Tertiary Care Hospital In Delhi Research Articles

Effective Communication and Conflict Management Workshop for Nursing Interns: Experience at a Tertiary Care Hospital of Delhi, India

Introduction: Communication is an important skill required in health care settings to deal with many problems including conflict management. Nurse serves patients in challenging environment with limited infrastructure, overcrowded wards and OPD, which poses the challenge of conflict and its management. Method: Two workshops on the topic of communication and conflict management for nursing interns were conducted, these included various methods of teaching such as lecture and role-plays and interactive activities based on real-life situations. Data were collected on a pretested feedback forms and responses were obtained on 5-point Likert scale and also by open-ended questions. Result: Majority of the nurse interns strongly agreed/ agreed that the topics were appropriate, increased their knowledge and they would recommend the workshop to their peers in future. They had learnt how to overcome barriers (93.61%), professional communication (87.23%), and good communication skills (72.34%). Other take home messages, were, be a good listener, simple and precise message and empathy. They had also learnt various styles to solve conflict (95.48%). Conclusion: Student nurses were keen to learn about the effective communication and conflict management and were willing to implement learning at workplace.

Impact of COVID-19 on mental health of healthcare professionals working in COVID-19 designated clinical areas in India

Background: In the wake of the pandemic of coronavirus disease 2019, there are reports of its impact on psychological wellbeing of the health care workers.Methods: This cross-sectional survey was conducted in June 2020 in a tertiary care hospital in Delhi, India among conveniently sampled 93 participants i.e. doctors and nurses directly engaged in clinical activities in COVID-19 designated areas. A self-administered questionnaire through Google forms elicited symptoms of depression, anxiety, insomnia, and distress measured using the 9-item patient health questionnaire, 7-item generalized anxiety disorder scale, 7-item insomnia severity index, and 22-item impact of event scale-revised respectively.Results: Majority (53.8%) of the participants were male and their mean age was 30.2 years. Most (72%) were nurses, the rest being doctors. A substantial proportion of the participants had depression (47.4% of the sample), anxiety (29.0%), insomnia (32.3%) and distress (22.6%). Symptoms were disproportionately higher in female and single participants, nurses; those with history of chronic illness, staying in institute provided temporary accommodation, working on regular basis and perceiving lack of adequate personal protective equipment. Taking prophylactic hydroxychloroquine was associated with lower symptom rates.Conclusions: This survey revealed a considerable prevalence of mental health outcomes in HCWs demonstrating an association with age, gender; marital, professional and employment status, history of chronic illness, access to PPE, stay at institute provided temporary accommodation and prophylactic hydroxychloroquine use.

The Changing Pattern of the Quantum of Biomedical Waste Generated from a Tertiary Care Hospital in Delhi.

Background As a consequence of growth and advancement in health care, production of health care waste has seen an exponential upward trend. Waste from individual health care facilities can vary based on the nature and scope of health care services they provide. Objectives To analyze the amount of biomedical waste generated by a tertiary care hospital. Methods Biomedical waste generated by the hospital from 2005 to 2019 was quantified and analyzed to calculate the total amount of incinerable waste, recyclable plastic waste, and sharp and glass waste. The amount of waste generated per bed per day and the compound annual growth rate (CAGR) were also calculated. Results The total amount of biomedical waste generated in 2005 was 65,658 kg, which has substantially increased to 374,712 kg in 2019, with a CAGR of 12.5%. The hospital was producing average biomedical waste of 0.179 kg/bed/day in 2005, which has increased four times in 2019 to reach 0.709 kg/bed/day. The overall estimated plastic waste was 31% of the total biomedical waste in 2005 and 53% in 2019. Conclusion The generation of biomedical waste is likely to see significant upward trends unless diligent deliberations are held between different stakeholders in regard to the reintroduction of reusable materials and waste reduction strategies.

