Care Hospital In Maharashtra Research Articles

Prevalence of urinary tract infections and its antibiogram in diabetic and non-diabetic patients attending tertiary care hospital in Maharashtra

Objective: To compare the prevalence of UTI in diabetic and non-diabetic patients and to compare its antibiotic resistance pattern. Materials and Methods: A cross-sectional study was conducted in 228 diabetic and 228 non-diabetic patients from November 2016 to January 2018. After obtaining an informed consent, clinical data was collected using pre-structured questionarre. Clean catch mid-stream urine sample were collected and processed for identification of uropathogens through culture using standard microbiological procedure. Antibiotic susceptibility test was carried out using Kirby Bauer Disk Diffusion method. Result: The prevalence of UTI in diabetic patients is 15.35% which is greater compared to 12.28% in non-diabetic patients. E.coli was found to be most predominant organism in both diabetic and non-diabetic patients. The most frequently isolated organism in case of diabetic were E.coli (51.42%), K.pneumonie (17.14%), MRSA (8.57%), Pseudomonas aeruginosa (5.71%), MSSA (2.85%), Citrobacter species(2.85%), CONS (2.85%), Candida (2.85%) and two samples showed mixed flora. In case of non-diabetic patients, organisms isolated were E.coli (50%), K.pneumonie(14.28%), MRSA (10.71%), Pseudomonas aeruginosa (10.71%), MSSA (3.57%), Citrobacter species(3.57%), CONS (3.57%) respectively. E.coli isolates from UTI of diabetic patients showed significantly higher resistance rates to CIP, CTX, CAZ, GEN, NIT compared with those from non-diabetic patients. The overall multidrug resistance was observed in 32 out of 35 bacterial isolates in diabetic patients (91.4%). Conclusion: Prevalence of UTI among diabetic and non-diabetic pts is comparable with published articles. Because of great proportion of asymptomatic bacteruria in diabetic pts, urine culture should be performed in all diabetic pts. Most common uropathogen is E.coli. Keywords: Diabetes, non-diabetic, Urinary tract infections, Antibiotics, Uropathogens.

Needle stick injury and health care workers: Scenario at GMC Akola, Maharashtra

Introduction: Needle stick injuries are the most common occupational hazard for health care workers as well as they carry the highest risk of transmission of various blood borne infections. The greatest menace are hepatitis B and hepatitis C followed by HIV. The present study was carried out to determine the incidence of needle stick injury (NSI) among the health care workers (HCWs) and also the efficacy of preventive strategy. Materials and Methods: This study was conducted at ICTC-1 (Voluntary counselling and testing centre), Department of Microbiology, GMC Akola which is a 600 bedded, tertiary care hospital in Maharashtra, India. The study was carried out over two and half years from April 2015 to October 2017 on various HCWs. Data was collected from ICTC-1 and follow up of patient was done up to 6 months. Biomedical waste (BMW) management workshops and training were also conducted every 6 months. Results: A total of 318 HCWs who were exposed to NSI visited ICTC-1. The highest rate was found among intern doctors (31.44%) and waste handlers (29.87%) followed by student nurses (20.44%), staff sister/brother (11.32%), laboratory technician (5%) and senior doctors (1.88%). There has been increased reporting and awareness among the HCWs due to the regular workshops and training programmes for BMW management. Conclusion: A lot needs to be done to reduce the burden of NSI. Substitution of needles with safe, newer devices, adequate training of health care workers regarding safe use and disposal of needles, post exposure prophylaxis, vaccination (Hepatitis B) might change the scenario. Keywords: Needle stick injury, Waste disposal, Biomedical waste management, Occupational health hazards.

