Percutaneous Injuries Research Articles

Magnetic resonance imaging classification in a percutaneous needle injury rat model of intervertebral disc degeneration

BackgroundDuring the development of disease-modifying intervertebral disc degeneration (IDD) drugs, the rat model of IDD is frequently used for disease progression assessment. The aim of this study was to describe a magnetic resonance (MRI) scoring system for the assessment of different disc conditions in puncture-induced IDD, allowing standardization and comparison of results obtained by different investigators.MethodsA total of 36 Sprague-Dawley rats were utilized in the present study. The animals were divided into two groups: a sham group and an IDD group caused by puncture. The rats in the IDD group were subsequently divided into six categories based on time frames, with five rats in each category. The sham group was divided into two sub-groups (n = 3) for 28 and 56 days, respectively. T2-weighted images of rats consecutively studied with MRI of the coccygeal discs were classified according to the time course using the corresponding histological data. Additional scoring of the micro-CT was employed to identify the progression of bone destruction of the rat model of IDD.ResultsA comparison of the MRI results between the sham group and the IDD group revealed a significant reduction in NP height, area, T2WI value, and DHI in the latter group (P < 0.05). The micro-CT results demonstrated that following acupuncture, there was a notable decline in the BV, Tb.N, and height of the coccygeal vertebra, while the BS/BV and Tb.Sp exhibited a significant increase (P < 0.05). The histological results were analogous to the MRI results, indicating a progressive exacerbation of IDD and a corresponding increase in NP score (P < 0.05). The results of the MRI were found to be consistent with those of the micro-CT and histological analyses (P < 0.05). The results of the study demonstrate a robust correlation between MRI analysis and histological findings. Live animals are employed for MRI analysis to improve experiment comparability. The reliability of the MRI scoring system ensures assessment of disease progression in live animals, while promoting cost savings and animal welfare by avoiding the sacrifice of animals at different times.ConclusionsThe described scoring paradigm has quantitatively been found to differentiate IDD disease progression in an in vivo rat model. Hence, we suggest employing it to evaluate the rat IDD model and assess the effects of treatments in this model.

The Incidence of Clinical Injuries among Undergraduate Dental Students: A Prevention Protocol

Dental students are frequently exposed to percutaneous injuries (PCIs) due to the nature of their clinical work, which involves sharp instruments and close patient contact. The COVID-19 pandemic further emphasized the need for stringent biosafety measures and the use of personal protective equipment (PPE). Despite these precautions, injuries remain prevalent, highlighting the need for comprehensive education and training in biosafety and infection control. This study investigates the incidence and causes of injuries among undergraduate dental students during clinical sessions. This study was conducted at the Department of Dentistry, National and Kapodistrian University of Athens, focusing on injuries reported from 2021 to 2024. Data were collected through self-reported clinical records. The primary variables assessed included the type of injury, the instrument involved, the clinical procedure performed, and the immediate actions taken post-injury. Serological testing was conducted on students and patients to assess the risk of the transmission of bloodborne pathogens. The findings reveal a high prevalence of injuries, with needles being the most common cause (51.4%), followed by other tools such as dental probes (25.7%) and burs (8.6%). The most frequent injury type is piercing (74.2%), primarily affecting the fingers (88.6%). Periodontal treatments, restorative procedures, and endodontic treatments are the main activities leading to injuries, with 17.1% of injuries being caused by each. No statistically significant results are recorded. Despite regular medical records for most patients treated by injured students, serological testing shows significant positivity rates for HCV and HBV. Notably, most injured students demonstrate their commitment to safety by adhering to recommended post-exposure protocols, including wound cleaning, disinfecting, and serological testing. Furthermore, the impact of COVID-19 heightened the importance of personal protective equipment (PPE) and reinforced occupational health standards. Our study highlights the critical need for enhanced biosafety awareness and training among undergraduate dental students to reduce injury risks.