Incidence rate and epidemiology of cervical spinal injuries and management in tertiary care hospital of Delhi: A institutional based retrospective study

Introduction: Cervical spine injuries were the most common problem nowadays that many people experiencing due to high-intensity trauma. In contrast, substantial heterogeneity and lack of data exist among clinical spine trauma epidemiological studies limiting the ability to compare and pool data. The most common mechanism of injury is usually motor vehicle accidents. However, its patient-centered characterisation and quantification are lacking. Materials and Methods: Incidence and characteristics of cervical spine injury were identified in the tertiary care hospital of Delhi. Fifty-six cervical spine injuries admitted patients among all 228 spinal trauma patients who presented in the orthopaedic trauma emergency registry were recruited in this study. Results: There were 56 subjects identified (8.53%) with cervical spine injury admitted per further evaluation. Among these, 85.7% were male. Mainly age group involve is 20–40 year (median age – 24 year), mostly injured by road traffic accident (RTA) (35.7%). The cervical injury commonly has upper, and subaxial vertebrae fractures and anterolisthesis are much common than retrolisthesis. The hospital stay of listhesis patient is usually more than disc bulge patients. Halovent application is more common in the upper cervical (c 1 –c 2 ), like anterior cervical plating with dissectomy is common in disc bulge cervical patients. Conclusion: Cervical spinal injury is associated with RTA in the young age group. A head injury like trauma should take into consideration in every cervical patient. Early management with better operative techniques can decrease hospital stay and increase the recovery rate of patients.

Transgenders are the most vulnerable amongst individuals engaging in receptive anal intercourse: A cross-sectional study from North India.

Background:In India, sexuality not confirming to hetero-conjugal and peno-vaginal norm is abhorred and discriminated against. Individuals engaging in Receptive Anal Intercourse (RAI) are marginalized. Reappraisal of their sexual health conditions is likely to promote inclusive health care.Methods:Eighty-five consenting adults with RAI history were recruited from a tertiary care hospital in Delhi. Clinico-demographic data was noted and anal cytology samples were reported by Bethesda 2014 terminology.Results:There were 29 transgenders (TGs), 51 males (31 bisexual) and five females. Fifty-four subjects were Human Immunodeficiency Virus (HIV) infected (22 TGs, 31 males (17 bisexual) and one female) and 52 were receiving anti-retroviral treatment (ART). Thirty-one subjects had anal warts (6 TGs, 20 males, five females). Anal cytology revealed squamous intra-epithelial lesions (SIL) in 20 (5 TGs, 13 males, two females). TGs had significantly risker sexual practices than homosexual males, bisexual males and females, with consistently earlier age of first RAI exposure and frequent childhood (≤16 years) RAI experience compared to homosexual males, bisexual males and females, even after stratification by HIV status, warts and SIL.Conclusions:TGs had the highest sexual health risk profile including higher frequency of HIV infection compared to other subjects with RAI history. Bisexuality was common; their risk profile was variably lower than homosexual males. Mindfulness of above is likely to help overcome barriers to health care access and promote compassionate approach at all levels including primary care physicians.

Effect of four weeks of integrated yoga intervention on perceived stress and sleep quality among female nursing professionals working at a tertiary care hospital

Background:Studies have reported that significant nursing professionals experience tremendous stress which often affects their sleep quality leading to poor well-being. Yoga being a mind body intervention reported to improve sleep quality and reduce stress.Aim:The present pilot study was designed to assess the effect of yoga on perceived stress and sleep quality of the female nursing professionals working at tertiary care hospital.Materials and Methods:Thirty-three apparently healthy nursing staffs in the age range of 30–60 years (mean age 40.60 ± 10.26) were recruited as participants of the study, from a tertiary care hospital in Delhi. Participants were administered perceived stress scale (PSS) and Pittsburgh sleep quality index (PSQI) before and after the yoga intervention. Participants received 4 week of yoga intervention for 45 min/day for 5 days a week.Results:There was a significant reduction on the postscores of PSS (t = 5.86, P < 0.0001, paired t-test) and PSQI (z = −4.38, P < 0.0001, Wilcoxon signed-ranks test) in comparison to prescores. After the yoga intervention, perceived stress reduced by 27.01% and the sleep quality improved by 38.68%.Conclusion:The finding of the study suggests effectiveness of yoga in reduction of the perceived stress and improvement of the quality of sleep of the nursing professional. However, the present findings need to be confirmed with further studies with larger sample size and robust research design.