Fine needle aspiration cytology: A diagostic tool in evaluation of lymphadenopathy in paediatric age

Introduction: Lymphadenopathy is one of the commonest clinical presentations in children and a common scenario for pediatrician. Unexplained lymphadenopathy often poses a great deal of anxiety and concern in parents. Fine needle aspiration cytology (FNAC) is a minimally invasive, cost effective and a well established technique as a high diagnostic efficacy tool. FNAC especially in benign inflammatory condition has aided in clinical practice by avoiding unnecessary excision biopsies also limiting its complications and psychological trauma to patient. The present study was conducted to evaluate FNAC as a diagnostic tool in pediatric lymphadenopathy and study spectrum of various cytomorphological patterns in paediatric age group. Materials and Methods: The present study was undertaken in the Department of Pathology, in a tertiary care hospital in Maharashtra. Reports of 312 pediatric FNAC (

Antimicrobial Resistance Pattern of Bacterial Pathogens in Intensive Care Unit (ICU) of Tertiary Care Hospital

Introduction: In ICU the spread of drug resistance has been realized that is related to widespread of antibioticsuses. In ICU the rate of antimicrobial resistance is higher than in general hospital setting. The emergence ofMDR bacteria is an increasing problematic cause of health care associated infections in ICUs, not only dueto increased morbidity and mortality, but also due to increased treatment costs as result of frequent empiricalfailure and lengthy hospital stay. Aim: The main purpose of this study was to know prevalence of the drugresistance pattern for the patients admitted in ICUs. Material and Method: The study was conducted in theDepartment of Microbiology of a tertiary care hospital in Maharashtra during December 2019 to May 2020.In this study patients admitted in ICUs of the hospital who were clinically suspected of having any infectionwere included. Depending on the clinical suspicion from the patients samples were collected. Sampleswere subjected to testing for identification and antibiotic susceptibility testing. Result: E.coli was the mostcommon organism isolated and shows highly resistance to Amoxcillin+Clavulanic acid, Ciprofloxacin.ESBL producer were 20.17% out of all isolate and 29.07% out of total Gram negative organism. Amongall Gram positive organism 13(61.90%) were Staphylococcus aureus in which 8(61.54%) were MRSA.Enterococcus showed 100% resistance to Erythromycin and Penicillin whereas Staphylococcus aureusshowed 84.62% and 69.23% resistance to Penicillin and Erythromycin respectively. Conclusion: This studyconcludes general overview of the incidence and antimicrobial resistance of bacteria isolated from ICU.Gram Negative Organisms are causing more infection than Gram Positive Organisms in ICU patients.Hence gram negative organisms are more resistance to higher antibiotics. So antibiotics are used carefully.Therefore antibiotics policies should be formed for ICU and other critical care facilities.

A cross-sectional study to assess the awareness of hepatitis B virus infection in auxiliary staff of a tertiary care hospital

Background: Hepatitis B virus (HBV) is 50-100 times more infectious than HIV and this communicable disease can be prevented by vaccination. Auxiliary staff (class IV workers) of a hospital is one of the most important health workers who work at ground level and are directly or indirectly exposed to blood and body fluids in the course of their work and therefore are at high risk of infection with blood-borne pathogens. They are expected to have an optimum level of awareness toward HBV infection. This study was conducted with the aim to study the awareness about HBV infection, and its transmission, vaccination and protective practices among auxiliary staff.Methods: A cross‑sectional descriptive study was carried out in 220 auxiliary staff of a tertiary care hospital in Maharashtra, using a pretested, pre-validated questionnaire.Results: Out of 220 respondents 146 had heard about HBV infection. Out of 146 respondents, 89 were aware about >1 routes of transmission, 135 heard about vaccination and 70 had taken 3 doses of vaccination. Almost all took protective measures at work-place.Conclusions: The results showed that respondents had inadequate awareness about of HBV infection, routes of transmission and vaccination.

