Objective To analyze drug use for 23 sick and wounded hospitalized in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital, during one month after Lushan earthquake, so as to provide references for the drug use for the sick and wounded women and children. Methods Medication information was retrospectively investigated in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. We extracted data including hospitalization duration, medication prescriptions, types and costs of essential medicines, types and costs of antibiotic medicines using the HIS system. Discharge diagnosis was standardized and classified according to ICD-10. Indicators of rational drug use included defined daily dose (DDD), defined daily dose statistic (DDDs), drug utilization index (DUI), children defined daily dose (cDDD), children drug utilization index (cDUI), proportion of essential medicines, proportion of antibiotic medicines, mismatch of medicine and diagnosis, repeated drug use, improper combination of drug, incorrect usage and dosage, and frequently drug change. Medication information was evaluated and discussed by the prescription working group. Discrepency was resolved by consulting with the panel. Results A total of 23 sick and wounded women and children were assessed during one month after Lushan Earthquake. There were 13 sick and wounded children in the department of pediatrics (mainly manifested as bronchial pneumonia) and 10 sick and wounded women in the department of gynaecology and obstetrics (mainly involved in cesarean delivery). Proportions of essential medicines were 13/13 in the department of pediatrics and 9/10 in the department of gynaecology and obstetrics. Proportions of antibiotic medicines were 10/13 in the department of pediatrics and 8/10 in the department of gynaecology and obstetrics. Irrational drug use was mainly caused by improper use of antibiotics. Conclusion The drug use for 23 hospitalized sick and wounded is rational in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. Evaluation methods of rational drug use in high-risk population are urgently needed. Using cDDD and cDUI is an active exploration for the evaluation of pediatric drug use, which needs more practice to test and improve.
Hot flashes are a common syndrome in postmenopausal women. The treatment is complex and different for specific patients. A clinical case and hormonal replacement therapy selection are provided to show evidence-based practice in this field.
Shortly after Wenchuan earthquake, the leader group of the West China Second Hospital accurately defined the role of the hospital during the medical rescue work and ensured the safety of the inpatients. It cooperated with West China Hospital, going to the main battlefield to rescue the injured people, congregating the main medical resources to the disaster areas for medical rescue. The model of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of the resources were ensured to meet the ever-changing demands from all levels of rescue work. Assembling the elite, 12 medical teams and 148 medical staff in all were dispatched to Beichuan, Mianyang, Shifang and Dujiangyan as well as other severe disaster areas. Up to June 2nd, 329 patients from the disaster area had been treated, of whom 132 were admitted into the inpatient department, no one died. Moreover, even during such a period of time, the routine medical service had been offered as regular to patients other than the wounded in the disaster.
After Wenchuan earthquake, the West China Second University Hospital immediately started the preparation of emergency pharmaceutical administration. The pharmaceutical department effectively controlled the provision, purchasing, utilization and donation of medications through a double-track operation system. In this way, the medication supply was ensured for both the patients suffering from the disaster and routine patients, which guaranteed the rationality in medication and promoted the utilization of the donated drugs so that more than 80 000 drug cost was saved for the hospital.
Objective To provide evidence for establ ishing a health care system for pregnant women after disasters by evidence-based evaluation on the comparison of programs in different countries of the world. Methods We electronically searched The Cochrane Library (Issue 2, 2008), MEDLINE (1966 to June 2008), EMbase (1984 to June 2008), VIP ( 1989 to June 2008), CBM ( 1978 to June 2008), Wangfang database (1997 to June 2008), CNKI (1994 to June 2008) and handsearched Journals such as Chinese Journal of Obstetrics and Gynecology to identify l iteratures and guidel ines on pregnant women healthy care system after calamity. The qual ity of l iteratures and guidel ines was assessed. Results A total of 293 studies were searched, of which 25 studies were identified with the focuses on the consequence of pregnancy, development of fetus and first-aid of injuries of pregnant women. We found the studies on pregnant women’s health care were l imited, and most of them were retrospective and cohort studies, which was related to the paroxysmal ity, rarity and complexity of the disaster.? Conclusions The high proportion of pregnant women among displaced persons underscores the importance of examining how behavioral changes and difficulties in access to health care influencing the maternal and infant health, which needs comprehensive planning and arrangement.
Objective To evaluate the evidence-based prevention and treatment of post-dural puncture headache (PDPH) for parturient women. Methods We searched The Cochrane Library (Issue 3, 2006), Medline (Jan. 1980 to Oct. 2006) and CBM-disc (Jan. 1980 to Oct. 2006) to identify current best evidence on the prevention and treatment of PDPH for parturient women. The quality of available evidence was critically appraised.Results We identified 2 Cochrane systematic reviews, 2 meta-analyses and 9 randomized controlled trials. Evidence indicated that posture, fluid, and pharmacological managements had no significant effect on PDPH except epidural blood patch. The selection of appropriate spinal needle and the technique of needle insertion may reduce the incidence of PDPH, whereas the effect of intrathecal saline infusion and catheter insertion need further clinical validation. Conclusions Epidural blood patch has definite therapeutic effect on PDPH. Appropriate spinal needle and insertion technique may effectively prevent PDPH for parturient women.