Predictors of severe dengue amongst children as per the revised WHO classification.

World Health Organization (WHO) revised its guidelines for classification and management of dengue in 2009. This revised system was found out to have good sensitivity and negative predictive value but poor specificity as well as positive predictive value. This retrospective study was carried out in a tertiary care hospital of Delhi, India to assess factors predicting the occurrence of severe dengue in children as per the revised classification. A total of 647 suspected dengue cases were admitted in the hospital in the year 2015. Detailed clinical and epidemiological data of 170 patients who were confirmed as dengue either by NS1 antigen test or by serology (Ig M positive) were recorded and statistically analyzed. The number of laboratory-confirmed cases was 170 and included thirty (17.65%) dengue fever (DF), 106 (62.35%) dengue with warning signs (DWS) and 34 (20.0%) severe dengue (SD) patients. Regression analysis revealed that presence of vomiting, altered sensorium, shock, peri-orbital edema, hepatomegaly, splenomegaly, severe anemia, thrombocytopenia, elevated urea and creatinine, decreased total protein and globulin were significantly associated with occurrence of severe disease. The addition of clinical features (peri-orbital edema and splenomegaly); and laboratory findings (elevated urea and creatinine, decreased serum protein and globulin) might help improve the sensitivity and specificity of the revised WHO dengue classification in predicting severe dengue.

Profile of Medico-legal Cases in Casualty of a Tertiary Care Hospital in Delhi

To establish more sensitive methods for detection of DYS385 in routine forensic casework.The primers recommended by Genome Database (GDB) and Schneider were used to amplify DYS385 respectively. Then, a semi-nested PCR of DYS385 was designed by using the two different primers as outer and inner primer. A series of experiments were carried out to achieve good result by adjusting the ratio of outer/inner primer and optimizing the PCR condition.It showed that an overall 112 bp shorter DYS385 fragments and better electrophoretic separation were obtained by using primer2B. By using the semi-nested PCR approach, the shorter specific DYS385 fragments could be amplified and detectable DNA amounted to 50 pg.This method is 20 fold more sensitive than the ordinary method.

Oxidative Stress Markers (8-Isoprostane and 8-Hydroxy-2-Deoxyguanosine) in Major Depression: A Case-control Study

Introduction: Depression is associated with activation of innate immune response leading to oxidative damage. The 8-isoprostanes and 8-hydroxy-2-deoxyguanosine (8-OHdG) are biomarkers of oxidative damage to lipids and Deoxyribonucleic Acid (DNA), respectively. They have been independently linked to depression. Aim: To study the oxidative stress markers (8-Isoprostanes and 8-OHdG) in subjects with major depression. Materials and Methods: In this observational case-control study 42 cases of depression, 13-25 years of age were recruited from Psychiatry Out Patient Department (OPD) at a tertiary-care hospital in Delhi, India, along with 42 healthy controls. They were assessed clinically and using psychometric evaluation scores, Beck’s Depression Inventory-II (BDI-II) and Hamilton Depression Rating Scale (HAM-D). All 42 subjects were on medication with antidepressants {33/42 with Selective Serotonin Reuptake Inhibitors (SSRI) 8/42 with Tricyclic Antidepressants (TCA) and 1/42 on a combination of both}. Routine laboratory investigations were done. Plasma 8-Isoprostane and serum 8-OHdG concentrations were measured in both cases and controls. The results obtained were analysed using relevant statistical tests on STATA version 11 (StataCorp, 2009). Results: Clinically, all patients had moderate to severe depression. BDI-II and HAM-D scores were raised in all cases as compared to the controls (28.81±5.60 vs 1.62±1.59 for BDI and 20.88±4.67 vs 1.33±1.43 for HAM-D, respectively). The concentration (in depressed vs controls) of plasma 8-Isoprostane (107.70±54.48 pg/mL vs 77.78±60.15 pg/mL) and serum 8-OHdG (2103.03±154 pg/mL vs 2017±164.69 pg/mL) were significantly elevated (p-value &lt;0.05). Though elevated in patients belonging to both genders, showed significant increase of 8-Isoprostane only in females and 8-OHdG only in males as compared to their healthy controls. No correlation of the levels of any of two markers was seen with clinical severity of depression of patients as assessed by BDI. Conclusion: Evidence of oxidative stress to lipids and DNA are present in the peripheral blood. These can be explored further in establishing the biomarkers for diagnosis and prognosis of depression.

Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms.

BackgroundMulti-drug resistant (MDR) Gram-negative bacteria are an emerging threat, both in hospital and community settings. As very few antibiotics are effective against such infections, the need of the hour is a new antibiotic or drug combination which can overcome the effect of extended-spectrum β-lactamases (ESBL) and metallo β-lactamases (MBL). A new antibiotic combination of ceftriaxone, sulbactam and disodium edetate (CSE) has recently been proposed to tackle the MDR organisms.ObjectiveOur study was carried out to assess the susceptibility of ESBL- and MBL-producing Gram-negative organisms to CSE.MethodsThe study was conducted in a tertiary-care hospital in Delhi, India, from February 2017 to June 2017. A total of 179 MDR (85 ESBL + 94 MBL) Gram-negative isolates from various clinical samples, identified by an automated system (Vitek 2) were tested against CSE using the Kirby-Bauer disc diffusion method. Susceptibility to CSE was recorded based on interpretative zone sizes of ceftriaxone as per 2017 Clinical and Laboratory Standards Institute guidelines.ResultsThe most common isolate was Escherichia coli (76/179; 42.4%) followed by Klebsiella pneumoniae (53/179; 29.6%) and Acinetobacter baumanii (27/179; 15.1%). The in vitro susceptibility of ESBL- and MBL-producing Gram-negative isolates to CSE was found to be 58/85 (68.2%) for ESBL and 37/94 (39.4%) for MBL.ConclusionThe in vitro susceptibility results obtained for CSE against ESBL-producing organisms is promising. It has the potential to emerge as a carbapenem-sparing antibiotic, active against ESBL-producing strains. Further clinical studies are required to establish the clinical efficacy of CSE against MDR pathogens.

Risk Factors and Subtyping of Ischemic Stroke in Young Adults in the Indian Population.

Objective: To evaluate the risk factors and etiological subtyping of ischemic stroke in young adults in the Indian population.Methods: This is a retrospective study of 160 patients, in the age group of 18 to 45 years with ischemic stroke, registered at a tertiary care hospital in Delhi, India between March 2014 and January 2018. Hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol consumption, previous history of stroke, valvular heart disease, coronary artery disease (CAD), atrial fibrillation, family history, and migraine were considered as the identifiable risk factors. Stroke subtyping was done according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.Results: The mean age of the patients was 36.2 years with 74% being males. Headache, vomiting, difficulty in speech, and hemiparesis were the common complaints at presentation. Common risk factors identified were hypertension (50%), prior stroke or transient ischemic attack (TIA; 32%), dyslipidemia (25%), family history of stroke (18%), and smoking (15%). The most common TOAST subtype was undetermined (64%), followed by other determined cause (ODC; 20%), and cardioembolism (15%).Conclusion: There is a certain dissimilarity in the risk factors for ischemic stroke in young adults living in developing countries compared to those belonging to developed nations. Primary and secondary prevention targeted at the modifiable risk factors of ischemic stroke is necessary. Cerebral artery dissection, being a prevalent cause of ischemic stroke in young adults, should be carefully evaluated. A more appropriate stroke classification system specifically tailored for younger patients is needed.

