North Indian Hospital Research Articles

A Platinum-Graded Green Hospital Building in India during COVID-19 Pandemic: From Planning to Execution and Outcome

Background: A green hospital building has superior qualities over general hospital buildings in terms of energy conservation, use of natural resources, clean indoor air quality, green housekeeping, and other characteristics that improve patient outcomes. During the COVID-19 pandemic, healthcare organizations worldwide faced significant challenges and difficulties running hospitals. These challenges motivated the healthcare administration to find possible solutions for possible protocols for the functioning of the hospital. Methods: It was a prospective study conducted at a tertiary care hospital in north India from March 2020 to Feb 2022. After multiple changes in the fields of committee formation, human resource management, training, setting of the donning area and the doffing area, setting of the patient care areas and the infection control practices, equipment utilization, protocols for the support services, patient status updation to family members, and finally maintaining the patient data for the official purpose. Results: The hospital statistics showed a recovery rate of 81%, a mortality rate of 18%, and average length of stay of 8 days in COVID-19 patient care. Conclusion: The experiences, the challenges learned, and the solutions made to combat this pandemic will be the guide for future pandemics. The green hospital building proved its supremacy in patient outcomes and is recommended by hospital administrators as a future hospital building.

Treatment Adherence and Factors Influencing It in End-Stage Renal Disease Patients on Maintenance Hemodialysis: A Study From a Tertiary Care Hospital in North India

Treatment Adherence and Factors Influencing It in End-Stage Renal Disease Patients on Maintenance Hemodialysis: A Study From a Tertiary Care Hospital in North India

Respiratory viruses associated with severe acute respiratory infection in children aged

With the increased availability of licensed vaccines for respiratory viruses such as severe acute respiratory syndrome coronavirus 2, respiratory syncytial virus (RSV), and influenza virus, a better understanding of the viral aetiology of severe acute respiratory infections (SARI) among children could help in optimising the use of these vaccines. We conducted a study among children aged <5 years hospitalised with SARI at a tertiary care children's hospital in north India and tested for common respiratory pathogens. We randomly enrolled eligible SARI cases aged <5 years from August 2013 to July 2015. SARI cases were defined as either <7-day history of fever with cough or in children aged eight days to three months, a physician diagnosis of acute lower respiratory infection requiring hospitalisation. We also enrolled an age-group matched control without any acute illness in a 2:1 ratio from the outpatient clinic within 24 hours of case enrolment. Nasopharyngeal and/or oropharyngeal swabs were collected and tested using TaqMan Array Cards, a real-time reverse transcription polymerase chain reaction-based multi-pathogen testing platform for selected respiratory viruses among the enrolled cases and controls. We compared the prevalence of each pathogen among cases and controls using the χ2 (χ2) or Fisher exact test (P < 0.05). We used logistic regression to estimate adjusted odds ratios (aORs) which were then used to calculate aetiologic fractions (EFs). We enrolled 840 cases and 419 outpatient controls. Almost half of the individuals in the whole sample were aged <6 months (n = 521, 41.4%). Females made up 33.7% of cases and 37.2% of controls. Viral detections were more common among cases (69%, 95% confidence interval (CI) = 66, 73) compared to controls (33%; 95% CI = 29, 38) (P < 0.01). RSV (n = 257, 31%; 95% CI = 28, 34%) was the most common virus detected among cases. Influenza A was detected among 24 (3%; 95% CI = 2, 4%), and influenza B among 5 (1%; 95% CI = 0, 1%) cases. The association between the virus and SARI was strongest for RSV (aOR = 23; 95% CI = 12, 47; EF = 96%). Antivirals were administered to 1% of SARI cases while 78% received antibiotics. Using a multi-pathogen molecular detection method, we detected respiratory viruses among more than two-thirds of children aged <5 years admitted with SARI in the Delhi tertiary care children's hospital. The guidelines for preventing and managing SARI cases among children could be optimised further with the improved availability of antivirals and vaccines.

