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Quality Control of Majoon-e-Nisyan and its Acute Oral Toxicity Study in Experimental Rats

  • Shaikh, Masud;Husain, Gulam M.;Naikodi, Mohammed Abdul Rasheed;Kazmi, Munawwar H.;Viquar, Uzma
    • CELLMED
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    • v.11 no.1
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    • pp.2.1-2.8
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    • 2021
  • The clinical condition Amnesia causes difficulty in learning new information and the inability to recall past events. It is primarily concerned with recent memory loss. Majoon-e-Nisyan (MJN) is a polyherbal Unani formulation, present in a semi-solid form. It is widely used potent drug of the Unani System of Medicine (USM) for treating Nisyan (amnesia). In the present study polyherbal Unani formulation, MJN has been studied for its quality control and acute toxicity. Standardization (quality control) of drugs deals with drug identity, drug quality and purity determination. Standardization of MJN had been done as per the Unani pharmacopoeial parameters approved by World Health Organization (WHO) - Pharmacognostical parameters, Physico-chemical parameters, high-performance thin-layer chromatography (HPTLC), microbial load, aflatoxin, and heavy metals. Solvents and chemicals used in the study were of analytical grade and used instrument were calibrated. By conducting an acute oral toxicity study in rats, the safety of MJN was assessed. The limit test method of OECD guideline 425 was followed in the study. Results of standardization and standard operating procedures (SOPs) for preparation of MJN may serve as the standard reference in the future. The data generated in the study for the quality control of MJN proved the quality of formulation and shows that MJN is not toxic in rats following acute dosing up to 2000 mg/kg bw. The data obtained in the paper for MJN may be used as a standard guideline for preparation of the formulation which can save time, cost, and resources for future research endeavours.

A study on the status and applicability of Korean medicine EMR for establishment of Korean medicine standard EMR certification criteria: Through surveys of Korean medical institutions and Korean medicine EMR companies

  • You Jin Heo;Cham Kyul Lee;Soo Min Ryu;Jung Won Byun;Jeong Du Roh;Na Young Jo;Byung Kwan Seo;Yeon Cheol Park;Yong Hyeon Baek;Jung Hyun Kim;Sun Mi Choi;Young Heum Yoon;Eun Yong Lee
    • The Journal of Korean Medicine
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    • v.44 no.4
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    • pp.150-162
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    • 2023
  • Objectives: The aim of this study is to explore and investigate the status of EMR currently used in Korean medical institutions and the suitability of the existing certification criteria for Korean medicine EMR certification. Methods: The survey was conducted using a related questionnaire from September to October 2022. The survey for current status and the suitability of the existing certification criteria was conducted separately between Korean medical institutions and Korean medicine EMR companies. Results: In a survey of Korean medical institutions on the current status of EMR, more than 80% answered that the imaging system and Korean medicine EMR could be linked. Most medical institutions did not exchange clinical information between institutions. When asked about the intention to develop standard EMR of Korean medicine in the future, 57% of institutions answered 'yes'. In future, if Korean medicine EMR certification criteria are developed, all EMR companies are willing to develop the EMR that satisfy them. Looking at the satisfaction survey of the existing EMR certification criteria of the Korean medicine EMR system, it was found that high/low satisfaction was shown in various areas, and in particular, the overall clinical information exchange function was insufficient. Conclusion: In order to introduce the Korean medicine EMR certification criteria, it must be considered of the current status of EMR and applicability of Korean medicine EMR for establishment of Korean medicine standard EMR certification criteria. By developing Korean medicine EMR certification criteria, high-quality medical services can be provided to medical consumers who want Korean medical treatment.

