Implementation of government e-marketplace in a tertiary care hospital of North India: advantages and challenges

Background: The procurement in public sector in India was revolutionized by Government e marketplace (GeM). This study was undertaken to elaborate the implementation process, identify advantages and challenges in a tertiary care institute of North India.Methods: The process of implementation of GeM was studied by reviewing the orders, records. Data related to items procured from year 2017 to 2019 was retrieved.Results: The procurement through GeM portal has steadily increased through the year. The portal offers many advanatges like simplification of procurement, paperless, time bound, transparent system with minimal human interface. Innovative approaches like GeM helpdesk, GeMmy are used. There could be better provisions for stringent quality assurance, rate contract or extended warranty or annual and comprehensive maintenance contracts on GeM..Conclusions: GeM portal is a relatively novel dynamic concept in the country and continuously evolving with a mandate to revolutionize public procurement

Impact of green corridors in organ donation: A single-center experience

With the onset of 21st century, organ donation (OD) has taken a big stride, still waiting for organ transplants is higher than its availability. Donating a life after one's death to someone you even do not know is one of the noble humanity causes. In Indian scenario, with the inception of Transplantation of Human Organs Act, 1994, multiple active initiatives were undertaken time to time for promoting OD; similarly, green corridors have also come in a big way for transfer of organs for interinstitutional transplantation. The institute undertook its first green corridor for OD in 2015 when liver was sent to one of the hospitals, and till date, 25 green corridors have been established where 27 organs have been shared with other institutes nationwide besides intrainstitute transplantations. Although this noble cause has taken its initial steps, still, innovations, and opportunities for promoting OD should be explored in a continuum for foreseeable better future

A descriptive study on child sexual abuse act in India

Background: Child sexual abuse (CSA) is a significant public health problem. Health care professionals can play an important role in the identification and reporting of such cases. This study was conducted to assess the awareness level among doctors working in a medical Institute about CSA. Materials and Methods: This is a cross-sectional descriptive study. Data was collected using a closed-ended structured questionnaire. Descriptive analysis was done to compute percentages and frequencies. Respondents' educational qualification, as well as the relationship between their level of education and their awareness of child abuse, was also assessed. Results: Nearly 70% of respondents came across child abuse cases, wherein sexual abuse was found to be the commonest (58%), followed by physical abuse (28%). Nearly 40% of child abuse cases were reported in the hospital where they worked, while 15% of child abuse cases occurred in other hospital areas. The study also revealed that 81% of respondents had knowledge about child sexual abuse. However, only 34% were aware of the repercussions of non-reporting of a child abuse case. Nearly 64% of respondents had an idea about an online complaint system for child abuse, and 70% were aware of the availability of a one-stop centre at a respondent's hospital. The majority (68%) were aware of the POCSO (Protection of Children from Sexual Offences) Act on sexual abuse. On seeking information regarding evidence of anal sexual abuse among children and adolescents, 36% were completely aware, and 13% were partly aware of it. Conclusion: There is a need for continued education and advancement of all health care professionals to improve the diagnosis and reporting of CSA

Clinical-Epidemiological Profile of Influenza A H1N1 Cases at a Tertiary Care Institute of India

Introduction: Influenza virus is a common human pathogen that has caused serious respiratory illness and death over the past century. In April 2009, a new strain of Influenza virus A H1N1, commonly referred to as "swine flu," began to spread in several countries around the world, and India confirmed its first case on 16 May 16 2009. Aim: To study the clinical and epidemiological profile of Influenza A H1N1 cases at the Government Medical College and Hospital, Chandigarh. Materials and Methods: Clinical epidemiological characteristics of Influenza A H1N1 cases from May 2009 to April 2010 were retrospectively, descriptively analyzed using data from the Influenza A H1N1 screening center and isolation ward at the Government Medical College and Hospital, Chandigarh. Data were Analyzed using MS Excel software. Results: At GMCH, till April 2010, a total of 4379 patients were screened for Influenza A H1N1, of which 365 patients were tested. The most common symptoms were fever (87.6%), cough (49.77%), sore throat (27%) and breathlessness (23.9%). The most common presentation (42.30%) of Influenza A H1N1 cases was fever and cold-like features, not cough. 29.58% (108) of the tested patients were found to be positive for the disease. Maximum cases were detected in the month of December, and the patients less than 40 years of age accounted for 81.4% (44 cases) of the cases. Influenza A H1N1 resulted in death of 54.9% (28) of the admitted cases, of which 46% (12) deaths occurred within 48 h of admission. Conclusion: On the basis of these findings, it can be safely hypothesized that prevalence of Influenza A H1N1 is high in the younger population, and fever, cough and sore throat are the most common symptoms with which the patients usually present

Quality of Life of Multi Drug Resistant Tuberculosis Patients: a Study of North India

Tuberculosis is still one of the leading causes of mortality and morbidity. Besides clinical impact, the disease affects the quality of life (QOL) too. With the rise of 21st century, multi-drug-resistant TB (MDR TB) has risen as a significant public health problem due to emergence of resistance to anti-tuberculosis therapy (ATT) drugs. This study was planned to analyze the impact of MDRTB on QOL. It was a six month analysis, with a sample size of 60 cases each of MDRTB and PTB. It was based on a pre-designed, pre-tested questionnaire using WHOQOL BREF scale.  Out of each group, 38 (63.33%) and 36 (60.0%) were in the 21-40 years of age groups, more than 60% married and were residing in the urban/urban slums. It was found that QoL of MDRTB patients was worse than PTB counterparts. The psychological and environmental domains (MDRTB vs. PTB 17.46 vs. 15.23 and 22.00 vs 18.91) were more affected as compared to physical and social domains (19.03 vs 20.05 and 7.88 vs 9.61) in MDRTB and PTB. Financially, MDRTB patients were worst suffers as compared to PTB as former were not being covered under any program, while both groups are affected socially due to social stigma attached with the disease. Thus, there is a need to design an applicable, reliable measure to better address the quality issues methodologically. This would further enable the health care professionals and management to devise relevant interventions to improve the quality of the patients, as well as the programme

Injury pattern of road traffic accident cases attending trauma centre of tertiary care hospital of North India

Introduction: Injury is a significant global health burden and can result in mortality if not attended to on time. Trauma system refers to a collection of services provided by various super-specialties. According to the WHO-World Bank Report, RTA will rise from ninth place to the third biggest cause of mortality. Materials and Methods: The study was done at Advanced Trauma Centre (ATC) at PGIMER, a teaching hospital of north India. Study included area from most of the patient come for treatment (rural/urban) and injury patterns seen in these patients, which included mode of injury, type of injury, type of road accidents and location of injury. Results and Observations: In maximum cases, 60.2% (245) of the mode of injury was RTA. It was seen that the maximum number of patients, 44.4%, (115) had motorbike/scooter collisions with vehicles. In most patients, the type of injury seen was 35.9% (147) head, neck and back injuries, and in maximum cases, the location of the accident site was road/street 63.2%. Discussion: In our country, where the trauma delivery system is poorly developed, teaching hospitals have to bear the burden of treating many patients. No concept of emergency medicine or trauma care is in use, even in urban areas. As a result, teaching hospitals' emergency departments receive many referrals for emergency conditions

Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study

Objectives Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.Setting Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.Participants We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.Results Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.Conclusion A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic