Determinants of road traffic accidents cases in tertiary care hospital at Ranchi, Jharkhand

Background: Worldwide, road traffic accident (RTA) poses a public health and development challenge and greatly affects the human capital development of every nation. This study aims in providing tangible evidences about determinants of road traffic accident cases at tertiary care center with a good area coverage giving insight into burden of RTA.Methods: This study was cross sectional hospital based study done in Rajendra Institute of Medical Science Ranchi, Jharkhand. Patients coming to emergency department were recorded and followed in ENT, neurosurgery and orthopedics department of RIMS, Ranchi in the period of one month (15th January to 20th Febuary2019).Results: Most of the patients were (59%) among the age group of 19-35 years of which 89.5% of the patients were male. 84.8% of the accident took place while motorcycle was driven. 53.3% of the patients were without license. Majority of the cases were driving between the speed of 30-60 km/hr at the time of accident. Majority of cases were not wearing helmet at time of accident (76%). Majority of accidents took place in state highway (53.3%) (roads connecting major cities of states). 59% of the accident took place at T-type junction. Major factor responsible was unusual behavior of man and animal (19%) and followed by overtaking (18.1%). Majority of the accidents were due to front collision (34.3%).Conclusions: There is a need for encouraging and promoting safe driving behavior among community members by the awareness through road safety campaigns and enforcement of road traffic laws to bring down the burden of RTA

Study on utilization of personal protective equipments by paramedical staffs: an institutional study at RIMS, Ranchi

Background: Personal protective equipment (PPE) continues to play an integral role in prevention of transmission of infection in the healthcare setting. The objective of this study is to determine the level of knowledge, attitude and practice of universal precautions for control of infection among health care workers.Methods: Cross sectional study were conducted at Rajendra Institute of Medical Sciences, Ranchi during the period of November 2018 to January 2019. 151 paramedical staffs were included as study population. Sampling method was consecutive sampling.Results: The present study included 151 paramedical staffs, based on our criteria about knowledge of PPEs, 88.7% (134) of participants had the knowledge, while 11.3% (17) did not have. 77% (116) of paramedical staffs received formal training while 23.2% (35) didn’t. 95.68% had the knowledge about PPEs who received training (116), while out of untrained person 65.71% already had knowledge about PPEs which is statistically significant. Departments which always use PPEs are emergency (50%) followed by pathology (16.6%) and Neurosurgery (13.3%) which is statistically significant. Those who frequently use PPEs, 89.6% had knowledge while 10.4% did not have. 85.4% of paramedical staff change gloves between procedures on same patient. Non availabilityof PPEs inhibit maximum percentage of Paramedical staffs 72% towards use of PPEs followed by lack of information and education 12% and uncomfortable PPEs 5%.Conclusions: Proper training should be provided to healthcare workers for universal precaution. Information about universal precaution can be spread in the form of posters in different wards.

Progression from tuberculosis to multi drug resistance-TB in revised national tuberculosis control programme: perspectives from health system care givers

Background: The aims and objectives were to study the progression from tuberculosis to multi drug resistance-TB in revised national tuberculosis control programme: perspectives from health system care givers.Methods: The study was carried out in TB Sanatorium ITKI, Sadar Hospital Ranchi and RIMS Ranchi. The interview of various health personnel including SAHIYAs was taken using a semi-structured questionnaire based on programmatic management of multi drug resistant tuberculosis guidelines -2016.Results: Among Doctors knowledge level was good compared to other health personnel which had mean value 7.33 (±2.79), laboratory technician 3.45 (±2.64), STS 4.67 (±1.59), Sahiya 2.1 (±0.73). Regarding capacity enhancement level all health personnel needed refresher trainings in which doctors got 4.67 (±1.58), laboratory technician 3.45±2.64, STS 1.72±0.34, and Sahiya 0.5±0.52. Specially sahiya needs training regarding MDR-TB because they are the connecting link between health system and community. Regarding execution level, Doctors got 1.86 (±0.74), laboratory technician 1.64 (±0.56), STS 1.64 (±0.56) and Sahiya (ASHA) 2.2 (±0.44). Sahiya were better than other health personnel at execution level.Conclusions: Advocacy, communication, and social mobilization are important aspects of TB control, Policy makers and administrators should be sensitized for need of adequate and sustained funding for TB control to ensure quality capacity building. They need to provide continuous and quality training of staff at different levels and retention of trained staff and periodic reviews to identify gaps and take corrective steps.

