Hospital Bangalore Research Articles

Lived-in Experience Among Caregivers of Autistic Children: A Qualitative Study from South India

Background: Autism is a developmental disorder that impairs the skills related to behavior, communication, interaction, and learning. This study was undertaken to understand the difficulties faced by caregivers in various aspects of life while taking care of children with autism and their unique life experiences. Methods: After obtaining ethical approval, the study was conducted in a tertiary care hospital in Bangalore, India. An informed consent and a subject information sheet were taken to obtain permission from the subjects. A baseline proforma was prepared for collecting the demographic data for both autistic children and the caregivers. An in-depth, face-to-face, semi-structured interview that consisted of around 10 questions was conducted for 30 minutes. The interview was recorded, later transcribed verbatim, and extracted into specific themes and subthemes. Results: The lived-in experiences throw light on many emotional, social, psychological, and physical distress the caregivers go through on a day-to-day basis. The daily hassles of every caregiver are unique and challenging. Five themes and corresponding subthemes were extracted as follows: emotional meltdown, change in family dynamics, spiritual transition, perceived social burden, and perception of a child’s future. Conclusion: The caregivers of children with autism faced various challenges such as physical and emotional turmoil, financial constraints, and the deprivation of a healthy social life almost every day. Interventional measures such as nurse-led clinics, counseling measure, and planning training sessions for nurses to deal with the various issues faced by the caregivers could be taken up to address the growing concerns of caregivers of children with autism.

Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: A randomized controlled trial

BackgroundSleep disturbance is commonly seen in fibromyalgia syndrome (FMS); however, high quality studies involving manual therapies that target FMS-linked poor sleep quality are lacking for the Indian population. ObjectiveCraniosacral therapy (CST), Bowen therapy and exercises have been found to influence the autonomic nervous system, which plays a crucial role in sleep physiology. Given the paucity of evidence concerning these effects in individuals with FMS, our study tests the effectiveness of CST, Bowen therapy and a standard exercise program against static touch (the manual placebo group) on sleep quality in FMS. Design, setting, participants and interventionA placebo-controlled randomized trial was conducted on 132 FMS participants with poor sleep at a hospital in Bangalore. The participants were randomly allocated to one of the four study groups, including CST, Bowen therapy, standard exercise program, and a manual placebo control group that received static touch. CST, Bowen therapy and static touch treatments were administered in once-weekly 45-minute sessions for 12 weeks; the standard exercise group received weekly supervised exercises for 6 weeks with home exercises until 12 weeks. After 12 weeks, all study participants performed the standard exercises at home for another 12 weeks. Main outcome measuresSleep quality, pressure pain threshold (PPT), quality of life and fibromyalgia impact, physical function, fatigue, pain catastrophizing, kinesiophobia, and positive–negative affect were recorded at baseline, and at weeks 12 and 24 of the intervention. ResultsAt the end of 12 weeks, the sleep quality improved significantly in the CST group (P = 0.037) and Bowen therapy group (P = 0.023), and the PPT improved significantly in the Bowen therapy group (P = 0.002) and the standard exercise group (P < 0.001), compared to the static touch group. These improvements were maintained at 24 weeks. No between-group differences were observed for other secondary outcomes. ConclusionCST and Bowen therapy improved sleep quality, and Bowen therapy and standard exercises improved pain threshold in the short term. These improvements were retained within the groups in the long term by adding exercises. CST and Bowen therapy are treatment options to improve sleep and reduce pain in FMS. Trial registration numberRegistered at Clinical Trials Registry of India with the number of CTRI/2020/04/024551.Please cite this article as: Ughreja RA, Venkatesan P, Gopalakrishna DB, Singh YP, Lakshmi VR. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: a randomized controlled trial. J Integr Med. 2024; 22(4): 474–484.

