HER2/neu protein is credibly overexpressed in colon and gastric adenocarcinomas in immunohistochemistry. There is significant association between grade of tumor and HER2/neu protein overexpression.
Objectives: This study was performed to access the knowledge of health care professionals regarding health care associated infections, nosocomial pathogens, fomites and their role in transmission of nosocomial pathogens. Study Design: Descriptive, questionnaire based, cross-sectional study. Setting: Tertiary care hospital of Lahore, Punjab. Period: From October 2017 to January 2018. Material & Methods: Questionnaires were carefully formulated to access basic knowledge of physicians, surgeons and nurses. Responses given were analyzed and recorded as frequency and percentage. Results: Regarding health care associated infections, respiratory tract infections were identified by 72% surgeons, 65% physicians and 59% nurses. Surgical wound infections were identified by 76% of surgeons and 81% nurses. 45.7% physician identified bacteraemia as nosocomial infection. Rate of identification for rest of nosocomial infections was sub optimum (<50%) by health care workers. Regarding identification of nosocomial pathogens, Methicillin Resistant Staphylococcus aureus was marked by 65% of physicians, 83.8% of nurses, 76% of surgeons. Pseudomonas nosocomial pathogen was identified by 40%, 46% and 64% of physicians, nurses and surgeons respectively. The rate of identification for rest of the nosocomial organisms was again sub optimum (<40%) by health care workers. Regarding fomites, mattresses and pillows, thermometer, stethoscopes were identified by 75.7%, 59.2 and 50% of Health care professionals respectively. Conclusion: This survey identified positive attitude among Health care workers towards infection control but low level of knowledge regarding health care associated infections and nosocomial pathogens. Therefore, to prevent nosocomial infections, there is strong need to develop strategies for improving knowledge of Health care professionals.
Background: Serous fluids like pericardial, pleural and ascitic fluids are frequently submitted for pathological evaluation. The differentiation of these fluids into transudates and exudates is the prime aim of the evaluation as this determines the patients’ further management. Light’s criteria, proposed about 50 years ago, utilize various biochemical parameters for this differentiation and are the most widely used criteria. Materials and Methods: This study was carried-out in Pathology department of Punjab Institute of Cardiology, Lahore. 60 serous fluid samples, including pericardial, pleural and ascitic fluids were analyzed routinely and classified into transudates and exudates applying Light’s criteria. The proportion of transudates and exudates were compared amongst different fluids by applying chi-square test, keeping level of significance at p-value <0.05. Cytological examination was reported according to the International System for Reporting Serous Fluid Cytopathology. Results: Most of the fluids, i.e., 44 out of 60 were exudates. This trend was most pronounced for pericardial fluids where 29 out of 31 were exudates. 13 pleural fluids out of 23 were exudative while only 2 out of 6 ascitic fluids were exudative. On cytological examination, 55 fluids were negative for malignant cells, 2 fluids harbored atypical cells and 3 were positive for malignant cells. Careful gross examination of fluids furnished vital information in many cases. Conclusion: Light’s criteria may not be equally applicable across all types of fluids. In our study it had a high sensitivity but low specificity for pericardial exudates. Hence, modification of the criteria may be required to enhance its validity. Careful gross and cytological examination may provide additional invaluable information that could significantly impact management strategies. Keywords: Pleural fluid, pericardial fluid, light’s criteria, transudate, exudate.
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