Tertiary Care Hospital In Delhi Research Articles

Health education: A Vital tool in changing environmental hygiene knowledge, attitudes and practices among food handlers in a tertiary care hospital of Delhi

BackgroundEnvironmental hygiene in food establishments is an important determinant of health. Health education package using combination of strategies is essential in preventing cross-contamination. ObjectiveTo determine change in environmental hygiene knowledge, attitudes and practices among food handlers following implementation of health education intervention. MethodsA before and after interventional study was conducted on 111 food handlers of food establishments in a tertiary care hospital of Delhi in 2021–22. Tool based on WHO & FSSAI guidelines was prepared with a scoring system to rate environmental hygiene knowledge (0–12), attitudes (0–10) and practices (0–12) including cleaning of surfaces, pest control, waste disposal & segregation, packaging of food along with utensil washing steps (0–10). Health education was given and scores on same tool were reassessed after 8 weeks of intervention. Nail bed swabs were taken as an indicator of bacteriological contamination. ResultsThe differences of mean scores of knowledge, attitudes and practices before & after intervention were statistically significant differences of 9.95 ± 0.95, 8.02 ± 0.68 and 7.91 ± 1.16 respectively (p < 0.05) while utensil washing practices before and after intervention were 2.78 ± 0.59 & 6.77 ± 0.74 with statistically significant difference of 3.99 ± 0.85. Before intervention, pathogenic organisms were isolated in nail bed swabs of 91 % of study participants while after intervention it was 12.6 %. Common species isolated were Klebsiella spp. (55.5 %), E. coli (15.9 %), Staphylococcus spp. (10.9 %) and Acinetobacter spp. (9.9). ConclusionImprovement in environmental hygiene KAP emphasizes need of ensuring implementation of existing guidelines. Thus, health education using planned combination of channels and strategies can achieve desired change.

NUTRITIONAL STATUS OF PERSONNEL CONTROLLING TRAFFIC IN A TERTIARY CARE HOSPITAL OF DELHI: A PROSPECTIVE PILOT STUDY

Background: Traffic controllers work in the middle of innumerous noisy and polluting vehicles and endure physical strain in an environment polluted by fumes, exhaust of vehicles, use of blowing horns, blow of dust in the air, etc. Their stressful lives often make them resort to unhealthy food choices, ill-timed and unbalanced meals, leading to many problems. Objective: The present study aimed to analyse the nutritional status of personnel controlling traffic in a tertiary care hospital of Delhi through the ‘ABCD’ approach of nutritional assessment: Anthropometric, Biochemical, Clinical and Dietary status to get a fair idea about their individual nutritional needs. Methodology: It was a prospective analysis done in hospital of Delhi by assessing anthropometry, biochemical, clinical parameters, and dietary status on a sample size of 48 personnel controlling traffic. Results: The results of the study showed that only few of the subjects were of appropriate weight (29%), were consuming adequate calories (18.75%), and were consuming adequate proteins (16.66%). Majority of them had health problems with deranged blood parameters and many were also subjected to substance abuse and had very little and inaccurate nutritional knowledge. Conclusion: The study highlighted the need for proper nutrition education sessions for them and the importance of nutritional counseling amongst them. Better health outcomes can thus be hoped with this prospective study in the target population.

THE AWARENESS AND PRACTICES OF POSTNATAL CARE IN MOTHERS DELIVERED AT A TERTIARY CARE CENTRE: A HOSPITAL-BASED STUDY Authors

