Occupational Stress among Health Care Workers

Occupational stress is a harmful response particularly physical and emotional, due to a mismatch between job requirements and the qualifications, resources, and worker’s needs; its chronic form is termed “Burnout.” Stress among health care workers is multifactorial. Its prevalence among healthcare professionals ranges from 27−87.4%. Occupational stress is a significant reason for physical and mental health, substance use, work-related delay, absenteeism, and emigration rate. Additionally, it can lead to patient safety concerns and poor quality of care. The mismatch between job requirements and the available resources, work overload, working environment, work experience, workplace conflict, gender discrimination, marital status, educational status, job satisfaction, and not being rewarded were some of the factors significantly associated with occupational stress among health care professionals. Moreover, the coronavirus disease 2019 (COVID-19) pandemic introduced additional stressors, such as staff redeployment and the fear of infection. WHO identified good primary health care as fundamental for achieving universal health coverage without financial hardship. Healthcare professionals’ physical and mental well-being is crucial for attaining this. Developing culturally and organizationally appropriate early interventions is the need of the hour to prevent a health care worker from entering a stress level that is non-adaptable beyond their coping abilities

CHOICE OF OPERATIVE TECHNIQUE FOR EMERGENCY CASES OF SIGMOID VOLVULUS IN A TERTIARY CARE HOSPITAL OF GUJARAT

Introduction: Sigmoid volulus is by far the most common type of volvulus, accounting for 75 to 90 % of all volvulus. Most common presenting symptom is abdominal pain and constipation. . It may be initially managed by sigmoidoscopy or rectal tube insertion but where fear of compromised vascular supply of the sigmoid colon is associated, immediate laparotomy after resuscitation must be undertaken to avoid gangrene and septic shock. The primary objective of the study is to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Methodology: All patients presenting with volvulus and needing emergency operative intervention during 1 years duration from January 2010 to December 2011 were included in this study. Total 41 patients were included in the study of which 25 presented with gangrenous sigmoid colon on laparotomy and viable sigmoid colon was present in the remaining 16 cases. Comparison is done with respect to mortality and early morbidity associated with different operative procedures. Results:  Highest mortality i.e. 33.3% observed among patients who underwent primary resection and anastomosis without proximal colostomy. Wound infection was more common following all forms of stoma procedure. Conclusion: Hartmann’s procedure goes a long way in decreasing mortality due to sigmoid volvulus in the emergency setting.

Financial incentive- Does this have impact on outcome of Tuberculosis?

Background: Although most public services provide tests and TB drugs free of charge worldwide, opportunity costs pose barriers to accessing TB services and treatment. 'Kumar Raajratna Bhimrao Ambedkar Vaidakiya Sahay Yojana (KRBAVSY)' popularly known as Free Medical Aid Scheme is in operation in Gujarat since early 70s for SC and since 1991 for SEBC to provide monetary incentive. Primary objective: Evaluation of utilization and effectiveness of Financial incentives given under Free Medical Aids scheme on RNTCP in Gujarat. Methodology: A retrospective cohort study was undertaken in which all TB patients registered under RNTCP in Gandhinagar district were evaluated for their eligibility for KRBAVSY scheme, and whether eligible patients got benefit or not. Also, treatment outcome of patients were compared. Results: Out of total 1430 patients inquired, 896 (62.7%) patients were found eligible for the scheme, while only 87 (9.7%) patients confirmed that they had got the benefit of scheme. Eligible patients who got benefit under scheme had almost five times higher odds of successful outcome of TB treatment. Conclusion: The TB patients who got benefit of KRBAVSY scheme had significantly better successful treatment outcome in comparison to the TB patients who did not get benefit

Bio-Medical Waste Handling Practices in Urban Health Centers of Surat Municipal Corporation

Background: Biomedical waste consists of solids, liquids, sharps, and laboratory waste that are potentially infectious or dangerous and are considered biomedical waste. It must be properly managed and safely disposed. Methodology: Cross-sectional study design, consisting of participant observation and interviews, among 20 health centres of Surat Municipal Corporation area. Results: Our study shows number of bags having inappropriate content was maximum in red bags (50.0%). Among the medical officers and nurse, knowledge regarding proper bag for collection of cotton gauze pieces and empty box is better than all other article. Conclusion: Healthcare waste management should be supported through appropriate education, training and the commitment of the healthcare staff, management and healthcare managers

Epidemiological Characteristics of Deceased H1n1 Cases in Civil Hospital, Gandhinagar During First Quarter Of 2015

