Incidence and Determinants of Low birth weight babies at rural tertiary care hospital in central Uttar Pradesh

Background: An infant’s birth weight is a reliable index of intrauterine growth and a sensitive predictor of newborn chances of survival, growth and long-term physical and psychosocial development. Low birth weight has been defined as birth weight <2.5 kg regardless of gestational age. The incidence of low birth weight (LBW) in India varies between 25–30% and of which 60–65% are because of intrauterine growth retardation. Aim & Objective: To determine the incidence and various determinants of low birth weight among babies delivered at rural tertiary care hospitals in central Uttar Pradesh. Methods and Material: The study was conducted at UPUMS, Saifai, Etawah, among pregnant women who delivered babies from 1st January 2018 to 31st December 2018. Details regarding age of the mother, gravida, parity, gestation period, presence of complications, the procedure for delivery and birth weight of the newborn were recorded and analyzed using SPSS software (version 23) Results: A total of 7615 deliveries were conducted (53.2% were males, 46.8% were females). The mean birth weight of babies was 2.65 Kg with S.D ± 0.52. Preterm babies were 32% while 67% were term babies and 23% of babies were low birth weight. There was a statistically significant association between birth weight of babies and factors like age of mother, parity of mother, gestation period, and presence of complications during the antenatal period. Conclusions: Prompt identification of high-risk factors, prevention of premature delivery, increasing the use of health services during pregnancy and management of the risk factors would reduce the incidence of low birth weight.

Stress perception among the elderly and its effect on some muscle strength parameters

Background: With improvement in living conditions in the population and the availability of treatments for various communicable and non-communicable diseases, the life expectancy and consequently the elderly population have increased. Stress leads to mental and physical problems. Aim and Objective: The aim of this study was to assess the effect of stress on muscle functions in the elderly. Materials and Methods: One hundred apparently healthy persons (50 males and 50 females) took part in the study. Perceived stress scale was used to measure their level of stress. Maximum voluntary contraction (MVC) and endurance time were measured with the help of a handgrip dynamometer. Results: The elderly population sample in our study showed a moderate level of stress, but there was no significant difference between the three age groups under study. Conclusion: A significant positive correlation between MVC and stress level was observed in our study subjects.

Antibiotic Susceptibility, Carrier State and Predictors of Outcome of Staphylococcus aureus Infections in Hospitalized Children

Objectives: To evaluate the antibiotic resistance pattern, clinical profile and predictors for adverse outcomes in children hospitalized due to staphylococcal infection; and the frequency of nasal and axillary carrier states in these children. Methods: This descriptive study enrolled 100 symptomatic children (aged 1 month - 12 years) in whom S. aureus was isolated from cultures of blood, pus or cerebrospinal fluid. All samples were processed as per the Clinical and Laboratory Standards Institute (CLSI) standards. Antimicrobial susceptibility was tested using disc diffusion method; minimum inhibitory concentration (MIC) for vancomycin was measured using E strips. Predictors for poor recovery were determined by univariate and multivariable logistic regression analysis. Results: Skin and soft tissue infections were the most common (47%) followed by respiratory infections (37%). Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 62%, out of which 63% (39/62) were multi-drug resistant. Carrier state was present in 49% (93% MRSA); 80% were axillary carriers. High MIC (>1 µg/mL) for vancomycin was seen in 65% of patients, and was the only factor associated with poor recovery [aOR (95%CI) 5.3 (1.6,18.5); P=0.008] on multivariable logistic regression analysis. Conclusion: MRSA is the predominant strain in severe staphylococcal infections requiring hospitalization, and majority of them are multidrug resistant. High MIC to vancomycin among S. aureus is an emerging concern.

Prevalence of needle stick injuries, its associated factors and awareness among nursing staff at tertiary care hospital of North India

Background: Needle Stick Injuries (NSIs) are defined as accidental skin penetrating injuries caused by needles. It is the single greatest occupational hazard to a medical personnel. In developing countries, needle stick injury is associated with the highest global prevalence of HIV, Hepatitis B, and Hepatitis C. Aim & Objectives: To estimate the prevalence of needle stick injuries, its associated risk factors and assess the awareness regarding needle stick injuries among nursing staff. Material & Methods: A cross-sectional study was conducted among nursing staff who were working at a tertiary care hospital in Northern India during June 2019 to November 2019. The study commenced after taking prior approval from institutional ethics committee. A census method was used to include the participants. Results: Around 66.7% of the nursing staff was exposed to NSIs during their working hours at the hospital. There was significant association of needle stick injuries with place of working and education of nursing staff in multivariate binary logistic regression. About 26% of the nurses were unaware that recapping should be done or not for used needle, and 35% of staff nurses recapped the needle after the use. Conclusion: Needle stick injuries can be prevented by continued education, effective training, providing better safety devices, a positive work environment.

Dengue in India: An Overview

Background: Dengue fever has become a major public health concern in our country, causing significant morbidity and mortality. Because there is no definite drug or commercially available vaccine for dengue, prevention is the only option. As a result, early reporting of dengue cases is required in order to implement preventive measures before the disease spreads to epidemic proportions. Therefore, healthcare providers should notify every dengue incident to local authorities in the current format, including the District Health Officer or Chief Medical Officer of district concerned and the Municipal Health Officer of municipality concerned every week (daily during the transmission period). Materials and Methods: The data on dengue (2015-2021 till Oct.) was available at the National Vector Borne Disease Control Programme under the Ministry of Health & Family Welfare, Government of India, and has been used in this paper. Results and discussion: During the last two decades (2000-2009 and 2010-2019), significant geographical spread of the dengue has been experienced in India with the repeated outbreaks, and an 11 fold increase in number of cases. Despite an increase in the incidence of dengue fever, the case fatality rate in India has decreased from 3.3% in 1996 to 0.4% in 2010 to 0.1% in 2019. Early diagnosis and timely referral play a critical role in bringing down Case Fatality Rate (CFR). Conclusion: Dengue is a manifestation arising from the process of increasing vector density and adaptation to human habitation, as well as human lifestyle transformation, unplanned developmental activities exacerbated by climate change.

