Department Of Tertiary Care Hospital Research Articles

Out-of-Pocket Expenditure in Patients admitted to Cardiology Department under ABPMJAY scheme in a Tertiary Care Hospital in Delhi: A Cross-Sectional Study

Introduction: The recent National Health Accounts 2019-20 data reveals that Out-of-Pocket Expenditure (OOPE) as a percent of Total Health Expenditure is more than 47% which is still higher compared to out-of-pocket health spending in other developing nations. Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), the world’s largest public-funded social health insurance scheme is a by-product of National Health Policy 2017 recommendations to achieve Universal Health Coverage and reduce OOPE in health. The present study was conducted to know the OOPE among the patients admitted to the Cardiology department under AB-PMJAY scheme in a tertiary care hospital in New Delhi. Methods: A descriptive cross-sectional study was carried out from January 2021 to April 2022 among the patients admitted under the PMJAY scheme in the Cardiology Department of Tertiary Care Hospital in New Delhi. A total of 320 patients were interviewed using a structured questionnaire divided into eight sections. The collected data was tabulated in Microsoft Excel and analyzed. Results: The study investigated out-of-pocket expenditure (OOPE) for patients, finding the scheme covered doctor consultations, bed charges, physiotherapy, implants, and oxygen, but some patients still faced OOPE for diagnostics (15%), medicines (22.5%), blood transfusions (8.75%), and ambulance with an average direct medical expenditure of approximately Rs. 1511 during the hospital stay at the current hospital. Compared to previous hospitalizations, OOPE for diagnostics, medicines, and blood transfusions significantly decreased under PMJAY. Overall, 60.3% of respondents were satisfied with the PMJAY scheme. Conclusion: The PMJAY scheme helped the beneficiaries to reduce the financial burden of health to a great extent. However, few of the beneficiaries continued to make some payments from their pockets for diagnosis, medication, etc. The main reason for this was a lack of knowledge and awareness about the scheme among the beneficiary population.

Patient Satisfaction in In-Patient Department in Tertiary care Hospital in Odisha

Patient satisfaction is a crucial factor in determining the overall Quality of services proved in the Hospital setting. It includes a collaborative and scientific inspection of the various departments associated with the patient that are being admitted to the Hospital. It gives an insight to the areas that need to be improved and increase the overall patient experience.

Artificial Intelligence in Detecting the Severity of Diabetic Retinopathy

BACKGROUND Diabetic retinopathy (DR) is the leading cause of visual impairment and blindness among individuals with diabetes mellitus. Early detection and timely intervention are crucial for preventing irreversible vision loss. However, traditional methods of DR screening are labor-intensive and reliant on the availability of skilled personnel, posing challenges in resource-constrained settings. Objective This study aims to evaluate the effectiveness of artificial intelligence (AI) in detecting the severity of DR compared to conventional ophthalmological assessments. METHODS A hospital-based observational study was conducted at the ophthalmology outpatient department of Tertiary care hospital, India over a six-month period. A total of 300 diabetic patients were included, and fundus photographs were obtained using a fundus camera. The images were then analyzed using an AI model trained on a diabetic retinopathy dataset. The severity of DR was graded according to established criteria, and the accuracy of the AI model was compared to that of ophthalmologist grading. RESULTS The AI model demonstrated an accuracy rate of 95.25% in grading the severity of DR. Comparison between AI and ophthalmologist grading showed close sensitivity and specificity rates across different DR grades, with the AI model slightly outperforming in certain categories. CONCLUSIONS Artificial intelligence shows promise as an effective and efficient tool for the screening and diagnosis of diabetic retinopathy. Its integration into healthcare systems could enhance early detection and treatment of DR, particularly in underserved regions with limited access to ophthalmological services. Further research and validation are warranted to optimize the use of AI in diabetic eye care and ensure its equitable distribution and ethical use.

Frequency of non-st segment elevation myocardial infarction (NSTEMI) in acute coronary syndrome among patients presenting with the chest pain in emergency department of tertiary care hospital.