Introduction: The postpartum period is the most crucial phase in a mother’s life. The unawareness of postpartum care can have disastrous consequences on both the mother and newborn. This study helps in the identification of gaps in postpartum care by studying awareness and practices in our postnatal women. Methods: This cross-sectional studywas conducted at a tertiary care hospital in Delhi, India between July 2022 to May 2023.Ethical clearance was obtained. About 200 postnatal women were enrolled in the postnatal clinic during their follow-up visit at six weeks of delivery. After informed consent,the details were collected as per the predesigned proforma. The awareness and practices on breastfeeding, family planning, and postpartum health were recorded. Results: Among 200 women, the majority were in the age group of 25 to 30 years. About 51% were multipara and 33.5% were graduates and most belonged to upper lower socioeconomicclass. About 86.5% were aware of exclusive breastfeeding practice and 81.5% had awareness of family planning methods. About 73% of our participants were aware of postnatal danger signs. The prevalence of anemia was 70.4% and 56.5% were noncompliant with iron and calcium supplements. Conclusion: Postnatal care constitutes an indispensable component of maternal health care. The high prevalence of postpartum anemia and non-compliance to iron and calcium intake among our postnatal mothers calls for an urgent need to emphasize counseling regarding the diet as well as iron and calcium prophylaxis during the discharge of postnatal women.

Out-of-pocket expenditure for antenatal care among women in a tertiary care hospital - A cross-sectional study

Background: The government of India has promoted several initiatives to provide support to all women during their pregnancy. Despite this, various studies report out-of-pocket expenditures (OOPEs) amongst antenatal women nationwide. Aims: We wanted to assess OOPE amongst antenatal women attending the outdoor patients’ department in a tertiary care hospital in Delhi. Materials and Methods: A cross-sectional study was conducted in 405 antenatal women attending the outdoor patients’ Department of Gynaecology and Obstetrics, VMMC and Safdarjung Hospital, New Delhi. During outpatient department hours, data were collected through purposive sampling in September 2022 using a self-developed, pre-tested interview schedule. Results: Median OOPE during the antenatal period was 5000 (interquartile range: 2350–9003) INR. The highest median cost for OOPE was reported for laboratory investigations, followed by the purchase of medicine(s) and consultation charges (at private facilities). Ninety-six per cent of the participants met OOPEs via salary, wage or pension. Conclusions: Our study reported OOPE amongst antenatal women visiting the outdoor patients’ Department of Gynaecology and Obstetrics of a tertiary care hospital. A substantial majority of participants were meeting their OOPE through salary, wage or pension. These findings underscore the financial burden faced by individuals during the antenatal period, particularly in accessing essential healthcare services.

Are we ushering into the pre-antibiotic era: alarming trends of antibiotic resistance in chronic otitis media in a tertiary care hospital in Delhi, India

Background: Chronic otitis media is an infection of the middle ear cleft for at least 12 weeks or more. It has a high prevalence rate in India pertaining to factors like malnutrition, overcrowding and poor hygiene. Thanks to greats like Paul Ehrlich and Alexander Fleming, Antimicrobials are a powerful and readily available form of treatment for this disease. Methods: In this study we re-evaluated the changing trends in bacteriological profile of COM and the antibiotic sensitivity pattern to most of the currently available antibiotics in a tertiary care hospital in India. Results: Most common pathogens found in our study were Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Proteus vulgaris, Enterococcus, Escherichia coli and Morganella morganii. A declining pattern in the sensitivity towards commonly used antibiotics with an alarming increase in MRSA was observed. Conclusions: The trends observed in our study warrant an urgent need for antibiotic policies, judicious use of antibiotics and vigilance in our hospitals.

A Study of Clinical and Socio-Demographic Profile of Elderly Patients with Opioid Use Disorder on Agonist Treatment Attending a Tertiary Care Teaching Institute of India

Background: Opioid use is one among the major substance of use in Indian population which is not only seen in younger age group but rather is an upcoming concern in the elderly population as well. Opioid agonist treatment for opioid use disorder is a better way of management, among which buprenorphine is a safer option. Despite, being an important area of health concern, opioid use is poorly studied in the geriatric population. Objective: To study the clinical and socio-demographic profile of elderly patients with opioid use disorder on agonist treatment attending a tertiary care teaching institute of urban Delhi. Method: A retrospective study was done in an OPD based opioid treatment centre of a tertiary care hospital in Delhi to analyze the socio-demographic, clinical profile, pattern of opioid use disorder and opioid agonist treatment (Buprenorphine) in elderly Indian population over a year. The data collected was further analyzed for descriptive and analytic statistics using SPSS version 23.0. Results: A total of 32 subjects of age &gt; 60years, with predominant male population having mean age of 63.6years we seen. They had heroin use by inhalation route as a major opioid use. The main source of referral was by friends and self with significant medical and psychiatric comorbidities that was seen in the elderly group. An average dose of 2.34mg of Buprenorphine was found to effectively manage the geriatric opioid use disorder. Conclusion: Opioid Used Disorder is common in Geriatric population and is often associated with both psychiatric and medical co-morbidities. Opioid agonist treatment is an effective approach in management of elderly cases of opioid use disorder. Declaration of Interest : None