Intelligence quotient in children with congenital hypothyroidism on treatment: A cross-sectional study

Introduction: Congenital hypothyroidism (CH) is the most commonly identified endocrine disorder. Early intervention can prevent intellectual deficits. Objective: To determine the intelligence quotient (IQ) and aetiology in children diagnosed with CH undergoing treatment and the associations between the IQ and the age of diagnosis. Method: A cross-sectional study was conducted in a tertiary care hospital in Bangalore, which enrolled 52 children aged 6 months to 15 years diagnosed with CH. Using a pre-designed proforma, we collected demographic data and confirmed CH aetiology. For IQ assessment, children under 3 years underwent the Vineland Social Maturity Scale (VSMS) and developmental screening test (DST), while those over 3 years were evaluated with the VSMS and Binet Kamat test of intelligence (BKT). Results: Among the 52 children with CH, dyshormonogenesis was the predominant aetiology. In the under-3-year age group (n=17), all demonstrated average to above-average intelligence. Among those over 3 years (n=35), 10.9% (95% CI: 6.5% to 17.2%) exhibited low average and borderline intelligence with the VSMS, and 5.7% (95% CI: 2.3% to 12.5%) had extremely low IQ (IQ &lt;70). The BKT scale showed 20% (95% CI: 12.8% to 29.7%) with low average and borderline intelligence, and 2.9% (95% CI: 0.7% to 8.3%) with extremely low IQ (IQ &lt;70). Children diagnosed at a mean age of 4.2 and 4.4 years exhibited intellectual disability on the VSMS and BKT scales, respectively. Conversely, those diagnosed at a mean age of 1.2 and 1.8 years showed average and above-average intelligence on the VSMS (p-value 0.02) and BKT scale (p-value 0.001), respectively. Conclusions: Children diagnosed with CH at mean ages of 4.2 and 4.4 years exhibited intellectual disability on the VSMS and BKT scales, respectively. Conversely, those diagnosed with CH at mean ages of 1.2 and 1.8 years showed average and above-average intelligence on the VSMS (p = 0.02) and BKT scale (p = 0.001), respectively.

The Health Arab Tourists’ Satisfaction Level of Services Provided: A Cross-sectional Study in Bangalore-Cross Sectional Study

Introduction: An indication of the quality of medical treatment is how satisfied patients are with the services received. Patient satisfaction is determined by how well they feel their care met their expectations. This survey was conducted in 2023 to assess how satisfied health tourists were with the services received from Bangalore Multispecialty hospitals. Method: It is a cross-sectional study was conducted from 21-3–2023 to 26-1-2023 at Multispecialty Hospital in Bangalore. : In this a cross-sectional study, 400 253 (63.2%) men and 147 (36.8%) women, the data collection instrument is a semi-structured questionnaire in this study. The respondents of this study are Arab tourists who received inpatient and outpatient services at least one day at hospitals. The hospitals were selected purposively but the potential respondents were chosen conveniently. These procedures ensure the researchers access a sufficient number of potential respondents from the hospitals for this study. Researchers of this study approached the respondents and requested they participate in this survey. The researchers informed participants that the information would be utilized only for research purposes and their support was anonymous and voluntary. The questionnaire has 56 general and specific items. Each of the specific items is scaled on five points; Very Good, Good, Moderate, Poor and very poor. In order to analyze the data both descriptive and inferential statistics were used Patient satisfaction and surgical outcomes were the main outcome measures. Results: 400 participants were included in the study (63.2% male and 36.85% Female). 79 of the surgeries were Neurosurgeries cases (19.8%) compared to 75 Oncology cases (18.8%). Regarding patient satisfaction, 96.8% of the patients regarding the quality of care. 66 % were satisfied with the hospital privacy and confidentiality measures. Conclusion: All of the Analyzed domains had excellent patient satisfaction rates, little problems, and successful surgical results in general. There is few things make patients unsatisfied like the waiting time for consultation so long, the method of payment in some hospital that there is limitation for cash payment ,and the language barrier the important factor play the major role.

A study on appropriate use and stewardship of proton pump inhibitors

Objective: To analyze the prescribing pattern of use of PPI with respect to “FDA-Approved Indications and Doses for PPI Therapy.” Materials and Methods: After obtaining approval from the Institutional Ethics Committee, a cross-sectional study was carried out among 400 inpatients in a tertiary care hospital in Bangalore. The data were collected from the patient case profile and prescriptions and noted in a self-designed data collection form. The statistical analysis of the collected data was performed using SPSS software and Excel. Results: The study, conducted on 400 patients, revealed a male majority (60%) and a female representation of 40%. Proton Pump Inhibitors (PPIs), mainly Pantoprazole (74.70%), were frequently prescribed, notably in General Medicine (220 patients). PPI use was generally appropriate: indication (99%), dose (97%), frequency (92.8%), and duration (91.8%). However, irrational prescriptions were noted: indication (1%), dose (3%), frequency (7.3%), and duration (8.3%). 139 drug interactions were identified, categorized into Major (39.6%), Moderate (46%), and Minor (14.4%). For example, Ondansetron and tramadol exhibited a major interaction. Among PPI combinations, 93.75% could affect CYP2C19 metabolism, and 6.3% had additive/synergistic toxicity potential.

Pyruvate kinase deficiency: A case series of congenital non-spherocytic hemolytic anemia

BackgroundPyruvate kinase deficiency (PKD) is a common cause of congenital non-spherocytic hemolytic anemia (CNSHA). The heterogeneity of clinical presentation complicates the diagnosis and management of this disease. The objective was to describe the clinical, laboratory, and genetic profile of pediatric patients with PKD. Material and methodsIt was a retrospective, observational study. Children and their family members presenting to the Department of Pediatric Hematology and Oncology, St John's Medical College Hospital Bangalore, India, and diagnosed with PKD during 2011–2023 were enrolled. ResultsEight patients were identified through retrospective chart reviews. Four cases were clustered in one family and affected twins in the second family. All patients had a history of neonatal jaundice; however, they varied in their severity and the requirement for transfusion support. Some patients underwent splenectomy and one had hematopoietic stem cell transplant. ConclusionPKD is a known cause of congenital non-spherocytic hemolytic anemia with heterogeneous presentation. A high index of suspicion, enzyme assay, and genetic studies are required for diagnosis.

A Study to Assess the Effectiveness of Ginger powder with Honey on Gastrointestinal symptoms in patients undergoing Chemotherapy in a selected hospital Bangalore

Introduction: Chemotherapy induced gastrointestinal symptoms are distressing and affect QOL, which may lead to non adherence to treatment regimen. This study was conducted to assess the effectiveness of ginger with honey on gastrointestinal symptoms in patients undergoing chemotherapy. Methods: A pre-experimental one group pretest post test design was adopted; wherein 66 cancer patients receiving chemotherapy selected using non-probability purposive sampling technique. Baseline variables were assessed. Pretest assessment of gastrointestinal symptoms, were done using VAS and a check list, at the end of the day after chemotherapy.100mg ginger powder with 5 ml of honey was administered orally thrice. (0 hr, 2hr and4hr of chemotherapy) Post test scoring was done after chemotherapy on the same day. Result: Ginger was found to be effective in reducing gastrointestinal symptoms [nausea p&lt;0.001, anorexia- p&lt;0.001, vomiting-p&lt;0.045]. Females had more nausea and subjects with respiratory cancers expressed more gastric burning/pain. Conclusion: Present study proves ginger with honey to be effective in reducing chemotherapy induced gastrointestinal symptoms. It can be used to achieve a better quality living.

Opportunistic Screening for Hypertension and Obesity among Patients Attending a Tertiary Care Hospital in Bangalore, India

Background: An estimated 1.28 billion adults in the age group of 30–79 years globally have hypertension. Opportunistic screening would be one method to screen all patients attending health care facility for hypertension and Cardiovascular risk factors. Objectives of this study was to assess the magnitude of the undiagnosed hypertension and obesity by opportunistic screening among the study participants and also to study the factors associated. Methods and Material: A cross-sectional study design was carried out in the outpatient department of General Medicine, in a teaching hospital, India. Blood pressure, BMI, waist circumference was measured among patients aged 30 and above. Results: Almost one third of the study participants were screened to be having Hypertension (27.6%). More than half of the study participants belonged to the category of overweight according to BMI (64.4%) and majority of them were obese according to waist circumference (Male-81.3%, Female-74.2%). Conclusions: Opportunistic screening is a simple and yet efficient method for screening patients for Hypertension and Obesity. Management of these two important risk factors at early stage will help in preventing cardiovascular events among the patients in the future Keywords Opportunistic screening, Non communicable disease, Hypertension, Obesity