Objective: To determine the frequency of NSTEMI (non- st elevation myocardial infarction) in acute coronary syndrome patients presenting with the chest pain in emergency department of tertiary care hospital. Study Design: Cross Sectional study. Setting: Jinnah Post graduate Medical College Hospital Karachi. Period: June 20, 2023. Methods: Enrolling 112 consecutive volunteers was carried out Interview questions focused on the participants' smoking, blood pressure, diabetes, and type of chest pain. Whether or not the participants had ACS, their diagnosis was documented. NSTEMI frequency was computed. Results: We have 112 patients enrolled with mean age was 52.73±14.24 years. Sixty five (58%) were male while forty seven (41.9 %) were females. out of 112 patients 45 (40.1%) were hypertensive, 32(28.5%) were diabetes and 29 (25.8%) were smoker. Among the participants 21 (18.7%) had NSTEMI and showed positive correlation with age, gender, nature of chest pain, hypertension and smoking. Conclusion: Among the individuals, one of the most frequent causes of chest pain was acute coronary syndrome. High suspicion and additional testing are they key tools for early diagnosis and management.

Relationship between Kinesiophobia and Disability in Individuals with Sacroiliac Joint Dysfunction: A Pilot Study

Abstract Introduction: Sacroiliac joint (SIJ) dysfunction, which accounts for 15%–30% of all low back pain, can be caused due to multiple pathologies and can cause long-term disability because of fear of movement and result in chronic pain. The paucity of literature regarding the same in SIJ dysfunction warranted this study. Hence, this study aimed to assess the presence of kinesiophobia and determine if there exists a correlation between kinesiophobia and disability in individuals with SIJ dysfunction. Materials and Methods: After ethical clearance, participants were screened for SIJ dysfunction (n = 22) from physiotherapy at the outpatient department of tertiary care hospitals, and assessment was taken; participants meeting the inclusion criteria were selected for the study (n = 19). Outcome measures – Tampa Scale of Kinesiophobia (TSK) and Oswestry were then administered. Results: Among 19 participants (male = 11 and female = 08), mean and standard deviation of TSK and Oswestry Scale were (39.95 ± 8.29) and (29.26 ± 16.73), respectively. A weak correlation (r = 0.204) was observed between the two, which was not statistically significant (P = 0.401). Conclusion: This study suggests that chronic pain may lead to a vicious cycle of fear of movement and avoidance of activities delaying the rehabilitation process. Psychological aspects of pain with conventional physiotherapy should be addressed in such patients.

Proportion of Urinary Tract Infection in Children between 6 Months to 5 Years of Age Presenting with Fever

Purpose: Fever serves as the most frequent cause of visits to emergency/outpatient pediatric departments among children under the age of five. Very frequently, the youngster is given antibiotics on an arbitrary basis without receiving the proper examination for a urinary tract infection (UTI). This study’s goals were to assess the prevalence of UTIs in febrile children between 6 months and 5 years of age. To study the proportion of UTIs in children between 6 months and 5 years presenting with fever. To study the association of various risk factors with UTI. Methodology: This Cross-sectional Descriptive observational research was done in the Pediatric department of tertiary care hospital from August 2020 to December 2022, in febrile kids between 6 months and 5 years age group using different variables. Association between two qualitative variables was seen by using Chi-square/Fischer’s exact test. A P < 0.05 was considered statistically significant whereas a P < 0.001 was considered highly significant. Results: Among the total study population, it was found that 5.58% of the patients with fever without focus had a UTI, while the majority of patients, 94.42% did not have a UTI but had fever without a specific focus. In UTI cases, urine culture growth patterns showed the presence of different isolates, including Escherichia coli (30.43%), Klebsiella (56.52%), Pseudomonas aeruginosa (8.7%), and Candida (4.34%). Conclusion: In the present research, the overall occurrence of UTI in children <5 years with fever without focus was 5.58%. Patients with significant pyuria and positive urine culture (UTI) were 43.75% and with significant pyuria but the sterile culture was 56.25%. So, it is concluded that significant pyuria can be sterile pyuria and cannot be labeled as UTI without confirmation on the urine culture report.

Identifying Typical Presentations of Vitamin B-12 Deficiency among Individuals Attending Tertiary Care Hospital in Central Gujarat: A Case Control Study.

