Needle Prick Injuries Research Articles

A resident’s sharp learning curve: Post-needle stick injury arteriovenous fistula of the finger

Iatrogenic vascular injuries can be encountered during diagnostic or therapeutic interventions. Traumatic arteriovenous fistulas (AVFs) occur due to penetrating injury involving contiguous arteries and veins. We report a case of a 27-year-old postgraduate trainee who presented with swelling over her left middle finger for 5 months following a needle prick injury at the same site 1 year back, which was diagnosed with ultrasound and dynamic magnetic resonance imaging angiography. Endovascular embolization is avoided in AVFs of the hand due to the risk of distal ischemia, and surgical excision with reconstruction is the preferred treatment.

Modelling Safety Behaviour from Safety Climate among Healthcare Workers in Benin City

It is counter-intuitive that the healthcare industry, whose mission is the care of the sick, is itself a “high-hazard” industry for the workers it employs. Injuries at the workplace are related to unsafe work behaviour and unsafe work procedures. This research work concerns modelling safety behaviour from safety climate among healthcare workers in Benin city. The model incorporates safety climate constructs as independent variables and safety behaviour as the dependent variable. A questionnaire survey obtained 277 responses from multiple healthcare facilities in Benin City. A purposive/judgmental sampling approach was adopted to get respondents that fit the study. Multiple regression analysis was appropriate in building the model. 10 variables were originally collated but only 7 variables with factor loadings greater than 0.6 were retained after principal component analysis, and only 5 variables were statistically significant for the model development. The beta coefficients were used to study the impact of each construct on the safety behaviour of employees. As a result, safety climate constructs like management commitment, supervisory environment, workers’ involvement, personal appreciation of risk, and supportive environment, were substantially correlated with the safety behaviour of employees with 15.13, -10.309, 5.647, 1.649, -12.288 beta coefficients respectively. The overall R2 determination coefficient was 0.897 which depicts the model explains 89.7% of the variance in safety behaviour. This model has enormous potential to inspire healthcare management to facilitate safety behaviour and to successfully monitor the safety of healthcare sector workers. This research reveals that slips, trips, falls, needle prick injuries, cross-contamination, infections and diseases, mental stress, exposure to x-ray radiation, direct contact with contaminated specimen, musculoskeletal disorder as the most recurring accidents/near misses experienced as a result of unsafe behaviour of healthcare workers in their organizations. This research also reveals unsafe behaviours such as improper use of PPE, no use of PPE, taking shortcuts, verbal abuse, unsafe injection practice, working long hours, negligence and carelessness as some of the unsafe behaviours of healthcare workers in their organizations. Findings from this research reveals shortage of staff, fines and associated legal fees, retraining of new staff as some of the cost and consequences of unsafe work behaviour by healthcare workers to their organizations. Management should concentrate on more significant constructs to achieve the optimal and successful safety performance of healthcare workers.

The comparative study of skin staples and polypropylene sutures for securing the mesh in Lichtenstein's tension-free inguinal hernia repair in HIV and hepatitis (B and C)-positive patients: a randomized controlled trial.

The mesh fixation in the Lichtenstein's hernioplasty was traditionally performed with polypropylene sutures. A modification of this technique uses skin staples for securing the mesh. Using polypropylene sutures may increase the needle prick injuries (NPIs) in HIV and hepatitis-positive patients. This is the first study in India to compare the efficacy of anchoring the mesh with skin staplers and polypropylene sutures in hepatitis and HIV-positive patients. Fifty-two seropositive patients undergoing sixty repairs were randomized into two groups. In the control group polypropylene mesh was secured with polypropylene sutures and the skin was closed with ethilon. In the study group polypropylene mesh was secured with skin staples and the skin was closed with staples from the same stapler. Duration of surgery, postoperative complications, NPIs, recurrences and costs were compared. The operation was significantly shorter when staples were used (median 46 vs. 57 min, P<0.00001). There was no significant difference in the incidence of postoperative complications. The NPIs was statistically significant in the suture group as compared to the stapler group (P<0.05). Using skin staples to secure the mesh in Lichtenstein inguinal hernioplasty significantly reduced the duration of surgery. It was as effective as conventional mesh fixation with polypropylene with added advantages to reduce the operating time, duration of exposure to infected blood, and the NPIs significantly in HIV, hepatitis B virus and hepatitis C virus-positive patients.

