Background -Christian mission hospitals in India are still grappling with rising service needs, rising expenses, and inefficiencies in service design, including antiquated care models. In this situation, the competencies of governing board members, the governing board's effectiveness, and their profile demand more attention.
Objectives- The objectives were to assess the profile, competencies and the effectiveness of governing boards of the selected Christian mission hospitals using the Board Self- Assessment Questionnaire (BSAQ).
Methods: A sample size of 30 Christian Mission Hospitals in India were selected using the purposive sampling method. The data was collected from the governing board members using the profile details form and Board Self Assessment Questionnaire (BSAQ).
Results: The findings of this study reveal that the representation of female governing board members was very high (89.8%) and the representation of external members was extremely less(11.4%). The representation of younger board members aged less than 40 years (12%) was also very less. The educational level of the board members was very good as the majority (67.1%) of them had undergraduate and postgraduate degrees in the healthcare and other fields. The study revealed that a significant number of board members had management degrees or short-term training which was an added advantage for effectiveness.
Conclusion- The demographic variables of governing board members like age, education and experience in current organisation did not have a significant association with their competencies. The study revealed that the overall effectiveness of governing boards of 30 hospitals is 0.62 which was good.

Background: Increased stress levels, when chronic in nature, may lead to diseases like hypertension, cancer, early ageing and fertility issues along with menstrual irregularities in females and lower sperm count in males as the age increases, due to hypothalamic-pituitary-adrenal (HPA) axis dysregulation. Aim: The aim of the present study was to assess the effect of perceived chronic stress and body mass index (BMI) in a subset of healthy population of male volunteers aged 18 to 45 years and female volunteers aged 18 to 40 years. Methods: The selected male and female population were stratified into age and stress matched groups and one time dehydroepiandrosterone-sulfate (DHEA-S) levels were ascertained to evaluate any changes DHEA-S levels were measured using Chemiluminescence method within six hours of collection of the blood samples, randomly collected at different time points in the day, and were then statistically evaluated using Mini Tab statistical tool. Results: The lower levels of DHEA-S were more pronounced in males than in females in age and stress matched stratified groups. With increasing age, the fall in DHEA-S was seen in both the genders, but a significant fall in DHEA-S levels was noted after the age of 35 years in males than in age matched females, even when BMI was considered as a new variable in the study. Conclusion: This study does not demonstrate any significant correlation between DHEA-S levels and increasing levels of perceived chronic stress and BMI in both the genders. The DHEA-S levels showed a decline with age as is a normal trend.

Background: Urinary tract infections (UTI) whether community or hospital-acquired are commonly caused by Escherichia coli. An antibiotic like Fosfomycin is very useful particularly among biofilm forming and multi drug resistant (MDR) bacteria. Our study is aimed at determining how well Fosfomycin succeeds in the In-vitro sensitivity testing of multi-drug resistant E.coli urinary isolates.

Materials and methods: 84 clinical specimens of urine were obtained over a period of one year from all adult patients admitted to the tertiary care centre suspected to have urinary tract infection. All suspected colonies of E.coli were identified and those that were multi drug resistant were tested with Fosfomycin by the disc diffusion method.

Result: Among these 84 MDR E.coli isolated, all were found susceptible to Fosfomycin and it was the most sensitive antibiotic when compared to the antibiotics used routinely for UTI. The next best susceptible antibiotic was nitrofurantoin, although ampicillin, cephalosporins, co-trimoxazole and fluroquinolones were found highly resistant.

Conclusion: Due to the alarming increase in resistance to many commonly used antibiotics in cases of urinary tract infections, newer antimicrobials will provide hope and the need of the hour is to tide over the current situation of multidrug resistance. Fosfomycin has now gained immense clinical interest throughout the world as it is a good alternative in cases of MDR pathogens including E.coli for the treatment of UTI.

Here is a case report of a 21-year-old female patient with skeletal Class II malocclusion, with Angle’s Class I molar relation and end on canine relation bilaterally. The patient presented with a normodivergent facial pattern, protruded upper and lower front teeth, a convex profile, competent lips, a decreased nasolabial angle, and posterior facial divergence. Treatment was carried out using the MBT system along with en-masse distalization facilitated by Infrazygomatic Crest and buccal shelf bone screws. The resulting facial changes were closely linked to the skeletal and dentoalveolar adjustments that were the focus of the treatment. For this case of borderline bimaxillary protrusion with a slightly convex profile, en-masse distalization proved more effective than premolar extraction and incisor retraction. This case also serves as a notable example of how to manage similar situations.

Background: Patient satisfaction is a key indicator of healthcare quality, with Waiting time (WT) playing a crucial role in shaping patient experiences, especially in outpatient settings.

Aims: This study aims to explore the impact of WTs on patient satisfaction in a Dermatology Outpatient Department (OPD) and provide insights for improving service delivery.

Methods: A survey of 120 patients aged 18-60 was conducted at a tertiary care hospital’s Dermatology OPD over one month. WTs and satisfaction levels were assessed using a structured questionnaire and a 5-point Likert scale.