Micronutrient status and associated factors of anemia among undernourished children of 5-18 years: First study from Himalayan foothills

ABSTRACT Purpose: Undernutrition in children is a critical worldwide concern that hampers both their physical and cognitive growth. The nutritional status of school-going children and adolescents remains insufficiently addressed with no comprehensive data. This is the first study from the Himalayan foothills that aims to assess the clinical and laboratory aspects of anemia with micronutrient status in undernourished children above the age of five along with association of clinical features with anemia severity. Materials and Methods: A cross-sectional study was conducted involving children aged 5-18 years with undernutrition in a tertiary hospital in North India over eighteen months. We observed the prevalence of anemia, its morphological type, micronutrient status, clinical features, and demographic parameters of these children. The association of various clinical features and anthropometric parameters with the severity of anemia was determined. Results: Of the 200 children who were enrolled in the study, 77% were found anemic, with the proportion of mild, moderate, and severe anemia being 18.2%, 46.8%, and 35%, respectively. Iron (67%) was the most common micronutrient deficient in these children with a significant number suffering from vitamin B12 (53.9%) deficiency. Folic acid deficiency was relatively low (10.4%). Body mass index (P = 0.009), fatigability (P = 0.001), pallor (P ≤ 0.001), poor academic performance (P = 0.023), and knuckle hyperpigmentation (P = 0.018) were significantly associated with the severity of anemia. Conclusion: Despite the significant tread in various aspects of human development, undernutrition and anemia remain a formidable challenge, especially in developing countries. A high proportion of anemia in undernutrition indicates the gravity of the issue, yet not received the deserved attention.

The Clinical Impression of NDM-producing Acinetobacter baumannii in Intensive Care Units of the University Referral Hospital in North India

The Clinical Impression of NDM-producing Acinetobacter baumannii in Intensive Care Units of the University Referral Hospital in North India

Utility of ICD-PM Classification in Assigning Cause of Death in Stillbirths in a Tertiary Care Hospital in North India

Utility of ICD-PM Classification in Assigning Cause of Death in Stillbirths in a Tertiary Care Hospital in North India

Is the combination of propranolol and flunarizine better than propranolol, flunarizine and amitriptyline alone in prophylaxis of migraine? An observational study at a tertiary care centre of North India

Background: Migraine is a primary headache disorder marked by recurrent attacks of pain and associated symptoms. Propranolol is traditionally considered highly effective for migraine prophylaxis, but other drugs have recently shown promise. Methods: This study was a prospective, observational, randomized, parallel-arm, unicentric trial conducted in the neurology department of a tertiary care hospital in North India. Patients with migraine without aura were randomly assigned to one of four treatment groups. After obtaining consent, patients were randomized using a random number table. Group 1 received propranolol (80 mg), group 2 received flunarizine (10 mg), group 3 received a combination of propranolol (40 mg) and flunarizine (10 mg), and group 4 received amitriptyline (10 mg) daily. The primary outcome was a change in the frequency of migraine days, while secondary outcomes included changes in moderate-to-severe headache days and disability levels. Results: The combination of propranolol (40 mg) and flunarizine (10 mg) was significantly more effective in reducing the frequency of migraine attacks at the end of 3 months compared to the group receiving amitriptyline (10 mg). However, no significant differences between the groups were observed at baseline, 1 month, and 2 months. For other outcomes, including adverse drug reactions (ADRs), there were no significant differences between the groups. Conclusions: The combination of propranolol (40 mg) and flunarizine (10 mg) demonstrated superior efficacy over amitriptyline (10 mg) after prolonged treatment, while its effectiveness was comparable to other groups at earlier time points. ADRs were similar across all groups.

Endoscopic dacrocystorhinostomy: Reasons for failure and possible solutions.

