Tertiary Care Hospital In Puducherry Research Articles

Effectiveness of Radial Artery Positioning Board (RAPB) on Radial Artery Access and Prevention of Access Site Complications among Patients Admitted in Critical Care Units at Tertiary Care Hospital, Puducherry

Background: Radial artery access is a fundamental procedure in critical care settings, yet achieving optimal wrist extension poses challenges. This study investigates the efficacy of a novel intervention, the radial artery positioning board (RAPB), in enhancing radial artery access success rates and preventing access site complications among critically ill patients.  Methods: Employing a randomized controlled trial with a two-group post-tests only control design, 160 patients were enrolled using a block random sampling method. The study, conducted at a tertiary care hospital in Puducherry, utilized both descriptive and inferential statistical analyses to assess the outcomes.  Results: Analysis revealed a significant improvement in the success rates of radial artery access (z = -11.125, p < 0.05) and a notable reduction in access site complications (z = 7.938, p < 0.05) in the RAPB group compared to the control group. Furthermore, a positive correlation was established between successful radial artery access using RAPB and the prevention of access site complications (r = 0.504, p < 0.05).  Conclusion: The findings underscore the effectiveness of RAPB in facilitating early radial artery access with heightened success rates and diminished access site complications among critically ill patients. Additionally, body mass index and comorbidities exhibited statistically significant associations with radial artery access (p < 0.05), emphasizing the need for tailored interventions in this population.

A Study on Suicidal Intent, Quality of Life, Medical and Psychiatric Comorbidity in Cancer Patients at a Tertiary Care Hospital in Puducherry

Background- Cancer is now widely recognised as a new epidemic globally which accounts for nearly 10 million deaths in year 2020. Aims and Objectives-The aim of the study was to estimate suicidal ideation among cancer patients and to evaluate the association between suicidal intent with the quality of life, medical and psychiatric comorbidities. Methods-The study group included 70 cancer patients who were surgically treated in the Department of Surgical Oncology in a tertiary care hospital in South India. The sample size was calculated using Open Epi Version 3.0. Sampling was done using consecutive sampling method. The study was conducted from March 2021 to September 2022. A socio-demographic information form, HADS (Hospital Anxiety Depression Scale), Beck Suicide Intent Scale and WHO-QOL BREF (WHO Quality of Life BREF) were used. Results- In our study 12.9% reported having attempted suicide in the recent past, 18.6% scored abnormal on anxiety scale and 40% scored depression level on HADS. Conclusions- Cancer patients are at increased risk of developing many psychiatric illnesses including anxiety, depression and suicidal attempts. The QOL of cancer patients are affected by these psychiatric comorbidities. Timely assessment and intervention can improve their QOL and also reduce the risks of suicide. There is a significant correlation between anxiety, depression and suicide attempt. Keywords: Suicide, Anxiety, Quality of Life, Cancer .

Assessment of Knowledge on Dietary Management of Chronic Kidney Disease Among Patients Undergoing Hemodialysis at a Tertiary Care Hospital in South India: A Cross-Sectional Analytical Study.

Background This cross-sectional analytical study aimed to assess the level of knowledge on dietary management of chronic kidney disease (CKD) among patients undergoing hemodialysis in a tertiary care hospital in Puducherry, South India. Methodology The study was conducted among 86 inpatients diagnosed with CKD and undergoing hemodialysis in the dialysis unit. They were selected by simple random sampling. The self-administered, validated, self-structured questionnaire was used to collect the data. The study was conducted from May to September 2019. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (chi-square) were used to find out the relationship between the level of knowledge and background variables using IBMSPSSStatistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). Results The findings indicated that the majority of patients were in the 20-30 age range (36, 41.9%), male (58, 67.4%), from nuclear families (58, 66.3%), with mixed dietary habits (60, 69.8%), and undergoing thrice-weekly hemodialysis (34, 53.5%). Additionally, 59 (68.6%) were hypertensiveand 14 (16.3%) were diabetic. Most patients exhibited a moderate level of knowledge (74, 86%), while a small percentage had inadequate (6, 7%) and adequate (6, 7%) knowledge, with a mean (SD) value of 2.00 (0.376). The study identified statistically significant associations between knowledge levels and age, occupation, food habits, duration of dialysis, pre-existing co-morbid illnesses, and treatment of hemodialysis with a p-value <0.05. Conclusions In conclusion, this study highlights that the majority of the CKD patients undergoing hemodialysis exhibit moderately adequate knowledge of dietary management. However, a notable need remains for further education and support in this area. Addressing these knowledge gaps is crucial, as it can empower nursing students and healthcare professionals to educate these patients on their dietary needs effectively. By providing comprehensive education and support, we can enhance the quality of care and improve outcomes for hemodialysis patients.

