ABSTRACT Patient satisfaction is gaining importance in terms of quality care delivered, especially in emergency departments (EDs), where patients are likely to exhibit anxiety, be uncertain, and time-sensitive. At a multispecialty hospital, where services are provided across a wide array of medical specialties, achieving a high level of patient satisfaction in the ED is even more imperative to preserve the institutional reputation and make integrated care possible. The purpose of this review is to examine the various factors that affect patient satisfaction in EDs, and specifically in multispecialty hospital settings. The major determinants include waiting time, communication with health care providers, staff attitude, management of pain, physical environment, and the competency of discharge instructions. All these aspects, in combination and separately, influence patient satisfaction, impacting emergency care organization quality and responsiveness. This review highlights different evidence-based interventions that promote satisfaction, such as better triage systems, staff training on patient-centered communication, infrastructural enhancement, and real-time feedback systems. In managing both systems and patient care factors in emergency care, the results emphasize the necessity of taking a holistic sustainable approach on the part of hospitals. Patient satisfaction in the ED is not solely about patient comfort but also an indicator of the quality of care, safety, and efficiency in operations, all of which are critical to acheiving better health outcomes and institutional excellence.
ABSTRACT Background: Individuals with schizophrenia have a higher prevalence of substance use disorders (SUDs) than the general population. This study aimed to investigate the prevalence of substance use and its association with sociodemographic factors among patients with schizophrenia. Materials and Methods: A cross-sectional study was conducted on 150 patients with schizophrenia attending the outpatient and inpatient facilities of the Department of Psychiatry at a tertiary care hospital. Sociodemographic data, substance use patterns, and diagnosis of SUDs were assessed using semi-structured proformas and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Results: The prevalence of substance use was found to be 52% among the participants. Alcohol (66.67%), tobacco (51.28%), and cannabis (16.67%) were the most commonly abused substances. Substance use was significantly associated with age, gender, occupation, family type, and marital status. Male gender, middle age (36–45 years), unemployment or self-employment, and belonging to a joint family were identified as significant risk factors for substance use in this population. Conclusion: This study highlights the high prevalence of SUDs among individuals with schizophrenia and the influence of sociodemographic factors on substance use patterns. Routine screening for dual diagnoses and addressing sociodemographic risk factors through targeted interventions are crucial for the holistic management of schizophrenia and the improvement of overall mental health outcomes.
ABSTRACT Background: Awareness of child sexual abuse (CSA) in the society among medical students should be instilled in the early stage as CSA can be presented in any field of specialty in the medical profession. Early identification and knowledge about the CSA should be made compulsory as a part of medical profession as many cases present in different departments as different cases related with emotional or physical abuse. This study has been conducted to spread awareness and instill in the young minds of undergraduates to carefully perform their duty in pointing out the suspected child abuse cases by knowing what to see in all the cases involving a child, irrespective of the department or specialty that they are brought in, so that we can make a small change in this society. Objective: The objective is to assess the knowledge and attitude of medical undergraduates and internees toward CSA in the society and determine the association between knowledge and attitude towards CSA in relation to the year of study and gender of the participants. Materials and Methods: A cross-sectional study was conducted among medical undergraduates and internees of Regional Institute of Medical Sciences, Imphal, from August 2025 to October 2025 (3 months). Questionnaires were distributed, and data entry was done using Statistical Package for the Social Sciences version 21 (Armonk NY: IBM Corp). Results: Out of 333 subjects, 134 (40.2%) were males and 199 (59.8%) were females. First-year students comprised 66 (19.8%), second-year students comprised 67 (20.1%), third-year students comprised 67 (20.1%), and final year students and internees comprised 65 (19.5%) and 68 (20.4%), respectively. An adequate score of 95.2% in 317 out of 333 participants was observed. The association between the year of study with score and gender with score is statistically insignificant ( P value) in both. Conclusion: It is high time now to include CSA as part of the medical curriculum in every specialty so as to sensitize our budding doctors toward CSA so that they will be future-ready to tackle the ever-increasing number of cases. In a case of CSA, precise documentation of findings is essential for a precise diagnosis so as to safeguard the children of the society. To achieve these goals in mind, standardized guidelines and properly trained healthcare professionals are top priority.
ABSTRACT The Systemic Immune–Inflammatory (SII) Index, calculated as platelet count multiplied by neutrophil count and divided by lymphocyte count, has emerged as a promising biomarker integrating key components of inflammation and immunity. It reflects the balance between pro-inflammatory and immune-regulatory mechanisms and has been investigated across diverse clinical domains. Evidence indicates that elevated SII is associated with adverse prognosis in oncology, increased morbidity and mortality in cardiovascular and cerebrovascular diseases, and greater severity in infectious and inflammatory disorders, including coronavirus disease 2019 and chronic liver disease. Compared with other hematological indices such as the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, SII offers a more comprehensive assessment of systemic immune–inflammatory status. Despite its potential, clinical application is limited by variability in cut-off thresholds, lack of standardized reference values, and confounding influences of comorbidities. Prospective, multicenter studies are needed to validate its predictive power and to explore integration into established prognostic models. This narrative review synthesizes current evidence on SII, highlighting its clinical utility, limitations, and future directions in precision medicine.
ABSTRACT Context: The advancement of regional nerve blocks has been proposed to provide immediate analgesia in femur fracture patients. Aims: To compare the analgesic efficacy of ultrasound-guided pericapsular nerve group block versus femoral nerve block (FNB) in optimal positioning for spinal anesthesia (SA) for the neck of femur fracture surgeries. Settings and Design: Prospective randomized control trial. Materials and Methods: This was a prospective randomized double-blind study wherein 80 patients undergoing neck of femur fracture surgeries were allocated into two groups: Group 1 patients receiving pericapsular nerve group block, and Group 2 patients receiving FNB. The analgesic efficacy and ease of spinal positioning (EOSP) were compared between the two groups. Statistical Analysis Used: Data will be entered in MS Excel, and statistical analysis will be performed by SPSS23 software. Results will be presented in descriptive statistics, and appropriate test significance will be applied with a 5% level of significance and 95% confidence levels. Results: The numerical rating scale values in Group 1 were reduced in comparison with Group 2 which is statistically significant ( P value < 0.00001). EOSP score was low in Group 1 compared with Group 2 which is statistically significant ( P value 0.018). Conclusions: Pericapsular nerve group block facilitates easier positioning during SA and offers superior analgesia compared with a femoral block before SA for the neck of femur fracture surgery and decreases the need for post-operative rescue analgesia.
