The incidence and patterns of and factors associated with inappropriate antibiotic use were studied in a tertiary care center in Thailand. The incidence of inappropriate antibiotic use was 25%. Admission to the surgical department (adjusted odds ratio, 2.0; P=.02) and to the obstetrics and gynecology department (adjusted odds ratio, 2.0; P=.03) were associated with inappropriate antibiotic use,...

Guillain-Barré syndrome (GBS) cases admitted to Canadian pediatric tertiary care centers were ascertained through active surveillance. From 1996 to 2012, 246 cases were identified, and 24 (10%) had onset ≤30 days after immunization. Annual rate of postimmunization GBS was 2.0 per 100,000 hospitalizations. Postimmunization GBS was an infrequent cause of pediatric hospitalization.

OBJECTIVE Although mandatory vaccination programs have been effective in improving the vaccination rate among healthcare workers, implementing this type of program can be challenging because of varied reasons for vaccine refusal. The purpose of our study is to measure improvement in the influenza vaccination rate from a multifaceted intervention at a Japanese tertiary care center where implemen...

BACKGROUND Implementation of World Health Organization case management guidelines for serious childhood illnesses remains a challenge in hospitals in low-income countries. Facilitators of and barriers to implementation of locally adapted clinical practice guidelines (CPGs) have not been explored. METHODS This ethnographic study based on the theory of participatory action research (PAR) was co...

We reviewed the effect of 3 interventions to reduce the incidence of intraventricular catheter-related ventriculitis, conducted at a tertiary care center in St Louis, Missouri, during an 8-year period. The incidence density of intraventricular catheter-related ventriculitis decreased substantially after the implementation of standardized management of intraventricular catheters.

AIM In a resource-poor country such as India, telepsychiatry could be an economical method to expand health-care services. This study was planned to compare the costing and feasibility of three different service delivery models. The end user was a state-funded long-stay Rehabilitation Center (RC) for the homeless. METHODOLOGY Model A comprised patients going to a tertiary care center for clin...

OBJECTIVE To evaluate the cost-effectiveness of tertiary referral care for ovarian cancer patients in the Netherlands. METHODS We collected clinical and registry data on 1077 newly diagnosed ovarian cancer patients treated from 1996-2003 in a random sample of Dutch hospitals. Decision modelling was used to compare the cost-effectiveness of treatment in general hospitals, semi-specialized hosp...

background: diabetes is a leading cause of cardiovascular disease (cvd). moreover, cvd accounts for primary cause of death among diabetic patients. physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in type 2 diabetic patients attending t...

objective: the scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool. methods: this prospective study was done at two medicine units (unit 5 and 10) of dhaka medical college hospital from july to december 2010 where all poisoning cases were seen. a total of 2890 patients were admitted out of wh...

Highly congested vicinal stereocenters comprised of tertiary and all-carbon quaternary centers were generated via Ir-catalyzed asymmetric allylic alkylation of β-ketoesters. These catalytic reactions proceed in excellent yields with a broad scope on either reaction partner and with outstanding regio-, diastereo-, and enantiocontrol. Implementation of a subsequent Pd-catalyzed alkylation affords...