Pathological and Etiological Aspects of Nephrotic Syndrome at the Niamey General Reference Hospital

Introduction: Studies have been conducted on nephrotic syndrome in Niger. The study aimed to determine the histological and etiological aspects of nephrotic syndrome. Patients and Method: This was a retrospective study from February 1st, 2018 to January 31st, 2024. All patients with nephrotic syndrome who underwent renal biopsy were included. Samples were analyzed at the anatomy-cytology pathology laboratory of the Faculty of Medicine in Dakar (Senegal). The variables studied included clinical, biological, histological and etiological characteristics. Data were analyzed using Excel 2013 and Epi-info 7.2.0 software. Results: The study included 119 patients with nephrotic syndrome. Prevalence of nephrotic syndrome was 11.24%. The male-to-female ratio was 2.25:1. The mean age at diagnosis was between 34.5 ± 18.84 years. Edema was the reason for admission in 40.34% of cases. The nephrotic syndrome was impure in 63.86% of cases. Nine histological lesions were identified. Focal and segmental glomerulosclerosis (40.09%), minimal change disease (23.53%), membranous nephropathy (13.45%), diabetic nephropathy (10.92%), membranous proliferative glomerulonephritis (3.36%), acute glomerulonephritis (3.36%), glomerular thrombotic microangiopathy (2.52%), non-IgA mesengial proliferative glomerulonephritis (1.68%) and amyloidosis (0.84%). Nephrotic syndrome was primary in 57.98% of cases. Secondary etiologies were dominated by diabetes (11.76%), followed by hepatitis B virus (9.24%), lupus, lymphoma, malaria, syphilis, cryoglobulinemia, sickle cell disease and HIV. Conclusion: Future studies should investigate the causes of glomerulopathy secondary to chronic tubulointerstitial lesions.

Management Measures for Preventing Postoperative Incision Infections in General Surgery at Primary Hospitals

Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.

A Comparative Analysis of the Control Effect of Medical Expenses between General Hospitals and Traditional Chinese Medicine Hospitals from 2012 to 2021

Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.

A qualitative study on nurses'reactions to inpatient suicide in a general hospital

Aims:To explore the impact of inpatient suicides on nurses working in front-line,the patterns of regulation and their needs for support.Methods:Data were collected through purposive sampling by conducting semi-structured and individual in-depth interviews in a tertiary referral hospital in China.Colaizzi's sevenstep phenomenological method was simultaneously used by two interviewers.Results:Reactions to inpatient suicides revealed three central themes:(1)inpatients were highly likely to commit suicide,(2)inpatient suicide was difficult to prevent,and(3)nurses lacked the necessary suicide prevention skills.Psychological responses mainly included shock and panic,self-accusation or guilt,sense of fear,and frustration.The impacts on practice were stress,excessive vigilance,and burnout.Avoidance and sharing of feelings played key roles in the regulation patterns of nurses.Conclusions:Nurses who experienced inpatient suicide became stressed.Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide.The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals.Such information can be used to develop effective strategies and provide individual support and ongoing education.Consequently,nurses will acquire suicide prevention skills and help patients achieve swift recovery.

Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals:A scoping review

Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.

Application of refined management in prevention and control of the coronavirus disease 2019 epidemic in non-isolated areas of a general hospital

Objective:This article summarizes the experience in the prevention and control of coronavirus disease 2019(COVID-19)epidemic in non-isolated areas in a general hospital.Methods:Based on refined management theory,we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas,systematically implemented various prevention and control measures,performed gridding audits,effectively communicated among teams and between medical staff and patients assisted by information techniques,and reported results for quality improvement.Results:There was no hospital-acquired COVID-19 infections among staff in the hospital.The rates of mask-wearing,epidemiological history screening,and the medical supplies disinfection were all 100%in the hospital.The accuracy rate of mask-wearing of patients and their families was 73.79%and the compliance rate of their hand hygiene was 40.78%.Conclusion:Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective.The accuracy rate of mask-wearing and hand hygiene compliance of patients and their families need to be further improved.

Fever Outpatient Service of General Hospital Applies “1 + 3 + 3” Emergency Management Mode to Deal with COVID-19 Pandemic

Purpose: To discuss the effect of “1 + 3 + 3” emergency management mode to deal with COVID-19 pandemic in fever outpatient service of general hospitals. Method: This paper analyzes and summarizes the problems encountered by fever outpatient service in dealing with the COVID-19 pandemic from three aspects of “One Team”, “Three-Key” Control and “Three Mosts”. Results: The application of “1 + 3 + 3” emergency management mode can effectively boost the orderliness and efficiency of fever outpatient service in dealing with COVID-19 pandemic. Conclusion: The “1 + 3 + 3” emergency management mode provides a new management mode and idea for dealing with COVID-19 pandemic, so the fever outpatient service of general hospitals can better improve the national overall anti-pandemic situation.