Comparison of Near Point of Accommodation and Near Point of Convergence with Positive Fusional Vergence among Young Adults, Bengaluru

Background: When encountered with mass screening and increased walk-in patients in outpatient departments (OPD), evaluating complete binocular vision assessment becomes time-consuming. Consequently, there is a need to streamline the testing process. This study also aims to explore if there are any correlations between Near Point of Accommodation (NPA) and Near Point of Convergence (NPC) with Positive Fusional Vergence (PFV). Methodology: A retrospective study was carried out at Sankara Eye Hospital in Bangalore. Data from patients aged 18 to 35, who underwent binocular vision assessment between 2016 and 2020, were included. Out of 101,896 patients who visited the hospital during this period, 3,449 attended the vision therapy clinic. Among them, 1708 patients met the criteria for inclusion, while 1,741 were excluded. Results: Out of 1708 subjects, 759 are females and 949 are males. The relationship between Near Point of Accommodation (NPA), Near Point of Convergence (NPC), and Positive Fusional Vergence (PFV) blur and break values were analysed. A positive correlation was observed between NPA and PFV blur (Spearman's rho = 0.069, p=0.004) and a negative correlation between NPC and PFV break (Spearman's rho = -0.370, p&lt;0.001). There was a significant difference between NPA and PFV blur, as well as NPC and PFV break (p=0.000), emphasizing the importance of incorporating all three tests in a binocular vision assessment. Conclusion: These results emphasize the necessity for complete binocular vision assessment to effectively diagnose and manage binocular vision anomalies. By accounting for the various parameters involved in this investigation, clinicians can enhance the precision and quality of their assessments and plan for appropriate treatment strategies for patients with binocular vision anomalies.

A cross-sectional study on drug utilization and it’s cost analysis in the urological disorders and other health issues in patients of a tertiary care hospital

To evaluate drug utilization patterns in terms of WHO indicators, urological disorders, and other health issues in patients of a tertiary care hospital.After obtaining approval from the Institutional Ethics Committee, a cross-sectional study was carried out among 200 inpatients in a tertiary care hospital in Bangalore. The data were collected from the patient case profile and prescriptions and noted in a self-designed data collection form. The statistical analysis of the collected data was performed using SPSS software and Excel. In a study of 200 patients with urological disorders (129 males and 67 females), common co-morbidities included diabetes, hypertension, and hypothyroidism. Benign Prostate Hyperplasia (BPH) and Urinary Tract Infections (UTI) were the prevalent diagnoses. Prescribed drugs included analgesics, antipyretics (26.7%), antibiotics (18.1%), proton pump inhibitors (18.0%), anti-hypertensives (8.7%), anti-emetics (7.9%), anti-hyperlipidemic (7.6%), vaccines (7.5%), and loop diuretics (5.5%). Average drugs per prescription were 6.94, with 23.79% prescribed generically. Antibiotics accounted for 48% of encounters, and injectables were used in 52% of cases. All the drugs came from the essential list. Polypharmacy affected 58% of patients over 50 years, with 32 major interactions and observed adverse drug reactions. The current research provides valuable insights into the overall pattern of drugs used in urological disorders. Physicians should be encouraged to increase generic prescribing to reduce medication cost burdens as well as to avoid unessential drugs, which may lead to polypharmacy and may result in other medication-related problems.

Effectiveness of Video-Assisted Teaching Programme on Knowledge Regarding Risk Factors Contributing to Coronary Artery Disease Among Hypertensive Patients at a Selected Hospital in Bangalore

