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   Table of Contents - Current issue
May-August 2021
Volume 9 | Issue 2
Page Nos. 35-68

Online since Tuesday, February 1, 2022

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Prevalence and determinants of latent tuberculosis infection among healthcare personnel in India: A scoping review p. 35
Raman Swathy Vaman, Mathew J Valamparampil, Sanjeev Nair
Introduction: Health personnel in high-burden countries are at a greater risk of tuberculosis (TB) infection, due to continuous exposure to diagnosed and undiagnosed pulmonary TB cases. A scoping review is done to ascertain the prevalence and risk factors for latent TB infection (LTBI) among India's healthcare personnel. Materials and Methods: A review of literature was done from Medline, CINAHL, Global Health and PubMed. Full-text review of 30 articles was done, and three were found to be eligible for final analysis. Results: The prevalence of LTBI was found to range from a quarter to one-third of the study participants. Available evidence has revealed the role of increased time being spent in the healthcare profession as an essential risk factor for the development of LTBI. The study participants were of younger age in all studies. There was a lack of representation of different categories of health workers. Discussion: Higher prevalence in younger participants poses significant threats to the well-being of healthcare professionals. The absence of proper guidelines for treating LTBI in high-prevalent settings and the lack of awareness among healthcare professionals regarding LTBI are significant challenges for preventing TB infection among healthcare professionals.
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Surgical antimicrobial prophylaxis: Knowledge and compliance of guidelines among surgeons in a tertiary care teaching hospital p. 40
Fatima Khan, Bhanu Chaudhary, Asfia Sultan, Yasir Alvi, Manzoor Ahmad, Pushkar Kumar, Mohammad Salman Shah, Haris Manzoor Khan
Introduction: Surgical antimicrobial prophylaxis (SAP) is considered vital for reducing surgical site infection, however, if inappropriate, it prolongs the hospital stay of patients, increases morbidity, promotes antimicrobial resistance and puts an economic burden on the health system. This study was carried out to assess the knowledge and compliance of SAP among surgeons in a hospital. Methods: A quantitative, non-interventional study was done among surgeons from a tertiary teaching hospital. First, we evaluated participant knowledge from different surgical specialities by the pre-designed questionnaire, and second, we audited surgeries during the study period of 3 months for a compliance rate of SAP. The score of responses and compliance to SAP variables during surgeries was studied. Results: We assessed a total of 184 participants for knowledge and 271 surgeries were audited. Among the variables of surgical prophylaxis, majority of the participants answered correctly about the route and timing of administration of SAP in 179 (97.3%) and 145 (78.8%) respectively. Only 66 (35.9%) knew about the correct choice of SAP while 78 (42.4%) responded correctly about the duration within which it should be stopped. However, two-third 138 (75%) were aware of the assessment of beta-lactam allergy before administration. Among the surgeries audited, 83.7% compliance was noted for the timing of administration of antibiotics, however, in only 42 (26.7%) cases SAP was stopped within 24 h of surgery and in only 38 (24.2%) cases cefazolin/cefuroxime was given as prophylaxis. Conclusion: This study highlighted the importance of knowledge and awareness of SAP guidelines among surgeons. There is a need to train surgeons regarding this important issue.
