was raised for the authorities to provide the regular school personnel with nurses in order to offer information and assistance in health matters, to promote health and safety and to collaborate with teachers and family for the pupils’ wellbeing.

Biography:

Azwihangwisi Helen Mavhandu-Mudzusi works at the University of South Africa as an Associate Professor. She holds a PhD in Management, a Master’s degree in Nursing, and Honors degrees in Psychology and Nursing. She has several diplomas in Nursing, both at a basic and an advanced level. Her main passion is advocacy for marginalized groups, especially people living with HIV and AIDS, and lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals in higher education institutions and rural communities. She has published 17 articles on gender and sexual diversity and HIV; and has represented papers at national and international conferences

Abstract:

Lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals experiences stigmatization and discrimination in their everyday lives. These experiences are noted in South Africa, even though its constitution of 1996 is recorded as the first constitution in the world to explicitly provide for non-discrimination against people based on gender and sexual orientation. This paper highlights the findings of an interpretative phenomenological analysis study conducted in a South African rural university. The purpose of the study was to gain an in-depth understanding of the experiences of LGBTI individuals with regard to utilisation of the health care services in a South African rural university. The findings of the study focus on citizenship rights and the discrimination that LGBTI students experience in accessing health care services. The main forms of discrimination reported are the heterocentric nature of services and treatment at the campus health clinic and the heteronormative prejudice held by university health care personnel. Recommendations are made to address the problematic social exclusion that arises from heterocentric delivery of health services and highlight the equal rights of LGBTI students to health care that addresses all students’ needs, regardless of sex, gender, sexual orientation and gender identity, in a South African rural university.

Biography:

Supawadee Krua-Chottikul has completed her Bachelor of Science in Nursing from Chiang Mai University, Thailand and Master’s degree in Education from Chulalongkorn University. During 1976–2013, she was an instructor in the field Antenatal Care and Postpartum Care at Faculty of Nursing, Navamindhadhiraj University. Now, she is Head of Maternal Nursing and Midwifery Department of Faculty of Nursing, Saint Louis College, Thailand.

Abstract:

To develop the student nurses’ competency based on the Thai Qualification Framework for nursing, a study of the students’ sense of the life congruence is necessary. This descriptive research aimed to examine sense of life congruence and to investigate the correlation of selected factors with the sense of life congruence of student nurses in the faculty of nursing of Saint Louis College. The purposive sampling was collected from October 1-15, 2015 among 350 second to fourth year nursing students. The research instruments comprised a demographic data form, reasoning-oriented child rearing form, instructor social support form, life experience form, and sense of the life congruence form. Reliability of instruments by using Cronbach’s alpha coefficient was 0.889, 0.895, 0.894, and 0.826 respectively. Data was analyzed by using descriptive statistic, Pearson’s coefficient of correlation and point bi-serial correlation.                        The results of this study showed that: The overall mean score of sense of life congruence was at rather high level (X=104.38, S.D=1.30). Factor of academic achievement, reasoning-oriented child rearing and instructor social support had a significantly positive low level in relation with the sense of life congruence (r=167**, 0.318** and 0.181** respectively). Additionally, factors of gender, academic year, family type and life experience were not correlated with the sense of life congruence.

Biography:

Abstract:

Background: Collaborative approach is a teaching method that embraces many advantages in knowledge enhancement and multiple-skill development. Nowadays, collaborative learning approach is also used in professional trainings. Students’ learning attitude is the key of learning achievement. However, little is known about how learning attitudes of nursing students respond to this learning approach.

Method: A cross-sectional design was used with a convenience sample using self-reported student attitudes toward group environment (SAGE) to measure learning attitudes in collaborative learning.

Results: A total of 327 undergraduate nursing students with mean age 20.4±1.83 years old were recruited. More than 270 students concurred with items related to the beneficial effects of collaborative approach in knowledge and skill development, building relationships and collaborative achievement. However, about 200 students reported some concerns, such as inadequate discussion and unfairness of grading/work distribution while working in a group. Of 4 learning attitudinal domains grouped from the SAGE items, the results showed that quality of product and process was the most significant (mean 46.9 and SD 6.39). The student interdependence was subsequently followed with mean 39.37 with SD 4.23.

Conclusion: Collaborative approach is an effective teaching mode to enhance knowledge and develop skills. Two attitudinal learning domains indicate better students’ learning attitudes determined by effective collaborative group formation with friends. The findings raise the awareness of nurse educators to devise strategies for facilitating students’ learning through collaborative approach by forming effective groups, providing adequate discussion, promoting group collaboration and ensuring fairness of grading and work distribution.

Biography:

Barritault Denis graduated in Physics, completed his PhD in Biochemistry at Paris University, Post-doctoral in Molecular Immunology at Pasteur Institute and NYU as NIH Fogarty Fellow. He joined INSERM unit in Paris as Developmental Biologist. He made the first description and patents of FGF extracted from retina in 1979 and 1982 as skin and cornea healing agent. He became Full Professor and Head of Research Institute in Cell and Tissue Regeneration. He invented the RGTA matrix therapy technology and illustrated the healing potential of RGTA in many tissue lesion models. Now, as President of OTR3 and Emeritus Professor, he succeeded to bring RGTA to clinics in several products. He is still active in research and is co-author in over 200 publications and 30 patents.

Abstract:

Extra cellular matrix (ECM) microenvironment regulates locally our continuous ability to replace dead cells by new cells. This central law of all living is known as tissue homeostasis. Heparan sulfates (HS) are key elements of the ECM scaffold that store, protect and position various cell communication peptides (CCP) in the cellular microenvironment. HS plays a pivotal role in the regulation of the bioavailability of CCP, cell proliferation, migration and differentiation required for tissue regeneration. Tissue injury will lead to destruction of cells and surrounding ECM. CCP released by inflammatory and circulating cells can then promote tissue repair, but with a loss of tissue quality, leaving scars or fibrosis. We have engineered biodegradable nano-polysaccharide mimicking HS, named RGTA for ReGeneraTing Agent. Introduced at the site of injury, RGTA will bind to the matrix proteins of the damaged ECM, and to the CCP produced by healthy neighboring cells, thereby restoring the ECM microenvironment and conditions for tissue homeostasis. This matrix therapy approach has considerably improved the quality of healing in various animal models with reduction or absence of fibrosis resulting in a real regeneration process. The RGTA technology has been validated in clinics and over hundred thousands of patients treated both for corneal and skin ulcers with no adverse effect. The presentation will describe the fundamental aspect and the mode of action of the RGTA technology and illustrate in many surgical indication, the clinical results of matrix therapy RGTA based products and discs sites potential for more application in acute surgery.

Biography:

Olufemi Oyebanji OYEDIRAN has just completed his MSc at Department of Nursing Science, Obafemi Awolowo University, Ife, Nigeria. He is presently a Chief Nursing Officer in operating room at LAUTECH Teaching Hospital, Osogbo, Nigeria. He is just an upcoming researcher who had published few papers in reputed journals.

Abstract:

Surgery plays an increasingly prominent role in healthcare around the world and growing attention is being focused on the safety and quality of such care.  Half of  all surgery related iatrogenic complications are avoidable and breakdown in communication and non- adherence of surgical team nurses inclusive to standard practice regarding sterilization, aseptic technique and prevention of wrong patient and site are all contributing factors. The study assessed perioperative nurses’ knowledge about safety practices in operating theatre and also evaluated various safety measures employed by the nurses to ensure patients safety in operating theatre.

Descriptive cross sectional design was adopted and the setting were eight selected tertiary health institutions in south western Nigeria. Multistage sampling technique was used to select 211 respondents from the setting. Yamane’s formulae was used to determine the sample size. Twenty point scale was used for knowledge with yes/no option and the score was categorized into poor (10-11), fair (12-13) and good (14-20). Questionnaire and observation were used to collect data between January and April 2015. Descriptive and inferential statistics were used to analyze the data with the aid of Statistical Product and Service Solution (SPSS) version 20. The P values was considered significant at >0.05

The results showed that (80.0%) of the respondents in both state and federal institutions had good knowledge about safety practices. Findings from questionnaire revealed that identification of patient at the red line as a measure to ensure patient safety in theatre had the highest mean (2.45 ± 1.42). Result from the observation revealed that use of operation schedule to send for patient from the ward had the highest means 6.91 ± 0.28 while only 57% of the respondents were using WHO surgical safety checklist. Findings also showed that socio-demographic and professional characteristics are predictors of good safety practices (F_4,196 = 5.047, p< .001) .

This study concluded that Perioperative nurses have good knowledge about safety practices and they engaged in standard safety practices in the operating theatres but WHO surgical safety have not been fully adopted in the selected theatres.

Key words: Safety Practices, Knowledge, Perioperative, Teaching Hospital, Western Nigeria

Biography:

Ghulam Abbas Panhwar is working Nursing Lecturer in 2014 still contnue PNS, LUMHS, Senior Nursing Instructor: 2008-9 at SWCON in Lahore and Nursing Tutor in the year of 2005-8 S.N LUMHS

Abstract:

Background:  Nature of occupation plays an important role in person’s daily life. Every occupation has various aspects, an employee may be satisfied with some and some may be stressful for him/ her. Stress is a nonspecific reaction to everything the body needs. Although Occupational stress, a common occurrence among various professions worldwide, it is seen with more frequency and intensity amongst those occupations related to human health professionals especially nurses. This study conducted to determine causes and level of stress in nurses of Liaquat University Hospital Hyderabad/ Jamshoro.
Objective: To determine the sources of occupational stress and level of stress & to suggest measures to decrease level of occupational stress among the staff Nurses of Liaquat University Hospital Hyderabad/ Jamshoro.