Objective To search and review the best clinical evidence to direct the use of ultrasound. Methods After developing clinical questions, we searched the following databases for evidence: PROQUEST (1984 to 2004), SUMSEARCH (1980 to 2004) and The Cochrane Library (Issue 4, 2004). The key words were “repeated ultrasound exposure and children development (outcome)”. Results We found 3 systematic reviews, 3 randomized controlled trials, 1 cohort study and 1 case-control study. Most of the trials concluded that the effects of ultrasound to fetus were to be identified, some of the trials showed that ultrasound exposure could have an effect on fetus growth and language ability after delivery. Conclusions The pregnant women should avoid ultrasound as much as possible.
ObjectiveTo observe the risk factors for osteoporosis in elderly women in Chengdu Shuangliu County, in order to provide a reference for the prevention of this disease. MethodsThrough random cluster sampling from 6 communities in Shuangliu County, 276 aged (60-84 years old) women accepted questionnaire survey from May 2010 to October 2012. Their bone mineral density was also measured. ResultsThe osteoporosis rate in these 276 elderly women was 49.64%. Different occupations had a significant impact on the occurrence of osteoporosis (P<0.05). Osteoporosis rate in elderly women in rural areas was higher than that in urban areas, but there was no significant difference (P>0.05). The rate of women who paid attention to calcium and vitamin D preparations was significantly lower than those with no supplement of calcium and vitamin D preparations (P<0.05). Single factor analysis showed that age, body mass index of age 30, present weight, menopause age, suffering from respiratory diseases were closely related to osteoporosis (P<0.05). Multivariate analysis showed that age, present weight, consumption of milk, menopause age, and respiratory disease history were closely correlated with osteoporosis incidence (P<0.05). ConclusionThe incidence of osteoporosis in women at age 60 or older in Chengdu Shuangliu County is high. Medical workers should strengthen the health education for those elderly women with osteoporosis and promote a healthy lifestyle and a balanced diet.
ObjectiveTo discuss clinical characteristics and nursing countermeasure of pregnant/delivery women with tuberculosis. MethodsFrom January 2012 to December 2013, 52 cases of pregnant women complicated with tuberculosis were included. We offered specific nursing according to the psychological counseling, reasonable administration, diet nursing, fever and prevention of hospital infection on the base of their clinical features, and then analyzed the effect. ResultsIn 52 patients who had undergone the tuberculosis and obsterrics and gynecology treatment, 4 puerperal patients died of severe pneumonia and multiple organ failure; in 48 gestational patients with tuberculosis, 23 early-middle term patients accept termination of pregnancy, and in 25 middle-late term patients, 3 had full-term natural labor, 4 underwent full-term cesarean section, 5 had premature labor, and 13 continued the pregnacy. Sixteen neonatus (including 4 given at the other hospitals) had normal results of physical examination without any deformity, in whom 5 had low body weight (body weight less than 2500 g), with negative results of tuberculin test and the result of 3-moth follow-up was normal. Three months after the anti-tuberculosis treatment, the lesion was obviously absorbed in 25 patients and in 23 patients within half of a year. No patients had hospital infection. ConclusionNursing care of pregnant patients with tuberculosis should strengthen the guidance on the patients health education, improve their compliance and self-protection knowledge. Also should strengthen the basic level medical personnel training and improve the ability of early diagnosis of tuberculosis and early treatment to reduce maternal mortality.
ObjectiveTo discuss whether there are some psychological changes in adult women patients when they first wear fixed orthodontic appliances. MethodsEighty adult women patients aged between 18 and 50 years old averaging 35, receiving fixed orthodontic treatment between January 2011 and August 2012 were selected as our study subjects. They completed a questionnaire regarding anxiety and depression at the first day when they came to the hospital and 7 days, one month, and three months after fixed appliance placement respectively. The scales of anxiety and depression of subjects were assessed according to the symptom checklist-90 (SCL-90). ResultsCompared with the norms, the SCL-90 scores of anxiety, depression and interpersonal relationship sensitivity were higher in these patients. The symptoms were more severe a week later, and were even more severe one month after the appliance placement. Three months later, the scores of all factors began to fall, but were still higher than those before the treatment. ConclusionThere is a certain extent of negative psychological influence on adult women patients during fixed orthodontic treatment. At the first week after the placement of fixed appliance, adult women patients may suffer from anxiety and depression.