20 research outputs found
Are doctor’s hands contributing in spreading nosocomial pathogens? Rapid appraisal from a tertiary care health center of Northern India
Background: Clinical white coats have very long history of being a symbol of hope and healing for medical professionals; however there has been a concern that white coats may play a big role in transmitting infections within and outside hospital settings.Aim of the study was to assess pattern of pathogenic bacteria on the hands of doctors of a tertiary care hospital along with effect of hand wash on reduction of contamination.Methods: The present study was a hospital based, cross sectional type. Eighty-six doctors of all designations (Junior doctors, n=51; and senior doctors, n=35) were included in this study. The swabs were taken at entry in the wards and also at exit from the wards without washing the hands. Then, swabs were taken after hand washing with tap water and subsequently after alcohol swabs. A total of four wards (2 General Medicine and Surgery wards each) included in the study. Isolated microorganisms were identified using Gram’s stain, hemolysis patterns and colony morphology. The data were analyzed using MedCalc statistical software.Results: Staphylococcus aureus was isolated in 24.41% at entry and in 52.33% at exit. Similarly Pseudomonas aeruginosa and Klebsiella pneumonia were not present on the hands of doctors at entry but isolated in 5.81% and 10.46% of doctors at exit. Pseudomonas aeruginosa and Klebsiella pneumonia were not present on the hands of doctors at entry in both medicine and surgery wards but isolated at exit. Complete removal/reduction of microorganism (100%) was recorded in Escherichia coli and Candida sp after tap water wash. Decrease in count of Pseudomonas aeruginosa up to 80.00% after tap water wash. 88.89 % decrease in microorganism after subsequent alcohol wash was seen in Staphylococcus aureus, Coagulase-negative Staphylococci and Klebsiella pneumonia. Conclusions: It has been observed that simple hand washing (first with water and then with alcohol) is an effective tool to reduce the contamination significantly. Thus, hospital infection control practices including hand washing need to be followed strictly.
Evaluation of corneal biomechanical properties following penetrating keratoplasty using ocular response analyzer
Purpose: To evaluate corneal biomechanical properties in eyes that has undergone penetrating keratoplasty (PK). Materials and Methods: Retrospective observational study in a tertiary care centre. Data recorded included ocular response analyzer (ORA) values of normal and post-keratoplasty eyes [corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and cornea-compensated intraocular pressure (IOPcc)], corneal topography, and central corneal thickness (CCT). Wilcoxon signed rank test was used to analyze the difference in ORA parameter between post-PK eyes and normal eyes. Correlation between parameters was evaluated with Spearman′s rho correlation. Results: The ORA study of 100 eyes of 50 normal subjects and 54 post-keratoplasty eyes of 51 patients showed CH of 8.340 ± 1.85 and 9.923 ± 1.558, CRF of 8.846 ± 2.39 and 9.577 ± 1.631 in post-PK eyes and normal eyes, respectively. CH and CRF did not correlate with post-keratoplasty astigmatism (P = 0.311 and 0.276, respectively) while a significant correlation was observed with IOPg (P = 0.004) and IOPcc (P < 0.001). Conclusion: Biomechanical profiles were significantly decreased in post-keratoplasty eyes with significant correlation with higher IOP as compared with that in normal eyes
Dual intravitreal foreign body: Intravitreal cilia in penetrating injury
Intraocular cilia, though a rare condition, has been previously reported in cases of open globe injury. We discuss a unique case of intravitreal cilia, found incidentally during vitrectomy for intravitreal foreign body removal
Optic nerve head granuloma, retinal vasculitis and elevated levels of angiotensin-converting enzyme: Dilemma of forme fruste ocular sarcoidosis
Purpose: To report 2 cases of optic nerve head (ONH) granuloma, with raised serum angiotensin-converting enzyme (ACE) levels not fitting into the existing criteria for ocular sarcoidosis (OS).
Case Report: Fundus photography, ultrasonography, fluorescein angiography, and optical coherence tomography were performed for both patients. Systemic workup was performed for granulomatous disorders, including sarcoidosis, tuberculosis, and syphilis. Both patients had ONH granulomas and elevated ACE levels, with one of the patients also presenting retinal vasculitis. No other focus of systemic sarcoidosis was localized. Both patients were treated with oral steroids, following which they showed a marked, rapid clinical improvement. Both patients remained stable for at least one year.
Conclusion: The current accepted criterion for diagnosis of OS may need changes to include such borderline cases due to lack of correlation between clinical and investigative findings
Prevalence and Predictors of Unmet Needs among the Elderly Residents of the Rural Field Practice Area of a Tertiary Care Centre from Northern India
To cite this article: Singh A, Bairwa M, Goel S, Bypareddy R, Mithra P. Practical area of tertiary care centre from Northern India. Abstract Background: Surrogate markers simple enough to be used by primary care workers have not been closely investigated by the community experts in rural Uttar Pradesh. We assessed the physical disabilities in activities of daily living (ADL) and unmet need in physical disabilities among rural elderly. Predictors of unmet needs in physical disabilities among the elderly were also identified. Methods: A community based cross-sectional study was conducted among elderly residents of the rural field practice area of a tertiary care centre in rural Uttar Pradesh. Three hundred and thirty five (335) participants aged 60 years and above from 9 villages were selected using the Probability Proportional to Size (PPS) sampling technique. Study tools were the proforma regarding socio-demographic details, socio-economic status and Stanford Health Assessment Questionnaire. Multivariate logistic regression analysis was performed to identify predictors of unmet needs. Results: 185 (55.2%) had physical disability in one or more activity limitation. Gender wise elderly females had more physical disability in one or more ADL categories than elderly males (66.8% vs. 42.0%). Almost one third (32.5%) of subjects had unmet need for one or more physical disabilities. the predictors of unmet needs that were identified in the study were female gender (P = 0.046), elderly aged 70 years and above (P = 0.032), those living alone (P = 0.035), low monthly family income (P = 0.044), financially fully dependent elderly (P = 0.0002), and those having 3 or more physical disabilities (P = 0.033). Conclusions: The findings of the study highlight that large number of needs of the disabled are still unmet. Greater, targeted efforts are needed to identify at-risk elderly people living in the community. These predictors would act as surrogate markers and can be easily used by primary care workers to plan and provide services to the elderly people in rural communities