ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF UROPATHOGENS AT A TERTIARY CARE HOSPITAL IN CENTRAL INDIA DURING COVID ERA.

Objective: The purpose of this study was to study the bacteriological profile of UTI in patients attending the tertiary care hospital and to study the antimicrobial sensitivity pattern of uropathogens.Methods: This cross-sectional study was conducted after obtaining clearance from the institutional ethics committee. Clean-catch mid-stream urine samples were collected from patients symptomatic of UTIs. Samples were cultured aerobically on CLED agar. Isolates having significant growth (>105CFU/ml) were further processed for identification using standard microbiological techniques and their antimicrobial susceptibility pattern was evaluated by the Standard Kirby Bauer disk diffusion method as per CLSI 2020 guidelines.Results: A total of 480 urine samples were processed, yielding 174 isolates. Escherichia coli (42.50%) was predominant, followed by Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter spp., Proteus spp., Providencia spp., Enterococcus spp., Citrobacter spp. and Morganella morganii. Gram-positive isolates exhibited high sensitivity towards vancomycin, linezolid, meropenem, and piperacillin tazobactum. Enteric coliforms exhibited high sensitivity towards colistin, meropenem, aminoglycosides, and piperacillin tazobactum. Non-fermenters exhibited high sensitivity towards colistin, meropenem, cefepime, and amoxycillin clavulanate.Conclusion: The rampant injudicious irrational overuse of antibiotics has led to the emergence of multi-drug resistant bugs, which is posing a serious challenge to clinicians in the management of infections. Developing therapeutic protocols guided by susceptibility profiles for tuning antibiotic therapy regimens is an important strategy in tackling this menace.

MICROSCOPIC AND DEMOGRAPHIC PROFILE OF SEXUALLY TRANSMITTED DISEASES AT A TERTIARY CARE CENTRE OF CENTRAL INDIA

Objective: To find out the prevalence of sexually transmitted diseases (STDS) among the patients attending the tertiary care center through microscopic screening.Methods: This Cross Sectional study was conducted from April 2018 to December 2019 wherein 500 samples were collected from patients attending the STD clinic of Skin and VD-OPD, and integrated counseling and testing center (ICTC), having cervical or urethral discharge along with signs and symptoms of sexually transmitted infections (STI) and were screened microscopically for the same.Results: This study reported only 2 cases suggestive of N. gonorrhoeae on microscopy, wherein the Gram-stained smear showed the presence of a particular arrangement of Gram-negative coffee bean shape cocci, both intracellular and extracellular, and plenty of pus cells.In Direct Microscopy findings, 49.2% of samples showed normal flora, 20.4% Gram-positive cocci, 15.8% Gram-negative cocci, 4% Clue cells, 13.8% with mixed flora, 3% Budding yeast-like cells and 0.4% showed Gram-negative cocci.Conclusion: Such studies involving the laboratory and demographic data should be conducted regularly, which can help in estimating the disease burden, strengthening the diagnostic capacity, and formulating the requisite strategy for tackling this problem through a syndromic approach.

Knowledge and practices of recording and maintaining patients 'dental records among private dental practitioners of Delhi, India

Proper recording and keeping dental records are an important part of any dental practice. It helps in improving patient care, has medico-legal importance and play significant role in human identification during mass disasters or criminal offences. Aim: To assess the knowledge and practices of recording and maintaining patients 'records among private dental practitioners of Delhi, India. Methods: Data for this cross-sectional study was collected from 160 dentists of Delhi using a self-administered questionnaire. The face and content validity as well as reliability of questionnaire was tested before the final data collection. A single trained examiner collected all the necessary information via personal visits or google forms. Chi-square test was applied to check the statistically significant difference between the dichotomous independent variables with respect to study participants' responses to the questionnaire. Results: The mean age of the study participants was 34.5 (SD 7.2) years.Digital method of recording patient's data and x-ray storage was more prevalent than manual method among the study participants. Slightly more than 40% of the dentists were keeping patient's records safe for a period of 6 to 10 years. Younger dentists with lesser years of practice were more explicit in recording and correcting patient records. Conclusion: Results of this study shows that private dental practitioners of Delhi are aware of medico-legal importance of dental records. Most of them were recording important findings and history of their patients. Dentists must be educated in two aspects namely correct method of recording and the ideal duration of storing their patients' dental records