Occupational percutaneous injuries and exposures at a dental teaching institution from 2017 to 2023

Background: All dental professionals face the risk of occupational percutaneous injuries and exposures. Previous studies have reported high incidents of percutaneous injuries among dentists. This study examined injury data over six years at a large teaching institution for trends to increase awareness and to design appropriate interventions to reduce injury rates. Method: Study injury data was collected for the department of employee and occupational health. The data was entered into an electronic incident reporting system from 2017-2023. Statistical analysis was performed with Openepi to determine injury trend by year and overall association by activity type. Result: There was a total of 168 injuries reported between 2017 and 2023. A majority of the injuries (54%) were caused by a needle or sutures followed by instruments at 41%. Most of the injuries (44%) occurred during treatment and while cleaning the surgical spaces at 15%. Only 13% of the injuries were attributed to handling or recapping needles. Chi-square test 0.2618 (p&gt;.05) indicated there was no significant difference between years and number of injuries. Overall chi-square p ( &lt; 0 .001) by activity type was significant indicating risk was not equal across all activities. Conclusion: Injuries declined during COVID-19 but soared back up in 2023. Needles, sutures, and instruments were the predominant source of injuries. Injuries occurred during treatment (43%), while cleaning the surgical space (15%) and while recapping or handling needles (13%). This study is the first step in understanding the trend and factors attributing to injuries to implement appropriate corrective actions. Further analysis should be conducted to identify specific procedures or clinical activities exposing employees to Occupational percutaneous injuries.

Perfil dos acidentes com exposição a material biológicoentre residentes e estudantes de medicina

Introduction: Resident physicians and medical students who suffered occupational accidents involving biological risks can present serious health problems. Objective: To describe occupational accidents involving exposure to biological material among medical undergraduates and residents at the State University of Campinas from 2011 to 2020. Method: This was a retrospective case series study conducted from the records of work accidents involving exposure to biological material that occurred among medical undergraduates and residents. Data were analyzed using the Statistical Analysis System (SAS) software, version 9.4. To check the association between the use of personal protective equipment and exposure route, the method Generalized Estimating Equations was used. Results: A total of 1,121 notifications were analyzed, of which 78.5% involved medical residents and 21.5% involved medical undergraduates. Most exposures were due to percutaneous injury (80.1%), the needle with lumen was the main causative agent (37.6%), and 49.0% accidents occurred during surgical procedures or sutures. The operating room and emergency unit had the highest number of accidents. It was evidenced association between accidents that occurred with exposure to the mucous membranes of eyes and non-adherence to eye protection (p&lt;0, 0001). Residents suffered more accidents in the first two years of residency (66.3%), whereas in medical undergraduate students, the prevalence was between the fifth and sixth year of the program (81.9%). Conclusions: Awareness and early education regarding the issue of safety in the work environment should be a priority in medical education, because they provide students with the necessary knowledge to protect themselves from occupational biological hazards.

IMF screws with orthodontic E chains as a novel technique for intermaxillary fixation

AbstractIntroductionEither in conservative or in surgical management of maxillo‐mandibular fractures, intermaxillary fixation (IMF) provides stable occlusion, while offering reduction in the fractured segments. Various techniques have been used for achieving IMF, among which Erich arch bar is the most conventional and routinely used technique. However, it poses a risk of percutaneous injury to the surgical team with every wire used in the technique, causes trauma to the periodontium of the teeth secured by wires and it is not very comfortable for the patient. The few IMF techniques that are recommended without wire require special armamentarium that are not universally available.Materials and MethodsOur novel IMF technique employing multiple looping of orthodontic E chains around IMF screws can provide adequate reduction and stabilization of the fractured segments with good occlusion before plating of the maxillo‐mandibular fractures. It can also be utilized for extended periods for closed reduction or postoperatively for guiding the occlusion.ResultsAs seen in our clinical experience using this novel technique, there is no risk of percutaneous injury to the surgical team. It provides stable occlusion, optimal reduction in the fractured segments and is accepted well by patients as no wires are used.ConclusionThis novel technique can be used in all patients who require IMF and is particularly useful in patients with periodontally compromised teeth or in those who are partially edentulous where conventional arch bar fixation cannot be performed. This technique will considerably reduce the operative time and aid in better patient compliance.