Study on Pediatric Nurses' Attitudes and Compliance with Hospital Infection Standard Precautions (아동병동 간호사의 병원감염 표준주의에 대한 인지도와 이행도)

  • Shin, Hye-Yeun;Kim, Kyung-Hee;Kim, Ki-Sook
    • Child Health Nursing Research
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    • v.17 no.4
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    • pp.238-246
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    • 2011
  • Purpose: The purpose of this study was to identify pediatric nurses' attitudes to, and compliance with, standard precautions in the prevention of hospital infections by enhancing their practice of standard precautions. Methods: The participants were 206 nurses who worked in pediatric nursing departments of a general medical institution in Seoul. The questionnaire was a modification of Kim (2008) and consisted of 18 questions about hand washing, personal protective equipment, sharps, linen and patient care equipment. Collected data were processed using SPSS 15.0 WIN. Results: Mean scores for attitudes to standard precautions and for compliance with standard precautions were 4.43 (${\pm}0.83$) and 4.22 (${\pm}0.44$) respectively. This difference was statistically significant (t=3.368, p=.001). The nurses' compliance with standard precautions differed significantly according to the general characteristics of age (F=8.705, p<.001), total clinical experience (F=9.426, p<.001), current department experience (F=6.555, p<.001), and education experience (t=0.616, p<.043). There was a positive correlation between attitudes to, and compliance with, standard precautions (r=.156, p=.025). Conclusion: The results of this study indicate that educational programs and policy on infection control and standard precautions for pediatric nurses are needed. Also these results should contribute to baseline data for establishing appropriate clinical policy on infection control.

Effects of Expert-Determined Reference Standards in Evaluating the Diagnostic Performance of a Deep Learning Model: A Malignant Lung Nodule Detection Task on Chest Radiographs

  • Jung Eun Huh; Jong Hyuk Lee;Eui Jin Hwang;Chang Min Park
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.155-165
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    • 2023
  • Objective: Little is known about the effects of using different expert-determined reference standards when evaluating the performance of deep learning-based automatic detection (DLAD) models and their added value to radiologists. We assessed the concordance of expert-determined standards with a clinical gold standard (herein, pathological confirmation) and the effects of different expert-determined reference standards on the estimates of radiologists' diagnostic performance to detect malignant pulmonary nodules on chest radiographs with and without the assistance of a DLAD model. Materials and Methods: This study included chest radiographs from 50 patients with pathologically proven lung cancer and 50 controls. Five expert-determined standards were constructed using the interpretations of 10 experts: individual judgment by the most experienced expert, majority vote, consensus judgments of two and three experts, and a latent class analysis (LCA) model. In separate reader tests, additional 10 radiologists independently interpreted the radiographs and then assisted with the DLAD model. Their diagnostic performance was estimated using the clinical gold standard and various expert-determined standards as the reference standard, and the results were compared using the t test with Bonferroni correction. Results: The LCA model (sensitivity, 72.6%; specificity, 100%) was most similar to the clinical gold standard. When expert-determined standards were used, the sensitivities of radiologists and DLAD model alone were overestimated, and their specificities were underestimated (all p-values < 0.05). DLAD assistance diminished the overestimation of sensitivity but exaggerated the underestimation of specificity (all p-values < 0.001). The DLAD model improved sensitivity and specificity to a greater extent when using the clinical gold standard than when using the expert-determined standards (all p-values < 0.001), except for sensitivity with the LCA model (p = 0.094). Conclusion: The LCA model was most similar to the clinical gold standard for malignant pulmonary nodule detection on chest radiographs. Expert-determined standards caused bias in measuring the diagnostic performance of the artificial intelligence model.

Efficiency Comparison of Radiological Work in the integration environment of PACS and OCS (PACS와 OCS연동으로 인한 방사선사 업무의 효율성 비교)

