International Journal of Medical Research & Review (IJMRR)
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Knowledge Regarding Post-Exposure Prophylaxis Of Hiv/Aids Infection And Perceived Threat Due To Needle Stick Injury Among Nursing Students Of Selected Nursing College At Jaipur ( Raj
Full text linkIntroduction: Needle stick injuries (NSI) has always been one of most important risk factors forhealthcare workers (HCWs) for transmission of various infections such as hepatitis B, hepatitis C andhuman immunodeficiency virus (HIV). As per 2008-2009 HIV estimates, there are an estimated 23.9lack people currently living with HIV/AIDS in India with an adult prevalence of 0.31% in 2009.
Material and methods: It is a descriptive non-experimental study carried out among nursingstudents studying at teaching institutes in Jaipur city (Rajasthan). A study was conducted duringyear 2020 and 92 Bsc nursing students were selected by using total enumerative sampling techniquerespectively. The reliability of knowledge tool was conducted through Kuder and Richardson Formula20 (KR20) result was 0.84 and reliability of 5 point rating scale was analyzed by using Cronbach Alfamethod it was 0.92.
Result: The level of knowledge of nursing students, in which (18) 22.5% hadpoor knowledge, (50) 62.50% had average knowledge and (12) 15% of them had good knowledgeregarding post-exposure of prophylaxis of HIV/AIDS infection. The level of perceived threat ofnursing students, in which (62) 77.5% had high level perceived threat, (17) 21.25% had moderatelevel perceived threat and (1) 1.25% of them had low level perceived threat due to needle stickinjury. It evidenced that for correlation between knowledge and level of perceived threat calculatedvalue of Karl Pearson\u27s correlation coefficient is 0.76 and tabulated value of correlation coefficient is0.250 for df 78 at 0.05 level of significance.
Conclusion: The present study reveals that majority ofnursing students had average knowledge regarding post-exposure prophylaxis of HIV/AIDS infectionand low level perceived threat due to needle stick injury
Impact on Undefined Normal Tissue by using different combination of Normal Tissue Objective and Dose Control Ring in IMRT Plans for Cervix cancer
Full text linkIntroduction: The normal tissue objective (NTO) is a tool used in inverse planning of Intensity Modulated Radiation Therapy (IMRT) to reduce dose spreading to surrounding normal tissues. The multitude of potential NTO setting combinations challenges optimal NTO tunning. In addition to NTO, Dose Control Ring (DCR) around the target may impact plan quality.
Aim and Objective: To find the impact on Undefined Normal Tissue (UNT) by using the different combinations of NTO and DCR in IMRT Plans for Cervical cancer plans.
Materials and Methods: Our sample consists of 30 patients with similar treatment prescription doses. Varian Eclipse Treatment Planning System (TPS) of Version13.6 was used in this study. 5 different plans were created for each patient. In every plan beam energy, several beams, Beam angle, Optimization algorithm - Photon optimizer (PO), Calculation algorithm – Anisotropic analytic algorithm (AAA)and evaluation methods were maintained constant. 5 plans were different only in the optimization process. Before generating plans DCR of thickness 1.0 cm and 0.5 cm away from the Planning Target Volume (PTV) was created. The plan with different combinations between NTO and DCR were A. Without NTO, B. Automatic NTO, C. Manual NTO, D. Automatic NTO + DCR, E. Manual NTO + DCR generated. The plan quality was evaluated by comparing PTV: Conformity Index (CI), Homogeneity Index, OAR Doses and mean dose to UNT.
Results: HI was better without NTO plans compared to all other plans. CI and OAR doses show a significant difference in Manual NTO along with DCR plans. The mean dose of UNT was less in Manual NTO along with DCR compared to all other plans and it was significantly less.
Conclusion: This study shows that manual NTO + Dose Control Ring gives better plan quality in terms of PTV coverage and less dose to Undefined Normal Tissue by maintaining Organ at Risk dose within the tolerance limits
Quality Improvement Project in the introduction of Major Trauma and Major Haemorrhage Protocol
Full text linkIntroduction: We recognised there was a need for a set criterion for the activation of MHP andMTTA at our Trust. The main aim is to streamline the trauma care that our patients would receivearound the clock. Ours is a large Major Trauma Unit regularly receiving a large volume of traumapatients of varying severity of injury
Objective: The use of a checklist for the initial management of MTTA and MHP to ensure the process is streamlined and led by the trauma team leader. This wouldhelp reduce the cognitive load that is often presented to the team leader. This would also help directjunior team members with limited experience in the initial management of major trauma.
