European Journal of Molecular & Clinical Medicine

Background: Poisoning in children is a worldwide epidemic, and there is no region in the world that is immune to this catastrophe. In paediatric practise, it is one of the most frequently encountered situations that could have been avoided. Both the cause of poisoning and the type of poisoning can vary greatly from one region of the world to another. This is because the availability of poison to children is influenced by a variety of factors, including population, socioeconomic standing, level of education, as well as local beliefs and practises.
Martial and Methods: A future hospital-based study in India with a prospective design. Over the course of three years, beginning in June 2021 and ending in June 2022, children hospitalized to Sambaram Institute of Medical Sciences and Research with suspected acute poisoning were the subjects of a study that was designed as a prospective investigation. A parent or other relative who was present throughout the interview provided background information about the youngster.
Results: 210 children were found to be suffering from acute poisoning. There were 125 males, and there were only 85 girls. In 110 of the instances, household goods were involved, while pharmaceuticals were involved in 62, toxic plants were involved in 21, agrochemicals were involved in 13, and other substances were involved in 4.
Conclusion: In conclusion, I would like to offer some suggestions for some strategies that can assist to minimize the prevalence of childhood poisoning in India, in addition to the morbidity and death associated with it. Keep the containers of kerosene oil securely sealed and out of the reach of youngsters at all times. Do not keep kerosene oil in soft drink bottles. Make people aware of the potential risks associated with vomiting after consuming kerosene oil. Keep any agricultural chemicals in a secure location. Instruct the general public on how to properly dispose of unused medication.

Sarah Medan General Hospital in recent years has faced the problem of decreasing
patient loyalty levels, this can be seen from the level of BOR in the last seven months in 2020
which tends to decrease every month. The marketing mix is considered to be a solution to the
problem of patient loyalty, especially related to service quality, price, promotion, and good
communication with customers. The study aimed to analyze the influence of marketing mix on
inpatient loyalty in Sarah Medan General hospital. The study was a quantitative survey with a
cross-sectional approach. The sample was 132 hospitalized. Data were analyzed using logistic
regression. The result shows that there was a significant influence between the marketing mix
seen from the process aspect and the physical appearance of the hospital on patient loyalty.
Where the physical appearance variable was the most dominant variable with a large odds ratio
of 5,134, which means that the better the physical appearance of the hospital, it is predicted that
it will increase patient loyalty by five times higher than the poor physical appearance of the
hospital. It is recommended for Sarah Medan Hospital to pay attention to and improve again
regarding the speed of availability of treatment rooms for inpatient registration and the speed
of response from medical personnel in taking medical actions, as well as maintaining
consistency of service flow.

Segmenting brain tumors is a major challenge in the production of scientific pictures. To order to maximize care outcomes and increasing the hospital success rate, early detection of brain tumors plays an important part. A challenging and time-consuming job is the manual segmentation of brain tumors from large quantities of MRI images produced in clinical routine. Automatic brain tumor segmentation is possible. This article aims to analyze strategies for the segmentation of brain tumors dependent on MRI. Automatic segmentation using deep learning approaches has recently been proven common because these approaches accomplish the latest findings much better than other methods would solve this issue. Deep learning approaches may also provide for effective analysis and unbiased interpretation of vast volumes of picture evidence dependent on MRI. There are many papers on MRI based brain tumor segmentation which focus on traditional methods. Different from others, we concentrate on the recent trend in the field of deep learning. Next, the brain tumors and techniques for segmenting the brain tumor are added. Then, the new architectures are explored with a emphasis on the current development in deep learning methods. Finally, an evaluation is introduced and further improvements are discussed to standardize brain tumor segmentation procedures dependent on MRI in the day-to-day clinical practice.