Intramedullary Nailing Technique for Proximal Humeral Fractures Using a Straight Antegrade Nail with Locking Tuberosity Fixation.

Intramedullary straight nail fixation of proximal humeral fractures using a locking mechanism provides advantages compared with plating, including (1) less soft-tissue dissection, which preserves periosteal blood supply and soft-tissue attachments; (2) improved construct stability for comminuted fractures or osteopenic bone; and (3) shorter operative time for simpler fractures. The patient is placed in the beach-chair position with the head of the bed elevated approximately 45°. The fracture is reduced with use of closed or percutaneous methods, ideally, or with an open approach if required. Temporary fragment fixation with percutaneous Kirschner wires can be utilized. A 1-cm incision is made just anterior to the acromioclavicular joint, overlying the zenith of the humeral head and in line with the diaphysis. A guide-pin is then placed through this incision and is verified to be centrally located and in line with the humeral diaphysis on fluoroscopic views. The guide-pin is advanced into the diaphysis. A cannulated 9-mm reamer is inserted over the guide-pin to create a starting position. The nail is then inserted, with adequate fragment reduction maintained until the proximal nail portion is buried under the subchondral humeral head. The proximal screw trajectory and alignment are checked fluoroscopically. The proximal locking screws are pre-drilled and inserted first using percutaneous drill sleeves through the radiolucent targeting jig. The screw is inserted through the guide and is advanced into the nail until appropriately seated. This process is then repeated for the other proximal screws as necessary. Finally, the distal diaphyseal screws are pre-drilled and inserted in a similar percutaneous fashion using the jig, and the jig is removed. Final orthogonal images are obtained. Copious irrigation of the incisions is performed and they are closed and dressed with a sterile dressing. The operative arm is placed in an abduction sling. Alternative treatment options for proximal humeral fractures include nonoperative treatment with use of a sling, percutaneous reduction and internal fixation with Kirschner wires, open reduction and internal fixation with a locking plate and screw construct, hemiarthroplasty, and anatomic or reverse total shoulder arthroplasty1. The presently described technique for proximal humeral fracture fixation using a straight, antegrade, locking nail allows for minimal soft-tissue disruption, preserving vascularity and soft-tissue support and achieving angularly stable fixation in often osteopenic bone. The superior and in-line entry point avoids complications of rotator cuff injury and/or subacromial impingement. The proximal locking screws avoid complications of screw penetration or migration. This technique is appropriate for surgically indicated Neer 2-, 3-, and 4-part humeral fractures, including in elderly patients, when the humeral head fragment remains viable1-5. Based on available Level-III and IV evidence using this technique, patients should expect recovered motion and the ability to perform daily activities independently, with a mean active elevation of 132° to 136°1,4,6, external rotation of 37° to 52°1,4,6, and internal rotation to L31. Pain scores improved significantly from preoperatively to postoperatively, with a mean pain score of 1.4 on the visual analogue scale3,4,6. Patient-reported outcomes were good to excellent, with Single Assessment Numerical Evaluation (SANE) scores of 80% to 81%1,6, mean Constant scores from 71 to 811,3,4,6, and high rates of patient satisfaction (97% satisfied or very satisfied)4. Studies also demonstrated good to excellent fracture healing, with no tuberosity migration and low rates of nonunion (0% to 5%)1,6 and humeral head necrosis (0% to 4%)1,4. Revision rates ranged from 10.5% to 16.7%4,6. The starting position of the guide-pin must be central and at the zenith of the humeral head on the anteroposterior Grashey and the scapular Y views, and the guide-pin must be aligned with the diaphysis prior to advancing it.Failure to bluntly dissect the percutaneous incisions risks injury to the axillary nerve.Verify correct version of the nail prior to drilling any screws, to avoid incorrect version and potential loss of functional rotation. ABD = abductionAP = anteroposteriorCT = computed tomographyER = external rotationFF = forward flexion (forward elevation)IR = internal rotationSANE = Single Assessment Numerical EvaluationSSV = Subjective Shoulder ValueVAS = Visual Analogue Scale.