nbspBackground Hypertension is not the only significant risk factor for the development and progression of Coronary artery disease CAD. By being aware of the risk factors associated with CAD and consistently adhering to preventive measures it is possible to mitigate these risks effectively. Objective To assess the effectiveness of video assisted teaching programme on knowledge regarding risk factors of coronary artery disease CAD among hypertensive patients at a selected hospital in Bangalore. Methods This evaluative research study included 60 hypertensive patients admitted at a selected hospital in Bengaluru. Demographic details of all the patients were collected. A structured knowledge questionnaire was used for collecting baseline data from the hypertensive patients on their knowledge and practice regarding risk factors of CAD. An intervention through a video-assisted teaching programme regarding risk factors of coronary artery disease was administered to all the patients. Pre-and post-knowledge data were compared using various descriptive and inferential statistics. Results The majority of hypertensive patients were 35 to 45 years old 50 and were admitted to special ward 48.3. Regarding prior information about CAD 83.3 reported to have prior information out of which 41.7 of patients reported to have received the information from others. 46.7 of patients had hypertension for lt 1 year. The level of knowledge increased from inadequate to adequate up to 93.3 post-intervention. The average level of practice increased from 26.7 to 91.7 post-intervention. Conclusion The result revealed that the video-assisted teaching programme was effective and appropriate in improving knowledge regarding the risk factors of CAD among hypertensive patients.

Emotional Intelligence and Occupational Stress Among Nursing Professionals in Tertiary Care Hospitals of Bangalore: A Multicentric, Cross-Sectional Study.

Nursing profession requires strength and resilience not just physically, but emotionally as well which requires them to adapt in stressful situations that they are often exposed to in their work environment. To determine the prevalence and associated factors of emotional intelligence (EI) and occupational stress (OS) among the nursing professionals from selected tertiary care hospitals in Bangalore, India. This was a multi-centric, cross-sectional study done among nurses with more than 1year of work experience and they were randomly selected from four tertiary care hospitals in Bangalore. The EI and OS were assessed using the Emotional intelligence scale (EIS) and Occupational Stress Index (OSI). Data was collected, both online and offline, owing to the ongoing COVID-19 pandemic. The data was analyzed using SPSS v21.0 to calculate the mean, associations, and regression. Out of the total 294, the mean age of the study participants was 27±4.92years. A total of 75 (25.5%) nurses had poor EI and 245 (83.3%) had moderate OSI. None of the participants had high OSI. There was a significant association between the severity grades of EI and OSI (P = 0.010) and a binary logistic regression showed that those staff with high EI had a lesser odd (OR 0.531, 95% CI 0.282-0.999) of developing occupational stress as compared to those with low EI. EI plays a significant role in reversing the effect of one's occupational stress. Thereby, the training curriculum should include skills and measures of resilience to facilitate their EI improvement.

Clinical Profile and Outcome of Children Using Mechanical Insufflation Exsufflation Device (Cough Assist) at a Tertiary Care Hospital in Bangalore, India

Abstract Background and Objective: Children with neuromuscular disorders (NMDs) face a higher risk of recurrent pneumonias. Mechanical insufflation–exsufflation (MI-E) is a technique designed to enhance cough effectiveness, improve mucus clearance, and ultimately enhance lung health by boosting expiratory airflow and cough peak flow in coordination with a cough. We assessed the safety and adverse effects of MI-E in our cohort. Materials and Methods: This retrospective study was conducted over a period of 1.5 years at a tertiary care hospital in Bangalore, South India. Children between 1 and 18 years of age were included in the study. The demographic details of each child were collected from hospital records, along with the indication for starting MI-E and the duration of usage of MI-E. Results: Thirty-three children (18 boys) were started on MI-E. The most common indication was spinomuscular atrophy. Before the start of MI-E, 30 children were on noninvasive ventilation and 13 had a tracheostomy. The median insufflation and exsufflation pressures used were in the range of +15 to 25 cm H2O and −15 to −25 cm H20, respectively. Auto mode was used in all the cases, and 28 children used it on a long-term basis. There was a decrease in the frequency of hospitalization (especially in children with NMD). Adherence was very good without any evidence of barotrauma or any other complications. Conclusions: We found that the MI-E device is a valuable tool for aiding airway clearance in children with NMDs. Its use not only prevents intensive care unit admissions, reducing hospital stay duration but many times mitigates the need for hospital admissions altogether.