A prospective study of B-Lynch suture in the management of atonic PPH at tertiary care centre

Postpartum haemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity especially in the developing countries like India. Uterine compression sutures, originally described by B-Lynch et al can successfully control life-threatening PPH. With this background, we studied the use of modified B-Lynch sutures in our setup.It was a single centre, hospital based cross sectional study conducted in the department of obstetrics and gynaecology in a tertiary care hospital in Maharashtra. About 50 cases during the study period (Nov 2017 to June 2019) who failed the medical management of control of PPH were included in the study. Demographic details like age, gestational age, religion, socio economic status and gravid were noted in the case record form. Amount of blood loss, success rates, immediate complications and follow up fertility were assessed.Among the 50 study subjects, 24% had blood loss of <1000ml, 54% had loss between 1000 to 1500ml, 16% had loss of 1501 to 2000ml and 6% had loss more than 2000ml in the present study. About 80% of the cases were successful and 20% failed in the present study. About 6% of the cases had wound gaping, 12% each had fever and had hospital stay more than 5 days and 14% of the cases had wound infection in the present study. About 90% of the cases had return of regular menstruation in the present study.The success rate of B Lynch suture was 80% in the present study. There were few post operative immediate complications in our study. Follow up data also suggested that majority of them recovered with normal routine. In our experience, the B-Lynch technique is a safe, effective and easily implemented method of arresting bleeding in cases of major primary PPH due to uterine atony.

Histopathological spectrum of neoplastic lesions: A two year study

Cancer is the second most common disease after cardiovascular disorders for maximum deaths in the world. The present research was undertaken to study the histopathological spectrum of neoplastic lesions in Rural Tertiary Care Hospital in Maharashtra. This retrospective study was carried out in the Department of Pathology at Shri Vasantrao Naik Government Medical College (VNGMC) Yavatmal, Maharashtra during October 2016 to November 2018. A detail history, diagnosis, primary site, morphology of neoplastic lesions and histopathological examination of all the specimens were done.Out of 3608 specimens examined, 724 cases had neoplastic lesions of which 499 cases were benign and 225 cases were malignant. The most commonly reported malignant tumors were those of oral cavity (47), breast (44), and gastrointestinal tract (22). Most commonly reported benign tumors in females were female genital tract lesions which constituted 170 cases followed by benign breast lesion (126) while in males, out of 123 cases, lipoma was diagnosed in 30 cases, followed by prostate hyperplasia (28) and other soft tissue tumor (28). In both the gender oral malignancies were commonest, while in males’ gastrointestinal tract malignancies and in females’ carcinoma of breast were the most frequent malignancies after oral malignancies. Commonest benign lesions in males were lipoma and while in female lesions of genital tract and breast were common.

Etiology and antibiotic resistant pattern in ventilator associated pneumonia patients in tertiary care hospital in Maharashtra

Etiology and antibiotic resistant pattern in ventilator associated pneumonia patients in tertiary care hospital in Maharashtra

Preparedness of a tertiary care hospital in Maharashtra, India on the background of CORONA pandemics 2020

Preparedness of a tertiary care hospital in Maharashtra, India on the background of CORONA pandemics 2020

Comparative study of ocular manifestations of HIV infection at a tertiary care hospital in Maharashtra, India

Purpose: We conducted the study to observe the change in infection patterns with the introduction of highly active antiretroviral therapy (HAART) and correlation of CD4 count with various ocular manifestations of acquired immune deficiency syndrome (AIDS).
 Design: This was a prospective observational cohort study.
 Methods: The study was conducted at a tertiary care teaching institute with established antiretroviral therapy (ART) centre. A total of 240 eyes of 120 ART-naive patients were enrolled. Ocular manifestations of these patients were observed and followed up for six months for any change with HAART.
 Results: Out of 240 eyes, 24 showed ocular involvement (10%), of which human immunodeficiency virus (HIV) microangiopathy and molluscum contagiosum were most common. Out of the four cases of HIV microangiopathy, two cases demonstrated complete resolution after six months of ART. Only one of three cases of cytomegalovirus (CMV) retinitis showed healing after six months of ART.
 Conclusions: Vision-threatening CMV retinitis and herpes zoster ophthalmicus can improve if specific treatment is initiated promptly. There is direct correlation between CD4 count, ocular manifestation, and prognosis of the patients; 33.33% of patients showed improvement in ophthalmic manifestations after HAART during a follow-up period of 6 months.