Changing the status of the hospital froma particular type such as Maternity Hospital to General Hospital has the consequence of adding several new services such as internal medicine, dental treatment, general surgery, etc. Internal medicine as a new service has the lowest visit in the past two years. Itmight happensince the public does not yet know its existence, so it needs to be promoted more. This study aims to analyze the market segmentation and buyer readiness stage of the community around the hospital.This studyemployed descriptive research through cross-sectionaldata collection. A total of 101 respondents were identifiedwith simple random samplingfrom a population living within a radius of 3 km from the hospital. Then this study used primary data obtained by utilizingquestionnaires consisting of several questions about the characteristics of respondents, psychographic, and buyer readiness stage. The results indicatedthat the market segment characteristics were people who arehighlyeducated, work as civil servants and entrepreneurs, and those with a middle economic level. Then the medical service center that was frequently visited was the clinic/primary health service. The purchase readiness was at the awareness level, meaning that the respondents are still in the early stage of being aware of the hospital existence.Promotion is needed to increase purchase readiness to the level of knowledge to generate conviction and purchase. Understanding market segments and purchase readiness level couldhelp hospitals to determine the suitable promotional methods for marketing campaigns.

Hospitals have an obligation to provide education and training to staff who are potentially exposed and have direct contact with patients. This research was conducted because the number of hand washing non-compliance in 2017 still become the high standard set by the hospital at 0%. The study aims to analyze the elements of hand washing training on nurses based on the training effectiveness by Kirkpatrick''s 2- Level theory. This research was descriptive, using a questionnaire to know the effectiveness of the training and the effectiveness of knowledge. The sample consisted of the nurses at DKT GubengPojok Hospital Surabaya. The sampling technique was total sampling with 14 nurses who participated in the training and also 20 nurses who did not attend, and there were 34 respondents. Fourteen nurses who participated in the training had an adequate reaction level about the training they get and supported by an average score of 78.29 had good knowledge and ability to remember the training material, compared with 20 nurses who did notattend the training. This research concludes that the identification of each element of training gets effective results. Moreover, the result showed the comparison of the knowledge level between the participating nursesand those who did not participate in practice as they received different grades.

Abstract: Background – Normally, women who had undergone normal delivery will
remain in the hospital for at least two days and who had undergone cesarean section for
five to six days. An accurate and exact care is very important for the mother who is
recovering from the ailments of pregnancy and delivery and also for the health of the
newborn. Anything can be happen in the postnatal period. in order to avoid any unwanted
occurrence or complications, essential care for mother and baby is a must. Objectives: 1)
To assess the perception of postnatal mothers regarding received Nursing care, 2) To
associate the level of perception with selected demographic variables. Materials and
methods: Survey research approach and descriptive study design was used in the study.
The study was conducted at A.V.B.R Hospital Sawangi Meghe, Wardha. 100 post natal
mothers who had undergone cesarean section were selected for the study. Non-probability
convenience sampling was used for the selection of the samples. Result: Each 50% of the
postnatal mothers were moderately and fully satisfied with the nursing care received and
none of the selected demographic variables were associated with level of perception
regarding nursing care received. Conclusion: Mothers who had undergone cesarean
section in AVBR hospital were satisfied with the nursing care provided.

Risk Management has an important role in identifying risks to reduce patient safety incidents. However, patient safety incidents are still very high. In 2016, there were 36 cases found at one of the hospitals in Surabaya. It means that it has not met zero-incident as the Hospital targets. The purpose of this study was to analyze the implementation of risk management at one of the hospitals in Surabaya. This study was a quantitative research with a cross-sectional research design which collected data at one time. The sampling technique was done withtotal sampling. The study results showed that 18 working units (81.8%) at the Hospital had implemented the risk identification process very well. Afterward, as many as 17 working units (77.3%) carried out an excellent risk analysis at the Hospital. They have classified types of risks found, and 15 working units (68.2%) at the Hospital have notably performed it. In addition, the risk control process as a follow-up of risk priority among 19 working units (86.4%) has been well-executed. However,risk management should be supported by awareness of all human resources at the Hospital. Thus, a strategy that can be carried out is strengthening collaboration among health workers, so they are integrated to adopt patient safety in accordance with their profession. The implementation of risk management was carried out very well in most of the hospital's working units. Still, the hospital needs more effort to raise awareness of the importance of patient safety.

