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Preoperative laboratory Testing by Surgeons: Implication on Anaesthetic Management

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International Journal of Clinical Medicine 2019年第6期10卷 345-352页

作者： Akwasi Antwi-Kusi William Addison Bright Ighodaro Obasuyi Philip Domoyeri Department of Anaesthesia and Intensive Care Komfo Anokye Teaching Hospital Kumasi Ghana Department of Anaesthesiology University of Port Harcourt Teaching Hospital Port Harcourt Nigeria Koforidua Regional Hospital Koforidua Ghana

Background: Request for preoperative laboratory investigations is usually done by surgeons. On some occasions, the patient may come with laboratory investigations that have been requested by the primary physician. This occurs in situations where the primary physician saw the patient first and referred to the surgeon. There is usually no indications based on history or physical examination before these laboratory request is done but rather on speculations that the “anaesthetist may require them”. This is done in order to avoid cancellation or delay of cases. The aim of this study was to find out how tests ordered in Komfo Anokye Teaching Hospital (K.A.T.H.) by the surgeons affected the decisions of the anaesthetists in the perioperative management of the patients. Methodology: This was a prospective, cross sectional study of patients undergoing elective surgery at K.A.T.H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. A close and open-ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anesthesia assessment. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22. Results: The average age of patients studied was 50 years. Abnormal test results did not influence the anaesthetic management in 70.5% of cases but led to either delay or cancelation of cases or requirement for transfusion of blood or blood products in 29.5% of cases. Conclusion: Preoperative laboratory tests ordered by Surgeons in KomfoAnokye Teaching Hospital do not significantly influence the anaesthetic managements of patients.

关键词： Preoperative laboratory Investigations Surgeons Anaesthetic Management Implication

Anatomical Study of MRI Optic Chiasm at the Bamako Anatomy laboratory

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Forensic Medicine and Anatomy Research 2020年第2期8卷 11-17页

作者： Babou Ba Siaka Diakité Abdoulaye Kanté Tata Touré Moumouna Koné Nouhoum Ongoiba Abdel Karim Koumaré Siaka Sidibé Laboratoire d’Anatomie et de Morphologie Clinique FMOS BamakoMali Service de Radiologie CHU Point GBamakoMali Service de Chirurgie“B” CHU Point GBamakoMali

Roughly quadrangular, the chiasma presents many morphological variations. The optical chiasm, odd and symmetrical structure of the optical pathways, is a required passage of the axons of neurons for the visual pathways. Any modification of its morphology evokes a pathological process, generally tumoral. The quality of MRI images rivals that of anatomical slices. So the MRI is essential for the study of the chiasma. The aim of this work was to study the morphometry of the optic chiasm in patients addressed for cerebral MRI to the imaging department of the university hospital of the POINT-G, during the period from July 29, to November 30, 2016. All patients who had a normal examination of the optic chiasma, numbering 15, were included in this study. In 86.66% of cases the chiasma had a quadrilateral form. Its average length was 8.73 mm and its average width was 13 mm. The average thickness was 4.13 mm.

关键词： Optical Chiasma MRI laboratory Anatomy

Analysis of the Effect of Subgroup Size on the X-Bar Control Chart Using Forensic Science laboratory Sample Influx Data

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Engineering（科研） 2017年第5期9卷 434-456页

作者： Samwel Victor Manyele Department of Forensic Science and DNA Services Government Chemist Laboratory Authority (GCLA) Dar es Salaam Tanzania

This paper analyzes the effect of subgroup size on the x-bar chart characteristics using sample influx (SIF) into forensic science laboratory (FSL). The characteristics studied include changes in out-or-control points (OCP), upper control limit UCLx, and zonal demarcations. Multi-rules were used to identify the number of out-of-control-points, Nocp as violations using five control chart rules applied separately. A sensitivity analysis on the Nocp was applied for subgroup size, k, and number of sigma above the mean value to determine the upper control limit, UCLx. A computer code was implemented using a FORTRAN code to create x-bar control-charts and capture OCP and other control-chart characteristics with increasing k from 2 to 25. For each value of k, a complete series of average values, Q(p), of specific length, Nsg, was created from which statistical analysis was conducted and compared to the original SIF data, S(t). The variation of number of out-of-control points or violations, Nocp, for different control-charts rules with increasing k was determined to follow a decaying exponential function, Nocp = Ae–α, for which, the goodness of fit was established, and the R2 value approached unity for Rule #4 and #5 only. The goodness of fit was established to be the new criteria for rational subgroup-size range, for Rules #5 and #4 only, which involve a count of 6 consecutive points decreasing and 8 consecutive points above the selected control limit (σ/3 above the grand mean), respectively. Using this criterion, the rational subgroup range was established to be 4 ≤ k ≤ 20 for the two x-bar control chart rules.