A study of sexual dysfunction in females having major depressive disorder

Introduction: Major depressive disorder has the highest lifetime prevalence of any psychiatric disorder and negatively impacts sexual functioning in many patients. Females hesitate to discuss sexual problems due to cultural barriers. So sexual dysfunctions are under-reported and under-studied. Method: This is a cross-sectional study to evaluate the pattern of sexual dysfunction in 18 to 40-year-old married females having major depressive disorder attending psychiatry OPD in a tertiary care hospital in Delhi, India. The severity of depression was assessed by the Hamilton Depression Rating Scale (HAM-D), and sexual functioning was assessed by the Arizona Sexual Experience Scale (ASEX) and Female Sexual Function Index (FSFI) scales. Data was analysed using SPSS. Mean and standard deviation (±SD) were used to describe quantitative data meeting normal distribution. As appropriate, the chi-square or Fisher’s exact test was used to compare categorical data amongst independent groups. Results: 64% and 56% of participants in drug naïve and on-treatment groups respectively had sexual dysfunction as per ASEX scale as compared to 10% of controls. As per the FSFI scale, 84% and 76% of participants of drug naïve and on-treatment groups had sexual dysfunction compared to 20% of the control group. Of all domains of sexual functioning, domains of desire, arousal, and orgasm were most commonly affected. Conclusion: This study showed a high prevalence of sexual dysfunction in depressed females emphasizing the need for direct inquiry about sexual problems by the treatment provider and appropriate management for the benefit of patients.

Effect of COVID-19 Pandemic on Knowledge, Attitude and Practices Towards Antenatal Care Among Antenatal Women: A Study From a Tertiary Care Hospital in Delhi, India.

Effect of the COVID-19 pandemic on knowledge, attitude, and practices toward antenatal care among antenatal women. Prospective observational study. After taking written and informed consent, 3000 term/near-term SARS CoV2-negative antenatal women admitted to the hospital for emergency were enrolled; excluding those in advance labour or critically ill. An interview was conducted and a knowledge, attitude, and practices (KAP) questionnaire was filled out based on verbatim answers. All women were then given individualized antenatal and postnatal care as per hospital protocols and discharged accordingly. The data obtained during the study was recorded on predesigned case proforma and analysed at the end of the study using the SPSS v. 23 software, after the application of appropriate statistical tests. All women knew about the pandemic and its signs and symptoms along with precautions to be taken. Most of the women 2652 (88.4%) thought that they were at increased risk of contracting an infection during pregnancy and 2208 (73.6%) thought that coronavirus can harm the baby and will increase the risk of pregnancy. Awareness of nearby health facilities providing antenatal care was in 71.2% and 94% were aware of functional outpatient department services but only 1.4% were aware of teleconsultation services. About 2094 women have had any ANC visits. All of them knew that taking iron, Ca and vitamin supplements and getting an ultrasound and investigations were necessary but only 1524 (50.8%) took these supplements regularly, 1752 (58.4%) got their ultrasound done and 41.6% got investigations done. Two thousand four hundred thirty-six (81.2%) women had this fear that they would contract COVID-19 infection during their visit to the hospital. All the respondents of our study wanted to have hospital delivery and knew that it was necessary to have ANC registration and none of them wanted to have home delivery. Mastering correct knowledge will foster a positive attitude among antenatal women and will not only prevent disease transmission but also improve pregnancy outcomes.

