Analysis of risk factors associated with caesarean section surgical site infections: a case control study

Background: Surgical site infection (SSI) is defined as infection occurring within 30 days after a surgical procedure and affecting either the incision or deep tissues at the operation site. SSIs are the most common nosocomial infections, accounting for 38% of hospital-acquired infections. Despite the advances in SSI control practices, SSIs remain common causes of morbidity and mortality among hospitalized patients. This study was undertaken with an objective to determine and analyze the risk factors associated with cesarean section SSIs.Methods: The study was carried out at Medical College and SSG Hospital, Baroda. After obtaining informed consent to be a part of the study, 140 subjects having cesarean section SSI as per the definition, were included as cases in the study. The controls (140) were also selected from the hospital subjects. The primary post-operative care was similar for the cases as well as controls. For patients who had SSI, samples of discharge from the cesarean section wound were collected and transported for culture. Antibiotics were given accordingly. Details about patient characteristics and outcomes were collected in the proforma for cases and controls and data analyzed.Results: The cesarean section SSI rate was 4.78%. Of the parameters studied, maternal age, parity, gestational age, HIV status, meconium stained amniotic fluid, amount of blood loss, previous surgery, duration of surgery were not associated with cesarean section SSI.Conclusions: Number of antenatal care (ANC) visits, haemoglobin, total white blood cells (WBC) count, pre eclampsia, premature rupture of membranes (PROM), non-progression in 2nd stage and subcutaneous tissue thickness were the independent significant risk factors associated with post-cesarean SSI

A comparison of sublingual with vaginal administration of misoprostol for induction of labor at term

Background: To compare the efficacy and safety of sublingual route of misoprostol with vaginal route of administration.Methods: This study was conducted at Department of Obstetrics and Gynecology, Medical College, Baroda, Gujarat, India. 50 cases each with a singleton term pregnancy and a live fetus requiring induction of labor were allocated to sublingual and vaginal administration of misoprostol. Outcome measures related to labor and maternal and fetal side effects were compared between the 2 groups and evaluated using Chi square test and relative risk (RR) with 95% confidence intervals (CI).Results: The sublingual route of misoprostol was associated with a reduced risk of failed induction, reduced time from initiation to induction, reduced induction to delivery interval and a higher incidence of maternal and fetal side effects. However, the differences were not statistically significant.Conclusions: The sublingual route of administration of misoprostol is comparable in efficacy and safety to the vaginal route for induction

Screening for retinopathy of prematurity in neonates

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of the retina among preterm infants. Neonates born at less than 32 weeks of gestation are at risk of developing ROP. However preterm infants born at 32 weeks or later can also develop severe ROP if they had turbulent NICU course or required prolonged oxygen therapy. Aims of the study were to determine incidence, risk factors of ROP in neonates and to determine the association of birth weight, gestational age and incidence of ROP.Methods: Prospective analytic study done in indoor patients in neonatal intensive care unit at a tertiary care center from June 2015 to May 2016.Results: Overall incidence of retinopathy of prematurity in preterm neonates is 18.4%. Incidence increases with decreasing gestational age. In preterm <28 weeks of gestational age, incidence of ROP is 35%. Incidence also increases with decreasing birth weight. Incidence of ROP in neonates with birth weight less than 1.25kg is 50%. Risk factors include prematurity, oxygen therapy, septicemia, intraventricular hemorrhage, anemia needing blood transfusion. Most patients of ROP have stage-1 disease (76%). The twenty one cases having ROP underwent laser ablative therapy. Earlier detection by screening leads to early intervention and prevention of blindness.Conclusions: The timely retinal screening of high-risk preterm infants is important to prevent the development of advanced ROP. Since ROP may produce serious sequel up to complete blindness, all efforts must be made to prevent the development of advanced ROP through elimination of preterm births, changes in the neonatal care and improvement in detection of threatening ROP markers