Effect of iron folic acid with tablet vitamin C compared to iron folic acid with routine verbal advice of vitamin C rich foods on the hemoglobin levels of anemic pregnant women attending a tertiary care hospital in Puducherry: protocol for a pragmatic trial

Background: In routine practice, pregnant women are advised to take iron folic acid (IFA) tablets with vitamin C-rich foods. If vitamin C tablets are given instead, there may be an improvement in the hemoglobin levels of pregnant women. The study aims to find the effectiveness of IFA tablet with vitamin C tablet compared to IFA tablet with verbal advice of vitamin C rich foods, over 6 weeks, on the hemoglobin levels of anemic pregnant women (13-33 weeks) attending a tertiary care hospital in Puducherry. Methods: A pragmatic trial will be conducted in the antenatal OPD of a hospital in Puducherry. Anemic pregnant women will be consecutively recruited until a sample size of 86 is attained. Permuted block randomization and allocation concealment will be used. After eligibility assessment, participants will be randomly assigned two arms. The intervention arm will receive IFA tablets with vitamin C tablets, while the control arm will be advised to take IFA tablets with vitamin C-rich food. Participants will be followed up at 6 weeks. The intention-to-treat approach will be used. Linear regression will be performed followed by multivariable linear regression to adjust for confounding variables. Conclusions: This study protocol is designed to investigate whether the hemoglobin status and control of anemia in anemic mothers can be improved by giving IFA tablets with vitamin C tablets in routine practice, rather than verbal advice to take IFA tablets with vitamin C-rich foods.

PRESCRIBING PATTERN OF DRUGS IN OUTPATIENT DEPARTMENT IN TERTIARY CARE HOSPITAL

Aim: The study was conducted to assess the prescribing behaviour for antimicrobials and various groups of drugs in tertiary care hospital in Puducherry. Prescription audit was done. Total 500 presc Method: riptions were analysed for sex wise distribution, no of patients for specic age group, antimicrobials prescribed in generic name, percentage of antibiotics, antacids, NSAIDs and multivitamins, among the prescribed drugs, groups of antibiotics, drugs prescribed from National List of Essential Medicines (2022), use ofxed drug combinations, injectable preparations if any. Results: Demographic analysis showed that out of 500 patients in OPD, most were female (53%) and in the age group between 41 to 60 years. In 500 number of prescriptions,9.96% of antibiotics were prescribed; uoroquinolones (5.42%) were prescribed more from antibiotics followed by extended spectrum penicillin (1.64%). 14.78%of antacids were prescribed; PPIs (11.28%) were prescribed more from antacids. 21.63% of NSAIDs were prescribed.11.66% were prescribed in generic names, 65.44% drugs were prescribed from National List of Essential Medicines (2022), 15.88% of FDCs were prescribed,6.13% of injectable preparations were prescribed. The rational use of antimicrobial agents is one of the main contribut Conclusion: ors to control worldwide emergence of bacterial resistance, side effects and reduced cost of the treatment

Dengue and typhoid co-infection: a case report from a tertiary care hospital in Puducherry

Acute undifferentiated febrile illness is the most common presenting symptom in both adults and children during the monsoon. Incidence of both vector- and water-borne diseases are highest during these seasons, co-infections of dengue with typhoid, malaria, leptospirosis, scrub typhus and other arboviruses can occur in endemic areas. We report the case of a 3-year-old child who presented with dengue and typhoid fever coinfection and subsequently recovered. In every febrile patients’ common infections should be evaluated with through history, clinical examinations and logical investigations. If not treated early, dengue and typhoid together, may lead to multi-organ involvement with significant morbidity and mortality.