A survey on 564 cases of inpatients with anxiety and depression in general hospitals in 2015

Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients from the Third Affiliated Hospital of Inner Mongolia Medical University were selected during January to June of 2015. Patients were assessed for anxiety and/or depression by use of Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAMAS) and Hamilton Depression Scale (HAMDS). Meanwhile, final diagnosis was made on the basis of diagnostic criteria listed in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Results: In different departments, the positive rate (HADS ≥ 8) was the highest in Department of Oncology (45.42%), and the lowest in Department of Gastroenterology (16.05%). After assessment with the help of HAMD and HAMA, the prevalence of anxiety/depression was the highest in Department of Oncology (46.43%), and the lowest in Department of Gastroenterology (16.05%). There was no statistical significance in diagnostic results acquired from HAMD and HAMA (p = .071). Two types of diagnostic methods were highly consistent (κ = 0.852, p = .000). Inpatients aged from 40 to 59 years, with junior high school education or below, very tiring work, poor marital status (separated, divorced, widowed), unharmonious family, low personal income, completely self-paying and family history of anxiety and depression, currently unable to take care of themselves were more prone to anxiety and depression (p < .05). Conclusions: The prevalence of anxiety and depression in medical patients in general hospitals is high due to many influencing factors. It is necessary to establish an effective diagnosis and treatment system for anxiety and depression, in order to make patients easy to receive an early and comprehensive treatment and improve their life quality.

Study of Sound Environment Influenced by the Crowd in Waiting Areas in General Hospitals

In this study,the crowd has been investigated and analyzed in waiting areas in large general hospitals in China in order to find the rules the variations of sound environment with the change of crowd. The field investigation,questionnaire,field-testing and computer simulation have been adopted. The results show that: the social /demographic characteristics of staff and patients are not significantly related to the satisfaction evaluation of sound environment; there is a significant correlation between the population density and LAeq of the background noise in waiting areas; when population density is 0,the LAeq of background noise is not 0 in waiting areas; the loudspeaker should be set in the waiting areas. Loudspeaker arrangements should be integrated into the ceiling lamp or construct facilities along the depth direction of the layout,and the two adjacent speakers recommended distance should be controlled at about 4 m. If the population density is controlled in the reasonable range,and sound absorption,noise reduction processing and electronic queuing system are adopted,sound environment of waiting areas will be built with noise interference relatively small in different population densities.

Characteristics of and management strategies for 54 suicidal inpatients in a general hospital

Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a patient safety adverse event network reporting system during hospitalization in a general hospital from November 2008 to January 2017.Results： Subjects who committed suicide in the general hospital were women and those who suffered from malignant neoplasms during general hospital treatment. Furthermore, most of the patients who committed suicide used more violent suicide methods. The most common and lethal means was jumping from heights at the windowsill.Conclusions： It is concluded that management straties for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment. It is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.

Prof. Peter Wiedemann,President of ICO/General Advisor of IJO,visited IJO Press and Xijing Hospital in Xi’an,China on 19th Nov. 2019

Warmly welcome Prof.Peter Wiedemann(middle),President of ICO/General Advisor of IJO to visit IJO Press Prof.Peter Wiedemann gave some guidance to IJO,recognized that it is a high-quality academic journal,and expected that it will make a greater contribution to the world ophthalmology.

Mediating effect of work engagement between job characteristics and nursing performance among general hospital nurses

Objective:This study aimed to determine the effects of job characteristics and work engagement on the nursing performance of nurses working in general hospitals.Methods:Data were collected from 169 nurses who are working in a general hospital in South Korea by using a cross-sectional descriptive survey design.Results:Nurses’job characteristics and work engagement showed positive effects on nursing performance.This effect was magnified when work engagement was used as a mediating variable.Conclusions:The findings elucidate the factors influencing job performance and provide managers with important information for developing programs to improve the job skills and work engagement of nurses.

Magnetic Resonance Imaging of Osteo-Articular System at the Douala General Hospital

