A non-interventional comparative study between medical and dental undergraduates regarding their knowledge, attitude and practice of antibiotic use in a tertiary care teaching rural hospital: emphasis on WHO fact-sheets

Background: The threat of antibiotic resistance is rapidly progressing and intensifying. The awareness generation of antibiotic use, its seriousness and significance are the first step towards restricting its progress. It is in this regards that this comparative questionnaire-based study was conducted.Methods: The knowledge, attitude and practice (KAP) among medical and dental students of a tertiary care teaching rural hospital was assessed.  Before initiating the study, their written consent was taken, and 125 structured questionnaires were distributed to medical and dental students. Data collected was further entered in Microsoft excel sheet and further comparison of KAP between them was analysed.Results: The results were depicted in percentage. Regarding the indiscriminate and injudicious use of antibiotics can lead to prolongation of illness, the medical students were more aware 82.4% compared to the dental 65.6%. When asked about additional burden of medical cost to the patient, the medical students responded with yes 88.8% and dental student’s response of yes was 47.22%. Also, medical 90.4% students had heard about antibiotic resistance and 60.8% from dental students, which implies that UG students should be made more aware of antibiotic resistance and its consequences.Conclusions: Thus, the results of the study give useful information about the knowledge, attitudes and practices of medical and dental students, that can be further utilized to plan suitable educational interventions that target at improving the knowledge for prescribing antimicrobial medicines. This can further help in minimizing the development of bacterial resistance

A cross-sectional questionnaire-based study of knowledge, attitude and practice of antibiotic usage among the undergraduate students of a tertiary care teaching rural hospital: with an emphasis of WHO fact-sheets

Background: Awareness regarding the antibiotic usage forms vital way to overcome the quickly deepening problem of antibiotic resistance. Hence, all the medical students should be made aware of the current emerging health related issues as future clinicians. It is in this regards that this study was undertaken among undergraduate (UG) students, in order to assess their knowledge, attitude & practice concerning antibiotic use.Methods: The present observational study was conducted over a period of four months starting from May 2018 till August 2018 among undergraduates. A total of 250 structured questionnaires were distributed. Data collected was further entered in Microsoft excel sheet and further analysed.Results: Total 250 students participated in this present study. Out of them, nearly 75.6% had heard about antibiotic resistance while 24.4% denied. Regarding the improper use of antibiotics that can cause antibiotic resistance 70% was aware. Moreover, nearly 40.4% attended a CME about rational use of antibiotics. The belief that the antibiotics are safe drugs hence they can be commonly used was reported by 48%. The results were grouped into knowledge, attitude and practice regarding the antibiotic use.Conclusions: Thus, the result gives us useful insight regarding KAP of the undergraduate students who will be future prescribers of antibiotics. This can be further applied to plan desirable educational informative interventions that focus on improving the knowledge for prescribing antibiotics in future clinicians, which can further help in reducing the development of antibiotic resistance

A study of effect of intra umbilical oxytocin in active management of third stage of labour

Background: Postpartum haemorrhage is a single major and leading cause of maternal morbidity and mortality. PPH is the loss of more than 500 ml blood following vaginal delivery or 1000 ml blood following caesarean section. India has a maternal mortality ratio of 167 per 1 lakh live births. The most common cause of maternal mortality is haemorrhage which accounts for 25-30% of maternal mortality of which PPH is a significant cause. Methods: 200 patients were included in this prospective observational study and divided into two groups, group A, underwent only active management of third stage of labour and group B received intra umbilical oxytocin administration in addition to AMTSL. The maternal and neonatal outcome was observed between the two and the difference was noted. Results: Mean duration of third stage of labour of group A patients was 3.89±0.89 minutes and Mean blood loss was 386±85.30 ml and that of group B patients was 1.96±0.68 minutes and 235±72.99 ml respectively. These were found to be statistically significant among all the other parameters. Conclusions: The duration of third stage of labour and the amount of postpartum blood loss was significantly less when intra umbilical injection of oxytocin was used in addition to AMTSL. So, to conclude intra umbilical vein oxytocin injection should be used routinely in addition to AMTSL in order to prevent PPH

Haematuria from early pregnancy in a morbidly adherent placenta: Case report and a short review

The morbidly adherent placenta has evolved into one of the potentially life-threatening conditions in obstetrics. Vaginal bleeding is the most common presentation of placenta percreta. Other symptoms include unusual dull, prolonged lower abdominal pain. Although haematuria is rare, it may be a presentation of the morbidly adherent placenta in early pregnancy. We report a case of placenta percreta with a very uncommon presentation of gross haematuria early in the second trimester managed successfully. It is emphasized that a high index of suspicion, ultrasound, and/or MRI can establish a preoperative diagnosis of the invasive placenta earlier. However, the diagnostic accuracy of cystoscopy is still under debate. With timely diagnosis, preparedness, and multidisciplinary care, it is possible to minimize catastrophic complications

Multimodal Medical Image Sensor Fusion Framework Using Cascade of Wavelet and Contourlet Transform Domains

Multimodal medical image fusion is effectuated to minimize the redundancy while augmenting the necessary information from the input images acquired using different medical imaging sensors. The sole aim is to yield a single fused image, which could be more informative for an efficient clinical analysis. This paper presents a two-stage multimodal fusion framework using the cascaded combination of stationary wavelet transform (SWT) and non sub-sampled Contourlet transform (NSCT) domains for images acquired using two distinct medical imaging sensor modalities (i.e., magnetic resonance imaging and computed tomography scan). The major advantage of using a cascaded combination of SWT and NSCT is to improve upon the shift variance, directionality, and phase information in the finally fused image. The first stage employs a principal component analysis algorithm in SWT domain to minimize the redundancy. Maximum fusion rule is then applied in NSCT domain at second stage to enhance the contrast of the diagnostic features. A quantitative analysis of fused images is carried out using dedicated fusion metrics. The fusion responses of the proposed approach are also compared with other state-of-the-art fusion approaches; depicting the superiority of the obtained fusion results

Nucleic acid delivery of immune-focused SARS-CoV-2 nanoparticles drives rapid and potent immunogenicity capable of single-dose protection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may target epitopes that reduce durability or increase the potential for escape from vaccine-induced immunity. Using synthetic vaccinology, we have developed rationally immune-focused SARS-CoV-2 Spike-based vaccines. Glycans can be employed to alter antibody responses to infection and vaccines. Utilizing computational modeling and in vitro screening, we have incorporated glycans into the receptor-binding domain (RBD) and assessed antigenic profiles. We demonstrate that glycan-coated RBD immunogens elicit stronger neutralizing antibodies and have engineered seven multivalent configurations. Advanced DNA delivery of engineered nanoparticle vaccines rapidly elicits potent neutralizing antibodies in guinea pigs, hamsters, and multiple mouse models, including human ACE2 and human antibody repertoire transgenics. RBD nanoparticles induce high levels of cross-neutralizing antibodies against variants of concern with durable titers beyond 6 months. Single, low-dose immunization protects against a lethal SARS-CoV-2 challenge. Single-dose coronavirus vaccines via DNA-launched nanoparticles provide a platform for rapid clinical translation of potent and durable coronavirus vaccines.</p