Methodology: This is a descriptive study conducted at Liaquat University Hospital Hyderabad/ Jamshoro hospital using a data collection tool “Hospital Consultants’ Job Stress & Satisfaction Questionnaire (HCJSSQ) February 2008” it is a structured personal interview questionnaire consisting of 25 sources of stress and each question have a scale of 0 (not at all), 1 (a little), 2 (quite a bit) and 3 (a lot).  The hospital staff Nurses was asked to rate each item according to the extent to which it had contributed to their stress as experienced in their jobs. A global rating of stress was also obtained.

Result: The mean age of staff nurses was 32.29 SD +7.025 years. Age ranged from 24 to 45 years.10 (10%) was male and 90 (90%) was female nurse making male to female ratio 1:9. Majority of staff nurses 40.64% responded moderate stress Followed by 35.48% of nurse’s responded severe stress. Than 16.32% of nurses responded mild stress. We found that older age group and more service length staff have highest frequency 61 (61%) belongs to above 30 years of age and majority of them were in severe or moderate stress level 26 (43%) nurses found in severe stage of stress and 24 (40%) nurses found in moderate level of stress.  The prime sources of stress were found to be having too great an overall volume of work as 56 % populations is in severe stress 32% in moderate stress and 32% are in mild stress. Encountering difficulties in relationships with junior medical staff as 51% nurses are in sever, 36% are in moderate and 9% are mild stress, Being involved with the emotional distress of patients as 50% population is in severe stress 38% in moderate and 5% in mild stress, Being responsible for the quality of the work of other staff level of stress as 38% are in sever, 50% are in moderate and 7% nurses are in mild occupational stress. Underpayment, inadequate staff, & being involved in the emotional distress of patients, inadequate facilities, and disturbance of home life are causes of stress among Nurses of Liaquat University Hospital Hyderabad.

Conclusion: It is concluded from this study that the staff Nurses were in occupational stress due to different causes as their severity as mild, moderate and sever stress due to the prime stressors so adequate measures should be taken to alleviate these stressors. This could be achieved through workload management, job redesign, & by offering occupational health education, continue education and with removing or minimizing all concerned stressors. The Health care systems are undergoing major structural and financial changes. Ongoing changes in health care delivery system include an increase in the complexity of cases, available related with causes and level of stress, fewer health and retirement benefits, and the feeling that professionals themselves have to work longer and harder just to maintain their current economic status. These trends strongly influence the workplace environment and are a potential source of occupational stress among nurses

Key Words: Stress, Occupational, Nurses Hospital.

Biography:

Dr.C.Susila ., RN,RM M.Sc (N), M.A.,MBA.,PhD(N)., working as professor cum principal in Billroth College of Nursing, Tamilnadu, India having more than 20years of Clinical  and teaching Experience. Published more than  30 papers in  International& National Journals and attended   70  International& National Conferences .Being External examiner for PhD (N), Recognized PhD Research Supervisor and .Co-guide .Served as Question Paper Setter and Practical Examiner, Served as External Observer for the University examinations. Editorial Board Member in the “International Journals”. NAAC Assessor for Health Sciences institutions, Colleges and Universities.the awards are  Best International Nurse,,Excellency in Teaching Award ,,Best Educationist Award,Best Nurse Educator,,Best Teacher Award ,,Best citizenship award ,and Academic excellence and outstanding contribution to research.

Abstract:

Women’s health has been a global concern for many decades. Women have more complex and stressful aging process, as a consequence of hormonal changes that occur during menopause. A descriptive study was conducted to assess the menopausal symptoms and quality of life among post-menopausal women residing at Kelambakkam,Chennai. The investigator interviewed 60 women who fulfilled the inclusion criteria through purposive sampling. Tool consisted of 4 parts – Demographic variables, Clinical variables, Assessment of menopausal symptoms and Quality of life. Data analysis revealed most of the women 26(43.33%) attained menopause at the age of 40-45 years,34(56.67%) of them were overweight based on BMI calculation, 26(43.33%) practiced dietary modifications to overcome problems related to menopause. There was a significant association between age in years, comorbid conditions and menopausal symptoms. 32(53.33%) of them expressed moderate level of quality of life. Menopause is a critical point in a women’s life, nurses should facilitate women with an easy menopausal transition and management of postmenopausal health problems.

Biography:

Maria Frani Ayu Andari Dias had completed her Bachelor of science in Nursing at the age of 23 years from Suaka Insan school of health sciences higher education Banjarmasin in South Borneo, Indonesia. In 2013, she and her team became one of the volunteer in free catarac surgery in Banjarmasin, South Borneo cooperated with A new vision from Singapore, an non-profit organizarion who works to help native people from around the world get their free catarac surgery. At that time, she worked as an anasthesiologist assitant. Now she becomes a master student in University of the Philippines Manila.

Abstract:

Lower extremity fracture is one of the fracture which often happen because human body concentrate the ability to move in the lower extremity. Based on the data from orthopedic’ polyclinic in Ulin Banjarmasin general hospital counted from January 2015 until august 2015, there are 847 cases of lower extremity fracture after post operation. Meanwhile, patient who get infected are 206 patients or 24.32%. Infection happen because of the personal infection. The purpose of this study is to find out the description of wound care implementation in patient with lower extremity fracture based on the instrument preparation, client preparation and wound care procedure in Tulip IB Orthopaedic ward Ulin Banjarmasin General hospital. This type of descriptive-quantitative research was using total sampling as sample technique.  There were 13 nurses from Tulip 1B orthopaedic ward Ulin Banjarmasin general hospital who participated in this study. Wound care implementation on client with lower extremity fracture based on instrument preparation is good with percentage of 100%, preparation of  client is less good with percentage of 84.61%, and procedure of wound care is good with percentage of 63.23%. As conclution, Wound care implementation placed in good category with percentage of 81.61% (up to 250 words)

Biography:

Dr Rasika Hendahewa is consultant surgeon from Caboolture hospital, Australia with special interest in laparoscopic and colorectal surgery. He also works as a senior lecturer in University of Queensland and has published many international papers in reputed journals including a recent Randomise control trail to improve theatre efficiency.

Abstract:

Enhance recovery after Surgery (ERAS) or ‘fast track’ pathways is a multidisciplinary approach to patients undergoing colorectal surgery design to improve the quality of overall care by expediting the recovery and reducing the hospital stay. These pathways use existing evidence to streamline and standardize the perioperative management of patients to improve pain management to speed up the intestinal recovery to facilitate rapid discharge from hospital and thus to minimize overall complication rate, minimize health cost and improve patient satisfaction. The fast track protocols are evidence based and shown to positively influence the patient outcomes. The main Principles are to reduce the fasting time, optimize analgesic control, laparoscopic surgery, minimal use of drains and early postoperative feeding. We have been practicing ERAS since 2012 and our recent retrospective study revealed a reduce hospital length of stay for our patients by 1.42days. In contrast to previous studies our data reveals the benefit of ERAS even in elderly patient cohorts. The hospital facilities been on the continuous demand with ever increasing patients numbers ERAS is the way forward in colorectal surgery

Biography:

Dr. Janet J. has completed her Masters degree in Nursing, Psychology, Social works and PDGHHM. She obtained Doctoral degree in Child health nursing from Dr. MGR. Medical University and Doctoral degree in Psychology from Bharathiar University, Tamil Nadu, India. She was former Principal cum Professor of SI-MET College of Nursing an Autonomous society under Govt. of   Kerala, India. She has published more than 10 papers in reputed International and National journals and has been serving as an editorial board member of Asian Journal of Nursing Research (AJNR).She is life member of TNAI, NRSI, IAAP and QCI.

Abstract:

The present study was made an attempt to develop and validate an observation check list to assess practice of life skills among children with specific chronic illness (Asthma and Epilepsy). The  Items for the checklist were generated based on Review of literatures, focus group discussion with ill children, parents and Psychologists, Physicians,  School Nurse ,headmasters and school teachers, personal interview with ill children, consultation and discussion with   experts in the subject of  life skills. After generating the check list content validity and reliability of   the check list were established by experts. An exploratory analysis was carried out with this checklist (42 items) from 20 high school students with specific chronic illness studying in 8^th and 9^th standard. The check list has graded with rating scale (very good, good, average and poor), to assess the Nursing practice of seven life skills. Internal consistency for the check list was examined using Cronbach’s Alpha (.795). India is a second most populous country in the world, with over 1.3 billion people (Demographics of India, May, 2016) more than sixth of the world population. India has more than 50% of its population below the age of 25.The adolescents makes the future of nation. The physical and mental changes that herald adolescence are the most visible and striking markers of this stage. Their developing brains bring new cognitive skills that enhance their ability to reason and to think abstractly. They develop emotionally, establishing a new sense of who they are and who they want to become.

Biography:

Abstract:

The quality of life (QOL) needs to be regularly assessed in hemodialysis patients. Hemodialysis patients suffer from average quality of life and survival. A descriptive research design was used, 96 respondents who had received haemodialysis treatment after completion of 1 month duration of hemodialysis in two different teaching hospital  at Bharatpur Chitwan. Data was collected by using standard tool Short Form-36 version2 through face to face structure interview schedule. The objective of study is to find out the quality of life (QoL) of haemodialysis patients. Various test such as one sample t-test, ANOVA test, independent t-test, Kruskal-Wallis test and Mann-Whittney U test, Pearson's correlation was applied.