Awareness and perspectives on paediatric dysbiosis among early-career clinicians at a tertiary care hospital in Delhi, India.

Awareness and perspectives on paediatric dysbiosis among early-career clinicians at a tertiary care hospital in Delhi, India.

Gray Transformation of Internal Medicine.

AimTo study the profile of patients hospitalized in an internal medicine facility of a public hospital and explore if there is a shift in the age distribution of hospitalized patients toward an older age group.MethodsThe study was conducted at a tertiary care hospital in Delhi where the department of medicine has six units and a particular unit is in charge of the emergency room one day a week and every sixth Sunday. A total of 716 patients hospitalized in the medicine ward through the emergency services each Wednesday and every sixth Sunday (i.e, admission days of a particular unit) during a period for six months (November 2017 to April 2018) were retrospectively identified and their name, age, sex, comorbidities, final diagnosis, duration of hospital stay, and the outcome were noted. This was compared with similar data collected from a previous study conducted in the same setting in the years 2010-2011. The data were analyzed using Stata version 13 software (StataCorp, College Station, Texas). Findings were compared using the chi-squared test or t-test, wherever applicable.ResultsThe mean age of patients hospitalized in 2010-2011 was 43.9 years, and this had increased to 48 years in 2018-2019 suggesting that the average patient being hospitalized in general medicine wards of a public hospital was now approximately five years older. Thirty-nine percent (39%) of the individuals admitted were more than 60 years of age in 2018-2019 as compared to 28.0% in 2010-2011. There was a significant rise in the cases of cardiovascular and gastrointestinal diseases and a decline in poisoning and infectious diseases from the year 2010-2011 to 2018-2019. A significantly higher prevalence of cardiovascular diseases, diabetes, and respiratory diseases was found in the current study among older adults.ConclusionThere has been a significant shift in the distribution of hospitalized patients in the internal medicine in-patient wards toward the older age group during the last decade. Also, there is a significant difference between the disease profiles of older and young patients. A comprehensive approach to geriatric medicine should be introduced and followed.

Clinical features, laboratory profile and outcomes among dengue patients admitted in a tertiary care hospital, Delhi NCR

Background: Globally, dengue, a mosquito-borne viral infection, is the most rapidly spreading vector-borne disease. Dengue fever is endemic in &gt;100 countries including India. Dengue has a variety of clinical presentations. The objective of the study was to understand the clinical features, laboratory profile and outcomes of dengue fever among patients admitted in a tertiary care hospital in Delhi, National Capital Region.Methods: This was a cross-sectional study among 75 dengue confirmed (NS-1 antigen and/or IgM antibody positive) patients with fever &lt;1 week. The variables included were socio-demographic; clinical features; laboratory and radiological profile and outcomes. Descriptive analysis was used.Results: The majority of the patients were aged between 18-40 years 72% and predominantly males 68%. A total of 18.7% patients (malaria: 13.3% and chikungunya: 5.3%) had co-infection. Fever was present in all the patients, followed by myalgia (74.7% patients), retro-orbital pain/headache 69.3%, and vomiting 45.3%. The mean hemoglobin was 13.9 gm/dl, leukopenia 46.7% patients, thrombocytopenia 96.0% and elevated liver enzymes 69.3%. Radiological examination showed pleural effusion 6.7%, gallbladder wall thickening 6.7%, splenomegaly 4.0%, and hepatomegaly 2.7%. The outcomes included ICU care 17.3%, ventilator support 13.3%, blood transfusion 14.7%, and mortality 1.3% during the hospital stay.Conclusions: Dengue has become a major public health problem in India. The most common clinical features are fever, myalgia, headache and vomiting; laboratory abnormalities are leukopenia, thrombocytopenia and deranged liver enzymes. No specific treatment exists, but early detection and proper medical care lowers fatality rates.

Prevalence and predictors of hypocalcaemia in severe acute malnutrition.