Introduction: Vitamin B12 is mainly obtained through non vegetarian diet, milk and milk products. Malabsorption and inadequate intake leads to haematological and neurological disorders. Objective:To determine the symptoms and signs associated with Vitamin B12 deficiency. Method: A case control study was conducted at the medicine department of tertiary care hospital. Patients visiting hospital with serum Vitamin B12 level below 200pg/ml were labelled as cases and more than 200 pg/ml were labelled as controls, irrespective of signs and symptoms of Vitamin B 12 deficiency.Controls were matched for age to minimize confounding. 160 cases and 160 controls were selected. Pretested semi structured questionnaire was used to identify signs and symptoms of Vitamin B12 deficiency among cases and controls. Chi square test was applied for each symptom between cases and control, of which 10 were significant (p<0.05). ROC curve was plotted for the 10 symptoms to check their usefulness for diagnosing vitamin B12 deficiency. Results: Area-Under Curve (AUC) was maximum under knuckle pigmentation (0.794), (Positive Likelihood Ratio (PLR)=3.24) followed by poor memory (0.684), (PLR=3.25) tingling and numbness (0.624), (PLR=1.84) and dizziness (0.605), (PLR=1.38) in respective order. Whereas fatigue, sore and swollen tongue, pale skin, breathlessness, palpitation, insomnia, memory loss were not associated with Vitamin B12 deficiency(p>0.05).Conclusion: Presence of knuckle pigmentation, poor memory, tingling and numbness, and dizziness can be defined as hallmarks of Vitamin B12 deficiency and can be used to predict and start Vitamin B12 supplementation.

A Case Control Study of Type 2 Diabetes Mellitus among Patients Attending Medicine Department of Tertiary Care Hospital, Gurugram, Haryana.

Introduction: Diabetes Mellitus (DM) is traditionally known as silent disease. Diabetes is no more restricted in urban areas only but is also established at rural areas as well. It is one of the leading cause of long term morbidity and a major health hazard in a developing country like India, therefore, it is pertinent to ind its associated risk factors. Objectives: To study the clinical presentation and risk factors associated with type2 diabetes mellitus patients attending SGT hospital. Method: It was a hospital based case control study done in medicine department of Tertiary Care Hospital, Gurugramusing the purposive sampling. There were 800 participants including 400 cases of type 2 diabetes mellitus and 400controls (age and gender matched).Information was collected on sociodemographic variables and risk factors using a pre-tested structured interview schedule. Results: The mean age among cases was 55.20+ 8.54 years and among control group was 53.96+9.29 years. The difference between education status and occupation of study subjects was found to be signi icant. Pain and numbness was the most common symptom which was 70.75%. On assessing risk factors, physical activity, the habit of smoking, family history and Body mass Index (BMI) had a positive association. Conclusion: The indings of the study revealed that a high proportion of risk factors such as family history of diabetes, literacy status, occupation, BMI, smoking and physical activity were prevalent in the type 2DM subjects.

Perceived implications of COVID-19 on physical, mental and social aspects of resident doctors in a tertiary care hospital.

The COVID-19 pandemic has put health care systems of many countries under major stress. Due to its high transmission capacity, it has spread across the globe at a rampant pace. India is one of the countries which has been severely affected by COVID-19. It has posed onerous tasks in front of doctors. Along with it, it has left physical, social and mental implications on well-being of doctors. The purpose of this study is to get an in-depth understanding about the implications of COVID-19 on physical, social and mental aspects of resident doctors in tertiary care hospital. We performed a qualitative study which involved in-depth interviews of resident doctors who have worked during the COVID-19 pandemic from general medicine department of tertiary care hospital. Interviews were then manually transcribed and analyzed. Data analysis by preparing transcript unveiled that doctors were constantly facing burnout and mental distress along with less social support. Our study also found that there was a shortage of resources and demonstrated poor doctor patient ratio which led to a decrease in efficiency of doctors. Our findings are not only confined to doctors facing burden but has also explored sanguine perceptions of resident doctors. While treating COVID-19 patients, resident doctors suffered a great setback. Providing them with mental aid, social support, ample resources and decreasing their work burden is recommended to effectively manage future pandemic.

Early treatment will prevent feto-maternal complications in thyroid disorders during pregnancy: A prospective study.