The findings showed that higher proportion of respondents were from 40-59 years (41.0%) and male (62.2%). The mean±SD was 57.45±16.25, 55.72±22.41 and 60.04±11.50 in overall QoL, physical and mental component summary respectively which was slightly above the average. All dimention and sub scale was satistically significant. Younger respondents had statistically significant with overall QoL (p<0.001) and physical component summary (p<0.001). Non diabetics had better in overall QoL (p=0.040) and physical component summary (p=0.033). Level of educational had also positive impact in overall QoL(p=0.010), physical (p=0.006) and mental component summary (p<0.001). Employment status (p=0.020) and sex (p=0.037) was also statistically significant with mental component summary. There was correlation between physical and mental component summary with overall QoL 0.970(p<0.001) and 0.698(p<0.001), and between the physical and mental component summary was 0.502(p<0.001). Below average score were seen in the general health (32.86±25.74) and vitality (41.53±13.98) sub scale. In order to improve quality of life family, physician, nurses and policy makers can use this finding.

Key words: Quality of life, Hemodialysis, Short-Form 36, Physical health, Mental health.

Biography:

He is a Professional Leader with medical & management background . MBBS Graduate from Delhi University, India. He holds Master in Hospital Administration degree from All India Institute of Medical Sciences (AIIMS), New Delhi. I have cleared my DNB in Hospital & Health Administration (Equivalent to M.D) from National Board of Examinations. I am also an ISO certified lead Auditor and NABH trained Assessor and trained in Six Sigma Green belt.

His twenty two years span of experience includes my tenure as Medical Superintendent, Indian Spinal Injuries Centre, Additional Medical Superintendent at Max Heart & Vascular Institute, Deputy Medical Superintendent at Sir Ganga Ram Hospital, 3 years as Govt of India posting at I.G.M.H. Male, Republic of Maldives and 1-½ yrs as C.M.O. at Batra Hospital & Medical Research Center, New (all multi speciality tertiary care hospital).

He possess necessary skills for fast pace business development & have strong contacts with medical fraternity, have good conceptual, planning, managerial and human relation skills .Given a chance I ensure of my professional excellence, hard work and. loyalty.

Abstract:

Management of Hospital Acquired infection is a very important aspect of health care management.

A Nosocomial infection affects approximately 2 million patients annually in acute care facilities in our country and their annual patient care costs several millions of rupees.

Studies shows that nearly one-third of nosocomial infections can be prevented by a well organized infection control program. But only less than 10% are actually prevented.

Health-care waste is an important source of HAI and should be considered as a reservoir of pathogenic microorganisms, which can cause contamination and give rise to infection. If waste is inadequately managed, these microorganisms can be transmitted by direct contact, air or by a variety of vectors. Infectious waste contributes in this way to the risk of nosocomial infections, putting the health of hospital personnel, and patients, at risk.

The aim of the Hospital Infection Control Program is dissemination of information, surveillance activities, investigation, prevention and control of nosocomial infections in the hospitals.

Introduction

This study describes the measure taken in a tertiary care hospital to control infection and its effect. There are big human and economic burdens of health care associated infections (HAIs). The appropriate resources and activities required for an effective Infection Prevention and Control Program (IPCP) are very important to minimize the incidence and adverse outcomes of these infections. The goals of IPCPs are to minimize these and other negative effects by contributing to patient safety through protecting patients from infections; protecting health care workers and visitors to health care facilities from infections; and accomplishing these goals in the most cost effective manner whenever possible, thus reducing the economic impacts of HAIs on individual health facilities, health systems and the national health care industry.

Health care associated infections occur in relation to health care interventions including invasive, diagnostic, surgical, and medical procedures. Examples of HAIs include bloodstream, surgical site, urinary tract, pulmonary, and skin and soft tissue infections. Transmission of infectious diseases, such as SARS, tuberculosis, influenza, Clostridium difficile (C. difficile), Norovirus, and antibiotic resistant organisms (e.g., MRSA [methicillin-resistant Staphylococcus aureus] and VRE [Vancomycin-resistant Enterococci]) to patients within the health care delivery system are also considered HAIs.

Infection Prevention and Control Programs were first introduced in the1950s. Initially referred to as Infection Control Programs, these hospital-based programs focused on the control of hospital-acquired infections, which were referred to as nosocomial infections. As health care increased in complexity and sophistication and expanded beyond acute care, the mandate of IPCPs should have expanded to encompass infections in all settings across the health care continuum. Contrary to expectations, however, IPCPs have seen their resources either decrease or remain static, and consequently have failed to achieve the needs of the expanding mandate.

Health care associated infections contribute to significant morbidity, mortality, and economic costs and the risk of hospital acquired infections is increasing. These infections are the most common complication affecting hospitalized patients. Effective IPCPs reduce nosocomial infections by at least 30% (10) and have repeatedly been shown to be effective in controlling infection outbreaks in the health care setting. Appropriate resources, both in quantity and in quality, are required to support effective IPCPs.

AIM of the Study

The aim of the study is to see the effect of Hospital Infection Control program in a tertiary care hospital ICU.

Materials and methods:

This study was conducted in the ICU of a tertiary care super specialty hospital (Indian Spinal Injuries Centre) by observing and monitoring the effect of implementing Hospital Infection control program in post operative cases over a period of 7 days from the date of surgery.

Indian Spinal Injuries Centre is a tertiary care specialized centre for Spinal Injury patient, Orthopedics and Joint Replacement. 

Infection control Program

Hospital control Program team consists of two Infection Control Nurses & One Infection Control Officer (microbiologist) who are responsible for infection control work.

There is a multidisciplinary Hospital Infection Control Committee chaired by Medical superintendent and Microbiologist is the member secretary and other members are from different clinical & nonclinical specialties, nursing and housekeeping.

Review of Literature

A nosocomial infection (derived from the Greek words nosos [disease] and komein [to care for], and later the Latin word for hospital nosocomium) is defined as an

"Infection that is not present or incubating when the patient is admitted to hospital or other health-care facility¹". The time frame for diagnosis of a nosocomial infection will thus clearly be dependent on the incubation period of the specific infection; 48–72 h after admission is generally deemed indicative of nosocomial, rather than community acquired, infection. Although generally associated with hospital admission (hence the term hospital-acquired infection), nosocomial infections can arise after admission to any health-care facility, and the term health-care associated infection is increasingly being used. Such infections are common and associated with great morbidity and mortality. Indeed, one provocative headline stated “Hospital acquired infections kill 5000 patients a year in England²”. The information for this news piece was taken from a government report on hospital-acquired infection in England, which suggested that there are at least 100 000 cases of hospital-acquired infection every year in England, costing the UK National Health Service some £1 billion each year³. In addition to their association with increased morbidity and mortality, nosocomial infections are frequently associated with drug-resistant micro-organisms, including Methicillin-resistant Staphylococcus aureus and extended spectrum lactamase (ESBL)-producing gram-negative bacteria, which can pose considerable therapeutic problems. Medico legal issues can also arise, since patients or their families sometimes blame the hospital or staff for the infection, and demand compensation.3 Nosocomial infections can affect any part of the body, but respiratory tract infections are most frequent, followed by central line infections, urinary tract infections, and wound infections.

Pathophysiology

The development of nosocomial infection is dependent on two key patho physiological factors: decreased host defences and colonization by pathogenic, or potentially pathogenic, bacteria. Although these two factors can arise independently, for infection to result both must be present to some degree.

Direct contact can include spread from the hands of health-care workers or visitors⁴, but also from contaminated equipment and infusions^5,6.

Underlying health impairment

Certain conditions predispose to bacterial colonization, and hence nosocomial infection, by impairing host-defense mechanisms. Patients with chronic lung disease are at an increased risk of developing nosocomial infection^7,8.

Poor nutrition and chronic debilitation are associated with reduced immune defense, explaining the increased risk of nosocomial infections in such patients¹⁰.

The acute disease process

The underlying disease process as well as the severity of disease can affect the risk of developing nosocomial infection. Patients with a primary diagnosis of trauma or burns are at an increased risk^11-14.

Trauma patients too have altered immune responses¹⁵, making  them more likely to develop infection. Perhaps unsurprisingly, severity of illness as assessed by severity scores has also been associated with the development of nosocomial infection^16,17,but rather associated with other risk factors for infection, such as prolonged length of stay¹⁸.

Invasive devices

In a report from the National Nosocomial Infection Surveillance (NNIS) system¹⁹, involving data from 498 998 patients, 83% of episodes of nosocomial pneumonia were associated with mechanical ventilation, 97% of urinary tract infections arose in patients with a urinary catheter in place, and 87% of primary bloodstream infections were in patients with a central line.

Treatment methods

Various therapeutic strategies are associated with a raised risk of nosocomial infection. Cook and colleagues12 noted that the administration of paralytic agents was an independent predictor of nosocomial pneumonia in their study of 1014 mechanically ventilated patients. Sedative drugs²⁰,corticotherapy²¹, antacids^22,23, stress-ulcer prophylaxis^11,214, previous antibiotic therapy⁹, and multiple blood transfusions 25 have all been identified as risk factors.

Epidemiology

The quoted incidence of nosocomial infection varies, according to the setting—ie, the type of hospital or intensive-care unit—the population of patients, and the precise definition used (hospital-acquired, intensive-care unit-acquired, nosocomial pneumonia). One of the largest databases related to nosocomial infection in intensive care . In this 1-day point  prevalence study, information was obtained on all patients who occupied a bed in an intensive-care unit over 24 h in 1992: 10 038 patients were recruited from 1417 western European intensive care units. Of these patients, 4501 were infected, and of those 2064 (21% of the total number) had an intensive-care-unit-acquired infection. There was a relation between the prevalence of nosocomial infection and mortality according to country¹¹, with greater incidence of infection and higher mortality rates in the southern European countries of Portugal and Greece than in Scandinavia and Switzerland (figure 1).

