Cross-sectional comparative study of socio-demographic and health profile of children in a NGO- run open house and street children in a metropolitan city

Background: Street children are underprivileged urban children who suffer poverty, deprivation of education, vulnerability to various types of abuse, lack of supervision by adults, and with varying status of street-based existence and contact with their families. The study compares the socio-demographic and health profiles of children in a NGO-run Open House and street children.Methods: Respondents satisfying intake criteria were interviewed using a pre-tested questionnaire and their height and weight were measured and the data were statistically analysed.Results: 72% were aged between 12-16 years. Their occupations included rag picking, unorganised labour, street vending, cleaning vehicles, hotel work and begging. The reasons for street living were parental abuse, poverty, parental death, or peer pressure. Between the two groups of children, there were significant differences in frequencies of genital lesions (p=0.014; OR=0.465), injuries (p=0.01; OR=0.5), scabies (p=0.01; OR=0.31), and pyoderma (p=0.03; OR =0.38). A majority from both groups chewed tobacco regularly, some were addicted to more than one substance and had started using addictive substances due to peer pressure or to alleviate depression.Conclusions: Multi-pronged interventions ought to focus on improving income levels and housing of impoverished families, curbing parental abuse, and providing educational and health care facilities, establishing more number of drop-in Open Houses, providing avenues for legal income, and educating on the hazards of promiscuity and substance abuse

Compliance with standard norms in collection, segregation and transport of biomedical waste in a tertiary care hospital: a cross-sectional study

Background: This cross-sectional study was conducted to determine the gaps between the stipulated procedures for collection, segregation and transportation of bio-medical waste (BMW) and the actual practices; the levels of BMW-related awareness and training status of hospital employees; the protocols for occupational exposure to hazardous BMW and their implementation; and to recommend corrective measures.Methods: Primary data were collected by interviewing the staff in-charge of all BMW generating units of a tertiary care hospital and by recording information by direct on-site observation on a checklist. The participant’s confidentiality was maintained throughout the study.Results: The interviews and actual observations in 26 BMW generating units (out-patient departments, in-patient wards, laboratories, operation theatres, post-mortem room) revealed availability of trained person in-charge for BMW (3.85%), mixing of infectious and non-infectious waste at point of generation (73.07%), untreated syringes sent for final disposal (60.86%), availability of colour-coded bags (50%) and absence of puncture-proof containers (85.71%). 84.61% of interviewees reported having taken tetanus and hepatitis B immunizations.Conclusions: The necessary interventions include periodic training and re-training of personnel, active supervision of BMW handlers to enforce the use of protective gear and vaccination of all staff against tetanus and hepatitis B. Periodic BMW audit would be essential to determine the trends in the diversity and quantities of waste produced in health care settings and facilitate administrators to devise strategies for improved management of BMW

Retention of case-based learning on infectious diseases by third-year medical students

Background: Undergraduate medical students infrequently see a variety of cases of infectious diseases during their batch-wise rotatory clinical postings. Traditional didactic teaching resulted in lack of learner-centred teaching, lack of in-depth knowledge and less retention of learning. The main aim and objective of this complete-enumeration, before-and-after study (without controls) is to employ case-based learning (CBL) as an adjunct to traditional didactic lectures (TDL) for teaching infectious diseases to third-year undergraduate medical students to study the retention of knowledge by comparing the cognitive domain scores in pre- and post-tests.Methods: After obtaining ethical permissions and written informed consent, TDLs were delivered to give a preview on ten topics (selected by lottery system from topics in syllabus) and a pre-test was conducted after TDL. After pre-test, CBL sessions were conducted jointly by two facilitators (using identical CBL modules) in two randomly-assigned sub-groups (n=28) to enable discussion. After CBL, two post-tests (identical to pre-test) were conducted at intervals of one and six months to determine the levels of retention of learning.Results: The differences in the student-wise and question-wise scores in the pre-test and one-month post-test and that between the pre-test and six-month post-test were highly significant. However, the difference between the mean scores in one-month and six-month post-test were not statistically significant.Conclusions: CBL modules using case scenarios were found to enable learning. The marginal differences between the scores in the one-month and six-month post-tests indicate that a single post-test administered six months after the educational intervention (CBL) would be adequate

Cross-sectional study on accidental occupational exposures amongst urban slum-based private medical practitioners

Background:This cross-sectional, complete enumeration study was conducted in an urban slum to determine the frequency of occupational exposure of private medical practitioners to patient body fluids and the remedial measures adopted following such events and also to examine their high-risk practices, personal protective measures, immunisation and training status in relation to occupational exposures.Methods: After Institutional Ethics Committee approval, private medical practitioners practising for ≥ 1 year in the locality who gave written informed consent were interviewed in their own clinics using a pre-tested formatted questionnaire.Results: Of the 108 respondents interviewed, the majority were non-allopathic, male practitioners. The speciality-wise and gender-wise differences in training in occupational exposure were not significant (p=0.135). Prior to disposal, 10.18% cut needles while 26.85% disinfected needles with 1% hypochlorite solution (p=0.0001). 50.93% never bent or recapped needles (p=0.0008). Only 19.44% regularly used gloves while examining patients (p=0.0039). 41.66% were completely unimmunised against Hepatitis B (p=0.004), while only one female non-allopathic practitioner (0.92%) had taken complete immunisation against tetanus (p<0.05). Of the 7.41% respondents who had history of needle stick injuries, only one female non-allopathic practitioner had reported occupational exposure. Those unaware about the need for post-exposure prophylaxis for occupational exposure and that anti-retroviral therapy was part of post-exposure prophylaxis constituted 87.96% and 95.37%, respectively.Conclusions: Reporting of occupational exposure, complete immunisation against hepatitis B and tetanus and use of personal protection was inadequate. Specialised hands-on training ought to be an integral component of continuing medical education for private medical practitioners.