Knowledge, attitude and practices of hand hygiene among nurses and nursing students in a tertiary health care center of Central India: a questionnaire based study

Background: Health care associated infections and emerging multi drug resistance in nosocomial pathogens is perceived as a serious public health threat with grievous concerns. Hand hygiene if practiced properly is cheapest, simplest and most effective tool in tackling this problem. The objective of this study was conducted to assess levels of knowledge, attitude and practice in various aspects of hand hygiene in nurses and nursing students in the study area for identifying gaps for planning necessary corrective measures.Methods: A cross sectional study involving self-administered pre-structured anonymous questionnaires administered to 50 staff nurses and 80 nursing students posted at a tertiary health care center of Central India. Z test of proportions was used to compare the percentages for each of the appropriate responses between the two study groups.Results: Most of the study participants exhibited moderate levels of knowledge and practice with marginal difference between two study groups. While nursing students were found to exhibit a remarkably higher level of attitude than staff nurses, difference being statistically significant.Conclusions: This study stresses upon the growing need for prompt interventions at institutional level for addressing the gaps evident from the study.

Trends in dental caries in Indian children for the past 25 years

The economic liberalization which was started 25 years back in India has led to a rising gross domestic product and per capita income and a decline in poverty. There has been an improvement in various health status indicators in the Indian population. As oral health is an integral part of general health, a retrospective study was designed to assess the effect of economic liberalization on dental caries experience in Indian children. Materials and Methods: A systematic literature search was conducted to find studies done on dental caries prevalence in children in India from the year 1992–2016. Mesh and free text terms “child,” “dental caries,” and “India” were searched in databases – PubMed and PubMed Central. A total of 1468 titles were screened, out of which 191 articles were shortlisted for further inspection. Finally, 69 studies were found suitable for final analysis. Results: The pooled caries prevalence was between 50.84% and 62.41% at 5-year interval. There was a decline in caries prevalence in 2–5 and 11–15 years of age group. The overall weighed mean of 2.4, 2.7, and 1.9 was observed in three different age groups. Significant caries index (SiC) of more than 3 was observed in all the age groups. Conclusion: The present review suggests that more than half of Indian children have been affected by dental caries. High SIC index score suggests a skewed distribution of caries among Indian children. This data may aid in planning further exploratory research and oral health care services for children by the stakeholders.

Assessment of oral health status of children with special needs in Delhi, India

Introduction: Children with special needs are considered to be a high risk group for dental diseases especially dental caries and periodontal diseases. Objective: Assessment of oral health status of children with special needs in Delhi, India. Material and methods: A cross sectional survey was conducted on 414 children with special needs belonging to four different disability groups i.e. Intellectually Disabled (ID), Physically Challenged, visually and hearing impaired. WHO Oral Health Assessment Form for children, 2013 was used for assessment of various parameters of oral health among the study population. Results: Of the 414 children, 305 were males and 109 females. Overall caries prevalence was 38%. Mean DMF value was 3.71 with ID children having higher mean than the other groups. A significant positive correlation was also observed between age and dental caries. Gingival condition was also worse in ID children and best in physically challenged ones. Highest numbers of trauma cases were recorded in visually impaired group. Delayed eruption of permanent teeth was most common in hearing impaired. 98.7% children required some form of dental treatment. Conclusion: Oral health of children with special needs was poor and urgent attention is required to plan a comprehensive dental health care programme for them.

Assessing consequences of untreated carious lesions using pufa index among 5-6 years old school children in an urban Indian population.

