Atharva Scientific Publications (E-Jounals)
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Impact of hand hygiene training module among healthcare providers working in neonatal intensive care unit: A before and after trial
Get PDFBackground: Healthcare-associated infections (HAI) include central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Maintaining strict hand hygiene (HH) compliance and asepsis is pivotal in reducing the HAI. Objective: The objective of this study is to evaluate the impact of a training module on HH practices of healthcare providers (HCPs) working in neonatal intensive care unit (NICU). Methods: An uncontrolled before and after study was conducted in a tertiary level NICU of a government hospital. All HCPs working in the NICU were eligible and included in the analyses. In the pre-intervention Phase I (November–December 2016) and in the post-intervention Phase II (February–March2017), trained HH auditors noted the HH compliance of all HCPs. All HCPs were trained in HH practices using the National Accreditation Board for Hospitals SAFE-I Hospital infection control training module, and then, HH compliance was compared in both the phases. HH compliance rates were measured among HCP at the end of each phase. Results: Overall HH compliance rates improved significantly in phase II when compared with phase I (97% and 77%, respectively, p=0.0001). Conclusion: Maintaining high HH compliance in an intensive care setting is challenging; therefore, adopting training modules to educate HCPs significantly improves HH compliance rates
Clinical profile and neuroimaging of neonates with influenza encephalopathy
Get PDFBackground: Pediatric influenza is found primarily in children under 5 years of age, and it is very difficult to distinguish the illness caused by influenza, a virus infection based on the signs alone. Objective: The objective of this study is to analyze the clinical profile and neuroimaging of neonates admitted with seizures followed by encephalopathy. Methods: A descriptive study was conducted among neonates admitted to our neonatal intensive care unit, with neurological manifestations such as poor feeding, lethargy followed by seizures and poor sensorium in the 1st week of life. During the study period, 14 neonates were included with similar neurological manifestations. Results: Our study neonates had poor feeding and lethargy (57.1%) before the onset of seizures. The mean day of the onset of seizure was day 4, and the mean duration of encephalopathy lasted for 63 h. We could detect influenza A in cerebrospinal fluid-polymerase chain reaction only in two neonates and H1N1 influenza in one neonate, but all our study neonates had consistent findings on the magnetic resonance imaging (MRI) brain suggestive of viral infection probably influenza A as its circulation in the community is considered common. The mean day of discharge from the hospital was 11.5 days. At discharge, all neonates were on breastfeeds and had no focal neurological deficit. Conclusions: The possibility of influenza A-related encephalopathy should be considered as a differential diagnosis if a neonate presents with poor feeding, lethargy followed by seizures and encephalopathy in the 1st week of life and their brain MR
Prevalence, clinical profile, and laboratory features of hospitalized under-five children with rotavirus-induced diarrhea
Get PDFBackground: Rotavirus is considered as an important causative agent for pediatric diarrhea. Despite recent studies, data available on the prevalence of diarrhea due to rotavirus, among under-five children, are scarce. Objective: The objective of this study is to estimate the prevalence, clinical profile, and laboratory features among hospitalized under-five children with rotavirusinduced diarrhea. Materials and Methods: A total of 145 under-five children with diarrhea were included in the study. The sociodemographic characteristics, clinical profile, and laboratory investigations of all the children were recorded. Stool samples collected were tested for rotavirus antigen using enzyme immunoassay. Results: Of 145 stool samples processed, rotavirus antigenwas positive in 33.10% of cases, and male-to-female ratio was 1.1:1. The majority (62.76%) of the children with diarrhea were aged ≤12 months. Rotavirus infection was significantly associated with socioeconomic status of the parents (p=0.023), maternal education (p=0.028), fever (p=0.029), vomiting (p=0.001), restlessness (p=0.001), perianal excoriation (p=0.045), bottle feeding (p=0.014), hypernatremia (p<0.001), and presence of reducing substances (p 0.001). Conclusion: Rotavirus-induced diarrhea was diagnosed in one-third of the study children. Maternal education, symptoms of fever, vomiting, presence of reducing substances, and age ≤12 months were found to be predisposing factors for rotavirus infection in under-five children. However, periodic reviewon rotavirus and other co-pathogenic infections are required to validate the current findings
Knowledge, attitude, and perception regarding breastfeeding practices among mothers of Indore city: A cross-sectional study
Get PDFIntroduction: Breast milk is planned for nursing young ones and therefore considered as nature’s most precious gift to humankind. However, despite strong evidences in support of breastfeeding, its prevalence has remained low worldwide. Objective: The objective of this study is to explore the knowledge, attitude, and perception toward breastfeeding among primigravida mothers and factors determining them. Materials and Methods: The study was conducted over 18 months on primigravida mothers admitted in postnatal care ward of tertiary care center of a medical college. Questionnaires were filled by mothers of newborns about various domains such as initiation of feeding, latching, maternal position during breastfeeding, prelacteal, colostrum, exclusive breastfeeding (EBF), and feeding at public places. Results: A total of 260 women aged 21–25 years were included in the study. Most of them were the housewives (81.5%), Hindu (95.4%), living in joint family (55.8%), and living in urban area (73.8%). About 90.4% initiated breastfeeding immediately after delivery and mothers have good knowledge on breastfeeding (81.1%). Mothers living in joint family had significantly more knowledge about the EBF and importance of colostrum. The source of their knowledge regarding breastfeeding was mostly medical staff (95.4%). Conclusion: The present study found that mothers had satisfactory knowledge regarding breastfeeding. Proper counseling and all level of support should be given to primigravida mothers, and breastfeeding practices can be increased by strengthening the existing program through media support and by removing social taboo regarding breastfeeding
Infatuation and love of an adolescent girl: Dynamics of parent child relationship