Other studies25,26-28 have quoted incidence rates of between 9% and 37%, dependent largely on the populations studied and the definitions used. Differences in surveillance techniques can also affect detection of nosocomial infection and, hence, rates²⁹.

However, we are becoming less invasive in our treatment techniques (less aggressive surgical procedure are used, fewer Swan-Ganz catheters are being placed, non-invasive mechanical ventilation is being applied when possible and appropriate), and are more aware of techniques that could prevent nosocomial infection (antibiotic-coated catheters, avoidance of naso tracheal intubation thus limiting sinusitis), which could result in a reduced incidence of infections. In a study on one intensive-care unit, comparing data over 25 years, the incidence of bacteraemia  increased from 1·8% in 1971–75 to 5·5% in 1991–95, with the largest increase seen between 1986–90 and 1991–95⁴⁶.Dagan and co-workers²⁸,however, reported a fall in the nosocomial infection ratio from 25·2 in 1987 to 20 in 1992.

Effect of nosocomial infection

The effect of nosocomial infection in terms of morbidity, mortality, and increased resource use is substantial. Nosocomial infection is associated with an increased length of stay^30-33,which results in an additional cost of about US$3·5 billion per year³⁴, without taking into account antibiotic or other therapeutic costs

Crude mortality rates associated with nosocomial infection vary from 12% to 80%, dependent on the population studied and the definitions used.

Organisms

Any organism can be implicated in nosocomial infection, and many infections are polymicrobial¹¹.Recent years have seen a swing in the pattern of infecting organisms towards gram-positive infections³⁵.The surveillance and control of pathogens of epidemiologic importance project (SCOPE) data³⁶ revealed that gram-positive cocci were isolated in 64% of 10617 episodes of nosocomial bacteraemia, whereas gram-negative bacilli were isolated in only 27% of cases. The EPIC study¹¹ identified the following as the most commonly reported nosocomial pathogens: Staphylococcus aureus (30%), Pseudomonas aeruginosa (29%), coagulase-negative staphylococci (19%), yeasts (17%), Escherichia coli (13%), enterococci (12%), Acinetobacter spp (9%), and Klebsiella spp (8%)³⁷. Other studies have noted similar patterns of causative microorganisms^19,26

Biography:

Prof Richards specialised in internal medicine in 1985 and subsequently as a pulmonologist and intensivist. He was awarded his PhD in medicine in 1992 and has authored 12 book chapters, 126 peer reviewed scientific papers and has 1196 citations. His Score on ResearchGate is 39.58. He has reviewed for the International Journal of Antimicrobial Agents, European Journal of Clinical microbiology and Infectious Diseases, BMC infectious diseases, antimicrobial agents and chemotherapy, Thorax , the International journal of Tuberculosis, Critical Care and others.

Abstract:

Optimal outcome and a reduction in the potential for resistance require that appropriate pharmacokinetic (PK) targets are achieved. Consequently, we need to target drug concentrations that are significantly higher than those conventionally presumed to be adequate. Drug exposure varies according to the molecular weight, degree of ionisation, protein binding and lipid solubility of each agent. In critically ill patients, hypoalbuminaemia increases the free fraction of hydrophilic drugs, which in turn increases the volume of distribution and clearance (CL), both of which result in reduced drug levels. Similarly, augmented renal clearance (ARC), defined as a creatinine clearance (CLcr) of >130 mL/min/1.73 m2, which occurs frequently in critically ill patients, particularly younger patients with normal or near-normal creatinine levels, may also significantly reduce drug exposure. Studies have demonstrated a greater mortality and lower cure with ARC, particularly with the additive effects of obesity, hypoalbuminaemia and increasing resistance, if conventional dosages are used. These concepts apply to antibiotics targeting Gram-negative and -positive organisms. Knowledge of PK and the resistance profiles of organisms in each environment is necessary to prescribe appropriately. This article discusses these issues and the doses that should be used.

Biography: Prof Richards specialised in internal medicine in 1985 and subsequently as a pulmonologist and intensivist. He was awarded his PhD in medicine in 1992 and has authored 12 book chapters, 126 peer reviewed scientific papers and has 1196 citations. His Score on ResearchGate is 39.58. He has reviewed for the International Journal of Antimicrobial Agents, European Journal of Clinical microbiology and Infectious Diseases, BMC infectious diseases, antimicrobial agents and chemotherapy, Thorax , the International journal of Tuberculosis, Critical Care and others.

Biography:

Professor of Surgery and Reconstructive Microsurgery
Chief Head and Neck and Endocrine  Surgery Unit Consultant Surgeon, CMO Al-Shatti Hospital, Muscat, Oman.
(April 2001 – April 2003).

General Director, Surgery hospital, Alexandria University Hospitals.
(January 2010 – June 2011)).

Chief  Emergency and Casualty Departments, Alexandria Main University Hospitals.
(January 2012 – july 2013).

Chair Head and Neck Surgery Unit, Surgery Dept, Alexandria Main University Hospital.  (February 2012 – till present).
 

Abstract:

Healthy life has become an important factor in health management. Marjorie Gordon introduced a formal framework for assessing functional health patterns (FHPs) under eleven headings in 1982. Surgery on the gastrointestinal tract is always invasive to some degree. Healing a wound is an energy requiring process that often requires adjunctive therapies in addition to wound care products to achieve success. Ultrasound is able to identify dermal structures with improved resolution, thereby offering a potentially more accurate visualization of deep dermal microcirculation and to analyze the tissue patterns of healing wounds. It is important for nurses to know about the various forms of cutaneous techniques (acupressure and TENS), the evidence for and against the use of some of these therapies, and the legal risks posed by patients’ use of these therapies. Using functional health patterns, a method of holistic assessment that provides information from a nursing rather than a medical perspective can provide the patient with a good experience of recovery. The aim of the current study was to compare between two cutaneous stimulation techniques on wound healing, related pain and functional health patterns of patients with abdominal surgery.

This study was conducted on 60 patients who underwent an abdominal surgery at the general surgical wards of Alexandria Main University Hospital. Every patient was assigned randomly into one of three groups (20 patients in each group) as follows:

Group (I): Subjected to routine daily hospital management (control group),

Group (II): Subjected to acupressure (study group I),

Group (III): Subjected to the use of transcutaneous electrical nerve stimulation device (TENS) (study group II).

Three tools were used in this study for data collection in addition to patients' sociodemographic data sheet including personal data and clinical data.

Tool 1. Surgical wound assessment including wound data base sheet, wound healing

 follow-up by ultrasound and wound characteristics follow-up sheet.

Tool 2. Holistic pain assessment sheet.

Tool 3. Postoperative functional health patterns structured interview schedule.

The tools were tested for its content validity by a jury of seven experts in the field. As for testing its applicability a pilot study was then carried out on five patients. According to the findings of the pilot study and comments of the jury members, the necessary modifications had been done. The data was collected in a period of fifteen months by the researcher. Functional health patterns assessed using tool 3 before and after sessions' completion (nine sessions of acupressure and TENS). Wound and pain assessment were done using tool 1& 2 before and after each session. Wound healing was assessed on the first and third day post-operative and the tenth day post-operative (either hospitalized or discharged) by using ultrasound with 14MHZ transducer. Dressing was done by the researcher for both study groups, while control group was dressed by the hospital staff according to the hospital routine.

From the findings of the present study, it can be concluded that:

• Ultrasound with 14MHz transducer can report detailed underlying skin structure description for wound healing including the skin layers thickness, presence of subcutaneous edema, site and size of subcutaneous fluid collection, degree of vascularity, and gap filling.
• Patients' functional health patterns are affected by the presence of surgical wound and related pain.
• Acupressure is more effective than TENS in reducing discomfort for patients underwent abdominal surgery in the form of wound pain, holistic pain, and wound tenderness of abdominal surgery patients.
• TENS and acupressure are valuable for improving abdominal wound healing with the superiority for TENS.
• Acupressure and TENS had nearly equal effects for the improvement of functional health patterns for patients with abdominal surgery.

Results

• A group of 60 patients with 60 abdominal wounds was enrolled in this study. 45% of the studied patients were among the age group 20-29 years.
• More than half (66.7%) of the patients were male. Manual work was the most common occupation encountered among the three groups (51.7%).
• Half of the patients underwent hernioplasty operation. All studied patients suffered from wound pain.
• Acupressure group had remarkable reduction of subcutaneous fluid collection size than TENS group for patients with hernioplasty wound. Both study groups (acupressure and TENS) were nearly equal in relation to wound characteristics follow-up.
• Acupressure was superior to TENS in reducing the intensity of wound pain as measured by VAS score since the mean score of VAS following acupressure (0.60±0.754) was significantly lower than that following TENS (0.90±1.021).
• Wound tenderness changed significantly in both, acupressure and TENS groups (FET= 25.619, P = 0.000).
• Regarding holistic pain assessment for abdominal surgery patients, the finding was that total number of patient changed according to the applicability of holistic pain. The mean score of holistic pain VAS had significantly decreased in the control group from 9.00±0.000 to 0.31±0.751, the mean score of  VAS had been decreased from 8.57±1.369 to 0.000±0.000 in the acupressure  group and from 9.00±0.707 to 0.000±0.000 in the TENS group. These changes were statistically significant (P=0.016).
• The findings of the present study showed that there was a considerable improvement of health perception for both acupressure and TENS group.
• The mean score of dependency for activities of daily living had decreased in the control group comparatively to the study groups (acupressure and TENS). The mean score of activity of daily living had been decreased from 3.80 to 0.60 following acupressure sessions, and from 4.50 to 0.30 following TENS sessions.
• A significant reduction of nutritional problems as reduction of nausea sensation in the acupressure group from 30.0% before sessions to 10% following acupressure sessions. For TENS group, the feeling of nausea had decreased from 45% before TENS sessions to 15% by the end of TENS sessions (P= 0.044).
• Concerning sleep/rest pattern, a significant reduction in sleeping problems for acupressure group from 15.0% before acupressure sessions to 0% after sessions completion and TENS group from 25.0% before TENS to 0% after TENS sessions (P= 0.039).
• With reference to sexuality/reproductive pattern, 40 male patients were changed significantly (P= 0.047) their reporting about effect of wound on sexuality from 75.0% agree to 32.5% after application of treatment modality.