Medication Adherence using Medication Possession Ratio and Proportion of Days Covered among Elderly Diabetic Patients Visiting a Tertiary Care Hospital in Puducherry

Background: Patient adherence to treatment is crucial for successful therapy while treating chronic conditions like diabetes mellitus. Medication possession ratio (MPR) and proportion of Days Covered (PDC) are the most common measures of medication adherence using refill records. Methods: A prospective hospital-based longitudinal study was carried out among elderly patients, both males and females on oral hypoglycaemic medication from May-August 2019 in the Department of General Medicine in Puducherry. MPR was calculated as the sum of the days' supply for all fills of a given drug in a particular period divided by the number of days in the period while PDC was calculated as the number of days the drug supplied during the study period divided by the number of days in the study period. MPR and PDC ≥ 80% was considered as adherence to medication. Results: In our study, 80% of elderly diabetic patients were adherent to medication according to medication possession ratio (MPR), while adherence according to the proportion of days covered was much lesser and was only 64.4%. We found a significant association between medication adherence in elderly diabetic patient’s factors such as monthly family income, literacy, and presence of a caretaker while there was no association between medication adherence in elderly diabetic patients upon the age of the patient, number of drugs prescribed and monthly cost of the medicines. Conclusion: Medication adherence in elderly diabetic patients mainly depends on many factors such as monthly family income, literacy and presence of the caretaker and not depending upon the age of the patient, number of drugs prescribed and monthly cost of the medicines. Larger studies are necessary to realize the proper impact of nonadherence on this group of the population

Genotype Distribution and Antibiotic Susceptibility Pattern of Clinical Isolates of Group B Streptococcus in a Tertiary Care Hospital in Puducherry, South India.

Streptococcus agalactiae apart from being a colonizer in the genital region is also associated with several other invasive infections in all age groups. With the varied distribution of serotypes across different regions of the world, universal vaccination is also unattainable. However, in India, the knowledge of group B Streptococcus (GBS) genotype distribution is deficient. Thus, this study was initiated to add data on this aspect. Methodology. A cross-sectional study was conducted using isolates of group B Streptococcus from all clinical specimens. Along with that, the clinical specimen type and the antibiotic resistance profile of the isolates were correlated with the genotypes recognized through a multiplex PCR assay. Among the 86 isolates subjected to multiplex PCR for genotype identification, five genotypes were identified with genotype Ib as the predominant one (34.9%), followed by III (20.9%), II (16.3%), Ia (12.7%), and V (11.6%). The results demonstrated a correlation of types Ib and III with vaginal colonization and type II with urine specimens in the current study. This preliminary study exhibited the distribution of common genotypes and their antibiotic resistance profiles in various GBS isolates. However, multiple studies across the country with larger sample sizes are needed to validate these findings.

A descriptive cross-sectional study on perceived barriers and facilitators regarding the use of menstrual cups among medical students in a tertiary care hospital in Puducherry

Introduction: Adolescence is the period between 10 and 19 years of life, and about one-fifth of the total female population in the world are in this age group who undergo the basic physiological phenomenon called menstruation. The issues related to menstruation are often neglected by family and community which affects the physical, mental and social functioning of the teenagers. By adopting sustainable menstrual hygienic practices, the major disorder of sexual and reproductive health. The objectives of this study were to determine the prevalence of the usage of menstrual cups among medical students, to assess the knowledge and practice about menstrual cup and to determine the barriers and facilitators regarding the use of menstrual cup. Methods: This study was a descriptive cross-sectional study conducted among the female medical students of Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry. The study tool was a Google Form comprising the sociodemographic details of the study participants and the details regarding the usage of menstrual products, especially menstrual cups. This study followed the universal sampling method, and a total of 164 students responded. The responses were downloaded from Microsoft Excel and analyzed using SPSS version 21. Results: Out of the total 164 study participants, 53% belonged to the age group of 18–22 years, 46% were in the age group of 23–27 years, and 1% were above the age of 27 years. Of these, 20% were 1st year, 16% were 2nd year, 21% were 3rd year, 29% were 4th year, and 14% were interns. The knowledge prevalence of menstrual cups was 78%. The prevalence of the usage of menstrual cups was 85%. Conclusion: Hence, much insight has to be tailored to the advancement in knowledge dissemination regarding sexual and reproductive health. The practice of safe, durable, and sustainable menstrual hygienic products such as menstrual cup has to be encouraged as they are cost effective and generate less waste. All menstruating women should be educated about menstrual cups and should be encouraged to use it.

