International Journal of Innovative Research and Development

Abstract

Background: The adoption and utility of endocavitary ultrasound examinations in Kenya has not gained much prominence despite its availability and superiority in terms of image resolution. The reasons for low utilization are not yet clear and there exists a gap in terms of available literature regarding the patients’ attitude towards the endocavitary ultrasound procedure. In order to promote widespread acceptability and utilization of this particular sonographic approach in the pelvic evaluation of female patients, the researchers sought out to explore the influence of patients’ attitude and perception towards the examination. Objectives: To evaluate the female patients’ perception regarding endocavitary ultrasound examination at Nyeri Level 5 Hospital. Specifically, the researchers sought to determine the effects on emotions that endocavitary ultrasound poses on the female patients and how these perceptions on endocavitary ultrasound influences female patients expectations. Methodology: This study employed the descriptive cross-sectional survey design based on self-administered questionnaire to gather the relevant data. The study population was female patients that underwent endocavitary pelvic ultrasound examination. The patients were asked on how they perceived endocavitary ultrasound before and after the examination. Results: 51% accounted for those female patients between the age of 25 to 34 years, 30% between the age of 15 to 24 years and 17% between the ages of 35 to 44 years. The level of education on these female patients varied dramatically, those with primary level of education constituting 7% secondary level 7% those with college level of education 46% and no formal education 30%. The occupation of these patients comprised civil servants accounting for 12%, self-employed with 30% farmers 28% and homemakers 28%. Thirty percent (30%) felt tense towards the procedure while 12% was upset by the procedure and 53% were worried of the procedure. Of those that were worried about the procedure, 80% anticipated pain, 90% had affinity of experiencing discomfort and the 97% felt embarrassed by the procedure. Only 12% would undergo for a similar examination again while 87% expressed unwillingness of undergoing the same procedure in future. Conclusion: The patients perception hinged on negative feelings in context when the patient has no prior knowledge of what Transvaginal sonography (TVS) entailed. Endocavitary examination calls for prior patient education or explanation as to what the procedure entails in order to enhance acceptability by the patient. 

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Background: Ultrasound examination turnaround time is the time between ordering a test by the clinician or the referring doctor at the time of submitting and or reporting of the results. Mae (1997: 83) argues that turnaround time definitions vary from institution to institution, hence necessitating specification by date, time, and type of the procedure. Ultrasound examinations are valuable in evaluation of both emergent, life threatening patients that have injuries that are not apparent on the initial physical examination as well as for routine examinations, all of which need to be as timely as possible. According to (Jill 2011: 253) timely and accurate diagnosis for ultrasound patients and initiation of optimal care is required. It is important that several quick steps in the management (including) extensive, thorough, but short interval ultrasound examinations with emphasis aligned towards reducing patient waiting time is put in place in the radiology department.

Objectives: Turn-around time (TAT) is one of the major determinants in the overall institutional processes growth evaluation tool. The purpose of this study was to evaluate the turnaround time for patients undergoing ultrasound examinations at the radiology department, Kenyatta National Hospital, Nairobi. The research was conducted between 2nd January and 30th May 2015 with turnaround time as the dependent variable while factors influencing turnaround time being the independent variables.

Methods: A three-month cross sectional descriptive survey in which 96 study subjects selected by systematic random sampling and then requested to complete a self-administered questionnaire. Data analysis was by Ms Excel and the results were tabulated and graphically presented.

Results: Out of the 96 patients’ respondents, 51 were females while 45 were males. The major causes of longer turnaround times identified were: power black outs, jumping of queues by other patients, and burnouts of the staffs while working alone. Majority of the respondents were dissatisfied with the turnaround times for ultrasound examinations.

Recommendations: Investment in more diagnostic imaging resources and personnel by the Kenyatta National Hospital is advised. Further research on customer satisfaction is also advised.

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In this case, an 11 years old female presented to our hospital with recurrent cramping lower abdominal pains for three consecutive months. She denied any history neither of dysuria nor per vaginal discharge. There was no history of sexual contact or sexual assault.  Prior to coming to our hospital, she had undergone treatment for lower urinary tract infection on a clinical basis without improvement. The doctor at our hospital facility ordered for an abdominal ultrasound and urinalysis tests. The urine was 0-5pus cells/hpf , nil protein, nil glucose, nil nitrite, and had a specific gravity of 1010. The ultrasound revealed free fluid collection with low-level internal echoes in the endometrial cavity that extended into the vagina with a bulging membrane and also extended to be involving the fallopian tubes that were visualized as dilated fluid-filled structures with surrounding free fluid in the adnexae.  This was then diagnosed as a severe case of haematometrocolpos that involved the fallopian tubes thus qualifying it to be haematosalpingometrocolpos or haematocolpometrosalpinx. Haematocolpometrosalpinx is a collection of blood and fluid within the fallopian tubes, uterus, and vagina. This condition is usually due to acquired or congenital anomalies of the uterus and vagina. It can present in children, adolescent females or adult females. Patients may be asymptomatic or can present with vague pelvic discomfort or pain during defecation or urination due to pressure on the rectum or bladder by the pelvic mass. Pelvic ultrasound is an important diagnostic tool in evaluating the cause of unexplained recurrent lower abdominal pains in adolescent and pre-adolescent females. Following Hymenectomy, the patient commenced normal menses with no pain in the subsequent months.

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