Associations between adverse maternal complications and fetal outcomes are known entity in thyroid disorders during pregnancy. Thus, prompt identification of thyroid disorders and timely initiation of treatment is essential. Universal screening and early treatment of pregnant women for thyroid disorder should be considered especially in a resource-limited country like India with a high prevalence of undiagnosed thyroid disorders and adverse feto-maternal outcomes. Early treatment will prevent feto-maternal complications in thyroid disorders in pregnant females visiting outpatient department in tertiary care hospital in rural settings. This study was conducted in a tertiary care rural-based medical college with participation from departments of Obstetrics and Gynaecology, Medicine, and ENT. Expectant mothers in first trimester who had urine pregnancy test positive in outpatient clinic were included after a written informed consent. Detailed history and examination was done. TSH was done if abnormal-FT3 and FT4 were done. All thyroid disorders were treated according to American Thyroid Association (ATA) 2017 guideline. All pregnancies were followed up for maternal complications and fetal outcomes. Data from the performa were entered in Office Excel and analysis was performed using STATA (14.2). Descriptive statistics (mean [standard deviation], Frequency [%], etc.) were used to depict profile of study participants, prevalence of thyroid dysfunction, and outcome measures. Chi-square test was employed to assess the association between thyroid dysfunction and various maternal and fetal outcomes. A P value less than. 05 was considered statistically significant. Of 350 pregnant females, 83 (23.5%) pregnant females had thyroid disorder. Of which, 33 (9.4%) had subclinical hypothyroidism, 37 (10.5%) had overt hypothyroidism, 11 (3.1%) had subclinical hyperthyroidism, and two (0.5%) had hyperthyroidism. The prevalence of hypothyroidism in pregnancy increases with increasing age (P value. 001) and not associated with parity, abortion, and consumption of iodized salt. Total patients with feto-maternal outcome follow-up were 241. Pre-eclampsia (P value. 004) was a significant complication in hypothyroid mothers. There was no significant difference in the rate of cesarean section and preterm delivery in hypothyroid and euthyroid mothers. Neonatal outcomes showed more trends of abortion, fetal demise, and IUFD in the hypothyroid group, although not statistically significant. (P value. 07). Due to the high prevalence of thyroid disorders during pregnancy, universal screening of thyroid disorders should be done in early pregnancy instead of high-risk screening. Early detection and early treatment in the first 10 weeks of pregnancy help to prevent maternal and fetal complications of thyroid disorders in pregnancy. Pre-eclampsia is to be monitored in treated pregnant females with hypothyroidism.

Evaluation of Potential Drug-drug Interactions in Prescription in Outpatient Department of Tertiary Care Hospital

Aims: To evaluate potential drug- drug interactions (pDDIs) in prescriptions generated in outpatient department.
 Study Design: A cross sectional, observational study.
 Place and Duration of Study: Pharmacy store, Government Medical College & Hospital, Nagpur, between July 2022 to September 2022.
 Methodology: Cross Sectional study performed in outpatient department from July 2022 to September 2022 analysed 382 patient prescriptions (Male : Female 1.41 : 1.0 ; Mean Age 33.67 ± 23.18 ) to evaluate for potential DDIs. Precription with atleast 2 drugs were included in the analysis. Data was analysed for potential drug- drug interactions using Rx list drug interaction checker Online, an online software to check drug-drug interactions (https://www.rxlist.com/drug-interaction-checker.htm) available on the website. Descriptive statistics were performed using MS Excel 2019.
 Results: Of the 382 (Male: Female 1.41 : 1.0 ; Mean Age 33.67 ± 23.18 )prescriptions analysed for potential DDIs , 55 prescription were found to have potential DDIs. In those 55 prescriptions, 73 potential DDIs were identified.
 Conclusion: Incidence of potential drug- drug interactions was found to be 14.39% in these study.

The clinical significance of electronic fetal heart rate monitoring in twins.