Profile of non-communicable Disease Risk Factors Among Nurses in a Tertiary Care Hospital in South India

The work nature of nurses and the associated lifestyle changes put them at high risk of developing non-communicable diseases (NCDs). This study was conducted to estimate the prevalence of NCD risk factors among nurses working in a tertiary care hospital in Puducherry and to determine the associated factors among nurses. We conducted a cross-sectional study among all nurses (N=1217) in the tertiary care hospital aged between 21 and 60 from May 2019 to April 2020. We assessed NCDs behavioral, physical and biochemical risk factors using a self-administered questionnaire. The adjusted prevalence ratio was calculated using a generalized linear regression model to determine factors associated with NCD risk factors. The response rate was 99% (1217/1229), and 77.5 % of the participants were women. Current tobacco use, and alcohol consumption were 1.5% (95% CI: 0.8-2.2) and 2.9% (95% CI: 2-3.9) respectively with significantly higher prevalence among men. Overweight or Obesity (BMI >23 kg/m2) was 77.7%, with a significantly higher prevalence among those aged ≥30 and married. Prevalence of hypertension was 14.4 % (95% CI: 12.5-16.4), and diabetes mellitus was 11.5 % (95% CI: 9.7-13.6) were significantly higher among those aged ≥50 years. One-third of nurses, 34.3% (95% CI: 31.6-37.1), had hypercholesterolemia, significantly higher among men. We found a high prevalence of various NCD risk factors among the nurses. We highlight the urgent need for initiating health promotion interventions, especially to improve intake of healthy diet and physical activity among nurses aged ≥30 years.

Primary hyperparathyroidism presenting as acute pancreatitis: An institutional experience with review of the literature.

BACKGROUNDAcute pancreatitis (AP) presenting as an initial manifestation of primary hyperparathyroidism (PHPT) is uncommon, and its timely diagnosis is crucial in preventing recurrent attacks of pancreatitis.AIMTo determine the clinical, biochemical, and radiological profile of PHPT patients presenting as AP.METHODSThis is a retrospective observational study, 51 consecutive patients admitted with the diagnosis of PHPT during January 2010 and October 2021 at a tertiary care hospital in Puducherry, India was included. The diagnosis of AP was established in the presence of at least two of the three following features: abdominal pain, levels of serum amylase or lipase greater than three times the normal, and characteristic features at abdominal imaging.RESULTSOut of the 51 consecutive patients with PHPT, twelve (23.52%) had pancreatitis [5 (9.80%) AP, seven (13.72%) chronic pancreatitis (CP)]. PHPT with AP (PHPT-AP) was more common among males with the presentation at a younger age (35.20 ± 16.11 vs 49.23 ± 14.80 years, P = 0.05) and lower plasma intact parathyroid hormone (iPTH) levels [125 (80.55-178.65) vs 519.80 (149-1649.55, P = 0.01)] compared to PHPT without pancreatitis (PHPT-NP). The mean serum calcium levels were similar in both PHPT-AP and PHPT-NP groups [(11.66 ± 1.15 mg/dL) vs (12.46 ± 1.71 mg/dL), P = 0.32]. PHPT-AP also presented with more gastrointestinal symptoms like abdominal pain, nausea, and vomiting with lesser skeletal and renal manifestations as compared to patients with PHPT-NP.CONCLUSIONAP can be the only presenting feature of PHPT. Normal or higher serum calcium levels during AP should always draw attention towards endocrine causes like PHPT.