关键词： Forensic Science laboratory Sample Influx Statistical Analysis X-bar Control Chart Sub-Group Size Control Chart Rules Multi-Rules for X-Bar Chart Out-of-Control Points

Analysis of Turnaround Time during Casefile and Sample Processing in Forensic Science laboratory

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Engineering（科研） 2018年第2期10卷 43-73页

作者： G. C. Omari S. V. Manyele G. Mwaluko Department of Mechanical and Industrial Engineering College of Engineering and Technology University of Dar es Salaam Dar es Salaam Tanzania Government Chemist laboratory Authority Dar es Salaam Tanzania

Turnaround time (TAT), is the total time interval from when a request for forensic laboratory analysis is received until when the results are collected by the client. The performance of the forensic science laboratory (FSL) is affected by extended TAT in the case-file and sample processing steps necessitating critical analysis reported in this paper. The total TAT was obtained as the sum of measured time interval for each work station (six of which were studied). Extended TAT leads not only to customer complaints, but also paves way for customers to seek for services from competitors, leading to lost competitive edge for the FSL. This study was conducted to establish the baseline data on TAT (between 2014 and 2015) to enable implementation of corrective actions. Six casefile processing steps were identified for which starting and completion times were recorded in dates, giving TAT values in days. The TAT data for each step was collected as each case file is processed and analyzed separately using statistical analysis while comparing the data for the two years (Y2014 and Y2015) and?among?three forensic science laboratory disciplines (biology/DNA, chemistry and toxicology). The overall turnaround time (TTAT) was?the?highest for forensic biology/DNA compared to forensic toxicology and chemistry. The analysis time (TAT2) was the longest of all six case-file processing steps. Using Pareto analysis, the three major steps necessitating root-cause analysis and intervention to minimize TAT were analysis turnaround time (TAT2), report collection time (TAT6) and report review time (TAT4). It was concluded that the causes for extended TAT are within control by the FSL management, although financial and human resources are required.

关键词： Turnaround Time Forensic Science laboratory Forensic Biology/DNA Forensic Chemistry Forensic Toxicology Statistical Analysis Pareto Analysis Root Cause Analysis

Microbiology laboratory and the management of motherchild varicella-zoster virus infection

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World Journal of Virology 2016年第3期5卷 97-124页

作者： Massimo De Paschale Pierangelo Clerici Microbiology Unit ASST-Ovest Milanese Hospital of Legnano

Varicella-zoster virus, which is responsible for varicella(chickenpox) and herpes zoster(shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella(particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times:(1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection;(2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear(atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation;(3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and(4) when the baby is born and it is necessary to confirm a diagnosis of varicella(and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.

关键词： Mother-child infection Congenital varicella syndrome Varicella-zoster virus Neonatal varicella Microbiology laboratory

Improving laboratory Test-Ordering with Information Technology

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International Journal of Clinical Medicine 2012年第6期3卷 446-458页

作者： Adnan Ali Baddour Anas Serag Dablool Saeed Saeed Al-Ghamdi College of Applied Medical Science Umm Al-Qura University Makkah KSA Faculty of Medicine Umm Al-Qura University Makkah KSA Makkah Public Health laboratory Ministry of Health Makkah KSA

The overuse of clinical laboratory services has been documented for many years. This overuse use does not contribute to the quality of medical care, does not shorten hospital stay, nor reduce mortality. The utilization of diagnostic laboratories has increased over the last decade around the world. This increased laboratory use is appropriate if it allows accurate diagnoses to be made, ideal treatment to be identified and monitored, accurate prognoses to be established, and patients’ hospital stays to be shortened. Thus, improving the appropriateness of testing behavior and reducing the number of laboratory tests have been recognized as essential parts of quality improvement program. In this study, the effectiveness of a computer-based system in improving the laboratory test-ordering in a general hospital was investigated. The study was conducted through four stages, the preparation stage, the pre-intervention stage, the post-intervention 1) stage and post-intervention 2) stage. Guideline and computer system were developed during preparation stage. Medical records were reviewed against guideline recommendations before any intervention during the pre-intervention stage, after guideline dissemination through educational workshops during the post intervention 1) stage, and after implementation of the computer system with the new requesting form during the post intervention 2) stage. The study revealed that the computer-based system achieved a statistically significant increase in the percentage of appropriate use from 44.6% in the post-intervention 1) stage to 55.6%, and a statistically significant increase in the compliance with guideline by prescriber as well as increased in guideline conformity rate from 16.7% in the post-intervention 1) stage to 32.5% in the post-intervention 2) stage, and decreased in the percentage of prescribers whose level was unsatisfactory from 85.4% the post-intervention 1) stage to 66.7% in the post-intervention 2) stage.