  • Yoo, Eun-Jeong;Kang, Hye-Keong;Kim, Kyeong-Joon;Ahn, Soo-Hyeon;Ahn, Tae-Hun;Lee, Ki-Hyeob;Choi, Hong-Joon;Kim, Seung-Sik
    • Korean Journal of Digital Imaging in Medicine
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    • v.5 no.1
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    • pp.86-92
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    • 2002
  • Information concerning a patient visit is to be sent from the OCS(Order Communication System) to the PACS(Picture archiving and Communication System) and when the image acquisition is completed, information regarding the procedures also actually preformed should be sent back to the OCS. It should be possible to present related medical information from the OCS at the same image workstation in a coherent way with the images in the PACS, Examples of the related medical information are: the report of a diagnostic image procedure, data on medication, laboratory results, admission and discharge letters, and surgery reports, because we could maximize the efficiency of Radiological Work, like decrease examination time and human mistakes, though the integration of PACS and OCS, Therefore, We research some hospitals to find integral lists of PACS and OCS but there are no sufficient ingredients. Further, the percentage of Integral lists of PACS and OCS is different in all hospitals because there is no such standard yet like HL7(Healthcare Level 7) and DICOM(Digital Imaging and Communications in Medicine). Accordingly, if all hospital would follow national standard like HL7 and DICOM, the integration of OCS and PACS would be efficient but in this situation radiological technician should take part in construction integration system of PACS and OCS positively, so we could improve efficiency of radiological work and our status.

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Development of Enzymatic Recombinase Amplification Assays for the Rapid Visual Detection of HPV16/18

  • Ning Ding;Wanwan Qi;Zihan Wu;Yaqin Zhang;Ruowei Xu;Qiannan Lin;Jin Zhu;Huilin Zhang
    • Journal of Microbiology and Biotechnology
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    • v.33 no.8
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    • pp.1091-1100
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    • 2023
  • Human papillomavirus (HPV) types 16 and 18 are the major causes of cervical lesions and are associated with 71% of cervical cancer cases globally. However, public health infrastructures to support cervical cancer screening may be unavailable to women in low-resource areas. Therefore, sensitive, convenient, and cost-efficient diagnostic methods are required for the detection of HPV16/18. Here, we designed two novel methods, real-time ERA and ERA-LFD, based on enzymatic recombinase amplification (ERA) for quick point-of-care identification of the HPV E6/E7 genes. The entire detection process could be completed within 25 min at a constant low temperature (35-43℃), and the results of the combined methods could be present as the amplification curves or the bands presented on dipsticks and directly interpreted with the naked eye. The ERA assays evaluated using standard plasmids carrying the E6/E7 genes and clinical samples exhibited excellent specificity, as no cross-reaction with other common HPV types was observed. The detection limits of our ERA assays were 100 and 101 copies/µl for HPV16 and 18 respectively, which were comparable to those of the real-time PCR assay. Assessment of the clinical performance of the ERA assays using 114 cervical tissue samples demonstrated that they are highly consistent with real-time PCR, the gold standard for HPV detection. This study demonstrated that ERA-based assays possess excellent sensitivity, specificity, and repeatability for HPV16 and HPV18 detection with great potential to become robust diagnostic tools in local hospitals and field studies.

Identification of Standard Compound of Ja-ha-guh Pharmacopuncture and Validation of Analytic Methods (자하거 약침의 지표물질 선정 및 분석법 벨리데이션)

  • Park, Sang-won;Lee, Jae-woong;Lee, Jin-ho;Ha, In-Hyuk;Byun, Jang-hoon;Jung, Bum-hwan;Jung, Hwa-jin;Lee, In-hee;Kim, Min-Jeong;Kim, Eun-Jee
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.1
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    • pp.33-40
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    • 2016
  • Objectives Despite the increasing use of Ja-ha-guh (Hominis-placenta ) pharmacopuncture in rehabilitative medicine field, its standard compound has yet to be investigated. The purpose of this study is to provide standardization for future studies and increase satisfaction of patients by utilizing standard pharmacopuncture. Methods Alanine and leucine were selected as potential standard compounds. LC/MS was used to devise an analytic method. This analytic method was subject to validation. According to validation guideline of Korea Food and Drug Administration, the specificity, linearity, precision, range, quantitative limits, detection limits and accuracy were measured. With this analysis, 3 lots of Ja-ha-guh pharmacopuncture were analyzed. Results Because the specificity, linearity, precision, range, quantitative limits, detection limits and accuracy meet criteria of the guideline, the analytic method was validated. It was found that Ja-ha-guh pharmacopuncture contained $211.02{\pm}7.28ug/ml$ of alanine and $372.03{\pm}7.58ug/ml$ of leucine. Conclusions Both alanine and leucine appear to be suitable standard compounds. These results are likely to contribute to further standardization of Ja-ha-guh for medical use.