Knowledge, awareness, and practice of postnatal care among mothers

Objective: The objective was to study the knowledge, awareness, and practices regarding the postnatal care among the mothers.Design and Setting: A pre-structured and pre-tested questionnaire was used to evaluate knowledge and awareness of postnatal carein mothers at a tertiary care center. The questionnaire was given after stabilization between 1 and 5 days of the postnatal period.Materials and Methods: Totally, 200 postnatal mothers (18-35 years) out of 540 mothers who were given antenatal and postnataleducation in our antenatal care center were selected. Study Period: June 2013-September 2013. Results: Knowledge of mothersregarding breastfeeding practices (78%), thermal care (89%), skin and eye care (72%) was good. They have poor knowledge regardingdangers of pre-lacteal feeds (45%), timing of first bath after birth (60%), umbilical cord care (60%), and vaccination (36%). About32% of them are practicing oil instillation into nostrils while 44% of mothers were intended to use gripe water for infantile colic.Conclusion: The study highlights that there is vital need to improve the knowledge and awareness in the society regarding communitybasednewborn care. We should also strive toward helping removing myths and wrong practices, which are rampant in the community

The effect of surveillance and appreciative inquiry on puerperal infections : a longitudinal cohort study in India

Peer reviewedPublisher PD

Compressive properties of commercially available polyurethane foams as mechanical models for osteoporotic human cancellous bone

<p>Abstract</p> <p>Background</p> <p>Polyurethane (PU) foam is widely used as a model for cancellous bone. The higher density foams are used as standard biomechanical test materials, but none of the low density PU foams are universally accepted as models for osteoporotic (OP) bone. The aim of this study was to determine whether low density PU foam might be suitable for mimicking human OP cancellous bone.</p> <p>Methods</p> <p>Quasi-static compression tests were performed on PU foam cylinders of different lengths (3.9 and 7.7 mm) and of different densities (0.09, 0.16 and 0.32 g.cm^-3), to determine the Young's modulus, yield strength and energy absorbed to yield.</p> <p>Results</p> <p>Young's modulus values were 0.08–0.93 MPa for the 0.09 g.cm^-3foam and from 15.1–151.4 MPa for the 0.16 and 0.32 g.cm^-3foam. Yield strength values were 0.01–0.07 MPa for the 0.09 g.cm^-3foam and from 0.9–4.5 MPa for the 0.16 and 0.32 g.cm^-3foam. The energy absorbed to yield was found to be negligible for all foam cylinders.</p> <p>Conclusion</p> <p>Based on these results, it is concluded that 0.16 g.cm^-3PU foam may prove to be suitable as an OP cancellous bone model when fracture stress, but not energy dissipation, is of concern.</p

Screening for retinopathy of prematurity in neonates

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of the retina among preterm infants. Neonates born at less than 32 weeks of gestation are at risk of developing ROP. However preterm infants born at 32 weeks or later can also develop severe ROP if they had turbulent NICU course or required prolonged oxygen therapy. Aims of the study were to determine incidence, risk factors of ROP in neonates and to determine the association of birth weight, gestational age and incidence of ROP.Methods: Prospective analytic study done in indoor patients in neonatal intensive care unit at a tertiary care center from June 2015 to May 2016.Results: Overall incidence of retinopathy of prematurity in preterm neonates is 18.4%. Incidence increases with decreasing gestational age. In preterm &lt;28 weeks of gestational age, incidence of ROP is 35%. Incidence also increases with decreasing birth weight. Incidence of ROP in neonates with birth weight less than 1.25kg is 50%. Risk factors include prematurity, oxygen therapy, septicemia, intraventricular hemorrhage, anemia needing blood transfusion. Most patients of ROP have stage-1 disease (76%). The twenty one cases having ROP underwent laser ablative therapy. Earlier detection by screening leads to early intervention and prevention of blindness.Conclusions: The timely retinal screening of high-risk preterm infants is important to prevent the development of advanced ROP. Since ROP may produce serious sequel up to complete blindness, all efforts must be made to prevent the development of advanced ROP through elimination of preterm births, changes in the neonatal care and improvement in detection of threatening ROP markers