Training need assessment of nursing personnel as super specialty tertiary care hospitals in Northern India

Background - Super specialty tertiary care hospital equips nurses with the requisite knowledge and skills to deliver high quality care in their practice areas. This has necessitated adopting a structured approach to the training needs assessment (TNA) to identify the development needs of the nursing workforce at a tertiary care centre. This study involves Micro Level – Task/Job analysis i.e. identifies and describes all the skills performed by employees in a particular job and the knowledge, skills, attitudes and other behaviours needed for successful job performance. Aim and objectives: The study explores the training needs of nursing personnel at super specialty tertiary care hospital in northern India by analyzing the areas of knowledge and skills deficit as perceived by the nurses and assessing the expectations of doctors, about the role of nurses and deficiencies in their current knowledge, skills Design: Structured questionnaire based descriptive cross sectional study Methods: A set of questionnaire were framed using core competencies of nurses listed by Massachusetts department of higher education and nursing council of Hongkong and A questionnaire based descriptive cross sectional study among nurses, faculty, senior residents and patients were done. Results: The total sample collected for the study was 274 which included 19 faculty, 44 senior résidents, 211 nurses. Training needs identified to be further developed for Grade II and grade I nurses both by nurses and doctors are maximum in patient care and research domain followed by managerial/administrative and communication domain. Training needs agreed to be promoted for ANS’s are maximum in managerial/ administrative and communication domain. Training needs recognized for DNS’s /NS/CNO are maximum in managerial/ administrative and research domain followed by communication domain Conclusion – This study reflects the training need assessment of nurses in a super specialty tertiary care hospita

Impact of the COVID-19 Pandemic on tuberculosis management in India: A Brief Overview

Chronicles suggests that emerging and re-emerging viral infections disrupting the normal lifestyle of humankind, whether in the form of HIV, Ebola, Influenza, Nepah, or the current SARS-CoV-2 pandemic. Such viral infections disrupt the healthcare system along with the prevention and control of epidemics and pandemics, resulting in an increased burden of such diseases in the post-pandemic period. Tuberculosis (TB) routine services are interfered with by severe lockdowns due to the new COVID-19 virus. This article tried to measure the long-term epidemiological effects of such interruptions on TB prevalence in high-burden countries. The participating facilities performed a comprehensive review based on modifications to the care of TB patients during the COVID-19 pandemic. Retrospectively, clinical factors and household contact information were collected from a literature survey. Researchers looked at numerous strategies over the following five years to see whether they might lessen the effects on TB incidence and death. Present comprehensive literature was collected and analyzed using suitable keywords such as "COVID-19," "Pandemics," "Tuberculosis," and "India" during the current COVID-19 pandemic to investigate the influence of COVID-19 on tuberculosis management. The present article looks at the effects of the breaks in the delivery of TB care in hospital and primary care settings. Lockdown, social isolation, measures to prevent viral transmission, and public health guidelines impacted tuberculosis care. The present study revealed that the COVID-19 pandemic has adversely affected numerous TB prevention, monitoring, and treatment programs. Still, these adverse effects are diminished by the prompt restoration of TB services and the application of particular therapies as soon as restrictions are lifted

Partial HELLP syndrome: case report

HELLP syndrome is a complication in pregnancy clustered by haemolysis, elevated liver enzymes, and a low platelet count. It is seen as a serious complication of preeclampsia and eclampsia. Serious manifestations like haemorrhage, infarction, rupture and other hepatic manifestations are usually associated with it. In this case study, 29 years old primigravida is a booked case admitted in ward at 39 weeks 1 day with decreased fetal movement for 2 days. No history of pain abdomen, bleeding per vaginum, discharge per vaginum. Her blood pressure records at the time of admission was 110/72 mmHg and she was normotensive throughout pregnancy. Urine routine examination was negative for urinary protein. However, blood tests showed platelet count of 66,1000/cumm, with ALT of 174 U/L and AST of 123 U/L on peripheral blood film. RBC were predominantly normocytic, normochromic with few macrocytes. WBC has normal morphology. Platelets were reduced on smear. Giant platelets were seen. Ursodeoxycholic acid 300 mg 12 hourly were given to the patient and 3 doses of vitamin K I/M 24 hourly. She was delivered by cesarean section which was performed due to failure of progression of labor with a deflexed head. There was presence of retroplacental clot of 4×3 cm indicating placental abruption, a complication of HELLP syndrome. From this we conclude that we should be careful in suspecting complications of full blown diseases even when the patients are asymptomatic but have atypical laboratory findings

Normalized factorial moments of spatial distributions of particles in high multiplicity events: A Toy model study