Get PDFBackground: Increased interest in romantic relationship (RR) is central to adolescents’ lives. RR has a significant influence on the emotional well-being of the adolescents and their future life. Objective: The present study aims at understanding the issues and concerns of adolescent girls in RR who come under care and protection issue. Methods: The study adopts a retrospective exploratory research design and analyzed the case reports maintained by psychiatric social workers. Reports elicit the information about the RR, marriage with the romantic partner, reason for run away with the marital partner, etc. Results: Majority of the adolescents run away with their romantic partner to get married and more than three-fourth of the adolescent girls believed that having sexual intercourse with their romantic partner would get their marriage approval and felt that marriage gave them sanction for the sexual relationship. Adolescents were worried about parent’s rejection of their romantic partner and had guilt feeling that they were not able to meet the expectations of parents nor they were able to fulfill the dreams of their parents. Most of the adolescents were also aware that their romantic involvement has been one of the reasons for academic decline; some have to drop out from the schools. Conclusion: It is important to understand the issues of adolescent girls in RR so that it would help us in designing interventions to facilitate developmental needs and for the healthy transition to adulthood
Primary Hodgkin’s Lymphoma With Chest Wall Ulceration and Hypereosinophilia: A Rare Presentation and Diagnostic Dilemma
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Management of temporomandibular joint dislocations in the emergency department - a case series
Get PDFThe temporomandibular joint (TMJ) or TMJ is a type of ginglymoarthrodial joint and its articulation involves both sliding and hinge type movements. Dislocation of this joint is a very painful condition and needs acute emergency care. Most of these acute dislocations can be managed by emergency physicians. However, chronic dislocations can be managed with the conservative approach. TMJ disorders are the rare complications in those patients, which are under antiretroviral therapy and until now, there are only few cases reports in the literature. We report three cases of TMJ dislocations that were managed successfully in an emergency room. No conclusive cause-effect relationship has been found linking the TMJ disorders to the human immunodeficiency virus-antiviral treatment
Broken sewing needle in the middle finger; a sewing mishap: Management
Get PDFAccidental penetrating injuries to the finger are common and their improper assessment can result in missed foreign bodies. Thesecan result in a wide range of complications. Removal of retained foreign bodies is really challenging. We report the case of amale tailor who came to the department with a chief complaint of accidental injury with sewing machine needle and the brokenpiece of needle got stuck in his finger. This case report highlights the management of deeply embedded broken needle without theuse of any expensive investigation. Even preoperative plain X-ray with a radio-opaque marker can localize the missed radio-opaqueforeign body accurately. A comprehensive approach results in a successful removal of the foreign body and improved quality of life
A Retrospective Audit of Widal Testing For Enteric Fever in the City Of Ahmedabad
Get PDFIntroduction: Widal test has been used extensively for the sero-diagnosis of Enteric fever in India, however, its accuracy and reliability are debatable. We studied widal testing and widal positivity rates in the entire city of Ahmedabad for the diagnosis of Enteric Fever. Methods We screened all 1700 possible diagnostic laboratory facilities, in Ahmedabad, in the public and private sector. We performed telephonic surveys for the initial filtering of facilities that could be conducting widal testing. It was followed by physical visits to probable facilities to confirm testing methods and preservation of reports of widal testing. We followed a systematic process for screening and selection of 23 laboratories, which conducted widal tests and had reliable data. While 14 laboratories refused to share data, data provided by three of them were inappropriate and couldn’t be used. We finally analyzed data from four large public hospitals, one private trust hospital and one corporate laboratory for variable periods in a span of 15 years (2000 – 2015). Result: The Widal testing rate was found to be 8.7% and widal positivity as 12.5% in a sample of 1.2 million clinically suspected in-patients. In 15 years, the private hospital had admitted 1/10th as many cases as all the public hospitals together. However, the widal testing and positivity rates were similar in both. We observed a lower proportion of widal positivity among children below 12 years and a disproportionate, but insignificant, gender distribution of widal positivity. Conclusion: This study indicates that the widal test, which is meant to be an initial screening test, is widely used in the city. We propose linkage of testing and reporting of widal with other more reliable and accurate tests such as Typhidot and blood culture in order to strengthen our knowledge of enteric fever epidemiology in India
Profile of serum electrolytes in critically Ill children: A prospective study
Get PDFObjective: The objective of this study is to identify the various electrolyte abnormalities in critically ill children admitted to pediatric intensive care unit (PICU) and their association with morbidity and mortality. Methods: This was a hospital-based prospective observational study conducted on 180 critically ill children in the age group 2 months to 15 years admitted in the PICU of a tertiary care hospital. Venous blood sample was obtained for the estimation of serum sodium, potassium, calcium, magnesium, and phosphate. The incidence of electrolyte abnormalities and their relation to the primary illness was calculated. Morbidity (mean duration of hospital stay) and mortality rates were evaluated and compared to patients with normal electrolyte levels. Results: Electrolyte abnormalities were seen in 108 children (60%); 72 patients (40%) were having normal electrolyte levels. Most common abnormality seen was hyponatremia in 50.5% patients (n=91). Morbidity and mortality were also higher in these patients. Overall mortality with dyselectrolytemia was 30.5% (n=33) as compared to those with normal electrolyte levels (4.1%, n=3) and was statistically significant (p<0.01). Conclusion: The present study showed a high incidence of electrolyte abnormalities in acutely ill children admitted to PICU. Since the specific symptoms of electrolyte abnormality often merge with the underlying disease, they remain unrecognized and contribute significantly to the morbidity and mortality besides the primary illness. Close monitoring and appropriate correction of electrolyte abnormalities will be useful in lowering mortality