关键词： Computer-Based System laboratory Test-Ordering Guideline Conformity Rate Compliance Level

New Perspectives for Workflow Analysis in the Health Italian Sector through Discrete Event Simulation: The Case of a Department of laboratory Medicine

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Intelligent Information Management 2015年第3期7卷 93-106页

作者： Adriano Torri Oscar Tamburis Teresa Abbate Alessandro Pepino Department of Electrical Engineering and Information Technologies University Federico II Naples Italy Department of Veterinary Medicine and Animal Productions University Federico II Naples Italy

The management systems currently used in the Italian healthcare sector provide fragmented and incomplete information on this system and are generally unlikely to give accurate information on the performances of the healthcare processes. The present paper introduces a combined discrete event simulation (DES)/business process management (BPM) approach as innovative means to study the workflow of the activities within the Department of laboratory Medicine of the “San Paolo” Hospital in Naples (Italy). After a first “As-Is” analysis to identify the current workflows of the system and to gather information regarding its behaviour, a following DES-based “What-If” analysis is implemented to figure out alternative work hypotheses in order to highlight possible modifications to the system’s response under varying operating conditions and improve its overall performances. The structure of the simulation program is explained and the results of the scenario analysis are discussed. The paper starts with a brief exploration of the use of DES in healthcare and ends with general observations on the subject.

关键词： Healthcare Management Performance Evaluation Discrete Event Simulation Business Process Management Department of laboratory Medicine

Predatory Efficacy of Cotton Inhabiting Spiders on Bemisiatabaci, Amrascadevastans Thripstabaci and Helicoverpa armigera in laboratory Conditions

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Journal of Northeast Agricultural University(English Edition) 2015年第3期22卷 48-53页

作者： Mohsin S B Li Yi-jing Tang Li-jie Maqsood I Ting Ma-sun Han Le-meng Khalil U R Andleeb S Muhammad S K Saleem M A College of Veterinary Medicine Northeast Agricultural University College of Environment Resources Northeast Agricultural University Department of Zoology Wildlife and Fishery Government College University Faisalabad

Distinction of predator＇s diet and prey choice preference is a hot topic of current investigations. Spider being generalist predator and cosmopoliter in nature acts as biological control agent in many agro-ecosystems. In the current study, predatory efficacy of five spiders （Pardosa birmanica, Cyclosa insulana, Thomisus projectus, Plexippus paykulli and Lycosa terrestris） inhabiting the cotton fieldevaluated in the laboratory conditions maintained at （27＋2）℃ temperature, 65%-5% relative humidity and 12 ： 12 h of light and dark photoperiod. Four key cotton pests＇ viz. Bemisiatabaci, Amrascaderastans Thripstabaci and Helicoverpa armigera were utilized in the choice and no-choice predatory studies. The findings of current investigation revealed that each predatory spider utilized at least one pest species. Predation rate was found higher in the no-choice predation because of unavailability of substitutes feeding source. The investigation also indicated each predatory spider killed more pests than consumed. The findings of this study support the predatory role of spiders in controlling the cotton major pests.

关键词： predatory spider efficacy cotton pest laboratory condition

Toolkits for Real Time Digital Audio Signal Processing Teaching laboratory

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Journal of Signal and Information Processing 2015年第2期6卷 92-98页

作者： Kizito Nkurikiyeyezu Faustin Ahishakiye Cyprien Nsengimana Etienne Ntagwirumugara Department of Electrical and Electronics Engineering University of Rwanda Kigali Rwanda

This paper describes an audio digital signal-processing toolkit that the authors develop to supplement a lecture course on digital signal processing (DSP) taught at the department of Electrical and Electronics Engineering at the University of Rwanda. In engineering education, laboratory work is a very important component for a holistic learning experience. However, even though today there is an increasing availability of programmable DSP hardware that students can largely benefit from, many poorly endowed universities cannot afford a costly full-fledged DSP laboratory. To help remedy this problem, the authors have developed C#.NET toolkits, which can be used for real-time digital audio signal processing laboratory. These toolkits can be used with any managed languages, like Visual Basic, C#, F# and managed C++. They provide frequently used modules for digital audio processing such as filtering, equalization, spectrum analysis, audio playback, and sound effects. It is anticipated that by creating a flexible and reusable components, students will not only learn fundamentals of DSP but also get an insight into the practicability of what they have learned in the classroom.

关键词： DSP Filter Digital Audio Effects Graphic Equalization laboratory Teaching