Introduction: Road traffic accidents (RTAs) are among the leading causes of mortality worldwide, and Bhutan is no exception. This study is the first of its kind to analyse the RTA records maintained by the Department of Forensic Medicine and Toxicology (DFMT) of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH). The objectives were to review RTA records and generate actionable insights prior to digitally archiving key data points and securely disposing of hard-copy records. Methods: This retrospective descriptive study reviewed RTA records maintained by the DFMT of JDWNRH. All RTAs recorded from January 2011 to December 2023 were included. Paper-based information was digitized using Google Forms and subsequently analysed using SPSS Version 31. Results: A total of 3,847 RTAs, including 41 (1.1%) fatalities, were recorded during the study period. Young adults aged 20–29 years accounted for the highest proportion of cases (37.7%). Individuals of Sharchop ethnicity (31.5%) and motor vehicle drivers (34.0%) comprised the largest groups of road users, followed by pedestrians (24.3%). The number of RTAs was higher during summer, on Sundays, within the City Core area, and between 15:00 and 18:00 hours. Off-road vehicular accidents (28%) were the most common type of RTA, and the majority of cases involved injuries to the extremities (92.4%).Conclusion: The study underscores the need for structured, comprehensive, and digitally integrated medico-legal documentation, particularly within the existing ePIS framework. The observed temporal fluctuations, seasonal variability, and episodic surges in RTAs indicate the need to transition from reactive case documentation to proactive, data-driven road safety planning.
Introduction: Growing antimicrobial resistance to commonly used antimicrobial exacerbates global burden of the bloodstream infection (BSIs). Understanding the local antimicrobial susceptibility pattern is crucial for effective antimicrobial stewardship. This study evaluated the antimicrobial susceptibility pattern and proportion of multidrug-resistant organisms (MDROs) among blood culture bacterial isolates at Eastern Regional Referral Hospital. Methods: The retrospective study reviewed blood culture records of 2025. A total of 79 positive blood cultures from 62 unique patients were included. Antimicrobial susceptibility testing was performed using standard microbiological methods and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were collected in REDCap and analyzed using SPSS version 32 and R version 4.6.0. Results: Of 981 blood cultures performed in 2025, 8.1% showed positive culture. Most cases occurred in patients over 40 years (74.7%), with a female predominance (53.2%). Sepsis was the predominant clinical diagnosis (78.5%), and 70.9% had comorbidities. Gram-negative organisms accounted for 78.5% of isolates led by E. coli (45.2%), which exhibited high susceptibility to amikacin (86.7%). Staphylococcus aureus (82.4%) was the main Gram-positive isolate demonstrating complete susceptibility to cloxacillin (100%). Overall, 23.0% (17/74) of the isolates were MDROs. For carbapenem resistance, 35.7% (5/14) of tested isolates were identified as CRO, representing 6.3% (5/79) of the total cohort. Conclusion: Gram-negative organisms, particularly, E. coli was the main causative pathogen. The findings provide vital insights into the local susceptibility patterns to guide antimicrobial stewardship programs.
Introduction: Accurate and timely reporting of laboratory results is essential for optimal patient management. The testing process in clinical biochemistry is divided into pre-analytical, analytical, and post-analytical phases. This study assessed the sample rejection rate and identified common pre-analytical errors in the Biochemistry Unit of Jigme Dorji Wangchuck National Referral Hospital. Methods: A retrospective observational study was conducted by reviewing records of all rejected samples in the Biochemistry Unit from January 2019 to December 2020. Results: Of 197,735 samples received for biochemical testing, 283 were rejected, giving an overall sample rejection rate of 0.14%. The most common reasons for rejection were insufficient sample volume (51%) and hemolysed samples (28%). The neonatal intensive care unit contributed the highest proportion of rejected samples (32%), followed by inpatient wards (25%) and the emergency department (17%). Conclusion: The sample rejection rate in the Biochemistry Unit was low at 0.14%, with insufficient sample volume being the leading cause of rejection. Targeted training in neonatal blood collection, adherence to standardized collection protocols, and the use of micro-collection tubes may help mitigate pre-analytical errors and improve sample adequacy.
Introduction: Maternal mortality remains a major public health concern, particularly in low- and middle-income countries (such as Indonesia. Delayed recognition of pregnancy danger signs contributes substantially to preventable maternal deaths. As mobile health (m-Health) platforms increasingly disseminate maternal health information, digital health literacy, the ability to search for, evaluate, and apply online health content, has emerged as a pivotal factor influencing maternal knowledge and decisionmaking. This study aimed to assess the level of digital health literacy among pregnant women, evaluate their knowledge of pregnancy danger signs, and examine the association between digital health literacy and knowledge of danger signs. Methods: A community-based cross-sectional study was conducted among 422 pregnant women recruited through systematic random sampling at primary healthcare centers. Data were collected using structured questionnaires, including the eHealth Literacy Scale and WHO-based pregnancy danger sign items. Data were analysed using SPSS version 26. Results: Overall, 54.5% of participants demonstrated high digital health literacy, while 63.3% had adequate knowledge of pregnancy danger signs. High digital health literacy was significantly associated with better knowledge (aOR=2.81; 95% CI 1.85–4.27; p<0.001). Education also showed a positive association, whereas parity did not emerge as an independent predictor. Conclusions: Digital health literacy plays a crucial role in shaping pregnant women’s awareness of obstetric danger signs. Strengthening it through targeted interventions embedded in antenatal and community health programs may enhance the timely recognition of complications, contributing to reductions in preventable maternal morbidity and mortality.
Introduction: Allergic rhinitis is one of the most common diseases being presented to the Ear, Nose, and Throat (ENT) Outpatient Department (OPD), affecting approximately 500 million people globally. The disease is associated with a substantial socioeconomic burden due to impaired quality of life, reduced work and school productivity and escalating healthcare costs. Intranasal corticosteroid sprays are well established as the most effective first-line treatment for patients with allergic rhinitis. Inadequate knowledge and improper use of intranasal corticosteroids may result in suboptimal therapeutic outcomes. The present study aims to evaluate the level of awareness and practices among patients with allergic rhinitis receiving intranasal corticosteroid therapy at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Bhutan. Methods: A cross-sectional study was conducted at the ENT OPD, JDWNRH from July 2022 to January 2023. Patients with allergic rhinitis were included in the study using a systematic random sampling, and data was collected using a standard validated questionnaire and analysed using Stata. Results: 201 patients were recruited for the study. 71% (n=142) had poor awareness regarding allergic rhinitis and its treatment. 55% (n=111) had poor practices, while only 43% (n=86) could demonstrate the correct technique of nasal spray application. Education level had a significant association with awareness and practices among patients with allergic rhinitis (aOR 2.74, 95% CI 1.34 – 3.75, p-value =0.001). Conclusion: Poor awareness and suboptimal practices were observed among patients with allergic rhinitis using intranasal corticosteroid at JDWNRH, which may potentially contribute to inadequate disease control.
