Physicians’ knowledge, approach, and perceived barriers to the diagnosis and management of sepsis in a public tertiary hospital in Lagos, Nigeria.

Introduction
In Nigeria, low compliance with protocols hinders sepsis care, delaying therapeutic decisions. This study
evaluated physicians’ knowledge, approach, and perceived barriers to the rapid identification and
adequate care of sepsis.

Methodology
The study was cross-sectional, among physicians at Lagos University Teaching Hospital (LUTH). All LUTH doctors, regardless of qualification and practice could participate. A self-administered questionnaire was transcribed into a google form and delivered to doctors’ platform. The questionnaire collected biodata, knowledge, evaluation, treatment approaches and barrier to sepsis care. All participating physicians gave informed consent. The study was approved by LUTH Health Research Ethics Committee. ANOVA was performed to compare physician group means. The mean scores were determined for each domain from participant responses. Respondent scores for knowledge, approach and perceived barriers were compared. Two-sided p-value of 0.05 was considered statistically significant.

Results
The study involved 165 doctors. Mean age was 39±9.0, with 92 (55.8%) males. Only 8 (4.8%) doctors had a 75% understanding of sepsis, only 3(1.8%) responders scored 75% on sepsis care according to SSC recommendation and 138(83.6%) responders reported high hurdles to sepsis care.
Senior registrars scored best on sepsis knowledge, while interns scored lowest(F=3.508, p=0.009). Mean score of approach to sepsis care among cadres were not significant(F=1.692, p=0.154). The interns reported the fewest impediment to sepsis care (F=2.686, p=0.033).

Conclusion
This study revealed that clinicians in a tertiary hospital in Nigeria, had inadequate knowledge and a suboptimal approach to the management of sepsis patients, as well as substantial barrier to their care. Poor knowledge was more widespread among physician of lower cadre, although poor approach persisted throughout all physician groups. Sepsis protocols, training and retraining of doctors on management guidelines would be instituted.

1. knowledge of sepsis diagnosis and management among doctors in developing countries is still very poor.
2. Among doctors with good knowledge of sepsis management, there is however low compliance with standard sepsis protocol.
3. There is the need for training and retraining of doctors on sepsis diagnosis and use of sepsis protocol

Background: Telemedicine, a part of Medical Informatics used to consult patients from remote places either via videoconferencing or transferring data and resources via Store and Forward method makes the quality of healthcare in Low-and middle- income countries more efficient, cost effective and accessible. The objectives of this study were to determine its effects on health care of Refugees and its efficacy in terms of referrals and cost reduction for Health care service providers among Bhutanese Refugees in eastern Nepal.

Methods: This was a cross sectional study done retrospectively from the records of patient’s data of Bhutanese Refugees from AMDA, Damak and prospectively by asking the questionnaire to the health care providers of Beldangi PHC of AMDA, Damak. Data analysis was done in datasheet created in Statistical Package for social Sciences (SPSS) and qualitative data was analyzed through domain analysis.

Results: The total percentage of patients that were seen via teleconsultation in primary center was 58 % male and 42 % females whereas from secondary Center, male was 43% and females 57%. The referral rate from those primary centers and secondary centers were decreased to 31 % and 39 % respectively from 72 % and 61 % from previous records. The budget expenditure was also decreased to 13.65 % from 29.41%.

Conclusions: Telemedicine shows beneficial in those types of refugee’s camps where there is chain of referring patients from Primary Health centers to tertiary care centers via secondary health care centers. As it not only decreased the referral rate but also save the budget expenditure which needed when referring those patients to other centers.

1. Telemedicine
2. Benefit in Refugees camps
3. Effectiveness of Telemedicine

Introduction: It’s well recognised that certain lifestyle habits, including low physical activity, are risk factors for many diseases. The possibility of doing so is likely to be modulated by environmental & social factors
Aim:
1. To assess the pattern of physical activity and sedentary behavior among adolescents.
2. To determine the relationship between physical activity, sedentary behaviour and psychosocial health
Methodology:
A community based cross-sectional study covering adolescents studying in selected pre university colleges of Mangaluru city in south India. A pre-tested, structured questionnaire based on the Physical Activity Questionnaire for Adolescents (PAQ-A) developed by Kowalski K et al. was used for collection of data. Positive and negative health indices were used for studying socio-psychological health. Statistical analysis was done by using proportions, rankings and Wilcoxon Rank test.
Results and conclusion:
Majority of the students had a positive socio-psychological health. Negative health indices were mostly absent among females. Physical activity showed a downward approach across both the sexes. Majority of the respondents carried out physical activities only once or twice a week and physical education classes were rarely attended by the students. Working on computer, watching television, studying and travelling made up for most of their daily sedentary behaviour. On an average other than the college classroom hours, about five to six hours a day was being spent on sedentary behaviour. Talking over the phone and playing video games also had their part in sedentary behaviour. Therefore considering seven hours of college and five to six hours of sedentary behaviour everyday, more than half a day was spent on sedentary behaviour, which is alarming.

At the conclusion of my presentation attendees will take away
1. Adolescents were performing physical activity only for once or twice in a week
2. Adolescents spent almost 12 hours in a day in sedentary behaviours
3. Majority of the students had a positive socio-psychological health.