A descriptive study of complications following vaginal surgeries for genital prolapse

Background: Pelvic organ prolapse is the descent of the pelvic organs into the vagina accompanied by urinary, bowel, and sexual. Many types of surgeries are done to fix the organ prolapse. Aims and Objectives: This study aims to study the intra-operative and immediate post-operative complications in patients undergoing surgery for genital prolapse. The study also aims to follow the patients for a period of 1 year evaluate the possible morbidity during the period and also assess the factors which contribute to this morbidity. Materials and Methods: The present study was conducted in a tertiary care hospital in Puducherry among 121 patients who were admitted in the department of obstetrics and gynecology for genital prolapse. It was intended to study the intraoperative, early post-operative, and long-term complications among these patients who underwent vaginal surgeries for genital prolapse. Results: Ward Mayo’s operation was done in the age group of 45–50 years and Manchester repair was done in the age group of 30–35 years. Patients who underwent Ward Mayo’s procedure had a parity of 3.5. Nearly 25% of patients had a parity of 25. There was a significant difference in operating time when surgeries were done by consultants when compared to senior residents (P=0.002) but there was no significant difference in blood loss (P=0.070). A significant increase in blood loss and operating time was noted when vaginal hysterectomy was combined with both anterior and posterior repair. In cases of complications, it was prolonged. Backache (4.95%, 4.13%, and 4.13) and psychological problems (4.13%. 6.61%, and 6.61%) after 6 weeks, 6 months, and 1 year, respectively, were common long-term complications that could be attributed to decreased awareness among our women. Conclusion: It is concluded from the study that vaginal surgeries for genital prolapse have lesser complications both intra-operatively and during the post-operative period. The patient’s characteristics such as age, parity, other illnesses, and surgical details such as choice of the operation, experience of the surgeon, additional procedures performed, blood loss, and antibiotic usage influence the morbidities associated with the surgery.

A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study.

Snakebite is a neglected problem with a high mortality in India. There are no simple clinical prognostic tools which can predict mortality in viper envenomings. We aimed to develop and validate a mortality-risk prediction score for patients of viper envenoming from Southern India. We used clinical predictors from a prospective cohort of 248 patients with syndromic diagnosis of viper envenoming and had a positive 20-minute whole blood clotting test (WBCT 20) from a tertiary-care hospital in Puducherry, India. We applied multivariable logistic regression with backward elimination approach. External validation of this score was done among 140 patients from the same centre and its performance was assessed with concordance statistic and calibration plots. The final model termed VENOMS from the term "Viper ENvenOming Mortality Score included 7 admission clinical parameters (recorded in the first 48 hours after bite): presence of overt bleeding manifestations, presence of capillary leak syndrome, haemoglobin <10 g/dL, bite to antivenom administration time > 6.5 h, systolic blood pressure < 100 mm Hg, urine output <20 mL/h in 24 h and female gender. The lowest possible VENOMS score of 0 predicted an in-hospital mortality risk of 0.06% while highest score of 12 predicted a mortality of 99.1%. The model had a concordance statistic of 0·86 (95% CI 0·79-0·94) in the validation cohort. Calibration plots indicated good agreement of predicted and observed outcomes. The VENOMS score is a good predictor of the mortality in viper envenoming in southern India where Russell's viper envenoming burden is high. The score may have potential applications in triaging patients and guiding management after further validation.

Study of Prevalence of Campylobacter Gastroenteritis among Pediatric Population Using a Multiplex PCR in a Tertiary Care Hospital in Puducherry, South India

Study of Prevalence of Campylobacter Gastroenteritis among Pediatric Population Using a Multiplex PCR in a Tertiary Care Hospital in Puducherry, South India

A Clinical Retrospective Study on the Transmission of COVID-19 From Mothers to Their Newborn and Its Outcome.