Assessment of adherence to ATT among HIV-TB co-infected patients attending the ART centre of a tertiary care hospital of Jharkhand

Background: Despite being preventable and curable, TB is the leading cause of HIV associated mortality. It is the most common opportunistic infection among HIV positive individuals with CD4 cell count <500/ mm3. Worldwide the number of people infected with both HIV & TB is rising. The objective of the study was to describe the socio-demographic profile of HIV-TB co-infected patients and to assess the adherence of HIV TB Co-infected patients to anti tubercular treatment (ATT) attending ART Centre, RIMS, Ranchi.Methods: It was a hospital based prospective study done at Rajendra Institute of Medical Sciences (RIMS), Ranchi. Duration of study was 14 months. A total of 117 patients were registered during the study period and were followed up for adherence to ATT.Results: Out of 117 patients 4 were excluded. Among 113 patients, mostly were male (74.3%) and from rural background (69.9%). Majority (94.7%) of the patients came for regular follow up and took medicines as advised. Adherence was significantly associated with education (p=0.025).Conclusions: In this study it was concluded that education significantly affected adherence to ATT among HIV-TB Co-infected patients of ART Centre of RIMS, Ranchi.

Assessment Of Antenatal Check-Up Among Pregnant Women Delivering In Obstetrics & Gynaecology Department Of A Tertiary Care Hospital Of Jharkhand

Background:Antenatal check up (ANC) is imperative for the timely diagnosis and treatment of pregnancy related morbidities.Good and timely ANC is a vital component for the safe motherhood and child survival. The study aims to describe the socio demographic prole & to assess the ANC Status and degree of acceptance of different services given in ANC among pregnant women.Methods: This was a cross sectional hospital based study done in Obs. &Gynae. department of RIMS, Ranchi for a duration of 3 months. All pregnant women admitted for delivery in Obs. & Gynae. department, RIMS, Ranchi during our data collection period were selected randomly from ve units. Total sample size during this period came out to be 163. Templates were generated in MS excel sheet and data analysis was done using SPSS software (version20.0).Results: After analysis of 163 subjects, it was found that about half (50.6%) of the patients were from rural background with non tribal ethnicity (68.11%). ANC registration was found in 98.1% of women and 34.4% women have more than four ANC visits. Conclusions: Majority of the women were taking ANC visits and getting iron supplementation with TTinjection.

Assessment of Sahiyya (Accredited Social Health Activist) in relation to antenatal services: Ormanjhi, Ranchi, Jharkhand.

Background: Accredited Social Health Activist (ASHA) acts as a „bridge‟ between the rural people and health service outlets and would play a central role, in achieving national health and population policy goals. In Jharkhand ASHA is known as “Sahiyya”. The present study was aimed to assess Sahiyyas in relation to antenatal services delivered by her in the field practice area Ormanjhi of Rajendra Institute of Medical Sciences (RIMS), Ranchi. Methods: This was a community based cross sectional study. All Sahiyyas (26), women having children under 3 years of age (196), pregnant women (140), Anganwadi workers (AWWs) (16) and Auxiliary Nurse Midwives (ANMs) (6) from the study area were recruited for the study. Assessment of antenatal services delivered by Sahiyyas was done based on interview with Sahiyyas which was then crosschecked through the responses of beneficiaries, AWWs and ANM. Results: All Sahiyyas in the study area were aware about her job responsibilities like help during registration and mobilization during pregnancy but when cross checked, 70.2% and 60.9% beneficiaries received help during registration and mobilization. Out of 336 beneficiaries, only 23.2% and 19.9% responded that were counselled by Sahiyyas on nutrition and adequate rest during pregnancy during their home visits. Conclusions: Sahiyyas were well aware of her responsibilities related to antenatal services like counselling mothers on diet, rest and other health advices through home visits but these jobs were not being done passionately by her as other incentive oriented jobs.