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Workplace violence is something we can discuss it, tolerating it but we can’t prevent it even we can’t accept it that it belongs to us, we are initiating it against people like us only. Nothing can solve violence, neither two wrong can make anything right. Though every sector is afflicted by it but healthcare sector is majorly affected by it because patients family is in great trauma of facing their people’s death and no one have been able to do anything to stop it. Accepting loved ones especially death has always been painful to everyone. But blaming some sector and taking revenge is big NO NO. As we all know prevention is better than cure so via this paper I am trying to address some prevention Strategies that may be helpful to de-escalate this issue on ground level.
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Background : Coronavirus disease 2019, first reported in December 2019 mainly presented with the symptoms of Cough, Fever, Shortness of breath, Myalgia, Weakness and anosmia. C-reactive Protein (CRP) is an acute-phase reactant protein which is synthesized by the liver in response to raised levels of interleukin-6 (IL-6) which is a biomarker of inflammation. Methods : This was a prospective observational study, done on 110 COVID-19 patients after applying inclusion and exclusion criteria. Detailed history, vaccination status, presence of comorbidities and thorough clinical examination was performed. Serum CRP levels was assessed and Computed Tomographic scan (CT scan) of Thorax was done. CORADS scoring and CT severity grading as per CT scan was done. All the above parameters were recorded in the preformed proforma and data was entered in excel spreadsheet and was analysed using SPSS v26 software. Results : Majority were males (56.3%) and majority were from 61-80 years of age. Majority (57.3%) patients were non-smokers. Hypertension was the most common associated comorbidity (86.4%)(r=0.743, p=0.000). There is a strong positive correlation between CRP levels and CTSS in COVID 19 patients and a strong negative correlation between the CRP levels and outcome of COVID-19 patients (r= -0.449, p=0.000). Conclusion : Elevated serum CRP value is associated with disease progression and poorer outcome.
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Background: Dermatophytosis is becoming increasingly unresponsive to conventional antifungals. Newer topical antifungals may be more effective in these patients. Aims: To evaluate and compare the efficacy and safety of amorolfine 0.25% cream and sertaconazole 2% cream in limited tinea cruris/corporis. Methods: A single-center, randomized (1:1), double-blind, parallel group, active-controlled trial (CTRI/2014/12/005246) was performed. Sixty-six untreated adults with acutely symptomatic tinea cruris/corporis were included in the study. All patients had limited cutaneous involvement and were KOH mount positive. Group A received amorolfine 0.25% cream, and group B received sertaconazole 2% cream twice daily application to the lesions for 4 weeks. After the baseline visit, four follow-up visits were carried out. The outcome measures for effectiveness were clinical and mycological cure. Safety parameters studied were treatment-emergent adverse events and changes in routine laboratory parameters. Results: Both sertaconazole and amorolfine significantly reduced symptoms (P < 0.001) in both groups. However, improvement in symptoms (pruritus, burning sensation, erythema, scaling and crusting) was significantly greater in the sertaconazole group at every follow-up visit. Sertaconazole cream was also more effective than amorolfine cream in reducing the number of lesions (P = 0.002 at 12 weeks) and improving the Dermatology Life Quality Index (P < 0.001) at all the follow-up visits. Adverse events were similar in the two groups (P = 0.117). Fungal cultures became negative in 92.3% of the sertaconazole group as compared to 80% in the amorolfine group (P = 0.010). Limitations: Antifungal susceptibility testing could not be done. Conclusion: Sertaconazole 2% is superior to amorolfine 0.25%, both in terms of effectiveness and tolerability. Improvement can be appreciated from second week onwards.