From this study the following recommendations had been suggested:

• Nurses play a vital role in surgical wound assessment approaches through 1-dimension, 2-dimension (ultrasound), and 3-dimension wound assessment techniques.
• Nurses should provide each patient with a simple illustrated booklet including the most important points regarding wound pain and common points, TENS, and acupressure techniques.
• Development of functional health patterns assessment tool for postoperative patients.
• As an efficient method of wound healing, acupressure and TENS courses should be taught to undergraduate nursing students in the Egyptian universities. It should be noted that in this regard, the Faculty of Nursing of Alexandria University has taken the initiative step.

Biography:

Abstract:

Introduction: Usually seen in young men, a pilonidal abscess is a condition that requires immediate drainage.

Objective: To compare incision and draining(I&D) of acute pilonidal abscess(PSA) and healing by secondary intention with I&D and subsequent delayed pits excision and closure(PE/PC).

Methods: A total of 62 patients admitted with PSA were randomized to undergo either incision and drainage (I&D) and healing by secondary intention (Group 1, n=33) or I&D and pits excision and closure (PE/PC) (Group 2, n=29). Demographic characteristics of the patients, abscess depth and location, duration and healing times of the symptoms, time required to return to work and ratio of chronic pilonidal sinus (PNS) development were recorded and the two methods were compared.

Results: No statistically significant differences were found between the groups in relation to gender, age and pre-operation findings, including discharge, infection, pain and the length and depth of abscess. There was no difference in length of hospital stay between the groups, and no statistically significant difference was found between the groups in terms of complication rate(p=0.298). A statistically significant difference(p=0.033) was however found between the two groups in the recurrence rate of a pilonidal abscess(9.09% in group 1 versus 3.44% in group 2). A statistically significant difference was also observed between the groups in terms of development of chronic PNS(p=0.020).

 Conclusions: According to the results of our study, incision and drainage, delayed pits excision and closure should be the primary procedure used, as opposed to skin incision, curettage and secondary healing for the treatment of PSA.

Biography:

Sanjay Kulkarni did his MBBS and MS in General Surgery from Armed Forces Medical College, Pune, India in 1992 and 2000 respectively. He has vast experience in managing trauma and emergency surgical cases while working in different centres in India. He has presented and chaired various surgical conferences and CMEs in India. Before joining PU-RCSI university in Malaysia, he was in the faculty at department of Surgery, AFMC Pune , one the most prestigious institutions in India.

Abstract:

IV fluids are the most commonly prescribed drugs in surgical practise. Inspite of their common use, very little is known about IV fluid therapy amongst medical personnel working in the ward. More often either too much or too little IV fluid is given in a particular patient. It has been proven beyond doubt that about 17-20%  of complications occur due to improper IV fluid therapy in a surgical patient. Hence it is imperative that physiology of fluid resuscitation, indications and adverse reactions should be known to clinician and paramedics. Debate continues about use of crystalloids or colloids, and ideal resuscitation fluid.

Biography:

M. Al azrak is a plastic surgeon, graduated in Faculty of Medicine, Cairo University, Egypt, in 2003 .After spending of Internship in Cairo University Hospitals; he started two years of residency in Trauma and Emergency Surgery Division, Fayoum General Hospital, Fayoum. Followed by two years of residency in General surgery department , Fayoum General Hospital .Then he moved to Kasr El Ainy School of Medicine - Cairo University, where he spent one year of residency in Burn and Plastic Surgery Unit , Surgery Department  and received Master of Surgery .Then he received residency for one year in Plastic Surgery Division ,General Surgery Department , Al Helal Specialized Hospital ( National Trauma Centre ) Ministry of Health & completed thesis in Flap Reconstruction of Post Burn Head and Neck Scar Contractures. He gained experience and wide access to surgical management of patients in rural hospitals, trauma & emergency, general surgery, diabetic foot management and wound healing in problematic situations .Starting from 2011 he became a Plastic Surgery Specialist in Burn & Plastic Surgery Unit, Fayoum General Hospital, Fayoum & board certified by European Board Of Plastic Reconstructive Aesthetic Surgery and affiliated researcher in Surgery Department, faculty of medicine, Cairo University.

Abstract:

Healing process is as vital as to lead all fields of surgery .Although it's full understanding is still ,but we can build our surgical practice up on established  basics .Factors affecting healing wither  local , general or technical factors must be address in total, prior to and while  we face or expecting to face wound problems or scars .[ A modified vision in regard to analysis and interaction between factors affecting healing can help to overcome some obstacles].Own body perception of the wound is important in leading the body to a suitable response which is variable according to the kind of tissue .So we can divide  the wound zone according to the perception of the body into two parts  ; perceived part and unperceived part ,hence the intervention for management will be different .Body perception depends on various mechanisms ,the most clear of them is humeral – neural mechanisms for homeostasis .So wound management can diverge widely into two directions ; passive management including just application of  topicals / some growth factors…etc ,and active management that includes using of different modalities with different levels of  invasiveness ;starting from VAC ,…etc .So , application of wound healing tools and products should be addressed in chronological stepped approach with respect to body response in order to avoid miss use of high technology modalities

Biography:

Abstract:

BACKGROUND:

Delivering healthcare using Robot Physicians is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships in ICUs. Our study assessed the nurse-physician collaboration satisfaction about care decisions from surgical intensive critical care nurses during Robot Physician night rounds in comparison with conventional telephone night rounds.

MATERIALS AND METHODS:

This study used a randomized trial to test whether Robot Physician enhances the nurse-ICU physician collaboration satisfaction about care decisions. ICU physician randomly used either the conventional telephone or the RP-7 robot (InTouch(®) Health,USA) to perform nighttime rounding in a surgical ICU. The Collaboration and Satisfaction about ICU Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of ≤0.05.

RESULTS:

From December 1, 2011 to December 31, 2015, 2000 off-shift nurses submitted 10600 surveys during telephone rounds and 10800 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (53 versus 50; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (91.0 versus 42.0; p >0.01), in comparison with telephone rounds (50.0 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone).

CONCLUSIONS:

Robot Physician rounding in the ICU was superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of ICU nurses contribute to the preference of night shift rounding method from the aspect of collaboration with the ICU physician about ICU care decision-making.

Biography:

M. Al azrak is a plastic surgeon, graduated in Faculty of Medicine, Cairo University , Egypt, in 2003 .After spending of Internship in Cairo University Hospitals, he started two years of residency in Trauma and Emergency Surgery Division , Fayoum General Hospital, Fayoum. Followed by two years of residency in General surgery department , Fayoum General Hospital .Then he moved to Kasr El Ainy School of Medicine - Cairo University, where he spent one year of residency in Burn and Plastic Surgery Unit , Surgery Department  and received Master of Surgery .Then he received residency for one year in Plastic Surgery Division ,General Surgery Department , Al Helal Specialized Hospital ( National Trauma Centre ) Ministry of Health & completed thesis in Flap Reconstruction of Post Burn Head and Neck Scar Contractures. He gained experience and wide access to surgical management of patients in rural hospitals, trauma & emergency , general surgery, diabetic foot management and wound healing in problematic situations .Starting from 2011 he became a  Plastic Surgery Specialist in Burn & Plastic Surgery Unit, Fayoum General Hospital , Fayoum & board certified by European Board Of Plastic Reconstructive Aesthetic Surgery and affiliated researcher in Surgery Department, faculty of medicine , Cairo University .

Abstract:

Back ground:

Management of diabetic foot is a mission challenged by physician from different specialties; Endocrinolists, podologists, general surgeons, vascular surgeons, Plastic Surgeons and in some instances, orthopedic surgeons & diabetic foot care trained nurses . Approaches are different according to the carried back ground and facilities  with the caring physician and hence the end result of management can be different .Application of plastic surgery concepts can influence the outcome as well as add to the management plane a more conservative approach and hence decrease tissue loss and avoid amputations in many instances .

Patients and methods :

 Ten patients with diabetic foot and soft tissue necrosis were subjected to  a more conservative approach based on keen debridement, combating infection  and  promoting wound healing for borderline tissues aiming at  decreasing loss and facilitating regeneration and repair .

Results :

Amputation was avoided in all cases and minimal tissue loss were achieved with conservation of the limbs and positive psychological implication upon the patients and regaining daily activities.

Discussion & Conclusion:

 It is found that approximately 85 % of lower extremity diabetic

amputations are preceded by a diabetic foot ulcer (DFU) and about 15 % of DFUs lead to amputation ⁽¹⁾ .Surgical care of diabetic patients means facing a diverse spectrum of foot disease. Considering that DFU can be a significant predictor of mortality in older patients as well as 68 % increase in mortality rate in five years after amputation in certain studies, 45% in other study⁽²⁾. Even after application of the five standard tenants of diabetic foot management; vascular and infection control, offloading, debridement and moist wound care, percent of cure in neuropathic ulcers in 12 weeks was 24 and 31 % of them healed at 20 weeks^(3,4).So plastic surgeon approach can minimize loss and provide healing promoters .

