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Clarity in directions and constant engagement efforts are crucial to implementing high-quality interventions in Quality Improvement (QI) initiatives. It underpins the successto achieve impactful improvement, effectiveness of interventions through clinical leadership and project sustainability. IKE modulator ic50 Our objective was toimplement a QI roadmapto improve QI participation of specialists and to clearly align projects and stakeholders to achieve departmental priorities and goals.
Baseline measurement ofDepartment of Internal Medicine (DIM) specialists involved in QI projects was performed. Root cause analysis and prioritization was conducted to determine the interventions.Series of interventions to address challenges faced by stakeholders to ensure congruency of directions that included collective learning sessions, planning of communication, and documenting progress with checkpoint meetings were carried out. A survey was conducted before and after interventions.
QI projects' participation rates ofDIM specialists iers activation barrier and promotes spread due to its simplicity to create and use for communication.
Department-specific goals and priorities with dedicated interventions are important in driving the interest and ownership to initiate QI projects that align to solve operational problems. The ease in creating the strategic themes model targeting key performance indicators and matching QI projects to the relevant themes, lowers activation barrier and promotes spread due to its simplicity to create and use for communication.Introduction One of the major hardships faced by married couples is the inability to conceive a child. This issue is becoming more prevalent given the increasing rate of infertility worldwide. Assisted reproductive technology (ART) has brought hope to infertile couples. We aim to estimate the live birth rate (LBR) and pregnancy rate in women with one ovary compared with those with two ovaries. Methods A retrospective cohort study of women who underwent ART at King Abdulaziz Medical City (Jan 2000 - Dec 2018) was conducted. Five cycles of patient data were collected. The LBR (both conditional and cumulative) was compared between women with one and two ovaries. Results The final analysis included 403 women. Of these, 9% (n = 37) had one ovary. The majority (59%, n = 233) had primary infertility. A male-associated factor accounted for 52% (n = 208) of the infertility cases. The total number of live births was 164; and the overall LBR from five cycles was estimated as 9%, 16%, 18%, 18%, and 15%, respectively. In the double ovary group, the highest rate was in the fourth cycle [19% (12-26)], while in the single ovary group peaked in the third cycle [27% (9-46)]. Pregnancy was at its highest in the first cycle, accounting for 88 pregnancies. Conclusion The outcomes of ART varied between study groups. LBR was lower in single ovary women. The average of five cycles in the single and double ovary groups was 13% and 15%, respectively. Nevertheless, there was no significant difference in LBR between single or double ovary women.Introduction Physicians' attitude towards a healthy lifestyle is important as it determines their extent of acceptance of these habits leading to overall well-being. Physicians with healthy lifestyle habits are more confident in advocating the same to their patients and their patients are keener in adopting lifestyle modifications. This study aimed to evaluate the lifestyle habits, wellbeing, and mental health of physicians in Pakistan. Methods A multi-center, cross-sectional survey was conducted with physicians across Pakistan from August to October 2020. A total of 1406 participants were gathered by the non-probability convenient sampling technique. Data were collected physically from the participants. A semi-structured, self-administered questionnaire comprising socio-demographic information, lifestyle habits, mental well-being, and well-being, in general, was filled. Mental wellbeing was assessed using the Warwick Edinburg Mental Wellbeing Scale (WEMWBS) comprising 14-positive items scored on a 1-5 point mental and physical well-being subsequently allowing them to cater to their patients more effectively. It is recommended that physician-patient-specific interventions should be developed to target the health status and mental well-being of a physician and to encourage the physicians especially the fresh medical graduates and young doctors to indulge in healthy activities.Anterior clinoidectomy (AC) is a key microsurgical step for the safe and successful management of parasellar pathologies that involve the anterior clinoid process (ACP) and the optic canal. Traditionally, extra and intradural ACs are performed separately according to the surgeon's experience or preference. The objective is to present and discuss the tailored AC concept through illustrative cases. We conducted a retrospective record review of three patients who underwent AC as a surgical step for the treatment of parasellar pathologies that involve the ACP and optic canal. A review of the relevant literature on AC was performed in the PubMed, LILACS, and SciELO databases. In all three cases, the pterional craniotomy was the preferred approach for AC. Case 1, a 47-year-old female patient with type III anterior clinoidal meningioma, underwent a tailored intradural technique (optic canal unroofing) with total tumor resection and complete visual recovery. Case 2, a 63-year-old female patient with a complex type II anterior clinoidal meningioma with extensive hyperostosis of the ACP, underwent a hybrid AC technique with complete removal of the tumor and visual improvement. Case 3, a 62-year-old female, underwent a tailored intradural AC for clipping an incidental carotid-ophthalmic aneurysm. Tailored AC aims to provide adequate exposure with less risk of neurovascular injury, allowing enough space to safely treat parasellar lesions. The type, size, and location of the lesion, as well as the surgeon's experience, should always be considered for surgical planning.Background In this study, the effects of tranexamic acid (TXA) and saline on intact cartilage and the recovery of experimental osteochondral lesions following microfracture in a rabbit model were compared. Methods Twenty adult rabbits were divided into four groups (1A, 1B, 2A, and 2B) based on with or without TXA use and microfracture. In addition, these groups were categorized into two different subgroups based on the use of TXA in Groups 1 and 2 (Groups A and B). Full-thickness cartilage defects were created on the weight-bearing surface of the medial femoral condyles unilaterally in Group 2 for the effect of TXA or saline on healthy cartilage tissue while a repetitive injection was applied in Group 1 for the effect of TXA or saline on intact cartilage. A single dose of 10 mg/kg TXA was injected into the knee joints of Group A and 10 mg/kg 0.9% saline solution injected in Group B for three consecutive days. All animals were sacrificed for the extraction of the medial condyles for histologic evaluation eight weeks after surgery.
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