Introduction: In preparation for future waves of H1N1 influenza, determining the correlates of the severity of disease may be very important. Methodology: A retrospective, descriptive study was carried out at the Civil Hospital, Gandhinagar which included all the deceased patients of Influenza A H1N1 from 1st January 2015 till 31st March 2015. The admission history and their medical records including certified cause of death of all deceased H1N1 patients were collected and assessed for clinico-epidemiological details. Result: Mean age of fatal cases was 51.4 years, male to female ratio was 1:0.9 and 68% resided in Gandhinagar rural area. Majority (68%) were referred from private hospital. Almost 50% of the deceased had some form of comorbid conditions. Fever (78.9%), breathlessness (73%) and dry cough (73.7%) were reported mainly among the deaths due to H1N1. Median time, from onset of symptoms to date of admission was 4 days; whereas that from admission to death was 2 days. Conclusion: Adult age, residing in rural area, delayed referral from private practitioner, presence of comorbid conditions were found to the few reasons associated with deaths due to H1N1

HEMATOLOGICAL CHANGES IN P.FALCIPARUM & P.VIVAX MALARIA

Introduction: Malaria continues to be a great health problem in some of the most populated areas of the world & continues to cause significant morbidity and mortality worldwide. The hematological abnormalities that have been reported to consistently with malaria are anemia, thrombocytopenia, atypical lymphocytosis and infrequently disseminated intravascular coagulation. Methodology: This cross sectional study was conducted in central hospital laboratory of a tertiary care hospital of Surat, Gujarat. The laboratory confirmed cases of malaria from August to October, 2012 were included in the study. Hematological profile of different spices of malaria was compared. Results: The difference in mean platelet count according to severity of infection was highly statistically significant according to ANOVA test both for P.Vivax and P.Falciparum. Platelet counts show decreasing trend according to severity of infection. Difference in the mean haemoglobin level and mean platelet counts of P.Vivax cases and P.Falciparum cases was also statistically significant. Conclusion: The low level of platelet can be used as predictor of severity of the infection. And thus, prediction of the hematological changes enables the clinician to establish an effective and early therapeutic intervention in order to prevent the occurrence of major complications

A Profile of Knowledge and Sexual Behaviors Among Textile Workers in Context of HIV And AIDS in Surat City

HIV infection and AIDS is more prevalent in India and occurs in all states.2 Today, there are around 2.5 million people living with HIV/AIDS in India.1 Surat city in the western state of Gujarat attracts a very large migrant population. As most of them belong to sexually active age group, their exposure to sex workers or having multiple sexual partnerships is very high. The aim of this study was to explore the sexual behavior among textile factory workers in Surat and assess the knowledge and awareness about mode of transmission of HIV. This cross-sectional study of 250 textile workers reveals that 76.4% worker know that HIV can be transmitted by unsafe sexual route while 43.2% of workers does not know that HIV can be spread through reused injections. 43 workers currently had extra marital or premarital sexual relations and among them 48.8% had used condom during last such intercourse

Scorecard - An innovative simplified tool to supplement the existing monitoring mechanism to assess and improve performance of antiretroviral treatment centers

Introduction: All 26 antiretroviral treatment (ART) centers of Gujarat were monitored by Gujarat State AIDS Control Society under the National AIDS Control Program. A comprehensive tool is needed to identify gap in service delivery and to prioritize monitoring visits. Objectives: To supplement the existing monitoring system, identify strengths/weakness of ART centers, and give recommendations. Methodology: Scorecard was developed in spreadsheet format with 17 scoring indicators on monthly base from March 2014 onward. The centers were classified in three color zones: green (score ≥80%), yellow (score <80% and ≥50%), and red (score <50%). Visits were prioritized at centers with more indicators in yellow/red zone. The performance of centers was compared for March 2014 and March 2015. Results: The statistically significant improvement was observed in indicator “ART initiation within 2 months of eligibility,” while after removing red zone from analysis, four more indicators named “eligible patients transferred out before ART initiation, general clients started on ART, antenatal women started on ART, and pre-ART follow-up CD4 done” reflect statistically significant improvement. Quadrant analysis was done for some indicators, which provide insight that less number of eligible patients may be a reason for low initiation of ART at one center, and at four other centers, the possible reasons for low retention are high death rate and high lost to follow-up rate. Based on these findings, the recommendations were made to regular mentoring centers, improve coordination between ART center and care and support centers (CSCs), and conduct verbal autopsy. Conclusion: Scorecard is a simple and cost-effective tool for monitoring, and by highlighting low-performing indicators, it helps in improving quality of services provided at ART centers

Evaluation Of Pre-Test and Post-Test Knowledge Questionnaire After Intensive ICTC Team Training Among Health Care Workers

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