Trends in seroprevalence of enteric transmitted hepatitis virus infections at a tertiary care hospital in Delhi: a 4-year review

Background: Hepatitis A virus (HAV) and hepatitis E virus (HEV), both enteric hepatitis viruses, are transmitted through the feco-oral route. These infections can range from asymptomatic or subclinical cases to acute viral hepatitis, occasionally leading to mortality. To gain an understanding of the disease and develop effective management strategies, comprehending the disease burden is essential. This study aimed to provide insights into the prevalence of enteric transmitted hepatitis viruses among individuals with acute hepatitis in the Delhi region. Methods: A retrospective investigation was conducted at a prominent tertiary care super specialty hospital in Delhi, spanning from February 2019 to December 2022. Serum samples from patients suspected of having hepatitis and sent for HAV and HEV testing were included. The samples underwent enzyme-linked immunosorbent assay to detect HAV and HEV immunoglobulin (Ig)M antibodies. Collected data was analyzed using SPSS software version 21, employing Chi-square and Fischer exact tests where applicable. Results: Throughout the study period, a total of 1275 samples were incorporated. Viral etiology was evident in 197 patients (15.45%). Among these, IgM HAV was identified in 142 patients (11.13%), and IgM HEV was present in 55 patients (4.31%). HAV infection was notably more prevalent in the pediatric age group (20.89% or 89/426; p&lt;0.001), while HEV was significantly more common among adolescents and adults (5.77% or 49/849; p&lt;0.001). Conclusions: Regular surveillance of enteric transmitted viruses causing hepatitis should encompass both hospital and community levels to accurately gauge disease burden and evolving epidemiology.

Pre- and Post-COVID-19 Appraisal of Antimicrobial Susceptibility for Urinary Tract Infections at an Outpatient Setting of a Tertiary Care Hospital in Delhi.

This study was conducted to understand the effect of the COVID-19 pandemic on urine culture and sensitivity results in an outpatient setting. There are plenty of data from inpatient and ICU settings but there is a paucity of data in outpatient or community settings. Thus, this study primarily targeted change in antibiotic resistance of urinary tract infection (UTI) agents in the pre- and post-COVID-19 period. In the study, urine samples received in the Department of Laboratory Medicine (microbiology laboratory) with a preliminary diagnosis of UTI between April 2019 and March 2021 were analyzed. Urine cultures and antibiotic susceptibility tests of the patients included in the study were examined in two periods (pre-pandemic and post-pandemic). A total of 22,372 urine samples were received in the pre-pandemic period (April 2019 to March 2020) and 4885 samples in the post-pandemic period (April 2020 to March 2021). The positivity rate obtained from urine cultures sent post-COVID-19 pandemic (16%) was significantly higher than those sent before the COVID-19 pandemic (8%). According to cultures and antibiogram results, resistance to ampicillin, amikacin, ceftazidime (p < 0.05), co-trimoxazole, levofloxacin, gentamicin (p < 0.05), nitrofurantoin, fosfomycin, and tetracycline decreased compared with the pre-COVID-19 period. In this study, we found that the frequency of significant bacteriuria increased significantly in the post-pandemic period. However, resistance to antibiotics decreased significantly in the post-COVID-19 period compared to the pre-COVID-19 period. There was no significant change in the etiology of UTI during the two time periods.

Dermatological Adverse Effects of Covid-19 Vaccine among Healthcare Workers: Findings from a Tertiary Care Hospital in Northern India

Objectives: The objective of this study was to identify the cutaneous manifestations that developed after covid-19 vaccination, with Covaxin and Covishield, in healthcare workers (HCW) and to identify any associated factors. Materials and Methods: A cross-sectional study was conducted over 3 months using an online and offline questionnaire that was circulated among the HCW working at a tertiary care hospital in Delhi. All the vaccinated HCWs who gave consent (n = 676) (n = number of participants) were included in the study. Data were summarised in an excel sheet and then analysed using SPSS, version 25. Results: Out of the 676 vaccine recipients, a higher number of participants were vaccinated with Covishield compared to Covaxin. Only 14 (2.0%) subjects developed new adverse dermatological manifestations following either vaccination. A higher incidence of adverse reaction was observed with Covaxin than with Covishield, but the difference was not significant. A significantly higher number of vaccinated paramedical workers developed new dermatological manifestations in the study period [P-value (probability value)] (P = 0.018). Conclusion: Our study demonstrated a low rate of cutaneous adverse reactions following vaccination with either Covaxin or Covishield. Further studies are hence needed to corroborate our findings.