Method/Intervention: An initial survey about MTTA and MHP from senior clinicians was carriedout. Several teaching sessions were undertaken. In addition to this, an algorithm for the initialmanagement in terms of transfer protocol was also introduced.
Results: From the clinicians’perspective, 89% of the respondents felt that the use of MHP and MTTA protocol would reduce thecognitive load whilst managing major trauma. There was an improvement in the level of confidenceof clinicians in the initial management of major trauma from 52.9 % to 89%.
Conclusion: Throughthis project, we hope that there is a better understanding of the need to have pre-defined criteria foractivation for MTTA and MTP for several reasons as highlighted in the article. The eventual aim of theproject is to streamline the initial management of the majorly injured patient and undertake thenecessary practical steps
Osteomyelitis of Jaw: A Case Report
No full textTubercular (TB) osteomyelitis of mandible is a rare and uncommon clinical condition. The clinical appearance of tubercular infection of temporomandibular joint (TMJ) comprises of nonspecific features resembling osteomyelitis, arthritis, or any other kind of chronic joint diseases. At times, localized painful swelling of the jaw may be the only manifestation. The presented case is of osteomyelitis of the jaw in a 14-year-old girl patient for whom TB was later suspected
Study on the Correlation Between Vitamin D and BMI in Type 2Diabetes Mellitus
Full text linkType 2 diabetes mellitus (DM) is associated with increased morbidity and mortality due to thedevelopment of complications, especially due to poor glycaemic control. Besides its role in calciumhomeostasis, Vitamin D has been involved in the pathophysiology as well as glycaemic control oftype 2 DM. 100 patients diagnosed with type 2 DM were included. Vitamin D levels along with BMIwere measured in all the individuals. In our study, we had the youngest patient with 18years andthe oldest patient with 78years. In the present study, we had maximum patients in the age groupbetween 41 to 50 years similar to various other studies. In our study male was 68% with femaleswere 38%. In the present study, we estimated vitamin D levels in all subjects and categorizationwas done as <20 and more than 20 ng/dl.48% of patients had vitamin D levels below 20ng/dl. Inthe present study, we compared the values of BMI with vitamin D levels where we did not noticemuch difference with the mean of individual category. In conclusion, we have identified a correlationconcerning vitamin D levels when compared with BMI statistically. Since the physiological role ofVitamin D in pancreatic beta-cell function and insulin sensitivity is well appreciated, and consideringthat almost 50% of the diabetes patients in the present study are Vitamin D deficient, it issuggested that Vitamin D levels improve the BMI in type 2 diabetes mellitus patient
To Study the Computed Tomography Temporal Bone Findings inPatients with Chronic Suppurative Otitis Media
Full text linkBackground: Chronic suppurative otitis media is a chronic inflammation of middle ear cleft. It canpresent with discharging ear and decreased hearing. Diagnosis is mostly on clinical examination withan otoscope or otoendoscope. Our study was undertaken to evaluate role of computed tomographyin defining extent and severity of various pathological changes occurring in temporal bone in case ofchronic suppurative otitis media.
Materials and Methods: Current study was a prospective cross-sectional study was conducted in Sri Venkateshwaraa Medical College and Research Center, Ariyur,Pondicherry from January 2019 to May 2020. Study included 60 patients clinically diagnosed with achronic middle ear infection and who were referred to Department of Radiodiagnosis and Imaging foran HRCT scan of temporal bone. All obtained data were entered in Microsoft Excel and analyzed withSPSS 23.0 software.
Results: In our study, a total number of 60 patients were involved. Youngestpatient was aged 7 years and oldest patient’s age was 63 years. Majority (28.33%) of patients wereaged between 21-30 years followed by 26.67% in 11-20 years age group. Our study found site andextent of involvement of middle ear and mastoid air cell system as follows: protympanum (20.00%);meso-tympanum (26.67%); posterior tympanum (30.00%); epitympanum (60.00%); hypo-tympanum (25.00%); peri-labyrinthine cells (1.67%); aditus (53.33%); antrum (40.00%); mastoidair cells (58.33%).