To determine the prevalence and predictors of hypocalcaemia in under-five children (1-59months) hospitalised with severe acute malnutrition (SAM). A cross-sectional study was designed to determine the prevalence of hypocalcaemia among children hospitalised with SAM. Serum Ca and 25-hydroxycholecalciferol (25-(OH)D) were estimated. Hypocalcaemia was defined as serum Ca (albumin-adjusted) <2·12mmol/l. To identify the clinical predictors of hypocalcaemia, a logistic regression model was constructed taking hypocalcaemia as a dependent variable, and sociodemographic and clinical variables as independent variables. A tertiary care hospital in Delhi, between November 2017 and April 2019. One-hundred and fifty children (1-59 months) hospitalised with SAM were enrolled. Hypocalcaemia was documented in thirty-nine (26 %) children hospitalised with SAM, the prevalence being comparable between children aged <6 months (11/41, 26·8 %) and those between 6 and 59 months (28/109, 25·7 %) (P = 0·887). Vitamin D deficiency (serum 25-(OH)D <30nmol/l) and clinical rickets were observed in ninety-eight (65·3 %) and sixty-three (42 %) children, respectively. Hypocalcaemia occurred more frequently in severely malnourished children with clinical rickets (OR 6·6, 95 % CI 2·54, 17·15, P < 0·001), abdominal distension (OR 4·5, 95 % CI 1·39, 14·54, P = 0·012) and sepsis (OR 2·6, 95 % CI 1·00, 6·57, P = 0·050). Rickets and hypocalcaemia are common in children with SAM. Routine supplementation of vitamin D should be considered for severely malnourished children. Ca may be empirically prescribed to severely malnourished children with clinical rickets, abdominal distension and/or sepsis.

Long-term Follow-up of Multidrug Resistant Tuberculosis Patients of Delhi, Who had Received DOTS Plus Treatment along with Home Care and Counseling

Background: To realize the vision of a world free of TB, it becomes mandatory to disallow Ex-TB and Ex-MDR TB patients to have relapse or become Extremely Drug Resistant (XDR). Long follow-up of treated cases, who also received home care and counseling hasn’t been done thus far in India. Objective: To find out whether 50% of Ex-MDR TB patients who had also received home based support with counseling are healthy after five years. Methods: This retrospective study of 109 Ex-MDR-TB patients was carried out by Community Health Department (CHD) of a Tertiary Care Hospital in Delhi. They had received daily MDR Regimen (starting from August 2009 to August 2010 from their respective DOTS Providers) and home care and strong counseling support. They completed it by 2011 or 2012. The study period was from May to August 2015. Result: After a long follow up of these patients in 2015 it was found that 71(65.14%) were alive &amp; healthy, 26(23.85%) dead, 5(4.59%) defaulters, 1(0.92%) failure cases, 4(3.67%) lost to follow-up, whereas 2(1.83%) were on treatment as they had relapsed. Conclusion: Our study concludes that more than 50% Ex-MDR TB cases who had also received home based support with counseling are alive &amp; healthy after five years. We recommend that a mechanism for home-based care &amp; counseling and Long Follow Up for MDR TB patients be developed. How to cite this article:Vaghela JF, Anand T. Long-term Follow-up of Multidrug Resistant Tuberculosis Patients of Delhi, Who had Received DOTS Plus Treatment along with Home Care and Counseling. J Commun Dis 2020; 52(2): 24-30. DOI: https://doi.org/10.24321/0019.5138.202015

Pattern of stress and anxiety behaviour among people with type 2 diabetes in a tertiary care hospital of Delhi, India: an observational study

