A study of assessment of knowledge, attitude and practice of antibiotic stewardship among healthcare providers in a tertiary care hospital of Sangli

Background: Antimicrobials are routinely used for variety of clinical conditions but are also misused leading to drug resistance bacteria in clinical practice. Consultants can gain the knowledge about it and can also have the depth of problem faced, their prescribing behavior mainly depends on their attitude and understanding of condition. Our aim of this study is to evaluate the knowledge and beliefs about antibiotics prescribing among health care workers in a tertiary care hospital of Sangli. Methods: Our present study was conducted in the Bharati hospital, BV (DU) medical college and hospital, Sangli. Ethical clearance from the institutional ethics committee was obtained and it was, cross-sectional questionnaire-based study carried out in the form of a survey in which a pretested, semi-structured, validated questionnaire was provided to junior residents, senior residents and faculty of different specialties and responses were recorded. Questionnaire comprises of 9 in knowledge, 10 in attitude and 10 in practice section. Results: Out of all participants 84.5% believed that no need of antibiotics for running and blocked nose. Majority 89.6% were expressed that sample culture should be sent before starting antibiotics. 90.4% participants believed that education of patients will help. Only 76.8% strictly adhere to the antibiotic policy of our hospital. Conclusions: The present study on antibiotic usage gives useful information about the knowledge, attitudes and practices of prescribers and help plan suitable educational modifications that aim at improving the antimicrobial prescribing and minimizing the development of drug resistance in our developing country

Development Of Real-Time Drinking Water Distribution Systems (DWDS) Modeling Technology Using The EPANET Extended Period Simulation (EPS) Modeling Toolkit

Real-time hydraulic and water quality modeling involves the modification of the EPS network model every few minutes to reflect the SCADA data, and this paper shares how this type of real-time modeling framework, HydroTrek, was built on top of the EPS foundation provided by the EPANET toolkit. The real-life applications of HydroTrek posed some interesting modeling challenges when the hydraulic time-step was reduced to match the SCADA time-step of one to five minutes. For example, a physical pump usually does not instantaneously, but a model pump does. In a sensitive network, that can mean a significant mismatch between the SCADA and model tank demands, and consequently in the modeled tank levels. If the real-time model is updated by discarding ‘all model rules’ and strictly run on the basis of the SCADA component status values, then the tank level discrepancies can get further exacerbated through the opening or closing of valves that influence these tanks . Some systems also operate multiple valves in parallel in a lead-lag configuration and switch the active configuration in a manner that can’t be represented in an EPS model. Increasing the hydraulic time-step can reduce the ‘hydraulic’ problems but has the unfortunate consequence of masking the water quality spikes which are important for anomaly detection and for reduction of false positives in contaminant warning systems. Also, an EPS model may represent a battery of pumps with a single pump curve and may include simple tank mixing, and those may not be sufficient for real-time modeling. The authors conclude that although the EPS toolkit behaves well through the major portion of the real-time simulation, further hydraulic and water quality modeling advances and refinements are needed to improve the match with SCADA data