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Objective: To analyze the risk factors for microbiologicallydocumented infection, mortality and hospital stay more than 5days in children with febrile neutropenia.Design: Cross-sectional study (July 2013-September 2014).Setting: Government-run, tertiary-care, university hospital inChandigarh, Northern India.Participants: 414 episodes in 264 children aged <12 years, notundergoing stem-cell transplantation.Outcome measures: Predictors for ‘high-risk’ febrileneutropenia.Results: Microbiologically-documented infections wereobserved in 82 children (19.8%); bacterial 14.2%, fungal 4.3%,polymicrobial 9.7%. Complications were documented in 109(26%) children. 43 (10.3%) died: 8 due to fungal and 35 due tobacterial sepsis. Children admitted within 7 days of the lastchemotherapy (P<0.01) and having a non-upper respiratory focusof infection (P<0.02) were at risk of developing microbiologically-documented infections and death. Platelet count <20000/uL(P=0.03) was an additional predictor for microbiologically-documented infections, while albumin <2.5 g/dL (P=0.04) and C-reactive protein >90 mg/L (P=0.02) were risk factors predictingmortality. The median (IQR) duration of hospital stay was 5 (3,8)days. Hospital stay >5 days was seen in 144 (35%) children.Children with acute myeloid leukaemia (P<0.01) and admittedwithin 7 days of chemotherapy (P=0.02) were likely to have aprolonged hospital stay >5 days.Conclusions: Febrile neutropenicchildren admitted within 7days of completion of chemotherapy, those with a non-upperrespiratory focus of infection, CRP >90 mg/dL, platelet <20000/uLand albumin <2.5 g/dL need to be considered as ‘high risk’ forcomplications and mortality.
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Tuberculosis (TB) is the most common cause of cervical lymphadenopathy in the TB-endemic zone, like India but it can also mimic other diseases. Four cases of cervical lymphadenopathy presented to us as initial treatment failure after completion of six months of antitubercular drugs (ATD), including rifampicin, isoniazid, pyrazinamide, and ethambutol. All were diagnosed as having tuberculosis either by fine needle aspiration cytology or clinically from outside our institution. In one case, tuberculosis was the final diagnosis but, unfortunately, it was multidrug-resistant. In other three cases, Hodgkin disease, Non-Hodgkin lymphoma, and Kikuchi’s disease were the diagnoses. In resource-poor countries, like India, which is also a TB-endemic zone, TB should be the first diagnosis in all cases of chronic cervical lymphadenopathy, based on clinical and/or cytological evidences. So, they were correctly advised antitubercular therapy (ATT) initially. Sometimes, TB mimics other aetiologies where apparent initial improvement with ATT finally results in treatment failure. Hence, investigations for microbiological and histopathological diagnosis are warranted, depending on the resources and feasibility. If these tests are not routinely available, the patients should be under close monitoring so that lymphoma, drug-resistant TB, or other aetiologies of cervical lymphadenopathy are not missed. Patients with cervical lymphadenopathy rarely presents acutely; so, a physician can take the opportunity of histopathological study of lymphnode tissue.
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Objective: To assess Accredited social health activists’ (ASHAs) ability to recognize illness in infants aged less than 2 months. Methods: Investigators observed 25 ASHAs conducting 47 visits. Results: ASHA-investigator agreement on the need to further assess infants was intermediate (kappa 0.48, P<0.001). Using IMNCI’s color codes, ASHAs misclassified 80% of infants. ASHAs did not follow home-based newborn care formats and skipped critical signs. Overall ASHA-investigator agreement on diagnosis was poor (kappa=0.23, P=0.01). Conclusion: There is a need for improved training, tools, and supportive supervision.
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It is well known that Mycobaterium avium complex (MAC) infection occurs commonly in immunecompromised patients. We are reporting a case of MAC infection in a person in whom no evidence of immune-compromisation has been found despite thorough examination.
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Eventration is a well-known congenital malformation of the diaphragm, usually asymptomatic and diagnosed incidentally on chest radiography. It is sometimes associated with a number of other congenital syndromes and anomalies. We report a rare case of eventration of left hemidiaphragm associated with gastric volvulus, ipsilateral thyroid agenesis and microphthalmia.