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Biomedical subjects

M Z Ansari

Publications and source records attributed to M Z Ansari.

29 records · Page 2Linked to original sources
PubMed1995

Hospital characteristics associated with unplanned readmissions.

The rate of unplanned readmission of patients to hospitals has been introduced into the Australian Council on Healthcare Standards accreditation program as an internal flag of problems in patient management and outcome. An emphasis, in the indicator definition, is placed on the unexpected nature of the admissions to exclude those which are unplanned but simply due to progression of a disease, and are therefore not 'unexpected'. The association of hospital characteristics with unplanned readmissions was examined using logistic regression on the data collected from hospitals surveyed in 1993. The risk of unplanned readmission was significantly higher in public hospitals than in private hospitals. Hospital bed-size also reflected differences in the risk of unplanned readmission, being significantly higher for hospitals with over 200 beds than for those with 1-100 beds. In rural areas, the risk of unplanned readmission was significantly lower in hospitals with 101-200 beds and over 200 beds compared to hospitals with 1-100 beds (p for trend = .004). However, in metropolitan areas, the risk of unplanned readmission increased with the size of the hospitals (p for trend < .0001). Monitoring of unplanned readmissions prompted internal clinical review and action in 31 per cent of hospitals, demonstrating the indicator's usefulness as an internal quality tool. However, the use of unplanned readmissions as an external performance measure must take into account a hospital's characteristics and will remain of limited value in the absence of clinical information about the expected or unexpected nature of the readmissions.

Australia↗
PubMed1995

Assessment of postoperative pulmonary embolism as a measure of patient care.

Hospitals presenting voluntarily for accreditation survey during 1993 submitted data on pulmonary embolism to the Australian Council on Health Care Standard (ACHS) Care Evaluation Program (CEP) as a part of their medical quality activities. The data were stratified by hospital type and bed-size, and compared to the provisional threshold of 1%. The mean duration of data collection was 24 weeks (range 8-74 weeks). Of hospitals with bed-size 1-50, 77% observed a zero pulmonary embolism rate. Hospitals with zero and non-zero pulmonary embolism rates were significantly different with respect to bed-size (P = 0.001). The rarity of pulmonary embolism and lack of prospective continuous monitoring poses considerable problems in interpretation of aggregate rates. Hospitals with a high patient throughout should continuously monitor their pulmonary embolism data to achieve a large denominator. For smaller hospitals with a low performance of major operations, collection of data on this clinical indicator is unlikely to be useful as a measure of quality of care.

Accreditation↗
PubMed1995

Errors in drug prescribing.

This study reports on early results following the introduction of one measure of medication prescription errors, that being the prescribing of a drug for which there is an 'alert' notice, into The Australian Council on Healthcare Standards Accreditation process. Characteristics of hospitals reporting of zero and non-zero errors were analysed using a logistic model. After adjusting for other hospital characteristics and duration of data collection, hospitals over 100 beds were more likely to report medication errors compared to hospitals with 1-100 beds. Reporting of these prescribing errors was not associated with the particular type or location of the hospital. However, as a result of monitoring of this indicator, a number of hospitals reported an increase in their quality assurance activities. It is a sentinel event and not a rate based indicator and, as a performance measure, is of greater value as an internal, rather than external, review mechanism.

Australia↗
PubMed1994

Higher lung cancer rates in young women than young men: Tasmania, 1983 to 1992.

In a background of changing lung cancer rates in the past decade, mean incidence and mortality rates for persons aged 25-44 in Tasmania for the decade 1983 through 1992 were examined using Tasmanian Cancer Registry data. The smoking behavior of Tasmanian adults and schoolchildren was also investigated, using data from a social survey conducted by the Australian Bureau of Statistics and from five secondary school smoking surveys. The Tasmanian age-standardized lung cancer incidence rates in 25-44 year olds for the 10-year period were 6.2 per 100,000 females and 3.3 per 100,000 males. Mean rates of incidence were higher for females than for males (P = 0.02). The corresponding mortality rates were 4.2 in females and 2.4 in males (P = 0.08). The prevalence of smoking by adult Tasmanian women is higher than that for other Australian women (P < 0.05), and their duration of smoking is longer (P < 0.01). Tasmanian schoolgirls have a higher smoking prevalence than Australian mainland schoolgirls (P = 0.01) and higher prevalence than Tasmanian schoolboys (P = 0.01). The data suggest that smoking prevalence among teenagers passed that for males only a decade before the observed excess of female incident cases among 25-44 year olds in Tasmania.

Adenocarcinoma↗
PubMed1994

Epidemiology of arboviral infections.