Endoscopic dacryocystorhinostomy is a well-established procedure with high success rate. There are multiple causes of failure of this procedure which affect surgical success. To analyze causes of failure in endoscopic dacryocystorhinostomy and ascertain methods to overcome causes of failure. After approval from the Institutional Review Board a retrospective review of 119 patients was undertaken over an 11-year period from 2008 to 2018. A tertiary care hospital in North India. Patients presenting to the Otorhinolaryngology out-patient department and diagnosed as failed endoscopic dacryocystorhinostomy cases. After thorough preoperative workup consisting of history, examination and diagnostic nasal endoscopy, patients underwent revision endoscopic dacryocystorhinostomy. After exclusion of 2 cases, 117 patients were included in the study. The mean age at presentation was 31.4 years. Number of previous surgeries: 92 patients had had one surgery, 20 patients had had two surgeries, 5 patients had had three surgeries and 9 patients had had multiple surgeries before presentation. All patients (100%) had epiphora, 75 (64.1%) patients had associated discharge and 4 (3.4%) had persistent medial canthal swelling. Duration of symptoms following previous surgery was 1-6 weeks. Commonest cause of failure was incomplete sac exposure in 117/117 cases (100%). Other causes were cicatricial closure of ostium in 47 (40.1%), synechiae in 20 (17%), canalicular obstruction in 4(3.4%), lacrimal sac diverticulum in 3 (2.5%), nasal polyps in 2 (1.7%), concha with adhesion in 2 (1.7%), septal deviation in 2 (1.7%) cases. Meticulous and thorough sac exposure is the most important factor affecting surgical success. Comprehensive preoperative assessment of cases, meticulous surgical technique, and postoperative follow up are needed for successful outcomes.

A Chart Review for Epidemiology and Outcome of Fungal Bloodstream Infections Among Neonates in a Tertiary Care Hospital at North India

Background and Aims The risk of fungal bloodstream infection (BSI) and accompanying mortality in neonates varies widely in between centres depending on the region, the population characteristics and the risk factors. Methods This chart review of neonatal cases with fungal BSI admitted in a tertiary care teaching hospital in North India aimed to comprehensively investigate the epidemiology, profile of fungal species (and their susceptibility to various antifungal agents), risk factors, clinical profile and outcomes in these neonates. The study spanned over a one-year period, from September 2022 to August 2023, included all symptomatic neonates with positive blood cultures for fungal pathogen. Results Over one year, 24 out of 1,174 neonates at risk were diagnosed with fungal BSI, with a cumulative risk of 2.0 per 100 neonates. A peak in cases occurred in February. Candida pelliculosa was the predominant species (75% of isolates), while Candida albicans constituted 4.2%. Most isolates were sensitive to fluconazole, except for some fluconazole-resistant Candida pelliculosa (5.5%) and Candida tropicalis (25.0%), which remained susceptible to amphotericin-B and voriconazole. Around 60% of neonates were preterm, 40% had very low birth weight and 37% were small for gestational age. Nearly all had received prior broad-spectrum antibiotics, with 92% receiving prolonged courses over five days. Respiratory support, including intubation and mechanical ventilation, was used in 83% before onset of fungal sepsis. Intriguingly, all neonates had some invasive device in place for more than seven days. Mortality rate of 25% was observed, with preterm birth and gastrointestinal anomalies contributing to adverse outcomes. Conclusions This study confirms the ongoing shift in trend from albicans to non-albicans Candida infections in our region as well. A seasonal peak of fungal sepsis noted in the month of February hinted at potential seasonal variation or lapses in infection control practices during colder months. The analysis of trends in fungal BSI might hold a significance within neonatal intensive care units (NICUs) for the prompt detection of outbreaks. Simultaneously, understanding and analysing risk factors associated with fungal BSI are essential for targeted prevention.

MRNA expression of vitamin D receptor, calcium-sensing receptor, cyclin D1, and PTH in symptomatic and asymptomatic primary hyperparathyroidism.