Biography:

Sathappan Subramanian has completed his MBBS from Madras University and MS (Otorhinolaryngology) from University Malaya, Kuala Lumpur. He is the Head of Division of Surgical Specialties at Cyber Jaya University College of Medical Sciences. He has published many papers in reputed journals.

Abstract:

ENT emergencies are very rare but it is important to recognize the common ENT emergencies. These emergencies can present as a result of infection, trauma, foreign bodies, or post-operative complications. These emergencies need proper clinical assessment and need urgent management. In this lecture, we will discuss the symptoms and signs of common ENT emergencies and appropriate initial management. Hence the junior doctors, nurses and allied health professionals will be ready to face the challenges in management of ear, nose and throat patients in emergency room.

Biography:

The development of late complete heart block is rare serious complication that requires life long follow up for patients at risk.

Increase awareness of this complication enable the physician to identify high risk group such transient heart block post surgery for more than 48 hours, prolonged PR interval post surgery,  evidence of Hiss bundle damage or  tri fascicular damage which can be suspected by change in QRS  morphology post surgery.

We believe that the development of complete heart block occurs more often than is generally realized for this reason patients with Down syndrome, AVSD,and post cardiac surgery should be considered to have a great risk of developing CHB, Realization of this risk will lead to early detection and promote treatment which may mean the difference between life and death for these patients

Abstract:

Late presenting complete heart block after pediatric cardiac surgery is rare complication and its management is controversial. In this report we described a child who underwent atrio-ventricular septal defect with normal sinus rhythm during post-operative period as well as during the first 2 years of follow up. She subsequently developed complete heart block with bradycardia that required pace maker insertion. The case discusses this unusual late-presenting complication, its possible risk factors and the management.

Biography:

Dr.Jaideep Kumar Trivedi after completing his MBBS and MS did MCh in cardiothoracic surgery in 2007 from Grant Medical College,Mumbai. He was awarded 1^st rank by the Mumbai university in MCh examination. He has published papers in national and international journals.Presently he is working as consultant cardiothoracic surgeon at Apollo hospital Vishakhapatnam, India. Till date he has performed more than 1000 cardiothoracic surgeries independently.

Abstract:

Liposarcoma is a malignant mesenchymal neoplasm, which is commonly seen in extremities and in retroperitoneum. The mediastinal location is extremely rare for this tumour, with the occurrence of pleomorphic variety of Liposarcoma being even rarer. We report a case of giant Pleomorphic liposarcoma in anterior mediastium extending into hemithorax on both sides innolving diaphragm, pericardium, anterior chest wall and compressing heart and both lungs which was successfully managed by complete surgical excision..

 Case report:

 A 39 year old male patient came to the outpatient department with progressively increasing breathlessness, chest discomfort, malaise and fatigue of 3 months duration.The radiograph of chest showed large ill defined radiodense opacity, centered at

mediastinum and extending into hemithorax on both sides.Patient was investigated CT scan ,MRI was done and surgery was planned. Surgery in a mass with such a extensive size

and invasion and maintenance of ventilation with such a limited capacity of lungs was a

big challenge for us. Surgical exploration was done by mid sternotomy and the mass was just below the sternum involving whole of the substernal space and pushing the heart downwards. Pericardium was opened from below, pericardectomy was done and plane of dissection was created. Mass was successfully excised in toto along with pericardium. The total dimensions of the mass measured 34x26x17cm, weighing 4Kg. Both lungs got nicely inflated ,patient was overnight ventilated and extubated next morning.Postop recovery was uneventful and patient was discharged on day5.Pathological examination of the surgical specimen suggested

 Pleomorphic liposarcoma. Patient was given adjuvant chemotherapy. No evidence of

 recurrence after 6 months.

Conclusion:Mediastinal liposarcomas constitute a very rare variety of mediastinal tumours. Surgical  removal is the optimal treatment for a mediastinal liposarcoma, as in other sites. If the entire tumor cannot be resected, surgical debulking often results in symptomatic relief.

 Radiotherapy and chemotherapy may be added as adjuncts to surgical excision but  liposarcomas seem to have low sensitivity. Recurrence is common in deep-seated liposarcomas and it becomes apparent within the first 6 months in most cases.Recurrence is related to the incomplete excision and tumor tissue left behind at the time of surgery. Hence complete surgical excision and close follow-up is recommended.

Biography:

Minyoung Kim has completed her Ph.D. at the age of 34 years and Assistant Professor from Ulsan University School of Nursing. She is the Adult Health advanced practice nurse for 10years. And she has published 9 papers in reputed journals.

Abstract:

Postoperative delirium has increased recently along with the aging population. Vascular surgery has been reported to be associated with a high incidence of postoperative delirium. We evaluated the incidence and the risk factors of postoperative delirium after vascular surgery. Methods: 212 patients who underwent vascular surgery in hospital during 3 years were retrospectively analyzed. Incidence, onset, duration, and risk factors were analyzed. Results: Mean age was 67.2 (SD ± 10.4) and male were 84.0%. Postoperative delirium was developed in 56 patients (26.4%) mostly on the day of operation and postoperative day one (range 0-3). Mean duration of delirium was 2.2 days (1-7). Logistic regression analysis identified the following risk factors; old age (OR; 1.107, 95% CI; 1.043 to 1.174; P=.001), hearing impairment (OR; 14.915, 95% CI; 1.350 to 12.615; P=.027), low physical activity (OR; 3.294, 95% CI; 1.129 to 9.609; P=.029), pain score (OR; 1.629, 95% CI; 1.095 to 2.423; P=.016), low serum albumin (< 3.2 g/dL) (OR; 3.409, CI; 1.206 to 9.634; P=.021), low serum cholesterol (< 120 mg/dL) (OR; 3.118, CI; 1.202 to 8.086; P=.019). Conclusion: The incidence of delirium presents in more than a fourth of all vascular surgery cases. The vulnerable population with delirium can be identified pre- or immediate post-operatively based on the study result.

Biography:

Nirvana Ahmed Elshalakany has completed my PhD at the age of 25 years and my master degree at the age of 29 years and M.D at the age of 35 years all from faculty of Medicine Ain shams university . Head of anaethesia, faculty of medicine, October six University.

 I has published a lot of papers and articles in reputed journals and has been serving  in teaching critical care theories in faculty of physiotherapy October six Univeristy.

Abstract:

Objectives: Regional anaesthesia is considered the optimal technique for obstetric patients; nevertheless, the optimal method of regional anaesthesia for delivery remains to be determined. In our study we investigate the safety, efficacy and cost benefits of single-dose spinal analgesia in comparison to epidural analgesia during labour.

study design: In our study women in advanced labour were randomly allocated into two equal groups using a computer-generated randomization table, one group (spinal group = S group) were given 3.75mg hyperbaric bupivacaine + 25ug fentanyl with 0.75ml saline, the other group (Epidural group = E group) were given 4ml bupivacaine with 4ml saline and 1ml (50ug) fentanyl Pain intensity was recorded by the parturient on a visual analogue scale. The quality of pain relief was

also rated with a verbal score directly after delivery. Side effects, such as hypotension, Pruritus, sedation, nausea and motor block were noted. Obstetric

Parameters were followed and recorded, Apgar score were noted, and all the results were compared in the two groups.

Results: onset of sensory block (detected by pin- prick test) was early (4.4±1.5 min Vs 12.5±2.3 min, p<0.001) and duration of sensory block was longer (120.4±15.6 Vs 103.2±18.3 min, p<0.001) in S group compared to E group, time to reach maximum dermatome level of sensory block (T₁₀) was shorter in S than E group   (8.3±2.4min Vs22.4±5.7min , p<0.001), two segment regression occur late in S group compared to E group(75.6±12.5 min Vs 66.3±9.4 min , p<0.001)  . Visual analogue scores after 5, 15, 30, 60, 90, 120 and 150min were lower in S group compared to E group, all the previous result is statically significant (p<0.001). 88%of the parturients in S group VS 60 % in E group scored the analgesic quality as excellent, the mean duration of analgesia (Mean±SD) was longer in S group compared to E group. 8% of parturients in S group Vs 14% of parturients in E group had hypotension. Motor block, sedation and nausea were 2-6% in both groups. Pruritus was seen in 60 % In E group VS 25% in Spinal one. No caesarean section was performed. Vacuum extraction was done in 15% Vs 25% among S group and E group respectively. Oxytocin augmentation was needed in 48% Vs62 %of the parturients among S group and E group respectively. Fetal heart rate disturbances following the spinal block were seen in 2 cases. Apgar score were high and No neonate had Apgar score <7 in both group. The overall cost was lower in S group compared to E group.  

Conclusions: Based on the results of our study we concluded that single dose Spinal analgesia is a good alternative to Epidural analgesia in controlling labour pain i.e. spinal compared to epidural is more easy performed, faster, less expensive ,and provide effective analgesia.

Biography:

Dr Saloni Bansal is one of the youngest, dynamic, enthusiastic and devoted assistant Professors of the Department of Obstetrics and Gynaecology  in the only second women medical college of India. She has been studious and meritorious all through her  career having received scholarship for sporty activities and appreciation awards for academic achievements during secondary education. Graduated from a reputed institute of the area with accolades in the form of glittering gold and silver medals and is one of the few postgraduates  from the premier Institute of India: All India Institute of Medical Sciences, New Delhi. Her thesis titled   ‘Role of Doppler in patients with IUGR, those with non-reactive NST-a comparison with biophysical profile’ is considered as the most relevant contemporary topic. Also an active participant of the ongoing research activities, she has  presented papers at various National level conferences and  been awarded first prize for the best presentation in one of those. With numerous international publications to her credit, she is also one of the co-authors of an editorial of an international journal as well as a reviewer.