IntroductionIndia is the second most populated country in the world. The declaration of the COVID-19 pandemic has caused significant morbidity and mortality in pregnant women and newborns. Due to the decreased lung volume and immunocompromised state, pregnant women are more prone to rapid clinical deterioration. Regarding the transmission of COVID-19 infection to newborns, there is no clear-cut evidence regarding the intrauterine or vertical transmission of COVID-19 from the affected pregnant women to their neonates.AimThis study aimed to assess the outcome of neonates born to mothers with COVID-19 in a tertiary care hospital in Puducherry, India.MethodsThis retrospective case record-based study was conducted among all neonates born to COVID-19-positive mothers at a tertiary care institution in Puducherry from April 2020 to June 2020. All the newborns born to COVID-19-positive mothers during the specified period of time were included in the study.ResultsA total of 98 COVID-positive mothers were included in the study. Of these, 13.27% showed mild upper respiratory infection, and one had a moderate category. The mean gestational age was 38.4+1.12 weeks. About 53.06% of COVID-19-positive mothers had C-sections, 45.92% had a normal vaginal delivery, and only one had an instrumental vaginal delivery. All the mothers gave birth to singleton neonates; of 98 newborns, 51 were female, and 47 were male with the mean birth weight of 3.1 ± 0.4 kg. Among the 98 neonates, only six developed COVID-19 infection. Among the six, four acquired infections during the first to second week of the postnatal period and two acquired infections during the fourth week. Three neonates born by normal vaginal delivery only had a fever; two neonates manifested fever, cough, and increased respiratory rate; and only one neonate developed hypoxia.ConclusionThe study showed that vertical transmission from the mother to the newborn is extremely minimal. In our study, six neonates acquired infection mostly due to the close contact of the newborn with the mother during rooming-in and breastfeeding.

Seroprevalence and risk factors for Hepatitis C virus among maintenance hemodialysis patients at a Tertiary Care Hospital in Puducherry, India

Background: Hepatitis C virus (HCV) infection is a serious public health problem and the most significant cause of liver disease in patient receiving dialysis for a long term. The prevalence of HCV infections among dialysis patients varies markedly from country to country. Tight infection control measures implemented in developed countries have minimized the transmission rate, while the prevalence still remains high in the developing world. The aim of this study is to estimate the prevalence rate of HCV infection in hemodialysis patients, to describe demographic characteristics of individuals infected with HCV and to determine whether HCV-polymerase chain reaction (PCR) testing identifies HCV infections not detected by anti-HCV testing. Methods: This retrospective record-based study was carried in Aarupadai Veedu Medical College and Hospital, a Tertiary Care Center in Puducherry, A total of 258 chronic renal failure patients on hemodialysis were studied and tested for anti-HCV antibodies by 4th generation HCV TRIDOT ELISA and real time-PCR. Results: Anti-HCV antibodies were positive in 34 (13.2%) patients, comprising 27 (79.4%) males and 7 (20.6%) females. The majority of patients were found to be positive; between 41 and 60 age 24 (70.5%). HCV RNA was detected in 38 (14.72%) patients. The mean age of patients undergoing dialysis was 45 years. 12 (35%) had raised aspartate transaminase (AST) levels and 14 (41%) had raised alanine transaminase (ALT) levels. Gamma-glutamyl transferase was found to be raised in 25 (73.5%) of the subjects. All the 34 HCV seropositive patients were hypertensive and 33% had diabetes mellitus. 23 (67.6%) patients had undergone dialysis in more than one center. Conclusions: Regular screening of patients for HCV is absolute necessity for early detection of HCV infection that could result in better management of patients and also stresses on the importance of HCV RNA detection by PCR. Strict adherence to universal precautions, the use of dedicated machines along with regular surveillance for HCV in HD units will dramatically decrease the risk of transmission of HCV.

Seroprevalence of transfusion-transmitted infections among blood donors in a tertiary care hospital in Puducherry

Seroprevalence of transfusion-transmitted infections among blood donors in a tertiary care hospital in Puducherry

Breastfeeding Positioning and Attachment among Postnatal Mothers: A Mixed Methods Study in a Tertiary Care Hospital in Puducherry, South India.