Serodiagnosis of Brucellosis in Patients with Fever of Unknown Origin at a Tertiary Care Hospital in Bangalore: A Cross-sectional Study

Introduction: Brucellosis is a zoonotic disease caused by bacteria of the genus Brucella. Although it is not commonly transmitted between humans, it can be transmitted through direct handling of cattle or their products, such as raw milk, unevenly heated milk, clotted cream, and cheese, for varying periods. Brucellosis is considered as one of the neglected zoonotic diseases worldwide, as it can cause debilitating acute infections and later become chronic with numerous complications. Aim: To determine the prevalence of brucellosis among patients with Pyrexia of Unknown Origin (PUO). Materials and Methods: This cross-sectional study was conducted in the Department of Microbiology at Ramaiah Medical College and Teaching Hospital in Bangalore, Karnataka, India, over a period of two years, from December 2019 to December 2021. The study included patients who visited the Outpatient Department (OPD) and those admitted to the hospital with fever persisting for more than 5-7 days and Fever of Unknown Origin (FUO). The total sample size was 180, and 5-10 ml of blood was collected from each patient under aseptic precautions from the median cubital vein for serological tests. The blood samples were stored at 2-8°C for the Rose Bengal Test (RBT) assay and Enzyme-Linked Immunosorbent Assay (ELISA). The demographic parameters considered included clinical history, age, gender, residency, and history of animal exposure. Data analysis was performed using the statistical software Statistical Package for the Social Sciences (SPSS) version 18.0, employing the Chi-Square test, Fisher’s-Exact test, and descriptive statistics. The significance level employed was set at p-value &lt;0.05. Results: Among 180 samples, six (i.e., 3.3%) were positive for the Brucella RBT (BRBT), while 11 (i.e., 6.1%) were positive for the (ELISA IgM), and 17 (i.e., 9.4%) were positive for the (ELISA IgG). Additionally, 22 samples (i.e., 12.22%) tested positive for either ELISA of IgG or IgM (ELISA IgG/IgM). Conclusion: The present study identified 22 patients (12.22%) with Brucella-positive cases who presented with various clinical signs and symptoms, originating from different geographical locations and regardless of gender. These findings suggest that all cases of FUO presented to a clinician should be evaluated for Brucella infection.

Phenomenological Study on Professional Role Transition of New Graduate Nurses

Background Transition from a newly graduated nurse to an expert nurse may involve personal professional intellectual and emotional changes along with skill and role changes. As the global shortage of nurses remains an important issue to be solved it is important to ensure that novice nurses have a safe and smooth professional role transition.Aim The study aimed to address the professional role transition of new graduate nurses during their initial years of practice.Methods A phenomenological research approach was used among the ten nurses who were working as staff nurses at a tertiary care hospital in Bangalore. An interview technique was used to collect the data in two phases Focused group interview and Individual interview.Results The collected data was categorized into three stages based on Judy Boychuk Duchscherrsquos transition theory. During the initial 3-4 months Doing stage the nurses were excited but soon realized that they were not prepared enough to manage the workload and responsibility of their role as staff nurses. The themes that emerged were ldquoBeing scared and stressedrdquo ldquoReality is differentrdquo and ldquoNeed to learnrdquo. Subjects felt scared and stressed and realized that the reality is different and understood the need to learn. During the next 9-12 months Being Stage their competency skill and confidence levels improved. ldquoGaining confidence and Trustworthinessrdquo were the themes that emerged during this phase. From 12 months and above Knowing phase the subjects experienced less stress gained confidence and improved their individual capacity to cope and the themes unfolded were ldquoYes I know and to be empoweredrdquo.Conclusion The study revealed the complexity in the transition from student to registered nurse. In the current scenario with an acute shortage of staff nurses it is vital to address this issue and to plan necessary reforms for strengthening the profession.

A Study to Evaluate the Effectiveness of a Structured Teaching Programme on Dietary Management of Hypertension among Hypertensive Patients Attending the OPD in Selected Hospitals in Bangalore

A Study to Evaluate the Effectiveness of a Structured Teaching Programme on Dietary Management of Hypertension among Hypertensive Patients Attending the OPD in Selected Hospitals in Bangalore

Current Screening and Management Practices for Gestational Diabetes Mellitus in Public Hospitals of South India