Low uptake of hepatitis B vaccination among healthcare workers in primary health facilities in Mwanza region, North-Western Tanzania.

Despite the availability of hepatitis B vaccines (HBV) in Tanzania, their uptake among healthcare workers (HCWs) in high-level facilities, such as tertiary hospitals where the vaccines are available, is low. However, their uptake among HCWs in primary health facilities remains understudied. The lack of this information limits the scaling up of HBV vaccination programs. A cross-sectional analytical study was conducted between June and July 2022 among HCWs in the Misungwi and Ilemela districts, which were purposefully selected. The sample size was calculated using the Taro Yamane formula, and data were collected using a self-administered questionnaire and analyzed using IBM SPSS® version 25. A total of 402 HCWs were recruited, their mean age was 34.9 ± 7.77 years, and only 18% (76/402) reported being fully vaccinated. HCWs in Ilemela showed higher uptake (χ2 = 23.64, df = 1, p = 0.00) of the vaccine than HCWs in Misungwi. Being male (aOR = 2.38, 95% CI 1.28-4.45, p = 0.006), working in an urban setting (aOR = 5.75, 95% CI 2.91-11.35, p = 0.00), and having an employment duration of more than 2 years (aOR = 3.58, 95%CI 1.19-10.74, p = 0.023) were significantly associated with higher odds of vaccination. Moreover, high perceived susceptibility to HBV infection (aOR = 2.20, 95% CI1.02-4.75, p = 0.044) and history of needle prick injuries (aOR = 6.87, 95%CI 3.55-13.26, p = 0.00) were significantly associated with higher odds of HBV vaccination. Low uptake of HBV vaccine among HCWs in primary health facilities was observed with a noteworthy difference between rural and urban settings. Therefore, advocacy campaigns and resource mobilization toward the promotion of HBV vaccination in primary health facilities are pivotal.

Prevalence of Work-Related Musculoskeletal Disorders and Its Effects amongst Nurses in the Selected Intellectual Disability Unit of the Limpopo Province.

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism.

EFFICACY AND SAFETY OF KNOTLESS BARBED SUTURES IN CAPSULAR CLOSURE FOLLOWING DISTAL FEMUR FRACTURE FIXATION.

Good wound closure is an important step in management of distal femur fracture to prevent infection and faster rehabilitation. Knotless barbed sutures can save time and distribute wound tension evenly. However, its role in terms of functional outcome, closure time, and postoperative complications has not been studied in a distal femur fracture. A total of 47 patients aged more than 18 years of distal femur fracture treated with distal femur locking plate were randomized either into either barbed or traditional suture groups. in the barbed group, capsular wound closure was carried out with 2-0 bidirectional barbed knotless sutures (Quill SRS® PDO, Angiotech, Vancouver, BC, Canada). In patients assigned to group B, capsular closure was done with 1-0 Vicryl® (Ethicon inc. Somerville, NJ) and 5-0 Ethibond® alternatively. The mean flexion at the knee joint was 105.7±15.6 degrees in the study group while it was 110.4±13.7 in the control group (p= 0.2133). Mean estimated closure time was significantly shorter in the study group as compared to the control group (p<0.05). Cases of needle prick injury were higher in traditional suture group. Patients developed stitch abscess and superficial infection in both groups. However, the difference in incidence between the two was not statistically significant. Barbed suture is an efficient method of wound closure. It reduces wound closure time with similar complication rate as with use of conventional sutures. Evidence Level II; Randomized Clinical Trial.

Hepatitis C virus infection in garbage pickers of different districts of Khyber Pakhtunkhwa, Pakistan.

