Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice do not provide the health professionals with legal impunity. A well-informed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31 July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients left against medical advice. The mean age was 36.48 years (3 days-91 years) and males 173 (52.3%) were prone to leave than females. Only 50 (15.1%) cases had well-informed consent with complications documented. Hundred (30.5%) patients had wanted to come on follow up the next day in the out-patient department while 41 (12.4%) had to leave because of financial reasons. Only seven (2.9%) of well-oriented patients gave their consent and the remaining 233 (97.1%) were by the kin present. Only 76 (23%) patients were sent home with a well-documented medicine prescription. Conclusions: The proportion of patients who left against medical advice was more than the studies done in a similar setting.
Background: Avian influenza is a threat to global health. This study aims to assess the knowledge, attitudes and practices related to avian influenza among poultry workers in Kathmandu, Nepal.Methods: This is a qualitative cross sectional study done among poultry workers and owners of poultry farms in Kathmandu valley from February 2019 to June 2019 with a face-to-face interview. Data was analysed in the Statistical package of the social sciences (SPSS) version 20.Results: Out of the 100 respondents, 70% were male. 5% were illiterate. 96% of them had knowledge that avian influenza is transferred from uncooked poultry, 57% of them had knowledge regarding symptoms of avian influenza. 57% of them also had knowledge regarding availability of vaccine against the disease with television and newspapers being major sources of information. Among them, 93% applied proper disposal practice regarding poultry wastes, 83% applied masks and boot covers for poultry rearing and 90% maintained hand hygiene before and after coming in contact with poultry.Conclusions: This study highlighted the knowledge among poultry workers about avian influenza, its symptoms and good practices for prevention of its transmission. Television and newspapers appeared to be the most effective means for imparting knowledge regarding avian influenza. Specific age groups should be targeted with appropriate interventions to improve the practices for better prevention of avian influenza.
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