Abstract:

Laparoscopic tubal ligation is one of the most commonly performed sterilization procedures offering advantages like a high success rate and early return to normal activity, but the appropriate anaesthetic technique has not been defined. Pain in laparoscopic tubal ligation is mediated through the release of prostaglandins from the traumatized  tubes which causes uterine contraction and crampy lower abdominal pain. To provide adequate anaesthesia and relaxation with minimal side-effects, drug has to be short acting, but with appropriate duration of action. There are various scales available for pain assessment, most reliable being visual analogue scale. Another behavioural rating scale for those unable to provide a self-report of pain. It is based on clinical observation and scored from  0–10.

Apart from minor side-effects like nausea, vomiting and dizziness the reported case-fatality rate for tubal sterilization is 3.6/100,000 procedures with general anaesthesia. Local anesthesia with sedation, has also been suggested as another anaesthetic technique but its effectiveness has still been a questionmark. May be the quality of anesthesia is unsatisfactory due to discomfort and contraction of abdominal muscles, but it offers the advantage of patient being awake, oriented, breathing spontaneously and fast-tracks recovery which is the main aim of day care laparoscopic tubal ligation. Hence the choice of anaesthesia should be individualized, based on anesthetic and/or obstetric risk factors and patient preference.

Present study aims to evaluate the role of intravenous paracetamol, as an effective analgesic. Paracetamol is a reliable option with a pharmacokinetic profile which is linear up to 2 g after single administration.The maximal plasma concentration (Cmax) of paracetamol is observed at the end of 15-minutes of  intravenous infusion which is 30μg/mL. Plasma half-life being  2.7 hours. Since paracetamol’s side effect profile is considerably superior, it is preferable over usual analgesics like opiates and non-steroidal anti-inflammatory drugs.

Biography:

Asem Anwar has completed his combined supervised MD thesis  at the age of 35 years from both Alazhar School of Medicine and Glasgow universities.
He is professor of obstetrics and gynecology at Alazhar School of Medicine Since 2002Ex Director of the maternity university hospital [Syed Galal ]Cairo-Egypt

Abstract:

Adhesion formation after abdominal or pelvic surgery is a common post-surgical complications and the consequences are a considerable burden for patients, surgeons and the entire health system.

This Cross sectional study was carried out among Egyptian pregnant women to assess the value of abdominal scar characteristics in predication of intraabdomonal and pelvic adhesions at repeat C-Sections

One hundred pregnant women  with one or more previous C-section were enrolled for the study.

The results showed that ladies with depressed scar were more likely to have dense abdominal and pelvic adhesions and more than 60% of those with more than 2 sections had combined dense adhesions at different sites of pelvis and abdomen. 

Biography:

Rajiv Mahendru  possessed Post-Graduate Degree in Obstetrics and Gynaecology from Himachal Pradesh University at the age of 29 years and became one of the youngest Professors. Presently, Head of the Department in the only second women medical college of India. He has 41 Publications in reputed journals and is the recipient of a prestigious Award for excellence in Medical field. Appointed as the Chief-editor of the  Special issue of an international journal of repute and has numerous presentations to his credit at international arena as an invited Guest Speaker. He is the member of editorial board of international journals, Academic Board of many universities, member of recruitment for medical teachers, and assessor for establishing Medical colleges. He has chaired numerous sessions in the National and International conferences. 

Abstract:

OBJECTIVE: To compare the effectiveness of preoperative vaginal preparation with saline and povidone iodine on postoperative infectious morbidity after total abdominal hysterectomy .

STUDY DESIGN: Randomized controlled trial consisting of 191 patients allocated into two groups: Group I and Group II of 94 and 97 patients, respectively

MATERIAL AND METHODS: Preoperative vaginal douching 12 hours before the surgery was done with 1 % povidone iodine for patients in group I and with normal saline for patients in group II. The main outcome measure was infectious morbidity within 6-8 weeks postoperatively requiring additional antibiotics, prolonged hospital stay or readmission.

RESULTS: The relative risk for infectious morbidity in group A was less compared to group II (8% vs 22% ). The mean duration of hospital stay was also less in Group I.

CONCLUSION: Preoperative vaginal douching with 1 % povidone iodine significantly reduces infectious morbidities after abdominal hysterectomy in immediate postoperative period as compared to vaginal douching with saline.

Biography:

Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of
Medicine, Ulsan, Korea
Corresponding Author: Yong-Soon Kwon, MD.
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, Republic of Korea

 

Abstract:

There are few methods to control heavy bleeding intra-operatively during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation is previously mentioned in the literature and a good method to control uterine bleeding intra-operatively, quickly, and safely. The TOUA was performed in two cases of cesarean delivery with placenta previa totalis to reduce intra-operative complication safely, especially intraoperative heavy bleeding.  In the two cases, cesarean deliveries were safely finished without any complications under TOUA method.

TOUA can be a good method to control intra-operative heavy bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.

Key words: TOUA, placenta previa, heavy bleeding

Biography:

Prof. Yong-Soon Kwon’s specialty, is one of the most common diseases among females worldwide, there are few types of treatment paradigm. Thankfully, Prof. Yong-Soon Kwon has developed a new approach to cure uterine fibroids. This has led many patients from all over the country to see Prof. Kwon in the OB/GY clinic at Ulsan University Hospital. Groups of patients from the USA and around Asia were greatly impressed by his research results and flew to Ulsan.

Abstract:

Background:
To introduce the safe and effective surgical technique of laparoscopic adenomyomectomy with transient occlusion of uterine arteries (TOUA) in patients with symptomatic uterine adenomyoma.

MATERIALS AND METHODS:

In a prospective case study, we examined all cases of laparoscopic adenomyomectomy with TOUA performed by a single surgeon at Ulsan University Hospital, Ulsan, Korea, between May 2011 and February 2014. Surgical outcomes included operative time, intraoperative injury of blood vessels, nerves, and pelvic organs, as well as intraoperative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia and the recurrence of adenomyomic lesions by ultrasonography at the 6-month follow-up after laparoscopic adenomyomectomy with TOUA.

RESULTS:

Seventy-one women who were refractory to medical treatment or who wanted surgical treatment for preserving their uterus underwent laparoscopic adenomyomectomy with TOUA using an endoscopic vascular clip. The mean age was 42.9 ± 5.35 years (mean age ± standard deviation). The mean diameter of the adenomyomas was 3.2 ± 2.16 cm. The mean operation time, and hospital stay were 84.09 ± 31.48 minutes and 5.42 ± 1.54 days, respectively. The mean estimated blood loss was 184.35 ± 134.25 mL, and no injury to the uterine arteries or pelvic nerves occurred. No cases of conversion to a laparotomy or major complications occurred. At the 6-month follow-up, complete remission of dysmenorrhea and menorrhagia occurred in 94.5% and 86.5% of patients, respectively.

The mean follow-up period is 18.7 months. During this period, recurrence rate is 5 cases (7%) and one of these 5 recurred cases was undertaken the operation (laparoscopic hysterectomy).

CONCLUSIONS:

Laparoscopic adenomyomectomy with TOUA could be a safe and effective surgical method for women with symptomatic uterine adenomyoma who want to preserve their fertility.

Key words: uterine adenomyoma, Laparoscopic adenomyomectomy, transient occlusion of uterine

Biography:

Sathappan Subramanian has completed his MBBS from Madras University and                  M.S ( Otorhinolaryngology) from  University Malaya , Kuala Lumpur. He is the Head, Division of Surgical specialties, at Cyber Jaya University College of medical sciences. He has published many papers in reputed journals

Abstract:

Nasal glamangioma is a painful swelling that appears in the septum. But most of the Glomangioma is a painful, tumor that appears as a solitary encapsulated nodular mass, almost always on the skin. The case of nasal glomangioma was rarely reported. We present a new case of glomangioma of the nasal septum in a 38-year-old woman. The tumor is removed via an intranasal excision under general anesthesia. No recurrence was found at 2 years of follow-up. Other differential diagnosis which include a true hemangiopericytoma and a paraganglioma. We describe the histopathlogical feature of this tumor and briefly review the literature.

Biography:

Dr Saw Khay Yong is a Consultant Orthopaedic Surgeon at the Kuala Lumpur Sports Medicine Centre in Kuala Lumpur, Malaysia. He completed his Masters in Orthopaedic Surgery (MCh Orth) at Liverpool University Medical School, UK in 1993. His specialisation in orthopaedic sports medicine includes knee joint arthroscopic surgery with application of stem cells for chondrogenesis together with bone and soft tissue regeneration. He has received numerous awards in the field of regenerative medicine for knee cartilage injuries. Other than his patent and publications in the field of peripheral blood stem cells for musculoskeletal regeneration, he regularly shares his experience and knowledge at local and international conferences and events as an invited speaker.

Abstract:

Musculoskeletal related injury is a common occurrence. In many cases the damage is permanent and can adversely affect a person’s quality of life. Now with advancing medical technology, the solution may lie in biologic therapy. In our centre, Kuala Lumpur Sports Medicine Centre, peripheral blood stem cells (PBSC) have been clinically proven to enable regenerative repair in cartilage. The science, surgical technique, harvesting and storage of PBSC and the post-operative rehabilitation programme that encompasses this therapy have sequentially been developed to maximise the chances of high quality cartilage regeneration and repair. As PBSC has been reported to contain pluripotent cells, it offers the tantalising promise of a solution to promote healing in the treatment of complex cases. This presentation highlights the successful cases, among many, in musculoskeletal system repair.