Background: The prevalence of stress and anxiety in diabetes is considerably higher than normal population and found to have a negative impact on diabetes. The aim of this study was to examine the relationships among perceived diabetes-related stress and anxiety behaviors in adults living with type 2 diabetes (T2DM).Methods: In this descriptive and cross sectional study, systematic random sampling technique was used to select the sample of type 2 diabetic patients. Scheduled interview of 412 type 2 diabetic patient was conducted at outpatient department of a tertiary care hospital in New Delhi.Results: Out of 412 diabetic patients, 58.7 percent feel diabetes-related stress and anxiety behaviors when they think about living with diabetes. Age of patients, educational status, occupation and average monthly family income of diabetic patients are statistically associated with perceived diabetes-related stress and anxiety behaviors of type 2 diabetes mellitus patients. Lifestyle behaviour like diet pattern (vegetarian or nonvegetarian diet) and moderate intensity activities like walking are also statistically associated with perceived diabetes-related stress and anxiety behaviors of type 2 diabetes mellitus patients.Conclusions: This study found a high prevalence of diabetes-related stress and anxiety behavior in patients with Type 2 DM. Therefore, the care of individuals with type 2 Diabetes Mellitus (DM) should include the screening and possible management of stress and anxiety in order to achieve and sustain treatment goals.

TB Outcome of DOTS Category I TB Cases Started on Re-treatment with Category II Regimen during the Years 2002 to 2015, in a Slum in Delhi

Objective: This study of TB Cat I cases retreated with Cat II treatment at a DOTS centre, was under taken to gather evidence as to whether TB patients are mostly relapse cases or failure cases and if there is any difference in their final outcome after retreatment. Methods: The secondary data maintained for a total of 1941 TB patients in the TB register, who were registered &amp; treated from 2002 to the year 2015 at Community Health Department (CHD) DOTS centre of a tertiary care hospital of Delhi was accessed and was entered in excel sheet and Statistical analysis was done using and MedCalc Software bvba [BE]. Out of 1301 total Cat I cases 94 were found who were restarted on Cat II regimen. Out of these 58 (61.7%) were Relapse cases and 36 (38.29%) failure cases. Result: The mean age was 32.03 with SD+16.33 years and 53.19% were males among 94 Cat I cases enrolled for retreatment. The Cat I Failure cases put on Cat II, showed failure in 12 (33.33%) Vs. failure in relapse cases 10 (17.24%). This low success to treatment (cured and Treatment completed) rate in Failure cases was highly significant (p&lt;0.0001). Conclusion: TB treatment outcome matters a lot. If a TB patient is not cured or does not complete treatment her/his TB could become Drug Resistant. All TB patients should be prevented from becoming failure cases during the course of treatment. If this is done TB morbidity and mortality could be controlled. How to cite this article:Vaghela JF, Mangal A. TB Outcome of DOTS Category I TB Cases Started on Re-treatment with Category II Regimen during the Years 2002 to 2015, in a Slum in Delhi. J Commun Dis 2019; 51(4): 62-68. DOI: https://doi.org/10.24321/0019.5138.201938

Epidemiological Profile of Trauma Victims Attending a Tertiary Care Hospital in Delhi and Application of Haddon Matrix to Identify Risk Factors of Road Traffic Accidents

Epidemiological Profile of Trauma Victims Attending a Tertiary Care Hospital in Delhi and Application of Haddon Matrix to Identify Risk Factors of Road Traffic Accidents

Cost of treatment and consequences for chronic hepatitis B and C virus infection at a tertiary care hospital in Delhi.

Patient living with chronic viral hepatitis in India faces the high cost of treatment and impoverishment. The present study is aimed to assess the cost of treatment and economic consequences among chronically infected viral hepatitis patients at a tertiary care hospital in Delhi. The descriptive cross-sectional study was undertaken during October 2016-January 2017. Three hundred and eighty-nine participants were interviewed through a schedule for variables and assessing both direct and indirect costs. Costs of hospital expenditure were extracted from records available with patients or databases of the hospital. The average outpatient expenditure and the inpatient costs were calculated. Direct nonmedical costs were also included. The analysis revealed the total cost of treatment ranged from Rs. 16,600/-to Rs. 1,709,000/-with a median of Rs. 193,500 per year. The cost of treatment increased with the severity of the disease. The cost of treatment led to impoverishment in 52.8% of families and imposed a substantial economic burden and consequences on the patients.