Background Gestational Diabetes Mellitus GDM leads to adverse maternal and foetal health outcomes. There are several benefits of screening pregnant women for GDM including reducing the impact and timing of GDM-associated complications. However there is limited evidence regarding GDM screening and management in public hospitals in low- and middle-income countries. Therefore we aimed to understand the current GDM screening and management practice in public hospitals in South India through the study of pregnant women in Bangalore.Methods We conducted a cross-sectional study in all the six tertiary-level public hospitals of Bengaluru which were providing antenatal services during September 2017. We compared the results of GDM screening in five of these hospitals with a tertiary public hospital wherein a cohort of women were studied during the same time wherein voluntarily consented women were subjected to GDM screening and were followed up through their pregnancy and post-partum.Results Among the 186 pregnant women included in the cross-sectional study 41.4 n77186 had undergone random blood sugar test and 22 n39186 underwent a confirmatory test in the form of either a Glucose Challenge Test GCT or Oral Glucose Tolerance Test OGTT for diagnosis. Similarly pregnant women underwent capillary blood glucose testing 5.1 n9186 fasting blood sugar 1.7 n3186 urine glucose and albumin level 1.7 n3186 testing. The prevalence of GDM in this cross-sectional study obtained via routine screening in public hospitals was 4.3 n8186 while in comparison the prevalence of GDM was 15.4 n1571019 in the ongoing cohort. Furthermore only 22.9 of cohort women diagnosed with GDM received any follow-up treatment in public hospitals. We also found that 12.1 and 7 of women achieved glucose control in the antenatal and postnatal period respectively.Conclusion Our results suggest that most women with GDM attending public hospitals may be ldquomissedrdquo from GDM diagnosis and treatment even in the major public hospitals in Bangalore. Therefore strengthening the GDM screening and management in public hospitals is imperative to avert the adverse risks of GDM among women and their children in urban areas.

A survey study on adverse effects of synthetic cosmetics

Background: Cosmetics are substances used to enhance the appearance or odour of the human body. The use of cosmetics in the present era has enormously increased and the chemicals present in them quite frequently cause adverse reactions like contact dermatitis, allergic reaction and so on. Therefore, a survey study was planned to evaluate awareness and knowledge about adverse effects of synthetic cosmetics among inmates of SDM Institute of Ayurveda and Hospital Bangalore. Methods: Descriptive survey study with self-administered questionnaire method sent to 500 participants selected randomly emailed through self-generated Google form. Results: Among 500 inmates of age between 18-50years, 427 (85.4%) responded as cosmetics are used for beautification, 454 (90.8%) inmates believe there will be long-term side effects by continuous use of synthetic cosmetics. 352 (70.4%) inmates are aware of harmful ingredients used in cosmetics. Conclusions: Majority of inmates have knowledge about adverse effects of cosmetics and are giving preference to herbal cosmetics. Inmates are even aware of hazardous toxic contents of cosmetics. The adverse effects caused by the cosmetics can be correlated to the toxicity signs and symptoms caused by of gara visha/artificial poisons and dushi visha/cumulative toxicity explained in ayurveda. The study forms the basis for future studies where in management of adverse effects of cosmetics could be tried in line of Garavisha and Dushivisha chikitsa.

The Effect of Education on Knowledge Regarding Breast Cancer Related Lymphedema Risk Reduction and Prevention Among Nursing Personnel.

