Hand hygiene with Interventions: An Observational Study from a Tertiary Care Institute over 2 years.: Hand Hygiene: obey and observe

Background - Appropriate adherence to hand hygiene (HH) practices by health care workers (HCWs) reduces the transmission of pathogens and subsequently the incidence of hospital acquired infections (HAIs), in health care settings. Strict monitoring and auditing of this simple and cost-effective intervention is very important, as it significantly contributes in reducing the HAIs. Material & Methods – A retrospective observational study, evaluating the HH audits from June 2021 till May 2023 in a tertiary health care facility in North India. HH audits were conducted in the ICUs and wards daily, by the trained infection control nurses (ICNs), using direct observation method based on World health organization (WHO) hand hygiene observational forms. HH total adherence (HHTAR), partial adherence (HHPAR) and complete adherence rate (HHCAR) were analyzed in Microsoft Excel sheet. HHTAR rates were compared among different profession, moments and the month wise trend was also observed over the period. Results –A total of 24,740 HH opportunities were observed.  The compliance rate for HHCAR, HHPAR and HHTAR were 20.3%, 41.5% and 61.4% respectively. Overall better compliance was reported from the ICUs, profession-specific compliance was highest among nurses (62.8%) and doctors (61.5%). Significant increase in adherence rate was appreciated post intervention 46.1% to 67.3%, (p value <0.01). Conclusion – Continuous monitoring and reinforcement with timely feedback for intervention and regular auditing is a necessity to improve and maintain the appropriate HH practices among the HCWs. Low- and middle-income countries need to focus more on this simple and promising measure to combat the increasing HAI rates

Healthcare infections and antimicrobial consumption in pre-COVID-19 era: a point prevalence survey in three hospitals in a region of central Italy: Hospital infections and antimicrobials use

Healthcare-associated infections (HAIs) are a major global public health concern, increasing the transmission of drug-resistant infections. This point prevalence survey investigated HAIs occurrence and antimicrobial consumption (AMC) in pre-COVID-19 era in the public hospitals of a region of Central Italy. Data were collected using the protocol standardised by the European Centre for Disease Prevention and Control. Three-hundred and sixty-four patients were included (59.3% male) in the study. Overall, HAIs prevalence was 6.6% (95%CI 4.4-9.5), ranging from 5.2% to 7.1% within the surveyed hospitals, with at least one infection in 24 patients (ten each in medical and surgical specialties wards, and four in intensive care). Risk factors for HAIs were advanced age, having undergone surgery and wearing invasive devices. At time of the survey, 44.7% (95%CI 39.7-49.9) of patients was under treatment with at least one antibiotic, and AMC varied between 43% and 48% within hospitals. In all hospitals, a prevalence higher than 10% was found for the prescription reasons other than prophylaxis or therapy. The results revealed a HAIs prevalence lower than that estimated compared to the most recent national data, in contrast to higher antimicrobial usage. These findings highlight the need to reinforce hygiene practices and develop bundles for HAIs, as a broad implementation of infection prevention and control practices extensively applied to both hub and spoke hospitals could significantly reduce their occurrence, as well as to implement antimicrobial stewardship for prescriptive appropriateness

Prevalence of Body Dysmorphic Disorder (BDD) among the Lebanese University students: Associated risk factors and repercussion on mental health

Background: Body Dysmorphic Disorder (BDD) is a psychological illness characterized by persistent and intrusive preoccupation with an imagined or slight defect in appearance. For individuals with BDD, these perceived defects are significant and prominent, leading to emotional distress, depression, anxiety, and impairment in daily functioning. Despite its impact, no prior studies have explored the prevalence of BDD among Lebanese university students. Objectives: This study aimed to determine the prevalence of BDD and investigate its association with mental health status (depression and anxiety), religiosity, eating disorder risk, and self-esteem among Lebanese University students.  Methodology: A cross-sectional study was conducted in March 2020, involving students from the Lebanese University. Data were collected using the dysmorphic concern questionnaire (DCQ), Rosenberg self-esteem scale (RSE), religiosity scale, patient health questionnaire (PHQ-9), generalized anxiety disorder assessment (GAD-7), Eating Attitude test-26 scale (EAT-26). Results: A total of 6448 participants were enrolled in our study. The overall prevalence of BDD among university students was (6.4%).Our results showed that Lebanese students with BDD were more likely to have anxiety ORadj 1.3 (95% CI:1.2-1.7) p-value 0.001, depression ORadj 1.2 (95% C:1.15-1.5) p-value 0.007, and eating disorder (Bulimia & Food preoccupation ORadj 1.06 (95% CI:1.03-1.2) P-value 0.0, and oral control ORadj 1.09 (95% CI:1.05-1.1)  P-value < 0.001) compared to those with no BDD. We also found that students with BDD had Lower Self-esteem ORadj 0.88 (95%CI: 0.78-0.9) P-value <0.001), and less likely to be religious ORadj 0.88 (95%CI: 0.82-0.9) P-value 0.02) compared to those with no BDD. Conclusion: This pioneering study in Lebanon sheds light on the prevalence of BDD among Lebanese university students and its associated factors. BDD was found to be significantly linked to elevated levels of depression, anxiety, and eating disorders, along with lower levels of self-esteem and religiosity. These findings underscore the importance of early detection of BDD during adolescence and young adulthood, necessitating timely psychological intervention to prevent chronicity and complications. Moreover, promoting widespread awareness through various social media and public platforms is essential to address this psychological issue effectively

Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infections in Intensive Care Units: A Multicentre Case-Control Study with a Competing-Risks Analysis: Risk factors for CRKP infections

Aim: This study investigated the risk factors for the development of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in adult patients in intensive care units (ICUs). Methods: A multicentre case-control study was conducted in ICUs in three tertiary hospitals in Turkey. The cases were patients culture-confirmed CRKP and a condition associated with healthcare-associated infections. Two controls were randomly selected for each case from among all other patients with an ICU stay at least as long as that of the corresponding case patient. A proportional semiparametric subdistribution hazards regression model was used to assess risk factors for CRKP infection. ICU discharge and non-CRKP-related deaths were treated as competing risks. Results: A total of 120 patients, 44 cases, and 76 controls were included in the analysis. Of the controls, 32 were discharged from the ICU and 44 died without acquiring CRKP infection. Endotracheal intubation (hazard ratio [HR]: 1.96, 95% confidence interval [CI]: 1.00–3.868) and type 2 diabetes mellitus (HR: 1.57, 95% CI: 0.888–2.806) were associated with an increased risk of CRKP infection, whereas carbapenem exposure (HR: 0.47, 95% CI: 0.190–1.1175) and the presence of a nasogastric tube (HR: 0.49, 95% CI: 0.277–0.884) were associated with a decreased risk of CRKP infection. Conclusions: Enteral nutrition support via a nasogastric tube may be associated with a reduced risk of CRKP-resistant infections in ICU patients. This hypothesis should be tested with a well-designed study

Adults’ perceived health promotion needs in the prediabetes stage: a meta-synthesis study

Introduction: One of the methods to promote pre-diabetic patients’ adherence to preventive behaviors and improving their lifestyle is to pay attention to their needs in the designed educational programs. Therefore, this study was conducted with the aim of identifying the needs of individuals with prediabetes. Methodology: Three databases, including ISI/Web of Sciences, PubMed, Scopus were searched without time limitation until August 2022. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines and to achieve the research goal, Sandelowski and Barroso's seven-step meta-synthesis method (2007) was used. Thematic synthesis was used to analyses the data.   Results: Out of the 1934 studies obtained, 34 studies were finally examined and 805 codes were recorded based on the extracted data. Through synthesizing and analyzing the primary studies, 8 main themes were extracted regarding individuals’ needs in the prediabetes stage: Information needs, Cultural needs, Psychological needs, Social support needs, Education needs, Financial needs, Service needs and Skill needs. Discussion and Conclusion: In addition to paying attention to the needs mentioned in other studies regarding activity, nutrition, social support, stress and emotions management, and monitoring the prediabetes condition, the present study examines the other aspects of the needs of individuals with prediabetes such as educational, service, skill, and cultural needs. Moreover, it also explains the perceived needs and their types in each of the dimensions in detail. It can be a proper guide for designing educational programs and various interventions to control the prediabetes condition, leading to a reduction in the prevalence of type 2 diabetes in the society

Direct Long-acting Antibodies: Updating the Language of RSV Prevention to Reflect the Evolution of mAbs

Background: The language of medicine is constantly evolving, typically to better describe a new understanding of disease, adjust to changing social sensibilities, or simply to reflect a new drug class or category. We address the need for an updated language around monoclonal antibodies, or “mAbs”—a widely used medical term, but one which is now too general to accurately reflect the range of mAb pharmaceuticals, their effects, and the intended patients. Methods: The question of “what should we call a monoclonal antibody immunisation against respiratory syncytial virus (RSV) to ensure accurate understanding of the product?” was the basis for a virtual advisory panel in May 2022. The panel was convened by Sanofi with the intention of reviewing appropriate language in terminology in the context of mAb-based prophylaxis for RSV. The panel comprised several global experts on RSV and vaccination, a trained linguist specializing in doctor-patient interactions and medical language, and several experts in marketing and communications. Results: We suggest the term “Direct Long-acting Antibody” (DLA) for a specific sub-class of mAbs for use in prevention of RSV disease in infants. This terminology should differentiate from other mAbs, which are generally not used as therapies in infants. Conclusions: This change will more accurately convey the specific mode of action of a mAb in infants, and how it could impact the prevention of communicable diseases: this class of mAbs is not an active treatment, but rather will offer direct and rapid protection lasting at least 5 months