The exact underlying mechanism for the differential clinical profiles of symptomatic and asymptomatic primary hyperparathyroidism (PHPT) patients has not been fully elucidated, and efforts to define the molecular mechanisms underlying the phenotypic heterogeneity of PHPT have been limited. The aim of this study was to explore the underlying molecular mechanisms involved in the pathogenesis of symptomatic and asymptomatic sporadic PHPT in Asian Indians. A prospective cohort study was conducted at a tertiary care hospital in North India. PHPT patients who underwent parathyroidectomy were included. The main outcome was the comparison of vitamin D receptor (VDR), calcium-sensing receptor (CaSR), cyclin D 1 (CD1), and parathyroid hormone (PTH) mRNA levels between symptomatic and asymptomatic PHPT patients and controls determined via quantitative real-time polymerase chain reaction (qRT-PCR). Forty-two PHPT patients were studied. The mean (SD) age was 49.7 (12.8) years. Twenty patients were asymptomatic. The median PTH levels were significantly greater in the symptomatic group than in the asymptomatic group (878 vs 653 pg/mL). CaSR and VDR mRNAs were significantly lower in both symptomatic and asymptomatic patients than in controls. CD1 and PTH mRNAs were significantly increased in symptomatic patients, but not in asymptomatic PHPT patients compared with controls. Symptomatic PHPT patients had significantly greater CD1 mRNA expression and reduced CaSR expression than asymptomatic patients. Symptomatic PHPT patients had significantly greater CD1 mRNA expression and lower CaSR expression than asymptomatic patients, underscoring the importance of the molecular mechanisms underlying the phenotypic heterogeneity of PHPT.

A Comparative Analysis of the Efficacy of Ginkgo Biloba and Caroverine in the Management of Idiopathic Tinnitus.

The sound sensation that is experienced in the ears or brain and is unrelated to any external sources of stimulus is known as tinnitus. Tinnitus Functional Index (TFI) is used to establish the presence of the condition and determine symptom severity, its impact on the patient's quality of life, thus in this study, we aim to compare the efficacy of caroverine and Ginkgo Biloba in the management of idiopathic tinnitus using TFI. This clinical study was conducted in at a tertiary care hospital in North India, for a duration of one year, among patients with chronic tinnitus. The sample size for this study consisted of 60 patients in each of three groups (caroverine, gingko biloba, and multivitamin). Assessments of TFI and pure-tone audiometry were performed to evaluate the efficacy of the two medications. The information pertaining to the subjects was kept anonymous and confidential. During data analysis, an association was significant for p value < 0.05. The patients in three groups were matched for the age, gender and duration of tinnitus. At 6 months of medication with Ginkgo Biloba, patients experienced a significant (p < 0.0001) decrease of 50.0% in tinnitus of moderate severity, and a complete resolution of severe tinnitus symptoms with a percentage change of -100.0%. In our study, Ginkgo Biloba Group has significantly improved the severity of idiopathic tinnitus. Tinnitus has diverse underlying mechanisms, can be a symptom of various underlying diseases, and is challenging to measure. Further research is warranted to validate and explore these treatment options further.

Sex-related Differences in Insulin Resistance in the Geriatric Population

Abstract Background: Diabetes mellitus significantly impacts long-term cardiovascular disease, increasing elderly mortality and morbidity. Half of elderly diabetics are asymptomatic, with vague symptoms. Insulin resistance (IR) and pancreatic beta-cell dysfunction are central to diabetes pathophysiology. Gender differences in IR and beta-cell function are increasingly recognized in diabetes research. Methods: In 18-month observational cross-sectional study focusing on elderly patients (60+) done at tertiary hospital in North India included 32 diabetic and 32 healthy controls. Fasting blood sample of eligible subjects were sent for hemogram, hemoglobin A1c (HBA1c), blood glucose, and insulin. IR and beta-cell function were calculated using the homeostasis model assessment (HOMA) model and analyzed using SPSS, with P &lt; 0.05. Results: The mean age of participants was 67.77 years and the average duration of having diabetes was 5.11 years. Median HOMA IR was significantly higher in cases compared to controls (4.23 vs 0.89, P &lt; 0.05), while HOMA β was comparable. HOMA IR decreased with longer diabetes duration, with a more rapid decline in female subjects compared to males. Subgroup analysis showed IR increased with age and was higher in females. Conclusion: Our research highlights gender-based differences in IR in the geriatric age group. Elderly women had higher IR compared to men. These findings are significant in understanding gender-specific metabolic differences and tailoring interventions. Further research with a larger sample size is warranted to corroborate these findings. Clinical Implication: This study addresses the gap in research on IR and beta-cell function in the elderly, particularly in India. This research can be compared with past studies on other age groups, aiding in the development of tailored diabetes treatments and improving therapeutic strategies for the elderly.