Needle Stick Injury: A Decade Retrospection Among Health Care Workers in a Tertiary Care Center.

Needle stick injury (NSI) is a common incidence in a health care facility which can have a great impact on the psychological status of a health care worker (HCW). In the present study, over a decade, 76 incidents of NSI were reported. Nurses (47.3%) were at high risk followed by doctors (28.94%). Recapping (30.2%) was the major activity associated with NSI. Percutaneous injury (97.3%) with a hollow bore needle to the fingers was the most common type of injury. Three (3.9%) of the sources were positive for Hepatitis B virus (HBV), and one (1.3%) for human immunodeficiency virus (HIV). Postexposure prophylaxis was administered to eight (10.5%) HCWs with high-risk exposure. The incidence of NSI is low, as there exists an underreporting which cannot be denied. Following stringent universal precautions and adoption of safety-guided devices can reduce the rate of injury to a great extent. Regular training, monitoring, auditing, and adequate control modalities are the core strategies to reduce the incidence of NSI.

A descriptive study of percutaneous injuries in National Healthcare Group POLYCLINICS dental clinics in Singapore from 2014 to 2020

IntroductionAll dental staff face risk of percutaneous injuries (PCI)s. Blood-borne diseases may be transmitted to staff via contaminated sharp instruments. Hence there are significant impacts on staff when PCIs occur. Though a PCI is an occupational hazard, it is preventable.AimThis study aims to identify factors associated with PCIs among dental staff by evaluating the circumstances and staff designations involved.MethodsPCIs were reported through an electronic incident reporting system from 2014 to 2020. Reports involved their nature and extent. Statistical analysis was carried out to find associations between factors such as injury site, type of instrument and staff designation.ResultsA total of 63 PCIs were included in this study. The type of instrument was found to be significantly associated with staff designation (p = 0.04, p < 0.05) with significantly more dental burs causing injury in dentists and more injuries caused by ‘other instruments’ in health attendants (p = 0.0083). Majority of PCIs occurred in dentists, then dental assistants and health attendants. Staff designation was significantly associated with the instance where PCIs occurred (p < 0.001). Dentists and dental assistants were more likely to sustain injuries during a dental procedure than before procedure and after procedure (p = 0.0167). The mean incidence of PCIs among our dentists was 15.6/100.ConclusionsAll dental staff are at risk of PCIs however dentists sustain the highest number of PCIs. Needles, dental burs and metal matrices are the top three instruments. Targeted interventions might help prevent/reduce PCIs.

Estimation of the Prevalence of Occupational Exposure to Biological Fluids among Anesthesiologists: A Survey Study.

Percutaneous injuries caused by sharps and exposure to biological fluids are a serious concern for anesthesiologists and pose a significant risk of transmission of blood-borne pathogens. The aim of this study was to estimate the prevalence of exposure to biological fluids among anesthesiologists. A questionnaire designed initially was validated after it was sent to 10 anesthesiologists with more than 5 years' experience. The validated questionnaire was then administered using Google Forms and the link was circulated electronically (e-mail, WhatsApp, and Telegram). This self-administered questionnaire was completed by 100 anesthesiologists. The various types and methods of body fluid years of exposure were also identified. The prevalence of occupational exposure to body fluids was 100%. Exposure to either blood or cerebrospinal fluids by sharps was seen in 82%. Majority of the pricks were encountered during recapping of used needles followed by pricks during intravenous cannulation. Body fluid exposure onto the bare skin most frequently encountered was blood, mostly obtained during intravenous cannulation. There were 8% patients who had exposure to human immunodeficiency virus (HIV) and hepatitis B or C patients for which they had taken postexposure prophylaxis. Prevalence of exposure to biological fluids among anesthesiologists is alarmingly high. This poses a high risk for transmission of diseases. The use of protective gears and changing our casual attitude can prevent majority of the exposures. The practice of recapping of used needles should be stopped.

