Innovative Journal of Medical and Health Science ijmhs en-US Innovative Journal of Medical and Health Science 2277-4939 All paper submissions must carry the following duly signed by all the authors:<br />“I certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (wherever applicable), as well as the writing of the manuscript, to take public responsibility for it. I believe the manuscript represents valid work. I have reviewed the final version of the manuscript and approve it for publication. Neither has the manuscript nor one with substantially similar content under my authorship been published nor is being considered for publication elsewhere, except as described in an attachment. Furthermore I attest that I shall produce the data upon which the manuscript is based for examination by the editors or their assignees, if requested.” The Effect of Nurses’ Implementation of Central Vascular Catheter Maintenance Care Bundle on Bloodstream Infection Among ICU Patients in KFGH and KAAUH <div class="sc-node sc-paragraph" data-id="paragraph-994bdae49cff1c816ae9f0176373de99" data-spx-state="enabled" data-spx-ctl-id="editor_paragraph"><span class="sc-text-property" data-path="paragraph-994bdae49cff1c816ae9f0176373de99.content"><span class="se-selection-fragment sm-local-user" data-offset="0" data-length="36"><span class="sc-strong" data-id="strong-8af1b330d9cc02ddcb6c5d9cf3905510" data-spx-ctl-id="editor_bold" data-offset="0" data-length="11">Background:</span> Bloodstream infections (</span><span class="sc-correction ts-spellcheck" data-id="suggestion-08accc7c22d3d12db5beaec14b034262" data-spx-ctl-id="assistive-writing_error_marker" data-offset="36" data-length="4"><span class="se-selection-fragment sm-local-user" data-offset="36" data-length="4">BSIs</span></span><span class="se-selection-fragment sm-local-user" data-offset="40" data-length="303">) are the most common type of healthcare-associated infections in clinical settings. Bloodstream infections are a leading known cause to increase the risk of patients' morbidity, mortality and length of hospital stay, and additionally, are typically increased in patients with severe underlying diseases</span><span class="sc-correction ts-spellcheck" data-id="suggestion-a9a8bc21339673f42e08b4c5053bdbd2" data-spx-ctl-id="assistive-writing_error_marker" data-offset="343" data-length="2"><span class="se-selection-fragment sm-local-user" data-offset="343" data-length="2">..</span></span><span class="se-selection-fragment sm-local-user" data-offset="345" data-length="359"> The study of CVC bundle implementation has not been adequately explored in Saudi Arabia (SA). This study aimed to assess the effect of nurses' implementation of central vascular catheter maintenance care bundle on blood stream infection among intensive care unit patients at King Fahd General Hospital (KFGH) and King Abdul-Aziz University Hospital (KAAUH). </span><br></span></div> <div class="sc-node sc-paragraph" data-id="paragraph-212d1082048790dc720a8dd2d818665a" data-spx-state="enabled" data-spx-ctl-id="editor_paragraph"><span class="sc-text-property" data-path="paragraph-212d1082048790dc720a8dd2d818665a.content"><span class="se-selection-fragment sm-local-user" data-offset="0" data-length="135"><span class="sc-strong" data-id="strong-8ed500e1f4ae1948e86e0ef542d184be" data-spx-ctl-id="editor_bold" data-offset="0" data-length="12">Objectives: </span>Assess the effect of nurses' implementation of central vascular catheter maintenance care bundle on blood stream infection.</span><br></span></div> <div class="sc-node sc-paragraph" data-id="paragraph-8fa7f5d514ee4605fe972b506ea19ba2" data-spx-state="enabled" data-spx-ctl-id="editor_paragraph"><span class="sc-text-property" data-path="paragraph-8fa7f5d514ee4605fe972b506ea19ba2.content"><span class="se-selection-fragment sm-local-user" data-offset="0" data-length="318"><span class="sc-strong" data-id="strong-737f3319b98bea982ff029965e683f39" data-spx-ctl-id="editor_bold" data-offset="0" data-length="8">Methods:</span> This study used quantitative research as a cause of defining the relationships between the variables which are the nurses’ implementation of the central vascular catheter maintenance care bundle and the bloodstream infection rate. An observational study were as it enables the researcher to focus on specific </span><span class="sc-correction ts-spellcheck" data-id="suggestion-d7eaa57f2b1a11b8fc2ff0e7ce5f045b" data-spx-ctl-id="assistive-writing_error_marker" data-offset="318" data-length="10"><span class="se-selection-fragment sm-local-user" data-offset="318" data-length="10">behaviours</span></span><span class="se-selection-fragment sm-local-user" data-offset="328" data-length="449">. The tools used in this study were Central vascular catheter maintenance care bundle checklist was used to assess the effect of nurses' implementation of a central vascular catheter maintenance care bundle on blood stream infection. A convenience sample of 63 patients of both sexes with central vascular catheter was selected from the two institutions. Ethical approval was granted from KAUH and KFHJ. Data collection was conducted for six months.</span><br></span></div> <div class="sc-node sc-paragraph" data-id="paragraph-4" data-spx-state="enabled" data-spx-ctl-id="editor_paragraph"><span class="sc-text-property" data-path="paragraph-4.content"><span class="se-selection-fragment sm-local-user" data-offset="0" data-length="195"><span class="sc-strong" data-id="strong-ff160f07d20c9a04ffd644b58e9e795e" data-spx-ctl-id="editor_bold" data-offset="0" data-length="8">Results:</span> A total of 63 patients and 37 nurses participated in this study. The average age of the study population was 51 years old (SD score of 51±20 years). The majority of gender were male (65%</span><span class="sc-correction ts-grammarcheck" data-id="suggestion-aa4bddb7804ebe0df31cd7e5b5a6270e" data-spx-ctl-id="assistive-writing_error_marker" data-offset="195" data-length="2"><span class="se-selection-fragment sm-local-user" data-offset="195" data-length="2"> )</span></span><span class="se-selection-fragment sm-local-user" data-offset="197" data-length="243">of the admitted patients were male (78%) had poor knowledge scores about contraception before counseling. The study reveals that the majority had diploma level education (87%) while(13%) had a bachelor's degree. As the researcher observed the </span><span class="sc-correction ts-spellcheck" data-id="suggestion-93bd4a1327c5aa8d8fc726e898a4e310" data-spx-ctl-id="assistive-writing_error_marker" data-offset="440" data-length="6"><span class="se-selection-fragment sm-local-user" data-offset="440" data-length="6">nurses</span></span><span class="se-selection-fragment sm-local-user" data-offset="446" data-length="437"> implementation of central vascular catheter maintenance care bundle, the table revealed that there was statistically significant difference between nurses' performing hand washing in relation to patients' bloodstream infection (P-value=0.001). There were (53.9%) of the nurses at both hospitals didn't perform hand washing techniques which lead to exposure of patients to infection. Other influencing factors included misapplication of </span><span class="sc-correction ts-spellcheck" data-id="suggestion-3eb13a7684f1ebcc4a0c1a161a0265df" data-spx-ctl-id="assistive-writing_error_marker" data-offset="883" data-length="13"><span class="se-selection-fragment sm-local-user" data-offset="883" data-length="13">chlorhexidine</span></span><span class="se-selection-fragment sm-local-user" data-offset="896" data-length="338"> antiseptic at KFGH which increased exposure to infection and showed significant statistical difference (P-value = 0.000). The fourth element of proper central vascular catheter site selection indicated the elevation of infection at the jugular vein site in (36.5%) of the cases followed by the femoral site (19%) it was not found at the </span><span class="sc-correction ts-spellcheck" data-id="suggestion-33c5b47ebf940c5173c509271c3e3138" data-spx-ctl-id="assistive-writing_error_marker" data-offset="1234" data-length="10"><span class="se-selection-fragment sm-local-user" data-offset="1234" data-length="10">subclavian</span></span><span class="se-selection-fragment sm-local-user" data-offset="1244" data-length="209"> vein site as recommended in current evidence. In addition, it was also noted that there was no significant correlation between exposure to infection and the daily review of central vascular catheter necessity</span><br></span></div> <div class="sc-node sc-paragraph" data-id="paragraph-20c271b5663b8242494cd9c1830093bd" data-spx-state="enabled" data-spx-ctl-id="editor_paragraph"><span