Introduction:Proper positioning and attachment play a key role in exclusive breastfeeding. Whereas incorrect breastfeeding techniques lead to poor milk transfer and early discontinuation of breastfeeding.Objectives:1. To assess the breastfeeding techniques among postnatal mothers and to identify the factors associated with improper positioning and poor attachment. 2. To prioritize the action points to improve the poor breastfeeding practices according to the viewpoint of the staff nurses.Materials and Methods:A hospital-based mixed-methods study was carried out in Puducherry for 6 months. In quantitative phase, 99 postnatal mothers were interviewed consecutively and breastfeeding techniques were observed based on Baby Friendly Hospital Initiative and Integrated Management of Neonatal and Childhood Illness guidelines. In qualitative phase, 45 staff nurses ranked the action points to improve the poor breastfeeding practices. Bivariate and multivariate analyses were employed. Mean rank and Kendalls' Concordance Coefficient were calculated for the ranked data.Results:About 28.3% and 27.3% of mothers demonstrated improper positioning and poor attachment, respectively. Young mothers, housewives, <10 days old infants, and failure to receive breastfeeding counseling were associated with poor breastfeeding techniques. Poster displays, healthcare workers' training, targeted counseling, and assistance were the priority action points suggested by the staff nurses.Conclusion:Maternal age, maternal occupation, infants' age, and breastfeeding counseling influenced breastfeeding techniques. The prioritized action points need to be implemented to achieve the level of Baby Friendly Hospital.

A study of association between serum zinc and HbA1c in type2 diabetic patients in a tertiary care hospital in Puducherry, Tamilnadu

Background: Diabetes currently affects more than 66.8 million people in India which has become a major health care problem, representing the largest number of any country in the world. Reduced concomitant intake of Zinc studies proved to be associated with risk of increased HbA1c percentage in individuals with Type 2 Diabetes patients.&#x0D; Aims and Objective: The current study was designed to assess serum Zinc level in Type 2 Diabetes patients and to find out the correlation between serum Zinc and HbA1c level in Type 2 Diabetic patients.&#x0D; Materials and Methods: One hundred patients were included in the study and they were divided into two groups like Group I (50 patients): Type 2 Diabetic patients with HbA1c more than 7 percent. Group II (50 patients): Type 2 Diabetic patients with HbA1c less than 7 percent (50). Estimation of blood glucose (Fasting and post prandial), Glycated haemoglobin (HbA1c) and serum Zinc was done. Statistical Analysis: The data is collected, recorded and analyzed statistically to determine the significance of different parameters by using SPSS package for windows version23.0.&#x0D; Results: The mean value of serum zinc was lower in the diabetic group whose HbA1c more than 7 (p value – 0.001) when compared to the diabetic group whose HbA1c less than 7.&#x0D; Conclusion: Estimating the level of serum zinc becomes important to know the status of insulin in diabetic patients and correlating the levels of HbA1c and Serum zinc in Type 2 DM patients, can monitor the levels of glycemic control and prevent the risk of development of complications.

Assessment of ten-year risk of cardiovascular event using WHO/ISH risk prediction chart among adults in a tertiary care hospital in Puducherry, India

Context: The changing trends have revealed that cardiovascular disease (CVD) has evolved as prime cause of mortality globally, and predicting this prior is of utmost interest in patient management. Objective: To assess the ten-year risk of fatal or non-fatal cardiovascular event using World Health Organization/ International Society of Hypertension (WHO/ISH) risk prediction chart among adults. Material and methods: A cross sectional study was conducted among 226 general medicine Outpatient Department (OPD) attendees of a tertiary care hospital. Their risk of encountering a major cardiovascular event such as myocardial infarction or stroke ten year later was assessed using the WHO/ISH risk prediction charts. Appropriate tests of significance were employed. Results: Among 226 study subjects, 174 (76.9%) at low risk, 36 (15.9%) at moderate risk and 16 (7.0%) were at high risk of developing major cardiovascular event in the next ten years. Risk factors such age above 50 years, male gender, presence of hypertension or diabetes and smoking were found to be significantly associated with increased risk of the predicted major cardiovascular event. Conclusions: WHO/ISH chart is a useful tool in identifying individuals at high-risk of cardiovascular disease (CVD) and could help in planning appropriate strategies to mitigate the estimated CVD burden in future.