Occupational exposure to HIV and utilization of post-exposure prophylaxis among healthcare workers at St. Peter’s specialized hospital in Addis Ababa, Ethiopia

Healthcare workers are susceptible to blood borne pathogens, such as human immunodeficiency virus (HIV). Occupational exposure to HIV infection among healthcare workers is becoming a global public health concern. However, there is limited evidence about occupational exposure of healthcare workers to HIV and utilization of post-exposure prophylaxis in Addis Ababa, Ethiopia. Accordingly, this study was conducted to assess the prevalence of occupational exposure to HIV and utilization of post exposure prophylaxis among healthcare workers at St. Peter’s specialized hospital, Addis Ababa, Ethiopia. A health facility-based cross-sectional study was conducted among 308 randomly selected healthcare workers in April 2022. Structured and pretested self-administered questioner was used to collect data. Occupational exposure to HIV was taken as any percutaneous injury or blood or other body fluids exposure while administering medications, specimen collection, and other procedures with HIV confirmed patients. Multivariable binary logistic regression analysis was used to identify factors associated with occupational exposure to HIV and utilization of post-exposure prophylaxis. Statistically significant association was declared on the basis of adjusted odds ratio with 95% confidence interval and p-value less than 0.05. The study found that 42.3% (95% CI 36.6, 47.9%) of the healthcare workers had occupational exposure to HIV during their career time, out of whom 16.1% (95% CI 11.9, 20.3%) used post-exposure prophylaxis. Healthcare workers with lower-level education such as diploma (AOR: 0.41, 95% CI 0.17, 0.96) and BSc (AOR: 0.51, 95% CI 0.26, 0.92), and healthcare workers who received infection prevention training (AOR: 0.55, 95% CI 0.33, 0.90) had less risk of exposure to HIV. On the other hand, nurses (AOR: 1.98, 95% CI 1.07, 3.67), midwifes (AOR: 3.79, 95% CI 1.21, 11.9), and physicians (AOR: 2.11, 95% CI 1.05, 4.22) had high risk of exposure to HIV compared with other professionals. Moreover, healthcare workers with BSc degree compared with healthcare workers with masters degree (AOR: 3.69, 95% CI 1.08, 12.6), healthcare workers with long service year (AOR: 3.75, 95% CI 1.64, 8.57), and healthcare workers who are working in facilities where prophylaxis is available (AOR: 3.41, 95% CI 1.47, 7.91) had higher odds to utilize post-exposure prophylaxis. Significant proportion of healthcare workers included in the current study had occupational exposure to HIV and very few of them used post-exposure prophylaxis. Healthcare workers need to use appropriate personal protective equipment, safely manage contaminated equipment, and safely administered medications and collect specimen to protect themselves from exposure to HIV. Moreover, use of post-exposure prophylaxis should be promoted when exposure exists.

Identifying and Decreasing Sharps Injuries Through Root Cause Analysis in a Large Urban Hospital System.

Despite safety mandates and interventions, sharps injuries remain an occupational risk for registered nurses (RNs). Sharps and needlestick injuries increase the risk of exposure to blood-borne pathogens. Post-exposure direct and indirect costs of these percutaneous injuries have been estimated at about US$700 per incident. The goal of this quality improvement project was to identify root causes of sharps injuries for RNs at a large urban hospital system. A retrospective evaluation of sharps injuries sustained by RNs, identification epsication of themes or root causes, and the development of a fishbone diagram to sort the causes into categories to identify workable solutions were conducted. Fisher's exact tests were performed to identify association between variables and root causes. A total of 47 sharps injuries were reported from January 2020 through June 2020. Among sharps injuries sustained by nurses, 68.1% were among nurses 19 to 25 years of age and 57.4% reported job tenure of 1 to 2 years. There was a statistically significant association between root causes and tenure range, gender, and procedure type (p < .05) with moderate effect size (Cramer's V = 0.35-0.60). Technique also was a primary cause of sharps injuries for blood draw (77%), discontinuing line (75%), injection (46%), intravenous (IV) start (100%), and suturing (50%). Technique and patient behavior were primary root causes of sharps injuries in this study. More sharps injuries caused by technique occurred among nurses with job tenure of 1 to 10 years, female, blood draw, discontinuing line, injection, IV start, and suturing procedures. The root cause analysis identified tenure, technique, and behavior as potential root causes of sharps injuries specifically occurring most during blood draw and injections at a large urban hospital system. These findings will inform nurses, especially new nurses in the proper use of safety devices and behaviors to prevent injury.