Lean management is a concept that is applied to increase efficiency and prevent waste in the production process. Sidoarjo Government Hospital has implemented lean management through Kaizen activities since 2016. Kaizen Festivals were held in 2016 and 2018. However, for four years, there has been no evaluation of the sustainability of kaizen activities.This study aimed to evaluate the sustainability of kaizen activities and identify the influencing factors. Quantitative contingency coefficient analysis was carried out on survey responses. The research was conducted at Sidoarjo Government Hospital involving 20 respondents from 22 total population of the kaizen unit team. Data collection was carried out through a questionnaire filled out by representatives of the kaizen unit team who participated in the Kaizen Festival from 2016 to 2018.The results showed that all 20 respondents participated in the Kaizen Festival in 2016 and 2018, but only 13 (65%) had kaizen activities in 2017. The three-year sustainability of kaizen activities was 85%, the two-year sustainability of kaizen activities was 40%, and the one-year sustainability of kaizen activities was 75%. The factors affecting the sustainability of kaizen activities were the other stakeholder support (r 0.707, p <0.05), the benefits (r 0.622, p <0.05), and the regulatory changes (r 0.519, p <0.05). Meanwhile, the role of the unit leader (p 0.531-0.715), staff support (p 0.335-0.666), and the supervision of top hospital management (p 0.188-0.718) did not have a statistical correlation with the sustainability of kaizen activities. Thus, the most important factor affecting the sustainability of kaizen activities was the other stakeholder support. All units implemented kaizen activities because of the encouragement of the kaizen festival.

Changing the status of the hospital froma particular type such as Maternity Hospital to General Hospital has the consequence of adding several new services such as internal medicine, dental treatment, general surgery, etc. Internal medicine as a new service has the lowest visit in the past two years. Itmight happensince the public does not yet know its existence, so it needs to be promoted more. This study aims to analyze the market segmentation and buyer readiness stage of the community around the hospital.This studyemployed descriptive research through cross-sectionaldata collection. A total of 101 respondents were identifiedwith simple random samplingfrom a population living within a radius of 3 km from the hospital. Then this study used primary data obtained by utilizingquestionnaires consisting of several questions about the characteristics of respondents, psychographic, and buyer readiness stage. The results indicatedthat the market segment characteristics were people who arehighlyeducated, work as civil servants and entrepreneurs, and those with a middle economic level. Then the medical service center that was frequently visited was the clinic/primary health service. The purchase readiness was at the awareness level, meaning that the respondents are still in the early stage of being aware of the hospital existence.Promotion is needed to increase purchase readiness to the level of knowledge to generate conviction and purchase. Understanding market segments and purchase readiness level couldhelp hospitals to determine the suitable promotional methods for marketing campaigns.

Hospitals have an obligation to provide education and training to staff who are potentially exposed and have direct contact with patients. This research was conducted because the number of hand washing non-compliance in 2017 still become the high standard set by the hospital at 0%. The study aims to analyze the elements of hand washing training on nurses based on the training effectiveness by Kirkpatrick's 2- Level theory. This research was descriptive, using a questionnaire to know the effectiveness of the training and the effectiveness of knowledge. The sample consisted of the nurses at DKT GubengPojok Hospital Surabaya. The sampling technique was total sampling with 14 nurses who participated in the training and also 20 nurses who did not attend, and there were 34 respondents. Fourteen nurses who participated in the training had an adequate reaction level about the training they get and supported by an average score of 78.29 had good knowledge and ability to remember the training material, compared with 20 nurses who did notattend the training. This research concludes that the identification of each element of training gets effective results. Moreover, the result showed the comparison of the knowledge level between the participating nursesand those who did not participate in practice as they received different grades.