class="sc-text-property" data-path="paragraph-20c271b5663b8242494cd9c1830093bd.content"><span class="se-selection-fragment sm-local-user" data-offset="0" data-length="616"><span class="sc-strong" data-id="strong-bab964e57224a0d29b4b16c086c20bbb" data-spx-ctl-id="editor_bold" data-offset="0" data-length="32">Conclusions and recommendations:</span> The relationship between nurses' implementation of central vascular catheter maintenance care bundle and bloodstream infection has had a positive effect on patients' bloodstream infection rates of intensive care unit As a result, this study recommends sustained efforts to educate the healthcare workers regarding the importance of bundle implementation and central vascular catheter care and provision of prompt feedback on adherence to aseptic technique. Moreover, healthcare providers should be involved in educational sessions on central line insertion, handling and maintenance.</span></span></div> Heba Abdul Aziz Zabidi, Dr. Gihan Mohammed Ali, Dr. Elham Naqshbandi ##submission.copyrightStatement## 2018-05-22 2018-05-22 8 5 52 62 10.15520/ijmhs.v8i5.2147 Soft Tissue Sarcoma; Management and Treatment Outcome in a Tertiary Health Institution in Northern Nigeria <p>Soft tissue sarcoma constitutes 7% of all cancers in Nigeria. A complete staging of this tumour is<br>important to evaluate the prognosis and plan the treatment in a multidisciplinary team. Management<br>of sarcoma includes surgery, which involve partial or complete excision of the tumour mass. Surgery<br>is the primary treatment modality for soft tissue sarcoma. Radiotherapy is useful in both localized<br>and metastatic disease. Reports have shown the benefit of radiation therapy in decreasing recurrence<br>rate in positive margin post excision. It is also useful for palliation of some symptoms. Chemotherapy<br>has been shown to improve the survival of patients. Doxorubicin and Ifosfamide have shown better<br>response in patients with these malignancies. The outcome of patients with soft tissue sarcoma depends<br>on the margins’ status post excision, performance status, grade, and stage of the disease.<br>MATERIALS AND METHODS<br>It is a five year retrospective study of patients with soft tissue sarcoma seen in the department<br>of radiotherapy and Oncology, Usmanu Danfodiyo University teaching hospital. The treatment and<br>overall survival at one year post diagnosis were reviewed with associating compounding variable.<br>RESULTS<br>A total of 123 patients were reviewed, out of which 69.9% of the patients had radiotherapy, and 64%<br>of the patients who had radiotherapy received palliative dose. The commonest chemotherapy used<br>was vincristine, which was used in 82% of the patients who had chemotherapy, while 76% received<br>doxorubicin and 10% had ifosfamide.<br>The overall survival at one year was assessed in 112 patients. There was no significant difference<br>between their age, gender, histological type and their survival at one year, however there was an<br>association between the performance status (ECOG) and surgical excision status.<br>CONCLUSION<br>The outcome of patients with soft tissue sarcoma after diagnosis is determined by the performance<br>status and the surgical excision margin. This will ultimately guide treatment of these groups of<br>malignancies.</p> Okuofo Charles ##submission.copyrightStatement## 2018-05-22 2018-05-22 8 5 41 51 10.15520/ijmhs.v8i5.2144 Familial diabetes suggests mitochondrial disease <p>In a recent, interesting article, Agarwal et al. report about a 62yo male with familial diabetes and a syncope due to familial AV-block-III [1] . We have the following comments and concerns.</p> Josef Finsterer Marlies Frank ##submission.copyrightStatement## 2018-05-22 2018-05-22 8 5 10.15520/ijmhs.v8i5.2145 Complex-IV Deficiency Manifesting as Cerebral-Dominant Mitochondrial Multiorgan Disorder Syndrome (MIMODS) <p>Recently, Arilla et al. presented a 36 years old Caucasian female, who was misdiagnosed as a pure psychiatric disorder (somatisation and conversion disorder, maniac episode, affective psychosis, “special” personality) during years until at age 35y the suspicion of a MID was raised [1]</p> Josef Finsterer Sinda Zarrouk Mahjoub ##submission.copyrightStatement## 2018-05-22 2018-05-22 8 5 10.15520/ijmhs.v8i5.2146