Hepatitis C Virus (HCV) is a significant health problem worldwide, especially in developing countries. Medical municipal waste pickers are at higher risk of exposure to infectious viral diseases. The current study aimed to explore HCV infection in different waste collectors. The objective of the current study was to investigate the incidence of HCV infection and associated risks among the waste collectors of five districts of Malakand Divisions and Bajaur district (old Bajaur agency) Khyber Pakhtunkhwa, Pakistan. During the study period (May-December 2017), blood samples were collected from 300 waste handlers and tested for anti-HCV antibodies using the ICT method. The results obtained from the data were analyzed statistically using SPSS 20 version. In this study, we included 300 males aged 9 to 76 years, which means 27.31 ± 11.9 years. The prevalence of HCV was 3.3% (10/300). Among the positive cases, HCV infection was slightly higher in married persons than in unmarried (3% vs. 0.33%, %, PV < 0.01, odds ratio 4.73, 95% CI =2.2-9.8). A high infection rate was reported in waste scavengers from the district Swat, followed by those in the Bajaur district. Needle prick injuries and barehanded practices were the significant risk factors for infected cases. Our findings highlight the need for personal protective equipment. It is suggested that all garbage collectors should be trained in handling waste to reduce infection.

Occupational Hazards among Health Workers in Hospitals of Mukalla City, Yemen

Background: Occupational health is a neglected public health issue among healthcare workers in developing countries like Yemen and they may expose them to various forms of hazards, which have had negative consequences on their wellbeing and performance at work. Objective: The study aims at exploring the forms of occupational health hazards prevalence and methods to mitigate these hazards among Health Care Workers (HCW) in governmental hospitals in Mukalla city. Methods: It is a cross-sectional study conducted among health workers in the main hospitals in Mukalla city in Hadhramout province in eastern Yemen. The sample size is calculated statistically as 366 workers from different categories including doctors, nurses and lab technicians. A sample of 391 workers were selected randomly who were distributed to be representative and proportional to the size of each professional category. Results: The prevalence of biological hazards among the healthcare workers accounted for 298 (76%) whereas the non-biological hazards accounted for 306 (78%). The most prevalent biological hazards are needle prick injury (80%) followed by exposure to contact with contaminated material (75%), while the most frequent non-biological hazards are back pain (79%) followed by extra-time work (72%). In logistic regression age, gender and duration of work and professional category have significant association with exposure of health workers to biological hazards while only gender is the only variable associated with non-biological hazards. Conclusion: There is a high prevalence of occupational hazards (biological and non-biological) among health workers in hospitals of Mukalla city. A prevention and infection control and patient safety programs are highly recommended in Mukalla hospitals to save health workers and patients.

Knowledge and preventive practice on needle prick injury among ANMs working at selected public health facility of Uttar Pradesh

BACKGROUND: Needle pricks injury (NPI) is the most frequent occupational hazard for nurses and other health care workers (HCWs). It is the commonest route by which blood-borne viruses and/ or infections transmit from patients to healthcare workers. Good knowledge and safe injection practices are important concept for ANM’s. AIM AND OBJECTIVE: (1) To assess the level of knowledge on needle prick injury among ANM’s. (2) To assess level of preventive practice on needle prick injury among ANM’s. (3) To find out the association between knowledge and preventive practice of needle prick injury with selected demographic variable. MATERIALS AND METHODS: Study adopts quantitative approach and Non-experimental descriptive exploratory design was used to assess the knowledge and preventive practice of ANMs regarding needle prick injury. The population for the study was registered ANM’s working at sub center level in Etawah district. Probability simple random (lottery method) sampling technique is adopted. RESULT AND DISCUSSION: Study observed that knowledge regarding needle prick injury among ANM’s had a wide range i.e. 40% ANM had good knowledge, 50% ANM had average knowledge. ANM’s Practice observation finds out that majority (40%) ANM were belonging to good practice and 46.66% were belonging to average practice. Study find out that that association of knowledge level in ANM worker is significant with age and work experience (p&lt;0.05). Association of preventive practice level in ANM worker was significant with duration of course (p&lt;0.05).

