ABSTRACT
Background: Amid this escalating pandemic crisis, adequate awareness about spread, control and prevention of COVID 19 is of utmost importance. As there is an emerging evidence on the presence of viable viral particles in the secretions and excreta of patients, untreated sewage, surfaces, it has become indispensable concern for the health care providers to be aware about the WASH (water, sanitation and hygiene) risks and practices. Hand hygiene is the leading measure for reducing healthcare-associated infections (HCAIs) and preventing the spread of antimicrobial resistance. Objective: The objective of this study was to evaluate the knowledge, attitude and practices of hand hygiene among housekeeping staff, technicians and attendants working in COVID-19 tertiary health care Centre. Materials and Methods: The study was conducted for the then present staff in JK hospital, COVID centre, Bhopal in the month of July, 2020. A standard form for recording the data was made. Housekeeping staff and attendants were involved from all the clinical departments. The tools for the data collection were: questionnaires including multiple choices, yes/no answers. A prior orientation was provided to the respondents regarding how to fill the questionnaire. The questions were verbally asked by the researcher and the responses were sought. Result: A total of 83 health care workers participated in the study. Amongst the total participants, 37.34% were males and 65.65% were females. Most of the participants were in the age group of 18-39 years, 69.88% of them had gained knowledge about infection control in COVID-19 through hospital, 74.70% of them had received training about hand hygiene in past 6 months. Comparing the pre and post training responses, it was observed that the knowledge component significantly increased on post training evaluation regarding correct steps of hand hygiene (90.31% from 55.01%). There was remarkable increment from 55.16% to 95.54% in the practice element of hand hygiene on post training evaluation for all the five moments. Women showed 42% improvement in their knowledge, attitude and practice of hand hygiene after training in comparison to men who did not show a significant habit change. Conclusion: Our study portrays moderate level of knowledge regarding many aspects of hand hygiene among health care workers. Education plays an important role in overcoming these barriers and makes it easy to incorporate changes in hand hygiene habits of healthcare workers. Middle aged workers show more sense of responsibility towards habit change as compared to the young.
ABSTRACT
Background: Congenital portosystemic venous shunts (CPSS) are uncommon foetal vascular developmental anomalies where splanchnic venous flow bypasses liver. Four cases of CPSS are reported at our centre. Case Summary (1) Eight years old female child presented with Dengue with no features of chronic liver disease and normal liver function test (LFT). Ultrasonography (UGS) abdomen reported an incidental finding of abnormal vascular shunt in liver. Further imaging revealed an anastomosis between portal vein and intrahepatic part of inferior vena cava (IVC), hypoplastic portal vein and multiple nodules in bilateral liver lobes. Interventional Radiologist closed the anastomosis using vascular plug. Child sustained the procedure well. (2) Two months old female patient presented with high GGTP cholestasis, dysmorphism and deranged LFT. On USG abdomen there was intrahepatic portosystemic shunt. MDCT abdomen revealed 2 vascular shunts between left portal vein to middle hepatic vein and left portal vein. Cholestasis responded with symptomatic treatment, hence being followed-up for observation till 1year of age for complications and possibility of spontaneous closure. (3) Twenty-two days old, full term female child presented with convulsions and high GGTP cholestasis with multiple hematomas in brain. LFTs were deranged. 2D-ECHO showed small PFO. USG abdomen suggested a channel between left portal vein and hepatic vein. Patient tested COVID positive hence quarantined now and further evaluation is awaited. (4) One day old, late preterm male baby presented with respiratory distress and pulmonary hypertension with antenatal scan suggesting ductus venous agenesis with hepatic vascular malformation. Patient developed cholestasis with deranged LFT. 2D-ECHO showed PDA and ASD. MDCT abdomen revealed connection between main portal vein and intrahepatic IVC. Conclusions: CPSS has heterogeneous presentation. It can be diagnosed antenatal or postnatal, may be asymptomatic or may present as neonatal cholestasis and may be associated with anomalies. Management may vary from case to case and mainly depends on complications and age of presentation.