Fully effective intrapartum cardiotocographic (CTG) fetal heart monitoring is still missing. Visual analysis is far from credibility. Additional, computerized analysis techniques were proposed however they did not substantially decrease possible risks of fetal asphyxia. In twin pregnancies the problem is even more complicated. Our goal is to find the most valuable parameters in intrapartum CTG surveillance in twins, based on actual FIGO criteria. Study included 58 women in labor who had been admitted to Delivery Department of tertiary care hospital with twin pregnancy in a period of one year. The features of the CTG (e.g., baseline, oscillation, decelerations, brady- or tachycardia) were grouped to create three variables that were closest to the FIGO CTG scale. All three groups were compared according to neonatal status (Apgar score at 5 min ≥ 7 or < 7; pH value in umbilical artery ≥ 7.20, < 7.20 or < 7.10 and BE (base excess) > or ≤ -12). Fetal status and its acid - base equilibrium was compared either with long term variability (LTV), short term variability (STV), or percentage of the signal loss. Out of 58 twin pregnancies, a total of 116 babies were born. One baby was born dead. From this group, 11 deliveries were natural births and 47 deliveries were C-sections. None of the analyzed features (pH, BE, Apgar, CTG features except tracing length, CTG FIGO categories) were statistically different between groups of singleton and twin pregnancies, except percentage of C-sections. No differences were found either for STV or LTV and fetal status.org CTG categories. Prior to cardiotocographic tracing of twins during labor, ultrasound examination should be mandatory. Considerable loss of signal in CTG tracing in twins should provoke ultrasonographic confirmation of the fetal status.

Diagnostic accuracy of plasma brain natriuretic peptide for evaluation of dyspnea NYHA-III and NYHA-IV in emergency department of tertiary care hospital.

To determine the diagnostic accuracy of breathing not properly (BNP) for evaluation of dyspnea NYHA III and IV due to systolic heart failure in emergency department patients keeping echocardiography as the gold standard. Cross-sectional validation study. Setting: Department of Accident and Emergency Duration of Study: 25 July 2022-25 January 2023. A total of 115 of both sexes presenting with acute onset of dyspnea and having NYHA Class III and IV were included. Emergency nursing staff had immediately taken a single venous blood sample for BNP and creatinine levels and a 2D echo was performed. Ejection fraction was recorded, and the diagnosis of systolic heart failure on the basis of an ejection fraction, that is less than or equal to 45% was documented. The age range in this study was from 18 to 65 years, with a mean age of 49.147±8.73 years. Mean BNP levels were 139.452±84.04pg/ml. Patients with NYHA class III was 67.8 and 32.2% belongs to NYHA class IV. BNP levels greater than or equal to 100pg/ml diagnosed 76 (66.1%) and echocardiography has diagnosed 68 (59.1%) patients with heart failure. BNP levels greater than or equal to 100pg/ml had shown sensitivity 94.1%, specificity 74.5%, and diagnostic accuracy 86%, positive predictive value 84.21%, negative prediction value 89.74%, likelihood positive ratio 3.68 and likelihood negative ratio was 0.08 in diagnosis of heart failure. BNP estimation is a sensible and particular procedure for diagnosing CHF in patients who present to the emergency department with acute dyspnea and may add extra advantages to the administration of patients with congestive heart failure (CHF) in our population.

Drug utilization study of anti-diabetic drugs in patients attending medicine outpatient department at a tertiary care hospital in Western Maharashtra

Background: Studies on antidiabetic drug utilization are important for the optimization of drug therapy and rational prescription of drugs. The aim of the present study was to understand the trends in prescription pattern of oral anti-diabetic drugs among type 2 diabetes mellitus (T2DM) patients attending medicine outpatient department of tertiary care hospital of Western Maharashtra. Methods: A prospective observational study was conducted at Medicine OPD of Government Medical College and Hospital, Miraj. All adult patients (≥18 years) diagnosed with T2DM and willing to give informed consent to participate in the study, were enrolled. The study was approved by Institutional Ethics Committee. The data was computed using MS excel and results were expressed as counts and percentages. Results: Out of 72 T2DM patients enrolled, male population (58.33%) had higher prevalence than females (41.67%). Biguanides (63.16%) were the most commonly prescribed class of oral antidiabetic drugs followed by sulfonylureas (35.09%). Metformin (63.16%) was the most commonly prescribed oral antidiabetic drug followed by glimepiride (30.70%). Combination of oral antidiabetic drugs (OADs) were prescribed in 52.78% and 47.22% patients were prescribed single drug. ‘Metformin and glimepiride’ was the most commonly prescribed combination. Conclusions: In a chronic disease like diabetes mellitus, constant follow up for successful management is a must. It also demands active participation by the patients. Continuing education for the clinicians to keep themselves abreast of the latest development will also contribute in the effective management of diabetes mellitus and rational prescription of antidiabetic drugs.