OBJECTIVE: To review the current state of knowledge regarding the epidemiology of arboviruses. DATA SOURCES: Computerized literature searches, identification of papers through review of article bibliographies, and Yale Arbovirus Research Unit, USA. STUDY SELECTION: Articles documenting research pertaining to the epidemiology of arboviruses with emphasis on factors that increase or decrease the spread of these infections. DATA EXTRACTION: The review articles were extracted independently by the authors. DATA SYNTHESIS: Arboviral infections are a global health problem accounting for significant morbidity and mortality in human and animal populations. They belong to the families Togaviridae, Flaviviridae, Bunyaviridae, Reoviridae, and Rhabdoviridae, and are transmitted to humans and domestic animals by the bite of infected arthropods. Rodents and birds are significant vertebrate hosts, while humans are usually not involved in the maintenance and spread of most arboviruses. Ecologic changes and human behavior are important in the spread of these infections. Clinical features range from mild fevers to fatal encephalitis. Surveillance, immunization, and vector control are important methods of prevention. CONCLUSION: It appears that the distribution and spread of arboviruses is greatly influenced by human behavior and ecologic changes in the environment. Awareness regarding these and other factors, such as travel history, history of bites of arthropods, concurrent epidemic pattern in the community, and knowledge of surveillance data are useful ways of identifying these infections. Future research may be directed toward methodical search for new arboviruses and their relation to human and animal disease.

Animals↗
PubMed1993

Evaluation of vero cell lysate antigen for the ELISA of flaviviruses.

The vero cell lysate antigen for the enzyme-linked immunosorbent assay (ELISA) of flaviviruses was evaluated for sensitivity, specificity including cross-reactions, and background by comparing with the standard ELISA. Human sera, in serial dilutions, were taken from subjects 14, 35, and 210 days postvaccination with 17D antigen. Early after injection, high sensitivity (82.9%) was shown by the cell lysate antigen method. Late after infection, high sensitivity was achieved by the standard method (96.2% and 94%), with significant difference (P = 0.0001). However, sensitivity achieved by the cell lysate antigen method was also acceptable (91.7% & 88.9%). The cell lysate antigen method showed high specificity and low cross reactivity early after infection. At 35 days postvaccination, no difference in specificity was observed between the two methods, but higher cross-reactions were observed for the standard method. This pattern continued at 210 days postvaccination, with significantly higher cross-reactions with the standard ELISA. The optical density differences by the two methods did not show significant relationship with the serial dilutions of human sera. No difference was observed in early and late infections in the background values of the negative control (Western equine encephalitis) between the two methods. The ELISA by the cell lysate antigen, within the limits of the experiments done, was found to be a good replacement for the ELISA by the standard method.

Animals↗
PubMed1992

Studies on the development and survival periods of the non-parasitic stages of Boophilus microplus (Canestrini), in the climatic conditions of Ranchi (India).

Engorged female ticks of Boophilus microplus were exposed in wire-gauze cylinders and glass tubes in an experimental grass plot at monthly intervals during 1989, and egg laying, egg development and larval survival periods observed and recorded. Rainfall and atmospheric relative humidity had an important influence on tick activity. Egg production was maximum, hatching percentage was high, incubation and prehatch periods were short, and larval survival and total longevity periods were long for ticks exposed during the warm and humid rainy season from June to September. Dry atmospheric conditions severely affected egg development, egg hatch and larval survival. Eggs failed to hatch in the dry months from December to April and only 29-38% hatched after a long incubation period of 41 days in November and May. On grass, the larvae of ticks exposed in November survived for the shortest period of 28 days and the larvae of ticks exposed in June survived for the longest period of 133 days. Low winter temperatures reduced egg production and prolonged the pre-oviposition, oviposition and incubation periods. It is suggested that the results of this study might be helpful in the development of measures to control tick infestation by planned dipping and restricted grazing during the period from late June to January when the pasture has a substantial load of larval ticks.

Animals↗
PubMed1990

Clinico-biochemical use of serum acetylcholine esterase following treatment with synthetic pyrethroids, cypermethrin and fenvalerate, in cattle and buffalo experimentally infested with Boophilus microplus.

Following treatment, cypermethrin and fenvalerate, were found to have inhibitory effect on serum acetylcholine esterase (AchE) activity of cattle and buffalo experimentally infested with B. microplus. The pattern of AchE activity in infested-pyrethroid-treated group was found to be significantly different from either healthy or tick-infested control. There was transient increase in the enzyme activity initially, followed by gradual decline and subsequent increase leading to normal level within 7 days of pyrethroid treatment. The enzyme activity was found to be low in buffalo than in cattle and the values remained below normal level up to day 7 in tick-infested group. The reversion of AchE activity to normal level in pyrethroid-treated group indicated that these compounds are prompt and safe ixodicides with least residual effect. The present investigation concludes that estimation of serum AchE might help in the clinico-biochemical diagnosis of tick toxin and pyrethroid toxicity in cattle and buffalo treated with these pyrethroids against tick infestation.

Acetylcholinesterase↗