ABSTRACT
Purpose: With improving survival of preterm neonates, retinopathy of prematurity (ROP) is emerging as a major cause of childhood blindness. Incidence of sight-threatening ROP can be reduced by improving the quality of care provided to preterm neonates. Methods: This before-and-after study was designed to develop a need-based intervention package to improve knowledge, skills, and practices of those providing care for preterm neonates, and to evaluate the effectiveness of this package when combined with point-of-care quality improvement (POCQI) in improving survival of preterm neonates without sight-threatening ROP. The study had a formative component to assess baseline knowledge, skills, practices and attitudes, and to assess the needs of the healthcare staff to improve the care of preterm neonates. It was conducted in four special care neonatal units (SCNU) in the state of Madhya Pradesh in India. Results: A theory of change was developed to guide the development of study tools including needs assessment and educational package development. The educational package thus developed has been tested at the study sites in combination with POCQI projects driven by local teams of healthcare providers. The effectiveness of the interventions has been evaluated by collection of individual-level data on neonates admitted at the study sites. Conclusion: A multidimensional educational package integrated with system changes in the form of quality improvement (QI) endeavours driven by local context and needs were developed and evaluated in the project.
ABSTRACT
A comparative study of intravenous urography (IVU) and ultrasonography (USG) was performed in 100 patients of all age groups, having symptoms and signs of various renal diseases. Sonography was found to be 100% sensitive and diagnostic in approximately 74% of renal pathologies included in this study, namely calculous disease (excluding midureteric calculi), obstructive lesions of pelvicalyceal system (PCS), cystic diseases, gross congenital lesions, traumatic lesions and neoplasms. It also provided information about the complications of long standing obstruction to PCS such as non-functional and atrophied kidneys, infection, etc. IVU proved better in midureteric calculi (100%), 88.2% of all congenital lesions including the major as well as minor variations. Both modalities proved to be of poor help in diffuse parenchymal diseases (IVU-40% and USG-50%) and renal tuberculosis (IVU-18.2% and USG-45.5%). Sonography was able to delineate the cause of obstruction to PCS in only 72.3% of cases as compared to 88% by IVU.