Rising food, housing and energy demand of increasing population creates an immense pressure on water resources, especially on water quality. The water quality around the globe is degrading primarily due to intense agricultural activities associated with rapid urbanization. This study attributes to cause of water quality problem, indices to measure water quality, methods to identify proper explanatory variables to water quality and it's processing to capture the special effect, and finally modeling of water quality using identified explanatory variables to provide insights. This would help policymakers and watershed managers to take necessary steps to protect water quality for the future as well as current generation. Finally, some knowledge gaps are also discussed which need to be addressed in the future studies.
OBJECTIVE
To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary‐care supra‐regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.
SUBJECTS AND METHODS
Male UC‐related morbidities were retrospectively identified from our computerized inpatient urology consultation system over a 1‐year period from July 2006 to June 2007. Relevant medical records were also reviewed. An anonymous questionnaire was used for the subjective assessment of interns about their training on UC. The primary outcome measures were the prevalence of urethral trauma secondary to UC by a non‐urological team member in non‐urological departments, risk factors and intern‐perceived adequacy of practical and theoretical training on UC during their intern year, and finally the supervision of interns during first UC.
RESULTS
Of 864 urological consultations, 51 (6%) were related to complications arising from male UC during the 1‐year period. The most common indication for UC was monitoring urinary output for acute medical illness (34/51, 67%). The most common complication was urethral trauma (35/51, 67%). The balloon was accidentally inflated in the urethra in six patients (12%). Of the 51 cases of UC‐related morbidity, 38 (74%) resulted from interns performing UC, and of these 28 (73%) occurred during the first 6 months of internship. Overall, 76% of interns felt that their practical training was none or inadequate; 52% (26/50) did not receive any supervision during their first UC.
CONCLUSIONS
UC‐related iatrogenic morbidity is not uncommon even in a tertiary‐care teaching hospital. This study identified that interns receive inadequate training on UC. Finally, most of the complications are potentially avoidable and can be prevented by adopting a proper technique of catheterization. Adequate training and supervision of medical students and interns can achieve this.
The quality of videos on YouTube regarding male UC is widely variable. Preselected videos are deemed useful by junior doctors regarding male UC and can be used as an educational adjunct before performing hands-on tasks.
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