Objective: To assess the practice of ordering unnecessary laboratory investigations by primary surgical teams. Method: The clinical audit was conducted from December 17, 2022, to January 15, 2023, at the Civil Hospital, Karachi, and comprised primary surgeons working in different surgical units who ordered laboratory investigations for patients as a part of preoperative assessment. Data was collected using a self-administered questionnaire. Data was analysed using SPSS 20. Results: Of the 280 surgeons approached, 249(89%) responded. The units covered were General surgery 96(38.5%), Gynaecology 74(29.7%), Neurosurgery 5(2.0%), Ear, Nose and Throat 19(7.6%), Plastic surgery 15(6.02%), Paediatric surgery 13(5.2%), Vascular surgery 8(3.21%), Oromaxilofacial 9(3.61%), Opthalmology 6(2.4%), and Orthopaedics 4(1.60%).As part of baseline investigations, 244(98%) surgeons ordered complete blood count, 173(69.5%) ordered urea and creatinine, 229(92%) ordered viral markers, 197(78.7%) ordered fasting and random blood glucose, and 178(71.5%) focussed on cardiac fitness. Conclusion: There was a found a need for standard protocols for pre-surgery evaluation so that unnecessary investigations may be avoided. Key Words: Preoperative, Investigation, Guidelines, Assessment, Audit.
In this review, we argue current advancement in the improvement, recent researches, general manifestation, epidemiology, global TB control program, pathogenesis, clinical features, diagnosis, treatment, risk factors and prevention. In excess of the last 24 years, incredible evolution has been made in TB vaccine research and expansion: In adding up inventive approaches are being pursued to more develop accessible vaccines, as well as discover fresh ones. Thus, there is superior reason for confidence in the field of TB vaccines that it will be probable to build up better vaccines than BCG. Because this BCG vaccine has certain issues which need to be addressed. BCG vaccine has a little impact on the pulmonary TB, means the disease is still transmissible and also the protective ability of BCG against pulmonary TB in adults is incomplete and inconsistent. Another issue of concern that compromises BCG's utility is that infants with HIV have an increased risk of developing disseminated BCG-Osis. A very hopeful TB vaccine, MVA85A, is presently in time II trials and is based on a genetically modified vaccine virus. Many other strategies are also being used to develop novel vaccines, plus both subunit vaccines such as Hybrid-1, HyVac4 or M72. A few of these vaccines can be well administered without needles making them preferable for areas where HIV is very frequent and few of these vaccines have been fruitfully experienced in humans and are now in extended testing in TB-endemic regions. To support further discovery, researchers across the globe are promoting latest economic models of vaccine advance, including prices, tax incentives and go forward market commitments. This review gives the vital suggestion of various vaccine growth approaches and its effective application in tuberculosis control.
Respiratory syncytial virus (RSV) is one of the most common causes of infection of the lower respiratory tract in infants and young children. In the United States RSV is responsible for 90,000 hospitalizations and 4,500 deaths each year 1, 1. Fleming, Pannell, and Cross3 reported that the average death rate from RSV is 6.7 per 100,000 population. Infants with congenital cardiac defects are at greater risk because changes associated with congestive heart failure and cardiac defects limit the ability to compensate during viral bronchiolitis, which in turn increases morbidity and mortality associated with this viral illness4,5. The infection can cause serious illness, prolonged hospitalization, and increased post-operative complications after surgical repair for children with congenital heart malformations6’ 7 ’8. There may also be long term sequelae, proven by a number of studies linking the infection with increased risk of subsequent development of reactive airway disease9,10, 11 compromising the ability of children with congenital heart disease to return to baseline.
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