Conclusion: HRCT scan is a unique method to detect early cholesteatoma andalso to detect cholesteatoma in hidden areas
Enteric Encephalopathy associated with reversible ECG changes: A Diagnostic Dilemma
Full text linkEnteric fever is common in India. It presents with various clinical manifestations. Encephalopathyand ECG changes are indicators of prognosis. Persistent ECG changes indicate a poor prognosis. Thepathogenesis of encephalopathy is unclear though prostaglandins and free oxygen species may beimplicated in the prognosis and justifies the use of steroids in enteric encephalopathy withantibiotics. The case presented here presented with encephalopathy and ECG changes whichreversed following antibiotic and steroid therapy. The importance of the case lies in the fact thattyphoid should not be missed in the diagnosis of encephalopathy and ECG should be done in allcases of enteric fever to determine the prognosis
A study to assess the practice of biomedical waste management and its influencing factors among health care providers at selected hospitals of Kolkata, West Bengal.
Full text linkBackground: Mismanagement of healthcare waste puts the community, the patients and healthcare workers at risk, both in terms of the risks from inadequate storage, transportation and disposal of infectious waste and from the environmental risks arising from hazardous burning. A descriptive survey was undertaken to assess the practice of Biomedical Waste Management and its influencing factors among health care providers.
Method: Quantitative, non-experimental Survey Research Design was adopted. A total of 105 health care providers, namely the Staff Nurses, Doctors and Group-D staff, were selected by convenient sampling technique from three government hospitals. Descriptive and inferential statistics were used for data analysis.
Result: The study findings revealed that the mean practice scores for Staff Nurses, Doctors and Group-D staff were 16.66, 14.77 and 16.03, respectively. There was a statistically significant association between the practice score of Staff Nurses and their age (χ2(1) = 8.11, p<0.05) and period of working experience in the hospital setup (χ2(1) = 8.24, p<0.05). The factors like unawareness (28.6%), lack of training or in-service education (41.9%), overload of work (61%), lack of supervision (36.2%), lack of audit (36.2%), lack of supplies (61.9%) as expressed by the health care providers also emerged from the study which is probably the negative factors leading to their average practice and poor practice.
Conclusion From the study findings, it can be concluded that only a few of the practices of health care providers were good, of which Staff Nurses were the majority group who adhere to good practices
A Rare Presentation of a Common Disease: A Diagnostic Dilemma
Full text linkMalaria affects millions of people across the globe .The classical clinical features may be absent, but the rapid diagnosis helps in early treatment and thus avoids complications .We present a case of co infection of Plasmodium vivax and Plasmodium falciparum malaria in a female patient presenting with fever and pain abdomen and incidental detection of splenic infarct .The co infection is uncommon and treatment should target both to avoid complications . Also, the exact pathogenesis is un known and though splenic infarct is uncommon and missed due to lack of symptoms , it should be followed up.
 
Shear Wave Elastography of Liver: Measurement of normal liver stiffness in healthy population and factors affecting it
Full text linkBackground: Shear Wave Elastography (SWE) is a recent non-invasive method for determining liverstiffness. SWE is a two-dimensional elastography technique in which an amplitude-modulated beamof focused ultrasound is used to generate shear waves which are then transmitted by the transducerto the region of interest (ROI), where the propagation speed of shear waves is measured. Thepresent study is the first attempt to measure the normal range of liver stiffness using SWE in ahealthy population from North India and to study the effect of age, gender, and BMI on the liverstiffness values in the healthy population.
Methods: This cross-sectional observational study wasconducted in the Department of Radiodiagnosis and Imaging, Government Medical College, Jammuon 117 healthy subjects without any known liver pathology or history of any liver disease. B-ModeUltrasound scan, followed by SWE Examination was performed on all subjects using SAMSUNGRS80EVO using CA1-7A convex array probe with a frequency of 1 to 7 MHz.
Results: Successfulresults were obtained in 98.2%. The mean value of liver stiffness in 115 healthy subjects was 4.74± 0.91 kPa, and the 95% confidence interval was 4.58-4.91 kPa. (Range: 2.7-7.8 kPa). There wereno statistically significant differences in liver stiffness values regarding age, gender and BMI in thehealthy population (all p> 0.05)