Incidence and Knowledge of Occupational Health Hazards in Prosthodontic Practice at a Tertiary Hospital in Islamabad

Aim: To explore various occupational hazards and assess the level of awareness among dental students Methods: Data was prospectively collected from 80 under-graduate and post-graduate students on voluntary basis. A questionnaire pertaining to the occupational hazards was handed over to the subjects and their responses were then tabulated for statistical analysis. The study design was descriptive cross sectional. Results: Among 80 participants, chemical burns was reported by 18(22.5%), thermal burns via hot instrument by 72(90%), injuries from spirit lamp by 64(80%) , needle prick injury by 37(46.3%), injuries from sharp instruments by 74(92.5%), injuries from micro-motor by 48(60%), allergic dermatitis by 25(31.3%), hot material injury by 63(78.8%) and eye irritation by 31(38.8%). While performing daily procedures and handling patients, 100% wore gloves, 95% of the participants wore masks, 32% used protective eye wear, 97.5% followed safety protocols and 92.5% washed their hands post-operatively. Adequate knowledge regarding occupational safety was reported by 100% of participants. The source of knowledge was found to be electronic media among 50% participants, social media among 27.5% participants and social media among the remaining 22.5%. Alarmingly, only 7.5% participants had received training regarding occupational safety. 48.8% followed occupational safety protocols and 93.8% were aware of the system that existed in case of any accidents happened. Conclusion: The findings of this study are consistent with the previous studies indicating a high risk of occupational health hazards in dentistry. Keywords: Occupational accidents, Prosthodontics, Allergic dermatitis

Risk of Exposure, Perception and Vaccination Status of Chronic Viral Hepatitis among Health Care Workers in Benue State, North Central Nigeria

Health care workers are high-risk group for contracting hepatitis B and C virus infections. Hepatitis B and C can be contracted in the hospital setting by needle prick injury, contact with blood (and body fluids) and during invasive medical procedures. This study aims to assess the risk of exposure, the concern or perception of healthcare workers about getting infected (with HBV and/or HCV) from the workplace and the level of HBV vaccination uptake among them. The study was carried out during a capacity building workshop organized for health care workers from all the Local Government Areas in Benue State. A self-administered questionnaire was distributed to 168 participants in attendance, after obtaining verbal consent. One hundred and thirty-eight (138) questionnaires were properly filled and returned, 115 (83.3%) have had needle prick injury, 127 (92%) have had blood spilling on them and 118 (85.5%) have been involved in the management of hepatitis patients. One hundred and nineteen (86.2%) were afraid of contracting hepatitis infection from their place of work, 133 (96.4%) were aware of hepatitis B vaccine for adult, 87 (63%) had received at least one dose of hepatitis B vaccine but only 56 (40.6%) received the complete three doses. Health care workers in Benue State are aware of the risk of contracting viral hepatitis at their workplace and are concerned about this risk. However, the uptake of hepatitis B vaccination among them remains poor.

ADHESIVE GLUE Vs SUBCUTICULAR SUTURING IN THYROIDECTOMY

BACKGROUND: Suturing has been the commonest method of surgical wound closure that is being practiced because of good results of skin closure. With adhesive glue being an alternative for skin closure which is less time consuming, comfortable, without the risk of needle prick injury and leaves behind a cosmetically acceptable scar. OBJECTIVES: The aim of this study is to compare subcuticular suturing versus adhesive glue for skin closure in thyroidectomy with respect to clinical outcome which included postoperative pain, wound complications, wound dehiscence and cosmesis. MATERIALAND METHODS: This prospective study of 100 cases of skin closure using subcuticular suturing versus adhesive in thyroidectomy was carried out at BGS Global institute of medical science and Hospital, Bangalore with the aim of comparing suturing versus adhesive glue, with respect to clinical outcome which included postoperative pain, wound complications, wound dehiscence and cosmesis. RESULT: 100 patients divided into 2 groups, randomly underwent subcuticular suturing and adhesive glue skin closure. Post- operative pain was less in glue group (p value &lt;0.001) and wound complications were comparable in both groups. CONCLUSION: Octylcyanoacrylate provides an effective and reliable means of skin closure and yields similar cosmetic results as with subcuticular skin sutures. The incidences of wound complications are comparable in both the groups. However the severity of postoperative pain is lesser in the adhesive group.

