This study examined the organizational culture of an emergency medicine department (EMD) in a tertiary hospital in Karnataka, India, using a prospective cross-sectional design from January to February 2024. It aimed to identify the predominant and supporting organizational cultures within the EMD and their influence on employee behavior and well-being, including job satisfaction, burnout, stress levels, and coping strategies. A total of 82 participants, including physicians, emergency medical technicians, and nurses, completed the Organizational Culture Assessment Instrument (OCAI) and a self-designed questionnaire. Ethical clearance was obtained (IEC2-656). Clan culture emerged as the dominant culture (73.17%), emphasizing collaboration and adaptability, correlated with lower stress levels and high job satisfaction (90.78%). Emotional exhaustion was the most common burnout symptom (53.66%). The coping strategies varied, with employees in Clan cultures seeking social support, while those in Hierarchy cultures sought guidance from superiors. This study highlighted the significant role of organization culture in employee well-being and EMD effectiveness, influenced by social values like respect for authority. The limitations included single-setting analysis, an uneven subgroup representation, and a lack of qualitative insights. Future research should involve multiple hospitals and qualitative methods for a comprehensive understanding.

We propose a generalized class of estimators to estimate general population parameters of susceptible research variables using additional auxiliary information in SRSWOR. The population constants such as the coefficient of variation, the population mean, the standard deviation, and the population mean square are defined using a conventional estimator. The expression for the mean square errors of the proposed class is derived up to the first order of approximation. To compare the effectiveness of the proposed class of estimators, an empirical study is conducted utilizing real and simulated data sets. Theoretical and empirical research demonstrates that the suggested generalized class of estimators outperforms other current estimators.

Introduction: Congestive heart failure (CHF), a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments, is a growing public health concern, with profound implications for patients’ physical and emotional well-being. In India, the burden of CHF is rising due to aging demographics and increasing prevalence of lifestyle-related risk factors. Among the subtypes of CHF, heart failure with preserved ejection fraction (HFpEF), i.e., heart failure with left ventricular ejection fraction of ≥50% with evidence of spontaneous or provokable increased left ventricular filling pressure, and heart failure with reduced ejection fraction (HFrEF), i.e., heart failure with left ventricular ejection fraction of 40% or less and is accompanied by progressive left ventricular dilatation and adverse cardiac remodeling, may present differing impacts on health-related quality of life (HRQoL), i.e., an individual’s or a group’s perceived physical and mental health over time, yet comparative data remains limited. This study assesses HRQoL among CHF patients using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), one of the most widely used health-related quality of life questionnaires for patients with heart failure based on physical and emotional dimensions and identifies sociodemographic and clinical variables influencing these outcomes. Methods: A cross-sectional analytical study was conducted among 233 CHF patients receiving inpatient and outpatient care at the Department of Cardiology at a quaternary care teaching hospital in coastal Karnataka in India. Participants were enrolled using convenience sampling. HRQoL was evaluated through the MLHFQ, while sociodemographic and clinical characteristics were recorded via a structured proforma. Statistical analyses included descriptive measures, independent t-test, Spearman’s correlation and stepwise multivariable linear regression to identify associations and predictors. Results: The mean HRQoL score was 56.5 ± 6.05, reflecting a moderate to high symptom burden. Patients with HFpEF reported significantly worse HRQoL (mean score: 61.4 ± 3.94) than those with HFrEF (52.9 ± 4.64; p < 0.001, Cohen’s d = 1.95). A significant positive correlation was observed between HRQoL scores and age (r = 0.428; p < 0.001), indicating that older individuals experienced a higher burden of symptoms. HRQoL also varied significantly across NYHA functional classes (χ² = 69.9, p < 0.001, ε² = 0.301) and employment groups (χ² = 17.0, p < 0.001), with further differences noted by education level, gender and marital status (p < 0.05). Multivariable linear regression identified age (B = 0.311, p < 0.001) and gender (B = –4.591, p < 0.001) as significant predictors of poorer HRQoL. Discussion: The findings indicate that patients with HFpEF experience significantly poorer HRQoL than those with HFrEF. Older adults and female patients reported greater symptom burden, underscoring the importance of demographic-sensitive care approaches. These results highlight the need for routine integration of HRQoL assessment into clinical practice and the development of comprehensive, personalized interventions addressing both physical and emotional health dimensions, especially for vulnerable subgroups. Conclusions: CHF patients, especially those with HFpEF, face reduced HRQoL. Key factors include age, gender, education, employment, marital status, and NYHA class, underscoring the need for patient-centered care.

Introduction: A tracheostomy is an important intervention for trauma patients referred to intensive care units (ICUs). Trauma patients often require prolonged intubation; timing of tracheostomy remains debated.The purpose of this study is to determine the impact of early tracheostomy on critical metrics such as mechanical ventilation duration, ICU length of stay (LOS) and ventilator acquired pneumonia (VAP) in trauma patients in ICU settings. Methods: We conducted a retrospective cohort study of 383 trauma patients who underwent tracheostomy in a tertiary teaching hospital ICU (January 2018–December 2022). Inclusion: trauma patients with temporary tracheostomy; Exclusion: permanent tracheostomies. Early tracheostomy (ET) was defined as ≤7 days of mechanical ventilation, late (LT) as >7 days. The dataset includes demographic information, Acute physiology and chronic health evaluation II score, Simplified acute physiology score II, Glasgow coma scale score, Injury severity Score, type and cause of injuries, ICU outcomes, length of stay and rates of ventilator-associated pneumonia (VAP). Data were analyzed using Mann–Whitney U and Chi-square tests; significance at p < 0.05.. The study involved a comparison of the duration of mechanical ventilation, ICU LOS, VAP rates and extubation trials between patients who underwent ET and LT. Results: Of the 804 patients who underwent tracheostomies from January 2018 to December 2022, 383 were trauma patients and were included in the study. There were no significant differences between the two groups in terms of age, sex, Acute physiology and chronic health evaluation II score, Simplified acute physiology score II and Injury severity score. The incidence of VAP was lower in the ET cohort (15.9%) than in the LT cohort (47.4%). The percentage of extubation trials was found to be higher in the LT cohort (43.1%) than in the ET cohort (9.3%), resulting in prolonged ICU LOS. Patients with an ET had a significantly shorter ICU LOS median of 15 days (IQR 13,17) and a mechanical ventilation median of 13 days (IQR 11,14) than LT patients who had an ICU LOS median of 33 days (IQR 30,36) and a mechanical ventilation median of 31 days (IQR 27,33) respectively. Conclusion: Implementing an early tracheostomy protocol for trauma patients in the ICU is associated with a decreased incidence of VAP, shorter duration of mechanical ventilation and shorter ICU LOS while maintaining consistent ICU and hospital outcomes. The adoption of a standardized approach to perform early tracheostomy helps in improving resource utilization and patient outcomes in trauma patients.