Hougaardfournier1454

ults of other studies of DPN in individuals with diabetes. There is a need for early detection and regular screening for DPN in patients with diabetes, with special attention given to patients with risk factors for DPN.

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Open globe eye injuries have poor visual outcomes. In Palestine, no studies have completely described the impact of time delays to surgery on visual outcomes. This study examines the causal factors for open globe eye injuries, time to presentation, and the effects of delays to surgery on visual outcomes.

A retrospective review was carried out of 413 patients with monocular open globe eye injuries attending St John Eye Hospital, Jerusalem, occupied Palestine territory, from Jan 1, 2000, to Dec 31, 2005. Injury cause, time to presentation, visual acuity on arrival, and the final corrected visual outcomes were assessed.

Open globe eye injuries were caused by traumatic injury during the Intifada in 2002 (13%) and military actions throughout the study period (14%), but most injuries (38%) occurred in workplace or were related to domestic eye injuries (20%). The median time from open globe eye injury to arrival at hospital was 4 hours (IQR 11-3); 290 (70%) of 413 patients arrived within 8 h of injury. Visual tudies should investigate whether delay in surgery affects outcomes in relation to the severity of injuries, as this study is cross-sectional and longitudinal epidemiological studies might yield better interpretations.

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Clinical audit plays a fundamental role in improving the quality of patient care and hence, is considered a cornerstone of clinical governance. This quality improvement tool is newly introduced in the health-care system of the Gaza Strip. Although the number of audits completed in Gaza has been increasing over the past few years, little evidence is available of subsequent quality improvements in practice.

An online survey was used to collect information on the audit team, location, applied methods, outcomes, presentation of data, and reaudit. Medical students and health-care professionals who had conducted audits between 2015 and 2018 were invited to complete the survey from Oct 12 to Nov 2, 2018.

Data on 62 audits were collected. Training in clinical governance was received by 55 auditors (89%) and a senior supervisor was available in 56 audits (90%). Audits were performed across different hospitals and specialties 18 (29%) in obstetrics, 16 (26%) in medicine, and 11 (18%) in each of surgery and paediaealth care and patients' safety. However, completion of audit cycles and the actual implementation of recommendations are lagging. Therefore, more focused efforts supported by both clinical and administrative leaderships are needed to implement changes and ensure continuous evaluation of their effectiveness.

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Needle stick injuries (NSIs) are preventable hazards that can be avoided with appropriate staff training and safety systems. We assessed the prevalence and awareness of NSIs among health-care workers and cleaners in hospitals in Gaza.

We did a cross-sectional study in four hospitals from July 14 to Oct 25, 2018. All cleaners and health-care workers were eligible to participate. Data were gathered via a survey tool designed for the study that covered sociodemographic data, NSI prevalence, and response to possible injuries. The primary outcomes were prevalence and staff awareness of NSIs.

538 staff participated in the survey, among whom the mean age was 28.9 (SD 7.71) years, 331 (62%) were men, 119 (22%) were doctors, 262 (49%) were nurses, 72 (13%) were medical students, and 85 (16%) were cleaners. 289 participants (54%) had had at least one NSI 59 doctors (50% of all doctors), 142 nurses (54%), 32 students (44%), and 56 cleaners (66%). NSIs were obtained during various activities, including 168 incidents (40%) during drug administration, 82 (20%) while recapping needles, 78 (19%) during wound suturing, 63 (15%) while cleaning, and 27 (6%) during arterial blood gas sampling. Only 94 (33%) of 289 participants with NSIs reported their injuries. Among the 195 (67%) participants who did not report NSIs, 41 (21%) did not know that they should do so, 65 (33%) did not know how to report, 62 (32%) believed that reporting was useless, and 27 (14%) forgot to report.

More than half the participants had had NSIs, but reporting of injuries was low. The Ministry of Health should provide targeted interventions and training to improve risk awareness and understanding of the importance of reporting for health-care employees. The strengths of this study are the large sample size and recruitment from diverse professional backgrounds. The main limitation was the lack of validation of the study instrument.

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Poor control of cancer pain is a major public health problem worldwide. Many potential barriers can lead to suboptimal treatment of cancer pain. One such barrier is inadequate measurement and assessment of cancer-related pain control. This study aimed to assess current pain control and management for hospitalized adult patients with cancer in the Gaza Strip.

A cross-sectional study was conducted from Dec 10, 2017, to April 25, 2018, in the Gaza Strip. The validated Brief Pain Inventory (BPI) questionnaire was translated into Arabic for data collection. The first section of the questionnaire described the patients' sociodemographic characteristics, the second evaluated the severity of cancer, and the third assessed the interference of pain with daily activities. A ten-point Likert scale was used to evaluate the magnitude of cancer pain and its impact on the patients' lifestyle. Participants were 12 years of age and older, and were patients with cancer who had been admitted to Al-Rantisi Hospital or Europeawithin the past week, 74% (54 of 73) were using analgesics daily, and 43% (31 of 73) reported that they needed potent analgesics. 15% (11 of 73) reported concerns about analgesic addiction. The level of functional impairment owing to pain, as reported using the ten-point Likert scale, was highest for daily activities and routines (median 9·0, IQR 7·0-10·0) and least for social relationships (5·0, 0·0-9·0). There was no statistically significantly association between cancer-related pain and gender, educational level, or occupation.

Most patients were taking analgesics but a large proportion reported the need for more potent or frequent doses of painkillers. JTE 013 concentration In addition, pain had a significant effect on the patients' lifestyle. These findings indicate poor control of cancer pain. There is an urgent need to address the reasons for this, to alleviate pain and to improve quality of life.

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