Clinico-pathological profile of hepatic involvement in type 2 diabetes mellitus patients attending tertiary care hospital in Maharashtra

Clinico-pathological profile of hepatic involvement in type 2 diabetes mellitus patients attending tertiary care hospital in Maharashtra

Audit of Paediatric Surgical Services in a Tertiary Care Hospital in Maharashtra, India

Audit of Paediatric Surgical Services in a Tertiary Care Hospital in Maharashtra, India

Awareness and satisfaction about state health insurance scheme among beneficiaries at tertiary care hospital in Maharashtra

Background: The Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) is cashless medical insurance scheme launched in 2nd July 2012 by Maharashtra government is for poor families like below poverty line, above poverty line categories, Antyodaya and Annapurna cards holders with annual income less than Rs. 1 lakh. It’s implemented throughout the state of Maharashtra in phased manner for a period of 3 years. The aim is to provide quality care and free medical facilities worth Rs. 1.5 lakh. Aim of this study is to see awareness of the scheme and satisfaction level among beneficiaries about RGJAY scheme.Methods: It’s a cross sectional hospital based study. 500 Patient enrolled under RGJAY scheme selected daily during study period January 2013 to June 2014 in Raigad district. Statistical analysis was done by using SPSS 21.0.Results: Most of the beneficiaries were male (63.4%), age group 40-70 (51.2%). 67.2% participants were aware about RGJAY and 35% were came to know through media. Only 20% participants utilized services under RGJAY scheme more than one time. 31% participant’s family members had taken benefits of the scheme. 45.4% participants were highly satisfied, 28.8% satisfied with services provided under RGJAY scheme.Conclusions: The participants were aware about the scheme, but utilization of the scheme was low in the population. Most of the participants were satisfied with services provided under scheme. It shows that scheme was successful in Raigad district.

Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.

Knowledge, attitude and practice regarding tuberculosis among the patients attending a tertiary care hospital in Maharashtra, India: a cross sectional study

Background: Tuberculosis is major public health problem especially in the low and middle income countries like India. We conducted a study to assess the knowledge, attitude and practice related to tuberculosis among the patients attending our tertiary care institute.Methods: A cross sectional study was conducted in a tertiary care hospital on the patients attending OPD of tertiary care hospital in Maharashtra. The patients with debilitating illness or bed bound patients and those diagnosed and cured of tuberculosis or were on treatment of tuberculosis were excluded from the study. A pretested and designed questionnaire was used to assess the knowledge, attitude and practice about the cause, clinical features and treatment of tuberculosis.Results: The mean age of the study subjects was 43.34±11.23 years with male: female ratio of 1.45. About 16.67% of the subjects stated that cause of TB is bacteria, 51.33% reported that cough was the most common symptom, 58.67% believed that it spreads from person to person and among the people who said it spreads 58.67% said that it can be preventable.Conclusions: About 1/5th of the study subjects expressed the cause of TB is bacteria or germs, and more than ½ believed that TB spreads from person to person. About 2/3rd of the patients felt that TB was a very serious disease; more than ½ of them expressed fear if they were diagnosed with TB but more than ½ of them also expressed rejection if they have a TB patient as a closed one.

The practice of off label prescribing and associated adverse drug reactions in pediatric inpatients in a tertiary care hospital in India