Mortality in type 1 diabetes mellitus: A single centre experience from the ICMR – Youth onset diabetes registry in India

IntroductionThe prevalence of youth onset diabetes is rising globally along with a greater burden of complications and mortality in them. The current study was undertaken to examine the mortality and causes of death in patients with youth onset diabetesregistered in a tertiary care hospital in North India. MethodsWe analyzed mortality and causes of death in 1088 patients with youth onset diabetes registered from 2006 to 2019 at University College of Medical Sciences, Delhi. Information of death was obtained telephonically or by home visit or from hospital records wherever available. Verbal autopsy according to ICMR questionnaire was performed and cause of death determined as per WHO ICD-10/11. ResultsAmong 898 youth onset type 1 diabetes mellitus (T1D) patients who had a mean follow up of 6.4 years, 105 deaths (11.6 %) occurred. Forty three percent of deaths had diabetes onset at 15 years or below, and 75.6 % had HbA1C > 10 %. Deaths occurred in 24.2 % within 2 years and in 53.6 % within 3 years of diagnosis. Chronic Kidney disease, infections and ketoacidosis were the commonest causes. ConclusionWe found poor glycaemic control and high mortality in people with youth onset T1D being treated at a tertiary care hospital in north India.

Problems/Issues in Blood Transfusion Process: A Focus Group Discussion (FGD) with Nursing Personnel in a Tertiary Care Center of North India

Background Blood and blood product transfusion is an essential component of the health care system. Nursing personnel constitute a significant aspect of the transfusion process as they are the last in the chain of the transfusion process to ultimately transfuse the blood and blood products to the recipient. Nurses face many problems/issues in this process. The present study highlights the problems/issues faced by them in the transfusion of blood and blood products. Objective To explore the problems/issues faced by nursing personnel related to blood and blood products transfusion process in a tertiary care hospital in North India. Methods A qualitative design was used. Three focused group discussions were conducted with 8–10 nurses in each group working in the Emergency Neurosurgery Ward of a tertiary care hospital in North India. Tools used were the sociodemographic and job profile of nurses and a focus group discussion (FGD) guide about blood and blood products transfusion. Each FGD session lasted for 15–20 minutes and data saturation was achieved after three FGDs. Colaizzi’s procedural steps were used to analyse the data. Themes and subthemes were generated. Results and Conclusion The problems/issues identified in the FGD were related to a lack of awareness regarding awareness, transportation, storage in the ward, thawing of fresh frozen plasma, problems in a blood bag, wastage of blood in case of children, inadequate nurse patients ratio, taking consent, Judicial request, proper prescription/orders, related to transfusion responsibilities, monitoring and documentation of blood, and blood products transfusion. The above problem/issues should be addressed and overcome to promote safe transfusion. It is recommended that regular In-service education programs should be planned for nursing personnel to update guidelines awareness, and the developed transfusion monitoring sheet should be implemented, to improve documentation and reduce transfusion errors.

Using Office-Based Zero-Degree Rigid Laryngoscopy to Predict Glottic Exposure in Microlaryngoscopy

