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Background To increase the availability of doctors in the public healthcare delivery system, the state government of Uttar Pradesh, India, has implemented a two-year compulsory service bond since 2018. Students of the 2018 batch are going to complete their Bachelor of Medicine, Bachelor of Surgery (MBBS) in 2023 and are supposed to serve through this bond. There are many dilemmas in the minds of medical students regarding their compulsory service bond. Hence, there is a need to know their attitude and perceptions regarding the compulsory service bond. This study was conducted to assess the attitude and perception of undergraduate medical students toward compulsory service bonds. Methods This was a mixed-method study conducted in July-September 2022 among undergraduate medical students at Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India. For quantitative data, a structured questionnaire was developed using Google Forms (Google LLC, Mountain View, California, United States) and circulated via WhatsApp (Meta Platforms, Inc., Menlo Park, California, United States) through the random sampling method. Focused group discussions were carried out to collect the qualitative data. Result Regarding the compulsory service bond after MBBS, 100 (31.8%) medical students were found to be interested and 56 (17.8%) were disinterested. The majority (n=158; 50.4%) of participants were neutral, while 278 (88.6%) medical students perceived it as an opportunity to help poor people. Higher possibilities of social recognition and respect were some noticeable perceptions of 243 (77.4%) MBBS students. Lack of confidence to tackle serious cases without a senior doctor's supervision was perceived as an important hurdle by 286 (91%) participants. Non-availability of advanced medical facilities, issues like the safety of doctors, and the lack of availability of electricity, roads, and infrastructure were also perceived as hurdles. Conclusions and recommendations Students perceived the compulsory service bond as an opportunity if met with certain conditions like a transparent method of posting and basic facilities or an incentive for accommodation and transportation. The compulsory service bond for addressing the shortfall of doctors in the public healthcare delivery system may be more effective if these hurdles are corrected and certain opportunities are met, as mentioned in the present study. This will help the government move smoothly towards achieving Universal Health Coverage (UHC).
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Background: Injuries of lower genital tract are commonly seen in obstetrics patients during labor and delivery. Nonobstetric genital injuries are seen less commonly. Research on injuries to the lower genital tract from nonobstetric trauma is therefore scant. The purpose of this study was to document causes, treatment, and outcomes among patients of lower genital tract injuries visiting to B. R. D. Medical College and Nehru hospital, Gorakhpur, U.P. Methods: Admission and operation theater registers of the department of obstetrics and gynecology during 1 year were scrutinized for cases admitted with the diagnosis of genital trauma. Bed-head tickets of patients were scrutinized with the help of a data abstraction form, and information regarding age, cause of injury, site, size and pattern of injuries, treatment, and short-term outcome were recorded. Results: Of a total of 43 cases of traumatic genital tract injuries, 39 women received treatment. Maximum cases were seen in girls aged 6-10 years. Three women were pregnant at the time of injury. Noncoital injuries predominated over coital injuries, i.e., 59% versus 38.4%. Among the noncoital injuries, fall was the most common cause accounting for 75% of the cases. Coital injuries following consensual sex occurred more commonly in women who were sexually active, lactating, or postmenopause. The chief presenting complaint was vaginal bleeding. Vaginal wall laceration/tear was the most common injury reported. Multiple injuries were seen in 40% (17/39) of the cases. Twenty-one cases of laceration/tear (53.8%) were repaired surgically of which seven required examination and repair under anesthesia. Vulvar hematomas were managed by incision and drainage. There was no major morbidity or mortality. Conclusions: The results of this study from eastern Uttar Pradesh, India, support those from other developing nations. Noncoital injuries were found to be the most predominant cause of non-obstetric genital trauma, though, contrary to others, children were seen to be at the greatest risk. It is important to teach children about playing safely and following safety measures while on the road. We must also make them aware so that they do not become victims of rape.
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BACKGROUND AND AIMS: Breast milk is the only food for the neonate with vast benefits. Although breastfeeding process is natural but extensive research has revealed that mother requires active support for establishing and sustaining appropriate breast feeding practices. Due to high patient load, effective counselling of all pregnant ladies becomes a huge task. Video-assisted counselling has been tried for establishing and sustaining breastfeeding practices as it helps mothers to understand the procedure and process better as the video image is animated with a narrative voice. The objective is to study the effectiveness of video assisted breast feeding counselling in establishing and sustaining breast feeding practices. MATERIALS AND METHODS: A Quasi experimental study was done in Obstetrics and Gynaecology department of BRD Medical College Gorakhpur from September 2019 to February 2020. Study subjects were pregnant ladies admitted in labour room for delivery. A total of 60 study subjects were allocated in Video-assisted breast feeding counselling group and same number in routine counselling group. Video-assisted counselling group breast feeding counselling was done with use of two videos (Video 1 is of 5 minute and 34 seconds duration and Video 2 is of 2 minutes and 50 seconds duration) demonstrations in labour room and post natal ward. Routine breast feeding counselling group received routine counselling as done by resident or consultants during their care. After the delivery the study participants were interviewed regarding their profile and breast feeding knowledge, motivation and behaviour and a scoring was done with Min. -0 to Max. 20 score. RESULT: Higher proportion of early initiation of breast feeding was observed in the video assisted counselling group as compared with the routine counselling group. The mean knowledge score of the subjects' video-assisted counselling group the mean knowledge score was significantly higher. Motivation of mother for breast feeding and improvement in their behaviour and skill in video-assisted counselling group was higher in comparison to routine counselling group. CONCLUSION: Video-assisted counselling was found effective in successful initiation and establishment of breast feeding.
