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1.
Background
Rotavirus is a common cause of diarrhea in children. There is a need for data on prevalence of rotavirus diarrhea especially in our setting. This study was carried out to determine the prevalence of rotavirus infection in children upto two years presenting with diarrhea and to ascertain factors associated with rotavirus infection in them.Methods
A cross sectional observational study was carried out to determine the prevalence of rotavirus infection amongst children less than 2 years presenting with diarrhea. The clinical profile of the children was analyzed along with detection of rotavirus antigen in stool.Results
A total of 250 children with diarrhea were included in the study. The Male: Female ratio was 0.97:1. We found 24% children presenting with diarrhea to be positive for rotavirus antigen. 78.3% of children with rotaviral diarrhea were in the age group of 6–15 months. There was a significant association between type of feeding and rotavirus diarrhea with reduced prevalence while on exclusive breast-feeding. Though only 10.4% of children with rotavirus diarrhea had severe dehydration, 61.5% of children with severe dehydration were positive for rotavirus.Conclusion
Rotavirus diarrhea caused substantial morbidity in our study population. The rotavirus positivity in these children was 24% and there was a significant association of rotavirus infection with type of feeding and severity of dehydration. 相似文献2.
Background
Stunting is a consequence of long term, cumulative inadequacies of health and nutrition. Health system uses underweight for growth monitoring for its simplicity. Lately there is renewed interest in stunting and especially severe acute malnutrition. Stunting is a relatively neglected indicator. It is therefore imperative to understand the causes of stunting early in infancy and childhood, so that preventive measures can be taken. Hence, the present study was undertaken to study the social determinants of stunting in rural Wardha.Methods
The present cross-sectional study was undertaken in three Primary Health Centres (PHCs) of Wardha district with total population of 88,187. The sample was drawn from three PHC areas by 30-cluster sampling technique. Stunting was defined using WHO Child Growth Standards for ‘height-for-age’. ‘Height-for-age’ values below 2 standard deviations were considered as stunted while below 3 standard deviations were considered ‘severe stunting’.Result
Prevalence of stunting was observed to be 52.3% and severe stunting was 25.1%. The significant determinants of stunting were found to be age, father's education, fathers' occupation, low income, not receiving Vitamin-A supplement during last 6 months and having anaemia. Sex, caste, mother's education and mothers' occupation did not contribute significantly to the stunting.Conclusion
Low income and related factors such as father's education and his occupation are important determinant of the stunting. Father being the decision maker, his education is of importance. Vitamin-A supplementation and anaemia as surrogate indicators for access to health care also found out to be significant determinants of stunting. 相似文献3.
Background
The aim of the present clinical and radiological study was to compare bioglass and calcium sulphate β-hemihydrate in the treatment of intraosseous defect in chronic periodontitis.Method
A total of 50 subjects with bilaterally symmetrical periodontal osseous defects with probing pocket depth = 5 mm and intraosseous defects ≥ 3 mm as seen on the radiographs were undertaken for the study. In one site (group A) bioactive glass was placed in defect and in contralateral site (group B) calcium sulphate β-hemihydrate was used in the defect site.Results
Clinical improvement was noted in all patients at the end of study. Both the groups showed reduction in probing pocket depth, increase in clinical attachment level, and reduction in osseous defect. Both materials were effective in achieving osseous gain.Conclusion
The osseous gain in group A subjects was 58.93%, whereas in group B subjects it was 48.56%. Calcium sulphate β-hemihydrates showed promising results and were cost effective. 相似文献4.
Background
Patients' satisfaction is a useful measure to provide an indicator of quality in healthcare and thus needs to be measured frequently. The aim of the study was to analyse and compare the level of satisfaction of patients attending the Outpatient Department of a Hospital.Methods
Study was conducted by using a pre-structured questionnaire with 120 samples. Samples were further stratified into sub-populations of Officers, Junior Commissioned Officers (JCOs) and Other Ranks (ORs) including dependents as study population.Results
JCOs predominantly expressed lower satisfaction judgement with several attributes. Overall satisfaction judgement with Outpatient Department services were rated lower by JCOs (2.56) when compared with Officers and ORs (3.10), the difference being statistically significant.Conclusion
Statistically significant differences have been identified by this study against various study attributes as well as overall impression towards OPD services among the study groups, which need to be addressed by the hospital leadership to achieve consumer delight. 相似文献5.