Biography:

Rusnani Ab Latif has in progress completed her PhD from Malaysia at University Teknologi MARA. She is the nurse educator from nursing college. She has published 2 papers journals related with her thesis.

Abstract:

Mothers of infants admitted in SCN are believed to have heightened distress especially when their infants were premature and low birth weight that required hospitalization. This will causes psychological distress and depression for the mothers. A cross-sectional study to investigate the psychological well being of mothers with low birth weight infants admitted to the SCN. It was conducted on one hundred and thirty (n=130) of mothers who delivered their babies at labor room, HRPZ II, Kota Bharu, Kelantan.  Depression Anxiety Stress Scale (DASS-21) score were used. Data were analyzed using the Chi-square tests. Statistically significant with p-value < 0.05. Maternal age was statistically significantly associated with anxiety (χ²=22.106, p=0.036) and stress (χ²=17.509, p=0.041) by using Chi Square test. No significant association between maternal age and depression (χ²=10.373, p=0.321). For others demographic variables, there is no statistically significant (p>0.05) with depression, anxiety and stress of mothers. In summary, in this study researcher found that there was a statistically significant association between maternal age with anxiety and stress. Based on the finding in this study, most of the respondent’s having anxiety compared with depression and stress. It becomes stressful event that might cause psychological distress or even emotional crisis in mother’s when their infants were premature that required in Special care Nursery (SCN). Nurses must have critical thinking such as determining what psychosocial variables affect maternal health behaviors; intervention programs designed to promote healthy behaviors can be developed. The implementation of the program of psychological intervention in the neonatal unit aimed at encouraging mothers to express feeling and expenses incurred by them express their feelings are recommended.

Biography:

Chris completed Diploma in RN (1980), Diploma in ICN (1983), and Diploma in RM (1993) from Kenya Medical training College, Nairobi; CertHSM (International) from Birmingham University (1996); BScN from American World University (2005); and is perusing MS International Management (Health Systems) with research interest in migration of health workers. He became Chief Nursing Officer in 2006 retiring as Director Nursing Services from Ministry of Health, Kenya, in 2015, after initiating several nursing skills development programs. He has made 9 international publications and several presentations in local and international conferences including participation in 6 WHAs and development of Global Code of Practice for international Recruitment of Health Workers

Abstract:

Sub-Saharan Africa (SSA) is well-known for communicable disease outbreaks such as malaria, HIV and AID, cholera and more recently Ebola. It is also famous for high infant/child and maternal mortalities. Resent literature shows steady rise in NCDs as lifestyle in SSA Region changes to western style. How well SSA is preparing to effectively handle the emerging double burden of disease remains a fundamental question. Although less quantified and less published, surgical healthcare in most parts of SSA is still wanting.   

SSA poor health systems is characterized by acute shortage of human resources for health, inadequate medical supplies, sparsely distributed health facilities, and management inefficiencies  that is epitomize by predominantly low life expectancies that is also facilitated by poor housing, poor road infrastructure, inadequate and poor transport systems, inadequate availability of foods and rampant famine.

In this scenario SSA lacks most of essential healthcare skills and competencies such as the ones intended to be discussed and promoted in this conference. Available skills are far too inadequate and poorly distributed to reach every part of the population. Thus patients in SSA suffer from inadequate access to quality healthcare. Yet able patients access quality healthcare by seeking highly expertise services abroad.

This paper therefore intends to explore medical-surgical nursing and its specialised sub-skills relevant in changing the quality and quantity of healthcare in SSA region. It explores availability, challenges, potentials, and the roles Africa and the World should play to ensure that nurses effectively contribute to improved healthcare in sub-Saharan Africa region, especially for women and children.  

Biography:

Sathappan Subramanian has completed his MBBS from Madras University and MS (Otorhinolaryngology) from University Malaya, Kuala Lumpur. He is the Head of Division of Surgical Specialties at Cyber Jaya University College of Medical Sciences. He has published many papers in reputed journals.

Abstract:

ENT emergencies are very rare but it is important to recognize the common ENT emergencies. These emergencies can present as a result of infection, trauma, foreign bodies, or post-operative complications. These emergencies need proper clinical assessment and need urgent management. In this lecture, we will discuss the symptoms and signs of common ENT emergencies and appropriate initial management. Hence the junior doctors, nurses and allied health professionals will be ready to face the challenges in management of ear, nose and throat patients in emergency room

Biography:

Matina Kampra is a Jurist, with MSc in Social Science and Health Research (University of Newcastle upon Tyne, UK) and a PhD from the National & Kapodistrian University of Athens, School of Medicine. She works at the Internal Unit of the Ministry of Health in Greece. Her publication refers to the discipline of epilepsy and education.

Abstract:

Introduction: It is well documented that epilepsy is a disorder which carries the burden of its nature. Not only does it affect the patients’ life, but their socials’ as well. With regard to children and youth with epilepsy during their school years, it is very important for their teachers to have an expert’s advice on the management of several issues raised during the school day.

Aim: A survey was conducted to explore teachers’ perceptions about the school nurse’s role, especially when there were children with epilepsy (CWE) in their school.

Methods: A total of 70 head-teachers of regular schools from all Greek counties were phone-interviewed with open-ended questions. The data were grouped and analyzed in depth.

Results: Of the 70 interviewed head-teachers, 68 insisted that schools need nurses (amongst other experts). 65 recognized that the role of the school nurse encompasses both educational and health goals. 67 insisted that school nurses could become a liaison between schools, family, health care professionals and the CWE. 66 referred to the nurses’ role for health policies and programs. 69 underlined the school nurses’ direct care to CWE.

Conclusion: The existence of school nurse was found to be essential for the Greek teachers especially in the case of CWE, since their absence was considered crucial. An urgent need was raised for the authorities to provide the regular school personnel with nurses in order to offer information and assistance in health matters, to promote health and safety and to collaborate with teachers and family for the pupils’ wellbeing.

Biography:

Supawan Tanupabrungsun has completed her Bachelor of Science in Nursing from Mahidol University, Thailand and Master degree in Physiology from Chulalongkorn University. Since 1986 – 2016, she is instructor in the field Fundamental and Med-Surg. Nursing department at Faculty of Nursing, Saint Louis College, Thailand.

Abstract:

In an effort to help nursing students develop self -efficacy. Using meditation is the most importance to help them. This study integrates the concentration-base-learning (CBL) technique to the professional nursing education. We develop a new technique by integratingSKT1 and The Four Foundation of Mind fullness a Buddhist meditation technique.

  Objective: This research aimed to study the effects of meditation practices on academic achievements, mental abilities and self-awareness in second year nursing students at Saint Louis College.

 Methodology:  This a quasi-experimental study with pre- and post-test research design. The subjects of 86 students were assigned to either control or treatment group by using stratified sampling strategy based on the pre-test scores. The first outcome, academic achievement, was simply measured with the four-point grading scale. The other two outcomes were measured with the evaluation forms, in which were assessed by three experts with .904 reliability score. The data was analyzed with a series of paired t-tests and presented with descriptive statistics.

Result: The result revealed the significant differences in mental abilities and self-awareness between the two groups. Specifically, the treatment group had higher average score of mental abilities and self-awareness.

Recommendations: The findings revealed that using meditation could effectively to promote mental ability and self-awareness. So, this intervention should be used in all students

Biography:

Mohammed Al Azrak is a Plastic Surgeon, graduated in Faculty of Medicine, Cairo University, Egypt, in 2003. After completing internship in Cairo University Hospital, he started two years of residency in Trauma and Emergency Surgery Division, Fayoum General Hospital, Fayoum, followed by two years of residency in General Surgery department, Fayoum General Hospital. He then moved to Kasr El Ainy School of Medicine - Cairo University, where he spent one year of residency in Burn and Plastic Surgery Unit, Surgery Department and received Master of Surgery. Then he received residency for one year in Plastic Surgery Division, General Surgery Department, Al Helal Specialized Hospital (National Trauma Centre) Ministry of Health & completed thesis in “Flap Reconstruction of Post Burn Head and Neck Scar Contractures”. He gained experience and wide access to surgical management of patients in rural hospitals, trauma & emergency, general surgery, diabetic foot management and wound healing in problematic situations. Starting from 2011, he became a Plastic Surgery Specialist in Burn & Plastic Surgery Unit, Fayoum General Hospital, Fayoum & board certified by European Board of Plastic Reconstructive Aesthetic Surgery and affiliated researcher in Surgery Department, Faculty of Medicine, Cairo University.

Abstract:

Healing process is as vital as to lead all fields of surgery. Although it's full understanding is still, but we can build our surgical practice up on established basics. Factors affecting healing either local, general or technical factors must be addressed in total, prior to and while we face or expecting to face wound problems or scars. A modified vision in regard to analysis and interaction between factors affecting healing can help to overcome some obstacles. Own body perception of the wound is important in leading the body to a suitable response which is variable according to the kind of tissue. So, we can divide the wound zone according to the perception of the body into two parts; perceived part and unperceived part, hence the intervention for management will be different. Body perception depends on various mechanisms and the most clear of them is humeral – neural mechanisms for homeostasis. So, wound management can diverge widely into two directions; passive management including just application of topicals/some growth factors, etc., and active management that includes using of different modalities with different levels of invasiveness; starting from VAC, etc. So, application of wound healing tools and products should be addressed in chronological stepped approach with respect to body response in order to avoid miss use of high technology modalities.