Increased Pill Burden and Adverse Effects of Psychotropics Correlated with Poor Quality of Life and Medication Nonadherence: A Cross-sectional Drug Utilization Study at a Tertiary Care Hospital in Delhi during COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health problems such as depression and anxiety. This study aims to investigate the prescribing pattern of psychotropic drugs in patients with common mental disorders which might be altered during the pandemic and also whether the pandemic could alter their quality of life (QOL) and medication adherence. After prior ethical approval, a descriptive cross-sectional drug utilization study (DUS) of 200 prescriptions was undertaken to evaluate the pattern of psychotropic drug usage as per WHO (World Health Organization)/International Network of Rational Use of Drugs (INRUD) guidelines. The correlation of the average number of drugs per prescription with QOL was observed. The correlation of adverse drug reactions (ADRs) with medication adherence was also analyzed. The average number of drugs per prescription during the pre-COVID-19 and COVID-19 period was estimated to be 2.48 and 2.96. The percentage of drugs prescribed by generic name in the two different periods (pre-COVID-19 and COVID-19) was 97.40 and 95.77%. The percentage of drugs prescribed from the list of essential medicines was 89.40 and 85.12%, respectively. The percentage of prescriptions with injections was 0.45% and 0.53%, respectively for the two periods. The QOL during the COVID-19 pandemic was found to be negatively correlated to the average number of drugs per prescription (correlation coefficient = -0.61) and medication adherence was found to be poor in patients who developed ADRs with the drugs prescribed (p-value of 0.001). In the tertiary care hospital described, rational drug prescribing was followed. Increase in the number of drugs per prescription was found to be associated with poor QOL and the development of ADRs led to medication nonadherence in the patients. Further studies with larger sample sizes are needed to confirm these results. How to cite this article: Kumar A, Halder S, Srivastava S, et al. Increased Pill Burden and Adverse Effects of Psychotropics Correlated with Poor Quality of Life and Medication Nonadherence: A Cross-sectional Drug Utilization Study at a Tertiary Care Hospital in Delhi during COVID-19 Pandemic. J Assoc Physicians India 2023;71(9):14-18.

Effect of COVID-19 on the Burden and Profile of Orthopaedic Patients Admitted Post-Resumption of Routine Services in a Tertiary Care Hospital in Delhi.

Purpose On resumption of routine services post-lockdown during coronavirus disease 2019 (COVID-19), we expected a backlog of orthopaedic patients who could not get appropriate and timely care and would now present with complications due to missed or delayed treatment. This study aimed to quantify the effect of COVID-19 on the burden and profile of orthopaedic patients admitted post-resumption of routine services. Materials and methods Data on all the patients admitted to the orthopaedic department were collected using an interviewer-administered schedule for a complete one-year period after the resumption of routine orthopaedic services in a tertiary care hospital in Delhi. For comparison of the burden of trauma patients with that during the pre-COVID-19 period, data were obtained from a similar study done on trauma patients in 2017 at the same institution. For patients with non-traumatic conditions, previous hospital records were used. Results A total of 1585 patients were admitted during the one-year period post-resumption of routine services following COVID-19 restrictions, which was 41% less than that compared to the corresponding pre-COVID-19 data. The proportion of patients from other neighbouring states showed a decline from 52% in the pre-COVID-19 period to 41.55% when healthcare services resumed during the COVID-19 period. Out of all admitted trauma patients in 2021, 12.7% presented with a missed or complication of treatment as compared to 3.1% in the pre-COVID period. Around half of them (52.5%) attributed their complications to a COVID-19-related lockdown. Conclusion There was a significant decline in the number of patients post-resumption of routine orthopaedic care services. Converting whole tertiary care teaching hospitals to COVID-19-dedicated hospitals must not be done as it leads to an increase in missed or complication of orthopaedic treatment.