Accurate Measurement of Agatston Score Using kVp-Independent Reconstruction Algorithm for Ultra-High-Pitch Sn150 kVp CT

  • Xi Hu;Xinwei Tao;Yueqiao Zhang;Zhongfeng Niu;Yong Zhang;Thomas Allmendinger;Yu Kuang;Bin Chen
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1777-1785
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    • 2021
  • Objective: To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose. Materials and Methods: This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared. Results: No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode. Conclusion: The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.

A Modified Length-Based Grading Method for Assessing Coronary Artery Calcium Severity on Non-Electrocardiogram-Gated Chest Computed Tomography: A Multiple-Observer Study

  • Suh Young Kim;Young Joo Suh;Na Young Kim;Suji Lee;Kyungsun Nam;Jeongyun Kim;Hwan Kim;Hyunji Lee;Kyunghwa Han;Hwan Seok Yong
    • Korean Journal of Radiology
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    • v.24 no.4
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    • pp.284-293
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    • 2023
  • Objective: To validate a simplified ordinal scoring method, referred to as modified length-based grading, for assessing coronary artery calcium (CAC) severity on non-electrocardiogram (ECG)-gated chest computed tomography (CT). Materials and Methods: This retrospective study enrolled 120 patients (mean age ± standard deviation [SD], 63.1 ± 14.5 years; male, 64) who underwent both non-ECG-gated chest CT and ECG-gated cardiac CT between January 2011 and December 2021. Six radiologists independently assessed CAC severity on chest CT using two scoring methods (visual assessment and modified length-based grading) and categorized the results as none, mild, moderate, or severe. The CAC category on cardiac CT assessed using the Agatston score was used as the reference standard. Agreement among the six observers for CAC category classification was assessed using Fleiss kappa statistics. Agreement between CAC categories on chest CT obtained using either method and the Agatston score categories on cardiac CT was assessed using Cohen's kappa. The time taken to evaluate CAC grading was compared between the observers and two grading methods. Results: For differentiation of the four CAC categories, interobserver agreement was moderate for visual assessment (Fleiss kappa, 0.553 [95% confidence interval {CI}: 0.496-0.610]) and good for modified length-based grading (Fleiss kappa, 0.695 [95% CI: 0.636-0.754]). The modified length-based grading demonstrated better agreement with the reference standard categorization with cardiac CT than visual assessment (Cohen's kappa, 0.565 [95% CI: 0.511-0.619 for visual assessment vs. 0.695 [95% CI: 0.638-0.752] for modified length-based grading). The overall time for evaluating CAC grading was slightly shorter in visual assessment (mean ± SD, 41.8 ± 38.9 s) than in modified length-based grading (43.5 ± 33.2 s) (P < 0.001). Conclusion: The modified length-based grading worked well for evaluating CAC on non-ECG-gated chest CT with better interobserver agreement and agreement with cardiac CT than visual assessment.

Architectural Planning of Out-Patient Clinic Department in Armed Forces Hospital (국군병원 외래진료부의 건축계획)

  • Kim, Jung-Nam;Ham, Wook;Park, Chang-Geun;Lee, Nak-Woon
    • Journal of Industrial Technology
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    • v.24 no.B
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    • pp.47-57
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    • 2004
  • This study is aiming to obtain the pabulum of architectural planning about out-patient clinic department in armed force hospital with search. The discussion was about characteristic problems and differentiated planning characteristics of common general hospital, So the conclusion of research is as follows. In army medical facilities, Because of architectural standard of out-patient clinic department about scale of facilities and characteristic in each examination-part is unprepared, it may have to be readied. Out-patient clinic department was become plan to scale about whole 7~8% in hospital to SB hospital in 95 but was planed about 5% of whole scale from PS hospital in 97. When plan hospital, increase of equipment and increase of module size about bed for the convenience of patient or employees are judged for cause in hospital since 97 years than previous hospital in 95.

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