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Severe acute respiratory syndrome coronavirus-2 IgG antibodies among health-care workers in a tertiary care hospital in Delhi India p. 48
Mala Chhabra, Stuti Kansra Arora, Anuradha Shulania, Sanjeet Panesar, Ankit Kumar Chauhan, Kriti Ganguly, Arvind Achra, Kirti Nirmal, Nandini Duggal
Introduction: COVID-19 is a novel viral disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that was first detected in Wuhan, China, in December 2019. Hospital health care workers (HCW's) are the frontline workforce for clinical care of cases and they are exposed to a higher risk of acquiring the disease than the general population. Thus, this study was planned with the aim to detect the presence of IgG antibody against SARS-CoV2 among the HCW's. Materials and Methods: This retrospective study was carried out from June to August 2020 among the HCW's of a tertiary care hospital in New Delhi. Information on demography, risk factors and COVID-19 infection was obtained on predesigned pro forma and the blood sample was collected in the plain vial for the detection of COVID 19 IgG antibodies, targeting recombinant Spike 2 protein and nucleoprotein, using the Indian Council of Medical Research approved enzyme-linked immunosorbent assays kit. Results: Eight hundred HCWs voluntarily participated in the study. The seroconversion rate among the HCW's enrolled in our study was found to be 16.75%. They were divided into three groups on the basis of reverse transcription-polymerase chain reaction (RT PCR) test done for SARS-CoV2 genes since 30 January 2020. In Group I, who were RT PCR positive, 34 (70.8%) were found to be seroconverted. In Group II who were RT PCR negative, 12.09% had IgG antibodies. Group III comprised 529 HCW's, who never got themselves tested for RT PCR, of these 13.8% had developed IgG antibodies. The most common symptom was found to be cough, fever, bodyache, loss of taste and loss of smell. The odds ratio amongst seroconverted and nonseroconverted HCW's was found to be significant in all the symptoms except for nasal discharge and sore throat. Among the significant symptoms the odds ratio was observed to be 16.09 and 12.99 for loss of taste and loss of smell, respectively, and was observed to be highly significant (P < 0.001). Only 1.5% had moderate and severe infection and the rest had mild infection or were asymptomatic. Seroconversion rate among the asymptomatic HCWs was found to be 10.84%. Conclusion: Serology plays an important role in understanding the pandemic COVID-19 by identifying the individuals who have been infected and seroconverted, infected but not seroconverted, infected and remained asymptomatic or who never got themselves tested but showed the presence of IgG antibodies.
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Medication adherence of antiretroviral drugs in HIV-positive children in Maharashtra p. 54
Tanishq N Gore, Neeraja Pasalkar, Rojin Mathew Daniel, Prasanna R Deshpande
Background: Human immunodeficiency virus (HIV) is a viral infection that can lead to acquired immunodeficiency syndrome (AIDS). It is a virus that breaks down the CD4 cells in the immune system which weakens the immune system allowing it to be vulnerable for lethal opportunistic infections. Aim and Objective: Medication adherence of antiretroviral drugs in HIV-positive children in Maharashtra. Methodology: A prospective, observational, multi-centric study was conducted among HIV-inflicted paediatrics in Maharashtra. This study was conducted for a duration of 6 months, i.e., from October 19 to March 20 on patients under the inclusion criteria. Marathi and English versions of MARS (Medication Adherence Report Scale) questionnaire and demographic details were collected form the participants. Results: A total of 75 questionnaires were distributed and procured, filled with vital information of the participants among the three study sites. The average age of the participants was found to be 14.1 years. Overall female predominance was there (55% girls. According to our scoring scale, an adherence of 90.66% was observed among the participants, whereas the other 9.33% were considered non-adherent or partially adherent. Conclusions: The present study indicates that the HIV-inflicted paediatric patients have a good knowledge about their medical condition and were adherent to antiretroviral therapy.
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Nature - The great leveller: It is a way to end the COVID era? p. 60
Raman Sardana, Leena Mendiratta, Hena Butta
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Role of single, paired and multiple specimens in the outcome of automated blood culture system – A 2 years study from South India p. 62
Aravinda Anjana, Adhikary Ranjeeta, Malavalli Venkatesh Bhavana, Hosdurg Bhaskar Beena
Automated blood culture (BC) system remains the best approach for early definitive management of sepsis. A retrospective analysis of samples received over 2 years was done to compare the sensitivity of single, paired and multiple BC sets. A total of 24,955 samples were received, of which 11,355 were single, 12,555 were paired and 1045 were multiple. BC sensitivity increased from 32.3% to 87% when samples increased from one to two, and a rise of another 13% with four sample sets (P < 0.0001). There is higher chance of missing positives if only a single BC sample was collected.
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COVID-19 pandemic and cross-training for epidemiology surge capacity p. 66
Indranath Roy
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