Willingness to Quit and Associated Factors Among Tobacco Users Attending Outpatient Departments of a Tertiary Care Hospital in Delhi, India.

Tobacco use has become a modern-day epidemic which significantly impacts health, socioeconomic status, and environmental sustainability. The readiness to quit or stop using tobacco is a crucial first step in changing one's behavior. Hence, the current study sought to assess the prevalence of willingness to quit and associated factors among tobacco users. This study was conducted on 425 tobacco users selected using multi-stage random sampling from the outpatient departments (OPDs) of a tertiary care hospital in Delhi, India. A pre-designed, interviewer-administered questionnaire was used to elicit information. Logistic regression was performed to assess the effect of independent factors on the willingness to quit. The mean age of the study participants was 39.37 years (S.D.=±12.99). The majority of the participants were male (400, 94.1%), and 25 (6.9%) were female. Overall, the prevalence of willingness to quit in the current study was 70% among the study participants. The results of the multivariable analysis showed that those belonging to urban areas, tobacco users with a duration of≤10 years, and those who received advice from a doctor to quit had a significantly higher willingness to quit than their counterparts. However, age, gender, marital status, education, religion, age of initiation of tobacco use, and nicotine dependence were not found to have a statistically significant relationship with the willingness to quit tobacco products. Willingness to quit was high among the study participants. The data in this study suggested that belonging to urban areas, duration of tobacco use, and doctor's advice to quit are important factors which need to be considered when framing future tobacco cessation programs.

Assessment of blood culture and tube agglutination serology test for the diagnosis of typhoid fever amongst malaria-negative patients: a one-year hospital-based study

Salmonella serotypes, including Salmonella Typhi, S. Paratyphi A, S. Paratyphi B, and S. Paratyphi C, are responsible for the systemic, protracted febrile sickness known as typhoid fever. Various antibody-based tests are being used for diagnosing typhoid fever. This study was carried out to assess the performance of the widal test and blood culture for the diagnosis of typhoid fever among malaria-negative patients in a tertiary care hospital in east Delhi, India. The study was conducted from July 2021 to June 2022 in the Department of Microbiology of a tertiary care hospital in Delhi. Patients, including the adult and pediatric population, were evaluated for typhoid fever and participated in an observational, prospective study on febrile patients that was malaria-negative. Venous blood samples were obtained under strict aseptic conditions and further processed for widal serology and blood culture tests for typhoid fever. In our study, the prevalence of blood culture-positive Salmonella species was 0.3% (30/10,000 = 0.3%) Among antimicrobial susceptibility patterns, S. Typhi revealed the highest resistance rates for Ciprofloxacin (43.33%), Azithromycin (36.66%), and third-generation cephalosporins. Out of 30 blood culture-positive Salmonella Typhi of typhoid fever patients, 5 (17%) samples were negative for the Widal test. Among 30 samples, all were blood culture positive, but only 25 samples show Widal titer above the baseline i.e. &gt;1:64. Although blood culture is the gold standard for the diagnosis of typhoid fever, the Widal test does play a role in the diagnosis and management of typhoid fever, especially in suspected cases when blood culture is negative, especially in government tertiary care hospitals.