Use of immunization as strategy for outbreak control of varicella zoster in an institutional setting
V.K. Bhatti Lee Budhathoki Mahadevan Kumar Gurpreet Singh Amol Nath Maj Gen Velu Nair 《Medical Journal Armed Forces India》2014
Background
Outbreaks of varicella gets reported often in India. However, outbreak in health care providers living in closed institutional setting and role of vaccination as post exposure prophylaxis for control of outbreak has not been studied extensively. This paper presents epidemiological investigation and control strategy undertaken in such scenario.Methods
This is an epidemiological investigation of chickenpox in nursing students which highlights role of early identification and appropriate control strategy to prevent explosive outbreak in high risk vulnerable population. Vaccination of all susceptible in addition to isolation of cases, quarantine of suspects and proper screening for new cases was the major control strategy adopted.Results
The index case was imported and all eight cases occurred within the incubation period of the case. Two cases occurred in students previously vaccinated for chickenpox. No second or third wave of infection occurred showing vaccination as effective tool in outbreak control strategy.Conclusion
Early identification of cases and vaccination of all susceptible contributed to effective control of the outbreak. 相似文献6.
Background
Stress fracture (SF) is the single most common cause for the lost number of manpower days during training of recruits in the Armed Forces. This prospective study was undertaken with a view to develop baseline data on incidence of SF and to identify related variables.Methods
A prospective study over a period of five years during 2004–2009 in which a total of 8,570 recruits were enrolled at the start of their training to find out the incidence and pattern of SFs.Results
A total of 604 (7.04%, 95% CI 6.40–7.40%) out of a total of 8,570 recruits sustained SF during the study period. The majority of fractures occurred during basic training. The factors like urban residence, vegetarianism and those without prior history of physical activity were found to be associated with SF. Tibia was the commonest bone involved.Conclusion
Prevention is undoubtedly the best approach in SF and other sports injuries. Priority should be given to individuals with good sports and physical activity background during recruitment. Intensity of training should be gradually increased during first three months (12 weeks) of training. 相似文献7.
C.N. Chaudhari K. Tandel N. Grover P. Bhatt A.K. Sahni S. Sen A.K. Prahraj 《Medical Journal Armed Forces India》2014
Background
Vancomycin is drug of choice for treatment of Methicillin Resistant Staphylococcus aureus (MRSA) infections. S. aureus with reduced vancomycin susceptibility (SA-RVS) is on rise. Current guidelines of detection of SA-RVS are based on MIC (Minimum Inhibitory Concentration) by broth or agar dilution methods. Vancomycin MIC by E test (Epsilometer Test) is an alternative. A study was undertaken to know the prevalence of SA-RVS and compare vancomycin MIC by agar dilution and E test.Methods
A prospective study was undertaken at tertiary care hospital; 232 clinical MRSA isolates were included. Vancomycin MIC was undertaken by agar dilution method and E test.Results
All isolates were sensitive to Linezolid. Two MRSA isolates had vancomycin MIC ≥4 μg/ml; vancomycin MIC50 and MIC90 of MRSA isolates was 0.5 and 0.2 μg/ml respectively by agar dilution method. There was agreement over 93.5% isolates in vancomycin susceptibility by agar dilution and E test. E test had sensitivity and positive predictive value of 1.0 (CI – 0.34–1.0) and 0.5 (CI – 0.17–0.83) respectively compare to agar dilution method.Conclusions
MRSA isolates continues to be susceptible to vancomycin and Linezolid. E test was found equally suitable in initial screening for vancomycin susceptibility. Due to geographic variation in prevalence, there is need of ongoing surveillance of SA-RVC. 相似文献8.
Background
There are very few community-based epidemiological studies on knowledge, attitude and practice about rabies prevention and control. This cross-sectional study was undertaken to determine the same in an urban slum area.Methods
A random sample of 200 people was selected from an urban slum area. A pre-tested pro-forma was used to collect the data.Result
All study participants had knowledge of rabies transmission by dog bite compared to only 23% having knowledge about its transmission by scratches and licks. Only 40% of the participants were aware that the disease would cause fatal illness. As a first aid measure after dog bite, 66% of the participants responded that they would wash the wound with water, 24% said that they would visit a doctor and the rest responded that either they would do nothing (3%) or would adopt some unconventional methods/religious practices (7%) to prevent the development of rabies. 55.5% of participants were aware about the role of vaccine in preventing rabies.Conclusion
The level of awareness about rabies and its control measures is not high. The attitudes and practices of the respondents reflect the lack of IEC activities, inaccessibility of treatment facilities and the lack of services that would enable community participation in rabies control. 相似文献9.
Background
In April 2009, Mexican health authorities announced an outbreak of a novel H1N1 influenza virus, which subsequently caused a pandemic. The world is now moving into the post-pandemic period. The experience gained in handling this pandemic at various levels under different settings has provided us many lessons for the future.Objective
To study the profile of various activities undertaken at flu screening centre as a response to pandemic influenza in a tertiary care hospital.Methods
Record-based study conducted in a tertiary care hospital of Pune. Required data was collected from records of flu OPD, ward and local health authority and interviewing related staff. Study included data from October 2009 to October 2010.Results
A total of 8020 people presenting with influenza like illness (ILI) were screened in the flu OPD under study. Out of these, only 388 (4.84%) met clinical criteria where throat samples were collected, out of which only 81 were found to be positive (20.88%). Total three fatalities (3.7%) occurred out of 81 who had tested positive. Most cases of flu were managed at home (76.54%) while only 19 (23.4%) lab confirmed cases of H1N1 required hospitalisation.Conclusion
Majority of cases of H1N1 (2009) were managed at home. Early diagnosis, quick initiation of treatment, infection control measures, and good care at the hospital can effectively reduce morbidity and mortality in H1N1 pandemic. 相似文献10.
Sushil Chawla M. Nakra S. Mohan B.C. Nambiar Raju Agarwal A. Marwaha 《Medical Journal Armed Forces India》2013
Background
Pregnant women are at risk to develop complications due to illness related to pregnancy or due to aggravation of pre-existing disease. These patients also require critical care and ICU admissions in some cases. To determine the current spectrum of diseases in an obstetric population resulting in admission to the intensive care unit (ICU) at a tertiary care hospital.Methods
A retrospective case series study and analysis of data from obstetric patients admitted for critical care management.Results
0.26% of the total obstetric patients admitted to the hospital required ICU admissions. 46% of patients were admitted to ICU for ventilator support. Pre-eclampsia and obstetrical hemorrhage were the common diagnosis for these patients.Conclusion
Critically ill obstetric patients require a team approach of the obstetrician, anesthesiologist and intensive care specialist for the optimal care of these patients. 相似文献11.
Objectives:
The aim of this work is to determine the prevalence of intestinal parasites and bacteria among the food handlers.Materials and Methods:
Two hundred food-handlers were subjected to a cross-sectional study working in the kitchen of a tertiary care hospital, i.e., Alnoor Specialist Hospital, Makkah, Saudi Arabia from February 2 to 27, 2009. The stool samples were examined for intestinal parasites following direct microscopic examination, formol ether concentration (Ritchie), and staining with modified acid fast staining techniques. For enteropathogenic bacteria samples were inoculated onto MacConkey''s agar, deoxycholate citrate agar, xylose lysine deoxycholate agar as per the World Health Organization protocol. Fingernail materials were examined microscopically for enteropathogenic bacteria and parasites.Results:
The majority (80%) of the food-handlers were young adults aged from 22 to 42 years. No intestinal parasites were detected from fingernail contents. Forty six (23%) stool specimens were positive for intestinal para¬sites. Giardia lamblia 18 (9%) was most frequent among the 10 different types of detected intestinal parasites followed by Entamoeba histolytica 9 (4.5%). No pathogenic bacteria were detected in all stool samples, whereas finger nails showed isolation of microorganisms as coagulase-negative staphylococci 79 (39.5%), followed by Staphylococcus aureus 35 (17.5%).Conclusion:
The findings emphasized the importance of food handlers as potential sources of infections and suggested health institutions for appropriate hygienic and sanitary control measures. 相似文献12.