OBJECTIVESPoor glottic exposure in microlaryngeal surgery can result in difficult instrumentation or incomplete surgery affecting surgical outcomes. Anticipating poor glottic exposure preoperatively allows surgeons to prepare adequately, ensuring successful surgery. This study aims to determine diagnostic utility of 4mm zero-degree rigid endoscopic laryngeal examination as a tool to predict glottic exposure in microlaryngoscopy. STUDY DESIGNCross-sectional observational study. METHODSThis is a cross-sectional study, conducted from 1st March 2022 to 30th November 2023 at the ENT department of a tertiary care hospital in North India. Total of 35 adult participants who underwent MLS were consecutively enrolled. Participants in whom the lesion was obscuring the anterior commissure and in whom gag reflex prevented complete 0-degree laryngeal examination were excluded from the study. All enrolled participants were evaluated preoperatively with a 4 mm rigid zero-degree laryngoscopic examination and the laryngoscore. The total score on the laryngoscore proforma was calculated and recorded. The visualized glottis on zero-degree laryngoscopy was graded as follows: Grade 1, anterior commissure and the entire glottic plane can be seen; Grade 2, glottis can be seen but not the anterior commissure; Grade 3, only the posterior half of the glottis can be seen; Grade 4, only the arytenoids can be seen. The glottic exposure on microlaryngoscopy was also assessed using the same grading system. Depending on the exposure of the anterior commissure, the cohort was divided into two groups: good laryngeal exposure and difficult laryngeal exposure. Receiver operating characteristic curve analysis was done to evaluate the predictive accuracy of 0-degree laryngoscopy and to compare it with laryngoscore. RESULTSA total of 35 adults participated in the study, of which 28 were men (80%) with median (range) age of 45(24-76) years. The area under the curve for 0-degree laryngoscopy and laryngoscore were 0.97 and 0.83 respectively. Optimal cutoff value (sensitivity, specificity) to identify difficult laryngeal exposure for 0-degree laryngoscopy and laryngoscore were 1.5 (93.3%,100%) and 4.5 (80%,85%) respectively. CONCLUSIONZero-degree laryngoscopy is an excellent predictor of glottic exposure on microlaryngoscopy. Its accuracy surpasses that of the laryngoscore in identifying an ideal candidate for microlaryngoscopy.

A multicentre study to evaluate the diagnostic performance of a novel CAD software, DecXpert, for radiological diagnosis of tuberculosis in the northern Indian population

Tuberculosis (TB) is the leading cause of mortality among infectious diseases globally. Effectively managing TB requires early identification of individuals with TB disease. Resource-constrained settings often lack skilled professionals for interpreting chest X-rays (CXRs) used in TB diagnosis. To address this challenge, we developed “DecXpert” a novel Computer-Aided Detection (CAD) software solution based on deep neural networks for early TB diagnosis from CXRs, aiming to detect subtle abnormalities that may be overlooked by human interpretation alone. This study was conducted on the largest cohort size to date, where the performance of a CAD software (DecXpert version 1.4) was validated against the gold standard molecular diagnostic technique, GeneXpert MTB/RIF, analyzing data from 4363 individuals across 12 primary health care centers and one tertiary hospital in North India. DecXpert demonstrated 88% sensitivity (95% CI 0.85–0.93) and 85% specificity (95% CI 0.82–0.91) for active TB detection. Incorporating demographics, DecXpert achieved an area under the curve of 0.91 (95% CI 0.88–0.94), indicating robust diagnostic performance. Our findings establish DecXpert's potential as an accurate, efficient AI solution for early identification of active TB cases. Deployed as a screening tool in resource-limited settings, DecXpert could enable early identification of individuals with TB disease and facilitate effective TB management where skilled radiological interpretation is limited.

A Retrospective Study on Analysis of Donor Deferral Characteristics of Plateletpheresis at a Tertiary Care Hospital in North India

A Retrospective Study on Analysis of Donor Deferral Characteristics of Plateletpheresis at a Tertiary Care Hospital in North India

Comparison between 80-microns versus 100-microns flap femtosecond LASIK for correction of myopia and myopic astigmatism.