Objectives: Osteoarticular pathology has benefited greatly from MRI. This modality was only recently introduced in our country and its implantation is still rare. The objective of this study was to evaluate the practice of MRI of osteoarticular system in Douala General Hospital. Method: It was a cross-sectional descriptive study during a five-month period from May to September 2017 involving all patients referred to the Imaging Department of the Douala General Hospital for osteoarticular MRI. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using axial, sagittal and coronal slices in T1-weighted, T2-weighted proton density. T1 gadolinium or water-fat saturation (WFS) slices were obtained after injection of a contrast agent (Dotarem). Collected data were analyzed using SPSS v20 and Microsoft Excel 2010 softwares. Results: 34 patients were enrolled in this study;osteoarticular MRI accounted for 12% of the activity behind MRI of the spine (40.4%) and the brain (42.5%). The mean age of patients was 37.6 ± 13.1 years with extremes between 6 and 61 years. There was male predominance with a sex ratio of 1.83. Trauma (44.2%) and pain (42.1%) were the most common indications. MRI of the lower limb (85.3%) and more particularly of the knee (68.9%) was more frequently performed than that of the upper limb (14.7%). Orthopedic surgeons (38.2%) and rheumatologists (26.5%) were the main referral physician. 73.5% of request’s forms did not conform to the eight compliance criteria according to the recommendations of French National Agency for Accreditation and Health Evaluation. Most of the examinations (94.1%) were performed without the injection of contrast agent (Dotarem). 97% of MRI was pathological. Traumatic pathologies (39.4%) were most frequent and concerned the knee (27.3%) and the ankle/feet (12.1%), followed by the degenerative pathologies (21.2%) which concerned the knee (18.2%) and hip joints (3%), inflammatory pathologies (12.1%) reaching the shoulder (9.1%) and wrist/hand (3%) while tumoral pathologies (6%) were reaching the knee (3%) and the leg (3%). Conclusion: The MRI of the osteoarticular system is quite common, ranking third after the MRI of the spine and the brain. This study showed that MRI has a significative impact on diagnosis of osteoarticular diseases whit a concordance of 97% with clinic.

Attitudes of General Hospital Staff towards Persons with Mental Illness: Associations between Place of Training, Ethnicity, and Type of Profession

Objective: Persons with mental illnesses (PMI) commonly report encountering discriminatory attitudes and behaviours by Health Care Professionals (HCPs) involved in their care. Such stigmatising attitudes and behaviours may affect recovery rates and erode quality of care provided by these HCPs. We assess attitudes of HCPs towards PMI in a tertiary general hospital in Singapore. Methods: An anonymised online questionnaire was sent to HCPs working in the hospital. Attitudes were assessed using the Opening Minds Stigma Scale for Healthcare Professionals (OMS-HC), with responses rated on a 3-point Likert scale. Results: Doctors and Chinese staff trained locally were significantly more likely to feel more comfortable treating persons with physical than psychiatric problems, whereas Indian staff were less likely to express such reservations. HCPs generally accepted physical complaints at face value, while nurses tended to adopt critical attitudes toward patients and negatively perceived the utility of psychiatric treatment. For instance, nurses were more likely to judge persons with mental illness as not trying hard enough to get better, while admitting to having difficulty feeling compassion for those with psychiatric problems. Staff who received undergraduate and postgraduate training overseas were more likely to develop favourable attitudes toward PMI. Conclusions: The study has uncovered gaps in the understanding of mental disorders and their treatment. These knowledge deficits should be rectified so as to reduce negative attitudes toward PMI.

Nurses Opinions Regarding Delirium Care in the Older General Hospital Population and in Older Cardiac Surgery Patients Specifically: A Multicentre Survey among Dutch Nurses

Background: Delirium is a high prevalent postoperative complication in older cardiac surgery patients and can have drastic consequence for the patient. Preventive interventions, diagnosis and treatment of delirium require specialized knowledge and skills. Objective: To gain insight in the current opinion and beliefs of nurses in hospitals concerning prevention, diagnosis and treatment of delirium in older hospital patients in general and specifically in older cardiac surgery patients. Methods: In a cross-sectional study from February to July 2010, we distributed a survey on beliefs on delirium care among 368 nurses in three hospitals in the Netherlands, in one hospital in all wards with older patients and in two hospitals in the cardiac surgery wards only. Results: Although in literature incidence rates up to 54.9% in cardiac surgery patients in hospitals are reported, with a response rate of 68% (250), half of the nurses believe that the incidence of delirium is not even 10%. Two thirds think that delirium in patients is preventable. Although, the Delirium Observation Scale is most often used for screening delirium, nearly all nurses do not routinely screen patients for delirium. Opinions on delirium of nurses working in cardiac surgery wards did not differ from nurses caring for older patients in other hospital wards. Conclusions: Nurses do have knowledge on delirium care, but there is a gap between the reported incidence in literature and the estimation of the occurrence of delirium by nurses. A two-way causal relationship emerges: because nurses underestimate the occurrence, they do not screen patients on a routine basis. And because they do not screen patients on a routine basis they underestimate the incidence.

