Service Quality Of Diagnostic Fine Needle Aspiration Cytology In A Tertiary Care Hospital Of Lahore (Process Measure As Patient's Perspective).

BACKGROUND: Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. METHODS: In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05). RESULTS: Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05). CONCLUSIONS: The study suggests that service quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients' point of view as most aspects of service quality in public hospitals of Pakistan, require improvements. In this manner patient's satisfaction regarding use of services in public hospitals can be made better.

Diabetes mellitus among tuberculosis patients in a tertiary care hospital of Lahore.

BACKGROUND: Diabetes is an important risk factor for Tuberculosis (TB) that might affect disease presentation and treatment response but has hitherto been neglected by the clinicians. There is inadequate data on the prevalence of diabetes mellitus (DM) among TB patients in Pakistan. This study was conducted to determine the frequency of TB patients having DM. METHODS: In this cross-sectional study, 158 TB patients admitted in Gulab Devi hospital were selected by systematic random sampling technique and data were collected using a pretested questionnaire. All patients underwent anthropometric measurements and baseline investigations. Diabetes was confirmed by determining fasting blood sugar level using cut-off value of 126 mg/dl. Data was entered in Epi-Data-6 and analyzed using Epi-Info. RESULTS: Among 158 patients of tuberculosis, 41 (25.9%) were found to be diabetic, out of which 9 (5.69%) were newly diagnosed with diabetes. Moreover 96 (60.8%) patients were 35-55 years of age. Male patients were 97 (61.4%). Most of the patients belonged to the rural area 118 (74.7%) while 115 (72.8%) patients were illiterate and 139 (88%) had monthly income less than 7000 PKR. CONCLUSION: The study concludes that among tuberculosis patients with diabetes mellitus, about 5.69% were newly diagnosed during the course of investigation. This raises the concern that importance is not being given to routine screening of tuberculosis patients for diabetes by the clinicians. Health professionals should be updated about the link between diabetes and TB.

Preparedness of Public Hospitals for the Coronavirus (COVID-19) Pandemic in Lahore District, Pakistan.

Background Pakistan reported more than a million cases during the coronavirus disease 2019 (COVID-19) pandemic, shuffling the already resource-constrained health system that is known for its high vulnerability and lack of adaption. Objective To find out the level of preparedness of public hospitals for the novel COVID-19 pandemic in Lahore district. Methods A descriptive cross-sectional study was conducted from April to July 2021 among all 18 public hospitals under Specialized Health Care and Medical Education (SHC&ME) in Lahore by administering World Health Organization (WHO) and SHC&ME modified and pre-tested interviewer based and observation checklist. The level of preparedness was assessed for 11 domains, and each domain was scored as a dichotomous variable (Yes and No). Hospital preparedness was labeled as 'acceptable,' 'insufficient,' and 'unacceptable.' Descriptive statistics were run by using SPSS version 26 (IBM Corp., Armonk, NY), and data are presented in the form of tables and bar graphs. Results Out of 18 hospitals, only three (17%) had an acceptable level of preparedness for COVID-19 (>70%). An unacceptable level of preparedness (<35%) was seen in one hospital (5%). Fourteen hospitals (78%) were insufficiently prepared (35-70%). Conclusion The study highlights the suboptimal preparedness in 83% of the public hospitals with a consistent pattern of deficiencies in surge capacity, logistics and resource management, essential services, including diagnostics, infection prevention, and control.