Standard Infection Control Practices among Peripheral Health Care Workers: A Knowledge, Attitude and Practice Study from a Rural Haryana

Background: Globally, around 2.5% of HIV and 40% of HBV among Health Care Workers (HCWs) are attributed to occupational exposure with an overall incidence of occupational exposure to blood/body fluids among HCW as 32.3%. There exists a gap between the knowledge and practice of standard infection control practices among HCW. Failure to follow these standard protocols leads to loss of precious work hours of this skilled work force.Methods: To know the knowledge, attitude and practice regarding standard infection control protocols, a community based, cross- sectional, analytical, non –interventional study was planned among health care workers at a Rural Community Health Centre (CHC) , Dighal of district Jhajjar (Haryana). A total of 50 HCWs were included in the study. The study was conducted during the months of July –August, 2016.Results: About 56% of HCWs were having the knowledge about the correct steps of hand washing but only 20% were actually practicing hand washing before administrating injections. Only 28% of participants were correctly using hub-cutter and needle destroyers after the injection practices. It was observed that 42% of subjects were still trying to re-cap needles after the injections. 60% of subjects felt that using standard precautions was cumbersome. 74% of the subjects felt that using standard precautions was expensive. 54% of study subjects felt that it was difficult to follow stand precautions in government institutions due to logistics issues. Only 28% of the participants had received complete vaccination against Hepatitis B.Conclusion: There exists a huge gap between the knowledge and practice of standard infection control protocols. Among most of the HCWs, the attitude was not positive towards using standard precautions despite having knowledge. Lack of initiative from the higher up officials, poor training, poor monitoring further complex the issue. Regular monitoring and supervision, capacity building of HCWs along with regular logistic supply are recommended

Use of intramedullary implants in adult diaphyseal fracture both bone forearm

Background: Fractures of the forearm bones are very common. The most common form of stabilization is plate and screw fixation. The role of Intramedullary nailing of fractures of the shafts of the adult radius and ulna is still to be defined. This study was perform to analyze anatomical and function outcome of the patients treated by Talwarkar square nail.Methods: We evaluated 46 patients (29 males and 17 females) had fracture both bone forearm treated by intramedullary nail. We analyzed patients in two broad group one with close fracture or grade I, II open fracture (34 patients) and other have open fracture grade IIIA or IIIB (12 patients). First group patients further analyzed weather close (22 patients) or open reduction (8 patients) required. Functional outcome was calculated by Grace and Eversman system.Results: Out of 32 patients of close fracture or open grade 1 or 2 fracture, 29 (90.62%) have excellent or acceptable result. All the patients (100%) in whom close reduction succeeds achieved excellent result. 22 (64.70%) patients close nailing possible.12 patients in whom open reduction required 9 (75%) goes into union. Close nailing have overall success rate is 90.62% where it fail and open nailing require success rate bring down to 75%.. Conclusions: IM nailing gives satisfactory results. Advantages of close nailing are- early union, low incidence of infection, small scars, less blood loss, short operating time with minimal surgical trauma, easier implant removal. Even though plate and screw fixation is the gold standard for stabilization of both bone forearm fracture but intramedullay implant can be used in selected cases with good result. To achieve acceptable result – early surgery, proper selection of the case, pre-operative planning, proper assessment of diameter, length and radial bowing of the nail, is required

Influence of Cohesion on Bed Load Transport of Bimodal Sediments

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Study of clinical outcome of acromioclavicular joint injury type III-VI treated by EndoButton and threads in adults

Background: Acromioclavicular joint dislocations are common in physically active young adults that too most common in persons who are participating in sports activities. Incidence is more in males who are participating in contact sports like rugby, basketball, hockey. It accounts for 9% of all shoulder injuries. Literature says the incidence is 3-4/1,00,000 population. The aim of the present study was to study the functional outcome of acromioclavicular joint after reconstruction of both acromioclavicular and coracoclavicular ligament using endo button system and to provide pain-free, mobile shoulder.Methods: In the present study, 15 patients were selected of age group 20-60 years. Acromioclavicular joint injuries are classified according to Rockwood classification and the findings from the physical examination and anteroposterior and axillary radiographs. All patients were treated as per status of injury level by either conservatively or operatively with open reduction and reconstruction of both ligament by using endo button thread system and its outcomes were assessed clinically and radiologically.Results: Patients were evaluated using American shoulder and elbow score (ASES) score and Constant shoulder score. Average ASES score was 90 (range 68.3-98.3) and constant score was 88 (range 63-96). According to constant score 7 patients had excellent outcome, 6 patients had good outcome, 2 patients had adequate outcome. All patients reported satisfaction with the treatment. The patients were followed upto 6 months.Conclusions: The technique proved to be effective in treating acute. Acromioclavicular joint dislocations (Rockwood type III-VI) with a high degree of patient satisfaction

Thyroid dysfunction in Human immunodeficiency virus infected patients and their correlation with CD4 count

