Aseptic-clinical hand hygiene knowledge survey amongst health care workers in a tertiary care hospital in Western India

Background: Maintenance of hand hygiene among health care workers (HCWs) is the cornerstone of infection prevention and control programmes in a health care facility. Poor hand hygiene amongst HCWs is the single most common cause of cross-transmission of infections between patients and HCWs in the hospital. The objective of this study was to identify the risk factors for non-adherence and assess the knowledge regarding maintenance of hand hygiene amongst health care workers at a tertiary health care centre in Western India.Methods: A descriptive, cross-sectional study was conducted on HCWs - doctors, undergraduate students and staff nurses at a tertiary care hospital and post-graduate institute in western India after ethical committee clearance. A self-report questionnaire by the World Health Organisation (WHO) for the Hand Hygiene Knowledge Survey (2009), which consisted of ten questions and “My 5 moments of hand hygiene”, was answered by the study participants after their written/informed consent. Data was analysed using one-way Anova and Student’s t-tests.Results: 317 participants responded to the survey which included 131 doctors, 111 medical students and 75 staff nurses. 90.85% participants routinely used an alcohol-based hand rub (ABHR) but their overall hand hygiene knowledge score was only 61.04%. Prior formal training in hand hygiene significantly improved the knowledge of HCWs (P<0.001). There was a significant difference between the knowledge and actual practice of “My 5 Moments of hand hygiene”.Conclusions: Hand hygiene knowledge remains unsatisfactory till date amongst HCWs. There is a need to educate HCWs through frequent training session’s right from the time of undergraduate medical study

Gastroscopic diagnosis of ankylostoma duodenale infestation as a cause of iron-deficiency anemia

Hookworm is one of the most common nematode causing intestinal infestation in the world. Patients with a mild hookworm load are usually asymptomatic, but a moderate or heavy hookworm burden can result in fatigue, recurrent abdominal pain and iron-deficiency anemia. We present here an unusual case of a 35-year-old man with iron deficiency anemia in whom adult hookworm were visualized and recovered on gastroscopy. There was no eosinophilia, and stool examination was negative for occult blood, and parasite ova/cysts. Upper gastroscopy revealed several squirming red worms in the stomach. Ancylostoma duodenale infection was confirmed by histopathological examination and eradicated by albendazole successfully. His anemia was corrected after treatment

Aseptic-clinical hand hygiene knowledge survey amongst health care workers in a tertiary care hospital in Western India

Background: Maintenance of hand hygiene among health care workers (HCWs) is the cornerstone of infection prevention and control programmes in a health care facility. Poor hand hygiene amongst HCWs is the single most common cause of cross-transmission of infections between patients and HCWs in the hospital. The objective of this study was to identify the risk factors for non-adherence and assess the knowledge regarding maintenance of hand hygiene amongst health care workers at a tertiary health care centre in Western India.Methods: A descriptive, cross-sectional study was conducted on HCWs - doctors, undergraduate students and staff nurses at a tertiary care hospital and post-graduate institute in western India after ethical committee clearance. A self-report questionnaire by the World Health Organisation (WHO) for the Hand Hygiene Knowledge Survey (2009), which consisted of ten questions and “My 5 moments of hand hygiene”, was answered by the study participants after their written/informed consent. Data was analysed using one-way Anova and Student’s t-tests.Results: 317 participants responded to the survey which included 131 doctors, 111 medical students and 75 staff nurses. 90.85% participants routinely used an alcohol-based hand rub (ABHR) but their overall hand hygiene knowledge score was only 61.04%. Prior formal training in hand hygiene significantly improved the knowledge of HCWs (P&lt;0.001). There was a significant difference between the knowledge and actual practice of “My 5 Moments of hand hygiene”.Conclusions: Hand hygiene knowledge remains unsatisfactory till date amongst HCWs. There is a need to educate HCWs through frequent training session’s right from the time of undergraduate medical study

Chronic Severe Iron Deficiency Anemia in Hospitalized Indian Patients: Laboratory Profile and Treatment Outcomes

Introduction: Iron deficiency anemia is a common finding which adds to the morbidity and mortality burden in hospitalized patients.  This study was done to evaluate the laboratory parameters and different treatment options for chronic severe iron deficiency anemia. Methods: A cross-sectional study was done on patients with chronic, untreated, severe anemia with hemoglobin (Hb) less than 8g% and a hypochromic microcytic peripheral smear. Blood indices, reticulocyte count, iron studies and bone marrow examination were done.All patients were treated either with oral or parenteral iron and the outcome was evaluated a day before discharge and 28 days post-treatment by repeating the hemogram and a six-minute walk test. Results: 148 anemic patients were initially enrolled. 73 patients were excluded as their peripheral smear did not show hypochromic, microcytic picture.  The remaining 75 were included. Average Hb on admission was 6.9 ± 1.74g/dL. Average serum ferritin levels of 17.0 ± 3.50 ng/ml. Depleted bone marrow iron stores were found in 69.45% cases. Rise in hemoglobin and improvement in functional capacity of patients at 28 days post treatment with parenteral iron was statistically significantly higher than that after oral iron therapy. Conclusion: Serum ferritin and bone marrow iron stores were sensitive indicators of IDA. Hemoglobin and functional capacityof patients treated with parenteral iron improved rapidly compared to oral iron

Carcinoma of the cystic duct presenting as obstructive jaundice

Cystic duct carcinoma is a rare disease. We present here a case of 33-year-old female patient who presented with obstructive jaundice. An abdominal ultrasound and computed tomography scan showed dilatation of intrahepatic biliary radicals with abrupt narrowing of the common bile duct and markedly distended gall bladder suggestive of obstructive pathology. Following an exploratory laparotomy, a markedly distended gall bladder, cystic duct specimen and infrapyloric lymph nodes were sent for histopathological examination. Histopathological examination revealed a well-differentiated adenocarcinoma of the cystic duct with no lymph node metastasis

Histopathological Study of Primary Bone Tumours and Tumour-Like Lesions in a Medical Teaching Hospital

Objectives: Histopathological study of bone tumours to determine the spectrum of bone tumours at a Medical teaching Hospital and to correlate it with demographic features like age, sex of patients and anatomical site of tumours. Material and Methods: A retrospective and prospective study of all histopathologically diagnosed bone tumours over a period of 10 years was done. Patients were assessed by clinical examination, radiological investigations, histopathological examination and fine needle aspiration cytology (FNAC) whenever available. Results: A total of eighty-two cases of primary bone tumours were recorded, of which benign tumours were the most common 62 cases (75.61%) followed by malignant tumours with 13 cases (15.85%) and 7 cases (8.54%) of tumour-like lesions. FNAC diagnosis was available in 26 cases (31.71 %) with 68.96 % benign tumours, 17.24% malignant and 3.45% were tumour– like lesions. The concordance and discordance rate of histopathological diagnosis was 76.93% and 23.07 % respectively. On histopathological diagnosis, the most common benign tumour was osteochondroma 34.15% followed by Giant cell tumour 19.51%. Osteosarcoma was commonest malignant tumour 8.54%. Maximum number of bone tumours occurred in 11-20 years of age and the male to female ratio was 1.2:1. Conclusions: Bone tumours occurredpredominantly in the second decade of life with a male preponderance. Osteochondroma was the most common benign tumour followed by Giant cell tumour and Osteosarcoma was the most common malignant bone tumour