Indian healthcare is described as the largest sector, both in revenue and employment. The quality of service—the characteristics that shape care experience beyond technical competence—is rarely discussed in the medical literature. This study reveals the determinants that affect the perception of quality of healthcare services from the patients' and service providers' points of view. A cross-sectional method was followed to determine the perception of quality of healthcare services and relating variables including infrastructure, reliability and responsiveness, empathy, affordability, and administration. The data collected from 400 respondents, including patients and service providers, for the study were analyzed using confirmatory factor analysis. Results confirmed that healthcare service quality aspects (i.e., physical environment, staff behavior, responsiveness, affordable services, admission process) positively relate to customers' perception. Findings will help the hospital managers articulate effective strategies to ensure superior quality of healthcare services to customers.

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Objective: The objective of this study was to evaluate the various virulence factors among all extended-spectrum beta-lactamase (ESBL)-producing Klebsiella isolates.Methods: Klebsiella species (n=201) isolated from various non-repeated clinical samples from October 2016 to May 2017 were collected and identified by biochemical method and confirmed by BD Phoenix. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method, and ESBL detection was done by combined disc diffusion method. Capsule detection was done by nigrosin dye staining, hypermucoviscosity was done by string test, biofilm was performed by microtiter plate assay, and hemagglutination was performed with human erythrocytes treated with tannic acid.Results: Among 201 ESBL-producing Klebsiella isolates, 63.2 % were multidrug resistance and 24.4% were extensively drug-resistant. Among these isolates, Klebsiella infection is more in older patients. All isolates were (100%) positive for capsule and siderophores production. Of all 201 isolates, 14 (7%) were strong, 61 (30.3%) were moderate, and 104 (51.8%) were weak biofilm producers. Among these isolates, 36 (17.9%) were type 1 fimbriae, 140 (69.7%) were type 3 fimbriae, and only 17 (8.5%) were positive for hypermucoviscosity.Conclusion: Several virulence factors were studied, in which biofilm with fimbriae is the main cause for the resistance of antibiotics. Bacterial resistance profile found to be high with ESBL production and multiple drug resistance in the majority of the Klebsiella isolates, which is a result of improper antibiogram schedule and their virulence property.

Objective: The objective of this study was to isolate and identify the fungal agents obtained from clinical samples of suspected mycoses patients attending Yenepoya hospital.Methods: Various clinical samples obtained from patients were subjected to preliminary examination according to standard mycological protocols such as KOH mount, wet mount, Gram’s staining, and Indian ink examination. Causative organisms were identified by macroscopically and microscopically after growth on sabouraud’s dextrose agar (with or without cycloheximide and chloramphenicol) and confirmed by lactophenol cotton blue mount, slide culture technique, urease test, and growth on chrome agar accordingly.Results: Of 274 clinical samples, 125 were culture positive in which the fungal isolates obtained were dermatophytes (all 3 genera), Candida species (including Candida albicans), Fusarium species, Aspergillus fumigatus, and Cryptococcus neoformans. Male predominance was found among the patients being 6:3 male:female ratio.Conclusion: Among the superficial infection, Trichophyton mentagrophytes was found to be predominant isolates; however, in systemic infection, C. albicans was the predominant isolates.

Although INDIAN healthcare is described as “the largest sector, both in revenue and employment.” Developments and improvements in healthcare services give importance to the concept of competition and encourage increased quality among the healthcare centers. The quality of service –the characteristics that shape care experience beyond technical competence- is rarely discussed in the medical literature. This study reveals the determinants that affect the perception of the quality of healthcare services from the patients’ points of view. A cross-sectional method was followed to determine the perception of quality of healthcare services and relating variables, including infrastructure, reliability & responsiveness, empathy, affordability, and administration. The data collected from 400 in-patients for the study were analyzed using Confirmatory Factor Analysis. This study connects the findings of related studies that the hospital service quality significantly affected patients’ perceptions. Results confirmed that healthcare service quality aspects (i.e., physical environment, staff behavior, responsiveness, affordable services, admission process) positively relate to patients’ perception. Findings will help the hospital managers articulate effective strategies to ensure superior quality of healthcare services to patients. The study will induce hospital management to focus on the quality of private healthcare service systems and improvements towards deficient healthcare services.