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ABSTRACT Introduction: Multiple myeloma (MM) is a common hematologic malignancy with variable degrees of immunodeficiency. Disease- and treatment-related compromise of the immune system predisposes patients to infections, which are a major cause of morbidity and mortality. Objective: We aimed to establish the incidence and main characteristics of infections in MM patients treated at our center over a 10-year period. Method and results: Of the 412 patients retrospectively analyzed, 154 (37.4%) were documented to have at least one episode of infection and were included in this study. A total of 244 infectious episodes were documented. The most common site of infection was the lung, followed by the genitourinary system. The most common infections were bacterial, followed by viral. Escherichia coli were the most common organism. In 160 (65.5%) episodes, the organism was not isolated. Thalidomide with dexamethasone was the most common treatment regimen, followed by melphalan with dexamethasone. Infection was the main cause of death in 26 (6.3%) out of all 412 patients. Conclusion: Infections are a notable cause of morbidity and mortality in the clinical course of MM patients. By considering patient and disease characteristics, a risk-adapted selection of the MM treatment should be employed, with special attention toward patient age and disease-associated organ dysfunction. Patient education, access to healthcare and physician vigilance are also essential. Vaccination and antimicrobial prophylaxis may be considered prior to or during therapy.
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Mortality , Drug Therapy , Infections , Multiple Myeloma/therapyABSTRACT
Background: The knowledge of the proper use, disposal of sanitary pads, and its related side effects during menstruation is a vital aspect of a woman’s well-being. Use of sanitary pads appropriately and replacing them on time are essential practices needed to maintain menstrual hygiene. Failure to do so may lead to detrimental consequences that could affect the health of women and make them susceptible to reproductive tract infections. Objectives were to assess a range of factors considered by female about the usage of sanitary pads and the various methods employed regarding its disposal.Methods: A cross sectional study was conducted from March to June 2018, in the city of Karachi, by students of Jinnah Sindh Medical University. A sampling technique was used to select 391 females. Data collection was carried out using a structured questionnaire, by convenience sampling. Response of the participants was acquired using a 5-point Likert scale.Results: In total, 391 females from the city took part in this study; their ages ranging between 15-45 years. 95.7% of these females preferred sanitary pads over cloth, tampons, menstrual cups and toilet paper. Many women using sanitary pads believed, pads should be replaced often while menstruating and failure to do so may increase the risk of contracting infections (p≤0.01).Conclusions: The findings showed that a significant number of women are aware of the risks associated with sanitary napkins and have adequate knowledge related to its proper usage. The study also presented no significant risk of adverse effects associated with the use of sanitary pads.
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Introduction: Congenital bone diseases, nutritional disorders like rickets, infective or metabolic conditions and trauma of bones and joints are most common orthopedic problems encountered among outdoor patients. This study was conducted to find out the prevalence of different orthopedic morbidities amongst outdoor patients of the Department of Orthopedics, Government Medical College, and District Ambedkarnagar. Material and Methods: These six months, observational, outdoor department study was carried out in Department of Orthopedics, Government Medical College, Ambedkarnagar, India. A total of 1000 individuals gave their consent and participated in the study. A structured, pretested schedule was used to collect the data on the demographic characteristics (age, gender, religion) and orthopedic problems. The data was analyzed using SPSS software. Results: A higher proportion of the outdoor patients was aged between 16-60 years (82.6%) and was females (50.1%). A higher percentage of orthopedic problems encountered were regional conditions of limbs (23.7%), followed by traumatic (23.0%) and degenerative (22.7%).Traumatic causes and neuromuscular disorders were more common among the males while degenerative, regional and rheumatic conditions were more common among the females. Conclusion: Larger nationwide community based studies are required to know the extent of the orthopedic problems and formulate better health policies.
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Background: Although numerous studies have demonstrated that hand hygiene reduces health care–associated infection rates, adherence to hand hygiene guidelines remains uniformly low among health care workers. The present study was undertaken to assess the hand hygiene practices among the nursing students of Bareilly and to suggest the suitable corrective and preventive measures to be taken in future. Methods: These six months cross sectional study was carried out among the nursing students of Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. A total of 50 students participated in the study. A structured, self-administered pretested questionnaire was used to collect detailed information about the subjects‟ self-reported hand washing practices. Knowledge was assessed using 25 questions which included multiple choice and “yes” or “no” questions. A scoring system was used where 1 point was given for each correct response to knowledge, positive attitudes and practices and 0 was given for incorrect knowledge, negative attitudes, and poor practices. Data entry and statistical analysis were performed using the Microsoft Excel and SPSS windows version 14.0 software. Results: Majority of the healthcare workers were females (72.0%), were aged between 31-40 years (60.0%) and had received formal training in hand hygiene in the last 3 years (90.0%). A higher proportion of them routinely used alcohol based hand rub (52.0%). Nearly 28% had poor knowledge and 72% had moderate knowledge regarding hand hygiene. Conclusions: The knowledge about good hand washing practices and compliance of the same according to WHO guidelines amongst health care workers is essential for lowering the health care associated infections. Our study shows the importance of improving the current training programs targeting hand hygiene practices among nursing students.
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Background & Objectives: Life style related risk factors are mainly implicated for increased burden of cardio- vascular diseases. Early identification of these risk factors especially among medical students is essential, considering their role as future physicians and role models in public health intervention. Prevalence of lifestyle related risk factors among the medical students of Rohilkhand Medical College and Hospital, Bareilly was studied. Methods: This cross sectional study was carried out among the first year medical students of Rohilkhand Medical College and Hospital, Bareilly after taking ethical clearance from institutional ethical committee and informed consent of students. A structured pretested questionnaire was used to collect detailed information about the subjects’ self-reported behavioral and lifestyle associated risk factors for (Tobacco use, alcohol consumption, physical inactivity and type of diet), the measurement of subject’s blood pressure and anthropometrical parameters. Results: Out of the 99 respondents, nearly 30.3% of students had a family history of hypertension while 41.4% had a family history of diabetes. Nearly one third were found to be overweight. The prevalence of hypertension was 24.2%. Nearly 14.1% respondents had a smoking habit while 8.1% consumed tobacco in smokeless form. About 10.1% students admitted that they had consumed alcohol during the last one year. Only one third of the respondents did regular physical exercise. A higher proportion of respondents (53.4%) were vegetarians. Most of students (83.8 %) added extra salt to their cooked food items. Also a higher proportion of respondents had an adverse food intake (56.6%). Conclusion: Early identification of lifestyle risk factors and their modification among medical students is required.
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Background & Objectives: Even after so many years of introduction of ECP, its awareness among community members as well as providers is very low. To assess the knowledge towards emergency contraception among nursing students. Methods: The cross sectional study involved a survey amongst married nursing students of Rohilkhand Medical College, Bareilly. A structured pretested schedule was used to collect data. Chi- square test was used to analyze data. Results: Nearly two third (32 out of 50) of females had heard about EC. Respondents who were aware of EC most commonly reported that they had first heard about EC from television (68.75%). Majority of those aware knew about pills (87.5%). Majority (85.5%) of subjects who had heard of EC knew that they could obtain EC from a chemist. In addition, most participants (81.25%) knew about the appropriate interval for efficacy between unprotected sex and taking EC. Nearly one third respondents had ever used an emergency contraception method. Only 34.0% were aware of side effects of an emergency contraceptive. Conclusion: Correct knowledge about EC should be strengthened among the health providers. This will help to reduce the number of induced abortions in future among them as well as general population.