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INTRODUCTION: To improve the quality of MCH services in high priority districts of eastern Uttar Pradesh, Regional Resource Training Center (RRTC) has been established in BRD Medical College Gorakhpur. Medical College faculties empanelled at RRTC Gorakhpur carried out the training and mentoring of medical officers of public health facilities. AIMS AND OBJECTIVES: To study the role of training and mentoring of medical officers in terms of quality improvements of MCH services at public health facilities. MATERIALS AND METHODS: The present study was carried out in women hospitals of seven districts and one of their respective CHCs of eastern Uttar Pradesh from December 2017 to October 2018. Data was collected by direct observation and review of records of OPD/IPD, labor room, operation theaters, blood bank, and blood storage facilities by mentoring team. Findings of these observations were recorded in predesigned 50 point quality assurance, and facility score was calculated. Technical score was calculated from data collected during one-to-one interaction of mentor and mentees in a predesigned and tested proforma. RESULT: Technical scores of medical officers showed marked improvement after mentoring visits in majority of facilities. Mentoring visits build the confidence of medical officers to deal with the complications like severe anemia, eclampsia, and postpartum hemorrhage as per latest guidelines and protocol. It also helped in the initiation and augmentation of LSCS at certain facilities. Technical scores at few facilities showed little improvement (DWH Sant Kabir Nagar, CHC Colonelganj). Mentoring visit also helped in overall facility improvement at these centers. CONCLUSIONS: The whole training and mentorship program was found effective to improve the knowledge and skills of the medical officer with few exceptions of opposition/resistance. It was found useful in overall facility improvement up to some extent.
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BACKGROUND AND AIMS: Acute kidney injury (AKI) became an important cause of mortality and morbidity in critically ill children, despite advancement in its management. In developing countries etiology of AKI are different from that of developed countries. MATERIALS AND METHODS: This observational study was carried out in pediatric intensive care unit (PICU) in 2 months to18 years of critically ill children. Kidney injury was defined and categorized by the pRIFLE criteria. RESULTS: Out of 361children, 86 children (23.8%) developed AKI at some point during admission, 275 children (age and sex matched) who did not develop kidney injury during hospitalization served as non-AKI children. Maximum cases of AKI were seen in 1-5 years of age. Maximum children of AKI were of viral encephalitis (n = 43, 50.0%) followed by scrub typhus (n = 14, 16.3%). Risk factors for the development of AKI were shock, PRISM score and longer hospital stay. In our study the mortality in AKI children (n = 30, 34.8%) was significantly higher (p = 0.005) as compared to non-AKI children (n = 56, 20.3%)). Duration on mechanical ventilation, PICU stay and hospital stay were also significantly (p = 0.001) higher in AKI children. CONCLUSION: AKI is common in critically ill children and associated with high mortality and morbidity. HOW TO CITE THIS ARTICLE: Bharat A, Mehta A, Tiwari HC, Sharma B, Singh A, Singh V. Spectrum and Immediate Outcome of Acute Kidney Injury in a Pediatric Intensive Care Unit: A Snapshot Study from Indian Subcontinent. Indian J Crit Care Med 2019;23(8):352-355.
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Carotid intima media thickness (cIMT) is considered as a surrogate marker for the various cardiovascular events that complicate nephrotic syndrome (NS). The present work was conducted to study cIMT in children with NS and to find out its correlation with dyslipidemia and other risk factors. This was a case control study conducted at a tertiary care hospital in children with NS who were more than 2 years with normal serum complement, being on therapy for NS for at least 1 year, glomerular filtration rate more than 90 ml/minute/1.73 m2 and absence of acute infection in previous 3 months. Sixty six children with NS constituted the case material and 128 age and sex matched children were taken as control. The mean age in case and control cohort was 6.71 ± 3.3 and 7.89 ± 3.95 years, respectively. The mean age of onset of illness was 4.32 ± 2.25 years. The mean duration of illness was 2.39 ± 1.44 years. Thickness of cIMT was higher in NS children as compared to control group in all the ages, but this difference was statistically significant only after 4 years of age. There was statistically significant, but weak positive correlation between cIMT and age of NS children, duration of disease and number of relapses. There was no correlation of cIMT with hypertension, body mass index, serum creatinine, and dyslipidemia. A negative, but statistically insignificant correlation of cIMT was found with serum albumin and serum cholesterol.
