Knowledge attitude and practice of paediatricians regarding tuberculosis case management in five major districts of Punjab state, India

Background: The operational research was done to assess the Knowledge, Attitude and Practice regarding TB case management of Pediatricians. Place were five major cities of Punjab state, India. i.e. Ludhiana, Jalandhar, Amritsar, Patiala and Bathinda.Methods: Study design was observational cross-sectional study. Period was one year. The data collection was done from Paediatricians from 5 cities inhabiting approximately half of the urban population of Punjab, using a pre-tested, structured questionnaire and knowledge of TB and its management was assessed.Results: Total of 139 pediatricians participated in the study, 69% were male. Majority pediatricians had adequate knowledge of TB disease and case suspicion. Adequate knowledge of TB diagnosis was seen in 87% doctors. Only 20% doctors had adequate knowledge about treatment of TB cases. Overall 64% of Pediatricians referred TB cases to DOTS centre for treatment.Conclusions: Improving the treatment knowledge of paediatricians can go a long way in improving management of TB cases.

Impact of bed side communication with fathers on their anxiety about newborn.

This study assessed the impact of bedside communication with fathers (N = 100) on their anxiety about sick neonates admitted in SCNU. The control group consisted of fathers of 100 sick babies communicated outside the unit. Anxiety was measured in both the groups on day 1 (at admission) and day 7, by using 5 point Likert Scale. At the time of admission there was no difference in the level of anxiety between the study group and controls (p >0.05; Mann Whitney test). There was a statistically significant difference (p <0.01; Mann Whitney test) in the level of anxiety between the study and control group at 7 days. When compared within the group, the anxiety in the fathers of study group was significantly less (p <0.01) at 7 days than at admission. In the control group there was no such significant difference. To conclude, bed side communication with fathers of admitted neonates reduces their anxiety significantly.

Intracranial hemorrhage in late hemorrhagic disease of the newborn.

This study was conducted to evaluate the clinical profile and outcome in late hemorrhagic disease of the newborn (HDN) with particular reference to intracranial hemorrhage. Infants (n = 42) presenting with late HDN from January 1998 to December 2001 were studied. Majority (76%) were in the age group of 1-3 months. All were term babies on exclusive breast-feeding and none received vitamin K at birth. 71% patients presented with intracranial hemorrhage, commonest site being intracerebral and multiple ICH. Visible external bleeding was noted in 1/3rd of patients only. Three patients expired. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Isolated intracranial hemorrhage is a common mode of presentation.