Abstract Objectives To assess the extent of use, patterns, variables and Adverse Drug Reactions associated with off label prescribing in Pediatrics. Methods A prospective observational study was conducted for a period of 6 months for children of the age group 0-17 years in a tertiary care Hospital in Maharashtra, India. Off label drug use was assessed using Micromedex and British National Formulary for Children (BNFC 2016–2017). Adverse Drug Reactions (ADRs) were assessed according to the physicians' notes, recorded during the patient's hospital stay. Pearson correlation coefficient was computed to assess the relationship between age and the number of off-label drugs. Odds ratio was calculated for the occurrence of ADRs in on-label prescriptions Vs off label-prescriptions. A P value of <0.05 was considered as significant. Key findings A total of 1514 prescriptions were evaluated in 300 patients. Out of which 542 (35.79%) and 423 (27.9%) were off label according to Micromedex and BNFC respectively. The number of patients who received at least one off label was found to be 225 (75%) – Micromedex and 223 (74.3%) – BNFC Unspecified indication and use of drugs outside the specified age limit were identified as the main variables associated with off label prescribing. Highest proportion of off-label drugs was found in Alimentary system. A total of 35 ADRs (OR 6.92 CI 95%(OR 6.92, 95% CI, 3.13-15.27)) were identified in 31 patients. Conclusions Off-label drug use is prevalent in the pediatric population and warrants an evidence-based approach to improve prescribing practices in pediatrics.

Determination of sex from greater sciatic notch of hip bone: A cross sectional study at tertiary care hospital in Maharashtra

Determination of sex from greater sciatic notch of hip bone: A cross sectional study at tertiary care hospital in Maharashtra

Study of drug prescription pattern in diarrhoea patients admitted to paediatric ward in a government tertiary care hospital in Maharashtra, India

Background: World Health Organization (WHO) has defined diarrhoea as, ‘the passage of loose stools by an individual, at least thrice a day or more frequently than normal’. It is most commonly caused by intestinal infection, mainly viral. Every year there are about 2 billion cases of diarrhoea worldwide, a second leading cause of mortality in children below the age of 5 years. WHO estimated that antibiotic treatment was necessary in only one in twenty cases of childhood diarrhoea. Yet huge resources are currently spent on anti-diarrhoeal drugs annually, most rendered useless or harmful. This study was proposed to evaluate the utilization pattern of drugs prescribed for diarrhoea in children, in a government tertiary care hospital in Maharashtra.Methods: This cross-sectional observational study was carried out in the paediatric ward of government tertiary care hospital, Maharashtra. All patients of age less than twelve years with diarrhoea admitted to paediatric ward within the study period of January 2015 - June 2016 were included in the study. Patients older than twelve years or admitted with other gastrointestinal diseases or co-mordbid conditions were excluded. Statistical analysis was done using descriptive statistics.Results: Majority of the patients admitted were males and more than half the patient population were in the age group of less than or equal to 3 years. Polypharmacy was found to be present in the prescribing pattern, with average, more than 4 drugs prescribed for diarrhoea treatment, in each prescription. Majority drugs were prescribed using brand names and parenteral route. Use of antibiotics was also found to be inappropriate in majority of the cases.Conclusions: The study highlighted the importance of drug utilisation studies and pointed out inappropriate drug prescribing trends for diarrhoea cases in a tertiary care hospital in Maharashtra.

Prescription Audit of Outpatient Departments of a Tertiary Care Hospital in Maharashtra

Prescription Audit of Outpatient Departments of a Tertiary Care Hospital in Maharashtra

KAP study on bio-medical waste management among interns in a tertiary care hospital in Maharashtra

Background: Biomedical Waste Management is Hazardous and can lead to many infections and diseases. Interns are the future physicians of tomorrow and they should be conscious about safe disposal and segregation practices. So, the present study was undertaken to assess the knowledge and awareness about Biomedical waste management in Interns. The aims and objectives were to assess the knowledge and awareness about biomedical waste management in Interns.Methods: This cross sectional study was carried out in 51 interns. A pretested self-administered questionnaire on BMW management was given to the interns.Results: Out of 51 interns 26 were girls and 25 were boys. 63% knew correct definition of biomedical waste. 23.5% said that authorization is required by CPCB. 15% had undergone training but 60% were keen to attend training programme. 86% had correct knowledge about sources of generation of BMW and 94% had knowledge of Biohazard symbol. Only 68% had knowledge of segregation of waste but none had knowledge of correct colour coding. 88% answered that record maintenance was essential for biomedical waste management. 94% said that BMW is teamwork.Conclusions: There is a need for rigorous training programme for interns and monitoring is needed.