Background: The aim of this study was to evaluate the prevalence of thyroid abnormalities in a subset of human immunodeficiency virus positive patients.Methods: This was a cross-sectional prevalence study conducted on adult HIV positive patients. The patients presenting with hypertension, diabetes mellitus, coronary artery disease or thyroid disorder were excluded from the study. An exhaustive medical history and investigation using biochemical, microbiological and radiological tests were performed to confirm the diagnosis. Additionally, tests were done to determine the free T3, T4, thyroid stimulating hormone and CD4 cell count in all the patients.Results: The prevalence of thyroid dysfunction in our study was 45.7%. Various types of thyroid dysfunctions obtained were euthyroid sick syndrome in 18.6%, subclinical hypothyroidism in 11.4%, secondary hypothyroidism in 10% and primary hypothyroidism and hyperthyroidism each in 2.9% cases. As the stage of HIV advanced, there is alteration in the level of thyroid stimulating hormone, FT3 and FT4. A direct correlation was found between FT3 and CD4 counts but no correlation was found between thyroid stimulating hormone and FT4 levels and CD4 counts.Conclusions: A higher prevalence of thyroid dysfunction that was largely asymptomatic was observed in HIV infected patients with significant change in the hormonal levels in patients with low CD4 count. A direct correlation was observed between FT3 hormone level and CD4 count

Investigating the effectiveness of anterolateral distal tibia plate in treating distal tibial fractures in adults: a prospective study

Background: “Pilon” fractures of the distal tibia are a term used usually by orthopaedic surgeons. High-energy trauma and related soft tissue injuries are the main causes. It might be challenging to treat distal one-third of tibial fractures that affect the articular process or not. The objective of this work is to analyze the result of the Anterolateral Distal Tibia Plate in distal tibial fracture treatment in adults. Methods: After receiving permission from the ethical committee, this prospective interventional analysis was conducted among 25 patients who satisfied the inclusion standards and were given anterolateral distal tibia plates. The scoring system created by “Ovadia and Beals” was used to evaluate patients at the conclusion of the follow-up period. Results: The participants in this research varied in age from 18 to 64, with a mean age of 36. 13 patients had a left tibia fracture and 12 patients had a right tibia distal end fracture. There were 4 open GA-I fractures and 21 closed GA-I fractures. 18 patients got fractures as a result of road traffic accidents (“high energy trauma”), and 7 patients sustained a fracture due to a fall (low energy trauma). The union of fracture occurred in 24(96%) patients and 1(4%) case showed delayed union. The average period of union was 18 weeks with the radiological signs of callus formation. 2 patients developed superficial and 1 patient developed deep infection. Conclusions: Distal end tibial fractures especially with intra-articular involvement may be effectively treated by anterolateral plating within a single stage, offers advantages such as adequate fracture exposure, soft tissue preservation, and reliable fracture healing

Optimization of laccase production from Aspergillus flavus by design of experiment technique: Partial purification and characterization

AbstractThe present study describes isolation of laccase producing fungal strain and optimization of the process parameters by design of experiment (DOE) technique to achieve the maximum production of extracellular laccases by Aspergillus flavus obtained from natural habitat. Bromophenol blue dye and ABTS (2,2′-azinobis 3-ethyl-benzothiazoline-6-sulfonate) were used as substrates for the screening of laccase activity. Design expert 8.0.7.1 software was used to optimize culture conditions such as carbon source, nitrogen source, temperature and pH. Subsequently, optimization for inoculums size was also carried out. The optimization studies revealed that the laccase yield was highest when operated at the following conditions: carbon source – cellulose (8%), nitrogen source – peptone (2%), temperature – 35°C, pH – 7 and inoculum of size 1.5cm

Bilateral Luxatio Erecta – Etiology, Diagnosis and Management

Luxation erecta is a rare form of shoulder dislocation, bilateral inferior shoulder dislocation is very rare and few cases have been published in the literature. We present a case of a male, fell down the ladder, presented with bilateral luxation erecta treated with close reduction, immobilisation and rehabilitation

Foundations Failures of Bridges and Geotechnical Investigations

In the present paper two cases of foundation failures due to which the complete bridge structure have failed are reported. The 93m long Palakmati high level brick masonry arch bridge on Hoshangabad - Piparia Road was constructed in year 1910. This bridge has shallow well brick masonry foundation with brick masonry wall type piers. Foundations of piers were on two circular shallow independent wells. The wells are resting on yellow soil. During floods of 1989, the pier No.3 sunk. This brought down 5 spans. Two well foundations were up-rooted. Cracks were developed in other arches also. The 90.5m long submersible R.C.C. trough slab type Mand bridge in 60/8 km on Ambikapur-Pathalgaon Road of 5. 5m width was constructed in the year 1945-46. The bridge has open foundation resting on rock whereas superstructure consist of R.C.C. portal framed structure. The foundation of first pier towards Ambikapur side sunk by about 0. 4m in August 1991. Due to this abrupt settlement the abutment and all the three piers have developed through cracks below the supports and severe cracks in all spans. Geotechnical investigations are carried out in these two cases and remedial measures are suggested for reconstruction of new bridges