ADR Monitoring and Reporting in General Medicine Department of Tertiary Care Hospital

ADR Monitoring and Reporting in General Medicine Department of Tertiary Care Hospital

6S Implementation and Impact Assessment in the Housekeeping and Linen Department of Tertiary Care Hospital

In modern days, healthcare cost is increasing tenfold along with immense pressure on healthcare providers to reduce the cost, improve quality of service and safety, lessen waiting time and eliminate the errors in the system. 6S targets at optimizing the process by eliminating waste and uses visual aids to achieve efficiency at workplace. The study aims at assessing the changes that is attained with the implementation of 6S in housekeeping and linen department of a tertiary care hospital. A quantitative method of data collection was employed with the help of a questionnaire and checklist. Independent Paired t-test, descriptive statistics and Repeated Measures ANOVA (RM-ANOVA) was used to analyse the data obtained. The Paired t-test indicated all the five sections of the questionnaire was very statistically significant (&lt;.001). The pre-implementation score for housekeeping department was 33.593% and post score was 91.406%. The score for linen department improved from 62.5% to 88.28%. The p-value for sort was .016 which is statistically significant, the p-value for Set in order was .064 which is greater than 0.05 that implies there is no statistical significance followed by shine, standardize, sustain and safety with p-value of &lt;.001, &lt;.001, .005 and .002 respectively which are statistically significant for housekeeping department. The p-value for sort, set in order and shine was found to be .251, .368, .156 respectively which tells that there is no statistically significant difference between the means. The p-value for standardize was .004, .022 for sustain and .002 for safety which is statistically significant.

Effectiveness of Caregiver Intervention for Improving Medication Adherence on Level of Medication Adherence and Attitude toward Medications among Nonadherent Patients with Mental Illness

Abstract Background: Nonadherence to medication is the major challenge in treating mental illness, resulting in worsening symptoms and prolonging the course of the illness. Caregivers spend a considerable amount of time with the patients. Therefore, proper training and education for caregivers help to improve treatment outcomes. Aim: This study aims to evaluate the effectiveness of caregiver intervention for improving medication adherence (CIIMA) on level of medication adherence and attitude toward medications among nonadherent patients with mental illness. Methods: This study was an experimental study using a randomized pretest posttest control group design. The study was conducted in the psychiatric outpatient department of tertiary care hospital in the eastern India. Eighty nonadherent patients with mental illness and their primary caregivers were randomly allocated to the experimental and control group using the concealment allocation method. Patients were assessed for their level of medication adherence using medication adherence rating scale, their attitude toward medication were assessed using drug attitude inventory and reasons for medication nonadherence were assessed using the Rating of Medication Influence. CIIMA consisted of individual psycho-education, pill card monitoring, weekly telephonic and text reminders provided to the experimental group, and routine treatment was provided to the control group. The level of medication adherence and attitude toward medication were reassessed for both groups after 1 month of the initial assessment. Results: After 1 month of CIIMA, 87.2% of patients in the experimental group were adherent to medication as compared 18.4% in the control group (P &lt; 0.001), significant improvement in their attitude toward medication and treatment in the experimental group as compared to the control group (P = 0.001). Conclusion: CIIMA is an effective, low-cost, nurse-led intervention can be delivered in the inpatient and outpatient units for improving medication adherence thereby preventing future relapse of their mental illness.

A cross-sectional study to assess the quality of life among cancer patients in a tertiary care hospital in a metropolitan city

Background: Cancer is a major cause of morbidity and mortality worldwide. Quality of life measures have now become a vital part of health outcome appraisal and an effective way of capturing the personal and social context of patients. The diagnosis of cancer brings many challenges, with a major concern being maintaining the highest quality of life possible during and after the experience. The objectives of the study were to assess the health-related quality of life among cancer patients and also to study the effects of type of cancer and treatment received after one month on their quality of life. Methods: It was a descriptive, cross sectional and hospital-based study. Total duration of study was 6 months (August 2019-February2020), conducted in Oncology department of a Tertiary care hospital. A total of 90 cancer patients were selected as study subjects and interviewed by a validated SF-36 questionnaire. Results: A total of 90 cancer patients were included in the study, of which 18 were males and 72 were females and majority were in the age range of 40-60 years. 75% of cancer patients were living a below average quality of life. The study population had different types of cancers. Among females 50% patients were suffering from CA Breast and remaining patients were suffering from different types of cancer. Conclusions: Most of the patients who came to the oncology department of tertiary care hospital during our period of study had low quality of life.