An Observational Study of Respiratory Dysfunction in Parkinson’s Disease at a Tertiary Care Hospital in Delhi

Abstract Objectives: The purpose of this study is to evaluate the impact of Parkinson’s disease (PD) on respiratory function using spirometry. In addition, the study aims to investigate the relationship between the severity of PD and any impairments in a respiratory capacity as measured by forced vital capacity (FVC%). Methods: This case–control study (40 cases of PD vs. 40 healthy controls) was conducted from July 1, 2021, to October 31, 2022, in a tertiary care hospital of New Delhi. Clinical symptoms and severity (Movement Disorder Society Unified Parkinson’s Disease Rating Scale [MDS-UPDRS] part-III score and Modified H and Y Scale) of the patients of PD were noted. A pulmonary function test (by spirometry) was performed and parameters such as forced expiratory volume in 1 s (FEV1), FVC, FEV1/FVC, and peak expiratory flow rate (PEFR) were noted. Mann–Whitney U-test (for two groups) and Chi-square test were used for the comparison of variables. Spearman rank correlation coefficient was used for the correlation of FVC (% predicted) with MDS-UPDRS part-III score and Modified H and Y stage. Results: Compared to controls, cases had significantly lower FVC% (70.5 vs. 88, P &lt; 0.01), significantly lower FEV1% (68 vs. 83.5, P &lt; 0.01), comparable FEV1/FVC (% predicted) (97 vs. 96, P = 0.805) and significantly lower PEFR (% predicted) (80.5 vs. 92, P &lt; 0.01). The pattern of lung involvement was restrictive, normal, and obstructive in 72.50%, 20%, and 7.50% of cases, respectively. FVC (% predicted) showed a significant negative correlation with MDS-UPDRS part-III score (r = −0.895, P &lt; 0.01) and with Modified H and Y Scale (r = −0.792, P &lt; 0.01). Conclusion: Patients with PD had significantly more deranged respiratory dysfunction and there was significantly higher respiratory dysfunction with increasing severity of PD. A proper screening of lung functions may allow an early detection of respiratory dysfunction, thereby helping to initiate an early pulmonary rehabilitation to prevent respiratory complications.

The Prevalence of Violence Against Resident Doctors and Its Subsequent Effects on Patient Management in a Tertiary Care Hospital in Delhi, India.

Introduction Workplace violence (WPV) is a significant problem for healthcare professionals across the world, regardless of whether they work in developed or developing countries. Studies have shown that in India, up to 75% of doctors have experienced some form of violence in the workplace. The purpose of the present study was to examine the extent of violence against doctors and its impact on patient management. Methodology This cross-sectional study was conducted in a tertiary care hospital in New Delhi in June 2022. A total of 326 resident doctors from six departments were selected using stratified random sampling. Data were collected using a semi-structured interview schedule and a pre-validated questionnaire. Statistical analysis was done using Stata 17, and ethical clearance was obtained from the Institute Ethical Committee. Result Workplace violence was prevalent among healthcare professionals, with 80.4% (95% confidence interval (CI): 75.6%-84.5%) experiencing verbal abuse and 21.7% (95% CI: 17.4%-84.5%) experiencing physical violence. Perceived delays in treatment and patient deaths were the most common causes of violence. Most participants were hesitant to report WPV due to time-consuming reporting processes and a lack of organisational support. WPV had a negative impact on doctors' mental and personal well-being, with 73.3% reporting its negative impact. WPV has led to a decrease in the provision of surgical and medical interventions. Conclusion The study findings suggest that a significant proportion of doctors in a tertiary care hospital in Delhi encounter some form of workplace violence. Despite the high incidence of WPV, reporting of these events remains low due to inadequate support and deficient reporting procedures within healthcare organisations. The negative impact of WPV is not limited to the physicians' psycho-social well-being but extends to their approach to patient care as well. Therefore, taking appropriate actions to prevent WPV is crucial for ensuring the safety and well-being of healthcare professionals and improving patient outcomes.