Oral health status and microbial load of Streptococcus mutans in children with Cerebral palsy in a tertiary care hospital in Delhi

Background: Cerebral palsy (CP) is a childhood debilitating condition which impairs the physical and mental ability of an individual to maintain oral health. Aim: The objective of the present study was assessment of dental neglect and burden of treatment needs of children affected with CP as compared to normal children in a tertiary care hospital in Delhi. Settings and Design: A sample size of 104 children of age group of 6–14 years was selected, in which 52 children of CP (case group) and 52 normal school children (control group) were recruited. Materials and Methods: Children from both groups were examined, and calculation of drug master files (DMFS), defs, oral hygiene index (OHI), and gingival index was done. The presence of trauma and malocclusion was assessed. Present caries activity was assessed by the level of Streptococcus mutans present in saliva in both groups. Treatment needs were then assessed based on intraoral findings. Statistical Analysis: Data were analyzed by SPSS 20.0 software. Student's t-test and nonparametric statistical tests such as Chi-square test and Mann–Whitney test were used as per the nature of variables studied for statistical analysis with the level of significance denoted at P < 0.05. Results: The mean DMFS, gingival index, OHI, and treatment needs were observed to be higher in the CP group. Increased S. mutans levels were observed in saliva of CP patients. Defs score, trauma, and malocclusion were not statistically significantly higher in CP group as compared to the control group. Conclusion: Cerebral palsy group had a poor oral and gingival health, a higher DMFT and burden of treatment needs and an increased risk of further caries progression due to high caries activity indicated by increased level of salivary Streptococcus mutans than the control group.

Lamellar keratoplasty techniques

Lamellar keratoplasty (LK) has revolutionized corneal graft surgery in several ways. Deep anterior LK (DALK) has eliminated risk of failure due to endothelial rejection. Endothelial keratoplasty (EK) has almost eliminated induced astigmatism and the “weak” graft–host junction as seen with penetrating keratoplasty (PK) and also reduced the risk of endothelial rejection. LK provided new insights into posterior corneal anatomy that led to better understanding and performance of DALK and to the development of another EK procedure, namely pre-Descemet's EK (PDEK). Surgical procedures for LK were further refined based on the improved understanding and are able to deliver better surgical outcomes in terms of structural integrity and long-term patient satisfaction, reducing the need of further surgeries and minimizing patient discomfort. In most specialist centers, anterior lamellar techniques like DALK and EK techniques like Descemet's stripping EK (DSEK) and Descemet's membrane EK (DMEK) have replaced the full-thickness PK where possible. The introduction of microkeratome, femtosecond laser, and PDEK clamp have made LK techniques easier and more predictable and have led to the innovation of another LK procedure, namely Bowman membrane transplant (BMT). In this article, we discuss the evolution of different surgical techniques, their principles, main outcomes, and limitations. To date, experience with BMT is limited, but DALK has become the gold standard for anterior LK. The EK procedures too have undergone a rapid transition from DSEK to DMEK and PDEK emerging as a viable option. Ultrathin-DSEK may still have a role in modern EK.

Medical School and Stress: A Cross-sectional Study of Stress among Medical Students in Uttar Pradesh University of Medical Sciences in district Etawah

Background: Medical education has come long way since the era of Hippocrates. It is progressively evolving into a more organized and complicated system. All over the world, Medical education is criticized as one of the most demanding and stressful academics, showing effects on physical and mental health of medical students. This research was conducted to study stress and its factors in students of UPUMS, Saifai, Etawah, Uttar Pradesh. Aim & Objectives: To estimate the prevalence of stress among medical students of UPUMS. To estimate internal consistency of Medical Students Stress Questionnaire (MSSQ-40). Material & Methods: A Cross-sectional study was carried out during Oct. 2017 - Mar. 2018 among MBBS Students of all academic years in Uttar Pradesh University of Medical Sciences (UPUMS), Saifai. All the students enrolled in the university available on the day of data collection were recruited in the study. MSSQ-40 was the study tool to assess stress. Ethical clearance was obtained from Ethical Committee. Statistical analysis done in SPSS-23. Results: The mean age of subjects was 22.4±2.3 years, more than 84% of the respondents had moderate and high stress. More number of females perceived stress than the male, 33% female were suffering from high & severe stress. statistically significant. Conclusion: Gender & grades had clear association with stress, academics & interpersonal relation caused more stress. Early detection and effective intervention can prevent future illness among medical students.

Giant Splenic Hydatid Cyst in Pediatric Age

Giant hydatid cyst in spleen is rare in the pediatric age group. We came across two cases of giant splenic hydatid cysts in pediatric age group, out of which, one case had pulmonary, liver and splenic hydatid cyst which was managed with single stage approach. As a single stage approach is a novel method with less morbidity, it should be adopted as a preferred method for the management of pulmonary and abdominal hydatidosis. Hydatid cyst is described as a slow growing cyst in literature, but the presentation of giant size hydatid cyst in our 7 and 12 year old child is difficult to explain by this concept of slow growth.