Occupational Hazards among Health Workers in Hospitals of Mukalla City, Yemen

Background: Occupational health is a neglected public health issue among healthcare workers in developing countries like Yemen and they may expose them to various forms of hazards, which have had negative consequences on their wellbeing and performance at work. Objective: The study aims at exploring the forms of occupational health hazards prevalence and methods to mitigate these hazards among Health Care Workers (HCW) in governmental hospitals in Mukalla city. Methods: It is a cross-sectional study conducted among health workers in the main hospitals in Mukalla city in Hadhramout province in eastern Yemen. The sample size is calculated statistically as 366 workers from different categories including doctors, nurses and lab technicians. A sample of 391 workers were selected randomly who were distributed to be representative and proportional to the size of each professional category. Results: The prevalence of biological hazards among the healthcare workers accounted for 298 (76%) whereas the non-biological hazards accounted for 306 (78%). The most prevalent biological hazards are needle prick injury (80%) followed by exposure to contact with contaminated material (75%), while the most frequent non-biological hazards are back pain (79%) followed by extra-time work (72%). In logistic regression age, gender and duration of work and professional category have significant association with exposure of health workers to biological hazards while only gender is the only variable associated with non-biological hazards. Conclusion: There is a high prevalence of occupational hazards (biological and non-biological) among health workers in hospitals of Mukalla city. A prevention and infection control and patient safety programs are highly recommended in Mukalla hospitals to save health workers and patients.

Knowledge, Compliance and Determinants of Use of Standard Precautions for Infection Control among Health Care Workers – A Teaching Hospital Based StudyKnowledge, Compliance and Determinants of Use of Standard Precautions for Infection Control among Hea

Introduction: Standard Precautions, which are easily implementable and universally acceptable interventions, can help reduce the transmission of infections in the health care setting. However, knowledge and compliance with regard to Standard Precautions remains unsatisfactory. Materials and Method: This cross sectional study was conducted on 200 health care workers (HCWs) at ESIC Medical College &amp; Hospital, Faridabad. A self-administered structured questionnaire with specific subsections to assess knowledge, attitude and practice of Standard Precautions was used for data collection. Regression analysis was used to analyze the relation between knowledge, attitude and compliance. Chi Square test was used to determine relation between various determinants and the knowledge and practice of Standard Precautions. Results: Mean knowledge, attitude and compliance scores among HCWs were 11.47 + 4.16, 7.09 + 1.46 and 10.72 + 2.57 respectively. A moderately positive correlation was observed between knowledge and attitude scores (r=0.421, p&lt;0.001). Mean knowledge scores were higher for females, higher professional posts, those with previous Hepatitis B immunization and those with history of recent occupational exposure. Compliance scores were higher for females, for those with more professional post and in those with history of recent needle stick injury. A significantly greater number of females (p=0.02), trained HCWs (p=0.003), doctors &amp; nurses (p=0.003), Hepatitis B immunised personnel (p=0.003) and those with history of recent occupational exposure (p&lt;0.001) within the past 1 year had satisfactory knowledge scores. Similarly, significantly more number of female HCWs (p=0.004), nurses (p=0.001), experienced HCWs (p=0.01), and those with history of recent needle prick injury (p=0.04) achieved satisfactory compliance scores. Conclusion: The knowledge and compliance of Standard Precautions is generally poor. Pre- induction and periodic in- house training in Standard Precautions should be mandatory for all health care workers along with compulsory Hepatitis B immunization to reduce the risk of occupational exposure in the health care setting.

Evaluation of non-radiation occupational hazards faced by radiologists

Background: Radiologist perform tedious task of reporting in this fast growing health sector. The present study was conducted to determine non-radiation occupational hazards faced by radiologists.Materials & Methods: The present study was conducted on 114 radiologists who agreed to participate in the study. Information regarding film based versus workstation reporting, working hours, musculoskeletal injuries, depression, the causes of stress etc. was recorded to assess various mental health issues. Results: Forty radiologists had >10 years of experience, 50 had 5-10 years and 24 had 1-5 years, 50 were working n USG only, 34 predominantly workstation based and 30 predominantly film based, 50 used to work >70 hours per week, 39 between 40-70 hours and 25 less than 25 hours per week. Various non- radiation occupational hazards were neck pain in 78, shoulder pain in 65, wrist pain in 96, elbow pain in 53, tenosynovitis in 68, carpal tunnel syndrome in 34, chronic eye strain in 70, needle prick injury in 25, varicose veins in 35, depression in 60 and burnout in 52 radiologists. The difference was significant (P< 0.05). Conclusion: Authors found that various non- radiation occupational hazards such as neck pain, shoulder pain, wrist pain, tenosynovitis, carpal tunnel syndrome, chronic eye strain, varicose veins and depression