This study aimed to compare the safety, efficacy, and visual outcomes of 80-microns LASIK versus 100-microns LASIK in managing myopia and myopic astigmatism. The study was conducted at a tertiary care hospital in North India. This was a prospective contralateral eye study that included patients with myopia and myopic astigmatism seeking refractive correction. The eligibility criteria included normal corneal topography, an epithelial thickness less than 60 microns, a calculated percentage tissue ablation (with 100-microns flap) less than 40%, a calculated residual stromal bed thickness (with 100-microns flap) more than 300 microns, and willingness to participate and follow up. Patients with glaucoma, cataracts, other visually disabling ocular pathologies, and a history of past ocular surgery were excluded. All patients underwent LASIK with 80-microns LASIK in one eye and 100-microns LASIK in the other eye. The patients were followed up for 6 months, and the results were analyzed. The study included 216 eyes of 108 patients. The mean preoperative spherical equivalent in the 80-microns group and the 100-microns group was -3.53 ± 1.81 and -3.69 ± 1.32 diopters, respectively (P = 0.78). The mean 6 months decimal postoperative UCVA was 0.98 ± 0.13 in the 80-microns group and 0.97 ± 0.14 in the 100-microns group (P = 0.99). The postoperative change in the higher-order aberration profile was comparable in both groups (P = 0.78). The percentage tissue ablation was significantly lower in the 80-microns group (P = 0.002). The incidence of flap micro striae and OBL was higher in the 80-microns group, while neither of these had any visual implications. The study concluded that 80-microns LASIK is an efficacious and safe alternative to 100-micron LASIK, especially useful in patients with higher myopia.

The Role of Perceived Stigma and Social Support in Predicting the Quality of Life in Adult Patients living with HIV/AIDS attending ART centre in a tertiary care hospital in North India

Background: HIV/AIDS remains an international public health concern causing enormous morbidity and mortality. Although antiretroviral therapy (ART) has improved the outlook for patients living with HIV/AIDS (PLWHA), many still face psychosocial challenges that negatively impact their quality of life (QOL). HIV related perceived stigma and social support have a bearing on their QOL. Aims and Objectives: To assess the QOL of PLWHA attending an ART centre in Jammu, India and to assess the role of perceived stigma and social support in predicting QOL in this population. Material and Methods: This cross-sectional study was conducted at the ART centre of Government Medical College, Jammu for 8 months. A sample of 300 PLWHA was selected using a convenience sampling strategy. Data was collected using questionnaires assessing socio-demographic profile, QOL (POZQOL), perceived stigma (12-item short version of the HIV stigma scale), and perceived social support (MSPSS). Results: Mean scores for various domains of QOL i.e. Psychological, Social, Health concerns and Functional were 10.79±3.76, 10.18±3.70, 8.81±3.16 and 10.76±3.35 respectively. Perceived Stigma and social support were found to be significantly correlated with all QOL domains. Conclusion: QOL of PLWHA was enormously influenced by various socio-demographic factors, stigma, and perceived social support. Targeted interventions to reduce stigma, strengthen social support systems can improve QOL for PLWHA.

Analysis of Rates and Reasons of Whole Blood Donor Deferral at a Tertiary Care Hospital

Background: Safe blood donors form the backbone of safe blood transfusion services. Donor eligibility policies are a critical layer of blood safety designed to ensure selection of healthy donors and to protect recipients from any harm. Aim: Analysis of rates and reasons of blood donor deferral at a tertiary care hospital in north India. Methodology: The present study is a retrospective study done in a tertiary care centre in Jammu region. The data was collected over a period of 2 years from January 2018 to December 2019.The various causes for deferral of the donor from donation were collected from donor deferral register which was recorded using regular questionnaire- based interview in the registration card followed by thorough medical history elicitation and minimal physical examination. Result: The total number of potential donors screened during the study period were 4728, out of which 532 were deferred because of various reasons. The deferral rate was calculated to be 11.25%.The mean age of deferred donors was 31.2±8.4 years. Most common cause for deferral both among males and females was low Haemoglobin level (less than 12.5gm %) i.e., 28.58%, followed by alcohol intake in last 24 hrs i.e., 11.09%, history of medication (6.2%); medical causes (5.83%); and Jaundice 5.26%. Deferral rate was found to be more among replacement donors (18.98%) than voluntary donors (6.62%). The permanent deferral was 16.65%. Conclusion: The deferral rate in this study is comparable to the deferral rates in other centres. The data will be very essential and helpful in testing the applicability of donor selection criteria. By identification of the causes for temporary deferrals, appropriate measures can be put in place to motivate and inform these potential donors to return for blood donation at a later date after the underlying cause has been rectified. Keywords: Blood donor deferral, permanent deferral, temporary deferral