Background: Dental caries is a major chronic noncommunicable disease affecting whole of mankind. Nontreatment of caries can have severe consequences such as pain, abscess formation, space infection, etc., which leads to loss of function, working hours or absence from school in children. These consequences are equally important, while planning dental care program for a community. Aim: The aim of this study is to assess the prevalence and severity of consequences of untreated carious lesions using pufa index that is, pulpal involvement, and ulcer due to root fragments, fistula, and abscess index among 5-6 year old school children in an urban Indian population. Materials and Methods: A cross-sectional survey was conducted on 603 school going children of 5-6 year age group in mainly an urban Indian population. Children from 12 randomly selected schools were examined for pufa and decayed extracted filled indices. Results and Conclusions: Overall mean pufa value was 0.9 ± 1.93 and prevalence was 38.6% with major contribution from P component of index. Untreated caries ratio was 35%, suggesting that more than one-third of the developed carious lesions cause adverse events in a population. This study emphasis the need for treating dental caries at its earliest possible stage to avoid severe consequences. The pufa index can be used as tool to highlight these adverse consequences to dental professionals and health authorities.

Comprehensive review of caries assessment systems developed over the last decade

Introduction:World Health Organization (WHO) in the year 2007 recognized the growing burden of oral diseases worldwide and emphasized the need to scale up action based on comprehensive data collection systems. In view of the global epidemic of untreated caries in children there is an urgent need to establish a scoring system that both assesses and quantifies various advanced stages of caries. Furthermore, the available data are not readily comparable due to the different scoring systems used. The DMF index despite having limitations has been widely utilized in oral epidemiological surveys. It is recommended by the WHO for measuring and comparing the experience of dental caries in populations. The path of future research in caries epidemiology will depend on finding an ideal caries index. Objective:This review is prepared to present and critically evaluate various new caries assessment systems that have been developed in the last decade. Literature review: A literature search was done to find out major caries assessment systems developed over last decade, it revealed there were five new indices developed to assess caries. These indices were critically evaluated to list their strengths and limitations. Conclusion:There are many promising new caries indices purposed, but still there is a need for further studies to evaluate their validity and reliability before they can replace DMFT index.

Tobacco cessation: what role can dental professionals play?

Introduction: Tobacco dependence is classified as a disease by the International Classification of Diseases (ICD-10), but, medical and dental professionals have neither seriously taken this fact nor made any serious attempt to tackle this disease. Apart from supporting wider tobacco control measures, oral health professionals can help patients to stop using tobacco. This may be the single most important service dentists can provide for their patients’ overall health. Objective:This review is prepared with the object to help both clinicians and oral health professionals to scale up their involvement in tobacco control activities, including advocacy and smoking cessation programs. Literature review:Studies have shown that 70% smokers indicate that they want to quit, but a meagre 2% succeed. The dental practice setting provides a unique opportunity to assist tobacco users in achieving tobacco abstinence. Still, More than 40% of dentists do not routinely ask about tobacco use and 60% do not routinely advise tobacco users to quit, while 61.5% of dentists believe their patients do not expect tobacco cessation services. Conclusion: Interventions by dentist has been found to be effective in helping people to quit tobacco consumption. A step-wise approach and patience must be adopted while dealing with such patients.

Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India.

Oral health is fundamental to general health and well being. Schools can provide a supportive environment for promoting oral health. School policies and education on health-related matters are imperative for the attainment of good oral health and control of related risk behaviors. Aim: This study was conducted to assess oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. The ultimate goal was to implement an oral health-promotion program in this area. Materials and Methods: A total of 440 children (216 males and 224 females) from 12 schools were included in this study. All the participants were requested to complete a 13-question closed-ended questionnaire. The statistical significance of any difference between the two genders was determined using the Chi-square test. Results: Only 25% of the participants said that they cleaned their teeth more than once in a day. Thirty-two percent did not clean their teeth daily. Over the preceding 1 year, 45.5% of the childern had had some problem with their teeth and/or gums, but only 35.9% visited the dentist. Among these children, 8.2% used tobacco in some form. Oral health-related knowledge of girls was significantly better than that of boys. Conclusion: Based upon the findings of the present study, the knowledge, attitude, and practices of the surveyed children with regard to oral health is poor. Hence, there is a need for regular oral health education of the children, as well as their parents and school teachers.