Aim The development of lymphedema post-breast-cancer surgery has been identified as a significant burden worldwide, with nurses at the forefront of prevention and risk reduction practices.Prevention is of crucial importance to avoid lymphedema formation and its complications.Thisstudy aims to assess the knowledge gained through an educational session regarding risk reduction and prevention of breast cancer-related lymphedema (BCRL) among nursing professionals and compare the pre-test and post-test knowledge. Methods and material The research approach was quantitative in nature, and the design adopted was a pre-experimental, one-group pre-test post-test design.The study was conducted in a 400-bed multispecialty teaching hospital in Bangalore, Karnataka. After obtaining formal permission from the authorities, the participants were approached and informed about the purpose of the study.Eighty-four staff nurses working with breast cancer-related lymphedema (BCRL) patients participated in the study. The data for the study was collected using a validated questionnaire based on the National Lymphedema Network's (NLN) breast cancer-related lymphedema (BCRL) risk reduction and preventive guidelines.The questionnaire consisted of two sections.Section A consisted of the staff nurses' demographic data, and Section B consisted of questions on risk reduction and prevention of lymphedema. The pre-test was conducted, followed by a structured teaching session on risk reduction and prevention of lymphedema among 84 staff nurses working with BCRL patients.After the teaching session, the post-test was conducted. Results Descriptive and inferential statistics were used for analysis in this study.The t-test determined the statistical significance using the software SPSS (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). The result showed that the mean knowledge score was 4.286 with SD 0.97 in the pre-test, which increased to 4.452 with SD 1.511 with a significant p-value (<0.001). Conclusion According to the study's findings, nurses must get standardized lymphedema training in order to prevent lymphedema from developing in patients having breast cancer surgery.The study's outcome has implications on the focus areas for nurses in the context of the team's adoption and dissemination of breast cancer-related lymphedema preventive measures. Key messages of this study are - 1) BCRL is an irreversible, progressive complication with no cure if not diagnosed early. 2) Poor knowledge of lymphedema prevention among nurses leads to frustration for BCRL patients. 3) Risk reduction and prevention education enable the patient to reduce BCRL complications, minimize the severity of the condition, and improve the quality of life. 4) Pre-habilitation - patient education on early diagnosis and risk reduction/prevention of BCRL reduces the cost, time, and energy for the patient and health care delivery system.

Novel multidrug-resistant sublineages of Staphylococcus aureus clonal complex 22 discovered in India.

Staphylococcus aureus is a major pathogen in India causing community and nosocomial infections, but little is known about its molecular epidemiology and mechanisms of resistance in hospital settings. Here, we use whole-genome sequencing (WGS) to characterize 478 S. aureus clinical isolates (393 methicillin-resistant Staphylococcus aureus (MRSA) and 85 methicilin-sensitive Staphylococcus aureus (MSSA) collected from 17 sentinel sites across India between 2014 and 2019. Sequencing results confirmed that sequence type 22 (ST22) (142 isolates, 29.7%), ST239 (74 isolates, 15.48%), and ST772 (67 isolates, 14%) were the most common clones. An in-depth analysis of 175 clonal complex (CC) 22 Indian isolates identified two novel ST22 MRSA lineages, both Panton-Valentine leukocidin+, both resistant to fluoroquinolones and aminoglycosides, and one harboring the the gene for toxic shock syndrome toxin 1 (tst). A temporal analysis of 1797 CC22 global isolates from 14 different studies showed that the two Indian ST22 lineages shared a common ancestor in 1984 (95% highest posterior density [HPD]: 1982-1986), as well as evidence of transmission to other parts of the world. Moreover, the study also gives a comprehensive view of ST2371, a sublineage of CC22, as a new emerging lineage in India and describes it in relationship with the other Indian ST22 isolates. In addition, the retrospective identification of a putative outbreak of multidrug-resistant (MDR) ST239 from a single hospital in Bangalore that persisted over a period of 3 years highlights the need for the implementation of routine surveillance and simple infection prevention and control measures to reduce these outbreaks. To our knowledge, this is the first WGS study that characterized CC22 in India and showed that the Indian clones are distinct from the EMRSA-15 clone. Thus, with the improved resolution afforded by WGS, this study substantially contributed to our understanding of the global population of MRSA. IMPORTANCE The study conducted in India between 2014 and 2019 presents novel insights into the prevalence of MRSA in the region. Previous studies have characterized two dominant clones of MRSA in India, ST772 and ST239, using whole-genome sequencing. However, this study is the first to describe the third dominant clone, ST22, using the same approach. The ST22 Indian isolates were analyzed in-depth, leading to the discovery of two new sublineages of hospital-acquired Staphylococcus aureus in India, both carrying antimicrobial resistance genes and mutations, which limit treatment options for patients. One of the newly characterized sublineages, second Indian cluster, carries the tsst-1 virulence gene, increasing the risk of severe infections. The geographic spread of the two novel lineages, both within India and internationally, could pose a global public health threat. The study also sheds light on ST2371 in India, a single-locus variant of ST22. The identification of a putative outbreak of MDR ST239 in a single hospital in Bangalore emphasizes the need for routine surveillance and simple infection prevention and control measures to reduce these outbreaks. Overall, this study significantly contributes to our understanding of the global population of MRSA, thanks to the improved resolution afforded by WGS.