The Frequency of Maternal Complications after Home Delivered

Objective: To determine the frequency of maternal complications among women delivered at home by Traditional Birth Attended (TBA) Dais presenting at the emergency department of tertiary care hospital. Study Design: Descriptive case series Study setting: The study was conducted at the Emergency Department of Gynecology Unit –III of Liaquat University Hospital, Hyderabad. Study Duration: Six months from 1st May 2018 to 30th November 2018. Methods and Material: A sample of 140 was obtained, participants were selected by using the Non-probability sampling technique and all the women from 20 to 45 years of age either primipara or multiparous who delivered at home by traditional birth attendant (TBA) Dais and presented within 12 hours up to 10 days after delivery at emergency department of Gynecology Unit –III of Liaquat University Hospital, Hyderabad included, after getting informed and written consent from their family members, a questionnaire was used to collect information from the women or her relatives. Data was collected for the complications like post-partum hemorrhage, a retained product of conceptus, perpural sepsis perineal tears injuries. We have used SPSS version 20.0 software for both data entering and analysis. Frequencies and standard deviations were calculated and the chi-square test was used to analyse categorical variables. P values less than 0.05 were considered statistically significant. Result: The total number of women who delivered at home by (TBA’s)/ Dia’s and developed maternal complications presented in the emergency department within 12 hours up to 10 days during the study period was 140. The average age of the patients was SD 29.27±5.21 years. Regarding parity, 58(41.43%) were primigravida and 82(58.57%) multigravida. The postpartum hemorrhage was the commonest maternal complication observed in 62.14% (87/140) cases, retained placental products 27.14% (38/140), purpureal sepsis 7.86% (11/140) and perineal tear injuries 17.14% (24/140). Retained placental product, perianal tear injury and PPH were not statistically significant among different ethnicity while the rate of puerperal sepsis was statistically significant among different ethnicity groups. The frequency of PPH and perianal tear injury was significantly high among those women who had primigravida while the rate of Retained placental products and Puerperal sepsis was high in multigravida but it was not statistically significant. Conclusion: This study concluded that home deliveries conducted by untrained birth attendants were associated with increased maternal morbidity and a high risk of maternal mortality. The postpartum hemorrhage was the most common maternal complication observed in women after home delivery by a Traditional Birth Attended (TBA) Dais.

Is your blood bag safe for transfusion? Bacterial screening of donor blood and its components: An essential infection control tool for safe transfusion practice

Introduction: Transfusion-associated bacterial sepsis is still a major public health concern that has received little attention. Data on bacterial contamination of blood are scarce, despite rising demand for blood transfusions. Blood bags intended for transfusion should be free of microorganisms. Aim: The aim of the study was to assess the prevalence, identify the microorganisms involved in bacterial contamination of donor blood and blood components and determine blood products most likely to be contaminated, received in microbiology laboratory for sterility testing. Settings and Design: The study was carried out in the department of microbiology in association with the transfusion medicine department of tertiary care hospital in Western Uttar Pradesh from January 2023 to June 2023. Methodology: A total of 87 cellular blood components were tested aerobically for bacterial contamination using the BD BACTEC™ FX 40 automated culture system. For incubation, culture vials that showed positive signals were subcultured onto a set of solid media followed by bacterial identification and antimicrobial susceptibility testing. Results: The overall prevalence rate was 14.9% (whole blood 18.75%, platelets 14.2%, packed cells 13.3% and fresh frozen plasma 10.5%). The contaminants were Aeromonas hydrophila, Sphingomonas paucimobilis, Escherichia coli, Coagulase-negative Staphylococcus spp., Pseudomonas aeruginosa, Delftia acidovorans, and Candida albicans. Discussion: The bacterial contamination in blood products suggests the patient who receives blood products is at risk of developing infection. Implementing proper blood transfusion policies, donor screening and technical staff training will all help to reduce the contamination rate of blood and blood components. Conclusion: Bacterial contamination of blood bags indicates a potential risk of healthcare-associated infection. Microbiological Sterility testing for donor blood bags in blood banks should be used as mandatory infection control Tool for Quality assurance.