Occupational exposure to blood and body fluids and use of human immunodeficiency virus post-exposure prophylaxis amongst nurses in a Gauteng province hospital.

BackgroundHealthcare facilities in South Africa are confronted by several challenges arising from Human immunodeficiency virus (HIV) and acquired immune diseases syndrome infection pandemic. All categories of nurses continue to experience accidental occupational exposure to blood and body fluids (BBFs) of patients who are HIV-positive. Studies conducted revealed that nurses fail to report the occurrence of the exposures. This represents a serious challenge because they contract HIV infections whilst in the process of helping others.ObjectivesThe purpose of this study was to determine the occupational exposures and use of HIV post-exposure prophylaxis (PEP) amongst nurses at the selected tertiary academic hospital, Tshwane district, Gauteng province, South Africa.MethodsA quantitative descriptive study was conducted with 94 male and female clinical nurses, using a self-administered questionnaire that facilitated collection of biographical data, occupational exposures to BBFs and use of HIV PEP. The data analysis included univariate and bivariate descriptive analyses.ResultsOf the 94 nurses, n = 40 (43%) had been exposed to BBFs, either through sharp or needle prick injuries or splashes but only 16 (46%) of them reported the incident. Nurses were not keen to report accidental occupational exposures to BBFs in their own facility and rather sought HIV PEP outside their workplace. They gave different reasons for their behaviour. For example, ‘I did not know where to report’.ConclusionOur study highlights the gaps that exist in reporting occupational exposure to BBFs and obtaining HIV PEP. Therefore, we recommend evaluation of these occupational exposures to BBFs and the management thereof, as well as to address the identified problems.

Proportion of needle stick injury and its characteristics among nursing staffs in a tertiary care teaching hospital in Trivandrum, South India

Introduction: A cross-sectional study was conducted among health care workers (Nurses) at a tertiary care hospital in Trivandrum, Kerala to study the proportion of needle stick injury and associated factors. A semi structured questionnaire was used to collect data from the study participants at their work place. Participants were asked to recall needle stick injuries (NSIs) in the preceding 6 months and definition of needle stick injury was formulated. Factors such as work experience, type of procedure, action taken following injury etc were also studied. Results: The prevalence of NSIs was 94(47%). Mean age of 200 participants was 32.8 years (+ 6.8), all were female. Emergency department accounted for highest (62.8%) of NSIs. & it was maximum (42.6%) during injection procedure. Heavy work load (37.2%) followed by inattention (32%) were prime causes. Following injury 34% of nurses washed injury site with soap & water and applied antiseptics as well. usage of personal protective equipment(PPE) was 84%. Prime causes for not using PPEs were lack of supply and inappropriate size of gloves respectively. Usage of PPEs were found to be significant in preventing NSIs. Conclusion: Prevalence of NSI is high and measure for safety concern. There is urgent need of close monitoring and implementation of uniform NSIs programme like safe practices, safe disposal of sharps, mandatory reporting of needle stick injury at work station. Provision of post exposure prophylaxis following NSIs. Limitation: Small sample size, purposive-sampling and impact of information broacher regarding NSIs could not be accessed. Keywords: Nurses, Cross-sectional study, Needle prick injury, Proportion

A cross-sectional observational study to assess the awareness regarding needle prick injuries among health care providers of a tertiary care teaching hospital in Madhya Pradesh, India