Impact of work schedules of senior resident physicians on patient and resident physician safety: nationwide, prospective cohort study

ObjectiveTo determine whether long weekly work hours and shifts of extended duration (≥24 hours) are associated with adverse patient and physician safety outcomes in more senior resident physicians (postgraduate year...

Risk assessment, prevention, and post-exposure prophylaxis of needle-stick injuries among health-care workers

Background: All health-care professionals should be concerned about percutaneous injuries brought on by needle sticks and other sharp objects since they increase the potential of occupational transmission of blood-borne diseases such as hepatitis C, hepatitis B, and human immunodeficiency virus from the patient to the health-care professionals. The causes include several things, such as the type and design of the needle, recapping activity, handling or transferring specimens, colliding with sharps or other health-care workers during clean-up, manipulating needles while working on the patient line, passing/handling devices or failing to dispose of the needle in a puncture-proof container. Aim and Objective: This study aims to evaluate the risk of needle-stick injuries (NSI) among healthcare professionals and their understanding of the condition to give useful information on post-exposure therapy and preventative strategies. Materials and Methods: This cross-sectional study was divided into an incidence study on NSI, and a study on the level of knowledge, risk assessment, prevention, and post-exposure prophylaxis. A total of 211 healthcare workers belonging to a tertiary care hospital participated. Institutional ethical approval was taken before the study. Data were evaluated by using SPSS software for descriptive analysis. Results: The study reveals that staff nurses (n = 65, 30.8%) were at higher risk for NSI followed by laboratory technicians (n = 53, 25.1%). The major causes observed were blood withdrawal (n = 83, 39.3%), followed by suturing (n = 32, 15.2%). Conclusions: It is concluded, that the greatest strategy to prevent numerous illnesses among healthcare professionals is to prevent NSI. It should be a crucial component of workplace prevention programs, and training on safety procedures ought to be a continuous process for all health-care centers. Risk assessments, prevention tactics, and post-exposure prophylaxis guidelines are a must to follow.

Behavioural video to navigate predoctoral dental students toward safer practice (revision of EJE-21-4739).

Local anaesthesia is considered essential knowledge within the dental profession as it helps to address pain management. Operator percutaneous needlestick injuries associated with the delivery of dental anaesthesia are common for dental healthcare providers. The study proposes a supplemental technique to reduce self-inducing novice operator needlestick injury to complement existing pedagogies for the preclinical local anaesthesia curriculum. The purpose of the study is to evaluate whether a local anaesthesia behavioural video can navigate students to safer clinical practice. Further, a supplemental technique is proposed in whether assessing instrument retraction technique in clinical patient care leads to decreased self-inducing intraoral needle stick injury for novice predoctoral dental operator. Beginning in 2011, predoctoral dental students were asked to view a "what not to do" video within a summative assessment and identify at least five behaviours that were unacceptable errors for delivering local anaesthesia. Operator intraoral needlestick injury was also tracked per the bloodborne exposure reports within predoctoral patient clinics. Data from the learners' responses identified progression in recognising unacceptable errors from behavioural video. Intraoral needlestick injury, 8 and 9 years prior and after the introduction of video showed significance with a low correlation coefficient. More data need to be gathered and evaluated in other dental school settings to determine whether this supplemental educational video decreases needlestick injury in novice operators. Results suggest this behavioural video may guide novice operators to overall safer clinical practice.

Evaluation of Surgical Glove Perforation and Sharps Injury in Oral and Maxillofacial Surgery.