Healthcare providers perceptions regarding the presence of Birth Companion during childbirth at a tertiary care hospital in India

BackgroundDespite an increase in institutional births and a fall in maternal mortality, the satisfaction of women with their birthing experience in public health institutions is low. Birth Companion (BC) is an important part of the Labour Room Quality Improvement Initiative introduced by the Government of India in 2017. Despite mandates, its implementation has been unsatisfactory. Little is known about the perception of healthcare providers about BC.MethodsWe conducted a facility-based, cross-sectional quantitative study with doctors and nurses in a tertiary care hospital in Delhi, India to gauge their awareness, perception and knowledge about BC. Following universal total population sampling, the participants were administered a questionnaire, which was completed by 96 of 115 serving doctors (response rate of 83%), and 55 of 105 serving nurses (response rate of 52%).ResultsMost (93%) healthcare providers were aware of the concept of BC, WHO’s recommendation (83%) and Government’s instructions (68%) on BC during labour. A woman’s mother was the BC of choice (70%) closely followed by her husband (69%). Ninety-five percent of providers agreed that the presence of a BC during labour will be beneficial, in providing emotional support, boosting the woman’s confidence, providing comfort measures, helping in the early initiation of breastfeeding, reducing post-partum depression, humanizing labour, reducing the need for analgesia and increasing chances of spontaneous vaginal births. Yet, support for the introduction of BC in their hospital was low due to institutional barriers like overcrowding, lack of privacy, hospital policy, risk of infection; privacy issues and costs.ConclusionsWidespread adoption of the concept of BC would require, besides directives, a buy-in by the providers, and action on their suggestions. These include greater funding for hospitals, creating physical partitions to ensure privacy, sensitization and training of health providers and BC, incentivizing hospitals and birthing women, formulation of guidelines on BC, standards setting and a change in institutional culture.

COVID-19 Vaccine Acceptance During Pregnancy, Women's Views, and Influencing Factors.

COVID-19 vaccination is advised for pregnant women all over the world; however, vaccine acceptance is variable across the globe. This study was conducted by enrolling 292 antenatal women attending the outpatient department (OPD) in a tertiary care hospitalin Delhi, India, between August 1, 2022 and October 31, 2022, with the aim to determine the acceptability of vaccination against COVID-19 disease in pregnancy, women's views regarding the vaccine and to ascertain reasons for acceptance or denial during pregnancy. Of the 292 pregnant women who completed the questionnaire, 39.73% had received both doses of vaccination against COVID-19 disease before pregnancy, and 39.04% had received a singledose. Twenty-one percent of women did not receive any vaccine. Eighty-four percent of the unvaccinated and 35% of the women with a single dose of thevaccine refused further doses during pregnancy. The most common concern was the fear that the vaccine might cause harm to the fetus (35.3%), followed by the fear of vaccine-related reactions (25.4%). Also, 14.6% of women feared that the vaccine might cause them to abort the ongoing pregnancy. Thirteen percent of women stated their intent to receive the vaccine after they were informed regarding its safety and requirement. No difference was found in the acceptability of the vaccine based on the educational status of women or on the monthly income of the families. Adequate communication regarding safety information on COVID-19 vaccines is a must forpregnant women and their families to provide reassurance about the need and safety of the vaccines. It would facilitate making informed decisions and is likely to be helpful in increasing vaccine acceptance.

Development, validation, and usability testing of prototype mobile application for oral health promotion during pregnancy in India.

Oral diseases are a silent epidemic. The objectives of the study were to develop, validate, and assess the usability of an oral health prototype mobile application for oral health promotion among pregnant women in India. A cross-sectional study was conducted in Tertiary Care Hospital in Delhi, India, after obtaining Ethical Clearance from the Institutional Ethical Committee Board. The study was conducted in three phases: development of the prototype app, its validation, followed by usability testing of the app. Mobile app was validated by 30 pregnant women and 30 subject experts using Heuristic Analysis Scale and usability testing by 30 pregnant women based on System Usability Scale (SUS). Data were analyzed with IBM SPSS version 21.0. Majority (over 90%) of pregnant women and subject experts strongly acknowledged that the app educated the users using positive motivation strategies, instilling comprehensive knowledge and faced no issues with the appropriate functionality of the app. The prototype app scored 73.75 on SUS, indicating high usability. This study holistically explored various dimensions of oral health care in pregnant women. Its novelty is proven by the fact that the content of the prototype application has been phase wise developed and validated by pregnant women and subject experts. Usability testing of the app indicated its high acceptability and ease of use among pregnant women in India.