Results and Analysis: The results revealed significant WT variations: registration averaged 18 minutes, OPD waiting was 41 minutes, and pharmacy services had a 22-minute wait. Higher satisfaction was reported for doctor consultations and pharmacy services, while administrative tasks like registration and billing had higher dissatisfaction rates.
Statistical analysis showed a moderate negative correlation between registration WT and satisfaction, while doctor consultations had a moderately positive impact. Billing processes also negatively affected satisfaction, while pharmacy service times positively influenced the patient experience. Overall, a strong negative correlation existed between total time spent and patient satisfaction.

Conclusion: The study highlights the importance of reducing WTs, especially in administrative processes like registration and billing, which significantly affect satisfaction. To enhance patient satisfaction, recommendations include streamlining administrative processes by utilizing technology to reduce WTs for registration and billing. Hospitals should improve communication with patients about WTs, possibly through real-time updates via text messages. Decentralizing administrative tasks could also reduce congestion at registration and billing points. Additionally, optimizing workflow in the Dermatology OPD by adjusting appointment schedules and staffing during peak hours can improve efficiency. Prioritizing high-quality, patient-centered consultations and enhancing pharmacy services are also key strategies to improve overall patient experience.

Background: Effective staffing in hospital maintenance departments is crucial for ensuring the smooth operation of healthcare facilities and maintaining high-quality patient care. However, determining optimal staffing levels can be challenging due to various factors such as workload fluctuations, skill mix, and budget constraints.

Objective: This research aims to provide a comprehensive assessment of staffing needs in the hospital maintenance department by conducting a workload analysis and applying insights from these studies, ultimately contributing to improved operational efficiency and patient care. Methods: Data was collected from 03/06/2024 to 09/06/2024 through direct interviews with staff to assess current work processes, biometric attendance reports, and other relevant sources.

Results: The study findings indicate that the maintenance department's actual working hours (9.24 hours/day) exceed the desired working hours (7.5 hours/day), resulting in overtime work (1.7-2 hours/day), which affects employee well-being, productivity, and efficiency. Moreover, the staffing analysis reveals a significant shortage of staff, with 23 additional personnel required to meet workload demands.

Conclusion: This report highlights the critical need for additional staff in the maintenance department to address workload demands and prevent adverse outcomes, ensuring improved operational efficiency and patient care.

The management of anesthesia in neonates presents unique challenges, particularly in complex surgical cases such as occipital region meningo-myelo-encephalocele. This case report details the anesthesia management of a 28-day-old male neonate weighing 2.9 kg, who was posted for surgical intervention following missed prenatal care leading to this congenital anomaly. The report discusses the difficulties encountered, including challenging intubation, prone positioning, intravenous access, and intraoperative hypothermia management. A comprehensive anesthesia plan was implemented, utilizing sevoflurane for induction and maintenance, with careful monitoring throughout the procedure. The extubation process was meticulously planned, ensuring the neonate met all criteria for safe extubation. Postoperative care in the Pediatric Intensive Care Unit (PICU) focused on monitoring for complications and ensuring adequate pain management. The neonate was discharged on postoperative day 12, demonstrating the importance of tailored anesthesia strategies in high-risk neonatal surgeries. This case highlights the critical need for thorough preoperative assessments and the implementation of evidence-based practices to enhance patient outcomes.

Background: The disease known as acne vulgaris affects the pilosebaceous unit, causing inflammatory lesions like pustules, papules, and nodules which leave scars, as well as non-inflammatory lesions like open & closed comedones1.

Aim and Objectives: This study aimed to compare the efficacy of moringa oleifera seed oil extract with 2.5% benzoyl peroxide in mild to moderate acne vulgaris.

Materials and Methods: A prospective, open-labelled randomized, active-controlled study consisting of 60 healthy volunteers of both genders aged 12 to 40 years attending the Department of Dermatology OPD at Gulbarga Institute of Medical Sciences Hospital, Kalaburagi- Karnataka, for the Acne vulgaris treatment which is in mild to moderate phase. Two therapy groups of 60 patients were created (30 in Group A & 30 in Group B). Group A subjects received Moringa oleifera seed oil extract and Group B subjects received 2.5% Benzoyl peroxide gel. Patients were monitored for 8 weeks on therapy, assessing efficacy by counting inflammatory and non-inflammatory lesions at baseline (day 0), 4th, 6th, and 8th week.

Results: At the end of the 8 weeks, treatment by using 2.5% Benzoyl peroxide gel showed a statistically significant difference in decreasing the total number of inflammatory & non-inflammatory lesions in mild to moderate cases of acne vulgaris than the group receiving Moringa oleifera seed oil extract.

Conclusion: The study showed that 2.5 percent Benzoyl peroxide gel has been more efficacious than Moringa oleifera seed oil extract treatment in decreasing the overall number of inflammatory & non-inflammatory lesions in mild to moderate cases of acne vulgaris.