The risk of exposure to infections during surgery is partly mitigated by gloving. However, perforation can reduce the effectiveness of gloving as a barrier to exposure. This study aimed at investigating the frequency of surgical glove perforation and factors predictive of these in our oral and maxillofacial surgical practice. The study was carried out at the National Hospital and the University of Abuja Teaching Hospital, Abuja, Nigeria. Consenting patients requiring oral surgical interventions were consecutively recruited into the study. Similarly, surgeons and their assistants who consented to the study were also enlisted in the study. At the end of every surgical procedure, gloves used by the surgeons and the assistants were tested for perforation. Variables investigated included the rate of perforations, the influence of the type of gloving, single versus double gloving, type of anaesthesia, and duration of surgery on rates. At a minimum of three operators per procedure, a total of 154 participants were involved in the study and 895 gloves were used. The number of glove perforations was 117(13.1%) with 82 (70.1%) involving the surgeons. There were 58/117 (49.6%) cases of perforation involving the dominant hand. Forefinger glove perforation accounted for 62 (52.9%) cases. Wire-related perforations were 72 (61.5%). Overall, nine cases of percutaneous injury were recorded. Duration of operation and double gloving were the predictive factors for perforations. Risk of sharps injury was relatively high due to the high incidence of glove perforation.

Education and Awareness Activities Regarding Hepatitis B and C Among Japanese Dental Health Workers in the Oita Prefecture

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are known to pose a major threat for dental health workers (DHWs). Previously, we reported that the HBV and HCV infection rates among DHWs in the Oita Prefecture in Japan were higher than those among the general population. The aim of this study was to disseminate knowledge about hepatitis and its prevention among the DHWs. Educational booklets were mailed to 2,197 DHWs working in 487 dental clinics. After anonymously responding to online questions about their experience with HBV and HCV testing, Hepatitis B vaccination, and percutaneous injury, the subjects were required to respond to additional questions about their understanding of hepatitis. A total of 521 DHWs (205 males and 316 females) responded to the questionnaires. Among them, 61.6% had experienced percutaneous injuries, but only 19.4% were fully aware of how to deal with them before reading the booklet, and also 10.6% had sufficient knowledge about hepatitis. The past Hepatitis B vaccination, past HBV testing rate, and past HCV testing rate were 62.4%, 71.8%, and 43.2%, respectively. The DHWs who are not dentists (n = 293) had significantly lower rates of past testing for their own hepatitis virus, knowledge about treatment of percutaneous injuries, and awareness of hepatitis as compared to dentists (n = 228). After reading the booklet, 99.5% of subjects found the booklet useful and 87.3% said it would influence their future hepatitis testing. The educational booklet was effective way to increase DHWs' knowledge about Hepatitis B and C and how to manage percutaneous injuries.

Knowledge of HIV/AIDS and the clinical and sexual practices of dental students

The aim of the study was to assess knowledge of HIV/AIDS and the clinical and sexual practices of dental students. This was a cross-sectional study in which a self-administered questionnaire about age, gender, and dental program term; knowledge of HIV/AIDS transmission and prevention; use of personal protective equipment; prevention and occurrence of accidental exposure to biological material; post-exposure conduct; and sexual behavior was answered by dental students (n = 148, answer rate of 91.9%). Descriptive and inferential statistical analyses (chi-square and Fisher's exact tests) were performed, at a significance level of 5%. Students correctly recognized the routes of HIV transmission, including “blood” (100%), “sexual.3%). Regarding frequency of condom use during sexual intercourse, 37% of dental students said “always,” 55.5% “sometimes” and 7.6% “never”. Regarding clinical practices, 99.3% of dental students said they used personal protective equipment, 28.4% had intercourse” (99.3%), “vertical transmission” (58.1%) and “sharing contaminated material” (94.6%), and ways of prevention, including “condom use” (100%) and “not sharing needles and syringes” (99suffered percutaneous injuries, the needle was the most cited exposure agent (32.5%) and in most cases (54.8%), no providences were taken after the accident. In conclusion, the students had good knowledge of HIV / AIDS and appropriate preventive attitudes in clinical care and handling of sharp instruments; however, they still need to be motivated with regard to condom use and oriented about care after accidental exposure to biological material.

