Effectiveness of Virtual Teaching Tools on Knowledge and Practice of Biomedical Waste Management among Housekeeping Staff of a Tertiary Care Centre, Rishikesh

Background: The present bio-medical waste (BMW) practices, setup, and framework explored that almost 82% of primary, 60% of secondary, and 54% of tertiary health-care facilities had no trustworthy BMW management system. This study aimed to improve the knowledge and practice of BMW management among housekeeping staff of a tertiary care center, Rishikesh. Materials and Methods: One group pre-test post-test quasi-experimental study was conducted on 139 housekeeping staff. A self-structured knowledge questionnaire and practice checklist through the interview method was used for data collection. Virtual teaching tools (video about BMW management and e-pamphlet) were developed for the study and used. Results: After the intervention, in post-test it was found that the majority of participants had excellent knowledge (111; 79.8%), some (24; 17.3%) had good, and only few (4; 2.9%) had moderate knowledge. None of the participants were found to have poor knowledge after the intervention. There is significant difference in pre-existing (15.89 ± 2.49) and post-test (21.20 ± 4.61) knowledge score, pre-existing practice (21.67 ± 2.13), and post-test (24.95 ± 2.42) practice. There was association between educations their work area with knowledge and significant relationship between work area and past training programs with practice. There is a significant correlation between pre-test knowledge and practice (p=0.00) and post-test knowledge and practice (P = 0.01). Conclusion: It is evident that a virtual teaching tool that comprises video and e-pamphlet is useful in improving the knowledge and practice of housekeeping staff on BMW management

A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions

• NEWS is routinely used to identify hospital patients at risk of deterioration. • Near patient testing of biochemical variables at hospital admission is widespread. • Combining NEWS with near patient testing might improve risk assessment. • NEWS was associated with death or critical care admission. • NEWS and near patient testing was worse at predicting outcome than NEWS alone

Epilepsy, poverty and early under-nutrition in rural Ethiopia

AbstractPurposeThe incidence of epilepsy in Ethiopia is high compared with industrialised countries, but in most cases the cause of epilepsy is unknown. Childhood malnutrition remains widespread. We performed a case–control study to determine whether epilepsy is associated with poverty and markers of early under-nutrition.MethodsPatients with epilepsy (n=112), aged 18–45years, were recruited from epilepsy clinics in and around two towns in Ethiopia. Controls with a similar age and gender distribution (n=149) were recruited from patients and relatives attending general outpatient clinics. We administered a questionnaire to define the medical and social history of cases and controls, and then performed a series of anthropometric measurements. Unconditional logistic regression was used to estimate multivariate adjusted odds ratios. Multiple linear regression was used to estimate adjusted case–control differences for continuously distributed outcomes.ResultsEpilepsy was associated with illiteracy/low levels of education, odds ratio=3.0 (95% confidence interval: 1.7–5.6), subsistence farming, odds ratio=2.6 (1.2–5.6) and markers of poverty including poorer access to sanitation (p=0.009), greater overcrowding (p=0.008) and fewer possessions (p<0.001). Epilepsy was also associated with the father's death during childhood, odds ratio=2.2 (1.0–4.6). Body mass index was similar in cases and controls, but patients with epilepsy were shorter and lighter with reduced sitting height (p<0.001), bitrochanteric diameter (p=0.029) and hip size (p=0.003). Patients with epilepsy also had lower mid-upper arm circumference (p=0.011) and lean body mass (p=0.037).ConclusionEpilepsy in Ethiopia is strongly associated with poor education and markers of poverty. Patients with epilepsy also had evidence of stunting and disproportionate skeletal growth, raising the possibility of a link between early under-nutrition and epilepsy

Cross-sectional observational study of epidemiology of COVID-19 and clinical outcomes of hospitalised patients in North West London during March and April 2020

Objective The aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.Design Observational cohort study.Setting London North West Healthcare NHS Trust (LNWH).Participants Patients tested and/or admitted for COVID-19 at LNWH during March and April 2020Main outcome measures Descriptive and analytical epidemiology of demographic and clinical outcomes (intensive care unit (ICU) admission, mechanical ventilation and mortality) of those who tested positive for COVID-19.Results The outbreak began in the first week of March 2020 and reached a peak by the end of March and first week of April. In the study period, 6183 tests were performed in on 4981 people. Of the 2086 laboratory confirmed COVID-19 cases, 1901 were admitted to hospital. Older age group, men and those of black or Asian minority ethnic (BAME) group were predominantly affected (p&lt;0.05). These groups also had more severe infection resulting in ICU admission and need for mechanical ventilation (p&lt;0.05). However, in a multivariate analysis, only increasing age was independently associated with increased risk of death (p&lt;0.05). Mortality rate was 26.9% in hospitalised patients.Conclusion The findings confirm that men, BAME and older population were most commonly and severely affected groups. Only older age was independently associated with mortality

Epidemiology of Congenital Rubella Syndrome (CRS) in India, 2016-18, based on data from sentinel surveillance.

BACKGROUND:Government of India is committed to eliminate measles and control rubella/congenital rubella syndrome (CRS) by 2020. In 2016, CRS surveillance was established in five sentinel sites. We analyzed surveillance data to describe the epidemiology of CRS in India. METHODOLOGY/PRINCIPAL FINDINGS:We used case definitions adapted from the WHO-recommended standards for CRS surveillance. Suspected patients underwent complete clinical examination including cardiovascular system, ophthalmic examination and assessment for hearing impairment. Sera were tested for presence of IgM and IgG antibodies against rubella. Of the 645 suspected CRS patients enrolled during two years, 137 (21.2%) were classified as laboratory confirmed CRS and 8 (1.2%) as congenital rubella infection. The median age of laboratory confirmed CRS infants was 3 months. Common clinical features among laboratory confirmed CRS patients included structural heart defects in 108 (78.8%), one or more eye signs (cataract, glaucoma, pigmentary retinopathy) in 82 (59.9%) and hearing impairment in 51. (38.6%) Thirty-three (24.1%) laboratory confirmed CRS patients died over a period of 2 years. Surveillance met the quality indicators in terms of adequacy of investigation, adequacy of sample collection for serological diagnosis as well as virological confirmation. CONCLUSIONS/SIGNIFICANCE:About one fifth suspected CRS patients were laboratory confirmed, indicating significance of rubella as a persistent public health problem in India. Continued surveillance will generate data to monitor the progress made by the rubella control program in the country