Satish Kumar R.M. Gupta Sourav Sen R.S. Sarkar J. Philip Atul Kotwal SM S.H. Sumathi 《Medical Journal Armed Forces India》2013
Background
Human parvovirus B19 is an emerging transfusion transmitted infection. Although parvovirus B19 infection is connected with severe complications in some recipients, donor screening is not yet mandatory. To reduce the risk of contamination, plasma-pool screening and exclusion of highly viraemic donations are recommended. In this study the prevalence of parvovirus B19 in healthy blood donors was detected by ELISA.Methods
A total of 1633 samples were screened for IgM and IgG antibodies against parvovirus B19 by ELISA. The initial 540 samples were screened for both IgM and IgG class antibodies and remaining 1093 samples were screened for only IgM class antibodies by ELISA.Results
Net prevalence of IgM antibodies to human parvovirus B19 in our study was 7.53% and prevalence of IgG antibodies was 27.96%. Dual positivity (IgG and IgM) was 2.40%.Conclusion
The seroprevalence of human parvovirus B19 among blood donor population in our study is high, and poses an adverse transfusion risk especially in high-risk group of patients who have no detectable antibodies to B19. Studies with large sample size are needed to validate these results. 相似文献13.
Inam Danish Khan Ajay Kumar Sahni Reena Bharadwaj VSM Lt Col Mahima Lall Gp Capt V.K. Sashindran 《Medical Journal Armed Forces India》2014
Background
One-tenth of all infectious diseases are attributable to emerging organisms. As emerging organisms sporadically affect a relatively small percentage of population they are not studied at large. This study was aimed at studying the characteristics of emerging organisms encountered from various clinical samples in an apex tertiary care multispeciality teaching and research hospital.Methods
16,918 positive isolates obtained from 66,323 culture samples processed in the clinical microbiology lab of an apex multispeciality hospital during 2011–2012 were included after a pilot study. Both manual and automated systems were used for identification and antimicrobial susceptibility. The frequency of isolation, sources, referring centers, resistance and susceptibility profiles, phenotypic characteristics and number of reports in PubMed were studied.Results
Out of 16,918 isolates, 13,498 (79.78%) were Gram negative bacteria, 3254 (19.23%) were Gram positive bacteria and 166 (0.98%) were yeasts. A total of 483 (2.85%, 95% CI 2.6%–3.1%) emerging organisms including 116 (0.69%, 95% CI 0.57%–0.81%) emerging species were identified comprising 54 genera.Conclusion
Emerging organisms are likely to evade routine identification or be disregarded as non-contributory. Astute efforts directed at identification of emerging isolates, decisions by clinical microbiologists and treating physicians and containment of infection are required. 相似文献14.
Diagnostic pediatric cardiac catheterization: Experience of a tertiary care pediatric cardiac centre
Background
Cardiac catheterization was considered gold standard for confirmation of diagnosis and analyzing various management issues in congenital heart diseases. In spite of development of various non invasive tools for investigation of cardiac disorders diagnostic catheterization still holds an important place in pediatric patients.Methods
300 consecutive diagnostic cardiac catheterization performed since April 2007 were included in this study. The study was undertaken to evaluate the profile of patients undergoing diagnostic cardiac catheterization, its results, assess its safety and its contribution toward solving various management issues.Result & Conclusion
Children who underwent cardiac catheterization ranged in weight from 1.6 kg to 35 kg, with their age range 0 day–12 years. The information obtained was of great importance for further management in over 90% cases. The procedure of cardiac cath is invasive, still it was proved to be quite safe even in smallest baby. 相似文献15.
Background
Contrast enhanced ultrasound (CEUS) has recently gained widespread acceptance as an adjunct to conventional grey scale ultrasound. The present pilot study was undertaken to evaluate the efficacy of this technique in characterisation of hepatic focal lesions.Methods
Adult patients who had at least one focal liver lesion underwent ultrasound evaluation in regular and contrast mode before and after intravenous administration of sulphur hexafluoride. The diagnoses were confirmed by comparison with a reference standard (multidetector CT), response to treatment or pathological correlation.Results
The rate of correct diagnosis for unenhanced ultrasound was 54%, CEUS was 72% and multidetector CT (MDCT) was 92%. A comparison of unenhanced ultrasound versus CEUS using the McNemar test yielded a p value of 0.0704 (>0.05). However, comparison of CEUS versus MDCT using the McNemar test yielded a p value of 0.0265 (<0.05). Additionally, comparison of unenhanced ultrasound versus MDCT using the McNemar test yielded a p value of <0.0001.Conclusion
CEUS increases diagnostic efficacy over unenhanced ultrasound but does not have any significant advantages over MDCT. Currently it may be used as a problem solving tool in atypical haemangiomas, echogenic focal liver lesions, contrast sensitivity and to avoid multiple studies utilising ionising radiation. 相似文献16.