Bacteriological study of surgical site infections in a tertiary care hospital at Miraj, Maharashtra state, India

Background: Surgical site infections (SSI) are one of the common post-operative complications. Apart from bacterial contamination of wound, various patient and environment related factors play role in development and outcome of SSI. The present study is undertaken to study the frequency of SSI with reference to factors contributing to it and the antimicrobial susceptibility pattern of the causative organisms.Methods: This single-observer, cross-sectional, complete-enumeration prospective study was carried out over a period of one year. 196 pus samples from cases of surgical site infections were processed for gram staining, culture, biochemical identification tests and antimicrobial susceptibility testing. Methicillin-Resistant Staphylococcus aureus (MRSA) strains were detected by using oxacillin and cefoxitin disk diffusion and minimum inhibitory concentration (MIC) of oxacillin was tested by broth dilution technique.Results: The overall frequency of SSI was 6.17%. Most common isolates were Staphylococcus aureus, coagulase negative Staphylococci (CONS), E. coli and Pseudomonas aeruginosa. The frequency of MRSA was 8.6%. The maximum frequency was among patients operated on emergency basis in surgical department.Conclusions: The most important determinants for SSI were emergency surgery and presence of co-morbid conditions. The frequency of occurrence was age-dependent, with maximum rate of SSI in males and females in the third and sixth decades of life, respectively

Outcome of combination of methods of educational interventions in physiology for first-year MBBS students

Background: This comparative, before and after study (without controls) was conducted in a municipal medical college to compare the cognitive domain scores obtained by first-year MBBS students after didactic lectures with that obtained after an educational intervention that combined integrated teaching with clinical scenarios.Methods: After obtaining prior permissions, the purpose of the study was explained to first-year MBBS students and written informed consent was obtained. After attending curriculum-based didactic lectures on the alimentary system, the students (n=62, females: n=29, 46.77% and males: n=33, 53.23%) took a pre-test comprising ten questions (total 20 marks). After the pre-test, the participants attended an educational intervention that combined integrated teaching with clinical scenarios on the same topic. Subsequently, the post-test was administered using a questionnaire that was identical to that of the pre-test.Results: The mean overall marks obtained in the pre-test was 14.73±1.87 (95% CI: 14.26-15.19), while that obtained in the post-test was 17.16±1.73 (95% CI: 16.73-17.59), exhibiting highly significant (p <0.00001) difference. The gender difference in scores was significant (p=0.011) for only question no. 1 in the pre-test and there was no significant gender difference in the post-test.Conclusions: A combined method of educational intervention was found to enhance the cognitive domain scores of students. Though a larger study would be needed to generalize the findings, male students seem to need an additional educational intervention to improve their cognitive domain scores. Despite time limitations in the teaching schedule for the first-year MBBS course, integrated teaching with case scenarios can be implemented to impart early clinical exposure

Investigations on RF Behavior of a V-Band Second Harmonic Gyrotron for 100/200 kW Operation

This article presents the investigations on RF-behavioral aspects for the possible operation of a V -band, continuous wave (CW) second harmonic gyrotron for plasma diagnostic application. Keeping in view the design goals and constraints, initial design studies for the mode selection and the computation of starting currents are carried out. From these studies, two possible modes, namely, TE 7,3 and TE 8,3 are considered for the second harmonic operation. Later, the cold cavity design and self-consistent calculations are carried out for the selected operating modes. All the computations are performed using the latest version of our in-house code Gyrotron Design Studio Second Harmonic Version 2020 (GDS2H-2020) with Glidcop as the cavity material. The RF behavior studies confirm the feasible operation of such a second harmonic gyrotron with power levels in excess of 115.52/217.64 kW with the chosen modes of operation

Realistic Design Studies on a 300-GHz, 1-MW, DEMO-Class Conventional-Cavity Gyrotron

This article presents the realistic initial design studies of a 300-GHz, 1-MW, conventional-cavity gyrotron for its probable application in the next-generation thermonuclear fusion reactors. Keeping the design goals, parameters, and constraints in view, the very high-order TE 49,18 mode is chosen as the operating mode after a careful mode-selection calculation considering realistic ohmic cavity losses. After mode selection and mode competition studies, the cold-cavity design and initial design of a triode-type magnetron injection gun (T-MIG) and a gyrotron magnet are carried out and an electron beam radius of 8.11 mm is obtained with 2.4% velocity spread. Furthermore, investigation on RF behavior of the cavity is performed with the T-MIG beam parameters. By varying the nominal beam parameters, single-mode self-consistent calculations are conducted and achieved the desired output power. Then, multimode time-dependent self-consistent calculations are carried out before and after space-charge neutralization (SCN) with realistic velocity spread (up to 6%) and different beam radii for the assessment of the start-up scenario. Before SCN without velocity spread, the beam voltage is depressed to 70.08 kV and 0.72-MW output power is obtained, whereas with velocity spread (6%), 0.69-MW output power is obtained with 8.11 mm of beam radius. After 60% of SCN in the start-up scenario with velocity spread (6%), the beam voltage increases to 74.83 kV, and thereby, an output power of 0.91 MW is obtained