Prevalence of excess screen time among secondary school children in rural India: a cause for concern: Screen time among secondary school children in rural India

Introduction: Screen time has increased during the COVID-19 pandemic, especially among children and teenagers. This has come at the expense of their healthy eating habits, physical activity and adequate amount of quality sleep. The excessive use of screen-device can lead to addiction which starts during adolescent years Objectives: 1) To assess prevalence of excess screen time among secondary school children. 2) To correlate BMI, sleep duration, duration of physical activity and food habits with screen time duration. Study settings and design: Cross-sectional study was conducted in secondary schools in the rural field practice area of a private medical college in Pune, India Methods and Material: The study included 184 school children from eighth to tenth standard. Data was collected using a self-administered, validated questionnaire. Results: Prevalence of excess screen time among secondary school children was 83.2%. Mobile phone was the most used device (98.9 %). There was a significant association between excess screen time and inadequate sleep. Conclusions: The present study reports high prevalence of excess screen time in rural school going children in rural India. There is a need for strategies to combat this in school health programs on priority

Risk factors of HIV/AIDS among men who have sex with men in Akwa Ibom State, Nigeria.

Background: Men who have sex with men (MSM) belong to the key population group which contributes to the high burden of HIV/AIDS despite the ongoing HIV prevention programs in Nigeria.  Objectives: The current study assessed the risk factors of HIV/AIDS among men who have sex with men in Akwa-Ibom State, Nigeria.  Methods: This study was a cross-sectional study of Four hundred men who have sex with men selected from three senatorial zones in Akwa Ibom State. A statistical package for service solution version 23 was used to analyze the data. Descriptive statistics, Relative risk and Binary logistic regression were used to compare proportions between risk factors and HIV/AIDS among the MSM. Results: More than half (50.5%) of the respondents were between the ages of 20-29 years. Above 66% of the respondent made their debut into MSM at the age bracket of 13-19years. This study found that about 44% preferred to have sex with men of the same age bracket. About 75% of the respondents said to have had sex with male partners within the last 3 months while only 25% of them answered ‘no’ to sexual intercourse within the past 3 months. In the same vein, 50% said they preferred unprotected sex with fellow men, and 34% preferred condomless sex with both male and female partners. Almost all the respondents (about 99%) reported having multiple sexual partners. More than 72% of the respondents said they had engaged in group sex, especially during their birthday, graduation parties and other occasions such as burial wake keep. More than half (64%) of the respondents reported that they use psychoactive substances (such as tramadol). Greater than half (54%) of the respondents reported having never shared injection needles. In this study, almost 97 % of the respondent reported having engaged in transactional sex in the past 3 months.11.8% of the 400 respondents tested positive while the rest tested negative for HIV. There was a significant association between risk factors and HIV among the MSM studied.  Conclusion: MSM in Akwa Ibom State have been found to engage more in high-risk behaviors which increases their vulnerability to contracting/transmitting HIV, therefore, a risk reduction program must be targeted at each specific identified risk is highly recommended. Key words: Risk factors, HIV/AIDS, men who have sex with men, Akwa-Ibom State, Nigeria

Psychotherapy, Artificial Intelligence and Adolescents: ethical aspects: AI in adolescent psychotherapy: ethical aspects

Artificial Intelligence (AI) has rapidly advanced in various domains, including its application in psychotherapy. AI-powered psychotherapy tools present promising solutions for increasing accessibility to mental health care. However, the integration of AI in psychotherapy raises significant ethical concerns that require thorough consideration and regulation to ensure ethical practice, patient safety, and data privacy. This article discusses the ethical considerations surrounding the utilization of AI in psychotherapy, emphasizing the need for responsible implementation, patient privacy, and the human-AI interaction. The challenge raised by the use of artificial intelligence requires a comprehensive approach. Schools, in particular, are crucial in providing both knowledge and ethical guidance, helping young individuals decipher the complexities of online content. Additionally, parental support is essential, requiring the provision of time, fostering relationships, encouraging dialogue, and creating a safe environment to share experiences amidst the intricacies of adolescence. Reimagining social and healthcare services tailored for adolescents is equally crucial, taking into account recent societal changes. The integration of AI in psychotherapy has vast potential to transform mental healthcare. However, ensuring its accuracy and effectiveness demands a proactive approach to address associated ethical considerations. By adopting responsible practices, preserving patient autonomy, and continually refining AI systems, the field can leverage the benefits of AI in psychotherapy while maintaining high ethical standards

The History of Pertussis: from an Ancient Scourge to a Contemporary Health Burden

The present article offers a historical overview on pertussis (whooping cough) by analysing the ancient epidemic manifestations of the disease and the path towards the discovery of an effective vaccine against it. It also highlights some recent challenges posed to public health by this disease