Background
Resistance to broad-spectrum beta lactams mediated by extended spectrum beta lactamases (ESBLs) and AmpC beta lactamases (AmpC βLs) enzymes is an increasing problem worldwide. Determination of their prevalence is essential to formulate an effective antibiotic policy and hospital infection control measures. Present study was undertaken to determine the prevalence of ESBL and AmpC βL producers in ICU of a tertiary care center.Methods
A total of 262 clinical isolates comprising of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis that were recovered from various clinical specimens over a one year period, were studied. Antibiogram profile was determined to conventionally used antibiotics, along with recommended tests for detection of ESBL and AmpC βL production.Results
40.07% (105/262) were found to be ESBL producers, 14.8% (39/262) were AmpC bL producers. The coexistence of ESBL and AmpC βL producers was detected in 9.9% (26/262) of the isolates.Conclusion
Screening of multidrug resistant bacteria especially belonging to the Enterobacteriaceae poses considerable therapeutic challenges in critical care patients because of the production of ESBL and AmpC βL. Strategies to keep a check on the emergence of such drug resistant microbes by hospital environmental surveillance and laboratory monitoring should form an important aspect of Hospital Infection control policy guidelines. 相似文献17.
Indranil Sikdar Shivinder Singh Rangraj Setlur C.V.R. Mohan Rashmi Datta S.R. Patrikar 《Medical Journal Armed Forces India》2013
Background
The structured labor analgesia programme in our tertiary care hospital has been in place for the past few years. We undertook this study to analyze the programme and to draw conclusions to further improve the outcomes.Methods
A prospective analysis of the data pertaining to 200 patients participating in an ongoing labor analgesia programme in a tertiary care hospital from Nov 2008 to Aug 2009 was performed.Results
Mean visual analog score (VAS) before epidural block was 8.34 ± 0.79. Post procedure the average VAS score was 2.20 ± 0.79. One hundred and fifty six (78%) parturients delivered vaginally, 18 (9%) required instrumentation with vacuum including 1 forceps delivery in a multiparous parturient. In 17parturients (8.7%) fetal distress led to a decision to perform LSCS for delivery. Multiparous patients were significantly more satisfied as compared to nulliparous patients (p = 0.010).Conclusion
The study demonstrated excellent pain relief and patient satisfaction with minimal complications. The safety and efficacy of epidural bupivacaine in concentrations less than 0.625% combined with 25 mcg of fentanyl demonstrated in our study should be considered are commendation for the widespread adoption of the procedure in tertiary care hospitals. 相似文献18.
19.
Diva Reddy A.S. Kushwaha Atul Kotwal SM D.R. Basannar Ajoy Mahen 《Medical Journal Armed Forces India》2012
Background
High blood pressure in childhood is a major risk factor for heart disease and stroke in adulthood. There is enough evidence to suggest that the roots of essential hypertension in adults extend into childhood. There is a paucity of literature on the blood pressure measurements amongst children. This study was done to study blood pressure profile of school children in rural area of Maharashtra.Aim & objectives
This cross sectional study was carried out to determine the prevalence of hypertension in children 6–15 years and to study the association between selected variables and blood pressure.Material & methods
This study was done using a predesigned questionnaire and making measurements of height, BMI and Blood pressure using standardized physical instruments following standard guidelines. The data was collected and analyzed using appropriate statistical tests.Results
The prevalence of hypertension in the study was found to be 4.4% with 3.5% in females and 5.1% in males.Conclusion
In the study, hypertension in students was found to be significantly associated with higher BMI and with family history of hypertension. Age, height and BMI were found to correlate positively with Blood pressure levels in this study. 相似文献20.