Scaling behavior of normalized factorial moments ($F_{q}$) of spatial distributions of the particles comprising a system may be studied to probe and to determine its characteristics. In heavy-ion collisions at ultra-relativistic energies, a strongly interacting complex system of quarks and gluons is created. The nature of the system created and multi particle production mechanism in these collisions is predicted to be revealed by the study of normalized factorial moments ($F_{{\rm{q}}}$) as function of various parameters. In this work, observations from the Toy model study of the scaling behavior of $F_{{\rm{q}}}$ moments, resilience of these moments to detector efficiencies and sensitivity towards fluctuations in the system will be presented.Comment: 6 pages, 9 figure

Resource allocation for D2D links in the FFR and SFR aided cellular downlink

Device-to-device (D2D) communication underlying cellular networks, allows direct transmission between two devices in each other's proximity that reuse the cellular resource blocks in an effort to increase the network capacity and spectrum efficiency. However, this imposes severe interference that degrades the system's performance. This problem may be circumvented by incorporating fractional frequency reuse (FFR) or soft frequency reuse (SFR) in OFDMA cellular networks. By carefully considering the downlink resource reuse of the D2D links, we propose beneficial frequency allocation schemes, when the macrocell has employed FFR or SFR as its frequency reuse technique. The performance of these schemes is quantified using both the analytical and simulation results for characterizing both the coverage probability and the capacity of D2D links under the proposed schemes that are benchmarked against the radical unity frequency reuse scheme. The impact of the D2D links on the coverage probability of macrocellular users (CUs) is also quantified, revealing that the CUs performance is only modestly affected under the proposed frequency allocation schemes. Finally, we provide insights concerning the power control design in order to strike a beneficial tradeoff between the energy consumption and the performance of D2D lin

Biliary atresia with hyaline cartilage at the porta hepatis: a novel finding of undetermined significance: a case report

Biliary atresia is an important cause of liver disease and morbidity in infants with unknown etiology. To date, only five cases of biliary atresia with hyaline cartilage at the porta hepatis have been described. We present the case of a 65-day-old male child, with further insight and detailed discussion of this heterotopia of undetermined significance.Keywords: biliary atresia, hyaline cartilage, liver diseas

FORMULATION AND EVALUATION OF SUBLINGUAL TABLET CONTAINING ANTIEMETIC DRUG

The aim of the present research is to formulate a sublingual tablet of antiemetic drug. Doxylamine succinate is an antihistaminic commonly used for the prevention and treatment of nausea and vomiting. Oral bioavailability of doxylamine succinate is low and shows extensive hepatic metabolism. The Objective of the present research is to formulate doxylamine succinate sublingual tablet to avoid hepatic first-pass metabolism and to improve its bioavailability. Sublingual route not only overcome the problem of dysphagia but also giving the rapid onset of action by enhancing permeability through site of administration Keywords: Sublingual tablet, Doxylamine succinate, Antiemetic, Dysphagia, Bioavailabilit

A Study to Determine Role of Fungus in Cases of Chronic Rhinosinusitis with or without Nasal Polyps in Indian Population

Introduction   Chronic rhinosinusitis (CRS) with or without nasal polyps is a significant public health burden worldwide and owing to its multifactorial etiology, it is often encountered across various medical and surgical specialities. Role of fungus in etiology of CRS has been debated for decades altogether and there is plethora of researches on cellular, molecular and biochemical aspects of fungal presence in nasal cavity and paranasal sinuses and how it affects. Although, there is denial at large on fungal effects on development of CRS, but the question, that whether concomitant and demonstrable presence of fungus in cases of CRS aggravates classic symptoms and signs, largely remains unanswered.     Material and Methods   This cohort study includes 121 subjects, which were divided in CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP) on basis of rigid nasal endoscopic findings. Severity of disease symptoms, among these groups was corelated with Lund – Mackay (LM) symptom scores and extent of disease with LM endoscopic staging scores and LM radiology scores. Histopathology samples for demonstrating presence of fungus were taken and cohort was further subdivided into Fungi positive CRS and Fungi negative CRS, and, LM scores were compared.     Results   In fungi positive CRS group, mean LM symptoms score was 7.09 with standard deviation (SD) ±1.07; mean LM endoscopy score was 6.64 with SD ±1.94 and LM radiological score was 14.58 with SD ±2.96. In Fungi negative group, mean LM symptoms score was 3.58 with   SD ±1.30; mean LM endoscopy score was 4.47 with SD ±1.57 and LM radiological score was 12.20 with SD ±2.98.     Conclusion   Results of this study were statistically significant that fungi positive group was found to have more severe symptoms and larger extent of disease as compared to fungi negative group which indicate that fungal presence may have a role in escalation of symptoms, signs and radiological scores and it may aggravate pre-existing CRS