Department of Otolaryngology Head and Neck Surgery of Chinese PLA General Hospital (National Key Discipline)

Institute of Otolaryngology of Chinese PLA ( Key Laboratory for the Prevention of Acoustic Trauma,PLA)Key Laboratory of Hearing Impairment Science(Chinese PLA Medical School)Ministry of Education Led by four generations of leadership from late Prof. JIANG Sichang (academician, Chinese Academy of Engineering), Prof.YANG Weiyan (Honorary President, Division of Otolaryngology

Comprehensive evaluation method of epidemic prewarning and treatment for COVID-19 in general hospitals

In recent years, due to frequent occurrence of public health emergencies, outbreaks of major infectious diseases represented by COVID-19have brought great harm to the lives and health of people. General hospitals are indispensable in disease prevention and control. The studyanalyzed a comprehensive evaluation method of epidemic prewarning and treatment for COVID‑19 in general hospitals through literature reviewand provided a reference for constructing urban public health prewarning and treatment system.

Socio-Demographic Factors, Clinical Characteristics and Maternal Prognosis of Hypertensive Disorders in Pregnancy at Panzi General Referral Hospital

Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal prognosis of these women with Hypertension during pregnancy. Material and Method: We conducted a cross-sectional study, we interview patients and after discussion we transcripts in a database in Excel software before analysis with SPSS version 20.0 and Stata 14.0 The qualitative variables have been summarised by the Percentage and the quantitative variables will be summarised by Means and Standard Deviation. The associations of the variables were calculated by Pearson’s chi-square test with a significance level set at a p-value Result: The average age of the patients was 30.33 ± 7.020 years, 92.1% were married, 79.8% lived in urban areas, most of the patients were overweight (43%), 92.1% of them had monofetal pregnancies, 36% were multiparous, 34.2% had a previous history of preeclampsia in pregnancy and 14% were known to have hypertension. Pre-eclampsia was the most frequent form of hypertension in pregnancy with 73.68% of cases and represents 84.8% of severe forms of hypertension in pregnancy, 53.4% of the patients delivered vaginally. Eclampsia was the most frequent complication in our patients with 31.7% frequency and among the socio-demographic parameters, age and body mass index were significantly associated with maternal complications. Conclusion: Maternal age and body mass index are important socio-demographic factors associated with the occurrence of maternal complications in women with hypertensive disorders in pregnancy.

The Psychological Experience of the Nursing Staff of the Medical Oncology Department in Cameroon: Case of the YaoundéGeneral Hospital

Background: The world of cancer care is an emotional place, given the severity of the disease being treated, the heavy workload, the suffering of patients, and the high number of deaths. The nursing staff who work there may be exposed to constant stress from these factors. This study aimed to explore the psychological experience of the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Methods: We carried out a cross-sectional study, in June 2017, involving the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Results: Sixteen out of 18 nurses were interviewed. All had worked in at least one other department prior to Oncology. The number of years of experience in Oncology ranged from less than one year to 13 years. The choice of the Oncology department was involuntary for 100% of the staff;of these, 62% had intentions of changing departments. Twenty-five percent had applied for a change of department, which was unsuccessful. Stress was expressed by 94% of the staff;93% thought that there was a solution to the stress experienced on a daily basis in the Oncology department. The main solutions proposed to manage this stress were: support for the staff, provision of work materials, and staff training. Conclusion: The nursing staff of the Medical Oncology Department of the Yaoundé General Hospital experiences a high level of stress and are in need of solutions.

Magnetic Resonance Imaging of the Spine at the Douala General Hospital (Cameroon)

Objectives: The objective of this study was to evaluate the interest of MRI in the diagnosis of spinal disorders in our area. Method: It was a cross-sectional, descriptive and retrospective study during a nine-month period from January to September 2015 involving all patients who performed a spine MRI in the Imaging Department of Douala General Hospital. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using sagittal and axial slices in T1-weighted and T2-weighted FSE spin echo and STIR sagittal slices and T1 gado. Water-fat saturation (WFS) slices were obtained after injection of a contrast agent. All the data collected were analyzed using Microsoft Excel 2010 and Sphinx version 4.0. Results: 220 patients were recruited. The mean age was 46.34. There was male predominance with a sex ratio of 1.5. The main indication was lumbar spine pain (36.8%), followed by cervical spine pain, sensory and motor disorder. Neurosurgeon (33.6%), neurologist (23.1%) and rheumatologist (13.6%) were the main referring physicians. The lumbar spine was the most explored (53.2%). Discal hernia (46.6%), arthrosis (31.3%) and degenerative disc disease (25.5%) were the main observed lesion. Infectious disorders were mainly represented by spondylitis (5%);Traumatic disorders by spondylolisthesis (8.6%). Tumors were mainly metastasis (4%). 21.3% of MRI were normal. MRI-clinical concordance was 78.63%. Conclusion: MRI allows an accurate assessment of spinal and spinal cord pathologies without exposing patients to radiation. It helped to confirm or refute the diagnosis suspected by clinics. However, its availability is limited in our country.