Background: Health care workers (HCW) are at risk of an occupational exposure to blood borne diseases like HIV and Hepatitis B through accidental needle stick injuries. This study was conducted to assess the awareness regarding needle prick injuries among health care providers and their exposure to NSIs in a tertiary care medical college hospital with 750 bed capacity.Methods: This cross sectional observational study was conducted on 300 voluntarily participated HCWs out of total 650 HCWs. A semi structured questionnaire was used to assess their knowledge about exposure to blood and body fluids, needle stick injuries and associated risks and post exposure prophylaxis. Details of previous exposures to NSIs in last one year (2017-18) were also asked and their opinion about role and responsibilities of hospital administration for management of NSI was also recorded.Results: More than 90% HCWs were aware of exposure to blood and body fluids, 80.7% were aware of needle stick injuries, all 100% were aware of transmission of HIV and Hepatitis B from NSis and 78% were aware of post exposure prophylaxis. 97 cases of NSIs occurred in last one year which was higher than estimated EPInet data. Injection needle was most commonly (93.8%) involved in causing accidental NSIs.Conclusions: Practice of universal precautions and standard injection procedures by HCWs should be followed and education, training, and group insurance should be provided by hospital administration for prevention of NSIs.

A prospective comparative clinical study on modified screw retained arch bar (SRAB) and conventional Erich's arch bar (CEAB).

Intermaxillary fixation (IMF) is commonly performed in the management of facial skeleton fractures. Various conventional methods like Erich's arch bar and Ivy eyelet wiring are the most commonly employed methods for achieving IMF, but they have their own disadvantages. Conventional Erich's arch bar (CEAB) has been modified recently by making perforations in the spaces between the winglets and securing the arch bar using 1mm screws. IMF using intraoral modified screw retained arch bar (SRAB) has been introduced for the treatment of mandibular fractures. The aim of this study was to compare the efficacy, advantages, disadvantages, indications, and potential complications associated with CEAB versus modified SRAB in the management of mandibular fractures. A randomized prospective study included 20 patients with mandibular fracture who were randomly allotted to two groups. Group A patients received modified SRAB and group B patients received CEAB. The parameters considered were time taken to place the arch bar, perforation in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, and needle (wire) stick injuries during IMF. The mean time taken for arch bar placement was 27.20min with modified SRAB as compared with 82.50min with CEAB. Incidence of glove perforations was more in group B patients. Oral hygiene status was good in 90% of the patients from group A whereas it was 100% fair in group B patients. This study has shown that both the techniques achieve satisfactory IMF with post-operative occlusion. IMF with modified SRAB reduces the operating time and the incidence of the needle (wire) prick injuries. But modified SRAB has its own limitations in spite of its ease of application.

Clinico-epidemiological study of iatrogenic cutaneous manifestations in neonates in intensive care unit in a tertiary care hospital

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Neonatal dermatology, by definition, encompasses the spectrum of cutaneous disorders that arise during the first four weeks of life ranging from from physiological and transient to grossly pathological lesions in the skin of a neonate. The aim and objectives of the study were to determine the quantum of iatrogenic problems which can be minimized and prevented.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 1000 neonates admitted in the tertiary care NICU of JJM Medical College were examined and spectrums of pathological cutaneous lesions noted.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among 1000 neonates examined, 101 had iatrogenic cutaneous conditions which were commonly seen in day one of life in 48 neonates and least in newborns between 15-21 days. Skin lesions were commonly seen in full term neonates (59), followed by preterm (39) and post term (3) neonates.Among the iatrogenic injuries needle prick injury (83), thermal burns (12) and bronze baby syndrome (11) were most commonly were noted in LBW and the normal for weight neonates. A variety of other conditions which could not be categorized into any of the above categories accounted for 5 cases. These included albinism, Waardenburg syndrome, TORCH complex and Down’s syndrome and Goltz syndrome.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Iatrogenic cutaneous abnormalities among neonates are under reported, with no detailed studies on these variants. Genetic, neonatal, maternal, social and geographic factors seen to influence the patterns of neonatal dermatoses. Hence, it is important for a dermatologist and paediatrician to have a thorough knowledge and to distinguish various iatrogenic manifestations and to minimize the outcomes during their stay in NICU.&lt;/p&gt;