Factors Associated with Percutaneous Injuries &amp; Needle Stick Injuries among Health Care Workers in Nyangabwe Referral Hospital Francistown, Botswana

The study is designed to establish the factors associated with percutaneous /needle stick injuries among health care workers (HCWs) working in Nyangabwe Referral Hospital. Institution-based cross-sectional study design was conducted among 222 randomly selected health care workers in Nyangabwe Referral hospital. The data was collected using self-administered questionnaires. The data was entered into epi info version 7.2.2.16 for analysis and exported to Microsoft excel for visualization. The multivariate regression model was used to determine the association of variables with needle stick injuries/percutaneous injuries with AOR and 95% CI &amp; P value ≤ 0.05. This study revealed that 57% of the health care workers in Nyangabwe referral hospital had sustained percutaneous injuries/needle stick injuries during their period of work in the hospital. Nurses were the most affected cadre. Needles, suture needles, and cannulas are the most contributors to percutaneous injuries and needle stick injuries. NSI/PI occurs mostly due to fatigue, workload, inattentiveness, and distraction. The most significant associated factors to PI/NSI were Education level, work unit, years of experience, use of IPC guidelines, work environment as well as working hours. Percutaneous injuries/needle stick injuries in this study area were prevalent. The most contributing factors to NSI/PI were work unit (medical and pediatric ward), Work environment (busy wards), hours of work (≥40 hours per week), non-utilization of infection prevention and control guidelines.

Underreporting of work accidents associated with blood-borne risk factors.

Work accidents (WA) due to percutaneous or mucocutaneous injury are extremely frequent among health professionals. The notification of these accidents ensures not only the compliance with legal requirements, but it also enables health institutions to develop, implement and evaluate strategies to prevent them. This study aimed to estimate the proportion of underreporting of work accidents caused by percutaneous and mucocutaneous lesions in a hospital setting, as well as its determinants. A self-administered questionnaire was made available to all hospital employees. Age, gender, professional category and type of service adjusted odds ratios (OR) and 95% confidence intervals (95%CI) were computed by multivariate logistic regression models. Underreporting of WA associated with biological risk factors was high, particularly in accidents by mucocutaneous injury (80.9%). Physicians were the professional category that least reported this type of work accidents (OR=4.64; 95%CI 2.20-9.78). The main determinants of underreporting were the underestimation of the risk of transmission and the excessive bureaucracy. The underreporting of work accidents associated with biological risk factors was considerable and it contributes to a high degree of uncertainty on accidents' characterization.

Seroprevalence of Hepatitis B and Hepatitis C in Inpatients for Alcohol and Drug Addiction Treatment in the Psychiatry Clinic of a Private Hospital

Aim: Hepatitis B (HBV) and hepatitis C virus (HCV) infections pose a serious health problem in our country as well as all over the world. The main transmission routes of these agents include parenteral contact with infected blood or body fluids (percutaneous injury), sexual transmission, and contact with blood and body fluids of infected people. Accordingly, people with drug abuse are an important risk group for these infections. The number of studies in this field in Turkish context is limited. In this study, we aimed to evaluate the seroprevalence of HBV and HCV in inpatients for alcohol and substance addiction treatment in a private hospital psychiatry clinic.&#x0D; Materials-Methods: This retrospective study relied on the files of the patients who were hospitalized in the Alcohol and Substance Treatment Clinic in the sense that the results of HBsAg, anti-HBs, and anti-HCV parameters were evaluated retrospectively from the hospital automation system.&#x0D; Results: Of the 568 patient included in the study, 154 (27.1%) were female, 414 (72.9%) were male, and the mean age was 35 (18-88). Findings revealed that 7 (1.23%) of the patients were positive for HBsAg, 229 (40.4%) for anti-HBs, and 41 (7.21%) for anti-HCV. There was no significant difference between HBsAg and Anti-HCV positivity rates by gender.&#x0D; Conclusion: In our study, anti-HCV positivity was detected at a very high rate (7.21%). It can be concluded that the evaluation of these people in terms of test accuracy with HCV RNA as well as treating the infections detected in this group with effective new generation antivirals will also be beneficial with respect to reducing the number of people who can transmit the infection.