Hand hygiene knowledge among undergraduate medical students in Junagadh, Gujarat, India

Background: Hand hygiene is now regarded as one of the most important element of infection control activities. Medical students in their clinical training phase throng the healthcare facilities and can potentially transmit infections besides being the healthcare providers of future when their pattern of training will reflect on their infection control practices. Therefore, this study was carried out to assess the knowledge of undergraduate medical students regarding hand hygiene practices.Methods: A cross-sectional study was carried out and data was collected by using “WHO hand hygiene knowledge questionnaire for health care workers” among 2nd M.B.B.S medical students at Junagadh. Knowledge was graded as good, moderate or poor based on the total number of correct answers.Results: Total 123 students participated in the study. There were 65 (53%) females and 58 (47%) were males. The mean hand hygiene knowledge score (out of 25) was 15.05 (SD: ±2.37, 95% CI: 14.63-15.48). Majority of the participants (76%) had moderate knowledge of hand hygiene practices.Conclusions: In the present study majority of the students had not received formal training regarding hand hygiene practices. Majority of the students had moderate knowledge of hand hygiene. Incorporation of teaching and training of hand hygiene practice in the undergraduate teaching during the initial study years is the need of the hour to prevent further emergence of antimicrobial resistance and health care associated infections.

Analysis of caesarean sections according to modified Robson’s ten group classification system at a tertiary care centre in Western India

Background: The increasing trends for Caesarean section (CS) in India and worldwide have been a cause of concern. The aim is to compare and analyse CS rates across the globe, WHO recommends the Robson’s ten group classification system (TGCS). This will help to target appropriate group of women for reduction of overall CS rates.Methods: This was a retrospective study design using hospital records for women delivered in December 2017. Data was entered and analysed using excel 2007 and presented using modified Robson’s ten group classification system.Results: Out of total 650 women delivered during the study period, 184 (28.3%) delivered by CS. Group 1 and group 2 included a total of 49.53% women in the present study. The CS rates varied from 100% in group 5 (previous CS), group 7 (breech, multiparous) and group 9 (abnormal lie) to as low as 0.9% in group 3. The present study highlights that group 5 i.e. women with previous CS, contributed maximum (37%) to the overall surgical deliveries with group 2 being the second largest contributor (21%).Conclusions: The findings of the study indicate that group 5-women with prior CS and group 2-women with induced labour contributed maximum to overall CS rates. TOLAC should be a routine and not optional. Simultaneously Judicious selection of women for induction, strict implementation of induction protocols to decrease the cases of failed inductions will also reduce primary CS. To monitor the CS rates and take appropriate actions it is recommended that Robson’s TGCS be used continuously in all health institutions.

Morbidities of Employees in a Biscuit Factory of Bengaluru City

The employees working in biscuit factories are exposed to various factors such as noise, heat, odor, flour dust, sugar dust, biscuit dust. At the individual level, flour induced rhinitis and asthma are frequently severe enough to cause considerable inconvenience, discomfort, and even abandonment of the trade. Methods: A cross-sectional study involving all the employees working at a biscuit manufacturing factory of Bengaluru city, was conducted from January to March 2015 after obtaining informed consent from each one of them. Medical pro forma form 16 as per factories act was used to assess the health status of the study population. The data were entered and compiled in Microsoft Excel sheet. Analysis was done using SPSS software version 20.0. Results: It was observed that 6.7% of the study population had hypertension, 5.7% of them were found to have skin problems , 6.5% had decreased visual acuity and 4% of the workers showed symptoms of respiratory morbidity. Discussion: A strong health surveillance system has to be devised for regular monitoring of the employees’ health and facilitate early detection of various morbidities.

An evaluative study on integrated child development services in urban slums of Jamnagar City, Gujarat.

Background: Integrated Child Development Services (ICDS) is one of the world’s largest community based schemes running in India for over three decades. Frequent evaluations of the scheme have been conducted to make it more effective to promote early childhood care. Objectives: Comprehensive assessment of services provided under ICDS in urban slums of Jamnagar city of Gujarat state. Methods: It was decided to study 15% of the total 297 AWCs of the city through Simple Random Sampling technique. The AWCs visited were evaluated with respect to infrastructure facility of the centre, record keeping activity & knowledge of AWWs, availability of essential drugs & logistics. Results: A total of 48 centers were evaluated. 24 centers operated from Kutcha or semi-pucca buildings and toilet facilities were lacking at 20 of the centers. Only about 44% of the enrolled 3-6 years children were present at the AWC on the day of visit. Nearly 40% of the enrolled children had varying grades of malnutrition. Unavailability of medicine kits & other logistics, was observed. Three fourth of the AWW described providing non-formal preschool education & supplementary nutrition as their only responsibilities forgetting other essential components of their service. One fourth of the AWW did not know proper time to initiate Breast Feeding and over one third (37.5%) of them did not know the Universal Immunisation Program schedule fully. Less honorarium & poor quality of supplementary food were their main difficulties. Conclusion: the AWC currently acts merely as a food distribution centre with minimal provision of other services. Regular growth monitoring of the children along with supervision of the services provided would be far more effective in improving the nutritional status of the children than supplementary nutrition alone.

Tuberculous brain abscess in a patient with HIV infection.

Tuberculous Brain Abscess (TBA) is a rare manifestation of CNS tuberculosis. Only a few cases have been reported in literature. A twenty six year old male presented with high grade fever, throbbing headache and altered sensorium. Examination revealed neck stiffness and papilloedema. His chest X-ray showed evidence of healed pulmonary tuberculosis. MRI Brain showed a well circumscribed hyper intense lesion in the left parietal region with perilesional edema and mass effects. Stereotactic aspiration of the abscess yielded frank creamy pus. PCR for Mycobacterium tuberculosis MPB 64 was positive which confirmed the lesion to be of tuberculous etiology. Patient responded well to four-drug regimen of antitubercular treatment.

Bacteriological analysis of street foods in Pune.

This study aimed to analyze the bacteriological profile of street foods sold in various parts of Pune city. A total of 75 randomly collected food samples were included in the study. Samples were processed for the presence of bacterial pathogens only. 88% of the food samples analyzed confirmed the presence of bacterial pathogens, indicating the need for stricter implementation of food sanitation practices to reduce the possible risk of transmission of infection on consumption of these foods. Other aspects related to the trade of street foods in the city like the age and sex profile of food vendors, educational status and the hygienic aspects involved in the preparation, selling and consumption of these items were also reviewed.

Tuberculosis of the gall bladder.

Tuberculosis of the gall bladder is rare. We report a patient with this condition with seedlings in the umbilicus.